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Petersen JF, Friis-Hansen LJ, Bryndorf T, Jensen AK, Andersen AN, Løkkegaard E. A Novel Approach to Predicting Early Pregnancy Outcomes Dynamically in a Prospective Cohort Using Repeated Ultrasound and Serum Biomarkers. Reprod Sci 2023; 30:3597-3609. [PMID: 37640889 PMCID: PMC10692000 DOI: 10.1007/s43032-023-01323-8] [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: 05/15/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Abstract
This study aimed to develop a dynamic model for predicting outcome during the first trimester of pregnancy using baseline demographic data and serially collected blood samples and transvaginal sonographies. A prospective cohort of 203 unselected women with an assumed healthy pregnancy of < 8 weeks' gestation was followed fortnightly from 4-14 weeks' gestation until either miscarriage or confirmed first trimester viability. The main outcome was development of a model to predict outcome from gestational age-dependent hazard ratios using both baseline and updated serial data from each visit. Secondary outcomes were descriptions of risk factors for miscarriage. The results showed that 18% of the women experienced miscarriages. A fetal heart rate detected before 8 weeks' gestation indicated a 90% (95% CI 85-95%) chance of subsequent delivery. Maternal age (≥ 35 years), insufficient crown-rump-length (CRL) and mean gestational sac diameter (MSD) development, and presence of bleeding increased the risk of miscarriage. Serum biomarkers, including hCG, progesterone, and estradiol, were found to impact the risk of miscarriage with estradiol as the most important. The best model to predict miscarriage was a combination of maternal age, vaginal bleeding, CRL, and hCG. The second-best model was the sonography-absent model of maternal age, bleeding, hCG, and estradiol. This study suggests that combining maternal age, and evolving data from hCG, estradiol, CRL, and bleeding could be used to predict fetal outcome during the first trimester of pregnancy.Trial registration ClinicalTrials.gov identifier: NCT02761772.
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Affiliation(s)
| | | | - Thue Bryndorf
- Gynecological Clinic, 10, 3, Ny Østergade, 1101, Copenhagen, Denmark
| | - Andreas Kryger Jensen
- Section of Biostatistics, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Research, North Zealand Hospital, Hillerød, Denmark
| | - Anders Nyboe Andersen
- The Fertility Clinic 4071, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Ellen Løkkegaard
- Department of Obstetrics and Gynecology, North Zealand Hospital, Hillerød, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Thomsen MM, Munthe-Fog L, Trier Petersen P, Hillig T, Friis-Hansen LJ, Roed C, Harboe ZB, Brandt CT. Pentraxin 3 in the cerebrospinal fluid during central nervous system infections: A retrospective cohort study. PLoS One 2023; 18:e0282004. [PMID: 36862691 PMCID: PMC9980753 DOI: 10.1371/journal.pone.0282004] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/07/2023] [Indexed: 03/03/2023] Open
Abstract
The present study describes diagnostic and prognostic abilities of Cerebrospinal fluid (CSF) Pentraxin 3 (PTX3) in central nervous system (CNS) infections. CSF PTX3 was measured retrospectively from 174 patients admitted under suspicion of CNS infection. Medians, ROC curves and Youdens index was calculated. CSF PTX3 was significantly higher among all CNS infections and undetectable in most of the patients in the control group, and significantly higher in bacterial infections compared to viral and Lyme infections. No association was found between CSF PTX3 and Glasgow Outcome Score. PTX3 in the CSF can distinguish bacterial infection from viral and Lyme infections and non-CNS infections. Highest levels were found in bacterial meningitis. No prognostic abilities were found.
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Affiliation(s)
- Martin Munthe Thomsen
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital, Hillerød, North Zealand, Denmark
- * E-mail:
| | - Lea Munthe-Fog
- Stemform/StemMedical, Cell Production and RnD, Søborg, Copenhagen Region, Denmark
| | - Pelle Trier Petersen
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital, Hillerød, North Zealand, Denmark
| | - Thore Hillig
- Department of Clinical Biochemistry, Copenhagen University Hospital, Hillerød, North Zealand, Denmark
| | - Lennart Jan Friis-Hansen
- Department of Clinical Biochemistry, University Hospitals Bispebjerg and Frederiksberg, University of Copenhagen, Copenhagen, Denmark
| | - Casper Roed
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital, Hillerød, North Zealand, Denmark
| | - Zitta Barrella Harboe
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital, Hillerød, North Zealand, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen Region, Copenhagen, Denmark
| | - Christian Thomas Brandt
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital, Hillerød, North Zealand, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen Region, Copenhagen, Denmark
- Department of Infectious Diseases, Zealand University Hospital, University of Copenhagen, Roskilde, Denmark
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Boyesen EO, Balsby IM, Henriksen M, Christensen R, Rasmussen JH, Nielsen FE, Nygaard H, Friis-Hansen LJ, Nielsen SD, Thudium RF, Porsberg C, Kristensen LE, Bliddal H. Triage Strategies Based on C-Reactive Protein Levels and SARS-CoV-2 Tests among Individuals Referred with Suspected COVID-19: A Prospective Cohort Study. J Clin Med 2021; 11:jcm11010201. [PMID: 35011944 PMCID: PMC8745759 DOI: 10.3390/jcm11010201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/09/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 01/08/2023] Open
Abstract
C-reactive protein (CRP) has prognostic value in hospitalized patients with COVID-19; the importance of CRP in pre-hospitalized patients remains to be tested. Methods: Individuals with symptoms of COVID-19 had a SARS-CoV-2 PCR oropharyngeal swab test, and a measurement of CRP was performed at baseline, with an upper reference range of 10 mg/L. After 28 days, information about possible admissions, oxygen treatments, transfers to the ICU, or deaths was obtained from the patient files. Using logistic regression, the prognostic value of the CRP and SARS-CoV-2 test results was evaluated. Results: Among the 1006 patients included, the SARS-CoV-2 PCR test was positive in 59, and the CRP level was elevated (>10 mg/L) in 131. In total, 59 patients were hospitalized, only 3 of whom were SARS-CoV-2 positive, with elevated CRP (n = 2) and normal CRP (n = 1). The probability of being hospitalized with elevated CRP was 4.21 (95%CI 2.38–7.43, p < 0.0001), while the probability of being hospitalized with SARS-CoV-2 positivity alone was 0.85 (95%CI 0.26–2.81, p = 0.79). Conclusions: CRP is not a reliable predictor for the course of SARS-CoV-2 infection in pre-hospitalized patients. CRP, while not a SARS-CoV-2 positive test, had prognostic value in the total population of patients presenting with COVID-19-related symptoms.
