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Nielsen RL, Bornaes O, Storgaard IK, Kallemose T, Jørgensen LM, Jawad BN, Altintas I, Juul-Larsen HG, Tavenier J, Durhuus JA, Bengaard AKP, Holst JJ, Kolko M, Sonne DP, Breindahl T, Damgaard M, Porrini E, Hornum M, Andersen O, Pedersen MM, Rasmussen HH, Munk T, Lund TM, Jensen PS, Andersen AL, Houlind MB. Appetite stimulation with cannabis-based medicine and methods for assessment of glomerular filtration in older patients with medical illness: A study protocol. Basic Clin Pharmacol Toxicol 2023; 133:237-253. [PMID: 37314893 DOI: 10.1111/bcpt.13914] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/05/2023] [Accepted: 06/07/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIM Malnutrition in older patients is linked to poor appetite. Cannabis-based medicine may have orexigenic properties in older patients, but this has to our knowledge never been investigated. In older patients, uncertainty applies to the accuracy of estimated glomerular filtration rate (eGFR) based on creatinine, which is crucial for medication prescribing. In older patients with poor appetite, the study aims (1) to assess the efficacy of Sativex® (8.1-mg delta-9-tetrahydrocannabinol [THC] and 7.5-mg cannabidiol [CBD]) to stimulate appetite and (2) to compare the performance of various GFR-estimates and measured-GFR (mGFR) for determining gentamicin clearance utilizing population pharmacokinetic (popPK) modelling methods. METHODS AND OBJECTIVES This study is composed of two substudies. Substudy 1 is an investigator-initiated single-center, double-blinded, randomized, placebo-controlled, superiority, cross-over study. Substudy 1 will recruit 17 older patients with poor appetite, who will also be invited to substudy 2. Substudy 2 is a single-dose pharmacokinetics study and will recruit 55 patients. Participants will receive Sativex® and placebo in substudy 1 and gentamicin with simultaneous measurements of GFR in substudy 2. The primary endpoints are as follows: Substudy 1-the difference in energy intake between Sativex® and placebo conditions; substudy 2- the accuracy of different eGFR equations compared to mGFR. The secondary endpoints include safety parameters, changes in the appetite hormones, total ghrelin and GLP-1 and subjective appetite sensations, and the creation of popPK models of THC, CBD, and gentamicin.
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Affiliation(s)
- R L Nielsen
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - O Bornaes
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - I K Storgaard
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - T Kallemose
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - L M Jørgensen
- Emergency Department, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - B N Jawad
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - I Altintas
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Emergency Department, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - H G Juul-Larsen
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - J Tavenier
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - J A Durhuus
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Cellular and Molecular Medicine, Center for Healthy Aging, Copenhagen, Denmark
| | - A K P Bengaard
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - J J Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M Kolko
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - D P Sonne
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Pharmacology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - T Breindahl
- Department of Clinical Biochemistry, North Denmark Regional Hospital, Hjørring, Denmark
| | - M Damgaard
- Department of Clinical Physiology and Nuclear Medicine, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - E Porrini
- Laboratory of Renal Function (LFR), Faculty of Medicine, University of La Laguna, La Laguna, Spain
| | - M Hornum
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Nephrology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - O Andersen
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Emergency Department, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - M M Pedersen
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - H H Rasmussen
- Center for Nutrition and Intestinal Failure, Aalborg University Hospital, Aalborg University, Aalborg, Denmark
- The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - T Munk
- The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - T M Lund
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - P S Jensen
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Orthopeadic Surgery, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - A L Andersen
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M B Houlind
- Department of Clinical Research, Acute CAG, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
- The Hospital Pharmacy, Herlev, Denmark
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Horsbøll TA, Dalton SO, Christensen J, Petersen A, Azawi NH, Donskov F, Andersen O, Nørgaard M, Lund L. Impact of comorbidity burden on renal cell carcinoma prognosis: A Danish nationwide cohort study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.6_suppl.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
360 Background: The incidence of renal cell carcinoma is increasing worldwide and have a 5-year relative survival rates of around 75%. Comorbidity has been found to be associated with complications and mortality after renal cancer surgery. No studies have focused on comorbidity as a prognostic factor in a nationwide cohort of patients with renal cell carcinoma with long-term follow-up. Purpose: The primary aim was to evaluate the prognostic impact of comorbidity on survival in older (≥70 years) and younger (<70 years) patients diagnosed with renal cell carcinoma. Methods: We established a nationwide register-based cohort of 7,894 patients aged 18 or more diagnosed with renal cell carcinoma in Denmark between 2006 and 2017, and followed their vital status for up to 13 years. We computed 1- and 5-year overall survival and hazard ratios (HRs) of death according to comorbidity status using Charlson Comorbidity Index (CCI) among patients aged < 70 years and ≥ 70 years. Results: In all, 36% of the patients had registered comorbidity at the time of diagnosis. Survival decreased with increasing CCI score. It did though increase for all groups of CCI scores (0, 1-2 and 3+) over time. For patients without comorbidity diagnosed in 2006-2008 and 2015-2017, 5-year survival rate increased from 57% to 69%. For patients with a CCI score of 1-2 vs 3, the 5-year survival rate increased from 46% to 62% vs 39% to 44%. In age- and gender-stratified analyses, patients with a CCI score of 1-2 and 3+ had increased mortality compared to patients without registered comorbidity (HR 1.15, 95 % CI 1.06-1.24) and (HR 1.56, 95 % CI 1.40-1.73). Patterns were similar for older (≥70 years) and younger (<70 years) patients. Particularly, diagnoses of congestive heart failure, peripheral vascular and cerebrovascular disease, dementia, chronic pulmonary disease, preexisting renal and liver disease, diabetes and lymphoma led to increased mortality. Conclusions: Comorbidity leads to inferior survival outcomes in patients with renal cell carcinoma, irrespective of age, despite an overall increasing survival. These data may guide patient counseling and prompt initiatives for controlling comorbidity.
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Affiliation(s)
| | | | | | - Astrid Petersen
- Department of Pathology, Aalborg University Hospital, Aalborg, Denmark
| | | | | | | | | | - Lars Lund
- Odense University Hospital, Odense, Denmark
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Biström M, Jons D, Engdahl E, Gustafsson R, Huang J, Brenner N, Butt J, Alonso-Magdalena L, Gunnarsson M, Vrethem M, Bender N, Waterboer T, Granåsen G, Olsson T, Kockum I, Andersen O, Fogdell-Hahn A, Sundström P. Epstein-Barr virus infection after adolescence and human herpesvirus 6A as risk factors for multiple sclerosis. Eur J Neurol 2020; 28:579-586. [PMID: 33065762 PMCID: PMC7839468 DOI: 10.1111/ene.14597] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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] [Received: 06/16/2020] [Accepted: 10/06/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Infections with human herpesvirus 6A (HHV-6A) and Epstein-Barr virus (EBV) have been linked to multiple sclerosis (MS) development. For EBV, late infection has been proposed as a risk factor, but serological support is lacking. The objective of this study was to investigate how age affects the EBV and HHV-6A associated risks of developing MS. METHODS In this nested case-control study, Swedish biobanks were accessed to find pre-symptomatically collected blood samples from 670 individuals who later developed relapsing MS and 670 matched controls. A bead-based multiplex assay was used to determine serological response against EBV and HHV-6A. Conditional logistic regression was used to calculate odds ratios and 95% confidence intervals. RESULTS Seropositivity against EBV exhibited a pattern where associations switched from a decreased risk of developing MS in the group below 20 years of age to an increased risk amongst individuals aged 20-29 and 30-39 years (p for trend 0.020). The age of transition was estimated to be 18.8 years. In contrast, HHV-6A was associated with increased MS risk in all age groups (total cohort odds ratio 2.1, 95% confidence interval 1.6-2.7). CONCLUSIONS This study suggests EBV infection after adolescence and age independent HHV-6A infection as risk factors for MS.
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Affiliation(s)
- M Biström
- Department of Clinical Science, Neurosciences, Umeå University, Umeå, Sweden
| | - D Jons
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - E Engdahl
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Stockholm, Sweden
| | - R Gustafsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Stockholm, Sweden
| | - J Huang
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Stockholm, Sweden
| | - N Brenner
- Infections and Cancer Epidemiology, German Cancer Research Center (Deutsches Krebsforschungszentrum), Heidelberg, Germany
| | - J Butt
- Infections and Cancer Epidemiology, German Cancer Research Center (Deutsches Krebsforschungszentrum), Heidelberg, Germany
| | - L Alonso-Magdalena
- Department of Neurology, Skåne University Hospital in Malmö/Lund and Institution of Clinical Sciences, Neurology, Lund University, Lund, Sweden
| | - M Gunnarsson
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - M Vrethem
- Department of Neurology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - N Bender
- Infections and Cancer Epidemiology, German Cancer Research Center (Deutsches Krebsforschungszentrum), Heidelberg, Germany
| | - T Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (Deutsches Krebsforschungszentrum), Heidelberg, Germany
| | - G Granåsen
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - T Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Stockholm, Sweden
| | - I Kockum
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Stockholm, Sweden
| | - O Andersen
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Fogdell-Hahn
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Stockholm, Sweden
| | - Peter Sundström
- Department of Clinical Science, Neurosciences, Umeå University, Umeå, Sweden
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Aaseth J, Nurchi VM, Andersen O. Clinical therapy of patients contaminated with Polonium or Plutonium. Curr Med Chem 2020; 28:7238-7246. [PMID: 33081668 DOI: 10.2174/0929867327666201020152253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/28/2020] [Accepted: 09/17/2020] [Indexed: 11/22/2022]
Abstract
Although most of the harmful radionuclides are of anthropogenic origin and released from military or industrial processes, radioactive substances also occur naturally in the environment, e.g. uranium. Low standards of nuclear facilities can lead to contamination of employees with radionuclides due to inhalation of gases or dust, or contamination of skin or wounds. Various sources for radionuclide exposure may represent concerns for radioactive polonium or plutonium exposure, for instance terrorist actions on the infrastructure such as on drinking water basins. Early health effects after extensive radiation exposure may be vomiting, headaches, and fatigue, followed by bone marrow depression, fever, and diarrhea. The main purpose of radionuclide mobilization is to minimize the radiation dose. Since some of the important radionuclides such as polonium and plutonium have very long biological half-times after their deposition in bone, liver or kidneys, rapid initiation of chelation treatment is usually imperative after a contamination event. The antidote DMPS (dimercaptopropanesulfonate is considered the drug of choice for polonium decorporation. DTPA (diethylenetriamine pentaacetate) is a potent chelator especially approved for radionuclide mobilization, including polonium and other actinides. Other chelators and drugs are under investigation as potential chelators of transuranic elements.
