Britta Tarp - Academia.edu (original) (raw)
Papers by Britta Tarp
BMJ Open
PurposeThe ENFORCE cohort is a national Danish prospective cohort of adults who received a severe... more PurposeThe ENFORCE cohort is a national Danish prospective cohort of adults who received a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine as part of the Danish National SARS-CoV-2 vaccination programme. It was designed to investigate the long-term effectiveness, safety and durability of SARS-CoV-2 vaccines used in Denmark.ParticipantsA total of 6943 adults scheduled to receive a SARS-CoV-2 vaccine in the Danish COVID-19 vaccination programme were enrolled in the study prior to their first vaccination. Participants will be followed for a total of 2 years with five predetermined follow-up visits and additional visits in relation to any booster vaccination. Serology measurements are performed after each study visit. T-cell immunity is evaluated at each study visit for a subgroup of 699 participants. Safety information is collected from participants at visits following each vaccination. Data on hospital admissions, diagnoses, deaths and SARS-CoV-2 PCR results are c...
British journal of rheumatology, Apr 1, 2002
Objectives. Recent studies have suggested that infective agents may be involved in the pathogenes... more Objectives. Recent studies have suggested that infective agents may be involved in the pathogenesis of giant cell arteritis (GCA), in particular Chlamydia pneumoniae and parvovirus B19. We investigated temporal arteries from patients with GCA for these infections as well as human herpes viruses using the polymerase chain reaction (PCR). Methods. Thirty temporal artery biopsies from 30 patients suspected of having GCA within a period of 1 yr were examined. Thirteen patients had classical GCA, two had biopsy-negative GCA, 10 patients had polymyalgia rheumatica and five patients had other conditions. DNA was extracted from frozen biopsies and PCR was used to amplify genes from Chlamydia pneumoniae, parvovirus B19 and each of the eight human herpes viruses: herpes simplex viruses HSV-1 and 2, Epstein-Barr virus, cytomegalovirus, varicella zoster virus and human herpes viruses HHV-6,-7 and-8. Results. In all 30 biopsies, PCR was negative for DNAs of parvovirus B19, each of the eight human herpes viruses and C. pneumoniae. Conclusions. We found no evidence of DNA from parvovirus B19, human herpes virus or C. pneumoniae in any of the temporal arteries. These agents do not seem to play a unique or dominant role in the pathogenesis of GCA.
Clinical Epidemiology, Jul 1, 2022
Data on the risk of ischemic heart disease (IHD) in patients with chronic hepatitis B virus (CHB)... more Data on the risk of ischemic heart disease (IHD) in patients with chronic hepatitis B virus (CHB) are conflicting. Our objective was to address the rate of IHD in patients with CHB compared with individuals without CHB (control-persons) from the general population. Study Design and Setting: We conducted a cohort study of prospectively obtained data from Danish nationwide registries. We produced cumulative incidence curves and calculated the unadjusted incidence rate ratio (IRR) of IHD in persons with and without CHB. The adjusted association between having CHB and developing IHD was examined using a cause-specific Cox regression model. Results: In total, 6472 persons with CHB and 62,251 age-and sex-matched individuals from the general population were followed for 48,840 and 567,456 person-years, respectively, during which 103 (1,59%) with CHB and 1058 (1,70%) control-persons developed IHD. The crude IRR was 1.13 (95% CI: 0.91-1.39). CHB did not have a statistically significant effect on the rate of IHD after adjusting for several confounding factors (adjusted hazard ratio: 0.96, 95% CI: 0.76-1.21). Conclusion: In this nationwide cohort study, we did not find any difference between rate of IHD in persons with CHB in comparison with the general population.
