Published in 2018

In vivo differentiation of common basal cell carcinoma subtypes by microvascular and structural imaging using dynamic optical coherence tomography

Themstrup, L., De Carvalho, N., Nielsen, S. M., Olsen, J., Ciardo, S., Schuh, S., Nørnberg, B. M-H., Welzel, J., Ulrich, M., Pellacani, G. & Jemec, G. B. E., feb. 2018, I : Experimental Dermatology. 27, 2, s. 156-165 10 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

The subtype of basal cell carcinoma (BCC) influences the choice of treatment. Optical coherence tomography (OCT) is a non-invasive imaging tool, and a recent development of an angiographic version of OCT has extended the application of OCT to image the cutaneous microvasculature (so-called dynamic OCT, D-OCT). This study explores D-OCT's ability to differentiate the common BCC subtypes by microvascular and structural imaging. Eighty-one patients with 98 BCC lesions, consisting of three subtypes: 27 superficial BCC (sBCC), 55 nodular BCC (nBCC) and 16 infiltrative BCC (iBCC) were D-OCT scanned at three European dermatology centres. Blinded evaluations of microvascular and structural features were performed, followed by extensive statistical analysis of risk ratio (RR) and multiple correspondence analysis. nBCC lesions displayed most characteristic structural and vascular features. Serpiginous vessels, branching vessels, vessels creating a circumscribed figure and sharply demarcated hyporeflective ovoid structures in the dermis were all associated with a higher risk of the subtype being nBCC. The presence of highly present lines and dark peripheral borders at the margin of ovoid structures was negatively associated with iBCC. Lastly, the finding of hyporeflective ovoid structures protruding from epidermis correlated with sBCC. We identified various microvascular and structural D-OCT features that may aid non-invasive identification of BCC subtypes. This would allow clinicians to individualize and optimize BCC treatment as well as aid follow-up of non-surgical treatment.

Originalsprog Engelsk
Tidsskrift Experimental Dermatology
Vol/bind 27
Udgave nummer 2
Sider (fra-til) 156-165
Antal sider 10
ISSN 0906-6705
DOI
Status Udgivet - feb. 2018

Originalsprog Engelsk
Tidsskrift Annals of the Rheumatic Diseases
Vol/bind 77
Udgave nummer 5
Sider (fra-til) 684-689
ISSN 0003-4967
DOI
Status Udgivet - 2018

Increased Suicide Risk in Patients with Hidradenitis Suppurativa

Thorlacius, L., Cohen, A. D., Gislason, G. H., Jemec, G. B. E. & Egeberg, A., jan. 2018, I : The Journal of investigative dermatology. 138, 1, s. 52-57 6 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Patients with skin disorders are considered at a higher risk of depression and anxiety than the background population. Patients with hidradenitis suppurativa (HS) may be particularly affected. We explored the association between HS and depression, anxiety, and completed suicides in the Danish national registries, expanding to include data on suicidal behavior, using both a cross-sectional and a cohort study design. Both designs included 7,732 patients with HS and a background population of 4,354,137. The cohort study revealed that HS patients had an increased risk of completed suicide after adjustment for confounding factors (11 per 7,732 vs. 2,904 per 4,354,137) (hazard ratio [95% confidence interval] = 2.42 [1.07-5.45]; P = 0.0334) and an increased risk of antidepressant drug use (1.30 [1.17-1.45]; P < 0.0001). In contrast to previous studies, the cross-sectional baseline data revealed nonsignificant association with depression (odds ratio [95% confidence interval] = 1.13; 0.87-1.47]; P = 0.36 and hospitalization due to depression (1.32 [0.94-1.85]; P = 0.1083). To the best of our knowledge, no previous studies have reported on the increased risk of completed suicide among HS patients. The increased risk of completed suicide is not solely explained by lifestyle and demographic differences and the results highlight the profound impact HS has on the lives of patients with this often devastating disease.