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Affiliation(s)
- Jan Aaseth
- Research Department, Innlandet Hospital Trust, 2381 Brumunddal. Norway
| | - Valeria Marina Nurchi
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, 09042 Monserrato. Italy
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Lindstroem MB, Andersen O, Kallemose T, Rasmussen LJH, Rosthoej S, Jervelund SS. The effect of the employment of consultants in the Emergency Department on quality of care and equity. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Hospitals struggle with increasing acute admissions and crowding in Emergency Departments (EDs) negatively affect length of hospitalisation, in-hospital mortality, patient safety and flow. In response to this, the Danish Health Authorities have recommended the presence of consultants in the ED to expedite the clinical decision-making process. In 2016, consultant-led triage and continuous presence of consultants was introduced at the ED at Hvidovre Hospital, Denmark. However, little is known on the effect of consultants in the ED, and how it affects care for patients of varying socioeconomic status. This study investigated whether the employment of consultants in a Danish ED affected the quality of care for acutely admitted medical patients in terms of length of admission, readmission, and mortality, and how this effect was distributed across socioeconomic status in patients.
Methods
Admission data was collected during two 7-month periods, one prior to and one after the organisational intervention, with 9,869 adult medical patients admitted for up to 48 hours in the ED. Linear regression and Cox proportional hazards regression analyses adjusted for age, sex, comorbidities, level of education and employment status were applied.
Results
Following the employment of consultants, an overall 11% increase in index-admissions was observed, and 90% of patients were discharged by a consultant with a reduced mean length of admission by 1.4 hours (95% CI: 1.0 - 1.9). No significant change was found in in-hospital mortality, readmission, or mortality within 90 days after discharge. No difference was found in quality of care across socioeconomic status.
Conclusions
Consultants in the ED was found to reduce length of admission without a negative effect on the quality of care for ED admitted medical patients in general, or for patients with lower socioeconomic status. To reduce readmission and mortality among acutely admitted patients, other means must be initiated.
Key messages
Consultants in the ED may reduce length of admission without a negative effect on the quality of care. To reduce readmission and mortality among acutely admitted patients, other means must be initiated.
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Affiliation(s)
- M B Lindstroem
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - O Andersen
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Acute Medical Department, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - T Kallemose
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - L J H Rasmussen
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - S Rosthoej
- Section of Biostatistics, University of Copenhagen, Department of Public Health, Copenhagen, Denmark
| | - S S Jervelund
- Section for Health Services Research, University of Copenhagen, Department of Public Health, Copenhagen, Denmark
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Abstract
This paper describes an indirect method for assessing spindle-inhibiting effects of chemicals by chromosome length measurement, and the use of this technique for evaluation of the spindle-inhibiting effects of metal compounds in human lymphocytes in vitro. This technique could identify the threshold concentration for spindle-inhibition for several metal compounds. Furthermore partial spindle-inhibition, leading to a high risk of abnormal chromosome segregation, which was observed at the threshold concentration. The results indicate that chromosome length measurements offer an indirect, but sensitive, test for evaluation of spindle-inhibition, able to identify the threshold concentration for effects on the spindle, thus allowing direct study of the induction of aneuploidy at the most relevant concentration.
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Affiliation(s)
- Ole Andersen
- Department of Environmental Medicine, Odense University, Campusvej 55, 5230 Odense M., Denmark
| | - Mogens Rønne
- Winslow Institute of Human Anatomy, Odense University, Campusvej 55, 5230 Odense M., Denmark
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7
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Christensen J, Kejs AMT, Schmidt LKH, Søgaard J, Rasted MC, Andersen O, Jakobsen E. Agreement between the Danish Cancer Registry and the Danish Lung Cancer Registry. Dan Med J 2020; 67:A04190257. [PMID: 32741437] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The Danish Cancer Registry (DCR) and the Danish Lung Cancer Registry (DLCR) are nation-wide registries recording Danish patients with lung cancer (LC). The aim of this study was to assess data agreement and possible consequences hereof on estimation of survival between patients in the two registries. METHODS Descriptive statistics were used for comparison of registered patients in 2013-2014 in the DCR and the DLCR. Furthermore, the one-year relative survival (1y-RS) and Cox proportional mortality hazard rates (MRR) were calculated. RESULTS In 2013-2014, a total of 9,111 Danish residents were identified with LC in the DCR and 9,316 were found in the DLCR. Merging the two registries showed an agreement of 87%, whereas 6% were included only in the DCR and 8% only in the DLCR. Including patients only registered in one registry, but who seemed to meet the inclusion criteria of both registries, would increase the agreement to 95%. No differences were seen for 1y-RS. However, MRR for patients in the DLCR was significantly lower than for patients in the DCR: 0.94 (95% confidence interval: 0.91-0.98). CONCLUSIONS Surprisingly, the DCR registered fewer patients in 2013-2014 than the DLCR, even though they employ the same primary data source. The agreement between the DCR and the DLCR was 87%; this may be increased to 95% if patients who seemed to meet the inclusion criteria of the other register were also included. The discrepancies found were mainly due to different definitions of dates of diagnosis, registrations probably missed by the algorithms and possible registration errors. Discrepancies resulted in a significant difference in MRR, but not in 1y-RS. FUNDING none. TRIAL REGISTRATION not relevant.
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Danckert B, Horsbøl TA, Andersen O, Dalton SO, Christensen J, Rasted M, Petersen A, Nørgaard M, Azawi N, Lund L, Donskov F. Registrations of Patients with Renal Cell Carcinoma in the Nationwide Danish Renal Cancer Database versus the Danish Cancer Registry: Data Quality, Completeness and Survival (DaRenCa Study-3). Clin Epidemiol 2020; 12:807-814. [PMID: 32801918 PMCID: PMC7394510 DOI: 10.2147/clep.s258755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/18/2020] [Accepted: 06/19/2020] [Indexed: 11/24/2022] Open
Abstract
Background The Danish multidisciplinary renal cancer group (DaRenCa) established the nationwide database DaRenCaData in 2010. The Danish Cancer Registry (DCR) has been considered the golden standard. In contrast to DCR, DaRenCaData required the diagnosis to be histologically or cytologically verified. DaRenCaData and DCR have not previously been compared. Patients and Methods We included patients with renal cell carcinoma registered in DaRenCaData and/or DCR from August 1st 2010 to December 31st 2015. We computed completeness and positive predictive value (PPV) of a diagnosis in DaRenCaData compared with DCR, 1-year, 3-year and 5-year mortality rate ratios, and relative survival. Results We identified 4890 patients in the two registries. Of these, 4326 were registered in DaRenCaData and 4714 in DCR. Completeness of DaRenCaData was 88% [95% CI, 87–89%] and increased during the period from 82% to 94%. The PPV was 96% [95% CI, 95–97%]. A total of 4150 patients (85%) were found in both registries, 4% (176 patients) in DaRenCaData only, and 12% (564 patients) in DCR only. The relative survival was higher for patients in DaRenCaData vs DCR; the 1-year and 5-year relative survival was 85% vs 81% and 65% vs 59%, respectively. Compared with patients registered in both registries, the mortality rates were higher in patients registered in DaRenCaData only (1-year hazard ratio (HR)=2.84 [95% CI, 2.20–3.68]) or DCR only (1-year HR=4.29 [95% CI, 3.72–4.93]). Observed in both registries, survival improved over time with a 7% yearly reduction in death based on estimations of 1-year mortality rate ratios. Conclusion DaRenCaData had high and increasing completeness and high PPV, establishing it as a high-quality research database. Observed in both registries, renal cell carcinoma mortality declined over time; patients only registered in DCR or DaRenCaData had poorer outcomes. This study points to the importance of assessing the inclusion criteria when interpreting registry-based studies.
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Affiliation(s)
- Bolette Danckert
- Director´s Office, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Trine Allerslev Horsbøl
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ole Andersen
- Director´s Office, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Næstved, Denmark
| | - Jane Christensen
- Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Astrid Petersen
- Department of Pathology, Aalborg University Hospital, Aalborg, Denmark
| | - Mette Nørgaard
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Nessn Azawi
- Department of Urology, Zealand University Hospital, Roskilde, Denmark
| | - Lars Lund
- Department of Urology and Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Frede Donskov
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
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9
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Bjerrum A, Lindebjerg J, Andersen O, Fischer A, Lynge E. Long-term risk of colorectal cancer after screen-detected adenoma: Experiences from a Danish gFOBT-positive screening cohort. Int J Cancer 2020; 147:940-947. [PMID: 31894860 DOI: 10.1002/ijc.32850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 12/28/2022]
Abstract
Fecal occult blood test (FOBT) screening for colorectal cancer (CRC) is implemented in several countries. Approximately half of all FOBT-positive persons have screen-detected adenomas. Despite removal of these, patients with large/multiple adenomas have increased risk of later developing new advanced adenomas and CRC. International guidelines exist for colonoscopic surveillance following adenoma removal. These divide patients into low-, intermediate- and high-risk groups. We followed 711 FOBT-positive patients with screening adenoma identified during population-based CRC screening in two Danish counties in 2005-2006. As reference population, we included 1,240,348 persons in the same age group from the rest of Denmark not included in the screening. We estimated the long-term CRC risk stratified by adenoma findings during screening and compared to the reference group. After 12 years follow-up, the CRC incidence among all adenoma patients was 322 cases per 100,000 person-years (95% confidence interval [CI]: 212-489) ranging from 251 (95% CI: 94-671) to 542 (95% CI: 300-978) cases per 100,000 person-years in the low- and high-risk groups, respectively. In the reference population, the CRC incidence was 244 (95% CI: 242-247) per 100,000. Patients with screen-detected high-risk adenomas after a positive FOBT had an almost doubled risk of CRC compared to the reference population (adjusted hazard ratio [aHR] 1.95, 95% CI: 1.08-3.51), and the incidence in those with no follow-up visits was over 3.6 (aHR 3.64, 95% CI: 1.82-7.29) times the incidence in the reference population. The increased CRC risk could be controlled if high-risk patients underwent follow-up colonoscopy (aHR 0.87, 95% CI: 0.28-2.69).
