Claus Jensen - Academia.edu (original) (raw)
Papers by Claus Jensen
Acta Orthop, 1996
We assessed the precision of 2 widely used radiographic classification systems for patients with ... more We assessed the precision of 2 widely used radiographic classification systems for patients with Kienböck's disease by repeated staging of 76 radiographic examinations by 3 independent observers. The intraobserver reproducibility was strong but the interobserver reliability was fair or moderate.
J Neuroimmunol, 2000
Chemokines and matrix metalloproteinases (MMPs) appear to be crucial in leukocyte recruitment to ... more Chemokines and matrix metalloproteinases (MMPs) appear to be crucial in leukocyte recruitment to the central nervous system in multiple sclerosis (MS). CCR5 Δ32, a truncated allele of the CC chemokine receptor CCR5 gene encoding a non-functional receptor, did not confer protection from MS. CCR5 Δ32 was, however, associated with a lower risk of recurrent clinical disease activity. High CSF levels of MMP-9 activity were also associated with recurrent disease activity. These results directly link intrathecal inflammation to disease activity in patients with MS, suggesting that treatments targeting CCR5 or treatment with MMP inhibitors may attenuate disease activity in MS.
OBJECTIVESBy repeated magnetic resonance imaging (MRI) to study synovial membrane regeneration an... more OBJECTIVESBy repeated magnetic resonance imaging (MRI) to study synovial membrane regeneration and recurrence of synovitis after arthroscopic knee joint synovectomy in patients with rheumatoid arthritis (RA) and other (non-RA) causes of persistent knee joint synovitis.METHODSContrast enhanced MRI was performed in 15 knees (nine RA, six non-RA) before and one day, seven days, two months, and 12 months after arthroscopic synovectomy.
International Orthopaedics, 2015
Regenerex is a novel porous titanium construct with a three-dimensional porous structure and biom... more Regenerex is a novel porous titanium construct with a three-dimensional porous structure and biomechanical characteristics close to that of normal trabecular bone. The aim of this study was to evaluate the adaptive bone remodeling of the proximal tibia after uncemented total knee arthroplasty (TKA) using a tibial tray with this novel coating compared to a well-proven standard porous coated (PPS) tibial tray. Sixty patients scheduled for TKA were randomized to receive either a Regenerex (n = 31) or a PPS tibial component (n = 29). Changes in bone mineral density (BMD) of the proximal tibia were measured at three, six, 12 and 24 months by dual-energy X-ray absorptiometry (DEXA). In the lateral region (ROI 3), a significant increase in BMD was seen in both groups at three, six, and 12 months after surgery. The relative increase at 12 months was 8.1 % (P = 0.007) for the PPS group and 6.5 % (P = 0.002) for the Regenerex group. Positive values were retained at 24 months in both groups. At 24 months BMD in the distal region below the central stem (ROI 1) had decreased in the PPS group by 3.4 % (P = 0.005) and in the Regenerex group by 2.4 % (P = 0.17). In the medial region (ROI 2) BMD remained unchanged at all follow-up evaluations in both groups. There were no significant differences between the two groups (P = 0.45) in any ROI at any follow-up evaluation. The significant increase in BMD of the lateral proximal tibia plateau with very limited changes medially and distally seen in both implants suggests that the novel porous titanium construct Regenerex and the PPS implant have a pronounced beneficial effect with regard to maintaining periprosthetic BMD in all regions of interest investigated.
Ugeskrift for laeger, Jan 2, 2001
Magnetic resonance imaging (MRI) lesion load is widely used in the clinical evaluation of patient... more Magnetic resonance imaging (MRI) lesion load is widely used in the clinical evaluation of patients with multiple sclerosis (MS), but little is known about the associated changes in cortical activation. For this purpose, we studied the association between the corticocerebral metabolic rate of glucose (CMRglc) and the MRI T2-weighted total lesion area (TLA). In addition, we investigated the correlation between cognitive and neurological disability and CMRglc. Twenty-three patients with clinically definite MS underwent measurements of the CMRglc, TLA, motor-evoked potentials (MEP), and cognitive and neurological disability. CMRglc was calculated with positron emission tomography (PET) and 18-F-deoxyglucose (FDG) and compared to that of nine healthy controls. A reduction in CMRglc (p < 0.01) was found in cortical global and regional lobar measurements. Furthermore, regional CMRglc (rCMRglc) was reduced in the dorsolateral prefrontal cortex, orbitofrontal cortex, caudate, putamen, tha...
Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 1998
In this retrospective study 48 humeral shaft fractures in 48 patients were operated on using the ... more In this retrospective study 48 humeral shaft fractures in 48 patients were operated on using the Seidel interlocking nail. The length of follow-up ranged from 6 to 60 months (median, 26 months). The treatment of fractures was satisfactory with the Seidel nail, but we emphasize the importance of countersinking the tip of the nail into the humeral head to avoid impingement. In 5 of 12 patients with nonunions, the procedure failed, and we found that the distal locking seemed to be inadequate. Pathological fractures (i.e., those caused by metastatic tumors) were all efficiently treated with the Seidel nail.
Journal of Orthopaedic Science, 2000
Tension-band wire fixation of olecranon fractures leads to a high re-operation rate because of th... more Tension-band wire fixation of olecranon fractures leads to a high re-operation rate because of the need to remove the metalware. This problem has commonly been thought to be related mainly to the backing-out of the Kirschner wires. A retrospective study was carried out in 55 patients with displaced olecranon fractures operated on with the tension-band wiring technique, in whom there was an overall 71.7% re-operation rate. Complications were few and minor in most patients. The main reason for the removal of the metalware was a direct complaint from the patient (in 61.3% of all removals). A literature review analyzing the causes of metalware removal is also presented.
Interactive cardiovascular and thoracic surgery, 2009
We have reviewed and discussed current knowledge on existing scoring systems regarding high resol... more We have reviewed and discussed current knowledge on existing scoring systems regarding high resolution computed tomography (HRCT) images for the assessment of primary graft dysfunction (PGD) after lung transplantation. Adult respiratory distress syndrome (ARDS) has been more widely studied and appears to have many morphological features similar to what is found in PGD, and might, therefore, be usefully extrapolated to PGD. Principles of HRCT, scoring systems based on HRCT and various terms describing PGD were reviewed and summarized. The sensitivity, inter-intra observer variability, and reproducibility of these systems were discussed. Lastly, the future perspectives for 64-multi-slice computed tomography (MSCT) in relation to PGD were discussed. Few studies on scoring systems of lung tissue by HRCT in ARDS patients and idiopathic pulmonary fibrosis (IPF) patients were found. Most studies were performed on patients with cystic fibrosis (CF). Sensitivity of HRCT for the detection of ...
Interactive cardiovascular and thoracic surgery, 2012
We evaluated the diagnostic value of high-resolution computed tomography (HRCT) images generated ... more We evaluated the diagnostic value of high-resolution computed tomography (HRCT) images generated from 64 detector multi-slice CT scanners (HRCT(64-MSCT) imaging) in relation to primary graft dysfunction (PGD) after lung-transplantation (LUTX) in a pilot study. PGD has mortality rates ranging from 17 to 50% over a 90-day period. Detailed HRCT lung images, reconstructed using 64-MSCT, may aid diagnostic and therapeutic efforts in PGD. Thirty-two patients were scanned four times within a year post-LUTX, in a single-centre prospective study. HRCT lung images were reviewed, evaluated and scored by two observers, for ground-glass (GG) opacities, consolidation, septal thickening (ST) and pulmonary embolism. Image and PGD scores were compared in each patient. GG and consolidation changes were largely present up until 2 weeks post-LUTX, and markedly reduced by the 12th week. ST was predominantly found in patients with PGD. There were no vascular changes found at CT angiographies. The most se...
