Published in 2020

Fysioterapeutisk træning til patienter med knæartrose

Henriksen, M. & Skou, S. T., 12 okt. 2020, I : Ugeskrift for Laeger. 182, 42

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Therapeutic exercise for knee osteoarthritis is recommended globally, based on more than 100 randomised, controlled trials documenting beneficial effects on pain and function. There are adverse effects of exercise and symptom exacerbations may occur in the first 4-6 weeks of an exercise programme, but will most often decline with time. If pain and function do not improve after a structured exercise program, other treatments must be considered. The effects of exercise decline over time, if regular exercise is not implemented in the daily life of the patient.

Bidragets oversatte titel Exercise for knee osteoarthritis
Originalsprog Dansk
Tidsskrift Ugeskrift for Laeger
Vol/bind 182
Udgave nummer 42
ISSN 0041-5782
Status Udgivet - 12 okt. 2020

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
Artikelnummer e031863
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.

Increased short- and long-term mortality following infections in dementia: a nationwide registry-based cohort study

Janbek, J., Taudorf, L., Musaeus, C. S., Frimodt-Møller, N., Laursen, T. M. & Waldemar, G., 16 okt. 2020, I : European Journal of Neurology. s. ahead of print Brit 221220

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND AND PURPOSE: Mortality following infections in dementia has not yet been comprehensively explored. The aim of this cohort study was to investigate the short- and long-term mortality following infections in dementia.

METHODS: Follow-up was from 1 January 2000 or the 65-year birthday until death, immigration, or 31 December 2015. Exposure was incident dementia and a first infection. The outcome was all-cause mortality. Mortality rate ratios (MRRs) were calculated using Poisson regression in 4 exposure groups (dementia yes/no, infection yes/no) by sex, infection site, and time since infection.

RESULTS: 1,496,436 people were followed with 12,739,135 person-years. MRR in dementia/infection was 6.52 (95% confidence interval: 6.43-6.60) and was increased for infections of all sites. Increased mortality was short term (30 days) and long term (10 years).

CONCLUSIONS: Increased mortality in people with dementia identifies them as a particularly vulnerable group that needs clinical attention.

Originalsprog Engelsk
Tidsskrift European Journal of Neurology
Sider (fra-til) ahead of print Brit 221220
ISSN 1351-5101
DOI
Status E-pub ahead of print - 16 okt. 2020

Bibliografisk note

© 2020 European Academy of Neurology.

OBJECTIVE: The aim of this study is to investigate the influence of local anesthetic (LA), operator experience level and needle type on patient procedural pain in relation to diagnostic lumbar puncture (LP).

METHODS: LP was performed with either a 22 gauge traumatic needle (22 TN) or a 22 gauge atraumatic needle (22 ATN). Immediately after LP patients documented a procedural pain score (PPS) on a 10-point Likert scale. Use of LA, needle type, anesthetic time interval (ATI), number of needle insertions and the LP operator experience level were registered. ATI was defined as the time from administration of LA to first needle insertion.

RESULTS: 104 patients had the LP procedure performed by 66 physicians (40 novices and 26 experienced physicians). Patients having the procedure performed by novices had a lower PPS of 2.56 if LA was administered compared to a higher PPS of 5.80 if LA was not administered (P = .046). Among experienced physicians there was no difference in PPS regardless of administration of LA. If novices administered LA, patient PPS was equal to patients having the procedure performed by an experienced operator. If novices performed the procedure with a 22 TN PPS decreased with increasing ATI (P = .01). No similar correlation was identified with the 22 ATN.

CONCLUSION: Our study suggests that LP operator experience level, the needle type used and ATI may influence patient PPS. Further studies are necessary for final conclusions. These studies must consider these factors to avoid fault conclusions.

Originalsprog Engelsk
Tidsskrift International Journal of Emergency Medicine
ISSN 0735-6757
DOI
Status E-pub ahead of print - 4 jul. 2020

Bibliografisk note

Copyright © 2020 Elsevier Inc. All rights reserved.

