Published in 2022

BACKGROUND: Becoming a mother is one of the most transitional experiences in life. It requires psychological, physical, and social adjustment and adaptation in various areas and can be conceived as both a stressful and joyful experience by many women. Especially, first-time pregnancies are recognised as a period of emotional sensitivity. Moreover, stress is a well-established risk factor for premature birth and low birth weight and might affect the health of the offspring. Thus, this study explores the perception of stress and worries in healthy Danish pregnant nulliparous women.

METHODS: We used a qualitative, inductive, exploratory design. Three focus group interviews were conducted with 16 healthy pregnant nulliparous women. Data from the focus group interviews were analysed using content analysis according to Graneheim and Lundman.

FINDINGS: Three main categories contributed to the core theme "Identity Limbo". The categories were: (1) The great responsibility, (2) Imagining picture-perfect, and (3) Two-in-one body. The participants expressed that holding on to their current identity was extremely important. They simultaneously tried to incorporate their new identity as mothers, which imposed sadness about saying goodbye to their old life, leaving them in an identity limbo. These women did not experience classic stressors such as bereavement, poverty, or trauma. Still, the great responsibility for the child's future, changes to their work and career, and saying goodbye to their pre-pregnancy identity were all essential contributors to feelings of stress in the women's current pregnancy and life.

CONCLUSION: Our findings suggest that the identity limbo triggered by pregnancy can make the transition to motherhood stressful for some women. Therefore, with the potentially severe consequences of stress in mind, developing tools that can help women and midwives focus on the mental transition of pregnancy is needed.

Originalsprog Engelsk
Artikelnummer 103421
Tidsskrift Midwifery
Vol/bind 112
Sider (fra-til) 1-9
Antal sider 9
ISSN 0266-6138
DOI
Status E-pub ahead of print - 2 jul. 2022

Bibliografisk note

Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.

A liver secretome gene signature-based approach for determining circulating biomarkers of NAFLD severity

Hagemann, C. A., Legart, C., Møllerhøj, M. B., Madsen, M. R., Hansen, H. H., Kønig, M. J., Helgstrand, F., Hjørne, F. P., Toxværd, A., Langhoff, J. L., Kielgast, U. L., Gluud, L. L., Ægidius, H., Rigbolt, K. T. G., Vilsbøll, T., Jelsing, J. & Knop, F. K., 2022, I: PLoS One. 17, 10, s. e0275901

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Non-invasive biomarkers of non-alcoholic fatty liver disease (NAFLD) supporting diagnosis and monitoring disease progression are urgently needed. The present study aimed to establish a bioinformatics pipeline capable of defining and validating NAFLD biomarker candidates based on paired hepatic global gene expression and plasma bioanalysis from individuals representing different stages of histologically confirmed NAFLD (no/mild, moderate, more advanced NAFLD). Liver secretome gene signatures were generated in a patient cohort of 26 severely obese individuals with the majority having no or mild fibrosis. To this end, global gene expression changes were compared between individuals with no/mild NAFLD and moderate/advanced NAFLD with subsequent filtering for candidate gene products with liver-selective expression and secretion. Four candidate genes, including LPA (lipoprotein A), IGFBP-1 (insulin-like growth factor-binding protein 1), SERPINF2 (serpin family F member 2) and MAT1A (methionine adenosyltransferase 1A), were differentially expressed in moderate/advanced NAFLD, which was confirmed in three independent RNA sequencing datasets from large, publicly available NAFLD studies. The corresponding gene products were quantified in plasma samples but could not discriminate among different grades of NAFLD based on NAFLD activity score. Conclusion: We demonstrate a novel approach based on the liver transcriptome allowing for identification of secreted hepatic gene products as potential circulating diagnostic biomarkers of NAFLD. Using this approach in larger NAFLD patient cohorts may yield potential circulating biomarkers for NAFLD severity.

Originalsprog Engelsk
Tidsskrift PLoS One
Vol/bind 17
Udgave nummer 10
Sider (fra-til) e0275901
ISSN 1932-6203
DOI
Status Udgivet - 2022

A Meta-Analysis of Antipsychotic-Induced Hypo- and Hyperprolactinemia in Children and Adolescents

Krøigaard, S. M., Clemmensen, L., Tarp, S. & Pagsberg, A. K., 8 sep. 2022, (E-pub ahead of print) I: Journal of Child and Adolescent Psychopharmacology.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Objective: Antipsychotic-related prolactin changes may expose children and adolescents to severe adverse reactions (ARs) related to pubertal development and growth. We therefore aimed to assess the effects of antipsychotics on prolactin levels and associated somatic ARs in children and adolescents. Methods: We systematically searched PubMed and CENTRAL for placebo-controlled randomized trials of antipsychotics in children and adolescents aged ≤18 years, reporting prolactin levels and related ARs. We conducted a random-effect meta-analysis and assessed risk of bias version 2 (ROB2). Results: Thirty-two randomized controlled trials with an average trial duration of 6 weeks, covering 4643 participants with an average age of 13 years and a male majority of 65.3%. Risk of bias across domains was low or unclear. The following antipsychotic compounds: aripiprazole (n = 810), asenapine (n = 506), lurasidone (n = 314), olanzapine (n = 179), paliperidone (n = 149), quetiapine (n = 381), risperidone (n = 609), and ziprasidone (n = 16) were compared with placebo (n = 1658). Compared with placebo, statistically significant higher prolactin increase occurred with risperidone (mean difference [MD] = 28.24 ng/mL), paliperidone (20.98 ng/mL), and olanzapine (11.34 ng/mL). Aripiprazole significantly decreased prolactin (MD = -4.91 ng/mL), whereas quetiapine, lurasidone, and asenapine were not associated with significantly different prolactin levels than placebo. Our results on ziprasidone are based on a single study, making it insufficient to draw strong conclusions. On average, 20.8% of patients treated with antipsychotic developed levels of prolactin that were too high (hyperprolactinemia), whereas only 1.03% of patients reported prolactin-related ARs. Data were highly limited for long-term effects. Conclusions: In children and adolescents, risperidone, paliperidone, and olanzapine are associated with significant prolactin increase, whereas aripiprazole is associated with significant decrease. Despite the significant changes in prolactin level, few ARs were reported. Study protocol on PROSPERO: CRD42018116451.

