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van der Velde N, Seppala LJ, Hartikainen S, Kamkar N, Mallet L, Masud T, Montero-Odasso M, van Poelgeest EP, Thomsen K, Ryg J, Petrovic M. European position paper on polypharmacy and fall-risk-increasing drugs recommendations in the World Guidelines for Falls Prevention and Management: implications and implementation. Eur Geriatr Med 2023; 14:649-658. [PMID: 37452999 PMCID: PMC10447263 DOI: 10.1007/s41999-023-00824-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/17/2023] [Indexed: 07/18/2023]
Abstract
Falls prevention and management in older adults is a critical global challenge. One of the key risk factors for falls is the use of certain medications. Therefore, to prevent medication-related falls, the following is recommended in the recent World Guidelines for Falls Prevention and Management: (1) assess for fall history and the risk of falls before prescribing potential fall-risk-increasing drugs (FRIDs), (2) use a validated, structured screening and assessment tool to identify FRIDs when performing a medication review, (3) include medication review and appropriate deprescribing of FRIDs as a part of the multifactorial falls prevention intervention, and (4) in long-term care residents, if multifactorial intervention cannot be conducted due to limited resources, the falls prevention strategy should still always include deprescribing of FRIDs.In the present statement paper, the working group on medication-related falls of the World Guidelines for Falls Prevention and Management, in collaboration with the European Geriatric Medicine Society (EuGMS) Task and Finish group on FRIDs, outlines its position on how to implement and execute these recommendations in clinical practice.Preferably, the medication review should be conducted as part of a comprehensive geriatric assessment to produce a personalized and patient-centered assessment. Furthermore, the major pitfall of the published intervention studies so far is the suboptimal implementation of medication review and deprescribing. For the future, it is important to focus on gaining which elements determine successful implementation and apply the concepts of implementation science to decrease the gap between research and practice.
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Affiliation(s)
- Nathalie van der Velde
- Amsterdam UMC, Department of Internal Medicine, Section of Geriatric Medicine, University of Amsterdam, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Lotta J Seppala
- Amsterdam UMC, Department of Internal Medicine, Section of Geriatric Medicine, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | | | - Nellie Kamkar
- Gait and Brain Laboratory, Lawson Research Health Institute, Parkwood Hospital, London, ON, Canada
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada
| | - Louise Mallet
- Faculty of Pharmacy, University of Montreal, Montréal, Québec, Canada
- Department of Pharmacy and Geriatrics, McGill University Health Center, Montréal, QC, Canada
| | - Tahir Masud
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Manuel Montero-Odasso
- Gait and Brain Laboratory, Lawson Research Health Institute, Parkwood Hospital, London, ON, Canada
- Schulich School of Medicine and Dentistry, London, ON, Canada
- Departments of Medicine (Geriatrics) and of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada
| | - Eveline P van Poelgeest
- Amsterdam UMC, Department of Internal Medicine, Section of Geriatric Medicine, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Katja Thomsen
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mirko Petrovic
- Department of Internal Medicine and Paediatrics, Section of Geriatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Legaard GE, Lyngbæk MPP, Almdal TP, Karstoft K, Bennetsen SL, Feineis CS, Nielsen NS, Durrer CG, Liebetrau B, Nystrup U, Østergaard M, Thomsen K, Trinh B, Solomon TPJ, Van Hall G, Brønd JC, Holst JJ, Hartmann B, Christensen R, Pedersen BK, Ried-Larsen M. Effects of different doses of exercise and diet-induced weight loss on beta-cell function in type 2 diabetes (DOSE-EX): a randomized clinical trial. Nat Metab 2023; 5:880-895. [PMID: 37127822 PMCID: PMC10229430 DOI: 10.1038/s42255-023-00799-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023]
Abstract
Diet-induced weight loss is associated with improved beta-cell function in people with type 2 diabetes (T2D) with remaining secretory capacity. It is unknown if adding exercise to diet-induced weight loss improves beta-cell function and if exercise volume is important for improving beta-cell function in this context. Here, we carried out a four-armed randomized trial with a total of 82 persons (35% females, mean age (s.d.) of 58.2 years (9.8)) with newly diagnosed T2D (<7 years). Participants were randomly allocated to standard care (n = 20), calorie restriction (25% energy reduction; n = 21), calorie restriction and exercise three times per week (n = 20), or calorie restriction and exercise six times per week (n = 21) for 16 weeks. The primary outcome was beta-cell function as indicated by the late-phase disposition index (insulin secretion multiplied by insulin sensitivity) at steady-state hyperglycemia during a hyperglycemic clamp. Secondary outcomes included glucose-stimulated insulin secretion and sensitivity as well as the disposition, insulin sensitivity, and secretion indices derived from a liquid mixed meal tolerance test. We show that the late-phase disposition index during the clamp increases more in all three intervention groups than in standard care (diet control group, 58%; 95% confidence interval (CI), 16 to 116; moderate exercise dose group, 105%; 95% CI, 49 to 182; high exercise dose group, 137%; 95% CI, 73 to 225) and follows a linear dose-response relationship (P > 0.001 for trend). We report three serious adverse events (two in the control group and one in the diet control group), as well as adverse events in two participants in the diet control group, and five participants each in the moderate and high exercise dose groups. Overall, adding an exercise intervention to diet-induced weight loss improves glucose-stimulated beta-cell function in people with newly diagnosed T2D in an exercise dose-dependent manner (NCT03769883).
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Affiliation(s)
- Grit E Legaard
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
| | - Mark P P Lyngbæk
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
| | - Thomas P Almdal
- Department of Endocrinology PE, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Immunology & Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Kristian Karstoft
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Pharmacology, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Camilla S Feineis
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
| | - Nina S Nielsen
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
| | - Cody G Durrer
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
| | | | - Ulrikke Nystrup
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
| | - Martin Østergaard
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
| | - Katja Thomsen
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
| | - Beckey Trinh
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
| | | | - Gerrit Van Hall
- Biomedical Sciences, Faculty of Health & Medical Science, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
- Clinical Metabolomics Core Facility, Clinical Biochemistry, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Jan Christian Brønd
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jens J Holst
- Department of Biomedical Sciences and the Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Bolette Hartmann
- Department of Biomedical Sciences and the Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Bente K Pedersen
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
| | - Mathias Ried-Larsen
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark.
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
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Seppala LJ, Kamkar N, van Poelgeest EP, Thomsen K, Daams JG, Ryg J, Masud T, Montero-Odasso M, Hartikainen S, Petrovic M, van der Velde N. Medication reviews and deprescribing as a single intervention in falls prevention: a systematic review and meta-analysis. Age Ageing 2022; 51:afac191. [PMID: 36153749 PMCID: PMC9509688 DOI: 10.1093/ageing/afac191] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND our aim was to assess the effectiveness of medication review and deprescribing interventions as a single intervention in falls prevention. METHODS DESIGN systematic review and meta-analysis. DATA SOURCES Medline, Embase, Cochrane CENTRAL, PsycINFO until 28 March 2022. ELIGIBILITY CRITERIA randomised controlled trials of older participants comparing any medication review or deprescribing intervention with usual care and reporting falls as an outcome. STUDY RECORDS title/abstract and full-text screening by two reviewers. RISK OF BIAS Cochrane Collaboration revised tool. DATA SYNTHESIS results reported separately for different settings and sufficiently comparable studies meta-analysed. RESULTS forty-nine heterogeneous studies were included. COMMUNITY meta-analyses of medication reviews resulted in a risk ratio (RR) of 1.05 (95% confidence interval, 0.85-1.29, I2 = 0%, 3 studies(s)) for number of fallers, in an RR = 0.95 (0.70-1.27, I2 = 37%, 3 s) for number of injurious fallers and in a rate ratio (RaR) of 0.89 (0.69-1.14, I2 = 0%, 2 s) for injurious falls. HOSPITAL meta-analyses assessing medication reviews resulted in an RR = 0.97 (0.74-1.28, I2 = 15%, 2 s) and in an RR = 0.50 (0.07-3.50, I2 = 72% %, 2 s) for number of fallers after and during admission, respectively. LONG-TERM CARE meta-analyses investigating medication reviews or deprescribing plans resulted in an RR = 0.86 (0.72-1.02, I2 = 0%, 5 s) for number of fallers and in an RaR = 0.93 (0.64-1.35, I2 = 92%, 7 s) for number of falls. CONCLUSIONS the heterogeneity of the interventions precluded us to estimate the exact effect of medication review and deprescribing as a single intervention. For future studies, more comparability is warranted. These interventions should not be implemented as a stand-alone strategy in falls prevention but included in multimodal strategies due to the multifactorial nature of falls.PROSPERO registration number: CRD42020218231.
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Affiliation(s)
- Lotta J Seppala
- Amsterdam UMC location University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Nellie Kamkar
- Gait and Brain Laboratory, Lawson Research Health Institute, Parkwood Hospital, London Ontario, Canada
- Department of Epidemiology and Biostatistics, University of Western Ontario, London Ontario, Canada
| | - Eveline P van Poelgeest
- Amsterdam UMC location University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Katja Thomsen
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Joost G Daams
- Research Support, Medical Library, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- ODIN (Odense Deprescribing INitiative), Denmark
| | - Tahir Masud
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Manuel Montero-Odasso
- Gait and Brain Laboratory, Lawson Research Health Institute, Parkwood Hospital, London Ontario, Canada
- Schulich School of Medicine and Dentistry, London Ontario, Canada
- Departments of Medicine (Geriatrics) and of Epidemiology and Biostatistics, University of Western Ontario, London Ontario, Canada
| | | | - Mirko Petrovic
- Department of Internal Medicine and Paediatrics (Section of Geriatrics), Ghent University, Ghent, Belgium
| | - Nathalie van der Velde
- Amsterdam UMC location University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Thomsen K, Fournaise A, Matzen LE, Andersen-Ranberg K, Ryg J. Does geriatric follow-up visits reduce hospital readmission among older patients discharged to temporary care at a skilled nursing facility: a before-and-after cohort study. BMJ Open 2021; 11:e046698. [PMID: 34389564 PMCID: PMC8365788 DOI: 10.1136/bmjopen-2020-046698] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Hospital readmission is a burden to patients, relatives and society. Older patients with frailty are at highest risk of readmission and its negative outcomes. OBJECTIVE We aimed at examining whether follow-up visits by an outgoing multidisciplinary geriatric team (OGT) reduces unplanned hospital readmission in patients discharged to a skilled nursing facility (SNF). DESIGN A retrospective single-centre before-and-after cohort study. SETTING AND PARTICIPANTS Study population included all hospitalised patients discharged from a Danish geriatric department to an SNF during 1 January 2016-25 February 2020. To address potential changes in discharge and readmission patterns during the study period, patients discharged from the same geriatric department to own home were also assessed. INTERVENTION OGT visits at SNF within 7 days following discharge. Patients discharged to SNF before 12 March 2018 did not receive OGT (-OGT). Patients discharged to SNF on or after 12 March 2018 received the intervention (+OGT). MAIN OUTCOME MEASURES Unplanned hospital readmission between 4 hours and 30 days following initial discharge. RESULTS Totally 847 patients were included (440 -OGT; 407 +OGT). No differences were seen between the two groups regarding age, sex, activities of daily living (ADLs), Charlson Comorbidity Index (CCI) or 30-day mortality. The cumulative incidence of readmission was 39.8% (95% CI 35.2% to 44.8%, n=162) in -OGT and 30.2% (95% CI 25.8% to 35.2%, n=113) in +OGT. The unadjusted risk (HR (95% CI)) of readmission was 0.68 (0.54 to 0.87, p=0.002) in +OGT compared with -OGT, and remained significantly lower (0.72 (0.57 to 0.93, p=0.011)) adjusting for age, length of stay, sex, ADL and CCI. For patients discharged to own home the risk of readmission remained unchanged during the study period. CONCLUSION Follow-up visits by OGT to patients discharged to temporary care at an SNF significantly reduced 30-day readmission in older patients.