Numerous studies have shown that the aetiology of community-acquired pneumonia (CAP) varies consi... more Numerous studies have shown that the aetiology of community-acquired pneumonia (CAP) varies considerably among different healthcare settings. Because empiric therapies for CAP should cover the major pathogens, reports examining CAP aetiology are considered crucial, particularly in Nordic countries that still rely on penicillin G or V treatments for most patients with CAP. The primary objective of our study was to report CAP aetiology. Secondary objectives included the estimation of positivity rates for different tests and the odds of a positive test for various subgroups. In this cohort study, microbiological data were analysed for an overall cohort (variable degree of microbiological testing) and for a subgroup that was tested for both, bacteria, viruses and fungi, using routine methods (defined as extensive testing). The overall cohort comprised 2,264 patients, including 315 who were extensively tested. Bacterial and viral monoinfections were the most commonly identified infection...
acknowledgments. Background and Aims: The first standard of care in treatment of chronic HCV geno... more acknowledgments. Background and Aims: The first standard of care in treatment of chronic HCV genotype 1 infection involving directly acting antivirals was protease inhibitors telaprevir or boceprevir combined with pegylated-interferon and ribavirin (triple therapy). Phase III studies include highly selected patients. Thus, treatment response and development of viral resistance during triple therapy in a routine clinical setting needs to be determined. The aims of this study were to investigate
Journal of Hepatocellular Carcinoma
We aimed to determine incidence of hepatocellular carcinoma (HCC) and decompensated liver cirrhos... more We aimed to determine incidence of hepatocellular carcinoma (HCC) and decompensated liver cirrhosis in persons with chronic hepatitis B virus (HBV) infection in Denmark stratified by disease phase, liver cirrhosis, and treatment status at baseline. Additionally, we aimed to assess the prognostic value of the PAGE-B HCC risk score in a mainly non-cirrhotic population. Patients and Methods: In this register-based cohort study, we included all individuals over the age of 18, with chronic HBV infection first registered between 2002 and 2016 in at least one of three nationwide registers. The study population was followed until HCC, decompensated liver cirrhosis, death, emigration, or December 31, 2017, which ever came first. Results: Among 6016 individuals included in the study, 10 individuals with and 23 without baseline liver cirrhosis developed HCC during a median follow up of 7.3 years (range 0.0-15.5). This corresponded to five-year cumulative incidences of 7.1% (95% confidence interval (CI) 2.0-12.3) and 0.2% (95% CI 0.1-0.4) in persons with and without baseline liver cirrhosis. The five-year cumulative incidence of decompensated liver cirrhosis was 0.7% (95% CI 0.5-1.0). Among 2038 evaluated for liver events stratified by disease phase, incidence of HCC was low in all who were non-cirrhotic and untreated for HBV at baseline. PAGE-B score was evaluated in 1529 persons. The 5-year cumulative incidence of HCC was 0, 0.8 (95% CI 0.5-1.8), and 8.7 (95% CI 1.0-16.4) in persons scoring <10, 10-17 and >17, respectively (c-statistic 0.91 (95% CI 0.84-0.98)). Conclusion: We found low incidence of HCC and decompensated liver cirrhosis in persons with chronic HBV infection in Denmark. Moreover, the PAGE-B score showed good accuracy for five-year risk of developing HCC in the population with chronic HBV infection in Denmark.
PurposeThe ENFORCE cohort is a national Danish prospective cohort of adults who received a Severe... more PurposeThe ENFORCE cohort is a national Danish prospective cohort of adults who received a Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine as part of the Danish National SARS-CoV-2 vaccination program. It was designed to investigate the long-term effectiveness, safety and durability of SARS-CoV-2 vaccines used in Denmark.ParticipantsA total of 6943 adults scheduled to receive a SARS-CoV-2 vaccine in the Danish COVID-19 Vaccination Program were enrolled in the study prior to their first vaccination. Participants will be followed for a total of two years with five predetermined follow-up visits and additional visits in relation to any booster vaccination. Serology measurements are performed after each study visit. T-cell immunity is evaluated at each study visit for a subgroup of 699 participants. Safety information is collected from participants at visits following each vaccination. Data on hospital admissions, diagnoses, deaths and SARS-CoV-2 polymerase chain re...