Thrombosis and Haemostasis, 2009
SummaryOral anticoagulation therapy is monitored by the use of international normalised ratio (IN... more SummaryOral anticoagulation therapy is monitored by the use of international normalised ratio (INR). Patients performing self-management estimate INR using a coagulometer, but studies have been partly flawed regarding the estimated precision and accuracy. The objective was to estimate the imprecision and accuracy for two different coagulometers (CoaguChek® S and XS). Twenty-four patients treated with coumarin were prospectively followed for six weeks. INR’s were analyzed weekly in duplicates on both coagulometers, and compared with results from the hospital laboratory. Statistical analysis included Bland-Altman plot, 95% limits of agreement, coefficient of variance (CV), and an analysis of variance using a mixed effect model. Comparing 141 duplicate measurements (a total of 564 measurements) of INR, we found that the CoaguChek S and CoaguChek XS had a precision (CV) of 3.4% and 2.3%, respectively. Regarding analytical accuracy, the INR measurements tended to be lower on the coagulom...
Spine, 1993
In a randomized, observer-blind trial, 150 men and women, aged 21-64 years, with chronic/subchron... more In a randomized, observer-blind trial, 150 men and women, aged 21-64 years, with chronic/subchronic low-back pain, followed one of these three treatment regimens: 1) intensive, dynamic back-muscle exercises; 2) conventional physiotherapy, including isometric exercises for the trunk and leg muscles; and 3) placebo-control treatment involving semihot packs and light traction. Eight treatment sessions were given during the course of 4 weeks, each session lasting 1 hour. The short-term effect was evaluated at the end of the treatment period and 1 month later, and the long-term effect at 6 and 12 months. The evaluations included recording of changes in pain level and assessment of overall treatment effect, which were indicated on visual interval scales. Subgroups of patients could be identified according to their treatment responses: physiotherapy was the superior treatment for the male participants, whereas the intensive back exercises appeared to be most efficient for the female participants. Patients with moderate or hard physical occupations tended toward a better response with physiotherapy, whereas intensive back exercises seemed most effective for those with sedentary/light job functions.
Scandinavian Journal of Infectious Diseases, 2012
This was a retrospective study analyzing the mortality and incidence of Aspergillus infection and... more This was a retrospective study analyzing the mortality and incidence of Aspergillus infection and invasive disease, comparing patients given voriconazole for 3 months following transplantation to patients not given prophylaxis. All consecutive patients (n = 147) transplanted at Copenhagen University Hospital, Rigshospitalet from 2002 to 2006 were included in the study; the study period included the 2 years before the initiation of fungal prophylaxis (88 patients) and the 2 years after (59 patients). Eight patients transplanted in this period were excluded leaving 139 patients in the study. No effect of voriconazole on the incidence of Aspergillus infection (colonization, or superficial or invasive infection) or on the time from transplantation to the first sign of infection was seen when the 2 groups of patients were compared. The cumulated incidence of infection was 45% without and 49% with prophylaxis, and in both groups approximately half of the infections occurred in the first 3 months, the time during which prophylaxis was given. There were significantly more cystic fibrosis (CF) patients among the Aspergillus-infected patients compared to other diagnoses, and the effect of prophylaxis was the same as in non-CF patients. There was a significantly lower mortality in the voriconazole-treated group compared to the non-prophylaxis group, but in an isolated analysis of Aspergillus-infected patients this difference no longer existed; hence, the difference in mortality must be attributable to a time effect and not to voriconazole prophylaxis. Routine use of voriconazole treatment for prophylaxis against Aspergillus infection in lung transplant recipients does not appear to be warranted.
Scandinavian Journal of Immunology, 2002
The pathogenetic role of autoantibodies in multiple sclerosis (MS) is uncertain. CD5+ B cells com... more The pathogenetic role of autoantibodies in multiple sclerosis (MS) is uncertain. CD5+ B cells commonly produce autoantibodies, but CD5 expression has also been implicated in B-cell tolerance. We studied B-cell subsets, anti-myelin protein antibody-secreting cells in cerebrospinal fluid (CSF) and a panel of serum autoantibodies in patients with clinically isolated syndromes (CIS), suggestive of MS and patients with clinically definite MS (CDMS). Patients with CDMS had a higher percentage of CD5- B cells in CSF than did control subjects (P = 0.02). CIS patients with immunoglobulin G (IgG) oligoclonal bands in CSF or multiple lesions on magnetic resonance imaging (MRI) had a higher percentage of CD5- B cells in CSF than did the remaining CIS patients (P = 0.03). The percentage of CD5- and CD80+ B cells correlated positively and the percentage of CD5+ B cells correlated negatively with the number of CSF cells secreting anti-myelin basic protein (anti-MBP) antibodies. The prevalence of serum autoantibodies was comparable in the three patient groups. We conclude that intrathecal expansion of CD5- B cells appears to be more characteristic in MS patients, and CD5+ B cells may be associated with a lower prevalence of anti-myelin antibody production.