Originalsprog Engelsk
Tidsskrift The Journal of investigative dermatology
Vol/bind 138
Udgave nummer 1
Sider (fra-til) 52-57
Antal sider 6
ISSN 0022-202X
DOI
Status Udgivet - jan. 2018

Infographic. The Adductor Strengthening Programme prevents groin problems among male football players

Harøy, J., Pope, D., Clarsen, B., Wiger, E. G., Øyen, M. G., Serner, A., Thorborg, K., Hölmich, P., Andersen, T. E. & Bahr, R. 30 okt. 2018 I : British Journal of Sports Medicine.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Originalsprog Engelsk
Tidsskrift British Journal of Sports Medicine
ISSN 0306-3674
DOI
Status Udgivet - 30 okt. 2018

Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA: A Systematic Review

Hui, C., Dunn, J., Morton, R., Staub, L. P., Tran, A., Hargreaves, S., Greenaway, C., Biggs, B. A., Christensen, R. & Pottie, K., 20 sep. 2018, I : International Journal of Environmental Research and Public Health. 15, 10

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Newly arrived migrants to the EU/EEA (arrival within the past five years), as well as other migrant groups in the region, might be under-immunised and lack documentation of previous vaccinations, putting them at increased risk of vaccine-preventable diseases circulating in Europe. We therefore performed a systematic review conforming to PRISMA guidelines (PROSPERO CRD42016045798) to explore: (i) interventions that improve vaccine uptake among migrants; and (ii) cost-effectiveness of vaccination strategies among this population. We searched MEDLINE, Embase, CINAHL, and Cochrane Database of Systematic Reviews (CDSR) between 1 January 2006 to 18 June 2018. We included three primary intervention studies performed in the EU/EEA or high-income countries and one cost effectiveness study relevant to vaccinations in migrants. Intervention studies showed small but promising impact only on vaccine uptake with social mobilization/community outreach, planned vaccination programs and education campaigns. Targeting migrants for catch-up vaccination is cost effective for presumptive vaccination for diphtheria, tetanus, and polio, and there was no evidence of benefit of carrying out pre-vaccination serological testing. The cost-effectiveness is sensitive to the seroprevalence and adherence to vaccinations of the migrant. We conclude that scarce but direct EU/EEA data suggest social mobilization, vaccine programs, and education campaigns are promising strategies for migrants, but more research is needed. Research should also study cost effectiveness of strategies. Vaccination of migrants should continue to be a public heath priority in EU/EEA.

Originalsprog Engelsk
Tidsskrift International Journal of Environmental Research and Public Health
Vol/bind 15
Udgave nummer 10
ISSN 1661-7827
DOI
Status Udgivet - 20 sep. 2018

Intra-articular 2.5% polyacrylamide hydrogel for the treatment of knee osteoarthritis: an observational proof-of-concept cohort study

Henriksen, M., Overgaard, A. F., Hartkopp, A. & Bliddal, H., nov. 2018, I : Clinical and Experimental Rheumatology.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVES: There is a drought of effective treatments of knee osteoarthritis (OA) and new therapies are needed. The present study has been conducted to establish an initial estimate of effectiveness of intra-articular (IA) injection of a proprietary 2.5% cross-linked polyacrylamide hydrogel (PAAG) for the treatment of knee OA symptoms and signs.

METHODS: Patients with knee OA were invited into a prospective open-label cohort study. The patients received up to two IA injections of 3 ml of PAAG 1 month apart. The WOMAC questionnaire was used to estimate effectiveness, and was collected at baseline and after 4, 7 and 13 months. Primary outcome was change from baseline for the WOMAC pain subscale after 4 months (Normalised to 0-100 points; 100 worst). Data was analysed using a mixed-effect model without imputation of missing data.

RESULTS: 84 patients (48 females) received IA PAAG. Of these WOMAC data were available from 62 after 4 months, 59 after 7 months, and 56 after 13 months. There were statistically and clinically significant reductions in WOMAC pain after 4 months (mean change -14.6 points [95% CI: -18.9 to -10.2]; p<.0001). Similar results were found in WOMAC stiffness, physical function, and WOMAC total. The improvement was sustained throughout the observation period.