Clinical Microbiology and Infection
Ugeskrift for Læger, 2016
Journal of Viral Hepatitis
Infectious Diseases, 2020
Abstract Background Numerous studies have shown that the aetiology of community-acquired pneumoni... more Abstract Background Numerous studies have shown that the aetiology of community-acquired pneumonia (CAP) varies considerably among different healthcare settings. Because empiric therapies for CAP should cover the major pathogens, reports examining CAP aetiology are considered crucial, particularly in Nordic countries that still rely on penicillin G or V treatments for most patients with CAP. The primary objective of our study was to report CAP aetiology. Secondary objectives included the estimation of positivity rates for different tests and the odds of a positive test for various subgroups. Methods In this cohort study, microbiological data were analysed for an overall cohort (variable degree of microbiological testing) and for a subgroup that was tested for both, bacteria, viruses and fungi, using routine methods (defined as extensive testing). Results The overall cohort comprised 2,264 patients, including 315 who were extensively tested. Bacterial and viral monoinfections were the most commonly identified infections. The dominant pathogen identified among extensively tested patients was Haemophilus influenzae (23.7%), followed by Streptococcus pneumoniae (20.6%). The tests with the highest positivity rates were sputum cultures (34.7%) and viral polymerase chain reaction (PCR, 24.4%). The odds of achieving a microbiological diagnosis increased significantly when extensive testing was performed compared with selective testing (OR 2.86, 95% CI 2.24–3.64). Conclusion Our study indicated that H. influenzae is the dominant responsible pathogen for bacterial CAP in Denmark. Thus, we believe that the current treatment recommendations that encourage the use of penicillin G or V for the majority of patients with CAP need to be revised.
Hepatology, 2013
trypsin disease, Wilson's disease, and hemochromatosis were negative. Abdo ultrasound demonstrate... more trypsin disease, Wilson's disease, and hemochromatosis were negative. Abdo ultrasound demonstrated diffuse, extensive steatosis in all the patients and nodules consistent with hepatocellular carcinoma (HCC) in two patients. RESULTS:BMI for all patients was over 30, and alcohol consumption was not significant. In all liver biopsies diffuse, macrovesicularsteatosis involved 40 to 70% of samples. The lobular hepatocytes showed prominent ballooning degeneration. Mallory Denk-hyaline bodies (MDBs) in four patients along with foci of lobular inflammation. The MDBs were observed by electron microscopy and stained by cytokeratin 18. The trichrome stain revealed bridging fibrosis. In family #1, there was a threefold increase in Kupffer Cells in the eldest sibling with NASH compared to livers of the younger siblings. In addition, lipid droplets were more numerous and larger in the hepatocytes and the collagen deposits were 5 times larger compared to the siblings. In family #2, the older brother had cirrhosis, minimal inflammation and mild fatty infiltration while the younger had fatty infiltration with no inflammation or fibrosis. In family #3, large lipid droplets and collagen deposition were observed in the siblings, one of whom had HCC. Over 2-4 year follow up, all patients had progressive severity of NASH one of whom developed HCC. CONCLUSION: The special finding in livers of patients with NASH was accumulation of groups of Kupffer Cells, which was not associated with focal necrosis. It is postulated that collections of these perisinusoidal macrophages in NASH are a unique response to chronic portal endotoxemia or bacteremia. The persistent activation of these macrophages could lead to the chronic release of cytokines and contribute to chronic inflammation, fibrosis and cirrhosis leading to HCC.
PLoS ONE, 2014
Background and Aims: The first standard of care in treatment of chronic HCV genotype 1 infection ... more Background and Aims: The first standard of care in treatment of chronic HCV genotype 1 infection involving directly acting antivirals was protease inhibitors telaprevir or boceprevir combined with pegylated-interferon and ribavirin (triple therapy). Phase III studies include highly selected patients. Thus, treatment response and development of viral resistance during triple therapy in a routine clinical setting needs to be determined. The aims of this study were to investigate treatment outcome and identify sequence variations after triple therapy in patients with chronic HCV genotype 1 infection in a routine clinical setting. Methods: 80 patients, who initiated and completed triple therapy in Denmark between May 2011 and November 2012, were included. Demographic data and treatment response were obtained from the Danish Database for Hepatitis B and C.