Originalsprog Engelsk
Tidsskrift Journal of Child and Adolescent Psychopharmacology
ISSN 1044-5463
DOI
Status E-pub ahead of print - 8 sep. 2022

A systematic review of blood eosinophils and continued treatment with inhaled corticosteroids in patients with COPD

Dalin, D. A., Løkke, A., Kristiansen, P., Jensen, C., Birkefoss, K., Christensen, H. R., Godtfredsen, N. S., Hilberg, O., Rohde, J. F., Ussing, A., Vermehren, C. & Händel, M. N., jul. 2022, I: Respiratory medicine. 198, s. 1-11 11 s., 106880.

Publikation: Bidrag til tidsskriftReviewpeer review

Inhaled corticosteroid (ICS) in patients with chronic obstructive pulmonary disease (COPD) has been debated for 20 years. In our systematic literature review and meta-analysis, we addressed the following: Should patients with COPD and a blood eosinophil count (EOS) of, respectively, a) < 150 cells/μl, b) 150-300 cells/μl, and c) > 300 cells/μl continue treatment with ICS? Protocol registered in PROSPERO (CRD42020178110) and funded by the Danish Health Authority. We searched Medline, Embase, CINAHL and Cochrane Central on 22nd July 2020 for randomized controlled trials (RCT) of ICS treatment in patients with COPD (≥40 years, no current asthma), which analyzed outcomes by EOS count and where >50% of patients used ICS prior. We used the GRADE method. Meta-analyzes for the outcomes were divided into EOS subgroups and analyzed for differences. We identified 11 RCTs with a total of 29,654 patients. A significant difference (p < 0.00001) between the three subgroups' reduction of risk of moderate to severe exacerbation was found. Rate ratios for EOS counts: <150 cells/μL was 0.88 (95%CI: 0.83, 0.94); 150-300 cells/μL was 0.80 (95%CI: 0.69, 0.94); >300 cells/μL was 0.57 (95%CI: 0.49, 0.66). Overall, the certainty of the effect estimates was low to very low due to risk of bias, unexplained heterogeneity, few RCTs, and wide confidence intervals. A clear correlation was demonstrated between effect of continued ICS treatment (number of exacerbations, lung function, and quality of life) and increasing EOS count. Our meta-analyses suggested that treatment with ICS seemed beneficial for everyone except patients with EOS count below 150 cells/μl.

Originalsprog Engelsk
Artikelnummer 106880
Tidsskrift Respiratory medicine
Vol/bind 198
Sider (fra-til) 1-11
Antal sider 11
ISSN 0954-6111
DOI
Status Udgivet - jul. 2022

Bibliografisk note

Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.

Objective: To evaluate the relationship between self-reported and performance-based measures of functioning in rheumatoid arthritis (RA), knee osteoarthritis (OA), and fibromyalgia (FM), and the influence of pain and fatigue. Method: Self-reported functioning was assessed by the Stanford Health Assessment Questionnaire, Fibromyalgia Impact Questionnaire, and Knee injury and Osteoarthritis Outcome Score. Performance-based measures of task-related physical activity included grip strength and Six-Minute Walk Test (6MWT). Assessment of Motor and Process Skills (AMPS) was used to obtain performance-based measures of activities of daily living (ADL) ability. Pain and fatigue were assessed by 100 mm visual analogue scales. Spearman’s rho correlation and regression modelling were applied. Results: Correlations between self-reported functioning and performance-based measures of ADL ability were weak to moderate, and strongest in OA (r = 0.57, p = 0.002), and AMPS ADL ability measures did not enter regression models as explanatory factors for self-reported functioning. Correlations between AMPS ADL ability measures and measures of task-related physical activity were weak, except for a strong correlation between AMPS ADL motor ability and 6MWT in OA (r = 0.63, p = 0.000). The 6MWT was the only performance-based test explaining variance in AMPS motor ability (OA = 42%; FM = 11%). Pain explained variance in self-reported ability and contributed to variance in AMPS ADL motor ability measures in OA. Conclusion: Self-reported and observed measures of functioning assess partly different aspects of functioning, and both approaches may therefore be relevant in a structured assessment of patients with musculoskeletal disorders.

Originalsprog Engelsk
Tidsskrift Scandinavian Journal of Rheumatology
Vol/bind 51
Udgave nummer 6
Sider (fra-til) 452-460
Antal sider 9
ISSN 0300-9742
DOI
Status Udgivet - nov. 2022

Bibliografisk note

Funding Information:
This research was supported by the Oak Foundation, the Health Insurance Foundation, the Aase and Ejnar Danielsen Foundation, the Danish Rheumatism Association, and the Danish Association of Occupational Therapists.