CONCLUSIONS: These results suggest beneficial effects of IA injection of PAAG on knee OA symptoms, even in the long term (1 year). This initial estimation of effectiveness is promising but needs to be confirmed in a randomised study with adequate measures taken to reduce risk of bias.

Originalsprog Engelsk
Tidsskrift Clinical and Experimental Rheumatology
ISSN 0392-856X
Status Udgivet - nov. 2018

Joining Parents' Bed at Night and Overweight among 2- to 6-Year-Old Children - Results from the 'Healthy Start' Randomized Intervention

Olsen, N. J., Rohde, J. F., Händel, M. N., Stougaard, M., Mortensen, E. L. & Heitmann, B. L., 2018, I : Obesity Facts. 11, 5, s. 372-380 9 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: Parental and child co-sleeping has been suggested as a risk factor for short sleep duration and poor sleep quality that may lead to overweight. We examined if joining parent's bed during night was associated with child overweight.

METHODS: Cross-sectional data from the 'Healthy Start' study including 635 2- to 6-year-old Danish children, who were all considered obesity prone. Of these, 496 children had complete information on BMI and whether the child joined parents' bed during night and if so, how frequently. International cut-offs for overweight according to age and gender were applied, and logistic regression was used to estimate odds ratio (OR) and 95% Confidence Intervals (CI). Analyses were adjusted for the child's age and gender, overall family stress, parental educational level, and parental BMI.

RESULTS: Children who did not join their parent's bed were more likely to be overweight compared to children who did (OR 1.75 (95% CI 0.99-3.10)). Children who rarely joined their parents' bed had OR 2.74 of being overweight (95% CI 1.01-7.44) compared to children who joined every night.

CONCLUSION: Children who rarely joined parents' bed during night were almost three times more likely to be overweight than those who joined every night.

Originalsprog Engelsk
Tidsskrift Obesity Facts
Vol/bind 11
Udgave nummer 5
Sider (fra-til) 372-380
Antal sider 9
ISSN 1662-4025
DOI
Status Udgivet - 2018

Kind of blue: A systematic review and meta-analysis of music interventions in cancer treatment

Bro, M. L., Jespersen, K. V., Hansen, J. B., Vuust, P., Abildgaard, N., Gram, J. & Johansen, C., 2018, I : Psycho-Oncology. 27, 2, s. 386-400

Publikation: Bidrag til tidsskriftReviewForskningpeer review

OBJECTIVES: Music may be a valuable and low-cost coping strategy for cancer patients. We conducted a systematic review and meta-analysis to identify the psychological and physical effects of music interventions in cancer treatment.

METHODS: We included randomized, controlled trials with adult patients in active cancer treatment exposed to different music interventions versus control conditions. Qualitative studies and systematic reviews were excluded. We identified a total of 2624 records through 2 systematic searches (June 2015 and September 2016) in PubMed, Scopus, EMBASE, Cinahl, Web of Science, Cochrane, and PsycINFO and used Risk of Bias Assessment, GRADE and Checklist for Reporting Music-Based Interventions to evaluate the music applied and quality of the studies. We conducted meta-analyses using Review Manager (version 5.3). PROSPERO reg. no. CRD42015026024.

RESULTS: We included 25 RCT's (N = 1784) of which 20 were eligible for the meta-analysis (N = 1565). Music reduced anxiety (SMD -0·80 [95% CI, -1.35 to -0.25]), pain (SMD -0.88 [95% CI -1.45 to -0.32]), and improved mood (SMD -0.55 [95% CI, -0.98 to -0.13]). However, studies were hampered by heterogeneity with I2 varying between 54% and 96%. Quality of the studies ranged from very low to low. The most effective mode of music intervention appeared to be passive listening to self-selected, recorded music in a single session design.

CONCLUSIONS: Music may be a tool in reducing anxiety, pain, and improving mood among patients with cancer in active treatment. However, methodological limitations in the studies conducted so far prevent firm conclusions.