Arthritis & Rheumatism, 1987
The effects of dietary supplementation with selenium were studied in 6 patients with severe, acti... more The effects of dietary supplementation with selenium were studied in 6 patients with severe, active rheumatoid arthritis (RA) and in 6 healthy control subjects. Initial concentrations of Se in red blood cells and in serum, and the activity of the Se-dependent enzyme glutathione peroxidase (GSH-Px) in red blood cells, serum, and granulocytes were significantly lower in RA patients compared with controls. During Se supplementation, however, the differences in Se levels and in GSH-Px activity between the 2 groups disappeared, except that, in RA patients, GSH-Px activity in granulocytes increased but remained significantly lower than in controls.
Clinical Epidemiology
Data on the risk of ischemic heart disease (IHD) in patients with chronic hepatitis B virus (CHB)... more Data on the risk of ischemic heart disease (IHD) in patients with chronic hepatitis B virus (CHB) are conflicting. Our objective was to address the rate of IHD in patients with CHB compared with individuals without CHB (control-persons) from the general population. Study Design and Setting: We conducted a cohort study of prospectively obtained data from Danish nationwide registries. We produced cumulative incidence curves and calculated the unadjusted incidence rate ratio (IRR) of IHD in persons with and without CHB. The adjusted association between having CHB and developing IHD was examined using a cause-specific Cox regression model. Results: In total, 6472 persons with CHB and 62,251 age-and sex-matched individuals from the general population were followed for 48,840 and 567,456 person-years, respectively, during which 103 (1,59%) with CHB and 1058 (1,70%) control-persons developed IHD. The crude IRR was 1.13 (95% CI: 0.91-1.39). CHB did not have a statistically significant effect on the rate of IHD after adjusting for several confounding factors (adjusted hazard ratio: 0.96, 95% CI: 0.76-1.21). Conclusion: In this nationwide cohort study, we did not find any difference between rate of IHD in persons with CHB in comparison with the general population.
Respiratory infections, 2020
Background: Community-acquired pneumonia (CAP) is a common cause of antibiotic prescription, hosp... more Background: Community-acquired pneumonia (CAP) is a common cause of antibiotic prescription, hospital admission and mortality. Guideline adherence has shown to be beneficial in CAP. However, adherence to recommendations is highly variable. We have previously conducted a quality improvement project to increase guideline adherence. The project itself was a success, but the impact on key outcomes has not been assessed yet. Material and methods To assess the impact of a stewardship programme containing various interventions, we conducted a before-after assessment on a propensity-score matched cohort (PSM). The cohort was matched on age, comorbidities, multiple infiltrates on chest X-ray, CURB-65 score, oxygen saturation at admission, and antibiotics before admission. We then compared the odds for various outcomes in the baseline period (11/2017-2/2018) with the follow-up period (11/2018-2/2019) using logistic regression. Results: The PSM cohort consisted of 345 patients in each period. ...
European Respiratory Journal, 1999
Pneumonia is one of the most frequent complications in acquired immunodeficiency syndrome-patient... more Pneumonia is one of the most frequent complications in acquired immunodeficiency syndrome-patients with Pneumocystis carinii as the leading cause. The true prevalence of atypical agents such as Chlamydia pneumoniae, C. trachomatis, Legionella pneumophila and Mycoplasma pneumoniae in this population of patients is unknown as the currently used method for diagnosing these agents is measurement of antibody levels. However, this method is of limited value in human immunodeficiency virus (HIV)-positive patients who may have a compromised antibody response. To evaluate the prevalence of Chlamydia spp., Legionella spp. and M. pneumoniae in HIV-infected patients with pulmonary disease, this retrospective study has applied inhibitor-controlled polymerase chain reaction analyses on 103 bronchoalveolar lavage (BAL) fluids representing 103 episodes of pneumonia in 83 HIV-positive patients. L. pneumophila was detected in 1% of the BAL fluids and M. pneumoniae was found as a coexisting pathogen in 2% of the samples. Chlamydia spp. could not be detected in any of the BAL fluids. By culture and staining methods 106 other microorganisms were detected with P. carinii and Streptococcus pneumoniae as the most frequently occurring. Pneumonia due to Chlamydia pneumoniae, Legionella pneumophila or Mycoplasma pneumoniae seems to be rare in Danish human immunodeficiency virus-infected patients, but might be considered as a possible cause in cases of treatment failure.