Publisher Copyright:
© 2021 Scandinavian Journal of Rheumatology Foundation.

An international Delphi exercise to identify items of importance for measuring response to treatment in ANCA-associated vasculitis

Quinn, K. A., Monti, S., Christensen, R., Jayne, D., Langford, C. A., Lanier, G. E., Mahr, A., Pagnoux, C., Shea, B., Viðarsdóttir, M. B., Tomasson, G. & Merkel, P. A., aug. 2022, I: Seminars in Arthritis and Rheumatism. 55, s. 152021

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: ANCA-associated vasculitis (AAV) is characterized by fluctuating levels of disease activity, but no formal criteria exist to measure response to treatment. This Delphi exercise aimed to reach consensus about which measures are considered by patients and physicians to be most important when assessing response to treatment in clinical trials of AAV.

METHODS: An international 3-round online Delphi exercise was conducted. Survey participants included patients with AAV and physicians with expertise in AAV. Survey participants were asked to rate (on a scale of 1-9) the importance of each item when assessing response to treatment in AAV. Items scored 7-9 by ≥70% participants were considered highly important.

RESULTS: 89 patients and 176 physicians completed three rounds of the Delphi exercise. The most highly rated items of response involved disease activity [extent of organ involvement, physician global assessment], mortality [survival], and patient-reported outcomes [patient global assessment and health-related quality of life measures]. Achievement of specific BVAS scores were highly rated only by physicians. Items highly rated only by patients included laboratory measures [changes on urinalysis and acute phase reactants], pain, and fatigue. Additional items related to damage and adverse events were highly rated by both groups.

CONCLUSION: There is consensus between patients and physicians on many items considered important to measure when assessing response to treatment in AAV. There are some items considered important by only patients or only physicians. These data will inform the next steps in the development criteria of response to treatment in AAV.

Originalsprog Engelsk
Tidsskrift Seminars in Arthritis and Rheumatism
Vol/bind 55
Sider (fra-til) 152021
ISSN 0049-0172
DOI
Status Udgivet - aug. 2022

Bibliografisk note

Copyright © 2022. Published by Elsevier Inc.

The aim of this community-randomised smoking cessation (SC) trial was to investigate both recruitment and SC-rates in three municipalities offering financial incentives (FIM) to smokers who stop smoking when attending a municipal SC-program and compare these with three municipalities investing in a campaign (CAM) that should encourage smokers to use the SC-program. Furthermore, in a non-randomised matched control design we investigated whether there was a difference in recruitment and SC-rates in the three FIM and the three CAM, comparing each with three matched control municipalities (MCM). Each municipality received approx. $16,000. The FIM rewarded persons who were abstinent when attending the municipal SC-program. The CAM spent the money on a campaign recruiting smokers to the SC-program. Two of three FIM were only partly active in recruiting smokers in the intervention year 2018. An intention-to-treat (ITT) approach was used in analyses. Complete case analyses and multiple imputation were used to address loss to follow-up. No difference in recruitment was found between the CAM and the FIM (p = 0.954), in adjusted analyses. In ITT analyses, FIM achieved significantly higher odds of validated abstinence from smoking at one-year follow-up (OR (95%CI): 1.63(1.1-2.4)), but not of self-reported continuous abstinence after six months than CAM. Compared with no intervention, campaigns increased the recruitment of smokers to the SC-program while financial incentives increased six months abstinence rates. In a randomised trial, no difference was demonstrated in the effect of financial incentives and campaigns to recruit smokers to a SC-program and financial incentives seemed superior to help smokers staying smoke-free for a year. TRIAL REGISTRATION: ClinicalTrials.Gov ID: NCT03849092.

Originalsprog Engelsk
Artikelnummer 106865
Tidsskrift Preventive Medicine
Vol/bind 154
Sider (fra-til) 106865
ISSN 0091-7435
DOI
Status Udgivet - 2022

Bibliografisk note

Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.

Association between dairy consumption and cardiovascular disease events, bone fracture and all-cause mortality

Guo, J., Givens, D. I. & Heitmann, B. L., 2022, I: PLoS One. 17, 9, s. e0271168

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Dairy products are important constituents of a healthy and balanced diet, but their association with health outcomes remains to be established. We investigated the association of total dairy, total fermented dairy, and different dairy subtypes (including total/high-fat/low-fat milk, yogurt, cheese, butter, and cream) and the risk of cardiovascular disease (CVD), coronary heart disease (CHD), bone fracture and all-cause mortality among 1746 Danish healthy men and women (30-60 years, 52%female). Hazard ratios (HRs) and 95% CIs were estimated using the multivariable Cox proportional hazard models. During a mean follow-up of 30 years, incident cases of CVD (n = 904), CHD (n = 332), fracture (n = 447) and all-cause mortality (n = 680) were reported. High intake of total fermented dairy was associated with lower fracture risk (HR 0.67, 95% CI: 0.51-0.90, P = 0.02) than observed in the lowest tertile of the fermented dairy group. Furthermore, high intake of low-fat milk was associated with lower risks of CVD (HR 0.84, 95% CI: 0.68-1.03, P = 0.03), CHD (HR 0.82, 95% CI: 0.59-1.16, P = 0.04), and all-cause mortality (HR 0.77, 95% CI: 0.61-0.97, P = 0.004) compared with the lowest tertile of low-fat milk group. No associations were found with other dairy subtypes. The findings from this prospective cohort study suggest an inverse association between total fermented dairy and fracture risk, and also inverse associations were found between low-fat milk consumption and risk of CVD, CHD and all-cause mortality.