Originalsprog Engelsk
Tidsskrift Psycho-Oncology
Vol/bind 27
Udgave nummer 2
Sider (fra-til) 386-400
ISSN 1057-9249
DOI
Status Udgivet - 2018

Long-term exposure to road traffic noise and incidence of breast cancer: a cohort study

Andersen, Z. J., Jørgensen, J. T., Elsborg, L., Lophaven, S. N., Backalarz, C., Laursen, J. E., Pedersen, T. H., Simonsen, M. K., Bräuner, E. V. & Lynge, E., 5 okt. 2018, I : Breast Cancer Research. 20, 1, s. 119

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: Exposure to road traffic noise was associated with increased risk of estrogen receptor (ER)-negative (ER-) breast cancer in a previous cohort study, but not with overall or ER-positive (ER+) breast cancer, or breast cancer prognosis. We examined the association between long-term exposure to road traffic noise and incidence of breast cancer, overall and by ER and progesterone receptor (PR) status.

METHODS: We used the data from a nationwide Danish Nurse Cohort on 22,466 female nurses (age > 44 years) who at recruitment in 1993 or 1999 reported information on breast cancer risk factors. We obtained data on the incidence of breast cancer from the Danish Cancer Registry, and on breast cancer subtypes by ER and PR status from the Danish Breast Cancer Cooperative Group, up to 31 December 2012. Road traffic noise levels at the nurses' residences were estimated by the Nord2000 method between 1970 and 2013 as annual means of a weighted 24 h average (Lden) at the most exposed facade. We used time-varying Cox regression to analyze the associations between the 24-year, 10-year, and 1-year mean of Lden and breast cancer, separately for total breast cancer and by ER and PR status.

RESULTS: Of the 22,466 women, 1193 developed breast cancer in total during 353,775 person-years of follow up, of whom 611 had complete information on ER and PR status. For each 10 dB increase in 24-year mean noise levels at their residence, we found a statistically significant 10% (hazard ratio and 95% confidence interval 1.10; 1.00-1.20) increase in total breast cancer incidence and a 17% (1.17; 1.02-1.33) increase in analyses based on 611 breast cancer cases with complete ER and PR information. We found positive, statistically significant association between noise levels and ER+ (1.23; 1.06-1.43, N = 494) but not ER- (0.93; 0.70-1.25, N = 117) breast cancers, and a stronger association between noise levels and PR+ (1.21; 1.02-1.42, N = 393) than between noise levels and PR- (1.10; 0.89-1.37, N = 218) breast cancers. Association between noise and ER+ breast cancer was statistically significantly stronger in nurses working night shifts (3.36; 1.48-7.63) than in those not working at night (1.21; 1.02-1.43) (p value for interaction = 0.05).

CONCLUSION: Long-term exposure to road traffic noise may increase risk of ER+ breast cancer.

Originalsprog Engelsk
Tidsskrift Breast Cancer Research
Vol/bind 20
Udgave nummer 1
Sider (fra-til) 119
ISSN 1465-542X
DOI
Status Udgivet - 5 okt. 2018

Long-term wind turbine noise exposure and incidence of myocardial infarction 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., dec. 2018, I : Environment International. 121, Pt 1, s. 794-802 9 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: Growing evidence supports the concept that traffic noise exposure leads to long-term health complications other than annoyance, including cardiovascular disease. Similar effects may be expected from wind turbine noise exposure, but evidence is sparse. Here, we examined the association between long-term exposure to wind turbine noise and incidence of myocardial infarction (MI).

METHODS: We used the Danish Nurse Cohort with 28,731 female nurses and obtained data on incidence of MI in the Danish National Patient and Causes of Death Registries until ultimo 2013. Wind turbine noise levels at residential addresses between 1982 and 2013 were estimated using the Nord2000 noise propagation model, as the annual means of a weighted 24-hour average (Lden) at the most exposed façade. Time-varying Cox proportional hazard regression was used to examine the association between the 11-, 5- and 1-year rolling means prior to MI diagnosis of wind turbine noise levels and MI incidence.

