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Morsing NV, Andreasen CM, Rasmussen TA, Moll LT. Cutaneous leishmaniasis in a patient with psoriatic arthritis treated with tumour necrosis factor-α inhibitor. Scand J Rheumatol 2024; 53:158-159. [PMID: 38275137 DOI: 10.1080/03009742.2023.2295627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 12/13/2023] [Indexed: 01/27/2024]
Affiliation(s)
- N V Morsing
- Department of Internal Medicine, Regional Hospital Gødstrup, Herning, Denmark
| | - C M Andreasen
- Department of Internal Medicine, Regional Hospital Gødstrup, Herning, Denmark
| | - T A Rasmussen
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - L T Moll
- Department of Internal Medicine, Regional Hospital Gødstrup, Herning, Denmark
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Schmidt AM, Laurberg TB, Moll LT, Schiøttz-Christensen B, Maribo T. The effect of an integrated multidisciplinary rehabilitation programme for patients with chronic low back pain: Long-term follow up of a randomised controlled trial. Clin Rehabil 2020; 35:232-241. [PMID: 33040598 PMCID: PMC7874370 DOI: 10.1177/0269215520963856] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: To compare the long-term effectiveness of an integrated rehabilitation programme with an existing rehabilitation programme, in terms of back-specific disability, in patients with chronic low back pain. Design: A single-centre, pragmatic, two-arm parallel, randomised controlled trial. Setting: A rheumatology rehabilitation centre in Denmark. Subjects: A total of 165 adults (aged ⩾ 18 years) with chronic low back pain. Interventions: An integrated programme (a pre-admission day, two weeks at home, two weeks inpatient followed by home-based activities, plus two 2-day inpatient booster sessions, and six-month follow-up visit) was compared with an existing programme (four-week inpatient, and six-month follow-up visit). Main measure: The primary outcome was disability measured using the Oswestry Disability Index after one year. Secondary outcomes included pain intensity (Numerical Rating Scale), pain self-efficacy (Pain Self-Efficacy Questionnaire), health-related quality of life (EuroQol-5 Domain 5-level (EQ-5D)), and depression (Major Depression Inventory). Analysis was by intention-to-treat, using linear mixed models. Results: 303 patients were assessed for eligibility of whom 165 patients (mean age 50 years (SD 13) with a mean Oswestry Disability Index score of 42 (SD 11)) were randomly allocated (1:1 ratio) to the integrated programme (n = 82) or the existing programme (n = 83). The mean difference (integrated programme minus existing programme) in disability was –0.53 (95% CI –4.08 to 3.02); p = 0.770). No statistically significant differences were found in the secondary outcomes. Conclusion: The integrated programme was not more effective in reducing long-term disability in patients with chronic low back pain than the existing programme.
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Affiliation(s)
- Anne Mette Schmidt
- Department of Public Health, Centre for Rehabilitation Research, Aarhus University, Aarhus C, Denmark.,Sano, Højbjerg, Denmark.,DEFACTUM, Central Denmark Region, Aarhus C, Denmark
| | - Trine Bay Laurberg
- Sano, Højbjerg, Denmark.,Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Line Thorndal Moll
- Spine Centre, Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Berit Schiøttz-Christensen
- Spine Centre of Southern Denmark, University Hospital Lillebælt, Middelfart, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Middelfart, Denmark
| | - Thomas Maribo
- Department of Public Health, Centre for Rehabilitation Research, Aarhus University, Aarhus C, Denmark.,DEFACTUM, Central Denmark Region, Aarhus C, Denmark
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Moll LT, Schmidt AM, Stapelfeldt CM, Labriola M, Jensen OK, Kindt MW, Jensen TS, Schiøttz-Christensen B. Prediction of 2-year work participation in sickness absentees with neck or shoulder pain: the contribution of demographic, patient-reported, clinical and imaging information. BMC Musculoskelet Disord 2019; 20:525. [PMID: 31706350 PMCID: PMC6842554 DOI: 10.1186/s12891-019-2906-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 10/22/2019] [Indexed: 11/11/2022] Open
Abstract
Background In cases of neck and shoulder pain, the responsibility for assessing work prognosis is held by clinicians with access to different domains of information. One of these domains is magnetic resonance imaging (MRI), and although MRI is increasingly used, it is unknown which domains of information contribute the most to the prediction of work prognosis. This retrospective cohort study explored the contribution of demographic, patient-reported, clinical, and MRI information to the prediction of work participation in sickness absentees with neck or shoulder pain. Methods From a secondary care setting, 168 sickness absentees with neck or shoulder pain were included. Based on registry data, a successful work outcome was defined as ≥50% work participation score (WPS) from Weeks 1 to 104 after enrolment. Prognostic variables were categorized into four domains (demographic, patient-reported, clinical, and MRI) resembling the order of information obtained in a clinical setting. Crude logistic regression analyses were used to identify prognostic variables for each domain (p < 0.2). This was followed by multivariable analyses including the identified variables in a domain-wise order. For each added domain, the probability of successful WPS was dichotomized leaving two possible classifications: ≥ 50% chance of successful WPS or not. In cross-tabulations of chance and the actual WPS outcome, positive and negative predictive values (PPV and NPV), sensitivity, specificity and area under the curve (AUC) were calculated. Results The combination of demographic and patient-reported variables yielded an NPV of 0.72 and a PPV of 0.67, while specificity was 0.82, sensitivity 0.54 and AUC 0.77. None of these values improved notably by adding clinical and MRI variables as predictors of successful WPS. Conclusions These results suggest that - among sickness absentees with neck or shoulder pain – clinical and MRI variables provide no additional information for the prediction of work participation compared with only demographic and patient-reported information.