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Affiliation(s)
- Katja Thomsen
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Syddanmark, Denmark
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Anders Fournaise
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Department of Cross-sectoral Collaboration, Region of Southern Denmark, Vejle, Denmark
| | - Lars Erik Matzen
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Syddanmark, Denmark
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Karen Andersen-Ranberg
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Syddanmark, Denmark
- Department of Public Health, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Jesper Ryg
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Syddanmark, Denmark
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
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Gade GV, Jørgensen MG, Ryg J, Riis J, Thomsen K, Masud T, Andersen S. Predicting falls in community-dwelling older adults: a systematic review of prognostic models. BMJ Open 2021; 11:e044170. [PMID: 33947733 PMCID: PMC8098967 DOI: 10.1136/bmjopen-2020-044170] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 02/24/2021] [Accepted: 04/16/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To systematically review and critically appraise prognostic models for falls in community-dwelling older adults. ELIGIBILITY CRITERIA Prospective cohort studies with any follow-up period. Studies had to develop or validate multifactorial prognostic models for falls in community-dwelling older adults (60+ years). Models had to be applicable for screening in a general population setting. INFORMATION SOURCE MEDLINE, EMBASE, CINAHL, The Cochrane Library, PsycINFO and Web of Science for studies published in English, Danish, Norwegian or Swedish until January 2020. Sources also included trial registries, clinical guidelines, reference lists of included papers, along with contacting clinical experts to locate published studies. DATA EXTRACTION AND RISK OF BIAS Two authors performed all review stages independently. Data extraction followed the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies checklist. Risk of bias assessments on participants, predictors, outcomes and analysis methods followed Prediction study Risk Of Bias Assessment Tool. RESULTS After screening 11 789 studies, 30 were eligible for inclusion (n=86 369 participants). Median age of participants ranged from 67.5 to 83.0 years. Falls incidences varied from 5.9% to 59%. Included studies reported 69 developed and three validated prediction models. Most frequent falls predictors were prior falls, age, sex, measures of gait, balance and strength, along with vision and disability. The area under the curve was available for 40 (55.6%) models, ranging from 0.49 to 0.87. Validated models' The area under the curve ranged from 0.62 to 0.69. All models had a high risk of bias, mostly due to limitations in statistical methods, outcome assessments and restrictive eligibility criteria. CONCLUSIONS An abundance of prognostic models on falls risk have been developed, but with a wide range in discriminatory performance. All models exhibited a high risk of bias rendering them unreliable for prediction in clinical practice. Future prognostic prediction models should comply with recent recommendations such as Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis. PROSPERO REGISTRATION NUMBER CRD42019124021.
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Affiliation(s)
- Gustav Valentin Gade
- Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Johannes Riis
- Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Katja Thomsen
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Tahir Masud
- Department of Healthcare for Older People, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Stig Andersen
- Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Toubøl A, Moestrup L, Ryg J, Thomsen K, Nielsen DS. Stakeholder perspectives of the dementia-friendly hospital: A qualitative descriptive focus group study. Dementia (London) 2020; 20:1501-1517. [PMID: 32930603 DOI: 10.1177/1471301220947848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The term dementia-friendly hospital is increasingly used to describe a variety of initiatives and strategies that are implemented to meet the challenges faced by patients with dementia during hospitalization. However, no definition of the dementia-friendly hospital currently exists. This qualitative focus group study aimed to describe stakeholders' perspectives of the dementia-friendly hospital. Four stakeholder groups were included: people with dementia, relatives, hospital staff, and representatives from the Danish Alzheimer Association. The thematic analysis suggests that a person-centered approach is a key feature. This approach is described as a continuously reflexive awareness of how to see the person behind the dementia diagnosis. We discuss possible revision of the current dementia discourse and the implications of the findings for future practice and research.
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Affiliation(s)
- Annemarie Toubøl
- 138728Health Sciences Research Center, UCL University College, Denmark
| | - Lene Moestrup
- Health Sciences Research Center, 138728UCL University College, Denmark
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Denmark
| | - Katja Thomsen
- Department of Geriatric Medicine, Odense University Hospital, Denmark
| | - Dorthe S Nielsen
- Centre for Global Health, 6174University of Southern Denmark, Denmark
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Pfeiffer P, Winther S, Yilmaz M, Möller S, Zitnjak D, Poulsen L, Thomsen K, Qvortrup C. PD-7 Updated survival analysis of the Danish randomized study comparing trifluridine/tipiracil with or without bevacizumab in patients with chemo-refractory metastatic colorectal cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.463] [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] Open
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Thomsen K, Christophersen L, Lerche C, Holmgaard D, Calum H, Hoiby N, Moser C. ePS3.08 Azithromycin potentiates avian IgY effects on pulmonary inflammation in a murine lung infection model. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30308-8] [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: 11/30/2022]
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Toubøl A, Moestrup L, Ryg J, Thomsen K, Nielsen DS. "Even Though I Have Dementia, I Prefer That They Are Personable": A Qualitative Focused Ethnography Study in a Danish General Hospital Setting. Glob Qual Nurs Res 2020; 7:2333393619899388. [PMID: 31976359 PMCID: PMC6958651 DOI: 10.1177/2333393619899388] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Received: 08/26/2019] [Revised: 12/05/2019] [Accepted: 12/16/2019] [Indexed: 01/01/2023] Open
Abstract
Patients with dementia often face challenges in hospital settings due to cognitive impairment. The aim of this study is to explore the encounter between patients with dementia and hospital staff, from the patient perspective. Focused ethnography guided the method for data collection and the analytical approach was abductive. The findings, based on 10 observations of patients with dementia and their encounter with hospital staff in a variety of hospital settings, reveal that staff often seem to not see the person beyond the dementia diagnosis. The findings also show, however, that significant moments are constantly negotiated during encounters between patients with dementia and hospital staff, moments which occasionally allow staff to see the patients to be seen as the person they are. A rethinking of the current dementia discourse is discussed, recommending attention to the two-way interaction between patients with dementia and hospital staff, and within this an awareness of a personable approach.
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Affiliation(s)
- Annemarie Toubøl
- University College Lillebaelt, Vejle, Denmark.,University of Southern Denmark, Odense, Denmark.,Odense University Hospital, Odense, Denmark
| | | | - Jesper Ryg
- University of Southern Denmark, Odense, Denmark.,Odense University Hospital, Odense, Denmark
| | | | - Dorthe Susanne Nielsen
- University College Lillebaelt, Vejle, Denmark.,University of Southern Denmark, Odense, Denmark.,Odense University Hospital, Odense, Denmark
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Gronlund C, Christoffersen KS, Thomsen K, Masud T, Jepsen DB, Ryg J. Effect of blood-flow restriction exercise on falls and fall related risk factors in older adults 60 years or above: a systematic review. J Musculoskelet Neuronal Interact 2020; 20:513-525. [PMID: 33265079 PMCID: PMC7716683] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This systematic review investigated the effect of low-load resistance training combined with blood-flow restriction (LL-BFR) on falls in older adults ≥60 years of age. The databases Embase, Medline, and Cochrane Library were searched from inception to October 1st, 2019 and reference lists of retrieved publications. Main outcomes were fall rates or proportion of fallers. Additional outcomes were physical performance, lower extremity muscle strength or function, and balance. Mean difference ±SD on falls and fall related outcomes were reported and Cochrane Collaboration's risk of bias tool was used to evaluate quality of evidence. Eight RCT-studies met the inclusion criteria. None reported falls data. Assessing physical performance tests (n=12), 8/12 of the LL-BFR groups showed a significant within-group improvement and 5/12 significant between-group effects comparing LL-BFR to respective controls. For muscle strength tests (n=16), 9/16 showed significant positive within-group improvement and 3/16 significant between-group effects. One study reported data on balance with conflicting results. In conclusion, LL-BFR might increase physical performance and muscle strength in older adults ≥60 years of age. None of the included studies investigated the effect on falls. Larger adequately powered studies are required before introducing LL-BFR as an alternative exercise modality to decrease fall risk.
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Affiliation(s)
- Caroline Gronlund
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark,Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark,Corresponding author: Jesper Ryg, Head of Geriatric Research, Consultant, PhD, Associate Professor, Department of Geriatric Medicine, Odense University Hospital, J.B. Winsløwsvej 4, DK - 5000 Odense C, Denmark E-mail:
| | - Kirstine S. Christoffersen
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark,Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Katja Thomsen
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark,Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Tahir Masud
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark,Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark,Department of Geriatric Medicine, Nottingham University Hospitals NHS Trust (NUH), Nottingham, UK
| | - Ditte B. Jepsen
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark,Department of Geriatric Medicine, Odense University Hospital, Svendborg, Denmark
| | - Jesper Ryg
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark,Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark,Corresponding author: Jesper Ryg, Head of Geriatric Research, Consultant, PhD, Associate Professor, Department of Geriatric Medicine, Odense University Hospital, J.B. Winsløwsvej 4, DK - 5000 Odense C, Denmark E-mail:
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Pfeiffer P, Yilmaz M, Möller S, Zitnjak D, Maltha L, Krogh M, Winther S, Petersen L, Hejlersen F, Thomsen K, Qvortrup C. Bevacizumab improves efficacy of trifluridine/tipiracil (TAS-102) in patients with chemorefractory metastatic colorectal cancer: a Danish randomized trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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12
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Minet LR, Thomsen K, Ryg J, Matzen L, Masud T, Ytterberg C. Physical, mental, and social functioning in women age 65 and above with and without a falls history: An observational case-control study. J Frailty Sarcopenia Falls 2018; 3:179-184. [PMID: 32300706 PMCID: PMC7155354 DOI: 10.22540/jfsf-03-179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2018] [Indexed: 11/17/2022] Open
Abstract
Objectives: There is a lack of knowledge about how falls are associated with the older person’s physical, mental, and social functioning which would help find effective methods for identifying rehabilitation needs in the older population to ensure appropriate follow-up. The aim was to investigate and compare functioning in women with and without a falls history. Methods: This was an observational case-control study. Study participants were fallers aged ≥65 years recruited consecutively from a hospital; age matched randomly selected community controls (fallers without contact with the healthcare system due to falls and non-fallers). Fallers were classified as once only fallers and recurrent fallers. Results: The sample constituted a group of older women with and without a falls history; 117 fallers from the Falls Clinic, and 99 fallers and 106 non-fallers community controls, median age 80 years. Both fallers from the clinic and the community had significantly lower functioning compared to non-fallers in all three domains. Recurrent fallers had poorer functioning compared to once only fallers. Conclusion: This study contributes to knowledge about older people’s functioning and disability in conjunction with a high fall-risk and highlights the importance of rehabilitation and prevention strategies that focus on early identification of disability in the older population regardless of falls history.