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Affiliation(s)
- Andreas Bjerrum
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Ole Andersen
- Nykøbing Falster Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Elsebeth Lynge
- Nykøbing Falster Hospital, University of Copenhagen, Copenhagen, Denmark
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10
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Christensen J, Højsgaard Schmidt LK, Kejs AMT, Søgaard J, Rasted MC, Andersen O, Ingeholm P, Iversen LH. Agreement between the Danish Cancer Registry and the Danish Colorectal Cancer Group Database. Acta Oncol 2020; 59:116-123. [PMID: 31559881 DOI: 10.1080/0284186x.2019.1669815] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: The Danish Cancer Registry (DCR) and the Danish Colorectal Cancer Group (DCCG) database are population-based registries collecting information on Danish patients with colorectal cancer (CRC). DCR registers all patients with incident CRC whereas DCCG records patients with first time CRC. The registries use different inclusion criteria. The consequencenses of this are unknown and not previously evaluated. The aim of this study was to examine the agreement between patients registered in DCR and DCCG and to evaluate its influence on estimated survival and mortality.Material and methods: Patients registered in DCR and DCCG with CRC in 2014-2015 were included. Because of different inclusion criteria, DCCG's inclusion criteria were applied to DCR. Descriptive statistics were used for comparisons. One-year relative survival (1-year RS) was calculated, and the Cox proportional hazard model used for calculating 1-year mortality rate ratios (1-year MRR).Results: In 2014-2015, DCR registered 9678 Danish residents with CRC that fulfilled DCCG's inclusion criteria, while DCCG registered 10,312 Danish residents with CRC. Allowing ±180 days between dates of diagnosis, 10,688 patients were registered with CRC in the merger of the two registries. Of these, 86% were included in both registers, 4% only in DCR, and 10% only in DCCG. No difference was found in 1-year RS between patients in DCR 86% (95% CI: 85-87) and DCCG 85% (95% CI: 84-86). However, patients registered in DCCG had a 1-year MRR of 1.09 (95% CI: 1.01-1.17) compared to DCR.Conclusion: An agreement of 86% of patients was found between the two registries. The discrepancy did not influence 1-year RS. DCCG registered more patients than DCR, and 1-year MRR of patients in DCCG was increased compared to patients in DCR. Regular linkage of the registries is recommended to improve data quality of both registries.
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Affiliation(s)
- Jane Christensen
- Danish Cancer Society Research Center, The Danish Cancer Society, Copenhagen O, Denmark
| | | | | | - Jes Søgaard
- Documentation and Quality, The Danish Cancer Society, Copenhagen O, Denmark
| | | | - Ole Andersen
- Danish Cancer Society Research Center, The Danish Cancer Society, Copenhagen O, Denmark
| | - Peter Ingeholm
- Department of Pathology, Herlev University Hospital, Herlev, Denmark
- The Danish Colorectal Cancer Group, Copenhagen, Denmark
| | - Lene Hjerrild Iversen
- The Danish Colorectal Cancer Group, Copenhagen, Denmark
- Department of Surgery, Aarhus University Hospital, Aarhus N, Denmark
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11
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Aaseth J, Nurchi VM, Andersen O. Medical Therapy of Patients Contaminated with Radioactive Cesium or Iodine. Biomolecules 2019; 9:E856. [PMID: 31835766 PMCID: PMC6995530 DOI: 10.3390/biom9120856] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 12/06/2019] [Accepted: 12/09/2019] [Indexed: 11/23/2022] Open
Abstract
Follow-up studies after the Chernobyl and Fukushima accidents have shown that 137Cs and 131I made up the major amount of harmful contaminants in the atmospheric dispersion and fallout. Other potential sources for such radionuclide exposure may be terrorist attacks, e.g., via contamination of drinking water reservoirs. A primary purpose of radionuclide mobilization is to minimize the radiation dose. Rapid initiation of treatment of poisoned patients is imperative after a contaminating event. Internal contamination with radioactive material can expose patients to prolonged radiation, thus leading to short- and long-term clinical consequences. After the patient's emergency conditions are addressed, the treating physicians and assisting experts should assess the amount of radioactive material that has been internalized. This evaluation should include estimation of the radiation dose that is delivered and the specific radionuclides inside the body. These complex assessments warrant the reliance on a multidisciplinary approach that incorporates regional experts in radiation medicine and emergencies. Regional hospitals should have elaborated strategies for the handling of radiation emergencies. If radioactive cesium is a significant pollutant, Prussian blue is the approved antidote for internal detoxification. Upon risks of radioiodine exposure, prophylactic or immediate treatment with potassium iodide tablets is recommended. Chelators developed from calcium salts have been studied for gastrointestinal trapping and enhanced mobilization after strontium exposure.
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Affiliation(s)
- Jan Aaseth
- Research Department, Innlandet Hospital Trust, 2381 Brumunddal, Norway
- IM Sechenov First Moscow State Medical University (Sechenov University), 119146 Moscow, Russia
| | - Valeria Marina Nurchi
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, 09042 Monserrato-Cagliari, Italy;
| | - Ole Andersen
- Department of Science, Systems and Models, Roskilde University, 4000 Roskilde, Denmark;
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12
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Skoog B, Link J, Tedeholm H, Longfils M, Nerman O, Fagius J, Andersen O. Short-term prediction of secondary progression in a sliding window: A test of a predicting algorithm in a validation cohort. Mult Scler J Exp Transl Clin 2019; 5:2055217319875466. [PMID: 35145727 PMCID: PMC8822449 DOI: 10.1177/2055217319875466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 08/14/2019] [Accepted: 08/19/2019] [Indexed: 12/03/2022] Open
Abstract
Introduction The Multiple Sclerosis Prediction Score (MSPS, www.msprediction.com) estimates, for any month during the course of relapsing–remitting multiple sclerosis (MS), the individual risk of transition to secondary progression (SP) during the following year. Objective Internal verification of the MSPS algorithm in a derivation cohort, the Gothenburg Incidence Cohort (GIC, n = 144) and external verification in the Uppsala MS cohort (UMS, n = 145). Methods Starting from their second relapse, patients were included and followed for 25 years. A matrix of MSPS values was created. From this matrix, a goodness-of-fit test and suitable diagnostic plots were derived to compare MSPS-calculated and observed outcomes (i.e. transition to SP). Results The median time to SP was slightly longer in the UMS than in the GIC, 15 vs. 11.5 years (p = 0.19). The MSPS was calibrated with multiplicative factors: 0.599 for the UMS and 0.829 for the GIC; the calibrated MSPS provided a good fit between expected and observed outcomes (chi-square p = 0.61 for the UMS), which indicated the model was not rejected. Conclusion The results suggest that the MSPS has clinically relevant generalizability in new cohorts, provided that the MSPS was calibrated to the actual overall SP incidence in the cohort.
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Affiliation(s)
- B Skoog
- University of Gothenburg, the Sahlgrenska Academy, Institute of Neuroscience and Physiology, Section of Clinical Neuroscience and Rehabilitation, Sweden
| | - J Link
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - H Tedeholm
- University of Gothenburg, the Sahlgrenska Academy, Institute of Neuroscience and Physiology, Section of Clinical Neuroscience and Rehabilitation, Sweden
| | - M Longfils
- Department of Mathematical Sciences, Chalmers University of Technology, Sweden
| | - O Nerman
- Department of Mathematical Sciences, Chalmers University of Technology, Sweden
| | - J Fagius
- Neurology, Department of Neuroscience, Uppsala University, Sweden
| | - O Andersen
- University of Gothenburg, the Sahlgrenska Academy, Institute of Neuroscience and Physiology, Section of Clinical Neuroscience and Rehabilitation, Sweden
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Pedersen MM, Kirk JW, Petersen J, Bandholm TQ, Tjørnhøj-Thomsen T, Nilsen P, Andersen O. INCREASING 24 HOUR MOBILITY IN OLDER MEDICAL PATIENTS: THE WALK-COPENHAGEN PROJECT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.010] [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)
- M M Pedersen
- Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark, Hvidovre, Hovedstaden, Denmark
| | - J W Kirk
- Optimed, Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - J Petersen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - T Q Bandholm
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; Physical Medicine Research-Copenhagen (PMR-C), Copenhagen University Hospital, Hvidovre, Denmark; Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark
| | - T Tjørnhøj-Thomsen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Denmark
| | - P Nilsen
- Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Sweden
| | - O Andersen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
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Poulsen SS, Saber AT, Williams A, Andersen O, Købler C, Atluri R, Pozzebon ME, Mucelli SP, Simion M, Rickerby D, Mortensen A, Jackson P, Kyjovska ZO, Mølhave K, Jacobsen NR, Jensen KA, Yauk CL, Wallin H, Halappanavar S, Vogel U. Corrigendum to "MWCNTs of different physicochemical properties cause similar inflammatory responses, but differences in transcriptional and histological markers of fibrosis in mouse lungs" [Toxicol. Appl. Pharmacol., 284 (2015) 16-32]. Toxicol Appl Pharmacol 2018; 355:286. [PMID: 29908758 DOI: 10.1016/j.taap.2018.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Sarah S Poulsen
- National Research Centre for the Working Environment, Copenhagen DK-2100, Denmark; Department of Science, Systems and Models, Roskilde University, DK-4000 Roskilde, Denmark.
| | - Anne T Saber
- National Research Centre for the Working Environment, Copenhagen DK-2100, Denmark
| | - Andrew Williams
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario K1A 0K9, Canada
| | - Ole Andersen
- Department of Science, Systems and Models, Roskilde University, DK-4000 Roskilde, Denmark
| | - Carsten Købler
- Department of Micro- and Nanotechnology, Technical University of Denmark, DK-2800 Kgs. Lyngby, Denmark
| | | | - Maria E Pozzebon
- Veneto Nanotech SCpA, ECSIN - European Centre for the Sustainable Impact of Nanotechnology, I-45100 Rovigo, Italy
| | - Stefano P Mucelli
- Veneto Nanotech SCpA, ECSIN - European Centre for the Sustainable Impact of Nanotechnology, I-45100 Rovigo, Italy
| | - Monica Simion
- Laboratory of Nanobiotechnology, National Institute for Research and Development in Microtechnologies, 077190 Bucharest, Romania
| | - David Rickerby
- European Commission Joint Research Centre, Institute for Environment and Sustainability, I-21027 Ispra, VA, Italy
| | - Alicja Mortensen
- National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Petra Jackson
- National Research Centre for the Working Environment, Copenhagen DK-2100, Denmark
| | - Zdenka O Kyjovska
- National Research Centre for the Working Environment, Copenhagen DK-2100, Denmark
| | - Kristian Mølhave
- Department of Micro- and Nanotechnology, Technical University of Denmark, DK-2800 Kgs. Lyngby, Denmark
| | - Nicklas R Jacobsen
- National Research Centre for the Working Environment, Copenhagen DK-2100, Denmark
| | - Keld A Jensen
- National Research Centre for the Working Environment, Copenhagen DK-2100, Denmark
| | - Carole L Yauk
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario K1A 0K9, Canada
| | - Håkan Wallin
- National Research Centre for the Working Environment, Copenhagen DK-2100, Denmark; Department of Public Health, University of Copenhagen, DK-1014 Copenhagen K, Denmark
| | - Sabina Halappanavar
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario K1A 0K9, Canada
| | - Ulla Vogel
- National Research Centre for the Working Environment, Copenhagen DK-2100, Denmark; Department of Micro- and Nanotechnology, Technical University of Denmark, DK-2800 Kgs. Lyngby, Denmark
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Axelsson M, Sjögren M, Andersen O, Blennow K, Zetterberg H, Lycke J. Neurofilament light protein levels in cerebrospinal fluid predict long-term disability of Guillain-Barré syndrome: A pilot study. Acta Neurol Scand 2018; 138:143-150. [PMID: 29624650 DOI: 10.1111/ane.12927] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Although the recovery from Guillain-Barré syndrome (GBS) is good in most patients, some develop permanent severe disability or even die. Early predictors would increase the likelihood to identify patients at risk for poor outcome at the acute stage, allowing them intensified therapeutic intervention. MATERIALS AND METHOD Eighteen patients with a history of GBS 9-17 years ago were reassessed with scoring of neurological disability and quality of life assessment (QoL). Their previous diagnostic work-up included clinical examination with scoring of disability, neurophysiological investigation, a battery of serology tests for infections, and cerebrospinal fluid (CSF) examination. Aliquots of CSF were frozen, stored for 20-28 years, and analyzed by ELISA for determination of neurofilament light protein (NFL) and glial fibrillary acidic protein (GFAP). RESULTS Patients with poor outcome (n = 3) had significantly higher NFL and GFAP levels at GBS nadir than those with good outcome (n = 15, P < .01 and P < .05, respectively). High NFL correlated with more prominent disability and worse QoL at long-term follow-up (r = .694, P < .001, and SF 36 dimension physical component summary (PCS) (r =-.65, P < .05), respectively, whereas GFAP did not correlate with clinical outcome or QoL. CONCLUSION High NFL in CSF at the acute stage of GBS seems to predict long-term outcome and might, together with neurophysiological and clinical measures, be useful in treatment decisions and clinical care of GBS.
