Published in 2006

BACKGROUND: High resolution colour Doppler ultrasound shows intratendinous Doppler activity in patients with chronic Achilles tendinopathy. Treatment of this neovascularisation with sclerosing therapy seems to relieve the pain. However, the procedure often has to be repeated.

OBJECTIVE: To investigate the effect of electrocoagulation of the neovessels on tendon pain and tendon vascularity in patients with chronic Achilles tendinopathy.

METHODS: Colour Doppler ultrasound guided electrocoagulation was used on vessels in the ventral portion of the Achilles tendon in 11 patients (seven men, four women, mean age 41 years) with painful chronic mid-portion Achilles tendinosis. A unipolar coagulation device was used.

RESULTS: One patient dropped out after two months (dissatisfied with the results). The remaining 10 patients (91%) were satisfied. These 10 patients were still satisfied at six months of follow up and had returned to their previous level of activity. All 10 patients were "cured" after one treatment. The patient who dropped out received two treatments because of lack of progress. There was significantly reduced pain (Likert pain scale, 0-10) during activity, from a median of 7 (range 4 to 10) at baseline to 0 (0 to 8) at six months' follow up (p<0.005); and at rest, from 1.5 (1 to 5) to 0 (0 to 8) (p = 0.005). In all patients, vascularisation was unchanged at the six months follow up, with no significant change in semiquantitative or quantitative colour scoring.

CONCLUSIONS: Coagulation in the area with vessels entering the tendon appears to be effective treatment for painful chronic mid-tendinous Achilles tendinopathy. No effect on the intratendinous Doppler activity could be detected, suggesting that the effect is independent of changes in blood flow. Localisation of hyperaemia appears to be the key to the pathology and for targeting the treatment. One explanation could be that the effect is obtained by destruction of nerves accompanying the vessels.

Originalsprog Engelsk
Tidsskrift British Journal of Sports Medicine
Vol/bind 40
Udgave nummer 9
Sider (fra-til) 761-6
Antal sider 6
ISSN 0306-3674
DOI
Status Udgivet - sep. 2006

Published in 2005

Acidification of the osteoclastic resorption compartment provides insight into the coupling of bone formation to bone resorption

Karsdal, M. A., Henriksen, K., Sørensen, M. G., Gram, J., Schaller, S., Dziegiel, M. H., Heegaard, A-M., Christophersen, P., Martin, T., Christiansen, C. & Bollerslev, J., feb. 2005, I: American Journal of Pathology. 166, 2, s. 467-76 10 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Patients with defective osteoclastic acidification have increased numbers of osteoclasts, with decreased resorption, but bone formation that remains unchanged. We demonstrate that osteoclast survival is increased when acidification is impaired, and that impairment of acidification results in inhibition of bone resorption without inhibition of bone formation. We investigated the role of acidification in human osteoclastic resorption and life span in vitro using inhibitors of chloride channels (NS5818/NS3696), the proton pump (bafilomycin) and cathepsin K. We found that bafilomycin and NS5818 dose dependently inhibited acidification of the osteoclastic resorption compartment and bone resorption. Inhibition of bone resorption by inhibition of acidification, but not cathepsin K inhibition, augmented osteoclast survival, which resulted in a 150 to 300% increase in osteoclasts compared to controls. We investigated the effect of inhibition of osteoclastic acidification in vivo by using the rat ovariectomy model with twice daily oral dosing of NS3696 at 50 mg/kg for 6 weeks. We observed a 60% decrease in resorption (DPYR), increased tartrate-resistant acid phosphatase levels, and no effect on bone formation evaluated by osteocalcin. We speculate that attenuated acidification inhibits dissolution of the inorganic phase of bone and results in an increased number of nonresorbing osteoclasts that are responsible for the coupling to normal bone formation. Thus, we suggest that acidification is essential for normal bone remodeling and that attenuated acidification leads to uncoupling with decreased bone resorption and unaffected bone formation.