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Affiliation(s)
- Lisbeth Rosenbek Minet
- Department of Clinical Research, University of Southern Denmark.,Health Sciences Research Centre, UCL University College.,Department of Rehabilitation, Odense University Hospital
| | - Katja Thomsen
- Department of Clinical Research, University of Southern Denmark.,Department of Geriatric Medicine, Odense University Hospital
| | - Jesper Ryg
- Department of Clinical Research, University of Southern Denmark.,Department of Geriatric Medicine, Odense University Hospital
| | - Lars Matzen
- Department of Geriatric Medicine, Odense University Hospital
| | - Tahir Masud
- Department of Geriatric Medicine, Odense University Hospital.,Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Charlotte Ytterberg
- Department of Clinical Research, University of Southern Denmark.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Function Area Occupational Therapy & Physiotherapy, Karolinska University Hospital
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13
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Lerche CJ, Christophersen L, Jensen PO, Goetze JP, Nielsen PR, Thomsen K, Hoiby N, Bundgaard H, Moser C. P4509Dabigatran improves antibiotic efficacy in experimental Staphylococcus aureus endocarditis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4509] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C J Lerche
- Rigshospitalet - Copenhagen University Hospital, Dept. of Clinical Microbiology, Copenhagen, Denmark
| | - L Christophersen
- Rigshospitalet - Copenhagen University Hospital, Dept. of Clinical Microbiology, Copenhagen, Denmark
| | - P O Jensen
- Rigshospitalet - Copenhagen University Hospital, Dept. of Clinical Microbiology, Copenhagen, Denmark
| | - J P Goetze
- Rigshospitalet - Copenhagen University Hospital, Dept. of Clinical Biochemistry, Copenhagen, Denmark
| | - P R Nielsen
- University Hospital, Dept. of Pathology, Roskilde, Denmark
| | - K Thomsen
- Rigshospitalet - Copenhagen University Hospital, Dept. of Clinical Microbiology, Copenhagen, Denmark
| | - N Hoiby
- Rigshospitalet - Copenhagen University Hospital, Dept. of Clinical Microbiology, Copenhagen, Denmark
| | - H Bundgaard
- Rigshospitalet - Copenhagen University Hospital, Dept. of Cardiology, Copenhagen, Denmark
| | - C Moser
- Rigshospitalet - Copenhagen University Hospital, Dept. of Clinical Microbiology, Copenhagen, Denmark
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Thomsen K, Larsen S, Christophersen L, Lerche C, Høiby N, Moser C. WS04.2 Azithromycin treatment of Pseudomonas aeruginosa infection potentiates IgY pulmonary protection in vivo. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30138-3] [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: 10/14/2022]
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15
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Abstract
OBJECTIVE To investigate the effect of whole-body vibration exercise (WBV) on fracture risk in adults ≥50 years of age. DESIGN A systematic review and meta-analysis calculating relative risk ratios, fall rate ratio and absolute weighted mean difference using random effects models. Heterogeneity was estimated using I2 statistics, and the Cochrane Collaboration's risk of bias tool and the GRADE approach were used to evaluate quality of evidence and summarise conclusions. DATA SOURCES The databases PubMed, Embase and the Cochrane Central Register from inception to April 2016 and reference lists of retrieved publications. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials examining the effect of WBV on fracture risk in adults ≥50 years of age. The primary outcomes were fractures, fall rates and the proportion of participants who fell. Secondary outcomes were bone mineral density (BMD), bone microarchitecture, bone turnover markers and calcaneal broadband attenuation (BUA). RESULTS 15 papers (14 trials) met the inclusion criteria. Only one study had fracture data reporting a non-significant fracture reduction (risk ratio (RR)=0.47, 95% CI 0.14 to 1.57, P=0.22) (moderate quality of evidence). Four studies (n=746) showed that WBV reduced the rate of falls with a rate ratio of 0.67 (95% CI 0.50 to 0.89, P=0.0006; I2=19%) (moderate quality of evidence). Furthermore, data from three studies (n=805) found a trend towards falls reduction (RR=0.76, 95% CI 0.48 to 1.20, P=0.24; I2=24%) (low quality of evidence). Finally, moderate to low quality of evidence showed no overall effect on BMD and only sparse data were available regarding microarchitecture parameters, bone turnover markers and BUA. CONCLUSIONS WBV reduces fall rate but seems to have no overall effect on BMD or microarchitecture. The impact of WBV on fractures requires further larger adequately powered studies. This meta-analysis suggests that WBV may prevent fractures by reducing falls. PROSPERO REGISTRATION NUMBER CRD42016036320; Pre-results.
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Affiliation(s)
- Ditte Beck Jepsen
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Katja Thomsen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Geriatric Medicine, Odense University Hospital, Svendborg, Denmark
| | - Stinus Hansen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
- OPEN-Odense Patient data Explorative Network, Odense University Hospital/ University of Southern Denmark, Odense, Denmark
| | - Tahir Masud
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Geriatric Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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16
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Minet L, Thomsen K, Ryg J, Matzen L, Ytterberg C, Andersen-Ranberg K, Masud T. GAIT SPEED, COGNITIVE IMPAIRMENT, AND DUAL TASK CONDITIONS IN FALLERS AND NON-FALL CONTROLS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1360] [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)
- L. Minet
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark,
- Odense University Hospital, Odense, Denmark,
- University College Lillebaelt, Odense, Denmark,
| | - K. Thomsen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark,
- Odense University Hospital, Odense, Denmark,
| | - J. Ryg
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark,
- Odense University Hospital, Odense, Denmark,
| | - L. Matzen
- Odense University Hospital, Odense, Denmark,
| | - C. Ytterberg
- Karolinska Institutet, Stockholm, Sweden,
- Karolinska University Hospital Huddinge, Stockholm, Sweden,
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark,
| | | | - T. Masud
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
- Odense University Hospital, Odense, Denmark,
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17
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Adamson P, Ader C, Andrews M, Anfimov N, Anghel I, Arms K, Arrieta-Diaz E, Aurisano A, Ayres DS, Backhouse C, Baird M, Bambah BA, Bays K, Bernstein R, Betancourt M, Bhatnagar V, Bhuyan B, Bian J, Biery K, Blackburn T, Bocean V, Bogert D, Bolshakova A, Bowden M, Bower C, Broemmelsiek D, Bromberg C, Brunetti G, Bu X, Butkevich A, Capista D, Catano-Mur E, Chase TR, Childress S, Choudhary BC, Chowdhury B, Coan TE, Coelho JAB, Colo M, Cooper J, Corwin L, Cronin-Hennessy D, Cunningham A, Davies GS, Davies JP, Del Tutto M, Derwent PF, Deepthi KN, Demuth D, Desai S, Deuerling G, Devan A, Dey J, Dharmapalan R, Ding P, Dixon S, Djurcic Z, Dukes EC, Duyang H, Ehrlich R, Feldman GJ, Felt N, Fenyves EJ, Flumerfelt E, Foulkes S, Frank MJ, Freeman W, Gabrielyan M, Gallagher HR, Gebhard M, Ghosh T, Gilbert W, Giri A, Goadhouse S, Gomes RA, Goodenough L, Goodman MC, Grichine V, Grossman N, Group R, Grudzinski J, Guarino V, Guo B, Habig A, Handler T, Hartnell J, Hatcher R, Hatzikoutelis A, Heller K, Howcroft C, Huang J, Huang X, Hylen J, Ishitsuka M, Jediny F, Jensen C, Jensen D, Johnson C, Jostlein H, Kafka GK, Kamyshkov Y, Kasahara SMS, Kasetti S, Kephart K, Koizumi G, Kotelnikov S, Kourbanis I, Krahn Z, Kravtsov V, Kreymer A, Kulenberg C, Kumar A, Kutnink T, Kwarciancy R, Kwong J, Lang K, Lee A, Lee WM, Lee K, Lein S, Liu J, Lokajicek M, Lozier J, Lu Q, Lucas P, Luchuk S, Lukens P, Lukhanin G, Magill S, Maan K, Mann WA, Marshak ML, Martens M, Martincik J, Mason P, Matera K, Mathis M, Matveev V, Mayer N, McCluskey E, Mehdiyev R, Merritt H, Messier MD, Meyer H, Miao T, Michael D, Mikheyev SP, Miller WH, Mishra SR, Mohanta R, Moren A, Mualem L, Muether M, Mufson S, Musser J, Newman HB, Nelson JK, Niner E, Norman A, Nowak J, Oksuzian Y, Olshevskiy A, Oliver J, Olson T, Paley J, Pandey P, Para A, Patterson RB, Pawloski G, Pearson N, Perevalov D, Pershey D, Peterson E, Petti R, Phan-Budd S, Piccoli L, Pla-Dalmau A, Plunkett RK, Poling R, Potukuchi B, Psihas F, Pushka D, Qiu X, Raddatz N, Radovic A, Rameika RA, Ray R, Rebel B, Rechenmacher R, Reed B, Reilly R, Rocco D, Rodkin D, Ruddick K, Rusack R, Ryabov V, Sachdev K, Sahijpal S, Sahoo H, Samoylov O, Sanchez MC, Saoulidou N, Schlabach P, Schneps J, Schroeter R, Sepulveda-Quiroz J, Shanahan P, Sherwood B, Sheshukov A, Singh J, Singh V, Smith A, Smith D, Smolik J, Solomey N, Sotnikov A, Sousa A, Soustruznik K, Stenkin Y, Strait M, Suter L, Talaga RL, Tamsett MC, Tariq S, Tas P, Tesarek RJ, Thayyullathil RB, Thomsen K, Tian X, Tognini SC, Toner R, Trevor J, Tzanakos G, Urheim J, Vahle P, Valerio L, Vinton L, Vrba T, Waldron AV, Wang B, Wang Z, Weber A, Wehmann A, Whittington D, Wilcer N, Wildberger R, Wildman D, Williams K, Wojcicki SG, Wood K, Xiao M, Xin T, Yadav N, Yang S, Zadorozhnyy S, Zalesak J, Zamorano B, Zhao A, Zirnstein J, Zwaska R. First Measurement of Electron Neutrino Appearance in NOvA. Phys Rev Lett 2016; 116:151806. [PMID: 27127961 DOI: 10.1103/physrevlett.116.151806] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Indexed: 06/05/2023]
Abstract
We report results from the first search for ν_{μ}→ν_{e} transitions by the NOvA experiment. In an exposure equivalent to 2.74×10^{20} protons on target in the upgraded NuMI beam at Fermilab, we observe 6 events in the Far Detector, compared to a background expectation of 0.99±0.11(syst) events based on the Near Detector measurement. A secondary analysis observes 11 events with a background of 1.07±0.14(syst). The 3.3σ excess of events observed in the primary analysis disfavors 0.1π<δ_{CP}<0.5π in the inverted mass hierarchy at the 90% C.L.