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Affiliation(s)
- M. Axelsson
- Department of Clinical Neuroscience; Institute of Neuroscience and Physiology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - M. Sjögren
- Department of Clinical Neuroscience; Institute of Neuroscience and Physiology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - O. Andersen
- Department of Clinical Neuroscience; Institute of Neuroscience and Physiology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - K. Blennow
- Department of Psychiatry and Neurochemistry; Institute of Neuroscience and Physiology; The Sahlgrenska Academy; The University of Gothenburg; Mölndal Sweden
- Clinical Neurochemistry Laboratory; Sahlgrenska University Hospital; Mölndal Sweden
| | - H. Zetterberg
- Department of Psychiatry and Neurochemistry; Institute of Neuroscience and Physiology; The Sahlgrenska Academy; The University of Gothenburg; Mölndal Sweden
- Clinical Neurochemistry Laboratory; Sahlgrenska University Hospital; Mölndal Sweden
- Department of Molecular Neuroscience; UCL Institute of Neurology; London UK
- UK Dementia Research Institute; London UK
| | - J. Lycke
- Department of Clinical Neuroscience; Institute of Neuroscience and Physiology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Westin O, Rasmussen LJH, Andersen O, Eugen-Olsen J, Friberg J. P1898Soluble urokinase plasminogen activator receptor (suPAR) is an independent risk factor for stroke in patients with atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- O Westin
- Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Department of Cardiology, Copenhagen, Denmark
| | - L J H Rasmussen
- Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Copenhagen, Denmark
| | - O Andersen
- Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Copenhagen, Denmark
| | - J Eugen-Olsen
- Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Copenhagen, Denmark
| | - J Friberg
- Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Department of Cardiology, Copenhagen, Denmark
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17
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Andersen O, Hildeman A, Longfils M, Tedeholm H, Skoog B, Tian W, Zhong J, Ekholm S, Novakova L, Runmarker B, Nerman O, Maier SE. Diffusion tensor imaging in multiple sclerosis at different final outcomes. Acta Neurol Scand 2018; 137:165-173. [PMID: 28741711 DOI: 10.1111/ane.12797] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Methods to evaluate the relative contributions of demyelination vs axonal degeneration over the long-term course of MS are urgently needed. We used magnetic resonance diffusion tensor imaging (DTI) to estimate degrees of demyelination and axonal degeneration in the corpus callosum (CC) in cases of MS with different final outcomes. MATERIALS AND METHODS We determined DTI measures mean diffusivity (MD), fractional anisotropy (FA), and axial (AD) and radial (RD) diffusivities in the CC of 31 MS patients, of whom 13 presented a secondary progressive course, 11 a non-progressive course, and seven a monophasic course. The study participants were survivors from an incidence cohort of 254 attack-onset MS patients with 50 years of longitudinal follow-up. As reference, we included five healthy individuals without significant morbidity. RESULTS In patients with secondary progression, compared to all other groups, the corpus callosum showed increased RD and reduced FA, but no change in AD. None of the parameters exhibited differences among non-progressive and monophasic course groups and controls. CONCLUSION Increased RD was observed in secondary progressive MS, indicating significant myelin loss. Normal RD values observed in the clinically isolated syndrome and non-progressive groups confirm their benign nature. AD was not a characterizing parameter for long-term outcome. Demyelination revealed by increased RD is a distinguishing trait for secondary progression.
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Affiliation(s)
- O. Andersen
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - A. Hildeman
- Department of Mathematical Sciences Chalmers University of Technology and University of Gothenburg Gothenburg Sweden
| | - M. Longfils
- Department of Mathematical Sciences Chalmers University of Technology and University of Gothenburg Gothenburg Sweden
| | - H. Tedeholm
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - B. Skoog
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - W. Tian
- Department of Imaging Sciences Medical Center University of Rochester Rochester NY USA
| | - J. Zhong
- Department of Imaging Sciences Medical Center University of Rochester Rochester NY USA
| | - S. Ekholm
- Department of Imaging Sciences Medical Center University of Rochester Rochester NY USA
- Department of Radiology Sahlgrenska University Hospital Gothenburg Sweden
| | - L. Novakova
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - B. Runmarker
- Department of Clinical Neuroscience Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - O. Nerman
- Department of Mathematical Sciences Chalmers University of Technology and University of Gothenburg Gothenburg Sweden
| | - S. E. Maier
- Department of Radiology Sahlgrenska University Hospital Gothenburg Sweden
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18
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Andersen O. MS and infections-Abandoned and surviving hypotheses. Acta Neurol Scand 2017; 136 Suppl 201:4-9. [PMID: 29068491 DOI: 10.1111/ane.12846] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2017] [Indexed: 11/29/2022]
Abstract
In this introduction, we follow the ups and downs of infections in MS pathogenesis. Our arguments focus on specific agents and events, not referring to general MS epidemiology. The historical approach continues on to contemporary data and a critical analysis.
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Affiliation(s)
- O. Andersen
- Institution of Neuroscience and Physiology; University of Gothenburg Neurology; Sahlgrenska University Hospital; Göteborg Sweden
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Celius EG, Andersen O, Fredriksen JL. Preface. Acta Neurol Scand 2017; 136 Suppl 201:3. [PMID: 29068489 DOI: 10.1111/ane.12842] [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] [Accepted: 08/31/2017] [Indexed: 11/27/2022]
Affiliation(s)
- E. G. Celius
- Department of Neurology; Oslo University Hospital; Ullevål and Institute of Health and Society; Faculty of Medicine; University of Oslo; Oslo Norway
| | - O. Andersen
- Institute of Neuroscience and Physiology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - J. L. Fredriksen
- Department of Neurology; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis; Rigshospitalet Glostrup; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
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Houlind M, Treldal C, Aakjær M, Palm H, Malmquist B, Andersen O, Christrup L, Petersen K. Renal function estimations and dose recommendations for Gabapentin, Ibuprofen and Morphine in acute hip fracture patients. Scand J Pain 2017. [DOI: 10.1016/j.sjpain.2017.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Aims
Optimization of pain management is essential for fasttrack surgery and safety in acute hip fracture (AHF) patients. Kidney function determines the doses of several postoperative painkillers, but previous studies have shown the standard Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation overestimate glomerular filtration rate (GFR) in elderly and underweight patients. The optimized Cockcroft Gault (CGop) equation might be more accurate in this patient group. The study aims to (1) investigate the differences in estimated GFR (eGFR) based on CKD-EPI and CGop and (2) to simulate this impact on recommended dosing of standard painkillers in AHF patients.
Methods
Patients admitted with AHF from January to April 2015 were included. eGFR was calculated for each patient by CKD-EPI and CGop based on the lowest measured serum creatinine between 1 and 4 days postoperatively. CKD-classification (1–5) was performed based on both eGFR values. If patients were classified differently based on the two eGFR values, then drug dosages were simulated for Morphine, Ibuprofen and Gabapentin according to prescribing recommendations in Renbase®.Two-sided Mann–Whitney test was used to compare median values between groups.
Results
176 patients (62% women) with a median age of 76 years were included. CKD-EPI (78.0mL/min/m2) estimated eGFR significantly higher compared with GGop (58.9, P < 0.001). Depending on the equation used to estimate GFR, CKD ≥ 3 (eGFR < 60 mL/min/m2) occurred in 23–53% all patients. Using CGop to estimate GFR resulted in CKD re-classification for 63% of all patients. Using CKD-EPI to estimate GFR resulted in significantly higher doses of Morphine, Ibuprofen and Gabapentin (P < 0.0001) in re-classified patients.
Conclusions
GFR estimates are significantly higher when calculated by CKD-EPI compared to CGop, and this difference results in significantly higher recommended doses of painkillers in AHF patients. Future studies should include a gold standard for measuring GFR and maybe alternative biomarkers for the renal function.