Scandinavian Journal of Gastroenterology, 2013
Objective. The correlation between plasma Chromogranin A concentrations and changes in tumor size... more Objective. The correlation between plasma Chromogranin A concentrations and changes in tumor size evaluated by computed tomography (CT)as a gold standard -was evaluated. Material and methods. One hundred and sixteen patients with CgA-producing ileo-cecal neuroendocrine tumors were evaluated by events, which were recorded when a CT was followed by another CT 1 -12 months later. Change in tumor size was defined as regression, progression, or stable disease using RECIST criteria 1.1. Of 426 events, there were 97 with progression, 279 with stable disease, and 50 with regression. Based on the ROC curves a cutoff value of 25% change was selected to discriminate between increased, decreased, or unchanged CgA concentrations in plasma, using a sensitive radioimmunoassay with well-defined epitope specificity. Results. In the 97 events showing tumor progression diagnostic sensitivity and specificity of an increased CgA concentration were 86% and 86%, respectively. The positive and negative predictive values were 64% and 85%, respectively. In the 279 events with unchanged tumor size the diagnostic sensitivity and specificity of an unchanged CgA concentration were 73% and 86%, and the positive and negative predictive values were 91% and 63%, respectively. In the 50 events showing tumor regression, diagnostic sensitivity and specificity of a decrease in CgA concentration were 78% and 91%, the positive and negative predictive values being 55% and 97%. Conclusions. CgA concentrations in plasma have a high diagnostic accuracy in monitoring patients with ileo-cecal neuroendocrine tumors. In particular, an increase in plasma CgA concentration was useful to indicate tumor progression.
Scandinavian Journal of Gastroenterology, 2010
To evaluate contrast-enhanced ultrasound (CEUS) and compare it to ultrasound (US) and 64-slice-CT... more To evaluate contrast-enhanced ultrasound (CEUS) and compare it to ultrasound (US) and 64-slice-CT (64-CT) for diagnosing, staging and evaluation of resectability of pancreatic cancer. US, CEUS and 64-CT were performed in 49 consecutive patients with pancreatic head tumors and with suspected cancer. After evaluation 44 patients had pancreatic head adenocarcinoma and 5 had chronic pancreatitis, all confirmed by histology. The sensitivity of US, CEUS and 64-CT for diagnosing malignant pancreatic head tumors was 89%, 86% and 93%, respectively, and the overall accuracy was 82%, 86% and 88% respectively. There was no significant difference in the malignant tumor size measurement between US and CEUS (p = 0.3619) or between US and 64-CT (p = 0.2129), but a significant difference was seen in the size measured by CEUS and 64-CT (p = 0.0197). The CEUS measurements on the tumor size were smaller. The overall accuracy for M staging of the patients who had surgery for adenocarcinoma was 86% and 90% for US + CEUS and 64-CT, respectively. By performing the CEUS and 64-CT we additionally found, respectively, 35% and 45% non-resectable patients of a group of patients, who were considered resectable on the primary radiological image material. CEUS may be a useful diagnostic tool in the diagnosis and staging of pancreatic head tumors. For the assessment of resectability CEUS did not prove useful. However, CEUS seemed very useful as an additional instrument in the detection of non-resectable patients already considered resectable on primary radiological image material.
Neurology, 2000
... Copenhagen:University of Copenhagen, 1998. ↵ Mortensen EL, Gade A. On the relation between de... more ... Copenhagen:University of Copenhagen, 1998. ↵ Mortensen EL, Gade A. On the relation between demographic variables and neuropsychological test performance. Scand J Psychol 1993;34:305–317. CrossRef. ↵ Spreen O, Benton AL. ...