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Affiliation(s)
- P Adamson
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C Ader
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Andrews
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - N Anfimov
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - I Anghel
- Argonne National Laboratory, Argonne, Illinois 60439, USA
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - K Arms
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - E Arrieta-Diaz
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - A Aurisano
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - D S Ayres
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - C Backhouse
- California Institute of Technology, Pasadena, California 91125, USA
| | - M Baird
- Indiana University, Bloomington, Indiana 47405, USA
| | - B A Bambah
- School of Physics, University of Hyderabad, Hyderabad 500 046, India
| | - K Bays
- California Institute of Technology, Pasadena, California 91125, USA
| | - R Bernstein
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Betancourt
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - V Bhatnagar
- Department of Physics, Panjab University, Chandigarh 106 014, India
| | - B Bhuyan
- Department of Physics, IIT Guwahati, Guwahati 781 039, India
| | - J Bian
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - K Biery
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - T Blackburn
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - V Bocean
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D Bogert
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Bolshakova
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - M Bowden
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C Bower
- Indiana University, Bloomington, Indiana 47405, USA
| | - D Broemmelsiek
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C Bromberg
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - G Brunetti
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - X Bu
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Butkevich
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - D Capista
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - E Catano-Mur
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - T R Chase
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - S Childress
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - B C Choudhary
- Department of Physics & Astrophysics, University of Delhi, Delhi 110007, India
| | - B Chowdhury
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - T E Coan
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - J A B Coelho
- Department of Physics and Astonomy, Tufts University, Medford, Massachusetts 02155, USA
| | - M Colo
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - J Cooper
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L Corwin
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - D Cronin-Hennessy
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - A Cunningham
- Physics Department, University of Texas at Dallas, 800 W. Campbell Road, Richardson, Texas 75083-0688, USA
| | - G S Davies
- Indiana University, Bloomington, Indiana 47405, USA
| | - J P Davies
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - M Del Tutto
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P F Derwent
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K N Deepthi
- School of Physics, University of Hyderabad, Hyderabad 500 046, India
| | - D Demuth
- Math, Science and Technology Department, University of Minnesota-Crookston, Crookston, Minnesota 56716, USA
| | - S Desai
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - G Deuerling
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Devan
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - J Dey
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Dharmapalan
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - P Ding
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S Dixon
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - Z Djurcic
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - E C Dukes
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - H Duyang
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - R Ehrlich
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - G J Feldman
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - N Felt
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - E J Fenyves
- Physics Department, University of Texas at Dallas, 800 W. Campbell Road, Richardson, Texas 75083-0688, USA
| | - E Flumerfelt
- Department of Physics and Astronomy, University of Tennessee, 1408 Circle Drive, Knoxville, Tennessee 37996, USA
| | - S Foulkes
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M J Frank
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - W Freeman
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Gabrielyan
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - H R Gallagher
- Department of Physics and Astonomy, Tufts University, Medford, Massachusetts 02155, USA
| | - M Gebhard
- Indiana University, Bloomington, Indiana 47405, USA
| | - T Ghosh
- Instituto de Física, Universidade Federal de Goiás, Goiánia, Goiás 74690-900, Brazil
| | - W Gilbert
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - A Giri
- Department of Physics, IIT Hyderabad, Hyderabad 502 205, India
| | - S Goadhouse
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - R A Gomes
- Instituto de Física, Universidade Federal de Goiás, Goiánia, Goiás 74690-900, Brazil
| | - L Goodenough
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - M C Goodman
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - V Grichine
- Nuclear Physics Department, Lebedev Physical Institute, Leninsky Prospect 53, 119991 Moscow, Russia
| | - N Grossman
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Group
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - J Grudzinski
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - V Guarino
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - B Guo
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - A Habig
- Department of Physics and Astronomy, University of Minnesota-Duluth, Duluth, Minnesota 55812, USA
| | - T Handler
- Department of Physics and Astronomy, University of Tennessee, 1408 Circle Drive, Knoxville, Tennessee 37996, USA
| | - J Hartnell
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - R Hatcher
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Hatzikoutelis
- Department of Physics and Astronomy, University of Tennessee, 1408 Circle Drive, Knoxville, Tennessee 37996, USA
| | - K Heller
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - C Howcroft
- California Institute of Technology, Pasadena, California 91125, USA
| | - J Huang
- Department of Physics, University of Texas at Austin, 1 University Station C1600, Austin, Texas 78712, USA
| | - X Huang
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - J Hylen
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Ishitsuka
- Indiana University, Bloomington, Indiana 47405, USA
| | - F Jediny
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - C Jensen
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D Jensen
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C Johnson
- Indiana University, Bloomington, Indiana 47405, USA
| | - H Jostlein
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G K Kafka
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - Y Kamyshkov
- Department of Physics and Astronomy, University of Tennessee, 1408 Circle Drive, Knoxville, Tennessee 37996, USA
| | - S M S Kasahara
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - S Kasetti
- School of Physics, University of Hyderabad, Hyderabad 500 046, India
| | - K Kephart
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G Koizumi
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S Kotelnikov
- Nuclear Physics Department, Lebedev Physical Institute, Leninsky Prospect 53, 119991 Moscow, Russia
| | - I Kourbanis
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - Z Krahn
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - V Kravtsov
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - A Kreymer
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - Ch Kulenberg
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - A Kumar
- Department of Physics, Panjab University, Chandigarh 106 014, India
| | - T Kutnink
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - R Kwarciancy
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J Kwong
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - K Lang
- Department of Physics, University of Texas at Austin, 1 University Station C1600, Austin, Texas 78712, USA
| | - A Lee
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - W M Lee
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K Lee
- Physics and Astronomy Department, UCLA, Box 951547, Los Angeles, California 90095-1547, USA
| | - S Lein
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - J Liu
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - M Lokajicek
- Institute of Physics, Czech Academy of Sciences, Prague, Czech Republic
| | - J Lozier
- California Institute of Technology, Pasadena, California 91125, USA
| | - Q Lu
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P Lucas
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S Luchuk
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - P Lukens
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G Lukhanin
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S Magill
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - K Maan
- Department of Physics, Panjab University, Chandigarh 106 014, India
| | - W A Mann
- Department of Physics and Astonomy, Tufts University, Medford, Massachusetts 02155, USA
| | - M L Marshak
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - M Martens
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J Martincik
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - P Mason
- Department of Physics and Astronomy, University of Tennessee, 1408 Circle Drive, Knoxville, Tennessee 37996, USA
| | - K Matera
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Mathis
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - V Matveev
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - N Mayer
- Department of Physics and Astonomy, Tufts University, Medford, Massachusetts 02155, USA
| | - E McCluskey
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Mehdiyev
- Department of Physics, University of Texas at Austin, 1 University Station C1600, Austin, Texas 78712, USA
| | - H Merritt
- Indiana University, Bloomington, Indiana 47405, USA
| | - M D Messier
- Indiana University, Bloomington, Indiana 47405, USA
| | - H Meyer
- Physics Division, Wichita State University, 1845 Fairmout Street, Wichita, Kansas 67220, USA
| | - T Miao
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D Michael
- California Institute of Technology, Pasadena, California 91125, USA
| | - S P Mikheyev
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - W H Miller
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - S R Mishra
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - R Mohanta
- School of Physics, University of Hyderabad, Hyderabad 500 046, India
| | - A Moren
- Department of Physics and Astronomy, University of Minnesota-Duluth, Duluth, Minnesota 55812, USA
| | - L Mualem
- California Institute of Technology, Pasadena, California 91125, USA
| | - M Muether
- Physics Division, Wichita State University, 1845 Fairmout Street, Wichita, Kansas 67220, USA
| | - S Mufson
- Indiana University, Bloomington, Indiana 47405, USA
| | - J Musser
- Indiana University, Bloomington, Indiana 47405, USA
| | - H B Newman
- California Institute of Technology, Pasadena, California 91125, USA
| | - J K Nelson
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - E Niner
- Indiana University, Bloomington, Indiana 47405, USA
| | - A Norman
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J Nowak
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - Y Oksuzian
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - A Olshevskiy
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - J Oliver
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - T Olson
- Department of Physics and Astonomy, Tufts University, Medford, Massachusetts 02155, USA
| | - J Paley
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P Pandey
- Department of Physics & Astrophysics, University of Delhi, Delhi 110007, India
| | - A Para
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R B Patterson
- California Institute of Technology, Pasadena, California 91125, USA
| | - G Pawloski
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - N Pearson
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - D Perevalov
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D Pershey
- California Institute of Technology, Pasadena, California 91125, USA
| | - E Peterson
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - R Petti
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - S Phan-Budd
- Department of Physics, Winona State University, P.O. Box 5838, Winona, Minnesota 55987, USA
| | - L Piccoli
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Pla-Dalmau
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R K Plunkett
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Poling
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - B Potukuchi
- Department of Physics and Electronics, University of Jammu, Jammu Tawi, 180 006 Jammu & Kashmir, India
| | - F Psihas
- Indiana University, Bloomington, Indiana 47405, USA
| | - D Pushka
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - X Qiu
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - N Raddatz
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - A Radovic
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - R A Rameika
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Ray
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - B Rebel
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Rechenmacher
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - B Reed
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - R Reilly
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D Rocco
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - D Rodkin
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - K Ruddick
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - R Rusack
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - V Ryabov
- Nuclear Physics Department, Lebedev Physical Institute, Leninsky Prospect 53, 119991 Moscow, Russia
| | - K Sachdev
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - S Sahijpal
- Department of Physics, Panjab University, Chandigarh 106 014, India
| | - H Sahoo
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - O Samoylov
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - M C Sanchez
- Argonne National Laboratory, Argonne, Illinois 60439, USA
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - N Saoulidou
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P Schlabach
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J Schneps
- Department of Physics and Astonomy, Tufts University, Medford, Massachusetts 02155, USA
| | - R Schroeter
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - J Sepulveda-Quiroz
- Argonne National Laboratory, Argonne, Illinois 60439, USA
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - P Shanahan
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - B Sherwood
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - A Sheshukov
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - J Singh
- Department of Physics, Panjab University, Chandigarh 106 014, India
| | - V Singh
- Department of Physics, Banaras Hindu University, Varanasi 221 005, India
| | - A Smith
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - D Smith
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - J Smolik
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - N Solomey
- Physics Division, Wichita State University, 1845 Fairmout Street, Wichita, Kansas 67220, USA
| | - A Sotnikov
- Joint Institute for Nuclear Research Joliot-Curie, 6 Dubna, Moscow Region 141980, Russia
| | - A Sousa
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - K Soustruznik
- Charles University in Prague, Faculty of Mathematics and Physics, Institute of Particle and Nuclear Physics, Prague, Czech Republic
| | - Y Stenkin
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - M Strait
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - L Suter
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - R L Talaga
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - M C Tamsett
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - S Tariq
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - P Tas
- Charles University in Prague, Faculty of Mathematics and Physics, Institute of Particle and Nuclear Physics, Prague, Czech Republic
| | - R J Tesarek
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R B Thayyullathil
- Department of Physics, Cochin University of Science and Technology, Kochi 682 022, India
| | - K Thomsen
- Department of Physics and Astronomy, University of Minnesota-Duluth, Duluth, Minnesota 55812, USA
| | - X Tian
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - S C Tognini
- Instituto de Física, Universidade Federal de Goiás, Goiánia, Goiás 74690-900, Brazil
| | - R Toner
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA
| | - J Trevor
- California Institute of Technology, Pasadena, California 91125, USA
| | - G Tzanakos
- Department of Physics, University of Athens, Athens 15771, Greece
| | - J Urheim
- Indiana University, Bloomington, Indiana 47405, USA
| | - P Vahle
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - L Valerio
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L Vinton
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - T Vrba
- Czech Technical University in Prague, Brehova 7, 115 19 Prague 1, Czech Republic
| | - A V Waldron
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - B Wang
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - Z Wang
- Department of Physics, University of Virginia, Charlottesville, Virginia 22904, USA
| | - A Weber
- Subdepartment of Particle Physics, University of Oxford, Oxford OX1 3RH, United Kingdom
- Rutherford Appleton Laboratory, Science and Technology Facilities Council, Didcot OX11 0QX, United Kingdom
| | - A Wehmann
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - N Wilcer
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R Wildberger
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - D Wildman
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K Williams
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S G Wojcicki
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - K Wood
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - M Xiao
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - T Xin
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA
| | - N Yadav
- Department of Physics, IIT Guwahati, Guwahati 781 039, India
| | - S Yang
- Department of Physics, University of Cincinnati, Cincinnati, Ohio 45221, USA
| | - S Zadorozhnyy
- Institute for Nuclear Research of Russian Academy of Sciences, 7a 60th October Anniversary Prospect, Moscow 117312, Russia
| | - J Zalesak
- Institute of Physics, Czech Academy of Sciences, Prague, Czech Republic
| | - B Zamorano
- Department of Physics and Astronomy, University of Sussex, Falmer, Brighton BN1 9QH, United Kingdom
| | - A Zhao
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - J Zirnstein
- School of Physics and Astronomy, University of Minnesota-Twin Cities, Minneapolis, Minnesota 55455, USA
| | - R Zwaska
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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Thomsen K, Trøstrup H, Christophersen L, Lundquist R, Høiby N, Moser C. The phagocytic fitness of leucopatches may impact the healing of chronic wounds. Clin Exp Immunol 2016; 184:368-77. [PMID: 26830371 DOI: 10.1111/cei.12773] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Chronic non-healing wounds are significantly bothersome to patients and can result in severe complications. In addition, they are increasing in numbers, and a challenging problem to the health-care system. Handling of chronic, non-healing wounds can be discouraging due to lack of improvement, and a recent explanation can be the involvement of biofilm infections in the pathogenesis of non-healing wounds. Therefore, new treatment alternatives to improve outcome are continuously sought-after. Autologous leucopatches are such a new, adjunctive treatment option, showing promising clinical effects. However, the beneficial effect of the patches are not understood fully, although a major contribution is believed to be from the release of stimulating growth factors from activated thrombocytes within the leucopatch. Because the leucopatches also contain substantial numbers of leucocytes, the aim of the present study was to investigate the activity of the polymorphonuclear neutrophils (PMNs) within the leucopatch. By means of burst assay, phagocytosis assay, migration assay, biofilm killing assay and fluorescence in-situ hybridization (FISH) assay we showed significant respiratory burst in PMNs, active phagocytosis and killing of Pseudomonas aeruginosa by the leucopatch. In addition, bacterial-induced migration of PMNs from the leucopatch was shown, as well as uptake of P. aeruginosa by PMNs within the leucopatch. The present study substantiated that at least part of the beneficial clinical effect in chronic wounds by leucopatches is attributed to the activity of the PMNs in the leucopatch.