RESULTS: Of 23,994 nurses free of MI at cohort baseline, 686 developed MI by end of follow-up in 2013. At the cohort baseline (1993 or 1999), 10.4% nurses were exposed to wind turbine noise (≥1 turbine within a 6000-m radius of the residence) and 13.3% in 2013. Mean baseline residential noise levels among exposed nurses were 26.3 dB, higher in those who developed MI (26.6 dB) than among those who didn't develop MI (26.3 dB). We found no association between wind turbine noise and MI incidence: adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) comparing nurses with 11-years mean residential noise levels of <21.5 dB, 21.5-25.4 dB, 25.4-29.9 dB, and >29.9 dB, to non-exposed nurses were 0.89 (0.64-1.25), 1.20 (0.82-1.77), 1.38 (0.95-2.01), and 0.88 (0.53-1.28), respectively. Corresponding HR (95% CI) for the linear association between 11-year mean levels of wind turbine noise (per 10 dB increase) with MI incidence was 0.99 (0.77-1.28). Similar associations were observed when considering the 5- and 1-year running means, and with no evidence of dose-response.

CONCLUSIONS: The results of this comprehensive cohort study lend little support to a causal association between outdoor long-term wind-turbine noise exposure and MI. However, there were only few cases in the highest exposure groups and our findings need reproduction.

Originalsprog Engelsk
Tidsskrift Environment International
Vol/bind 121
Udgave nummer Pt 1
Sider (fra-til) 794-802
Antal sider 9
ISSN 0160-4120
DOI
Status Udgivet - dec. 2018

Lower risk of hip fractures among Swedish women with large hips?

Klingberg, S., Mehlig, K., Sundh, V., Heitmann, B. L. & Lissner, L., apr. 2018, I : Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 29, 4, s. 927-935 9 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

In women, a large hip circumference (HC) related to lower hip fracture risk, independent of age and regardless if HC was measured long before or closer to the fracture. In older women, body mass index (BMI) explained the protection.

INTRODUCTION: In postmenopausal women, HC has been suggested to inversely associate with hip fracture while this has not been investigated in middle-aged women. We examined the association between HC, measured at two different time points, and hip fracture in a Swedish female population-based sample monitored for incident hip fractures over many years.

METHODS: Baseline HC, measured in 1968 or 1974 (n = 1451, mean age 47.6 years), or the HC measures that were the most proximal before event or censoring (n = 1325, mean age 71.7 years), were used to assess the effects of HC on hip fracture risk in women participating in the Prospective Population Study of Women in Gothenburg. HC was parameterized as quintiles with the lowest quintile (Q1) as reference. Incident hip fractures over 45 years of follow-up (n = 257) were identified through hospital registers.

RESULTS: Higher quintiles of HC at both baseline and proximal to event were inversely associated with hip fracture risk in age-adjusted models, but only baseline HC predicted hip fractures independently of BMI and other covariates (HR (95% CI) Q2, 0.85 (0.56-1.27); Q3, 0.59 (0.36-0.96); Q4, 0.57 (0.34-0.96); Q5, 0.58 (0.31-1.10)).

CONCLUSIONS: A large HC is protective against hip fracture in midlife and in advanced age, but the association between proximal HC and hip fracture was explained by concurrent BMI suggesting that padding was not the main mechanism for the association. The independent protection seen in middle-aged women points to other mechanisms influencing bone strength.

Originalsprog Engelsk
Tidsskrift Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Vol/bind 29
Udgave nummer 4
Sider (fra-til) 927-935
Antal sider 9
ISSN 0937-941X
DOI
Status Udgivet - apr. 2018

Make it REAL: four simple points to increase clinical relevance in sport and exercise medicine research

Bandholm, T., Henriksen, M., Treweek, S. & Thorborg, K., 7 sep. 2018, I : British Journal of Sports Medicine. 52, 22, s. 1407-1408

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Originalsprog Engelsk
Tidsskrift British Journal of Sports Medicine
Vol/bind 52
Udgave nummer 22
Sider (fra-til) 1407-1408
ISSN 0306-3674
DOI
Status Udgivet - 7 sep. 2018

Management of major organ involvement of Behçet's syndrome: a systematic review for update of the EULAR recommendations