Originalsprog Engelsk
Tidsskrift American Journal of Pathology
Vol/bind 166
Udgave nummer 2
Sider (fra-til) 467-76
Antal sider 10
ISSN 0002-9440
DOI
Status Udgivet - feb. 2005

Evidence based prevention of hamstring injuries in sport

Petersen, J. & Hölmich, P. jun. 2005 I : British Journal of Sports Medicine. 39, 6, s. 319-23 5 s.

Publikation: Bidrag til tidsskriftReviewForskningpeer review

A common soft tissue injury in sports involving sprinting and jumping is the hamstring strain. A major problem with hamstring strains is the high incidence of reinjury. Muscle injuries can be classified as direct or indirect and are typically grouped into three categories according to severity. A number of potential risk factors have been proposed for hamstring strains. Only a few are evidence based and some are mainly based on theoretical assumptions. There is a lack of clinical research on the effectiveness of rehabilitation programmes for hamstring strains. Although the initial treatment of rest, ice, compression, and elevation is accepted for muscle strains, no consensus exists for their rehabilitation. Not much evidence based research has been carried out on prevention of hamstring strain. To our knowledge only two prospective studies have so far been published. As the injuries are common in football and other sports involving sprinting and jumping, there is a need for further research preferably in the form of randomised controlled trials.

Originalsprog Engelsk
Tidsskrift British Journal of Sports Medicine
Vol/bind 39
Tidsskriftsnummer 6
Sider (fra-til) 319-23
Antal sider 5
ISSN 0306-3674
DOI
Status Udgivet - jun. 2005

Evidence for health promotion in hospitals

Tønnesen, H., Fugleholm, A. M. & Jørgensen, S. J., 2005, Health promotion in hospitals: Evidence and quality management. Copenhagen: WHO Regional Office for Europe

Publikation: Bidrag til bog/antologi/rapportBidrag til bog/antologiForskningpeer review

Originalsprog Engelsk
Titel Health promotion in hospitals: Evidence and quality management
Udgivelsessted Copenhagen
Forlag WHO Regional Office for Europe
Publikationsdato 2005
Status Udgivet - 2005

Forebyggelse på danske sygehuse

Goldstein, H. & Tønnesen, H., 7 mar. 2005, I: Ugeskrift for Laeger. 167, 10, s. 1177-80 4 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskning

Bidragets oversatte titel [Preventive medicine in Danish hospitals]
Originalsprog Dansk
Tidsskrift Ugeskrift for Laeger
Vol/bind 167
Udgave nummer 10
Sider (fra-til) 1177-80
Antal sider 4
ISSN 0041-5782
Status Udgivet - 7 mar. 2005

How do we handle it in Denmark: Implementation of codes for DRG and HP - First experiences in Denmark

Tønnesen, H., Thygesen, V. & Petersen, N. S., 2005, I: Journal für Anästhesie und Intensivbehandlung. 12

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Originalsprog Engelsk
Tidsskrift Journal für Anästhesie und Intensivbehandlung
Vol/bind 12
Status Udgivet - 2005

Learning effect of isokinetic measurements in healthy subjects, and reliability and comparability of Biodex and Lido dynamometers

Lund, H., Søndergaard, K., Zachariassen, T., Christensen, R., Bülow, P., Henriksen, M., Bartels, E. M., Danneskiold-Samsøe, B. & Bliddal, H., mar. 2005, I: Clinical Physiology and Functional Imaging. 25, 2, s. 75-82 8 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

The aim of this study was to examine the learning effect during a set of isokinetic measurements, to evaluate the reliability of the Biodex System 3 PRO dynamometer, and to compare the Biodex System 3 PRO and the Lido Active dynamometers on both extension and flexion over the elbow and the knee at 60 degrees s(-1). Thirteen (nine women, four men) healthy participants were measured five times using the Biodex and once using the Lido dynamometer. The intervals between the first four tests were 20 min, and 1 week between tests 4 and 5. Between Biodex and Lido measurements there was a 20 min time interval. When comparing the first five measurements (Biodex), no systematic effect over time and an excellent reliability were found with respect to elbow and knee flexion and extension. No difference in muscle strength (Nm) between the Biodex and Lido was observed for knee flexion (P = 0.59), knee extension (P = 0.18) and elbow extension (P = 0.63). However, elbow flexion showed a 14.8% (95% CI: 11.2-18.4%; P = 0.0001) higher peak torque on Biodex. In conclusion, no learning effect was observed and the Biodex proved to be a highly reliable isokinetic dynamometer. A difference was observed when comparing Biodex and Lido on elbow flexion, but the difference did not outrange the expected variation found with a typical isokinetic measurement, which is why both sets of equipment seem applicable in clinical practice.