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Affiliation(s)
- K Thomsen
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen
| | - H Trøstrup
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen
| | - L Christophersen
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen
| | | | - N Høiby
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen
| | - C Moser
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen
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Ried-Larsen M, Christensen R, Hansen KB, Johansen MY, Pedersen M, Zacho M, Hansen LS, Kofoed K, Thomsen K, Jensen MS, Nielsen RO, MacDonald C, Langberg H, Vaag AA, Pedersen BK, Karstoft K. Head-to-head comparison of intensive lifestyle intervention (U-TURN) versus conventional multifactorial care in patients with type 2 diabetes: protocol and rationale for an assessor-blinded, parallel group and randomised trial. BMJ Open 2015; 5:e009764. [PMID: 26656025 PMCID: PMC4679918 DOI: 10.1136/bmjopen-2015-009764] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Current pharmacological therapies in patients with type 2 diabetes (T2D) are challenged by lack of sustainability and borderline firm evidence of real long-term health benefits. Accordingly, lifestyle intervention remains the corner stone in the management of T2D. However, there is a lack of knowledge regarding the optimal intervention programmes in T2D ensuring both compliance as well as long-term health outcomes. Our objective is to assess the effects of an intensive lifestyle intervention (the U-TURN intervention) on glycaemic control in patients with T2D. Our hypothesis is that intensive lifestyle changes are equally effective as standard diabetes care, including pharmacological treatment in maintaining glycaemic control (ie, glycated haemoglobin (HbA1c)) in patients with T2D. Furthermore, we expect that intensive lifestyle changes will decrease the need for antidiabetic medications. METHODS AND ANALYSIS The study is an assessor-blinded, parallel group and a 1-year randomised trial. The primary outcome is change in glycaemic control (HbA1c), with the key secondary outcome being reductions in antidiabetic medication. Participants will be patients with T2D (T2D duration <10 years) without complications who are randomised into an intensive lifestyle intervention (U-TURN) or a standard care intervention in a 2:1 fashion. Both groups will be exposed to the same standardised, blinded, target-driven pharmacological treatment and can thus maintain, increase, reduce or discontinue the pharmacological treatment. The decision is based on the standardised algorithm. The U-TURN intervention consists of increased training and basal physical activity level, and an antidiabetic diet including an intended weight loss. The standard care group as well as the U-TURN group is offered individual diabetes management counselling on top of the pharmacological treatment. ETHICS AND DISSEMINATION This study has been approved by the Scientific Ethical Committee at the Capital Region of Denmark (H-1-2014-114). Positive, negative or inconclusive findings will be disseminated in peer-reviewed journals, at national and international conferences. TRIAL REGISTRATION NUMBER NCT02417012.
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Affiliation(s)
- Mathias Ried-Larsen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
- The Danish Diabetes Academy, Odense University Hospital, Odense, Denmark
| | - Robin Christensen
- Musculoskeletal Statistics Unit, Department of Rheum, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Katrine B Hansen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Diabetes and Metabolism, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mette Y Johansen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Pedersen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Morten Zacho
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Louise S Hansen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Katja Kofoed
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Katja Thomsen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mette S Jensen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rasmus O Nielsen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Chris MacDonald
- Department of CopenRehab, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
| | - Henning Langberg
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
- Department of CopenRehab, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
| | - Allan A Vaag
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Diabetes and Metabolism, Copenhagen University Hospital, Copenhagen, Denmark
| | - Bente K Pedersen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kristian Karstoft
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
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20
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Lerche CJ, Christophersen LJ, Trøstrup H, Thomsen K, Jensen PØ, Hougen HP, Bundgaard H, Høiby N, Moser C. Low efficacy of tobramycin in experimental Staphylococcus aureus endocarditis. Eur J Clin Microbiol Infect Dis 2015; 34:2349-57. [PMID: 26440039 DOI: 10.1007/s10096-015-2488-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 09/03/2015] [Indexed: 12/31/2022]
Abstract
The empiric treatment of infective endocarditis (IE) varies widely and, in some places, a regimen of penicillin in combination with an aminoglycoside is administered. The increasing incidence of Staphylococcus aureus IE, poor tissue penetration by aminoglycosides and low frequency of penicillin-susceptible S. aureus may potentially lead to functional tobramycin monotherapy. Therefore, this study aimed to evaluate tobramycin monotherapy in an experimental S. aureus IE rat model. Catheter-induced IE at the aortic valves were established with S. aureus (NCTC 8325-4) and rats were randomised into untreated (n = 22) or tobramycin-treated (n = 13) groups. The treatment group received tobramycin once-daily. Animals were evaluated at 1 day post infection (DPI), 2 DPI or 3 DPI. Quantitative bacteriology and cytokine expression were measured for valves, myocardium and serum. A decrease of bacterial load was observed in valves and the spleens of the treated (n = 6) compared to the untreated group at 2 DPI (n = 8) (p ≤ 0.02 and p ≤ 0.01, respectively), but not at 3 DPI (n = 7). Quantitative bacteriology in the myocardium was not different between the groups. Keratinocyte-derived chemokine (KC) in the aortic valves was significantly reduced at 2 DPI in the tobramycin-treated group (p ≤ 0.03). However, the expression of interleukin (IL)-1b, IL-6 and granulocyte-colony stimulating factor (G-CSF) in the valves was not different between the two groups. In the myocardium, a significant reduction in IL-1b was observed at 2 DPI (p ≤ 0.001) but not at 3 DPI. Tobramycin as functional monotherapy only reduced bacterial load and inflammation transiently, and was insufficient in most cases of S. aureus IE.
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Affiliation(s)
- C J Lerche
- Department of Clinical Microbiology 9301, Copenhagen University Hospital, Rigshospitalet, Juliane Maries vej 22, 2100, Copenhagen, Denmark.
| | - L J Christophersen
- Department of Clinical Microbiology 9301, Copenhagen University Hospital, Rigshospitalet, Juliane Maries vej 22, 2100, Copenhagen, Denmark
| | - H Trøstrup
- Department of Clinical Microbiology 9301, Copenhagen University Hospital, Rigshospitalet, Juliane Maries vej 22, 2100, Copenhagen, Denmark
| | - K Thomsen
- Department of Clinical Microbiology 9301, Copenhagen University Hospital, Rigshospitalet, Juliane Maries vej 22, 2100, Copenhagen, Denmark
| | - P Ø Jensen
- Department of Clinical Microbiology 9301, Copenhagen University Hospital, Rigshospitalet, Juliane Maries vej 22, 2100, Copenhagen, Denmark
| | - H P Hougen
- Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | - H Bundgaard
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - N Høiby
- Department of Clinical Microbiology 9301, Copenhagen University Hospital, Rigshospitalet, Juliane Maries vej 22, 2100, Copenhagen, Denmark.,Institute of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - C Moser
- Department of Clinical Microbiology 9301, Copenhagen University Hospital, Rigshospitalet, Juliane Maries vej 22, 2100, Copenhagen, Denmark
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21
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Thomsen K, Christophersen L, Bjarnsholt T, Jensen PØ, Moser C, Høiby N. Anti-Pseudomonas aeruginosa IgY Antibodies Induce Specific Bacterial Aggregation and Internalization in Human Polymorphonuclear Neutrophils. Infect Immun 2015; 83:2686-93. [PMID: 25895968 PMCID: PMC4468541 DOI: 10.1128/iai.02970-14] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 04/10/2015] [Indexed: 01/24/2023] Open
Abstract
Polymorphonuclear neutrophils (PMNs) are essential cellular constituents in the innate host response, and their recruitment to the lungs and subsequent ubiquitous phagocytosis controls primary respiratory infection. Cystic fibrosis pulmonary disease is characterized by progressive pulmonary decline governed by a persistent, exaggerated inflammatory response dominated by PMNs. The principal contributor is chronic Pseudomonas aeruginosa biofilm infection, which attracts and activates PMNs and thereby is responsible for the continuing inflammation. Strategies to prevent initial airway colonization with P. aeruginosa by augmenting the phagocytic competence of PMNs may postpone the deteriorating chronic biofilm infection. Anti-P. aeruginosa IgY antibodies significantly increase the PMN-mediated respiratory burst and subsequent bacterial killing of P. aeruginosa in vitro. The mode of action is attributed to IgY-facilitated formation of immobilized bacteria in aggregates, as visualized by fluorescence microscopy and the induction of increased bacterial hydrophobicity. Thus, the present study demonstrates that avian egg yolk immunoglobulins (IgY) targeting P. aeruginosa modify bacterial fitness, which enhances bacterial killing by PMN-mediated phagocytosis and thereby may facilitate a rapid bacterial clearance in airways of people with cystic fibrosis.
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Affiliation(s)
- K Thomsen
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - L Christophersen
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - T Bjarnsholt
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Department of International Health, Immunology and Microbiology, Faculty of Health Sciences University of Copenhagen, Copenhagen, Denmark
| | - P Ø Jensen
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - C Moser
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - N Høiby
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Department of International Health, Immunology and Microbiology, Faculty of Health Sciences University of Copenhagen, Copenhagen, Denmark
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22
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Thomsen K, Jepsen DB, Matzen L, Hermann AP, Masud T, Ryg J. Is calcaneal quantitative ultrasound useful as a prescreen stratification tool for osteoporosis? Osteoporos Int 2015; 26:1459-75. [PMID: 25634771 DOI: 10.1007/s00198-014-3012-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 12/17/2014] [Indexed: 11/30/2022]
Abstract
Calcaneal quantitative ultrasound (QUS) is attractive as a prescreening tool for osteoporosis, alternative to dual-energy X-ray absorptiometry. We investigated the literature of the usability of calcaneal QUS. We found large heterogeneity between studies and uncertainty about cutoff, device, and measured variable. Despite osteoporosis-related fractures being a major health issue, osteoporosis remains underdiagnosed. Dual-energy X-ray absorptiometry (DXA) of the hip or spine is currently the preferred method for diagnosis of osteoporosis, but the method is limited by low accessibility. QUS is a method for assessing bone alternative to DXA. The aim of this systematic review was to explore the usability of QUS as a prescreen stratification tool for assessment of osteoporosis. Studies that evaluated calcaneal QUS with DXA of the hip or spine as the gold standard was included. We extracted data from included studies to calculate number of DXAs saved and misclassification rates at cutoffs equal to high sensitivity and/or specificity. The number of DXAs saved and percentage of persons misclassified were measures of usability. We included 31 studies. Studies were heterogeneous regarding study characteristics. Analyses showed a wide spectrum of percentage of DXAs saved (2.7-68.8%) and misclassification rates (0-12.4%) depending on prescreen strategy and study characteristics, device, measured variable, and cutoff. Calcaneal QUS is potentially useful as a prescreen tool for assessment of osteoporosis. However, there is no consensus of device, variable, and cutoff. Overall, there is no sufficient evidence to recommend a specific cutoff for calcaneal QUS that provides a certainty level high enough to rule in or out osteoporosis. Calcaneal QUS in a prescreen or stratification algorithm must be based on device-specific cutoffs that are validated in the populations for which they are intended to be used.