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Affiliation(s)
- M.B. Houlind
- Optimed, Clinical Research Center, Hvidovre Hospital , The Capital Region of Denmark , Copenhagen , Denmark
- The Hospital Pharmacy , Copenhagen University Hospital , The Capital Region of Denmark , Copenhagen , Denmark
- Department of Pharmacology and Pharmacotherapy, Faculty of Pharmaceutical Sciences , University of Copenhagen , Copenhagen , Denmark
| | - C. Treldal
- Optimed, Clinical Research Center, Hvidovre Hospital , The Capital Region of Denmark , Copenhagen , Denmark
- The Hospital Pharmacy , Copenhagen University Hospital , The Capital Region of Denmark , Copenhagen , Denmark
| | - M. Aakjær
- Optimed, Clinical Research Center, Hvidovre Hospital , The Capital Region of Denmark , Copenhagen , Denmark
- The Hospital Pharmacy , Copenhagen University Hospital , The Capital Region of Denmark , Copenhagen , Denmark
- Department of Pharmacology and Pharmacotherapy, Faculty of Pharmaceutical Sciences , University of Copenhagen , Copenhagen , Denmark
| | - H. Palm
- Department of Orthopaedic Surgery, Hvidovre Hospital , The Capital Region of Denmark , Hvidovre , Denmark
| | - B. Malmquist
- Department of Orthopaedic Surgery, Hvidovre Hospital , The Capital Region of Denmark , Hvidovre , Denmark
| | - O. Andersen
- Optimed, Clinical Research Center, Hvidovre Hospital , The Capital Region of Denmark , Copenhagen , Denmark
| | - L.L. Christrup
- Department of Orthopaedic Surgery, Hvidovre Hospital , The Capital Region of Denmark , Hvidovre , Denmark
| | - K.K. Petersen
- SMI, Department of Health Science and Technology , Aalborg University , Aalborg , Denmark
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Pedersen M, Petersen J, Beyer N, Damkjær L, Juul-Larsen H, Bodilsen A, Andersen O, Bandholm T. MOBILITY DURING AND AFTER HOSPITALIZATION IN OLDER MEDICAL PATIENTS: THE STAND-CPH TRIAL. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2315] [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: 11/12/2022] Open
Affiliation(s)
- M.M. Pedersen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark,
- Physical Medicine Research-Copenhagen (PMR-C), Department of Physiotherapy, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark
| | - J. Petersen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark,
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark,
| | - N.A. Beyer
- Musculoskeletal Rehabilitation Research Unit, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen, Denmark,
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,
| | - L. Damkjær
- Department of Rehabilitation, Copenhagen Municipality Health Administration, Copenhagen, Denmark,
| | - H.G. Juul-Larsen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark,
| | - A.C. Bodilsen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark,
- Physical Medicine Research-Copenhagen (PMR-C), Department of Physiotherapy, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark
| | - O. Andersen
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark,
| | - T.Q. Bandholm
- Optimed, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark,
- Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark,
- Physical Medicine Research-Copenhagen (PMR-C), Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark,
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Bjerrum A, Andersen O, Fischer A, Lindebjerg J, Lynge E. Long-term risk of colorectal cancer after negative colonoscopy in a Danish gFOBT screening cohort. Int J Cancer 2017; 141:503-511. [PMID: 28463410 DOI: 10.1002/ijc.30756] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 04/19/2017] [Indexed: 01/28/2023]
Abstract
Faecal occult blood test (FOBT) screening for colorectal cancer (CRC) is implemented in several countries. Approximately half of all screen positive persons have negative colonoscopy, but consensus is lacking on how these persons should be followed up. Health authorities in Denmark and The Netherlands recommend suspending screening for 8-10 years, while patients in UK are invited to screening after 2 years. In this cohort-study, we followed 166,277 individuals invited to FOBT-screening in 2005-2006 and a reference group comprising the remaining 1,240,348 Danes of the same age. We linked Danish population and health service registers to obtain information about colonoscopy outcome and incident CRC. We estimated CRC risk by colonoscopy outcome (adenoma, other colorectal pathology or negative colonoscopy) for the reference group, the screening group, and subgroups. Persons with positive screening FOBT followed by negative colonoscopy had the same long-term CRC risk as persons with adenoma detected due to a positive screening FOBT (aHR 1.33, 95% CI: 0.65-2.71). We found no difference in the long-term CRC risk between persons with negative colonoscopy after a positive FOBT screening test and the unscreened reference population (aHR 1.05, 95% CI: 0.62-1.78). Since FOBT screen positive persons in our study remained at average risk of CRC despite of a negative index colonoscopy, we question the safety of suspending FOBT screening for this group. It needs to be monitored whether recent efforts to improve colonoscopy quality have been successful in ensuring low CRC risk after negative colonoscopy also in FOBT positive persons.
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Affiliation(s)
- Andreas Bjerrum
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ole Andersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Elsebeth Lynge
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Abdullah OB, Grand J, Sijapati A, Nimskov P, Nielsen FE, Schmidt JC, Pérez N, Kirkegaard T, Fløjstrup M, Brabrand M, Galthen-Sørensen M, Ramoskiene R, Arshad A, Lassen A, Teglbjærg LS, Andersen O, Jørgensen LM, Sivertsen DM, Kirk JW, Petersen J, Klausen HH, Bodilsen AC, Petersen J, Bandholm T, Haupt T, Sivertsen DM, Andersen O, Hansen CS, Pottegård A, Ekelund U, Forberg JL, Jensen HK, Lassen AT, Madsen JLB, Graumann O, Posth S, Pietersen PI, Konge L, Laursen CB, Madsen JLB, Hansen SN, Jensen KM, Brabrand M, Hasselbalch RB, Pries-Heje M, Ravn L, Lind M, Rasmussen LS, Jensen BN, Havshøj U, Henriksen DP, Brabrand M, Lassen AT, Nygaard HH, Maschmann C, Skjøt-Arkil H, Mogensen CB, Hansen LH, Wittenhoff L, Mogensen CB, Skjøt-Arkil H, Duvald I, Duvald I, Rasmussen LJH, Ladelund S, Haupt TH, Ellekilde G, Eugen-Olsen J, Andersen O, Betzer M, Lyngby R, Elkjær M, Jørgensen C, Brabrand M, Gram B, Pries-Heje MM, Hasselbalch RB, Ravn L, Lind MN, Boel T, Ulriksen PS, Jensen NH, Jensen KM, Mølleskov E, Fog IØ, Kristensen MR, Jensen E. Meeting abstracts from the 7th Danish Emergency Medicine Conference. Scand J Trauma Resusc Emerg Med 2017. [PMCID: PMC5374601 DOI: 10.1186/s13049-017-0364-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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24
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Bjerrum A, Andersen O, Fischer A, Lindebjerg J, Lynge E. Colorectal cancer mortality 10 years after a single round of guaiac faecal occult blood test (gFOBT) screening: experiences from a Danish screening cohort. BMJ Open Gastroenterol 2016; 3:e000120. [PMID: 28074150 PMCID: PMC5174813 DOI: 10.1136/bmjgast-2016-000120] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/03/2016] [Accepted: 10/18/2016] [Indexed: 01/12/2023] Open
Abstract
Background In Denmark, colorectal cancer (CRC) is the third most frequent cancer. Randomised trials have shown that guaiac faecal occult blood test (gFOBT) screening can reduce CRC mortality, but a recent large randomised study from Finland did not find any effect. A feasibility study was carried out in Denmark in 2005–2006 where residents aged 50–74 years in 2 Danish counties were invited once to participate in gFOBT screening. We used the unique Danish registers to assess the impact of gFOBT screening in this group on CRC incidence and mortality. Methods In this cohort study, we followed a group comprising 166 277 individuals invited to screening and a reference group comprising the remaining 1 240 348 Danes of the same age. We linked the Danish population and health service registers to obtain information about colonoscopies, polypectomies, incident CRC and cause of death. Results After a median follow-up time of 8.9 years, the CRC mortality was significantly lower in the screening group than in the reference group with an adjusted HR (aHR) of 0.92 (95% CI 0.86 to 0.99), while the aHR for all-cause mortality was 0.95 (95% CI 0.94 to 0.96). For screening participants, the aHR for CRC mortality and all-cause mortality was 0.72 (0.64 to 0.80) and 0.59 (0.57 to 0.60), respectively. Conclusions About 10 years after a single round of gFOBT screening, we found a significant 8% deficit in CRC mortality in the screening group compared with other Danes. We found almost the same deficit in all-cause mortality, and on this basis, it is not possible to conclude that one screening round had an effect on CRC mortality. Our study indicated that close monitoring of the outcome of CRC screening is warranted.
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Affiliation(s)
- Andreas Bjerrum
- Department of Public Health , University of Copenhagen , Copenhagen K , Denmark
| | - Ole Andersen
- Department of Public Health , University of Copenhagen , Copenhagen K , Denmark
| | - Anders Fischer
- Copenhagen University Hospital Herlev , Herlev , Denmark
| | - Jan Lindebjerg
- Department of Pathology , Vejle Hospital , Vejle , Denmark
| | - Elsebeth Lynge
- Department of Public Health , University of Copenhagen , Copenhagen K , Denmark
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Andersen O, Aaseth J. A review of pitfalls and progress in chelation treatment of metal poisonings. J Trace Elem Med Biol 2016; 38:74-80. [PMID: 27150911 DOI: 10.1016/j.jtemb.2016.03.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 03/14/2016] [Accepted: 03/17/2016] [Indexed: 01/31/2023]
Abstract
Most acute and chronic human metal poisonings are due to oral or inhalation exposure. Almost 80% of published animal experiments on chelation in metal poisoning used single or repeated intraperitoneal, intramuscular or intravenous administration of metal and chelator, impeding extrapolation to clinical settings. Intramuscular administration of dimercaptopropanol (BAL) has until now been used in acute arsenic, lead, and mercury poisonings, but repeated BAL administration increased the brain uptake of As, Pb and Hg in experimental animals. Also, diethyl dithiocarbamate (DDC) has been used as antidote in acute experimental animal parenteral Cd poisoning, and both DDC and tetraethylthiuram disulfide (TTD, disulfiram, Antabuse) have been used in nickel allergic patients. However, even one dose of DDC given immediately after oral Cd or Ni increased their brain uptake considerably. The calcium salt of ethylenediamminetetraacetic acid (CaEDTA) but not dimercaptosuccinic acid (DMSA) increased the brain uptake of Pb. In oral Cd or Hg poisoning, early oral administration of DMSA or dimercaptopropane sulfonate (DMPS) increased survival and reduced intestinal metal uptake. Oral administration of Prussian Blue or resins with fixed chelating groups that are not absorbed offer chelation approaches for decorporation after oral exposure to various metals. Diethylenetriaminepentaacetic acid (DTPA) nebulizers for pulmonary chelation after inhalation exposure need further development. Also, combined chelation with more than one compound may offer extensive advances. Solid knowledge on the chemistry of metal chelates together with relevant animal experiments should guide development of chelation procedures to alleviate and not aggravate the clinical status of poisoned patients.
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Affiliation(s)
- Ole Andersen
- Roskilde University, Roskilde, Denmark, Denmark.
| | - Jan Aaseth
- Innlandet Hospital Trust and Hedmark University College, Elverum, Norway, Norway
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26
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Sundal C, Vedeler C, Miletic H, Andersen O. Morvan syndrome with Caspr2 antibodies. Clinical and autopsy report. J Neurol Sci 2016; 372:453-455. [PMID: 27802867 DOI: 10.1016/j.jns.2016.10.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/24/2016] [Accepted: 10/26/2016] [Indexed: 12/01/2022]
Affiliation(s)
- C Sundal
- Section of Clinical Neuroscience, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Sweden
| | - C Vedeler
- Department of Neurology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - H Miletic
- Department of Pathology, Haukeland University Hospital, Bergen, Norway; Department of Biomedicine, University of Bergen, Bergen, Norway
| | - O Andersen
- Section of Clinical Neuroscience, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Sweden.