Originalsprog Engelsk
Tidsskrift PLoS One
Vol/bind 17
Udgave nummer 9
Sider (fra-til) e0271168
ISSN 1932-6203
DOI
Status Udgivet - 2022

OBJECTIVES: A few previous studies have described a potential role of Ω-3 long-chain polyunsaturated fatty acids from marine animals in obesity in children, but the results are conflicting. The objectives of this study were to examine if intake of marine fat was related to less gain in body mass index (BMI) and body fat (BF) over a 15-mo period among Danish children age 2 to 6 y, and if potential associations depended on which types of fatty acids were replaced.

METHODS: A total of 355 children age 2 to 6 y were included in the study. Weight, height, and BF percentage (BF%) assessed by bioimpedance were measured by trained research personnel. Multivariable linear regression models were used to investigate associations between marine fat intake and changes in BMI or BF% over the subsequent 15 mo. To investigate substitution effects, we constructed regression models that included marine fat and all other energy yielding dietary components, except for the nutrient to be substituted for either all fats or specific subgroups (saturated, monounsaturated, or other polyunsaturated fatty acids).

RESULTS: No significant associations were observed between intake of marine fat and development in BMI or BF% in any of the analyses, either with or without specified substitutions. Furthermore, the results were independent on whether intake was expressed in g/d or percentage of energy, and were not modified by age or BMI status.

CONCLUSIONS: This study suggests that marine fat intake and fat composition in a diet may have little or no effect on weight and adiposity development among preschool-aged children.

Originalsprog Engelsk
Tidsskrift Nutrition (Burbank, Los Angeles County, Calif.)
Vol/bind 103-104
Sider (fra-til) 111775
ISSN 0899-9007
DOI
Status Udgivet - 2022

Bibliografisk note

Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

Association between Pre-Pregnancy BMI and Inflammatory Profile Trajectories during Pregnancy and Postpartum in Brazilian Women with Periodontitis: The IMPROVE Trial

Santana, D. D., Kac, G., Dos Santos, P. P. T., da Silva, T. C., Benaim, C., Cocate, P. G., Trindade de Castro, M. B., Heitmann, B. L. & Adegboye, A. R. A., 25 feb. 2022, I: International Journal of Environmental Research and Public Health. 19, 5, 2705.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

This study aimed to explore the association between pre-pregnancy BMI and longitudinal changes in inflammatory markers from the second trimester of pregnancy to 6-8 weeks postpartum in women with periodontitis. This is a secondary exploratory analysis of 68 women who took part in a feasibility clinical trial in Rio de Janeiro, Brazil. Inflammatory markers included C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), and matrix metalloproteinase-9 (MMP-9) blood concentrations at 11-22 (T0) and 30-36 gestational weeks (T1), and 6-8 weeks postpartum (T3). Longitudinal generalised linear mixed-effects models were used to identify possible associations between pre-pregnancy BMI and changes in concentrations of inflammatory markers. Pre-pregnancy excess weight (β = 4.39; 95% CI, 2.12-6.65) was significantly associated with increased CRP levels from pregnancy to postpartum. There were no significant associations between pre-pregnancy BMI and longitudinal changes in IL-6, IL-10 and MMP-9. Our findings provide evidence that a higher pre-pregnancy BMI may lead to increases in CRP levels during pregnancy in women with periodontitis, irrespective of the severity of clinical periodontal parameters. Further studies need to investigate if predictors of changes in inflammatory markers can be used as prognostic factors for gestational outcomes.

Originalsprog Engelsk
Artikelnummer 2705
Tidsskrift International Journal of Environmental Research and Public Health
Vol/bind 19
Udgave nummer 5
ISSN 1661-7827
DOI
Status Udgivet - 25 feb. 2022

Bilateral oophorectomy and rate of colorectal cancer: A prospective cohort study

Koch, T., Therming Jørgensen, J., Christensen, J., Duun-Henriksen, A. K., Priskorn, L., Kildevæld Simonsen, M., Dehlendorff, C., Jovanovic Andersen, Z., Juul, A., Bräuner, E. V. & Hickey, M., 1 jan. 2022, I: International Journal of Cancer. 150, 1, s. 38-46 9 s., 33776.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Worldwide, colorectal cancer is the second most common cancer and third cause of cancer death in women. Estrogen exposure has been inversely associated with colorectal cancer. Oophorectomy reduces circulating estrogen, but the effect on colorectal cancer remains uncertain. The aim of this study was to examine the association between unilateral and bilateral oophorectomy and subsequent risk of colorectal cancer, and whether this association varied by menopausal status at time of oophorectomy, use of hormone replacement therapy (HRT) at baseline, hysterectomy and baseline body mass index (BMI). The study included 25 698 female nurses (aged ≥45 years) participating in the Danish Nurse Cohort. Nurses were followed from baseline until date of colorectal cancer, death, emigration or end of follow-up at December 31, 2018, whichever came first. We examined the association between oophorectomy and colorectal cancer (all ages and stratified by menopausal status). The potential modifying effects of hysterectomy, HRT use at baseline and BMI were investigated. During 542 140 person-years of follow-up, 863 (3.4%) nurses were diagnosed with colorectal cancer. Bilateral oophorectomy was associated with a 79% increased colorectal cancer rate, adjusted rate ratio (aRR) (95% confidence interval [CI]): 1.79 (1.33-2.42). Effect estimates following unilateral oophorectomy also showed higher rate of colorectal cancer, although less pronounced and nonstatistically significant (aRR) (95% CI): 1.25 (0.86-1.82). Similar results were seen when stratifying by menopausal status. The association was not modified by baseline HRT use, hysterectomy or BMI. Oophorectomy was associated with increased rate of colorectal cancer, with highest rates among women with bilateral oophorectomy.