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Affiliation(s)
- K Thomsen
- Institute of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29 Entrance 112, 7th floor, 5000, Odense C, Denmark,
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23
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Thomsen K, Ryg J, Hermann AP, Matzen L, Masud T. Calcaneal quantitative ultrasound and phalangeal radiographic absorptiometry alone or in combination in a triage approach for assessment of osteoporosis: a study of older women with a high prevalence of falls. BMC Geriatr 2014; 14:143. [PMID: 25526670 PMCID: PMC4289572 DOI: 10.1186/1471-2318-14-143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 06/05/2014] [Accepted: 12/12/2014] [Indexed: 12/03/2022] Open
Abstract
Background The objective of this study was to investigate if application of United Kingdom National Osteoporosis Society (UK-NOS) triage approach, using calcaneal quantitative ultrasound (QUS), phalangeal radiographic absorptiometry (RA), or both methods in combination, for identification of women with osteoporosis, would reduce the percentage of women who need further assessment with Dual Energy X-ray Absorptiometry (DXA) among older women with a high prevalence of falls. Methods We assessed 286 women with DXA of hip and spine (Hologic Discovery) of whom 221 were assessed with calcaneal QUS (Achilles Lunar), 245 were assessed with phalangeal RA (Aleris Metriscan), and 202 were assessed with all three methods. Receiver operator characteristics (ROC) curve for QUS, RA, and both methods in combination predicting osteoporosis defined by central DXA were performed. We identified cutoffs at different sensitivity and specificity values and applied the triage approach recommended by UK-NOS. The percentage of women who would not need further examination with DXA was calculated. Results Median age was 80 years (interquartile range [IQR]) [75–85], range 65–98. 66.8% reported at least one fall within the last 12 months. Prevalence of osteoporosis was 44.4%. Area under the ROC-curve (AUC) (95% confidence interval (CI)) was 0.808 (0.748-0.867) for QUS, 0.800 (0.738-0.863) for RA, and 0.848 (0.796-0.900) for RA and QUS in combination. At 90% certainty levels, UK-NOS triage approach would reduce the percentage of women who need further assessment with DXA by 60% for QUS, and 43% for RA. The false negative and false positive rates ranged from 4% to 5% for QUS and RA respectively. For the combined approach using 90% certainty level the proportion of DXAs saved was 22%, the false negative rate was 0% and false positive rate was 0.5%. Using 85% certainty level for the combined approach the proportion of DXAs saved increased to 41%, but false negative and false positive values remained low (0.5%, and 0.5% respectively). Conclusions In a two-step, triage approach calcaneal QUS and phalangeal RA perform well, reducing the number of women who would need assessment with central DXA. Combining RA and QUS reduces misclassifications whilst still reducing the need for DXAs.
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Affiliation(s)
- Katja Thomsen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
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Thomsen K, Ryg J, Matzen L, Hermann AP, Masud T. Choice of osteoporosis guideline has important implications for the treatment decision in elderly women referred to a fall clinic. Dan Med J 2014; 61:A4980. [PMID: 25441734] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Different guidelines are used worldwide to make decisions on treating osteoporosis. Some are based on fracture risk calculations, whereas others use criteria based on bone mineral density (BMD) T-scores, risk factors, or fragility fractures. The aim of this study was to explore how osteoporosis treatment decisions in a group of elderly women with falls would be affected if fracture risk-based guidelines were used as compared to guidelines based on BMD T-scores. METHODS We studied 88 women attending a falls clinic. Dual energy X-ray absorptiometry and vertebral fracture assessment were performed and clinical risk factors were identified. We calculated the percentage of women recommended for treatment using five guidelines: Danish Bone Society (DBS-DK), UK National Osteoporosis Guideline Group (NOGG-UK), US National Osteoporosis Foundation (NOF-US); and we applied a 20% cut-off to fracture risk calculations by the Garvan Fracture Risk Calculator and Q-fracture 2012. Agreement was calculated using kappa statistics. RESULTS The median age (interquartile range) was 81 years (75-85.5 years). The proportion of women (95% confidence interval) recommended for treatment was DBS-DK 56% (44.7-66.3%), NOGG-UK 51% (40.1-62.1%), NOF-US 88% (78.5-93.5%), Garvan 91% (82.9-96.0%), Q-fracture 58% (47.0-68.4%). The guidelines agreed on treatment recommendations for 23 (26%) of the 88 women studied. The kappa score was 0.13 (p < 0.0001). CONCLUSION This study showed that the choice of guideline has a major impact on the treatment decisions in elderly women with falls. FUNDING not relevant. TRIAL REGISTRATION ClinicalTrial.gov (NCT01600547).
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Affiliation(s)
- Katja Thomsen
- Geriatrisk Afdeling G, Odense Universitetshospital, Sdr. Boulevard 29, indg. 112, 7., 5000 Odense C, Denmark.
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Thomsen K, Christophersen L, Moser C, Jensen P, Bjarnsholt T, Høiby N. 120 Anti-Pseudomonas aeruginosa IgY antibodies promote bacterial clearance in a murine pneumonia model. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60256-3] [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: 11/16/2022]
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Cao B, Christophersen L, Thomsen K, Sønderholm M, Bjarnsholt T, Jensen PØ, Høiby N, Moser C. 63 Distribution of tobramycin and the impact on bacterial killing in a biofilm model. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60200-9] [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: 10/25/2022]
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Heinitz S, Schumann D, Neuhausen J, Köchli S, Thomsen K, Platacis E, Lielausis O, Bucenieks I, Zik A, Romančuks A, Kravalis K, Buligins L, Türler A. A comparison between the chemical behaviour of lead-gold and lead-bismuth eutectics towards 316L stainless steel. RADIOCHIM ACTA 2013. [DOI: 10.1524/ract.2013.2063] [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: 11/24/2022]
Abstract
Summary
Lead-gold eutectic (LGE) has been recently proposed as an alternative target material for high power spallation sources. In order to compare the corrosive properties of LGE to the better-studied eutectic of lead-bismuth (LBE), an isothermal twin-loop made of SS 316L was built and operated at the Institute of Physics of the University of Latvia. We have measured the concentration of steel alloying elements dissolved in both alloys at the end of two test campaigns via ICP-OES. In case of LGE, a pronounced concentration increase of Fe, Ni, Mn and Cr is found in the liquid metal, which is significantly higher compared to LBE. Similar results were obtained during complementary investigations on material samples exposed to both alloys in this twin-loop at 400 ◦C and 450 ◦C. These findings indicate that in contact with LGE, SS 316L steel suffers from substantial chemical attack. Detailed investigations using structure materials other than SS 316L have to be undertaken before qualifying LGE as a serious alternative to LBE.
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Affiliation(s)
- S. Heinitz
- Paul Scherrer Institute, Laboratory of Radiochemistry and Environmental Chemistry, 5232 Villigen, PSI, Switzerland
- University of Bern, Department of Chemistry and Biochemistry, 3012, Bern, Switzerland
| | - D. Schumann
- Paul Scherrer Institute, Laboratory of Radiochemistry and Environmental Chemistry, 5232 Villigen, PSI, Switzerland
| | - J. Neuhausen
- Paul Scherrer Institute, Laboratory of Radiochemistry and Environmental Chemistry, 5232 Villigen, PSI, Switzerland
| | - S. Köchli
- Paul Scherrer Institute, Laboratory of Radiochemistry and Environmental Chemistry, 5232 Villigen, PSI, Switzerland
| | - K. Thomsen
- Paul Scherrer Institute, Spallation Neutron Source Division, 5232 Villigen, PSI, Switzerland
| | - E. Platacis
- Institute of Physics, University of Latvia, 2169 IPUL, Latvia
| | - O. Lielausis
- Institute of Physics, University of Latvia, 2169 IPUL, Latvia
| | - I. Bucenieks
- Institute of Physics, University of Latvia, 2169 IPUL, Latvia
| | - A. Zik
- Institute of Physics, University of Latvia, 2169 IPUL, Latvia
| | - A. Romančuks
- Institute of Physics, University of Latvia, 2169 IPUL, Latvia
| | - K. Kravalis
- Institute of Physics, University of Latvia, 2169 IPUL, Latvia
| | - L. Buligins
- Faculty of Physics and Mathematics, University of Latvia, 1002 Riga, Latvia
| | - A. Türler
- Paul Scherrer Institute, Laboratory of Radiochemistry and Environmental Chemistry, 5232 Villigen, PSI, Switzerl
- University of Bern, Department of Chemistry and Biochemistry, 3012, Bern, Switzerland
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Thomsen K, Ryg J, Matzen L, Masud T. Who to treat for osteoporosis in a falls clinic – a comparison of different international guidelines. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.202] [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: 10/26/2022]
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Cavanagh JP, Granslo HN, Fredheim EA, Christophersen L, Jensen PO, Thomsen K, Van Gennip M, Klingenberg C, Flaegstad T, Moser C. Efficacy of a synthetic antimicrobial peptidomimetic versus vancomycin in a Staphylococcus epidermidis device-related murine peritonitis model. J Antimicrob Chemother 2013; 68:2106-10. [DOI: 10.1093/jac/dkt161] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Christophersen LJ, Trøstrup H, Malling Damlund DS, Bjarnsholt T, Thomsen K, Jensen PØ, Hougen HP, Høiby N, Moser C. Bead-size directed distribution of Pseudomonas aeruginosa results in distinct inflammatory response in a mouse model of chronic lung infection. Clin Exp Immunol 2013; 170:222-30. [PMID: 23039893 DOI: 10.1111/j.1365-2249.2012.04652.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Chronic Pseudomonas aeruginosa lung infection in cystic fibrosis (CF) patients is characterized by biofilms, tolerant to antibiotics and host responses. Instead, immune responses contribute to the tissue damage. However, this may depend on localization of infection in the upper conductive or in the peripheral respiratory zone. To study this we produced two distinct sizes of small alginate beads (SB) and large beads (LB) containing P. aeruginosa. In total, 175 BALB/c mice were infected with either SB or LB. At day 1 the quantitative bacteriology was higher in the SB group compared to the LB group (P < 0·003). For all time-points smaller biofilms were identified by Alcian blue staining in the SB group (P < 0·003). Similarly, the area of the airways in which biofilms were identified were smaller (P < 0·0001). A shift from exclusively endobronchial to both parenchymal and endobronchial localization of inflammation from day 1 to days 2/3 (P < 0·05), as well as a faster resolution of inflammation at days 5/6, was observed in the SB group (P < 0·03). Finally, both the polymorphonuclear neutrophil leucocyte (PMN) mobilizer granulocyte colony-stimulating factor (G-CSF) and chemoattractant macrophage inflammatory protein-2 (MIP-2) were increased at day 1 in the SB group (P < 0·0001). In conclusion, we have established a model enabling studies of host responses in different pulmonary zones. An effective recognition of and a more pronounced host response to infection in the peripheral zones, indicating that increased lung damage was demonstrated. Therefore, treatment of the chronic P. aeruginosa lung infection should be directed primarily at the peripheral lung zone by combined intravenous and inhalation antibiotic treatment.
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Affiliation(s)
- L J Christophersen
- Department of Clinical Microbiology 93.01, Copenhagen University Hospital, Rigshospitalet Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
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Malik F, Russell A, Pannirselvam M, Hinken A, Thomsen K, Ardiana A, Godinez G, Jia Z, Saikali K, Chen M, Morgans D, Jasper J. The Fast Skeletal Troponin Activator, CK-2017357, Increases Muscle Function and Survival in SOD1 (G93A) Mice; a Model of ALS (P05.169). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.169] [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] Open
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Abstract
We have studied bone turnover and bone status in 29 patients with hip fractures and compared them with normal subjects and patients with arthritis of the hip. Markers for bone formation, bone Gla protein, alkaline phosphatase and whole body retention of 99mTc-diphosphonate, and fasting urinary hydroxyproline, a marker for bone resorption, were all significantly higher in the hip fracture group than in the control group. The serum concentrations of 1,25-dihydroxyvitamin D were similar in the three groups, whereas the serum 25-hydroxyvitamin D concentration in the control group was higher than in the patient groups. The bone mineral content (BMC) measured in the distal forearm and the spine was lower than normal in the hip fracture group. We conclude that patients with hip fractures have an increased bone turnover with no signs of bimodality and low BMC values at all locations.