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Affiliation(s)
- Line Thorndal Moll
- DEFACTUM, P.P. Oerums Gade 11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Central Denmark Region, Denmark. .,Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Denmark. .,Spine Centre, Diagnostic Centre, Silkeborg Regional Hospital, Falkevej 1-3, DK-8600, Silkeborg, Denmark.
| | - Anne Mette Schmidt
- DEFACTUM, P.P. Oerums Gade 11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Central Denmark Region, Denmark.,Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Denmark.,Sano Aarhus, Egernvej 5, DK-8270 Højbjerg, Aarhus, Denmark
| | - Christina Malmose Stapelfeldt
- DEFACTUM, P.P. Oerums Gade 11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Central Denmark Region, Denmark.,Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Denmark
| | - Merete Labriola
- DEFACTUM, P.P. Oerums Gade 11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Central Denmark Region, Denmark.,Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Denmark
| | - Ole Kudsk Jensen
- Spine Centre, Diagnostic Centre, Silkeborg Regional Hospital, Falkevej 1-3, DK-8600, Silkeborg, Denmark
| | - Morten Wasmod Kindt
- Department for Diagnostic Imaging, Diagnostic Centre, Silkeborg Regional Hospital, University Research Clinic for Innovative Patient Pathways, Falkevej 1-3, DK-8600, Silkeborg, Denmark
| | - Tue Secher Jensen
- Department for Diagnostic Imaging, Diagnostic Centre, Silkeborg Regional Hospital, University Research Clinic for Innovative Patient Pathways, Falkevej 1-3, DK-8600, Silkeborg, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Campusvej 55 Odense M, DK-5230, Odense, Denmark
| | - Berit Schiøttz-Christensen
- Spine Centre of Southern Denmark, Hospital Lillebaelt Middelfart and Institute of Regional Health Research, University of Southern Denmark, Oestre Hougvej 55 Middelfart, DK-5500, Odense, Denmark
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Moll LT, Kindt MW, Stapelfeldt CM, Jensen TS. Degenerative findings on MRI of the cervical spine: an inter- and intra-rater reliability study. Chiropr Man Therap 2018; 26:43. [PMID: 30356854 PMCID: PMC6190655 DOI: 10.1186/s12998-018-0210-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 08/13/2018] [Indexed: 11/10/2022] Open
Abstract
Background Knowledge about the assessment reliability of common cervical spine changes is a prerequisite for precise and consistent communication about Magnetic Resonance Imaging (MRI) findings. The purpose of this study was to determine the inter- and intra-rater reliability of degenerative findings when assessing cervical spine MRI. Methods Fifty cervical spine MRIs from subjects with neck pain were used. A radiologist, a chiropractor and a second-year resident of rheumatology independently assessed kyphosis, disc height, disc contour, vertebral endplate signal changes, spinal canal stenosis, neural foraminal stenosis, and osteoarthritis of the uncovertebral and zygapophyseal joints. An evaluation manual was composed containing classifications and illustrative examples, and ten of the MRIs were evaluated twice followed by consensus meetings to refine the classifications. Next, the three readers independently assessed the full sample. Reliability measures were reported using prevalence estimates and unweighted kappa (Κ) statistics. Results The overall inter-rater reliability was substantial (Κ ≥ 0.61) for the majority of variables and moderate only for zygapophyseal osteoarthritis (Κ = 0.56). Intra-rater reliability estimates were higher for all findings. Conclusions The present classifications for some of the most common cervical degenerative findings yielded mainly substantial inter-rater reliability estimates and substantial to almost perfect intra-rater reliability estimates. . Trial registration Regional Data Protection Agency (J.no. 1-16-02-86-16). The letter of exemption from the Regional Ethical Committee is available from the author on request (case no. 86 / 2017).