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Tavenier J, Haupt T, Andersen A, Buhl S, Langkilde A, Andersen J, Jensen JE, Pedersen M, Petersen J, Andersen O. MON-P041: Nutritional Support During Hospitalization is Associated with an Earlier Decrease in Inflammation in Acutely Ill Older Medical Patients with SIRS. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30675-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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28
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Celius EG, Rocca M, Andersen O. Preface. Acta Neurol Scand 2016; 134 Suppl 200:3. [PMID: 27580898 DOI: 10.1111/ane.12653] [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] [Accepted: 07/07/2016] [Indexed: 11/28/2022]
Affiliation(s)
- E G Celius
- Department of Neurology, Oslo University Hospital and Institute of Health and Society, University of Oslo, Oslo, Norway
| | - M Rocca
- Division of Neuroscience, Institute of Experimental Neurology, Hospital San Raffaele, University of Milan, Milan, Italy
| | - O Andersen
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Callander M, Haghighi S, Landtblom AM, Ahlgren CE, Nilsson SI, Rydberg L, Al Khoury H, Rosegren L, Andersen O. Multiple sclerosis immunopathic trait and HLA-DR(2)15 as independent risk factors in multiple sclerosis. Mult Scler 2016; 13:441-5. [PMID: 17463066 DOI: 10.1177/1352458506070264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We analysed HLA haplotypes in pairs of 78 sporadic multiple sclerosis (MS) patients and 78 healthy siblings. The presence of 2 oligoclonal IgG bands, detected by immunoblotting of the cerebrospinal fluid in healthy siblings, has previously been defined as MS immunopathic trait (MSIT), based on a cut-off derived from healthy unrelated volunteers. The frequency of MSIT was 17.9% (n=14/78 siblings). The HLA-DR(15)2 allelle was present in 21.4% (n=3/14) of the siblings with MSIT, in 40.6% (n =26/64) of the siblings without MSIT, and in 59% (n =46/78) of the patients with clinically-definite (CD) MS. The distribution of zero, one or two HLA-DR(2)15 alleles was significantly skewed towards a lower allelle count in the siblings with MSIT compared with the group of unrelated siblings with MS (P=0.002), and also lower than their related siblings with MS (P=0.1). These results suggest that the MS susceptibility gene, HLA-DR(2)15 type, does not induce MSIT, and conceivably these are two separate risk factors in the development of MS. The effect of HLA-DR(2)15 and MSIT in sporadic MS appears to be synergistic. Multiple Sclerosis 2007; 13: 441-445. http://msj.sagepub.com
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Affiliation(s)
- M Callander
- Department of Neurology, University Hospital, Linköping, Sweden.
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30
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Haghighi S, Andersen O, Nilsson S, Rydberg L, Wahlström J. A linkage study in two families with multiple sclerosis and healthy members with oligoclonal CSF immunopathy. Mult Scler 2016; 12:723-30. [PMID: 17262999 DOI: 10.1177/1352458506070972] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
We studied two extended families in which not only multiple sclerosis (MS) segregates, but also approximately 18% of the cerebrospinal fluid (CSF) investigated blood relatives have ‘MS immunopathic trait’, an oligoclonal CSF immunopathy similar to that seen in MS, but with no neurological symptoms. Both families fit a genetic model for autosomal dominant inheritance for MS immunopathic trait, although with reduced penetrance in family A. In order to identify genetic factors of importance for the development of MS immunopathic trait, we performed a genome scan using the CHLC/Weber Screening Set (ver 6A), with 285 successful markers, to test the hypothesis that a single gene is causing the MS immunopathic trait in these families. Using a parametric method, we identified regions with suggestive linkage at chromosome 6q12 with a LOD-score of 2.4, putative linkage with LOD-score 1.5 at chromosome 6p21 (HLA region), putative linkage at chromosome 12q24 with a LOD-score of 1.7 and suggestive linkage at chromosome 19q13.2 with a LOD-score of 1.8. The LOD-score at chromosome 19q13.2 increased to 2.2 when only family A was analysed. In family A, all MS patients and two of five individuals with MS immunopathic trait had HLA DRB1*(15) and in family B, all blood relatives had the rare HLA type DRB1*0103, which is associated with other autoimmune diseases. We suggest that DRB1*0103 is a necessary but not sufficient condition for the susceptibility for MS immunopathic trait in this family.
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Affiliation(s)
- S Haghighi
- Institute of Clinical Neuroscience, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
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Abstract
A study was performed to investigate the morphological expression of the inherited syndrome “complex vertebral malformation” (CVM) in Holstein calves. A total of 107 late-term aborted, premature, or neonatal calves suspected of having CVM were necropsied and retrospectively analyzed for the causal mutation in the gene SLC35A3. Sixty-two calves were homozygous affected, 16 were heterozygous, and 29 were homozygous normal. Calves affected by CVM were growth retarded. Vertebral lesions identified by radiography were present in 61 cases, of which 58 also had costal malformation. Malformation of the head, primarily in the form of dysplasia or palatoschisis, was present in 15 cases. Bilateral symmetric flexion of the carpal and metacarpophalangeal joints was present in all cases, whereas posterior arthrogryposis was found in 54 cases. Interventricular septal defects occurred in 33 calves, often in combination with other cardiac malformations. A wide spectrum of additional malformations was found. Other congenital syndromes were in most cases distinguishable from CVM on a morphological basis. However, a calf with a prenatal infection with bovine virus diarrhea virus constituted a phenocopy. The study demonstrated that the morphological expression of CVM is wide, but certain aspects, i.e., growth retardation, vertebral malformation, and symmetric arthrogryposis, are almost constant findings. However, cases without vertebral defects and phenocopies constitute a diagnostic problem. A presumptive diagnosis of CVM can in most cases be based on necropsy findings combined with information on descent and paternal CVM genotype, whereas a definitive diagnosis requires genotyping.
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Affiliation(s)
- Jorgen S Agerholm
- Department of Veterinary Pathobiology and Clinical Studies, Royal Veterinary and Agricultural University, Bulowsvej 17, DK-1870 Frederiksberg C, Denmark
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Abstract
After the release of a report from France on the occurrence of malformed calves genetically related to a Holstein sire, a study was performed to characterize the defect. Danish breeders were encouraged to submit defective progeny of the sire for laboratory examination. Four cases were submitted, whereas a fifth case was only reported. Lesions in affected calves were analogous, with disproportionate growth retardation characterized by fascial dysplasia and shortening of the vertebral column and the abaxial skeleton. Endochondral osteogenesis was disturbed with disorganization of epiphyseal plate chondrocytes, a lesion consistent with generalized chondrodysplasia. Based on morphology, the defect was grouped as a “Dexter bulldog type”. A genetic etiology was suspected as cases occurred in a familial pattern. Genealogical evaluation revealed several common ancestors belonging to widely used breeding lines of US Holstein, but because of the extensive use of these sires, their presence in the pedigrees of affected calves might be accidental. Further studies are needed to determine the mode of inheritance.
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Affiliation(s)
- Jorgen S Agerholm
- Laboratory of Veterinary Pathology, Department of Pharmacology and Pathobiology, Royal Veterinary and Agricultural University, Bülowsvej, Frederiksberg C, Denmark
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Cross JB, Zhang J, Yang Q, Mesleh MF, Romero JAC, Wang B, Bevan D, Poutsiaka KM, Epie F, Moy T, Daniel A, Shotwell J, Chamberlain B, Carter N, Andersen O, Barker J, Ryan MD, Metcalf CA, Silverman J, Nguyen K, Lippa B, Dolle RE. Discovery of Pyrazolopyridones as a Novel Class of Gyrase B Inhibitors Using Structure Guided Design. ACS Med Chem Lett 2016; 7:374-8. [PMID: 27096044 DOI: 10.1021/acsmedchemlett.5b00368] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 02/06/2016] [Indexed: 12/20/2022] Open
Abstract
The ATPase subunit of DNA gyrase B is an attractive antibacterial target due to high conservation across bacteria and the essential role it plays in DNA replication. A novel class of pyrazolopyridone inhibitors was discovered by optimizing a fragment screening hit scaffold using structure guided design. These inhibitors show potent Gram-positive antibacterial activity and low resistance incidence against clinically important pathogens.
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Affiliation(s)
- Jason B. Cross
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Jing Zhang
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Qingyi Yang
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Michael F. Mesleh
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | | | - Bin Wang
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Doug Bevan
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Katherine M. Poutsiaka
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Felix Epie
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Terence Moy
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Anu Daniel
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Joseph Shotwell
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Brian Chamberlain
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Nicole Carter
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Ole Andersen
- Evotec U.K., Ltd., 114 Innovation
Drive, Milton Park, Abingdon, Oxfordshire OX14 4RZ, United Kingdom
| | - John Barker
- Evotec U.K., Ltd., 114 Innovation
Drive, Milton Park, Abingdon, Oxfordshire OX14 4RZ, United Kingdom
| | - M. Dominic Ryan
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Chester A. Metcalf
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Jared Silverman
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Kien Nguyen
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Blaise Lippa
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
| | - Roland E. Dolle
- Cubist Pharmaceuticals, Inc., 65 Hayden Avenue, Lexington, Massachusetts 02421, United States
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Trac LN, Andersen O, Palmqvist A. Deciphering mechanisms of malathion toxicity under pulse exposure of the freshwater cladoceran Daphnia magna. Environ Toxicol Chem 2016; 35:394-404. [PMID: 26419489 DOI: 10.1002/etc.3189] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/07/2015] [Accepted: 07/30/2015] [Indexed: 06/05/2023]
Abstract
The organophosphate pesticide (OP) malathion is highly toxic to freshwater invertebrates, including the cladoceran Daphnia magna, a widely used test organism in ecotoxicology. To assess whether toxic effects of malathion are driven primarily by exposure concentration or exposure duration, D. magna was pulse exposed to equivalent integrated doses (duration × concentration): 3 h × 16 μg/L, 24 h × 2 μg/L, and 48 h × 1 μg/L. After recovery periods of 3 h, 24 h, and 48 h, the toxicity of malathion on different biological levels in D. magna was examined by analyzing the following endpoints: survival and immobilization; enzyme activities of acetylcholinesterase (AChE), carboxylesterase (CbE), and glutathione S-transferase (GST); and AChE gene expression. The results showed no difference in survival among equivalent integrated doses. Adverse sublethal effects were driven by exposure concentration rather than pulse duration. Specifically, short pulse exposure to a high concentration of malathion resulted in more immobilized daphnids, lower AChE and CbE activities, and a higher transcript level of AChE gene compared with long pulse exposure to low concentration. The expression of the AChE gene was up-regulated, indicating a compensatory mechanism to cope with enzyme inhibition. The study shows the need for obtaining a better understanding of the processes underlying toxicity under realistic exposure scenarios, so this can be taken into account in environmental risk assessment of pesticides.