Ozguler, Y., Leccese, P., Christensen, R., Esatoglu, S. N., Bang, D., Bodaghi, B., Çelik, A. F., Fortune, F., Gaudric, J., Gul, A., Kötter, I., Mahr, A., Moots, R. J., Richter, J., Saadoun, D., Salvarani, C., Scuderi, F., Sfikakis, P. P., Siva, A., Stanford, M., Tugal-Tutkun, I., West, R., Yurdakul, S., Olivieri, I., Yazici, H. & Hatemi, G., 1 dec. 2018, I : Rheumatology (Oxford, England). 57, 12, s. 2200-2212 13 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Objective: To assess the efficacy and safety of treatment modalities for major organ involvement of Behçet's syndrome (BS), in order to inform the update of the EULAR recommendations for the management of BS.

Methods: A systematic literature review of all randomized controlled trials, controlled clinical trials, or open label trials assessing eye, vascular, nervous system or gastrointestinal system involvement of BS was performed. If controlled trials were not available for answering a specific research question, uncontrolled studies or case series were also included.

Results: We reviewed the titles and abstracts of 3927 references and 161 studies met our inclusion criteria. There were only nine randomized controlled trials. Observational studies with IFN-α and monoclonal anti-TNF antibodies showed beneficial results for refractory uveitis. Meta-analysis of case-control studies showed that immunosuppressives decreased the recurrence rate of deep vein thrombosis significantly whereas anticoagulants did not. CYC and high dose glucocorticoids decreased mortality in pulmonary arterial aneurysms and postoperative complications in peripheral artery aneurysms. Beneficial results for gastrointestinal involvement were obtained with 5-ASA derivatives and AZA as first line treatment and with thalidomide and/or monoclonal anti-TNF antibodies in refractory cases. Observational studies for nervous system involvement showed improved outcome with immunosuppressives and glucocorticoids. Meta-analysis of case-control studies showed an increased risk of developing nervous system involvement with ciclosporin-A.

Conclusion: The majority of studies related to major organ involvement that informed the updated EULAR recommendations for the management of BS were observational studies.

Originalsprog Engelsk
Tidsskrift Rheumatology (Oxford, England)
Vol/bind 57
Udgave nummer 12
Sider (fra-til) 2200-2212
Antal sider 13
ISSN 1462-0324
DOI
Status Udgivet - 1 dec. 2018

Manual lymphatic drainage adds no further volume reduction to Complete Decongestive Therapy on breast cancer-related lymphoedema: a multicentre, randomised, single-blind trial

Tambour, M., Holt, M., Speyer, A., Christensen, R. & Gram, B., nov. 2018, I : British Journal of Cancer. 119, 10, s. 1215-1222 8 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: We investigated the comparability of Complete Decongestive Therapy (CDT) including manual lymphatic drainage (MLD) vs. without MLD in the management of arm lymphoedema in patients with breast cancer.

METHODS: Patients randomised into either treatment including MLD (T+MLD) or treatment without MLD (T-MLD) received treatment 2×weekly for 4 weeks. The primary outcome was the volume reduction (%) of arm lymphoedema at 7-month follow-up. The secondary outcomes were volume reduction after the end of treatment, circumference of the arm, patient experience of heaviness and tension, and health status.

RESULTS: Despite difficulties enrolling the planned number of patients (160), 77 were randomised and 73 (38 in T+MLD, 35 in T-MLD) completed the trial. In both groups, the volume of lymphoedema decreased significantly, with no difference between groups (1.0% [95% CI, -4.3;2.3%]): the precision in the 95% confidence interval indicates that the efficacy was comparable; the mean (SE) changes at month 7 were -6.8%(1.2) and -5.7% (1.2) in the T+MLD and T-MLD, respectively. There were no statistically significant differences with respect to any of the secondary outcomes. The results were robust and the conclusion was not sensitive even to various alternative assumptions or analytic approaches to data analysis.

CONCLUSION: Manual lymphatic drainage adds no further volume reduction in breast cancer patients.