Originalsprog Engelsk
Artikelnummer 33776
Tidsskrift International Journal of Cancer
Vol/bind 150
Udgave nummer 1
Sider (fra-til) 38-46
Antal sider 9
ISSN 0020-7136
DOI
Status Udgivet - 1 jan. 2022

Bibliografisk note

Publisher Copyright:
© 2021 UICC.

Brain Response to a Knee Proprioception Task Among Persons With Anterior Cruciate Ligament Reconstruction and Controls

Strong, A., Grip, H., Boraxbekk, C-J., Selling, J. & Häger, C. K., 22 mar. 2022, I: Frontiers in Human Neuroscience. 16, s. 1-13 13 s., 841874.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Knee proprioception deficits and neuroplasticity have been indicated following injury to the anterior cruciate ligament (ACL). Evidence is, however, scarce regarding brain response to knee proprioception tasks and the impact of ACL injury. This study aimed to identify brain regions associated with the proprioceptive sense of joint position at the knee and whether the related brain response of individuals with ACL reconstruction differed from that of asymptomatic controls. Twenty-one persons with unilateral ACL reconstruction (mean 23 months post-surgery) of either the right (n = 10) or left (n = 11) knee, as well as 19 controls (CTRL) matched for sex, age, height, weight and current activity level, performed a knee joint position sense (JPS) test during simultaneous functional magnetic resonance imaging (fMRI). Integrated motion capture provided real-time knee kinematics to activate test instructions, as well as accurate knee angles for JPS outcomes. Recruited brain regions during knee angle reproduction included somatosensory cortices, prefrontal cortex and insula. Neither brain response nor JPS errors differed between groups, but across groups significant correlations revealed that greater errors were associated with greater ipsilateral response in the anterior cingulate (r = 0.476, P = 0.009), supramarginal gyrus (r = 0.395, P = 0.034) and insula (r = 0.474, P = 0.008). This is the first study to capture brain response using fMRI in relation to quantifiable knee JPS. Activated brain regions have previously been associated with sensorimotor processes, body schema and interoception. Our innovative paradigm can help to guide future research investigating brain response to lower limb proprioception.

Originalsprog Engelsk
Artikelnummer 841874
Tidsskrift Frontiers in Human Neuroscience
Vol/bind 16
Sider (fra-til) 1-13
Antal sider 13
ISSN 1662-5161
DOI
Status Udgivet - 22 mar. 2022

Bibliografisk note

Copyright © 2022 Strong, Grip, Boraxbekk, Selling and Häger.

Changes in leisure time physical activity unrelated to subsequent body weight changes, but body weight changes predicted future activity

Petersen, J. D., Siersma, V., Andersen, M. K. K. & Heitmann, B. L., feb. 2022, I: Journal of Sports Sciences. 40, 3, s. 288-298 11 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Physical activity and obesity are known to be associated. We investigated whether a change in leisure time physical activities (LTPA) predicts a subsequent weight change, or vice versa. We used data from a longitudinal study among Danish adults surveyed in 1983–1984, 1987–1988, and 1993–1994. Between two sequential surveys, the change in LTPA was grouped as no change, became less or more active; the change in body weight was defined as no change, lost or gained of more than one body mass index (BMI) unit. Among 2386 adults, change in LTPA was not associated with subsequent weight change. However, a loss in body weight (BMI change < −1 unit) was associated with subsequent either becoming less [OR = 1.49, 95% CI (1.03–2.15)] or borderline more active [OR = 1.37, 95% CI (0.99–1.90)]. Subgroup analyses showed particularity among females that a loss in body weight was associated with subsequent becoming more active [OR = 1.83, 95% CI (1.15–2.89)]. Our results suggest that change in LTPA is unrelated to subsequent weight change, but loss in body weight seems related to subsequent more active among female adults.

Originalsprog Engelsk
Tidsskrift Journal of Sports Sciences
Vol/bind 40
Udgave nummer 3
Sider (fra-til) 288-298
Antal sider 11
ISSN 0264-0414
DOI
Status Udgivet - feb. 2022

Bibliografisk note

Publisher Copyright:
© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Comparative effectiveness research on proximal femoral nail versus dynamic hip screw in patients with trochanteric fractures: a systematic review and meta-analysis of randomized trials

Xu, H., Liu, Y., Sezgin, E. A., Tarasevičius, Š., Christensen, R., Raina, D. B., Tägil, M. & Lidgren, L., 3 jun. 2022, I: Journal of orthopaedic surgery and research. 17, 1, s. 292

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: The treatments for trochanteric fractures try to regain early mobility and limit morbidity and risk of reoperations. The most currently used dynamic hip screw (DHS) and the proximal femoral nail (PFN) are both with pros and cons. We aimed to assess the comparative effectiveness of these interventions for trochanteric fractures by evaluating the surgical performance and postoperative outcomes.