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Affiliation(s)
- Lam Ngoc Trac
- Department of Environmental, Social and Spatial Change, Roskilde University, Roskilde, Denmark
| | - Ole Andersen
- Department of Nature, Systems and Models, Roskilde University, Roskilde, Denmark
| | - Annemette Palmqvist
- Department of Environmental, Social and Spatial Change, Roskilde University, Roskilde, Denmark
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35
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Granberg T, Hashim F, Andersen O, Sundal C, Karrenbauer VD. Hereditary diffuse leukoencephalopathy with spheroids - a volumetric and radiological comparison with multiple sclerosis patients and healthy controls. Eur J Neurol 2016; 23:817-22. [DOI: 10.1111/ene.12948] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 11/13/2015] [Indexed: 02/02/2023]
Affiliation(s)
- T. Granberg
- Division of Medical Imaging and Technology; Department of Clinical Science; Intervention and Technology; Karolinska Institutet; Stockholm Sweden
- Department of Radiology; Karolinska University Hospital; Stockholm Sweden
| | - F. Hashim
- Division of Medical Imaging and Technology; Department of Clinical Science; Intervention and Technology; Karolinska Institutet; Stockholm Sweden
- Department of Radiology; Karolinska University Hospital; Stockholm Sweden
| | - O. Andersen
- The Sahlgrenska Academy; Department of Neuroscience and Physiology; Section of Clinical Neuroscience and Rehabilitation; University of Gothenburg; Gothenburg Sweden
| | - C. Sundal
- The Sahlgrenska Academy; Department of Neuroscience and Physiology; Section of Clinical Neuroscience and Rehabilitation; University of Gothenburg; Gothenburg Sweden
- Department of Neurology; Haukeland University Hospital; Bergen Norway
| | - V. D. Karrenbauer
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
- Department of Neurology; Karolinska University Hospital; Stockholm Sweden
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Treldal C, Jacobsen CB, Mogensen S, Rasmussen M, Jacobsen J, Petersen J, Lynge Pedersen AM, Andersen O. Effect of a local anesthetic lozenge in relief of symptoms in burning mouth syndrome. Oral Dis 2016; 22:123-31. [DOI: 10.1111/odi.12386] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 09/26/2015] [Accepted: 10/23/2015] [Indexed: 11/28/2022]
Affiliation(s)
- C Treldal
- Clinical Research Centre; Copenhagen University Hospital; Hvidovre Denmark
| | - CB Jacobsen
- Clinical Research Centre; Copenhagen University Hospital; Hvidovre Denmark
| | - S Mogensen
- Clinical Research Centre; Copenhagen University Hospital; Hvidovre Denmark
| | - M Rasmussen
- Clinical Research Centre; Copenhagen University Hospital; Hvidovre Denmark
| | - J Jacobsen
- Section for Pharmaceutical Design and Drug Delivery; Department of Pharmacy; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - J Petersen
- Clinical Research Centre; Copenhagen University Hospital; Hvidovre Denmark
| | - AM Lynge Pedersen
- Section for Oral Medicine, Clinical Oral Physiology, Oral Pathology and Anatomy; Department of Odontology; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - O Andersen
- Clinical Research Centre; Copenhagen University Hospital; Hvidovre Denmark
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Andersen O. Nordic MS Epidemiology. Introduction. Acta Neurol Scand 2015; 132:1-3. [PMID: 26046551 DOI: 10.1111/ane.12423] [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: 11/29/2022]
Affiliation(s)
- O. Andersen
- Section of Clinical Neuroscience and Rehabilitation; Institute of Neuroscience and Physiology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Andersen O. Conclusion: National incidence and risk factor assessments may become a basis for the evaluation of prevention trials – prospects from the Third Nordic MS Symposium. Acta Neurol Scand 2015; 132:71-5. [PMID: 26046562 DOI: 10.1111/ane.12434] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2015] [Indexed: 11/29/2022]
Abstract
This symposium started with an overview of recent incidence and prevalence data from the Scandinavian national registers and continued with a critical analysis of several alleged risk factors for MS. These risk factors are constantly changing and therefore might explain current incidence changes. In addition, they may be the subject of preventive measures.
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Affiliation(s)
- O. Andersen
- Section of Clinical Neuroscience and Rehabilitation; Institute of Neuroscience and Physiology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Andersen O. Stone Walls as a Means of Understanding the Different Types of Reindeer Herding: A Study from the Lule Sami Area on the Norwegian Side of the Border. Arctic Anthropology 2015. [DOI: 10.3368/aa.51.2.23] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mogensen S, Sveindottir K, Treldal C, Nygaard A, Mohammad A, Kristensen C, Petersen J, Andersen O. PO-124: New local anesthetic lozenge induces no risk of aspiration in healthy subjects and head/neck cancer patients. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34884-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Jons D, Sundström P, Andersen O. Targeting Epstein-Barr virus infection as an intervention against multiple sclerosis. Acta Neurol Scand 2015; 131:69-79. [PMID: 25208981 DOI: 10.1111/ane.12294] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2014] [Indexed: 12/25/2022]
Abstract
We here review contemporary data on genetic and environmental risk factors, particularly Epstein-Barr virus infection, for multiple sclerosis. There is an important immunogenetic etiological factor for multiple sclerosis. However, a general assumption is that immune defense genes are activated by the environment, basically by infections. We contend that the relationship between infectious mononucleosis and multiple sclerosis cannot be completely explained by genetics and inverse causality. Epstein-Barr infection as indicated by positive serology is an obligatory precondition for multiple sclerosis, which is a stronger attribute than a risk factor only. Data on events in the early pathogenesis of multiple sclerosis are cumulating from bio-banks with presymptomatic specimens, but there is only little information from the critical age when Epstein-Barr infection including infectious mononucleosis is acquired, nor on the detailed immunological consequences of this infection in individuals with and without multiple sclerosis. We discuss how focused bio-banking may elaborate a rationale for the development of treatment or vaccination against Epstein-Barr virus infection. A cohort in which intervention against Epstein-Barr infections was performed should be the object of neurological follow-up.
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Affiliation(s)
- D. Jons
- Section of Clinical Neuroscience and Rehabilitation; Institution of Neuroscience and Physiology; the Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - P. Sundström
- Section of Neurology; Department of Pharmacology and Clinical Neuroscience; University of Umeå; Umeå Sweden
| | - O. Andersen
- Section of Clinical Neuroscience and Rehabilitation; Institution of Neuroscience and Physiology; the Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Poulsen SS, Saber AT, Mortensen A, Szarek J, Wu D, Williams A, Andersen O, Jacobsen NR, Yauk CL, Wallin H, Halappanavar S, Vogel U. Changes in cholesterol homeostasis and acute phase response link pulmonary exposure to multi-walled carbon nanotubes to risk of cardiovascular disease. Toxicol Appl Pharmacol 2015; 283:210-22. [PMID: 25620056 DOI: 10.1016/j.taap.2015.01.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 01/07/2015] [Accepted: 01/12/2015] [Indexed: 10/24/2022]
Abstract
Adverse lung effects following pulmonary exposure to multi-walled carbon nanotubes (MWCNTs) are well documented in rodents. However, systemic effects are less understood. Epidemiological studies have shown increased cardiovascular disease risk after pulmonary exposure to airborne particles, which has led to concerns that inhalation exposure to MWCNTs might pose similar risks. We analyzed parameters related to cardiovascular disease, including plasma acute phase response (APR) proteins and plasma lipids, in female C57BL/6 mice exposed to a single intratracheal instillation of 0, 18, 54 or 162μg/mouse of small, entangled (CNTSmall, 0.8±0.1μm long) or large, thick MWCNTs (CNTLarge, 4±0.4μm long). Liver tissues and plasma were harvested 1, 3 and 28days post-exposure. In addition, global hepatic gene expression, hepatic cholesterol content and liver histology were used to assess hepatic effects. The two MWCNTs induced similar systemic responses despite their different physicochemical properties. APR proteins SAA3 and haptoglobin, plasma total cholesterol and low-density/very low-density lipoprotein were significantly increased following exposure to either MWCNTs. Plasma SAA3 levels correlated strongly with pulmonary Saa3 levels. Analysis of global gene expression revealed perturbation of the same biological processes and pathways in liver, including the HMG-CoA reductase pathway. Both MWCNTs induced similar histological hepatic changes, with a tendency towards greater response following CNTLarge exposure. Overall, we show that pulmonary exposure to two different MWCNTs induces similar systemic and hepatic responses, including changes in plasma APR, lipid composition, hepatic gene expression and liver morphology. The results link pulmonary exposure to MWCNTs with risk of cardiovascular disease.
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Affiliation(s)
- Sarah S Poulsen
- National Research Centre for the Working Environment, DK-2100 Copenhagen, Denmark; Department of Science, Systems and Models, Roskilde University, DK-4000 Roskilde, Denmark.
| | - Anne T Saber
- National Research Centre for the Working Environment, DK-2100 Copenhagen, Denmark.
| | - Alicja Mortensen
- National Food Institute, Technical University of Denmark, Søborg, Denmark.
| | - Józef Szarek
- Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland.
| | - Dongmei Wu
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario K1A 0K9, Canada.
| | - Andrew Williams
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario K1A 0K9, Canada.
| | - Ole Andersen
- Department of Science, Systems and Models, Roskilde University, DK-4000 Roskilde, Denmark.
| | - Nicklas R Jacobsen
- National Research Centre for the Working Environment, DK-2100 Copenhagen, Denmark.
| | - Carole L Yauk
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario K1A 0K9, Canada.
| | - Håkan Wallin
- National Research Centre for the Working Environment, DK-2100 Copenhagen, Denmark; Department of Public Health, University of Copenhagen, DK-1014 Copenhagen K, Denmark.
| | - Sabina Halappanavar
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario K1A 0K9, Canada.
| | - Ulla Vogel
- National Research Centre for the Working Environment, DK-2100 Copenhagen, Denmark; Department of Micro- and Nanotechnology, Technical University of Denmark, DK-2800 Kgs. Lyngby, Denmark.
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Cao Y, Skaug MA, Andersen O, Aaseth J. Chelation therapy in intoxications with mercury, lead and copper. J Trace Elem Med Biol 2015; 31:188-92. [PMID: 24894443 DOI: 10.1016/j.jtemb.2014.04.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/22/2014] [Accepted: 04/23/2014] [Indexed: 11/15/2022]
Abstract
In the present review we provide an update of the appropriate use of chelating agents in the treatment of intoxications with compounds of mercury, lead and copper. The relatively new chelators meso-2,3-dimercaptosuccinic acid (DMSA) and 2,3-dimercapto-propanesulphonate (DMPS) can effectively mobilize deposits of mercury as well as of lead into the urine. These drugs can be administered orally and have relatively low toxicity compared to the classical antidote dimercaptopropanol (BAL). d-Penicillamine has been widely used in copper overload, although 2,3-dimercaptosuccinic acid or tetrathiomolybdate may be more suitable alternatives today. In copper-toxicity, a free radical scavenger might be recommended as adjuvant to the chelator therapy.