Interhospital Transport of Sick Newborns In Denmark

Heiring, C., Zachariassen, G., Christensen, P. S., Kjærgaard, S., Nielsen, H. V., Hansen, T. G., Mortensen, S., Hertel, S. A. & Breindahl, M., 30 mar. 2020, I : Ugeskrift for Laeger. 182, 14A

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Interhospital transport of sick newborn infants is dangerous, but the risk of adverse events can be reduced, when transport is being performed by trained neonatal retrieval teams. In this review, we describe the current organisation of neonatal retrieval service in Denmark. The services are based at the neonatal intensive care units of the four university hospitals. Improved cooperation and harmonisation of operations between the teams is needed, as this is a prerequisite for the development of a national clinical consensus guideline and national quality metrics enabling benchmarking both within Denmark and abroad.

Bidragets oversatte titel Interhospital transport of sick newborns in Denmark
Originalsprog Dansk
Tidsskrift Ugeskrift for Laeger
Vol/bind 182
Udgave nummer 14A
ISSN 0041-5782
Status Udgivet - 30 mar. 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., sep. 2020, I : Journal of muscle research and cell motility. 41, 2-3, s. 211-219 9 s.

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
Vol/bind 41
Udgave nummer 2-3
Sider (fra-til) 211-219
Antal sider 9
ISSN 0142-4319
DOI
Status Udgivet - sep. 2020

Muscle function assessed by the non-invasive method acoustic myography (AMG) in a Danish group of healthy adults

Bartels, E. M., Olsen, J. K., Littrup Andersen, E., Danneskiold-Samsøe, B., Bliddal, H., Kristensen, L. E. & Harrison, A. P., 2020, ScienceDirect.

Publikation: AndetUdgivelser på nettet - Net-publikationForskningpeer review

Originalsprog Engelsk
Publikationsdato 2020
Udgiver ScienceDirect
Status Udgivet - 2020

Neonatal vitamin D levels and cognitive ability in young adulthood

Specht, I. O., Janbek, J., Thorsteinsdottir, F., Frederiksen, P. & Heitmann, B. L., aug. 2020, I : European Journal of Nutrition. 59, 5, s. 1919-1928 10 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

PURPOSE: Intelligence has a strong influence on life capability, and thus, identifying early modifiable risk factors related to cognitive ability is of major public health interest. During pregnancy, vitamin D is transported from the mother to the fetus through the placenta in the form of 25-hydroxyvitamin D (25(OH)D). Levels of 25(OH)D have in some studies been associated with childhood neurodevelopment; however, results from all studies are not in agreement. We investigated if neonatal 25(OH)D3 concentrations were associated with Børge Priens IQ test score (BPP) in young adulthood.

METHODS: In this nested cohort study, 25(OH)D3 concentrations were measured in dried blood spots from 818 newborns. We followed the children for their IQ BPP test scores in the Danish Conscription Register, which holds information on test results from the BPP test on individuals who have been recruited for Danish mandatory military draft board examination. Using general linear models, we investigated the crude and adjusted relationship between quintiles of 25(OH)D3 concentrations and BPP IQ test results.

RESULTS: The study population consisted of 95.8% men, with a mean age of 19.4 years. The median and range of the neonatal 25(OH)D3 levels were 26.2 nmol/L (0-104.7 nmol/L). The overall Wald test did not show an association between neonatal 25(OH)D3 levels and BPP IQ scores (p = 0.23); however, individuals within the 3rd (BPP IQ = 101.0, 98.0-103.9) and 4th (BPP IQ = 101.2, 99.1-104.3) quintiles had slightly higher BPP IQ scores than individuals from the first quintile (BPP IQ = 97.6, 94.6-100.6).

CONCLUSIONS: Our results support the hypothesis that individuals with the lowest levels of neonatal vitamin D might have slightly lower BPP. However, more studies are needed with larger study populations to confirm our results.

Originalsprog Engelsk
Tidsskrift European Journal of Nutrition
Vol/bind 59
Udgave nummer 5
Sider (fra-til) 1919-1928
Antal sider 10
ISSN 1436-6207
DOI
Status Udgivet - aug. 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

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