BMJ Open
PurposeThe ENFORCE cohort is a national Danish prospective cohort of adults who received a severe... more PurposeThe ENFORCE cohort is a national Danish prospective cohort of adults who received a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine as part of the Danish National SARS-CoV-2 vaccination programme. It was designed to investigate the long-term effectiveness, safety and durability of SARS-CoV-2 vaccines used in Denmark.ParticipantsA total of 6943 adults scheduled to receive a SARS-CoV-2 vaccine in the Danish COVID-19 vaccination programme were enrolled in the study prior to their first vaccination. Participants will be followed for a total of 2 years with five predetermined follow-up visits and additional visits in relation to any booster vaccination. Serology measurements are performed after each study visit. T-cell immunity is evaluated at each study visit for a subgroup of 699 participants. Safety information is collected from participants at visits following each vaccination. Data on hospital admissions, diagnoses, deaths and SARS-CoV-2 PCR results are c...
British journal of rheumatology, Apr 1, 2002
Objectives. Recent studies have suggested that infective agents may be involved in the pathogenes... more Objectives. Recent studies have suggested that infective agents may be involved in the pathogenesis of giant cell arteritis (GCA), in particular Chlamydia pneumoniae and parvovirus B19. We investigated temporal arteries from patients with GCA for these infections as well as human herpes viruses using the polymerase chain reaction (PCR). Methods. Thirty temporal artery biopsies from 30 patients suspected of having GCA within a period of 1 yr were examined. Thirteen patients had classical GCA, two had biopsy-negative GCA, 10 patients had polymyalgia rheumatica and five patients had other conditions. DNA was extracted from frozen biopsies and PCR was used to amplify genes from Chlamydia pneumoniae, parvovirus B19 and each of the eight human herpes viruses: herpes simplex viruses HSV-1 and 2, Epstein-Barr virus, cytomegalovirus, varicella zoster virus and human herpes viruses HHV-6,-7 and-8. Results. In all 30 biopsies, PCR was negative for DNAs of parvovirus B19, each of the eight human herpes viruses and C. pneumoniae. Conclusions. We found no evidence of DNA from parvovirus B19, human herpes virus or C. pneumoniae in any of the temporal arteries. These agents do not seem to play a unique or dominant role in the pathogenesis of GCA.
Clinical Epidemiology, Jul 1, 2022
Data on the risk of ischemic heart disease (IHD) in patients with chronic hepatitis B virus (CHB)... more Data on the risk of ischemic heart disease (IHD) in patients with chronic hepatitis B virus (CHB) are conflicting. Our objective was to address the rate of IHD in patients with CHB compared with individuals without CHB (control-persons) from the general population. Study Design and Setting: We conducted a cohort study of prospectively obtained data from Danish nationwide registries. We produced cumulative incidence curves and calculated the unadjusted incidence rate ratio (IRR) of IHD in persons with and without CHB. The adjusted association between having CHB and developing IHD was examined using a cause-specific Cox regression model. Results: In total, 6472 persons with CHB and 62,251 age-and sex-matched individuals from the general population were followed for 48,840 and 567,456 person-years, respectively, during which 103 (1,59%) with CHB and 1058 (1,70%) control-persons developed IHD. The crude IRR was 1.13 (95% CI: 0.91-1.39). CHB did not have a statistically significant effect on the rate of IHD after adjusting for several confounding factors (adjusted hazard ratio: 0.96, 95% CI: 0.76-1.21). Conclusion: In this nationwide cohort study, we did not find any difference between rate of IHD in persons with CHB in comparison with the general population.