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Affiliation(s)
- Erika Olivia Boyesen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Copenhagen, Denmark; (E.O.B.); (I.M.B.); (M.H.); (R.C.); (L.E.K.)
| | - Ida Maria Balsby
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Copenhagen, Denmark; (E.O.B.); (I.M.B.); (M.H.); (R.C.); (L.E.K.)
| | - Marius Henriksen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Copenhagen, Denmark; (E.O.B.); (I.M.B.); (M.H.); (R.C.); (L.E.K.)
| | - Robin Christensen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Copenhagen, Denmark; (E.O.B.); (I.M.B.); (M.H.); (R.C.); (L.E.K.)
- Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, 5000 Odense, Denmark
| | - Jens Henning Rasmussen
- Department of Emergency Medicine, Copenhagen University Hospital, Bispebjerg Frederiksberg Hospital, 2400 Copenhagen, Denmark; (J.H.R.); (F.E.N.); (H.N.)
| | - Finn Erland Nielsen
- Department of Emergency Medicine, Copenhagen University Hospital, Bispebjerg Frederiksberg Hospital, 2400 Copenhagen, Denmark; (J.H.R.); (F.E.N.); (H.N.)
| | - Hanne Nygaard
- Department of Emergency Medicine, Copenhagen University Hospital, Bispebjerg Frederiksberg Hospital, 2400 Copenhagen, Denmark; (J.H.R.); (F.E.N.); (H.N.)
| | - Lennart Jan Friis-Hansen
- Department of Clinical Biochemistry, Bispebjerg Frederiksberg Hospital, 2400 Copenhagen, Denmark;
| | - Susanne Dam Nielsen
- Department of Infectious Diseases 8632, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark; (S.D.N.); (R.F.T.)
| | - Rebekka Faber Thudium
- Department of Infectious Diseases 8632, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark; (S.D.N.); (R.F.T.)
| | - Celeste Porsberg
- Department of Pulmonary Medicine, Bispebjerg Frederiksberg Hospital, 2400 Copenhagen, Denmark;
| | - Lars Erik Kristensen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Copenhagen, Denmark; (E.O.B.); (I.M.B.); (M.H.); (R.C.); (L.E.K.)
| | - Henning Bliddal
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Copenhagen, Denmark; (E.O.B.); (I.M.B.); (M.H.); (R.C.); (L.E.K.)
- Correspondence: ; Tel.: +45-3816-4158
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Thomsen MK, Njor SH, Rasmussen M, Linnemann D, Andersen B, Baatrup G, Friis-Hansen LJ, Jørgensen JCR, Mikkelsen EM. Validity of data in the Danish Colorectal Cancer Screening Database. Clin Epidemiol 2017; 9:105-111. [PMID: 28255255 PMCID: PMC5322846 DOI: 10.2147/clep.s124454] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background In Denmark, a nationwide screening program for colorectal cancer was implemented in March 2014. Along with this, a clinical database for program monitoring and research purposes was established. Objective The aim of this study was to estimate the agreement and validity of diagnosis and procedure codes in the Danish Colorectal Cancer Screening Database (DCCSD). Methods All individuals with a positive immunochemical fecal occult blood test (iFOBT) result who were invited to screening in the first 3 months since program initiation were identified. From these, a sample of 150 individuals was selected using stratified random sampling by age, gender and region of residence. Data from the DCCSD were compared with data from hospital records, which were used as the reference. Agreement, sensitivity, specificity and positive and negative predictive values were estimated for categories of codes “clean colon”, “colonoscopy performed”, “overall completeness of colonoscopy”, “incomplete colonoscopy”, “polypectomy”, “tumor tissue left behind”, “number of polyps”, “lost polyps”, “risk group of polyps” and “colorectal cancer and polyps/benign tumor”. Results Hospital records were available for 136 individuals. Agreement was highest for “colorectal cancer” (97.1%) and lowest for “lost polyps” (88.2%). Sensitivity varied between moderate and high, with 60.0% for “incomplete colonoscopy” and 98.5% for “colonoscopy performed”. Specificity was 92.7% or above, except for the categories “colonoscopy performed” and “overall completeness of colonoscopy”, where the specificity was low; however, the estimates were imprecise. Conclusion A high level of agreement between categories of codes in DCCSD and hospital records indicates that DCCSD reflects the hospital records well. Further, the validity of the categories of codes varied from moderate to high. Thus, the DCCSD may be a valuable data source for future research on colorectal cancer screening.