Originalsprog Engelsk
Tidsskrift Clinical Physiology and Functional Imaging
Vol/bind 25
Udgave nummer 2
Sider (fra-til) 75-82
Antal sider 8
ISSN 1475-0961
DOI
Status Udgivet - mar. 2005

Præoperativt rygeophør og alkoholstop

Faurschou, P., Ralov, H., Holm, R. H. & Tønnesen, H., 2005, I: Månedsskr Prakt Lægegern. 4

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Originalsprog Dansk
Tidsskrift Månedsskr Prakt Lægegern
Vol/bind 4
ISSN 0373-2746
Status Udgivet - 2005

Reduction of the disintegrin and metalloprotease ADAM12 in preeclampsia

Laigaard, J., Sørensen, T., Placing, S., Holck, P., Fröhlich, C., Wøjdemann, K. R., Sundberg, K., Shalmi, A-C., Tabor, A., Nørgaard-Pedersen, B., Ottesen, B., Christiansen, M. & Wewer, U. M., jul. 2005, I: Obstetrics and Gynecology. 106, 1, s. 144-9 6 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVES: The secreted form of ADAM12 is a metalloprotease that may be involved in placental and fetal growth. We examined whether the concentration of ADAM12 in first-trimester maternal serum could be used as a marker for preeclampsia.

METHODS: We developed a semiautomated, time-resolved, immunofluorometric assay for the quantification of ADAM12 in serum. The assay detected ADAM12 in a range of 78-1248 microg/L. Serum samples derived from women in the first trimester of a normal pregnancy (n = 324) and from women who later developed preeclampsia during pregnancy (n = 160) were obtained from the First Trimester Copenhagen Study. ADAM12 levels were assayed in these serum samples. Serum levels of ADAM12 were converted to multiples of the median (MoM) after log-linear regression of concentration versus gestational age.

RESULTS: Serum ADAM12 levels in women who developed preeclampsia during pregnancy had a mean log MoM of -0.066, which was significantly lower than the mean log MoM of -0.001 for ADAM12 levels observed in serum samples from women with normal pregnancy (P = .008). The mean log MoM was even lower in serum derived from preeclamptic women whose infant's weight at birth was less than 2,500 g (n = 27, mean log MoM of -0.120, P = .053).

CONCLUSION: The maternal serum levels of ADAM12 are significantly lower during the first trimester in women who later develop preeclampsia during pregnancy when compared with levels in women with normal pregnancies. Because the secreted form of ADAM12 cleaves insulin-like growth factor binding protein (IGFBP)-3 and IGFBP-5, the IGF axis may play a role in preeclampsia. ADAM12 may be a useful early marker for preeclampsia.

LEVEL OF EVIDENCE: II-2.

Originalsprog Engelsk
Tidsskrift Obstetrics and Gynecology
Vol/bind 106
Udgave nummer 1
Sider (fra-til) 144-9
Antal sider 6
ISSN 0029-7844
DOI
Status Udgivet - jul. 2005

Terminologi: Forebyggelse, sundhedsfremme og folkesundhed

Tønnesen, H., Søndergaard, L., Jørgensen, T., Overgaard, D., Kristensen, I., Barfod, S., Philipsen, H. H. & Hjalsted, B., 2005, København: Sundhedsstyrelsen.