Multiple Sclerosis, 2005
The objectives of this study were (1) to determine how cerebrospinal fluid (CSF) neurofilament he... more The objectives of this study were (1) to determine how cerebrospinal fluid (CSF) neurofilament heavy chain (NfHSMI34 and NfHSMI35) levels relate to clinical outcome in optic neuritis (ON) and multiple sclerosis (MS) relapse patients treated with high dose oral methylprednisolone; and (2) to correlate neurofilament and myelin basic protein (MBP) concentrations, particularly as the latter was previously associated with clinical disability. Fifty subjects participated in two double-blind, randomized, placebo-controlled clinical trials. Eight/18 patients in the ON trial and 15/32 subjects in the MS attack trial were treated with oral methylprednisolone. In the MS attack trial group, CSF NfHSMI34 and NfHSMI35 measured at week 3 and DCSF NfHSMI34 levels from baseline to week 3 were predictive of clinical outcome at week 8 and 52. In the ON group, no such association was seen. When both groups were combined, baseline CSF NfHSMI34 and NfHSMI35 correlated positively with baseline enhancing l...
Journal of Neuroimmunology, 1995
Acta Orthop, 1996
We assessed the precision of 2 widely used radiographic classification systems for patients with ... more We assessed the precision of 2 widely used radiographic classification systems for patients with Kienböck&amp;amp;amp;amp;amp;#39;s disease by repeated staging of 76 radiographic examinations by 3 independent observers. The intraobserver reproducibility was strong but the interobserver reliability was fair or moderate.
J Neuroimmunol, 2000
Chemokines and matrix metalloproteinases (MMPs) appear to be crucial in leukocyte recruitment to ... more Chemokines and matrix metalloproteinases (MMPs) appear to be crucial in leukocyte recruitment to the central nervous system in multiple sclerosis (MS). CCR5 Δ32, a truncated allele of the CC chemokine receptor CCR5 gene encoding a non-functional receptor, did not confer protection from MS. CCR5 Δ32 was, however, associated with a lower risk of recurrent clinical disease activity. High CSF levels of MMP-9 activity were also associated with recurrent disease activity. These results directly link intrathecal inflammation to disease activity in patients with MS, suggesting that treatments targeting CCR5 or treatment with MMP inhibitors may attenuate disease activity in MS.
OBJECTIVESBy repeated magnetic resonance imaging (MRI) to study synovial membrane regeneration an... more OBJECTIVESBy repeated magnetic resonance imaging (MRI) to study synovial membrane regeneration and recurrence of synovitis after arthroscopic knee joint synovectomy in patients with rheumatoid arthritis (RA) and other (non-RA) causes of persistent knee joint synovitis.METHODSContrast enhanced MRI was performed in 15 knees (nine RA, six non-RA) before and one day, seven days, two months, and 12 months after arthroscopic synovectomy.
International Orthopaedics, 2015
Regenerex is a novel porous titanium construct with a three-dimensional porous structure and biom... more Regenerex is a novel porous titanium construct with a three-dimensional porous structure and biomechanical characteristics close to that of normal trabecular bone. The aim of this study was to evaluate the adaptive bone remodeling of the proximal tibia after uncemented total knee arthroplasty (TKA) using a tibial tray with this novel coating compared to a well-proven standard porous coated (PPS) tibial tray. Sixty patients scheduled for TKA were randomized to receive either a Regenerex (n = 31) or a PPS tibial component (n = 29). Changes in bone mineral density (BMD) of the proximal tibia were measured at three, six, 12 and 24 months by dual-energy X-ray absorptiometry (DEXA). In the lateral region (ROI 3), a significant increase in BMD was seen in both groups at three, six, and 12 months after surgery. The relative increase at 12 months was 8.1 % (P = 0.007) for the PPS group and 6.5 % (P = 0.002) for the Regenerex group. Positive values were retained at 24 months in both groups. At 24 months BMD in the distal region below the central stem (ROI 1) had decreased in the PPS group by 3.4 % (P = 0.005) and in the Regenerex group by 2.4 % (P = 0.17). In the medial region (ROI 2) BMD remained unchanged at all follow-up evaluations in both groups. There were no significant differences between the two groups (P = 0.45) in any ROI at any follow-up evaluation. The significant increase in BMD of the lateral proximal tibia plateau with very limited changes medially and distally seen in both implants suggests that the novel porous titanium construct Regenerex and the PPS implant have a pronounced beneficial effect with regard to maintaining periprosthetic BMD in all regions of interest investigated.