Numerous studies have shown that the aetiology of community-acquired pneumonia (CAP) varies consi... more Numerous studies have shown that the aetiology of community-acquired pneumonia (CAP) varies considerably among different healthcare settings. Because empiric therapies for CAP should cover the major pathogens, reports examining CAP aetiology are considered crucial, particularly in Nordic countries that still rely on penicillin G or V treatments for most patients with CAP. The primary objective of our study was to report CAP aetiology. Secondary objectives included the estimation of positivity rates for different tests and the odds of a positive test for various subgroups. In this cohort study, microbiological data were analysed for an overall cohort (variable degree of microbiological testing) and for a subgroup that was tested for both, bacteria, viruses and fungi, using routine methods (defined as extensive testing). The overall cohort comprised 2,264 patients, including 315 who were extensively tested. Bacterial and viral monoinfections were the most commonly identified infection...
acknowledgments. Background and Aims: The first standard of care in treatment of chronic HCV geno... more acknowledgments. Background and Aims: The first standard of care in treatment of chronic HCV genotype 1 infection involving directly acting antivirals was protease inhibitors telaprevir or boceprevir combined with pegylated-interferon and ribavirin (triple therapy). Phase III studies include highly selected patients. Thus, treatment response and development of viral resistance during triple therapy in a routine clinical setting needs to be determined. The aims of this study were to investigate
Journal of Hepatocellular Carcinoma
We aimed to determine incidence of hepatocellular carcinoma (HCC) and decompensated liver cirrhos... more We aimed to determine incidence of hepatocellular carcinoma (HCC) and decompensated liver cirrhosis in persons with chronic hepatitis B virus (HBV) infection in Denmark stratified by disease phase, liver cirrhosis, and treatment status at baseline. Additionally, we aimed to assess the prognostic value of the PAGE-B HCC risk score in a mainly non-cirrhotic population. Patients and Methods: In this register-based cohort study, we included all individuals over the age of 18, with chronic HBV infection first registered between 2002 and 2016 in at least one of three nationwide registers. The study population was followed until HCC, decompensated liver cirrhosis, death, emigration, or December 31, 2017, which ever came first. Results: Among 6016 individuals included in the study, 10 individuals with and 23 without baseline liver cirrhosis developed HCC during a median follow up of 7.3 years (range 0.0-15.5). This corresponded to five-year cumulative incidences of 7.1% (95% confidence interval (CI) 2.0-12.3) and 0.2% (95% CI 0.1-0.4) in persons with and without baseline liver cirrhosis. The five-year cumulative incidence of decompensated liver cirrhosis was 0.7% (95% CI 0.5-1.0). Among 2038 evaluated for liver events stratified by disease phase, incidence of HCC was low in all who were non-cirrhotic and untreated for HBV at baseline. PAGE-B score was evaluated in 1529 persons. The 5-year cumulative incidence of HCC was 0, 0.8 (95% CI 0.5-1.8), and 8.7 (95% CI 1.0-16.4) in persons scoring <10, 10-17 and >17, respectively (c-statistic 0.91 (95% CI 0.84-0.98)). Conclusion: We found low incidence of HCC and decompensated liver cirrhosis in persons with chronic HBV infection in Denmark. Moreover, the PAGE-B score showed good accuracy for five-year risk of developing HCC in the population with chronic HBV infection in Denmark.
PurposeThe ENFORCE cohort is a national Danish prospective cohort of adults who received a Severe... more PurposeThe ENFORCE cohort is a national Danish prospective cohort of adults who received a Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine as part of the Danish National SARS-CoV-2 vaccination program. It was designed to investigate the long-term effectiveness, safety and durability of SARS-CoV-2 vaccines used in Denmark.ParticipantsA total of 6943 adults scheduled to receive a SARS-CoV-2 vaccine in the Danish COVID-19 Vaccination Program were enrolled in the study prior to their first vaccination. Participants will be followed for a total of two years with five predetermined follow-up visits and additional visits in relation to any booster vaccination. Serology measurements are performed after each study visit. T-cell immunity is evaluated at each study visit for a subgroup of 699 participants. Safety information is collected from participants at visits following each vaccination. Data on hospital admissions, diagnoses, deaths and SARS-CoV-2 polymerase chain re...