METHODS: PubMed, Web of Science and Cochrane Central Register were searched for RCTs comparing DHS and PFN for trochanteric fractures. All selected studies and the risk of bias were assessed. Clinical data including operative time, intraoperative blood loss, intraoperative fluoroscopy time, successful closed reduction and complications like nonunion, implant failure and reoperation were recorded. Random-effects models were used in Review Manager software, and GRADE was applied for the interpretation of the evidence.

RESULTS: From 286 identified trials, twelve RCTs including 1889 patients were eligible for inclusion; six RCTs directly comparing DHS with PFN, while other six compared DHS with proximal femoral nail antirotation (PFNA). Compared to DHS, PFN had shorter operative time and led to less intraoperative blood loss. However, DHS need less intraoperative fluoroscopy time than PFN. No difference was seen for the achievement of closed reduction. For risk of postoperative complications, no difference was seen between PFN and DHS for non-union, risk of implant failure and revision surgery.

CONCLUSIONS: PFN(A) resulted in a shorter operative time and less intraoperative blood loss compared to DHS. However, no difference was seen for postoperative complications. Trial registration PROSPERO: CRD42021239974.

Originalsprog Engelsk
Tidsskrift Journal of orthopaedic surgery and research
Vol/bind 17
Udgave nummer 1
Sider (fra-til) 292
ISSN 1749-799X
DOI
Status Udgivet - 3 jun. 2022

Bibliografisk note

© 2022. The Author(s).

BACKGROUND: Kindergartens can potentially contribute substantially to the daily level of physical activity and development of motor skills and might be an ideal setting for improving these as a public health initiative. We aimed to examine whether children from rural outdoor kindergartens had a lower risk of motor difficulties than children from urban conventional kindergartens.

METHODS: Motor test results were measured during the first school year by school health nurses using a six-item test of gross- and fine motor skills (jumping, handle a writing tool, cutting with a scissor following a line, one-leg stand on each leg, throwing and grabbing). Register-based information was available on potential confounding factors.

RESULTS: We included 901 children from outdoor kindergartens and 993 from conventional kindergartens with a mean (SD) age of 6.5 years (0.4). The children from the two types of kindergarten differed according to demographic information, with outdoor kindergarten children more often being from more affluent families (long maternal education level: 47.5% vs. 31.0%, p &lt; 0.0001) and fewer girls attending the outdoor kindergartens (42.7% vs. 49.5%, p = 0.003). In the adjusted models, we found no evidence of differences in the risk of motor difficulties between children attending either type of kindergarten (OR: 0.95, 95%CI: 0.71; 1.27, p = 0.72).

CONCLUSION: Our results do not support outdoor kindergartens as a potential intervention to improve motor abilities among children. Randomized controlled trials are needed to confirm these findings.

Originalsprog Engelsk
Tidsskrift International Journal of Environmental Research and Public Health
Vol/bind 19
Udgave nummer 21
ISSN 1661-7827
DOI
Status Udgivet - 29 okt. 2022

Comparison of two frailty screening tools for acutely admitted elderly patients

Nygaard, H., Henriksen, M., Suetta, C. & Ekmann, A., 6 jul. 2022, I: Danish Medical Journal. 69, 8

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

INTRODUCTION: Frailty is a clinical syndrome that arises due to age-related decline, diseases, malnutrition and lifestyle. Two major perspectives on frailty exists: frailty as a phenotype and frailty as an accumulation of deficits. The two types are measured by Fried's Phenotype (FP) and the Clinical Frailty Scale (CFS), respectively. The aim of this study was to investigate which model best predicts 90-day mortality in elderly patients acutely admitted to an emergency department in Denmark.

METHODS: This study comprised a prospective cohort with the following inclusion criteria: age > 65 years, acute admission and admission >24 h. Bispebjerg Hospital, Odense University Hospital and Hospital of Southwest Jutland participated in the study. The FP and the CFS were measured in all patients. Descriptive statistics, relative risk (RR), odds ratio (OR), risk difference and receiver-operating characteristics (ROC) analysis were performed. The outcome was 90-day mortality.

RESULTS: A total of 1,030 patients participated (mean age: 78.2 years, 54% female). Among these, 221 were frail by the FP (score > 3) and 555 participants were frail by the CFS (score > 5). Within 90 days, 128 died. The analyses revealed significant associations between frailty and 90-day mortality. For the FP, the RR was 2.67 (95% confidence interval (CI): 1.93-3.69), p less-than 0.001; and for the CFS, the RR was 4.12 (95% CI: 2.65-6.42), p less-than 0.001. The adjusted OR for the CFS was 4.38 (95% CI: 2.68-7.13); for the FP, 3.88 (95% CI: 2.51-6.01).

CONCLUSION: A significant association existed between frailty and 90-day mortality in the Danish cohort. However, the CFS is a better predictor of 90-day mortality the FP. Even so, the CFS still has a lack of sensitivity and specificity.

FUNDING: none TRIAL REGISTRATION. not relevant.