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Affiliation(s)
| | - Sisse Helle Njor
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus
| | - Morten Rasmussen
- Department of Digestive Diseases K, Bispebjerg Hospital, Copenhagen
| | - Dorte Linnemann
- Department of Pathology, Herlev and Gentofte Hospital, Herlev
| | - Berit Andersen
- Department of Public Health Programs, Randers Regional Hospital, Randers
| | - Gunnar Baatrup
- Department of Surgery, Odense University Hospital; Department of Clinical Science, University of Southern Denmark, Odense
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Friis-Hansen LJ, Engelsen J, Fruekilde P, Dalhoff KP, Jacobsen P. [Unwitting chemical submission: what drugs are used, and what should physicians do when "something" may have been put into a patient's drink?]. Ugeskr Laeger 2004; 166:4453-8. [PMID: 15626096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Friis-Hansen LJ, Johansen AMT, Jacobsen P, Abildstrøm SZ. [Insufficient registration of drug poisonings in Denmark]. Ugeskr Laeger 2004; 166:4475-7. [PMID: 15626103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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7
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Bundgaard JR, Friis-Hansen LJ. [Beta-thalassemia in a Danish family]. Ugeskr Laeger 2002; 164:1819-20. [PMID: 11957441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
We report a case of beta-thalassaemia in a family of Danish origin, owing to a C to T substitution in codon 39 of the beta-globin gene.
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Affiliation(s)
- Jens Rene Bundgaard
- Klinisk biokemisk afdeling, KB 3014, H:S Rigshospitalet, DK-2100 København ø.
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Jønsson V, Friis-Hansen LJ, Hou-Jensen K. [Picture of the month. Splenomegaly with hereditary stomatocytosis]. Ugeskr Laeger 2000; 162:4158. [PMID: 10962920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- V Jønsson
- H.S Rigshospitalet, Finsenscentret, haematologisk afdeling L 4042
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9
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Friis-Hansen LJ, Gøtze JP, Philip J. [Pregnancy complications and thrombophilia]. Ugeskr Laeger 1999; 161:5034. [PMID: 10489799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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10
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Friis-Hansen LJ, Andersen NS, Scheibel E. [Autoantibodies against coagulation factor VIII]. Ugeskr Laeger 1998; 160:6061-5. [PMID: 9800508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Autoantibodies towards coagulation factor VIII is a rare disease, incidence 1 pr. 2.5-5 million/year. The symptoms are most often subcutaneous or intramuscular haemorrhages or uncontrollable bleeding after minimal traumas. Screening tests show prolonged activated partial thromboplastin time, normal prothrombin time and thrombocyte count. Production of autoantibodies is controlled by prednisolone which may be supplemented with chemotherapy, i.e. azathioprine. Bleeding can be controlled by using coagulation factor concentrates that bypass factor VIII. If diagnosed early, there is a good chance of both stopping bleeding and suppressing autoantibody production. In order to be able to detect patients at risk of having factor VIII autoantibodies, it is recommended to screen all bleeding patients using activated partial thromboplastin time, prothrombin time and thrombocyte count. All patients showing isolated prolonged activated partial thrombin time should be referred to a laboratory specialized in coagulation problems for immediate evaluation.
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Andersen NS, Friis-Hansen LJ, Scheibel E. [Acquired coagulation factor VIII deficiency. A 4-year survey of patients at the East Danish Hemophilia Center]. Ugeskr Laeger 1996; 158:2542-5. [PMID: 8686008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
An East Danish population of acquired haemophilia A (factor VIII inhibitors) patients are described in a retrospective survey. Fifteen patients attended the centre during the period 1981-1994. The epidemiology, clinical presentation, time from début until diagnosis and response to treatment are presented. Acquired factor VIII inhibitors are rare and without treatment the disease has a high mortality and morbidity. Inhibitors mostly develop among the elderly, independent of sex and almost half have no known underlying disease. When the diagnosis is clear, bleedings may be controlled and the patient may be cured by treatment that eliminates the inhibitor. Time until diagnosis varies a lot, for some patients it takes years. It is therefore important to be aware of the disease, so that time with risk of fatal bleeding is shortened as much as possible.
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Affiliation(s)
- N S Andersen
- Haemofilicentret, medicinsk haematologisk afdeling L-4041, Rigshospitalet, København
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