Publikation: Bog/antologi/afhandling/rapportBogForskning

Originalsprog Dansk
Udgivelsessted København
Forlag Sundhedsstyrelsen
Status Udgivet - 2005

Published in 2004

Altered cell-mediated immunity and increased postoperative infection rate in long-term alcoholic patients

Spies, C., Von Dossow, V., Eggers, V., Jetschmann, G., El-Hilali, R., Egert, J., Fischer, M., Schroeder, T., Höflich, C., Sinha, P., Paschen, C., Mirsalim, P., Brusch, R., Hopf, J., Marks, C., Wernecke, K. D., Pragst, F., Ehrenreich, H., Müller, C., Tønnesen, H., Oelkers, W., Rohde, W., Stein, C. & Kox, W. J., 2004, I: Anesthesiology. 100

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Originalsprog Engelsk
Tidsskrift Anesthesiology
Vol/bind 100
ISSN 0003-3022
Status Udgivet - 2004

Antidepressiva til hjaelp til rygestop

Møller, A. & Tønnesen, H., 11 okt. 2004, I: Ugeskrift for Laeger. 166, 42, s. 3697-9 3 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskning

Bidragets oversatte titel [Antidepressants for smoking cessation]
Originalsprog Dansk
Tidsskrift Ugeskrift for Laeger
Vol/bind 166
Udgave nummer 42
Sider (fra-til) 3697-9
Antal sider 3
ISSN 0041-5782
Status Udgivet - 11 okt. 2004

Forebyggelse før planlagt operation

Tønnesen, H., 13 sep. 2004, I: Ugeskrift for Laeger. 166, 38, s. 3281

Publikation: Bidrag til tidsskriftTidsskriftartikelForskning

Bidragets oversatte titel [Prevention in elective surgery]
Originalsprog Dansk
Tidsskrift Ugeskrift for Laeger
Vol/bind 166
Udgave nummer 38
Sider (fra-til) 3281
ISSN 0041-5782
Status Udgivet - 13 sep. 2004

Forebyggelsessamtaler. Har de en plads på en akutafdeling?

Nelbom, B. M., Tønnesen, H. & Backer, V., 9 aug. 2004, I: Ugeskrift for Laeger. 166, 33, s. 2791-5 5 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskning

Bidragets oversatte titel [Motivational counseling. Possible in an emergency department?]
Originalsprog Dansk
Tidsskrift Ugeskrift for Laeger
Vol/bind 166
Udgave nummer 33
Sider (fra-til) 2791-5
Antal sider 5
ISSN 0041-5782
Status Udgivet - 9 aug. 2004

Impact of the sex of first child on the prognosis in secondary recurrent miscarriage

Christiansen, O. B., Pedersen, B., Nielsen, H. S. & Nybo Andersen, A-M., dec. 2004, I: Human reproduction (Oxford, England). 19, 12, s. 2946-51 6 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: The carriage of a male fetus often initiates maternal immunological reactions against male-specific minor histocompatibility (HY) antigens, which, in theory, could result in subsequent recurrent miscarriage (RM).

METHODS: Information about subsequent pregnancy outcome was procured among 182 women with RM after a birth (secondary RM) referred since 1986 using questionnaires, telephone interviews and registers.

RESULTS: Significantly more of the women had had a male first-born as compared with a female first-born (110 versus 72; P < 0.02). By January 2002, 58% of those who had a male first-born had given birth to a second live infant compared with 76% of those who previously had had a female first-born (P = 0.01). Women in the former group had a significantly lower chance of having a second child than those in the latter (adjusted hazard ratio 0.59; 95% confidence interval 0.41-0.86). The number of miscarriages after admission and the risk of secondary infertility were significantly greater in women with a male first-born than among those with a female first-born (P < 0.001 and P = 0.02; respectively).

CONCLUSIONS: A male first-born seems to be associated with a less favourable reproductive potential among women with secondary RM. Maternal immunization against HY antigens may be responsible for these findings.

Originalsprog Engelsk
Tidsskrift Human reproduction (Oxford, England)
Vol/bind 19
Udgave nummer 12
Sider (fra-til) 2946-51
Antal sider 6
ISSN 0268-1161
DOI
Status Udgivet - dec. 2004

Plasma TNF binding capacity profiles during treatment with etanercept in rheumatoid arthritis