Originalsprog Engelsk
Tidsskrift Danish Medical Journal
Vol/bind 69
Udgave nummer 8
ISSN 1603-9629
Status Udgivet - 6 jul. 2022

Bibliografisk note

Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Computer-Assisted Image Analysis in Assessment of Peripheral Joint MRI in Inflammatory Arthritis: A Systematic Review and Meta-analysis

Haj-Mirzaian, A., Kubassova, O., Boesen, M., Carrino, J. & Bird, P., aug. 2022, I: ACR open rheumatology. 4, 8, s. 721-734 14 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: To summarize the feasibility of computer-assisted quantification of joint pathologies on magnetic resonance imaging (MRI) in patients with inflammatory arthritis by evaluating the published data on reliability, validity, and feasibility.

METHODS: A systematic literature search was performed for original articles published from January 1, 1985, to January 1, 2021. We selected studies in which patients with inflammatory arthritis were enrolled, and arthritis-related structural damage/synovitis in peripheral joints was assessed on non-contrast-enhanced, contrast-enhanced (CE), or dynamic CE (DCE)-MRI using (semi)automated methods. Data were pooled using random-effects model.

RESULTS: Twenty-eight studies consisting of 1342 MRIs were included (mean age, 54.8 years; 66.7% female; duration of arthritis, 3.6 years). Among clinical/laboratory factors, synovial membrane volume (SV) was moderately correlated with erthrocyte sedimentation rate (ESR) level (P < 0.01). Pooled analysis showed an overall excellent intra- and inter-reader reliability for computer-aided quantification of bone erosion volume (BEV; r = 0.97 [95% CI: 0.92-0.99], 0.93 [0.87-0.97]), SV (r = 0.98 [95% CI: 0.90-0.99], 0.86 [0.78-0.91]), and DCE-MRI perfusion parameters (r = 0.96-0.99). Meta-regression showed that computer-aided and manual methods provide comparable reliability (P > 0.05). Computer-aided measurement of BEV (r = 0.92), SV (r = 0.82), and DCE-MRI biomarkers (r = 0.72 N-total; r = 0.74 N-plateau; r = 0.64 N-washout) were significantly correlated with the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS; P < 0.01), allowing for earlier assessment of drug efficacy. On average, (semi)automated analysis of BEV/SV took 17 minutes (vs. 9 minutes for the RAMRIS) and DCE-MRI took 4 minutes (vs. 33 minutes for manual assessment).

CONCLUSION: Computer-aided image quantification technologies demonstrate excellent reliability and validity when used to quantify MRI pathologies of peripheral joints in patients with inflammatory arthritis. Computer-aided evaluation of inflammatory arthritis is an emerging field and should be considered as a viable complement to conventional observer-based scoring methods for clinical trials application.

Originalsprog Engelsk
Tidsskrift ACR open rheumatology
Vol/bind 4
Udgave nummer 8
Sider (fra-til) 721-734
Antal sider 14
ISSN 2578-5745
DOI
Status Udgivet - aug. 2022

Bibliografisk note

© 2022 The Authors. ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.

BACKGROUND: Patients with psoriasis have an impaired quality of life and higher use of analgesics than the general population. Whether such use is due to skin pain or a consequence of joint pain resulting from psoriatic arthritis (PsA) is not clear.

OBJECTIVES: To assess symptoms, disease burden, and use of analgesics in patients with psoriasis with and without PsA.

METHOD: Symptoms, general health (EurQol 5-dimension and 5-levels), and use of analgesics were assessed in patients with psoriasis and the general population from the Danish Skin Cohort.

RESULTS: We included 4016 patients with psoriasis (847 with concomitant PsA) and 3490 reference individuals. For patients with psoriasis having PsA, itch, skin pain, and/or joint pain was associated with worse general health. Use of opioids within 12 months was observed among 9.0% of the general population, 14.2% of patients with psoriasis without PsA, and 22.7% of patients with concomitant PsA. Of the symptoms, only joint pain was associated with use of analgesics (odds ratio, 3.72 (2.69-5.14); P < .0001).

LIMITATIONS: Cross-sectional design.

CONCLUSION: Patients with psoriasis (especially concomitant PsA) have a higher use of analgesics compared with the general population, which appears to be a result of increased joint pain.

Originalsprog Engelsk
Tidsskrift Journal of the American Academy of Dermatology
Vol/bind 86
Udgave nummer 3
Sider (fra-til) 590-597
Antal sider 8
ISSN 0190-9622
DOI
Status Udgivet - 2022

Bibliografisk note

Funding Information:
Dr Loft has been an honorary speaker for Eli Lilly and Janssen Cilag. Dr. Nguyen reports no potential conflicts of interest. Dr Kristensen has received fees for as a speaker and consultant for Pfizer, AbbVie, Amgen, Forward pharma, UCB, Gilead, Biogen, BMS, MSD, Novartis, Eli Lilly, and Janssen Pharmaceuticals. Dr Thyssen reports no relevant conflicts of interest. Dr Egeberg has received research funding from Pfizer, Eli Lilly , Novartis, AbbVie, Janssen Pharmaceuticals, the Danish National Psoriasis Foundation , the Simon Spies Foundation, and the Kgl Hofbundtmager Aage Bang Foundation , and honoraria as consultant and/or speaker from AbbVie, Almirall, Leo Pharma, Sun Pharmaceuticals, Galapagos NV, Samsung Bioepis Co, Ltd., Pfizer, Eli Lilly and Company, Novartis, Galderma, Dermavant, UCB, Mylan, Bristol-Myers Squibb, and Janssen Pharmaceuticals.