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Affiliation(s)
- Yang Cao
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marit Aralt Skaug
- Faculty of Public Health, Hedmark University College, Elverum, Norway.
| | - Ole Andersen
- Department of Science, Systems and Models, Roskilde University, Roskilde, Denmark
| | - Jan Aaseth
- Innlandet Hospital Trust, Kongsvinger Hospital Division, Kongsvinger, Norway
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Abstract
The present review provides an update of the general principles for the investigation and use of chelating agents in the treatment of intoxications by metals. The clinical use of the old chelators EDTA (ethylenediamine tetraacetate) and BAL (2,3-dimercaptopropanol) is now limited due to the inconvenience of parenteral administration, their own toxicity and tendency to increase the neurotoxicity of several metals. The hydrophilic dithiol chelators DMSA (meso-2,3-dimercaptosuccinic acid) and DMPS (2,3-dimercapto-propanesulphonate) are less toxic and more efficient than BAL in the clinical treatment of heavy metal poisoning, and available as capsules for oral use. In copper overload, DMSA appears to be a potent antidote, although d-penicillamine is still widely used. In the chelation of iron, the thiols are inefficient, since iron has higher affinity for ligands with nitrogen and oxygen, but the new oral iron antidotes deferiprone and desferasirox have entered into the clinical arena. Comparisons of these agents and deferoxamine infusions are in progress. General principles for research and development of new chelators are briefly outlined in this review.
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Affiliation(s)
- Jan Aaseth
- Innlandet Hospital Trust, Kongsvinger Hospital Division, Kongsvinger, Norway
| | - Marit Aralt Skaug
- Faculty of Public Health, Hedmark University College, 2418 Elverum, Norway.
| | - Yang Cao
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ole Andersen
- Department of Science, Systems and Models, Roskilde University, Roskilde, Denmark
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Andersen O, Gasda SE, Nilsen HM. Vertically Averaged Equations with Variable Density for $$\hbox {CO}_2$$ CO 2 Flow in Porous Media. Transp Porous Media 2014. [DOI: 10.1007/s11242-014-0427-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Press R, Askmark H, Svenningsson A, Andersen O, Axelson HW, Strömberg U, Wahlin A, Isaksson C, Johansson JEJ, Hägglund H. Autologous haematopoietic stem cell transplantation: a viable treatment option for CIDP. J Neurol Neurosurg Psychiatry 2014; 85:618-24. [PMID: 24262917 DOI: 10.1136/jnnp-2013-306014] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Only 70-80% of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) respond satisfactorily to the established first-line immunomodulatory treatments. Autologous haematopoietic stem cell transplantation (AHSCT) has been performed as a last treatment resort in a few therapy-refractory cases with CIDP. We describe the results of AHSCT in 11 consecutive Swedish patients with therapy-refractory CIDP with a median follow-up time of 28 months. METHOD Case data were gathered retrospectively for AHSCT treatments in 11 patients with CIDP refractory to the first-line immunomodulatory treatments, intravenous high-dose immunoglobulin, corticosteroids and plasma exchange and to one or more second-line treatments used in 10 of the 11 patients. RESULTS The median Inflammatory Neuropathy Cause and Treatment (INCAT) score within 1 month prior to AHSCT was 6 and the Rankin score 4. Total INCAT and Rankin scores improved significantly within 2-6 months after AHSCT and continued to do so at last follow-up. The motor action potential amplitudes (CMAP) improved already within 4 months (median) after AHSCT. Three of the 11 patients relapsed during the follow-up period, requiring retransplantation with AHSCT in one. Eight of the 11 patients maintained drug-free remission upon last follow-up. AHSCT was safe but on the short term associated with a risk of cytomegalovirus (CMV) and Epstein-Barr virus reactivation, CMV disease, haemorrhagic cystitis and pancreatitis. CONCLUSIONS Our results though hampered by the limited number of patients and the lack of a control group suggest AHSCT to be efficacious in therapy-refractory CIDP, with a manageable complication profile. Confirmation of these results is necessary through randomised controlled trials.
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Affiliation(s)
- R Press
- Department of Neurology, Clinical Neuroscience, Karolinska Institutet, Karolinska University Hospital Huddinge, , Stockholm, Huddinge, Sweden
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Søs Poulsen S, Jacobsen NR, Labib S, Wu D, Husain M, Williams A, Bøgelund JP, Andersen O, Købler C, Mølhave K, Kyjovska ZO, Saber AT, Wallin H, Yauk CL, Vogel U, Halappanavar S. Transcriptomic analysis reveals novel mechanistic insight into murine biological responses to multi-walled carbon nanotubes in lungs and cultured lung epithelial cells. PLoS One 2013; 8:e80452. [PMID: 24260392 PMCID: PMC3834097 DOI: 10.1371/journal.pone.0080452] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 10/03/2013] [Indexed: 12/22/2022] Open
Abstract
There is great interest in substituting animal work with in vitro experimentation in human health risk assessment; however, there are only few comparisons of in vitro and in vivo biological responses to engineered nanomaterials. We used high-content genomics tools to compare in vivo pulmonary responses of multiwalled carbon nanotubes (MWCNT) to those in vitro in cultured lung epithelial cells (FE1) at the global transcriptomic level. Primary size, surface area and other properties of MWCNT- XNRI -7 (Mitsui7) were characterized using DLS, SEM and TEM. Mice were exposed via a single intratracheal instillation to 18, 54, or 162 μg of Mitsui7/mouse. FE1 cells were incubated with 12.5, 25 and 100 μg/ml of Mitsui7. Tissue and cell samples were collected at 24 hours post-exposure. DNA microarrays were employed to establish mechanistic differences and similarities between the two models. Microarray results were confirmed using gene-specific RT-qPCR. Bronchoalveolar lavage (BAL) fluid was assessed for indications of inflammation in vivo. A strong dose-dependent activation of acute phase and inflammation response was observed in mouse lungs reflective mainly of an inflammatory response as observed in BAL. In vitro, a wide variety of core cellular functions were affected including transcription, cell cycle, and cellular growth and proliferation. Oxidative stress, fibrosis and inflammation processes were altered in both models. Although there were similarities observed between the two models at the pathway-level, the specific genes altered under these pathways were different, suggesting that the underlying mechanisms of responses are different in cells in culture and the lung tissue. Our results suggest that careful consideration should be given in selecting relevant endpoints when substituting animal with in vitro testing.
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Affiliation(s)
- Sarah Søs Poulsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Science, Systems and Models, Roskilde University, Roskilde, Denmark
| | | | - Sarah Labib
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Dongmei Wu
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Mainul Husain
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Andrew Williams
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | | | - Ole Andersen
- Department of Science, Systems and Models, Roskilde University, Roskilde, Denmark
| | - Carsten Købler
- Department of Micro- and Nanotechnology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Kristian Mølhave
- Department of Micro- and Nanotechnology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Zdenka O. Kyjovska
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Anne T. Saber
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Håkan Wallin
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Carole L. Yauk
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Ulla Vogel
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Micro- and Nanotechnology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Sabina Halappanavar
- Environmental and Radiation Health Sciences Directorate, Health Canada, Ottawa, Ontario, Canada
- * E-mail:
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Bobe K, Willbold E, Morgenthal I, Andersen O, Studnitzky T, Nellesen J, Tillmann W, Vogt C, Vano K, Witte F. In vitro and in vivo evaluation of biodegradable, open-porous scaffolds made of sintered magnesium W4 short fibres. Acta Biomater 2013; 9:8611-23. [PMID: 23542554 DOI: 10.1016/j.actbio.2013.03.035] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 02/23/2013] [Accepted: 03/22/2013] [Indexed: 11/27/2022]
Abstract
A cytocompatible and biocompatible, degradable, open-porous, mechanically adaptable metal scaffold made of magnesium alloy W4 melt-extracted short fibres was fabricated by liquid phase sintering. Cylindrical samples (3×5 mm) of sintered W4 short fibres were evaluated under in vitro (L929, HOB, eudiometer, weight loss) and in vivo conditions (rabbits: 6 and 12 weeks). The in vitro corrosion environment (e.g., temperature, flow, composition of corrosion solution, exposure time) significantly influenced the corrosion rates of W4 scaffolds compared with corrosion in vivo. Corrosion rates under cell culture conditions for 72 h varied from 1.05 to 3.43 mm y(-1) depending on the media composition. Corrosion rates measured in eudiometric systems for 24 h were ~24-27 times higher (3.88-4.43 mm y(-1)) than corrosion in vivo after 6 weeks (0.16 mm y(-1)). Moreover, it was found that the cell culture media composition significantly influences the ionic composition of the extract by selectively dissolving ions from W4 samples or their corrosion products. A pilot in vivo study for 6 and 12 weeks demonstrated active bone remodelling, no foreign body reaction and no clinical observation of gas formation during W4 scaffold implantation. Long-term in vivo studies need to be conducted to prove complete degradation of the W4 scaffold and total replacement by the host tissue.
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Herasimtschuk AA, Hansen BR, Langkilde A, Moyle GJ, Andersen O, Imami N. Low-dose growth hormone for 40 weeks induces HIV-1-specific T cell responses in patients on effective combination anti-retroviral therapy. Clin Exp Immunol 2013; 173:444-53. [PMID: 23701177 DOI: 10.1111/cei.12141] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2013] [Indexed: 12/22/2022] Open
Abstract
Recombinant human growth hormone (rhGH) administered to combination anti-retroviral therapy (cART)-treated human immunodeficiency virus-1 (HIV-1)-infected individuals has been found to reverse thymic involution, increase total and naive CD4 T cell counts and reduce the expression of activation and apoptosis markers. To date, such studies have used high, pharmacological doses of rhGH. In this substudy, samples from treated HIV-1(+) subjects, randomized to receive either a physiological dose (0·7 mg) of rhGH (n = 21) or placebo (n = 15) daily for 40 weeks, were assessed. Peptide-based enzyme-linked immunospot (ELISPOT) assays were used to enumerate HIV-1-specific interferon (IFN)-γ-producing T cells at baseline and week 40. Individuals who received rhGH demonstrated increased responses to HIV-1 Gag overlapping 20mer and Gag 9mer peptide pools at week 40 compared to baseline, whereas subjects who received placebo showed no functional changes. Subjects with the most robust responses in the ELISPOT assays had improved thymic function following rhGH administration, as determined using CD4(+) T cell receptor rearrangement excision circle (TREC ) and thymic density data from the original study. T cells from these robust responders were characterized further phenotypically, and showed decreased expression of activation and apoptosis markers at week 40 compared to baseline. Furthermore, CD4 and CD8 T cell populations were found to be shifted towards an effector and central memory phenotype, respectively. Here we report that administration of low-dose rhGH over 40 weeks with effective cART resulted in greater improvement of T lymphocyte function than observed with cART alone, and provide further evidence that such an approach could also reduce levels of immune activation.
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Andersen O. Carcinoma of the Fifth Toe: Report of Two Cases. Acta Radiol 2013. [DOI: 10.1177/028418515504400109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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