Originalsprog Engelsk
Tidsskrift British Journal of Cancer
Vol/bind 119
Udgave nummer 10
Sider (fra-til) 1215-1222
Antal sider 8
ISSN 0007-0920
DOI
Status Udgivet - nov. 2018

Married, unmarried, divorced, and widowed and the risk of stroke

Andersen, K. K. & Olsen, T. S., jul. 2018, I : Acta Neurologica Scandinavica. 138, 1, s. 41-46 6 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVES: Most studies report that marriage carries a lower risk of stroke than single living. Whether the marriage advantage is applicable with respect to all other marital status categories (unmarried, divorced, widow) remains unclear. We studied marital status and its association with incident stroke.

MATERIAL AND METHODS: We included all patients > 40 years of age admitted to hospital for stroke in Denmark during 2003-2012 and compared marital status to the general Danish population (5.5 millions). Relative risks (RR) for stroke were estimated in log-linear Poisson regression models adjusting for age, sex, calendar year, income, and length of education.

RESULTS: A total of 58 847 patients with incident stroke were included. Crude incidence rates of stroke (per 1000 per year) among the four marital status categories were as follows: 1.96 (married), 1.52 (unmarried), 2.36 (divorced), and 5.43 (widowed). Compared to married persons, adjusted risk of stroke was significantly increased for divorced (RR 1.23; CI 1.19-1.27) and unmarried men (RR 1.07; CI 1.03-1.11) but not for widowed men (RR 1.02; CI 0.98-1.06); risk was slightly increased for divorced women (RR 1.10; CI 1.06-1.15) while not for widowed (RR 1.0; CI 0.97-1.03) and unmarried women (RR 0.97; CI 0.97-1.03).

CONCLUSIONS: Divorce was associated with higher risk of stroke, especially in men. Living in marriage or as unmarried or widower had only little or no impact on the risk of stroke.

Originalsprog Engelsk
Tidsskrift Acta Neurologica Scandinavica
Vol/bind 138
Udgave nummer 1
Sider (fra-til) 41-46
Antal sider 6
ISSN 0001-6314
DOI
Status Udgivet - jul. 2018

Bibliografisk note

© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Multicentric reticulohistiocytosis is a rare form of paraneoplasia

Anderson, A. M., Todberg, T., Kofoed, K., Iversen, T. Z., Andersen, M., Hjorth, S. V. & Fassi, D. E. 1 jan. 2018 I : Ugeskrift for laeger. 180, s. V0817611

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

A 59-year-old woman developed a rash and severe arthralgia, which primarily affected her fingers. She displayed digital arthritis and nodules on the hands, chest, face, and oral cavity. Blood samples were normal. Skin biopsies revealed histiocytic proliferation. The surface marker profile and clinical findings were consistent with multicentric reticulohistiocytosis, which may occur as a paraneoplastic phenomenon. On workup, she was diagnosed with an otherwise asymptomatic stage IVC fallopian tube cancer. She experienced little effect of prednisolone, but her condition improved on antineoplastic treatment.

Originalsprog Dansk
Tidsskrift Ugeskrift for laeger
Vol/bind 180
Sider (fra-til) V0817611
ISSN 0041-5782
Status Udgivet - 1 jan. 2018

National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy

Stochkendahl, M. J., Kjaer, P., Hartvigsen, J., Kongsted, A., Aaboe, J., Andersen, B. M., Andersen, M. Ø., Fournier, G., Højgaard, B., Jensen, M. B., Jensen, L. D., Karbo, T., Kirkeskov, L., Melbye, M., Morsel-Carlsen, L., Nordsteen, J., Palsson, T. S., Rasti, Z., Silbye, P. F., Steiness, M. Z., Tarp, S. & Vaagholt, M., 2018, I : European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 27, 1, s. 60-75

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

PURPOSE: To summarise recommendations about 20 non-surgical interventions for recent onset (<12 weeks) non-specific low back pain (LBP) and lumbar radiculopathy (LR) based on two guidelines from the Danish Health Authority.

METHODS: Two multidisciplinary working groups formulated recommendations based on the GRADE approach.

RESULTS: Sixteen recommendations were based on evidence, and four on consensus. Management of LBP and LR should include information about prognosis, warning signs, and advise to remain active. If treatment is needed, the guidelines suggest using patient education, different types of supervised exercise, and manual therapy. The guidelines recommend against acupuncture, routine use of imaging, targeted treatment, extraforaminal glucocorticoid injection, paracetamol, NSAIDs, and opioids.