Funding Information:
Dr Loft has been an honorary speaker for Eli Lilly and Janssen Cilag. Dr. Nguyen reports no potential conflicts of interest. Dr Kristensen has received fees for as a speaker and consultant for Pfizer, AbbVie, Amgen, Forward pharma, UCB, Gilead, Biogen, BMS, MSD, Novartis, Eli Lilly, and Janssen Pharmaceuticals. Dr Thyssen reports no relevant conflicts of interest. Dr Egeberg has received research funding from Pfizer, Eli Lilly, Novartis, AbbVie, Janssen Pharmaceuticals, the Danish National Psoriasis Foundation, the Simon Spies Foundation, and the Kgl Hofbundtmager Aage Bang Foundation, and honoraria as consultant and/or speaker from AbbVie, Almirall, Leo Pharma, Sun Pharmaceuticals, Galapagos NV, Samsung Bioepis Co, Ltd., Pfizer, Eli Lilly and Company, Novartis, Galderma, Dermavant, UCB, Mylan, Bristol-Myers Squibb, and Janssen Pharmaceuticals. Funding sources: None.

Publisher Copyright:
© 2021 American Academy of Dermatology, Inc.

OBJECTIVE: Kellgren-Lawrence grades (KLG) are frequently used for patient selection in clinical trials. The Ahlbäck radiographic grading system has been developed for moderate and severe knee OA. KLG 3 is comparable to Ahlbäck 1 and KLG 4 is subdivided into Ahlbäck 2-5. The objective of this study was to investigate if the Ahlbäck scoring system is able to subdivide patients with moderate to severe knee OA (KLG 3/4) into groups with different sensitivity to change in cartilage thickness.

MATERIALS AND METHODS: This study was based on 108 Osteoarthritis Initiative (OAI) participants with KLG 3/4. Baseline KLG scores were available from the OAI database; Ahlbäck scores were performed using the same x-rays. Cartilage thickness change in the weight-bearing femorotibial cartilage was analysed from baseline and year 1 3D FLASH MRI for the entire femorotibial joint (FTJ), the medial (MFTC) and the lateral compartment (LFTC) and for the location-independent ordered values 1 and 16 (OV 1/OV 16) representing the subregions with largest loss (OV 1) and gain (OV 16) within each knee.

RESULTS: Of the 108 patients, n = 30/78 had KLG 3/4. The corresponding Ahlbäck scores (1-5) were n = 30/33/36/9/10. Cartilage thickness changes between Ahlbäck groups showed no statistically significant difference for FTJ, MFTC, LFTC and OV 1, but change in OV 16 was significantly higher in Ahlbäck 4 knees (p = 0.03) compared to Ahlbäck 1-3 knees.

CONCLUSION: Radiographic knee OA grading with Ahlbäck scores was not superior to KLG for prediction of cartilage thickness loss over 1 year, in patients with moderate and severe knee OA supporting the continuous use of the easier and more widely used KLG.

Originalsprog Engelsk
Tidsskrift Skeletal Radiology
Vol/bind 51
Udgave nummer 4
Sider (fra-til) 777-782
Antal sider 6
ISSN 0364-2348
DOI
Status Udgivet - apr. 2022

Bibliografisk note

© 2021. ISS.

Does moderate intensity impact exercise and non-impact exercise induce acute changes in collagen biochemical markers related to osteoarthritis? - An exploratory randomized cross-over trial

Bjerre-Bastos, J. J., Nielsen, H. B., Andersen, J. R., Karsdal, M., Bay-Jensen, A-C., Boesen, M., Mackey, A. L., Byrjalsen, I. & Bihlet, A. R., 2022, I: Osteoarthritis and Cartilage.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Objective: To investigate acute changes in biochemical markers of cartilage turnover in response to moderate intensity exercise with and without joint impact in humans with knee osteoarthritis.

Design: We conducted a randomized, cross-over, exploratory clinical study. Twenty subjects with knee osteoarthritis (OA) were randomized, of which twenty completed 30 min of cycling and 15 completed 30 min of running on days 1 week apart. Fasting blood samples were taken before, immediately after and 1, 2, 3, and 24 h after activity was initiated. Midstream spot urine was sampled before and after activity. Serum samples were analyzed for concentrations of fragment of type II collagen degradation, C2M, fragment of type VI collagen degradation, C6M, cartilage oligomeric matrix protein, COMP, marker of type II collagen formation, PRO-C2, and urine for marker of crosslinked type II collagen degradation, CTX-II. To establish a reference, all subjects had similar samples taken during rest on a separate day. Data was analyzed in a restricted maximum likelihood based random effects linear mixed model.

Results: C2M trended to increase after cycling compared running (13.49%, 95%CI: -0.36-27.34%) and resting (12.88%, 95%CI: 0.2-25.6%) and the type II collagen formation/degradation ratio switched towards degradation after cycling, but not running. C6M trended to decrease after cycling (-8.1%, 95%CI: -14.8 to -1.4%) and running (-6.8%, 95%CI: -14.16-0.55%).

Conclusion: In persons with knee OA moderate intensity exercise without joint impact may induce acute changes in circulating levels of biochemical markers reflecting type II and VI collagen degradation.

Originalsprog Engelsk
Tidsskrift Osteoarthritis and Cartilage
ISSN 1063-4584
DOI
Status Udgivet - 2022

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