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Affiliation(s)
- Line Thorndal Moll
- 1DEFACTUM, Central Denmark Region, P.P. Oerums Gade 11, bygn. 1B, DK-8000 Aarhus C, Denmark.,2Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, DK-8000 Aarhus C, Denmark.,Spine Centre, Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Falkevej 1-3, DK-8600 Silkeborg, Denmark
| | - Morten Wasmod Kindt
- Department for Diagnostic Imaging, Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Falkevej 1-3, DK-8600 Silkeborg, Denmark
| | - Christina Malmose Stapelfeldt
- 1DEFACTUM, Central Denmark Region, P.P. Oerums Gade 11, bygn. 1B, DK-8000 Aarhus C, Denmark.,2Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, DK-8000 Aarhus C, Denmark
| | - Tue Secher Jensen
- Department for Diagnostic Imaging, Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Falkevej 1-3, DK-8600 Silkeborg, Denmark.,5Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark
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Moll LT, Jensen OK, Schiøttz-Christensen B, Stapelfeldt CM, Christiansen DH, Nielsen CV, Labriola M. Return to Work in Employees on Sick Leave due to Neck or Shoulder Pain: A Randomized Clinical Trial Comparing Multidisciplinary and Brief Intervention with One-Year Register-Based Follow-Up. J Occup Rehabil 2018; 28:346-356. [PMID: 28836120 PMCID: PMC5978826 DOI: 10.1007/s10926-017-9727-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose The aim of this study was to evaluate the effect of a multidisciplinary intervention (MDI) compared to a brief intervention (BI) with respect to return to work (RTW), pain and disability in workers on sick leave because of neck or shoulder pain. Methods 168 study participants with sickness absence for 4-16 weeks due to neck or shoulder pain were enrolled in a hospital-based clinical study and randomized to either MDI or BI. The primary outcome was RTW obtained by a national registry on public transfer payments. Secondary outcomes were self-reported pain and disability levels. One-year follow-up RTW rates were estimated by Cox proportional hazard regression adjusted for gender, age, sick leave prior to inclusion, part-time sick leave and clinical diagnosis. Secondary outcomes were analysed using logistic and linear regression analysis for pain and disability, respectively. Results In the MDI group, 50 participants (59%) experienced four or more continuous weeks of RTW while 48 (58%) returned to work in the BI group during the 1 year of follow-up. Results showed a statistically non significant tendency towards a lower rate of RTW in the MDI group than in the BI group (adjusted HR = 0.84, 95% CI 0.54, 1.31). There were no statistically significant differences in secondary outcomes between the MDI and BI groups. Conclusion The brief and the multidisciplinary interventions performed equally with respect to both primary and secondary outcomes. The added focus on RTW in the multidisciplinary group did not improve RTW rates in this group.
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Affiliation(s)
- Line Thorndal Moll
- DEFACTUM, Central Denmark Region, P.P. Oerums Gade 11, bygn. 1B, 8000, Aarhus C, Denmark.
- Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, 8000, Aarhus C, Denmark.
- Spine Centre, Diagnostic Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark.
| | - Ole Kudsk Jensen
- Spine Centre, Diagnostic Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark
| | - Berit Schiøttz-Christensen
- Spine Centre of Southern Denmark, Hospital Lillebaelt Middelfart and Institute of Regional Health Research, University of Southern Denmark, Oestre Hougvej 55, 5500, Middelfart, Denmark
| | - Christina Malmose Stapelfeldt
- DEFACTUM, Central Denmark Region, P.P. Oerums Gade 11, bygn. 1B, 8000, Aarhus C, Denmark
- Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, 8000, Aarhus C, Denmark
| | - David Høyrup Christiansen
- Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
| | - Claus Vinther Nielsen
- DEFACTUM, Central Denmark Region, P.P. Oerums Gade 11, bygn. 1B, 8000, Aarhus C, Denmark
- Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, 8000, Aarhus C, Denmark
| | - Merete Labriola
- DEFACTUM, Central Denmark Region, P.P. Oerums Gade 11, bygn. 1B, 8000, Aarhus C, Denmark
- Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, 8000, Aarhus C, Denmark
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Moll LT, Stapelfeldt CM, Schiøttz-Christensen B, Jensen OK, Christiansen DH, Nielsen CV, Labriola M. Return to work after neck or shoulder pain: a randomized clinical trial. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- LT Moll
- Department of Occupational Medicine, University Research Clinic, Regionl Hospital West Jutland, Herning, DK
| | | | | | - OK Jensen
- Spine Centre, Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, DK
| | - DH Christiansen
- Department of Occupational Medicine, University Research Clinic, Regionl Hospital West Jutland, Herning, DK
| | - CV Nielsen
- DEFACTUM, Central Denmark Region, Aarhus, DK
| | - M Labriola
- DEFACTUM, Central Denmark Region, Aarhus, DK
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Moll LT, Gormsen L, Pfeiffer-Jensen M. [Higher prevalence of depression in patients with rheumatoid arthritis--a systematic review]. Ugeskr Laeger 2011; 173:2564-2568. [PMID: 21985834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Chronic pain patients frequently suffer from depression. This systematic review finds that patients suffering from rheumatoid arthritis (RA) have a higher prevalence of depression than controls without RA. Depression is related to pain intensity, passive coping strategies and disability. For patients this may result in a decreased quality of life and a shorter lifespan. For society it results in increased health costs.
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Affiliation(s)
- Line Thorndal Moll
- Reumatologisk Afdeling U, Aarhus Universitetshospital, Nørrebrogade 44, 8000 Aarhus C, Denmark.
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