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Affiliation(s)
- D Hartwell
- Department of Clinical Chemistry, Glostrup Hospital, University of Copenhagen, Denmark
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Abstract
Epidemiological and prospective studies in man and animals have indicated an inverse relationship between calcium intake and cardiovascular mortality and blood pressure (BP). We have therefore studied the effect of dietary calcium on blood pressure in two groups of women. In a cross-sectional study 103 early postmenopausal women were stratified into three groups according to daily calcium intake calculated from a questionnaire. Both diastolic and systolic blood pressures were identical in the three groups. We thereafter conducted a prospective placebo-controlled trial on the effect of calcium supplementation. Twenty-eight healthy women were randomized to placebo treatment (n = 14) or calcium supplementation 2,000 mg daily (n = 14) for one year. In both groups BP remained at initial levels throughout the study and was identical in the two groups at measurements every three months. We thus conclude that calcium supplementation has no effect on BP in normotensive subjects on a high calcium diet.
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Geisler A, Schou M, Thomsen K. Renal Lithium Elimination in Manic-Depressive Patients – Initial Excretion and Clearance. Pharmacopsychiatry 2009. [DOI: 10.1055/s-0028-1094307] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Purcell JW, Reddy M, Davis J, Samayoa K, Vo CH, Thomsen K, Bean PA, Wood KW, Cases S. Ispinesib (SB-715992) a kinesin spindle protein (KSP) inhibitor has single agent activity and enhances the efficacy of standard-of-care therapies in pre-clinical models of breast cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-2122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #2122
Background: Ispinesib is a novel highly specific small molecule inhibitor of kinesin spindle protein (KSP), a motor protein that is essential for formation of a bipolar mitotic spindle and for cell cycle progression through mitosis. KSP is expressed only in proliferating cells and not in post-mitotic neurons. In preclinical models and clinical studies thus far, ispinesib exhibits a favorable safety profile compared with tubulin-targeted therapies. Ispinesib has demonstrated clinical activity in patients with locally advanced or metastatic breast cancer that failed to respond/relapsed after treatment with taxanes and anthracyclines, and is currently being evaluated in a Phase I/II trial as first-line treatment in chemotherapy-naïve patients with locally advanced (Stage IIIB) or metastatic (Stage IV) breast cancer. In the current study, we explored the anti-tumor activity of ispinesib as a single agent and in combination with approved therapies in preclinical models of breast cancer. Methods: We implanted cells representative of hormone receptor positive luminal tumors (MCF-7), tumors overexpressing Her-2 (KPL4, HCC1954, BT474) or triple-negative basal tumors (MDA-MB-468) in immunodeficient female Nude or SCID mice. We started dosing Ispinesib when tumor volume reached 100-150mm3 and monitored xenograft growth for 60 days post treatment. Results: Ispinesib administered i.p. as a single agent on a q4dx3 schedule at its MTD induced tumor regressions in all five models of human breast cancer. In particular, all treated MDA-MB-468 xenografts (7/7) were tumor free survivors at 90 days post dosing. In tumors collected at different times post-dosing, we observed a strong mitotic arrest, inhibition of proliferation, and increased apoptosis by western blotting and IHC analyses of PH3, Ki67 and cleaved PARP respectively. We also determined the efficacy of ispinesib in combination with standard-of-care therapies in breast cancer. In the Her2 overexpressing models, the combination of ispinesib and herceptin markedly improved response rate and efficacy over either single agent. Tumor Growth Inhibition (TGI) was 99% for the combined agents, 67% for herceptin and 78% for ispinesib in KPL4. A similar benefit was found by combining ispinesib with lapatinib in BT474. Finally, ispinesib enhanced the anti-tumor activity of doxorubicin, causing an increase in TGI in 2 separate models (in MCF7, TGI was 86% for the combined agents, 39% for doxorubicin and 67% for ispinesib). Additional combination studies with capecitabine are under investigation.Conclusions: In distinct models of human breast cancer, ispinesib exhibited significant anti-tumor activity as a single agent. When used in combination, ispinesib enhanced the activity of standard-of-care therapies herceptin, lapatinib and doxorubicin. These data suggest that ispinesib may offer clinical benefit in the treatment of breast cancer, and support clinical studies of ispinesib in combination with these therapies.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2122.
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Affiliation(s)
- JW Purcell
- 1 Cytokinetics, Inc., South San Francisco, CA
| | - M Reddy
- 1 Cytokinetics, Inc., South San Francisco, CA
| | - J Davis
- 1 Cytokinetics, Inc., South San Francisco, CA
| | - K Samayoa
- 1 Cytokinetics, Inc., South San Francisco, CA
| | - CH Vo
- 1 Cytokinetics, Inc., South San Francisco, CA
| | - K Thomsen
- 1 Cytokinetics, Inc., South San Francisco, CA
| | - PA Bean
- 1 Cytokinetics, Inc., South San Francisco, CA
| | - KW Wood
- 1 Cytokinetics, Inc., South San Francisco, CA
| | - S Cases
- 1 Cytokinetics, Inc., South San Francisco, CA
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Wedderkopp N, Thomsen K, Manniche C, Kolmos HJ, Secher Jensen T, Leboeuf Yde C. No evidence for presence of bacteria in modic type I changes. Acta Radiol 2009; 50:65-70. [PMID: 19052939 DOI: 10.1080/02841850802524485] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Recent studies suggest an association between sciatica and Propionibacterium acnes. "Modic type I changes" in the vertebrae are closely associated with sciatica and lower back pain, and recent studies have questioned the ability of conventional magnetic resonance imaging (MRI) to differentiate between degenerative Modic type I changes and vertebral abnormalities caused by infection. PURPOSE To test whether bacteria could be cultured from biopsies of Modic type I changes. MATERIAL AND METHODS Twenty-four consecutive patients with Modic type I changes in lumbar vertebrae had a biopsy taken from the affected vertebra by a strict aseptic procedure. The biopsy was split into two specimens, which were inoculated into thioglycolate agar tubes in the surgical theatre and transported to the microbiology laboratory. In the laboratory, one specimen was streaked onto plates and analyzed for anaerobic and aerobic culture. The other tube was left unopened and incubated directly. Plates and tubes were incubated for 2 weeks and observed for visible growth. RESULTS None of the biopsies yielded growth of anaerobic bacteria. In one patient, both biopsies yielded growth of Staphylococcus epidermidis, and in another patient coagulase-negative staphylococci were isolated from one biopsy. Both patients received oral antibiotics without convincing effect on symptoms. CONCLUSION Our results showed no evidence of bacteria in vertebrae with Modic type I changes. The isolation of staphylococci from two patients probably represented contamination.
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Affiliation(s)
- N. Wedderkopp
- Back Research Center, Hospital of Funen, part of the Clinical Locomotion Science Group, Ringe, Denmark
- Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - K. Thomsen
- Back Research Center, Hospital of Funen, part of the Clinical Locomotion Science Group, Ringe, Denmark
- Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - C. Manniche
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | - H. J. Kolmos
- Back Research Center, Hospital of Funen, part of the Clinical Locomotion Science Group, Ringe, Denmark
- Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - T. Secher Jensen
- Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - C. Leboeuf Yde
- Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Podofillini L, Dang V, Thomsen K. Scoping-level Probabilistic Safety Assessment of a complex experimental facility: Challenges and first results from the application to a neutron source facility (MEGAPIE). Nuclear Engineering and Design 2008. [DOI: 10.1016/j.nucengdes.2008.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lucchinetti CF, Gavrilova RH, Metz I, Parisi JE, Scheithauer BW, Weigand S, Thomsen K, Mandrekar J, Altintas A, Erickson BJ, König F, Giannini C, Lassmann H, Linbo L, Pittock SJ, Brück W. Clinical and radiographic spectrum of pathologically confirmed tumefactive multiple sclerosis. Brain 2008; 131:1759-75. [PMID: 18535080 PMCID: PMC2442427 DOI: 10.1093/brain/awn098] [Citation(s) in RCA: 305] [Impact Index Per Article: 19.1] [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] [Indexed: 12/11/2022] Open
Abstract
Atypical imaging features of multiple sclerosis lesions include size >2 cm, mass effect, oedema and/or ring enhancement. This constellation is often referred to as ‘tumefactive multiple sclerosis’. Previous series emphasize their unifocal and clinically isolated nature, however, evolution of these lesions is not well defined. Biopsy may be required for diagnosis. We describe clinical and radiographic features in 168 patients with biopsy confirmed CNS inflammatory demyelinating disease (IDD). Lesions were analysed on pre- and post-biopsy magnetic resonance imaging (MRI) for location, size, mass effect/oedema, enhancement, multifocality and fulfilment of Barkhof criteria. Clinical data were correlated to MRI. Female to male ratio was 1.2 : 1, median age at onset, 37 years, duration between symptom onset and biopsy, 7.1 weeks and total disease duration, 3.9 years. Clinical course prior to biopsy was a first neurological event in 61%, relapsing–remitting in 29% and progressive in 4%. Presentations were typically polysymptomatic, with motor, cognitive and sensory symptoms predominating. Aphasia, agnosia, seizures and visual field defects were observed. At follow-up, 70% developed definite multiple sclerosis, and 14% had an isolated demyelinating syndrome. Median time to second attack was 4.8 years, and median EDSS at follow-up was 3.0. Multiple lesions were present in 70% on pre-biopsy MRI, and in 83% by last MRI, with Barkhof criteria fulfilled in 46% prior to biopsy and 55% by follow-up. Only 17% of cases remained unifocal. Median largest lesion size on T2-weighted images was 4 cm (range 0.5–12), with a discernible size of 2.1 cm (range 0.5–7.5). Biopsied lesions demonstrated mass effect in 45% and oedema in 77%. A strong association was found between lesion size, and presence of mass effect and/or oedema (P< 0.001). Ring enhancement was frequent. Most tumefactive features did not correlate with gender, course or diagnosis. Although lesion size >5 cm was associated with a slightly higher EDSS at last follow-up, long-term prognosis in patients with disease duration >10 years was better (EDSS 1.5) compared with a population-based multiple sclerosis cohort matched for disease duration (EDSS 3.5; P< 0.001). Given the retrospective nature of the study, the precise reason for biopsy could not always be determined. This study underscores the diagnostically challenging nature of CNS IDDs that present with atypical clinical or radiographic features. Most have multifocal disease at onset, and develop RRMS by follow-up. Although increased awareness of this broad spectrum may obviate need for biopsy in many circumstances, an important role for diagnostic brain biopsy may be required in some cases.
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Affiliation(s)
- C F Lucchinetti
- Department of Neurology, College of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
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Fazio C, Gröschel F, Wagner W, Thomsen K, Smith B, Stieglitz R, Zanini L, Guertin A, Cadiou A, Henry J, Agostini P, Dai Y, Heyck H, Dementjev S, Panebianco S, Almazouzi A, Eikenberg J, Letourneau A, Toussaint J, Janett A, Perret C, Joray S, Patorski J, Leung W, Meloni P, Turroni P, Zucchini A, Benamati G, Konys J, Auger T, Gessi A, Gorse D, Serre I, Terlain A, Vogt JB, Batta A, Class A, Cheng X, Fellmoser F, Daubner M, Gnieser S, Grötzbach G, Milenkovic R, Latgé C, Knebel J. The MEGAPIE-TEST project: Supporting research and lessons learned in first-of-a-kind spallation target technology. Nuclear Engineering and Design 2008. [DOI: 10.1016/j.nucengdes.2007.11.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Thomsen K, Beck S, Wilhelm B. The jabber chat tool EFDA Messenger and screen sharing tool EFDATV. Fusion Engineering and Design 2008. [DOI: 10.1016/j.fusengdes.2008.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Castro R, Vega J, Portas A, López D, Balme S, Theis J, Lebourg P, Fernandes H, Neto A, Duarte A, Oliveira F, Reis F, Purahoo K, Thomsen K, Schiller W, Kadlecsik J. PAPI based federation as a test-bed for a common security infrastructure in EFDA sites. Fusion Engineering and Design 2008. [DOI: 10.1016/j.fusengdes.2007.08.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Albrecht M, Kleinkauf-Houken A, Trams G, Thomsen K. 5jährige Erfahrungen mit adjuvanter Chemotherapie beim primären Mammakarzinom. Geburtshilfe Frauenheilkd 2008; 44:550-6. [PMID: 6567559 DOI: 10.1055/s-2008-1036300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
In 515 patients with primary carcinoma of the breast T1a-3aN1a-bM0, the authors conducted simple mastectomy with radical lymphonodectomy of the axilla from 1976 onwards to the time of reporting. In 190 patients with affected lymph nodes, assisting chemotherapy was effected with a combination of three drugs, namely, trofosfamide, methotrexate and 5-fluoro-uracil for a period of 12 months postoperatively. Patients whose lymph nodes remained free were not subjected to follow-up treatment. For both groups of patients, the rates of relapses and survival times were established for an average follow-up time of 41 months (15-75). No significant differences in the rates of relapses and localisation were seen on comparing both groups (P = 0.27). In the patients with affected lymph nodes, local relapses were somewhat more frequent than with patients whose lymph nodes were not affected (11.1% vs. 9.8%); the same also applied to the occurrence of metastases distant from the primary tumour (12.1% vs. 7.4%). Significant differences in survival rates in patients with affected lymph nodes were seen only in the tumour stages T1/T2 (P = 0.001) and for the stages T2/T3 (P = 0.009). The menopausal status of the patients did not show any significant differences in respect of probability of survival for both groups (N-:P = 0.75; N+:P = 0.79).