Ugeskrift for laeger, Jan 2, 2001
Magnetic resonance imaging (MRI) lesion load is widely used in the clinical evaluation of patient... more Magnetic resonance imaging (MRI) lesion load is widely used in the clinical evaluation of patients with multiple sclerosis (MS), but little is known about the associated changes in cortical activation. For this purpose, we studied the association between the corticocerebral metabolic rate of glucose (CMRglc) and the MRI T2-weighted total lesion area (TLA). In addition, we investigated the correlation between cognitive and neurological disability and CMRglc. Twenty-three patients with clinically definite MS underwent measurements of the CMRglc, TLA, motor-evoked potentials (MEP), and cognitive and neurological disability. CMRglc was calculated with positron emission tomography (PET) and 18-F-deoxyglucose (FDG) and compared to that of nine healthy controls. A reduction in CMRglc (p < 0.01) was found in cortical global and regional lobar measurements. Furthermore, regional CMRglc (rCMRglc) was reduced in the dorsolateral prefrontal cortex, orbitofrontal cortex, caudate, putamen, tha...
Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 1998
In this retrospective study 48 humeral shaft fractures in 48 patients were operated on using the ... more In this retrospective study 48 humeral shaft fractures in 48 patients were operated on using the Seidel interlocking nail. The length of follow-up ranged from 6 to 60 months (median, 26 months). The treatment of fractures was satisfactory with the Seidel nail, but we emphasize the importance of countersinking the tip of the nail into the humeral head to avoid impingement. In 5 of 12 patients with nonunions, the procedure failed, and we found that the distal locking seemed to be inadequate. Pathological fractures (i.e., those caused by metastatic tumors) were all efficiently treated with the Seidel nail.
Journal of Orthopaedic Science, 2000
Tension-band wire fixation of olecranon fractures leads to a high re-operation rate because of th... more Tension-band wire fixation of olecranon fractures leads to a high re-operation rate because of the need to remove the metalware. This problem has commonly been thought to be related mainly to the backing-out of the Kirschner wires. A retrospective study was carried out in 55 patients with displaced olecranon fractures operated on with the tension-band wiring technique, in whom there was an overall 71.7% re-operation rate. Complications were few and minor in most patients. The main reason for the removal of the metalware was a direct complaint from the patient (in 61.3% of all removals). A literature review analyzing the causes of metalware removal is also presented.
Interactive cardiovascular and thoracic surgery, 2009
We have reviewed and discussed current knowledge on existing scoring systems regarding high resol... more We have reviewed and discussed current knowledge on existing scoring systems regarding high resolution computed tomography (HRCT) images for the assessment of primary graft dysfunction (PGD) after lung transplantation. Adult respiratory distress syndrome (ARDS) has been more widely studied and appears to have many morphological features similar to what is found in PGD, and might, therefore, be usefully extrapolated to PGD. Principles of HRCT, scoring systems based on HRCT and various terms describing PGD were reviewed and summarized. The sensitivity, inter-intra observer variability, and reproducibility of these systems were discussed. Lastly, the future perspectives for 64-multi-slice computed tomography (MSCT) in relation to PGD were discussed. Few studies on scoring systems of lung tissue by HRCT in ARDS patients and idiopathic pulmonary fibrosis (IPF) patients were found. Most studies were performed on patients with cystic fibrosis (CF). Sensitivity of HRCT for the detection of ...