Clinical Microbiology and Infection
Ugeskrift for Læger, 2016
Journal of Viral Hepatitis
Infectious Diseases, 2020
Abstract Background Numerous studies have shown that the aetiology of community-acquired pneumoni... more Abstract Background Numerous studies have shown that the aetiology of community-acquired pneumonia (CAP) varies considerably among different healthcare settings. Because empiric therapies for CAP should cover the major pathogens, reports examining CAP aetiology are considered crucial, particularly in Nordic countries that still rely on penicillin G or V treatments for most patients with CAP. The primary objective of our study was to report CAP aetiology. Secondary objectives included the estimation of positivity rates for different tests and the odds of a positive test for various subgroups. Methods In this cohort study, microbiological data were analysed for an overall cohort (variable degree of microbiological testing) and for a subgroup that was tested for both, bacteria, viruses and fungi, using routine methods (defined as extensive testing). Results The overall cohort comprised 2,264 patients, including 315 who were extensively tested. Bacterial and viral monoinfections were the most commonly identified infections. The dominant pathogen identified among extensively tested patients was Haemophilus influenzae (23.7%), followed by Streptococcus pneumoniae (20.6%). The tests with the highest positivity rates were sputum cultures (34.7%) and viral polymerase chain reaction (PCR, 24.4%). The odds of achieving a microbiological diagnosis increased significantly when extensive testing was performed compared with selective testing (OR 2.86, 95% CI 2.24–3.64). Conclusion Our study indicated that H. influenzae is the dominant responsible pathogen for bacterial CAP in Denmark. Thus, we believe that the current treatment recommendations that encourage the use of penicillin G or V for the majority of patients with CAP need to be revised.
Hepatology, 2013
trypsin disease, Wilson's disease, and hemochromatosis were negative. Abdo ultrasound demonstrate... more trypsin disease, Wilson's disease, and hemochromatosis were negative. Abdo ultrasound demonstrated diffuse, extensive steatosis in all the patients and nodules consistent with hepatocellular carcinoma (HCC) in two patients. RESULTS:BMI for all patients was over 30, and alcohol consumption was not significant. In all liver biopsies diffuse, macrovesicularsteatosis involved 40 to 70% of samples. The lobular hepatocytes showed prominent ballooning degeneration. Mallory Denk-hyaline bodies (MDBs) in four patients along with foci of lobular inflammation. The MDBs were observed by electron microscopy and stained by cytokeratin 18. The trichrome stain revealed bridging fibrosis. In family #1, there was a threefold increase in Kupffer Cells in the eldest sibling with NASH compared to livers of the younger siblings. In addition, lipid droplets were more numerous and larger in the hepatocytes and the collagen deposits were 5 times larger compared to the siblings. In family #2, the older brother had cirrhosis, minimal inflammation and mild fatty infiltration while the younger had fatty infiltration with no inflammation or fibrosis. In family #3, large lipid droplets and collagen deposition were observed in the siblings, one of whom had HCC. Over 2-4 year follow up, all patients had progressive severity of NASH one of whom developed HCC. CONCLUSION: The special finding in livers of patients with NASH was accumulation of groups of Kupffer Cells, which was not associated with focal necrosis. It is postulated that collections of these perisinusoidal macrophages in NASH are a unique response to chronic portal endotoxemia or bacteremia. The persistent activation of these macrophages could lead to the chronic release of cytokines and contribute to chronic inflammation, fibrosis and cirrhosis leading to HCC.
PLoS ONE, 2014
Background and Aims: The first standard of care in treatment of chronic HCV genotype 1 infection ... more Background and Aims: The first standard of care in treatment of chronic HCV genotype 1 infection involving directly acting antivirals was protease inhibitors telaprevir or boceprevir combined with pegylated-interferon and ribavirin (triple therapy). Phase III studies include highly selected patients. Thus, treatment response and development of viral resistance during triple therapy in a routine clinical setting needs to be determined. The aims of this study were to investigate treatment outcome and identify sequence variations after triple therapy in patients with chronic HCV genotype 1 infection in a routine clinical setting. Methods: 80 patients, who initiated and completed triple therapy in Denmark between May 2011 and November 2012, were included. Demographic data and treatment response were obtained from the Danish Database for Hepatitis B and C.