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Purhonen P, Thomsen K, Maunsbach AB, Hebert H. Association of renal Na,K-ATPase alpha-subunit with the beta- and gamma-subunits based on cryoelectron microscopy. J Membr Biol 2007; 214:139-46. [PMID: 17557166 DOI: 10.1007/s00232-006-0056-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2006] [Revised: 11/29/2006] [Indexed: 11/28/2022]
Abstract
Na,K-ATPase transports Na(+) and K(+) across cell membranes and consists of alpha- and beta-subunits. Na,K-ATPase also associates with small FXYD proteins that regulate the activity of the pump. We have used cryoelectron microscopy of two-dimensional crystals including data to 8 A resolution to determine the three-dimensional (3-D) structure of renal Na,K-ATPase containing FXYD2, the gamma-subunit. A homology model for the alpha-subunit was calculated from a Ca(2+)-ATPase structure and used to locate the additional beta- and gamma-subunits present in the 3-D map of Na,K-ATPase. Based on the 3-D map, the beta-subunit is located close to transmembrane helices M8 and M10 and the gamma-subunit is adjacent to helices M2 and M9 of the alpha-subunit.
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Affiliation(s)
- P Purhonen
- Department of Biosciences and Nutrition and School of Technology and Health, Karolinska Institutet, Royal Institute of Technology, S-141 57, Huddinge, Sweden
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Abstract
The aetiology of congenital club foot is unclear. Although studies on populations, families and twins suggest a genetic component, the mode of inheritance does not comply with distinctive patterns. The Odense-based Danish Twin Registry contains data on all 73 000 twin pairs born in Denmark over the last 130 years. In 2002 all 46 418 twins born between 1931 and 1982 received a 17-page questionnaire, one question of which was ‘Were you born with club foot?’ A total of 94 twins answered ‘Yes’, giving an overall self-reported prevalence of congenital club foot of 0.0027 (95% confidence interval (CI) 0.0022 to 0.0034). We identified 55 complete twin pairs, representing 12 monozygotic, 22 dizygotic same sex (DZss), 18 dizygotic other sex (DZos) and three unclassified. Two monozygotic and 2 DZss pairs were concordant. The pairwise concordance was 0.17 (95% CI 0.02 to 0.48) for monozygotic, 0.09 (95% CI 0.01 to 0.32) for DZss and 0.05 (95% CI 0.006 to 0.18) for all dizygotic (DZtot) twins. We have found evidence of a genetic component in congenital club foot, although non-genetic factors must play a predominant role.
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Affiliation(s)
- V Engell
- Department of Orthopaedic Surgery, University Hospital of Odense, SDR Boulevard 29, DK-5000 Odense C, Denmark.
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Abstract
BACKGROUND High-frequency ultrasound of the skin has recently been introduced for assessment of systemic effects in the cutis and subcutis of oral and inhaled glucocorticoids in children. However, the use of high-frequency skin ultrasound in clinical trials is invalidated because important methodological aspects have not been addressed. The aim of the present study was to evaluate inter- and intraobserver, day to day and diurnal variations of measurement of thickness of cutis and subcutis, and the fraction of low echogenic pixels (fLEP) in the cutis and, furthermore, to assess effects of exercise on the cutis and subcutis and variations in subcutaneous thickness between anatomical locations in children with a high-frequency B-mode ultrasound scanning device. METHODS Three studies were conducted, each including 10 healthy prepubertal children. High-frequency skin ultrasound was performed with the 20 MHz Dermascan C (Cortex Technology, Hadsund, Denmark). In study 1, the same observer performed five consecutive scannings to assess intraobserver variations. In study two different observers performed scannings at 2 h intervals between 08:00 and 20:00 h, whereby interobserver and diurnal variations were assessed. In study 3, the same observer performed scannings in different anatomical locations on five consecutive days, and on one of these days before and after exercise. Thus day-to-day variations and the effect of exercise were assessed. RESULTS Low inter- and intraobserver variations were found on assessment of the thickness of cutis and subcutis, whereas high variations were found on evaluation of the dermal water content. Diurnal variations were absent, and day-to-day variations were low. Exercise caused significant increases in the thickness of cutis and subcutis on the thigh. CONCLUSION Low inter- and intraobserver variations make high-frequency ultrasound a precise and reliable tool for assessment of the cutaneous and subcutaneous thickness in children. In future trials, repetitive scannings need not to be performed at the same time of the day, whereas strenuous physical activity should be avoided on days of examination.
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Affiliation(s)
- A J Schou
- Children's Clinic Randers, Dytmaersken 9,3. Randers, Denmark.
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Schou AJ, Plomgaard AM, Thomsen K, Wolthers OD. Lower leg growth suppression caused by inhaled glucocorticoids is not accompanied by reduced thickness of the cutis or subcutis. Acta Paediatr 2004; 93:623-7. [PMID: 15174784 DOI: 10.1111/j.1651-2227.2004.tb02986.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Exogenous glucocorticoids suppress short-term lower leg growth in children as assessed by knemometry. The knemometric measurements, however, may be confounded by reductions in the thickness of the cutis and subcutis over the knee. AIM To assess whether inhaled glucocorticoid-induced suppression of short-term growth is accompanied by changes in the thickness of the cutis and subcutis. METHODS The study was a randomized, controlled, crossover trial with 1 wk treatment, run-in and washout periods. Active treatment was inhaled budesonide 200 microg twice daily. Short-term growth was assessed by knemometry, and the thickness of the cutis and subcutis over the knee, on the volar forearm and abdomen was measured by 20 MHz B-mode ultrasound. MATERIAL Nineteen children with asthma aged 7 to 13 y. RESULTS Lower leg growth was significantly reduced during budesonide treatment (0.27 mm/wk) compared to the treatment-free period (0.54 mm/wk) (p = 0.02, 95%: -0.50 to -0.05). Variations in the thickness of the cutis were seen during budesonide treatment (mean +/- SEM): -0.01 +/- 0.03 mm over the knee, -0.02 +/- 0.02 mm on the forearm and 0.01 +/- 0.02 mm on the abdomen. The variations in the total thickness of the cutis and subcutis were -0.05 +/- 0.12 mm, 0.06 +/- 0.12 mm and -0.06 +/- 0.10 mm during budesonide treatment. The variations in thickness of the cutis or subcutis were not statistically different during budesonide treatment and the treatment free period in any anatomical location. CONCLUSIONS Short-term lower leg growth suppression induced by inhaled glucocorticoids is not confounded by variations in thickness of cutis or subcutis. The present observations further establishes knemometry as a reliable tool for assessment of the risk of growth suppression of inhaled glucocorticoids in children with asthma.
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Affiliation(s)
- A J Schou
- Children's Clinic, Randers, Denmark.
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Xu QG, Cheng C, Sun H, Thomsen K, Zochodne DW. Local sensory ganglion ischemia induced by endothelin vasoconstriction: vulnerability of diabetic neurons and microvessels. Neuroscience 2004; 122:897-905. [PMID: 14643759 DOI: 10.1016/s0306-4522(03)00520-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 11/17/2022]
Abstract
In some disorders of the peripheral nervous system, it is relevant to understand how sensory neurons respond to selective ganglion ischemia. Sensory dorsal root ganglia may be susceptible to ischemic damage and irretrievable neuron loss because of their metabolic requirements. In diabetes, heightened sensitivity to ischemia associated with elevated endothelin levels might render ganglia particularly vulnerable. In this work, we created a model of local sensory ganglion ischemia by generating intense local vasoconstriction from applied endothelin-1 (ET). In this model, we compared relative vulnerability of L5 ganglia microvessels and neurons to ET in streptozotocin-induced diabetic rats and nondiabetic controls. Diabetic ganglia had reductions in baseline core ganglion blood flow (GBF) measured using microelectrode hydrogen clearance polarography and ET induced particularly profound declines. Serial GBF measurements made using a laser Doppler flowmetry probe also indicated that diabetic ganglia exposed to ET had a marked prolongation in its action. Neuron perikarya and proximal axon segments were more vulnerable in diabetes. Neurons exhibited loss of neurofilament labeling, dissolution of the neurons, replacement of neurons with "nests of Nageotte," displacement of nuclei to the periphery of perikarya, and nuclear labeling with TUNEL. Both intraganglionic axons and downstream sural sensory axons developed evidence of axonal degeneration. Local endothelin-induced vasoconstriction of microvessels supplying dorsal root ganglia provides a selective model of ischemia. Diabetic vessels and neurons, exposed to a greater depth and duration of ischemia from endothelin, are especially vulnerable.
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Affiliation(s)
- Q-G Xu
- Department of Clinical Neurosciences and the Neuroscience Research Group, University of Calgary, Room 182A, 3330 Hospital Drive, NW, Calgary, AB, Canada T2N 4N1
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Hansen TK, Møller J, Thomsen K, Frandsen E, Dall R, Jørgensen JO, Christiansen JS. Effects of growth hormone on renal tubular handling of sodium in healthy humans. Am J Physiol Endocrinol Metab 2001; 281:E1326-32. [PMID: 11701449 DOI: 10.1152/ajpendo.2001.281.6.e1326] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To investigate the mechanisms behind the water- and sodium-retaining effects of growth hormone (GH), we studied the effect of GH on 1) water and sodium homeostasis, 2) the renin-angiotensin-aldosterone system (RAAS), and 3) lithium clearance (C(Li)) with and without concomitant prostaglandin (PG) synthesis inhibition with ibuprofen. GH administration for 6 days induced a significant increase in plasma renin, which was abolished by coadministration of ibuprofen (mU x l(-1) x 24 h(-1): control: 22.4 +/- 4.3; GH: 37.7 +/- 8.8; ibuprofen: 15.2 +/- 3.0; GH + ibuprofen: 19.7 +/- 2.5; ANOVA: P < 0.01). Comparable increments in extracellular volume were seen after 6-day treatment with GH alone and in combination with ibuprofen [liters: control, 19.57 +/- 0.92; GH, 20.80 +/- 1.00 (ANOVA: P < 0.0005); ibuprofen, 19.38 +/- 0.90; GH + ibuprofen, 21.63 +/- 1.37 (ANOVA: P < 0.0005)]. Treatment with GH increased C(Li) and changed the tubular handling of sodium and water. The absolute distal sodium reabsorption was increased, and this was only partially counterbalanced by decreased reabsorption in the proximal tubules. The data demonstrate that GH-induced activation of the RAAS can be blocked by concomitant PG synthesis inhibition and that the tubular effects of GH include increased distal nephron sodium and water reabsorption.
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Affiliation(s)
- T K Hansen
- Medical Department M (Endocrinology and Diabetes), Institute for Basic Psychiatric Research, Aarhus University Hospital, DK-8000 Aarhus C, Denmark.
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