CONCLUSION: Recommendations are based on low to moderate quality evidence or on consensus, but are well aligned with recommendations from international guidelines. The guideline working groups recommend that research efforts in relation to all aspects of management of LBP and LR be intensified.

Originalsprog Engelsk
Tidsskrift European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Vol/bind 27
Udgave nummer 1
Sider (fra-til) 60-75
ISSN 0940-6719
DOI
Status Udgivet - 2018

Background: Non-Hodgkin lymphoma (NHL) is the most common hematologic malignancy in the world. Involvement of organochlorines has been proposed in disease etiology. No study has investigated organochlorine exposure in relation to survival after a NHL diagnosis.Methods: In a survivor cohort consisting of 232 NHL cases from the Danish Diet, Cancer and Health cohort, we examined the association between adipose tissue organochlorine concentrations [polychlorinated biphenyls (PCBs) and pesticides] and subsequent survival, using Cox proportional hazards models.Results: We found no statistically significant association between organochlorine concentrations and subsequent survival. If anything, there was a nonsignificant tendency toward an inverse association with PCBs, but not pesticides.Conclusions: In conclusion, the current study does not support an increased risk of death among NHL patients with high tissue concentrations of organochlorines.Impact: This is the first study to investigate adipose organochlorine concentrations and survival after a NHL diagnosis. Cancer Epidemiol Biomarkers Prev; 27(2); 224-6. ©2017 AACR.

Originalsprog Engelsk
Tidsskrift Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Vol/bind 27
Udgave nummer 2
Sider (fra-til) 224-226
Antal sider 3
ISSN 1055-9965
DOI
Status Udgivet - feb. 2018

Non-farmakologisk behandling og rehabilitering

Schiøttz-Christensen, B., Amris, K. & Wæhrens, E. E., 2018, Reumatologi. 4 udg. FADL's Forlag, s. 463-481 18 s.

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

Originalsprog Dansk
Titel Reumatologi
Antal sider 18
Forlag FADL's Forlag
Publikationsdato 2018
Udgave 4
Sider 463-481
Kapitel 23
ISBN (Trykt) 978-87-7749-969-2
Status Udgivet - 2018

Bibliografisk note

COPECARE

Non-pharmacological Effects in Switching Medication: The Nocebo Effect in Switching from Originator to Biosimilar Agent

Kristensen, L. E., Alten, R., Puig, L., Philipp, S., Kvien, T. K., Mangues, M. A., van den Hoogen, F., Pavelka, K. & Vulto, A. G., okt. 2018, I : BioDrugs. 32, 5, s. 397-404 8 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

The nocebo effect is defined as the incitement or the worsening of symptoms induced by any negative attitude from non-pharmacological therapeutic intervention, sham, or active therapies. When a patient anticipates a negative effect associated with an intervention, medication or change in medication, they may then experience either an increase in this effect or experience it de novo. Although less is known about the nocebo effect compared with the placebo effect, widespread interest in the nocebo effect observed with statin therapy and a literature review highlighting the nocebo effect across at least ten different disease areas strongly suggests this is a common phenomenon. This effect has also recently been shown to play a role when introducing a medication or changing an established medication, for example, when switching patients from a reference biologic to a biosimilar. Given the important role biosimilars play in providing cost-effective alternatives to reference biologics, increasing physician treatment options and patient access to effective biologic treatment, it is important that we understand this phenomenon and aim to reduce this effect when possible. In this paper, we propose three key strategies to help mitigate the nocebo effect in clinical practice when switching patients from reference biologic to biosimilar: positive framing, increasing patient and healthcare professionals' understanding of biosimilars and utilising a managed switching programme.

Originalsprog Engelsk
Tidsskrift BioDrugs
Vol/bind 32
Udgave nummer 5
Sider (fra-til) 397-404
Antal sider 8
ISSN 1173-8804
DOI
Status Udgivet - okt. 2018

Pages