Arthritis & Rheumatism, 1987
The effects of dietary supplementation with selenium were studied in 6 patients with severe, acti... more The effects of dietary supplementation with selenium were studied in 6 patients with severe, active rheumatoid arthritis (RA) and in 6 healthy control subjects. Initial concentrations of Se in red blood cells and in serum, and the activity of the Se-dependent enzyme glutathione peroxidase (GSH-Px) in red blood cells, serum, and granulocytes were significantly lower in RA patients compared with controls. During Se supplementation, however, the differences in Se levels and in GSH-Px activity between the 2 groups disappeared, except that, in RA patients, GSH-Px activity in granulocytes increased but remained significantly lower than in controls.
Clinical Epidemiology
Data on the risk of ischemic heart disease (IHD) in patients with chronic hepatitis B virus (CHB)... more Data on the risk of ischemic heart disease (IHD) in patients with chronic hepatitis B virus (CHB) are conflicting. Our objective was to address the rate of IHD in patients with CHB compared with individuals without CHB (control-persons) from the general population. Study Design and Setting: We conducted a cohort study of prospectively obtained data from Danish nationwide registries. We produced cumulative incidence curves and calculated the unadjusted incidence rate ratio (IRR) of IHD in persons with and without CHB. The adjusted association between having CHB and developing IHD was examined using a cause-specific Cox regression model. Results: In total, 6472 persons with CHB and 62,251 age-and sex-matched individuals from the general population were followed for 48,840 and 567,456 person-years, respectively, during which 103 (1,59%) with CHB and 1058 (1,70%) control-persons developed IHD. The crude IRR was 1.13 (95% CI: 0.91-1.39). CHB did not have a statistically significant effect on the rate of IHD after adjusting for several confounding factors (adjusted hazard ratio: 0.96, 95% CI: 0.76-1.21). Conclusion: In this nationwide cohort study, we did not find any difference between rate of IHD in persons with CHB in comparison with the general population.
Respiratory infections, 2020
Background: Community-acquired pneumonia (CAP) is a common cause of antibiotic prescription, hosp... more Background: Community-acquired pneumonia (CAP) is a common cause of antibiotic prescription, hospital admission and mortality. Guideline adherence has shown to be beneficial in CAP. However, adherence to recommendations is highly variable. We have previously conducted a quality improvement project to increase guideline adherence. The project itself was a success, but the impact on key outcomes has not been assessed yet. Material and methods To assess the impact of a stewardship programme containing various interventions, we conducted a before-after assessment on a propensity-score matched cohort (PSM). The cohort was matched on age, comorbidities, multiple infiltrates on chest X-ray, CURB-65 score, oxygen saturation at admission, and antibiotics before admission. We then compared the odds for various outcomes in the baseline period (11/2017-2/2018) with the follow-up period (11/2018-2/2019) using logistic regression. Results: The PSM cohort consisted of 345 patients in each period. ...
European Respiratory Journal, 1999
Pneumonia is one of the most frequent complications in acquired immunodeficiency syndrome-patient... more Pneumonia is one of the most frequent complications in acquired immunodeficiency syndrome-patients with Pneumocystis carinii as the leading cause. The true prevalence of atypical agents such as Chlamydia pneumoniae, C. trachomatis, Legionella pneumophila and Mycoplasma pneumoniae in this population of patients is unknown as the currently used method for diagnosing these agents is measurement of antibody levels. However, this method is of limited value in human immunodeficiency virus (HIV)-positive patients who may have a compromised antibody response. To evaluate the prevalence of Chlamydia spp., Legionella spp. and M. pneumoniae in HIV-infected patients with pulmonary disease, this retrospective study has applied inhibitor-controlled polymerase chain reaction analyses on 103 bronchoalveolar lavage (BAL) fluids representing 103 episodes of pneumonia in 83 HIV-positive patients. L. pneumophila was detected in 1% of the BAL fluids and M. pneumoniae was found as a coexisting pathogen in 2% of the samples. Chlamydia spp. could not be detected in any of the BAL fluids. By culture and staining methods 106 other microorganisms were detected with P. carinii and Streptococcus pneumoniae as the most frequently occurring. Pneumonia due to Chlamydia pneumoniae, Legionella pneumophila or Mycoplasma pneumoniae seems to be rare in Danish human immunodeficiency virus-infected patients, but might be considered as a possible cause in cases of treatment failure.