Gudbrandsdottir, S., Bliddal, H., Petri, A., Terslev, L., Danneskiold-Samsøe, B., Bjørnhart, B., Bendtzen, K. & Müller, K., 1 jan. 2004, I: Scandinavian Journal of Rheumatology. 33, 6, s. 385-8 4 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Etanercept (Enbrel) induces a rapid and sustained decline in disease activity in the majority of patients with refractory rheumatoid arthritis (RA). In these patients neutralization of TNFalpha and lymphotoxin (LT), previously termed TNFbeta is mediated by etanercept itself, as well as by naturally occurring soluble TNF receptors. However, the clinical response to treatment with etanercept may vary. Previously, pharmacokinetic studies have focused on the molar concentrations of etanercept, but very little is known about the kinetics of bioactive etanercept in patients treated with etanercept. The purpose of this study was to evaluate kinetics, including inter- and intraindividual variations of the total TNF binding capacity, in RA patients who were on a standard treatment schedule with etanercept.
Originalsprog Engelsk
Tidsskrift Scandinavian Journal of Rheumatology
Vol/bind 33
Udgave nummer 6
Sider (fra-til) 385-8
Antal sider 4
ISSN 0300-9742
Status Udgivet - 1 jan. 2004

Rygestop og kronisk obstruktiv lungesygdom

Møller, A. & Tønnesen, H., 11 okt. 2004, I: Ugeskrift for Laeger. 166, 42, s. 3695-7 3 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskning

Bidragets oversatte titel [Smoking cessation and chronic obstructive pulmonary disease]
Originalsprog Dansk
Tidsskrift Ugeskrift for Laeger
Vol/bind 166
Udgave nummer 42
Sider (fra-til) 3695-7
Antal sider 3
ISSN 0041-5782
Status Udgivet - 11 okt. 2004

Rygestop på arbejdspladsen

Tønnesen, H. & Møller, A. M., 11 okt. 2004, I: Ugeskrift for Laeger. 166, 42, s. 3700-2 3 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskning

Bidragets oversatte titel [Workplace smoking cessation]
Originalsprog Dansk
Tidsskrift Ugeskrift for Laeger
Vol/bind 166
Udgave nummer 42
Sider (fra-til) 3700-2
Antal sider 3
ISSN 0041-5782
Status Udgivet - 11 okt. 2004

Systematisk alkoholintervention på sygehus

Mortensen, T. L. & Tønnesen, H., 13 sep. 2004, I: Ugeskrift for Laeger. 166, 38, s. 3284-9 6 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskning

Bidragets oversatte titel [Systematic alcohol intervention in hospitals]
Originalsprog Dansk
Tidsskrift Ugeskrift for Laeger
Vol/bind 166
Udgave nummer 38
Sider (fra-til) 3284-9
Antal sider 6
ISSN 0041-5782
Status Udgivet - 13 sep. 2004

Test-retest reliability of trunk accelerometric gait analysis

Henriksen, M., Lund, H., Moe-Nilssen, R., Bliddal, H. & Danneskiold-Samsøe, B., jun. 2004, I: Gait & posture. 19, 3, s. 288-97 10 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

The purpose of this study was to determine the test-retest reliability of a trunk accelerometric gait analysis in healthy subjects. Accelerations were measured during walking using a triaxial accelerometer mounted on the lumbar spine of the subjects. Six men and 14 women (mean age 35.2; range 18-57) underwent the same protocol on 2 consecutive days. The raw acceleration signals from six self-selected walking speeds were transformed into a horizontal-vertical coordinate system to remove unwanted variability caused by gravity. Acceleration root mean square values, cadences, step and stride lengths were then computed and interpolated using quadratic curve fits and point estimates were calculated at a standardised walking speed of 1.35 m/s. Relative reliability was determined using two models of intraclass correlation coefficients (ICC(1,1) and ICC(3,1)) to assess any systematic shifts and absolute reliability was determined using measurement error (ME). The results of the study showed high ICC values (0.77-0.96) and ME values of 0.007-0.01 g for mean acceleration; 0.009 m for step lengths; 0.022 m for stride length and 1.644 step/min for cadences. In conclusion, the method was found to be reliable and may have a definite potential in clinical gait analysis.

Originalsprog Engelsk
Tidsskrift Gait & posture
Vol/bind 19
Udgave nummer 3
Sider (fra-til) 288-97
Antal sider 10
ISSN 0966-6362
DOI
Status Udgivet - jun. 2004

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