Interactive cardiovascular and thoracic surgery, 2012
We evaluated the diagnostic value of high-resolution computed tomography (HRCT) images generated ... more We evaluated the diagnostic value of high-resolution computed tomography (HRCT) images generated from 64 detector multi-slice CT scanners (HRCT(64-MSCT) imaging) in relation to primary graft dysfunction (PGD) after lung-transplantation (LUTX) in a pilot study. PGD has mortality rates ranging from 17 to 50% over a 90-day period. Detailed HRCT lung images, reconstructed using 64-MSCT, may aid diagnostic and therapeutic efforts in PGD. Thirty-two patients were scanned four times within a year post-LUTX, in a single-centre prospective study. HRCT lung images were reviewed, evaluated and scored by two observers, for ground-glass (GG) opacities, consolidation, septal thickening (ST) and pulmonary embolism. Image and PGD scores were compared in each patient. GG and consolidation changes were largely present up until 2 weeks post-LUTX, and markedly reduced by the 12th week. ST was predominantly found in patients with PGD. There were no vascular changes found at CT angiographies. The most se...
Thrombosis and Haemostasis, 2009
SummaryOral anticoagulation therapy is monitored by the use of international normalised ratio (IN... more SummaryOral anticoagulation therapy is monitored by the use of international normalised ratio (INR). Patients performing self-management estimate INR using a coagulometer, but studies have been partly flawed regarding the estimated precision and accuracy. The objective was to estimate the imprecision and accuracy for two different coagulometers (CoaguChek® S and XS). Twenty-four patients treated with coumarin were prospectively followed for six weeks. INR’s were analyzed weekly in duplicates on both coagulometers, and compared with results from the hospital laboratory. Statistical analysis included Bland-Altman plot, 95% limits of agreement, coefficient of variance (CV), and an analysis of variance using a mixed effect model. Comparing 141 duplicate measurements (a total of 564 measurements) of INR, we found that the CoaguChek S and CoaguChek XS had a precision (CV) of 3.4% and 2.3%, respectively. Regarding analytical accuracy, the INR measurements tended to be lower on the coagulom...
Spine, 1993
In a randomized, observer-blind trial, 150 men and women, aged 21-64 years, with chronic/subchron... more In a randomized, observer-blind trial, 150 men and women, aged 21-64 years, with chronic/subchronic low-back pain, followed one of these three treatment regimens: 1) intensive, dynamic back-muscle exercises; 2) conventional physiotherapy, including isometric exercises for the trunk and leg muscles; and 3) placebo-control treatment involving semihot packs and light traction. Eight treatment sessions were given during the course of 4 weeks, each session lasting 1 hour. The short-term effect was evaluated at the end of the treatment period and 1 month later, and the long-term effect at 6 and 12 months. The evaluations included recording of changes in pain level and assessment of overall treatment effect, which were indicated on visual interval scales. Subgroups of patients could be identified according to their treatment responses: physiotherapy was the superior treatment for the male participants, whereas the intensive back exercises appeared to be most efficient for the female participants. Patients with moderate or hard physical occupations tended toward a better response with physiotherapy, whereas intensive back exercises seemed most effective for those with sedentary/light job functions.
Scandinavian Journal of Infectious Diseases, 2012
This was a retrospective study analyzing the mortality and incidence of Aspergillus infection and... more This was a retrospective study analyzing the mortality and incidence of Aspergillus infection and invasive disease, comparing patients given voriconazole for 3 months following transplantation to patients not given prophylaxis. All consecutive patients (n = 147) transplanted at Copenhagen University Hospital, Rigshospitalet from 2002 to 2006 were included in the study; the study period included the 2 years before the initiation of fungal prophylaxis (88 patients) and the 2 years after (59 patients). Eight patients transplanted in this period were excluded leaving 139 patients in the study. No effect of voriconazole on the incidence of Aspergillus infection (colonization, or superficial or invasive infection) or on the time from transplantation to the first sign of infection was seen when the 2 groups of patients were compared. The cumulated incidence of infection was 45% without and 49% with prophylaxis, and in both groups approximately half of the infections occurred in the first 3 months, the time during which prophylaxis was given. There were significantly more cystic fibrosis (CF) patients among the Aspergillus-infected patients compared to other diagnoses, and the effect of prophylaxis was the same as in non-CF patients. There was a significantly lower mortality in the voriconazole-treated group compared to the non-prophylaxis group, but in an isolated analysis of Aspergillus-infected patients this difference no longer existed; hence, the difference in mortality must be attributable to a time effect and not to voriconazole prophylaxis. Routine use of voriconazole treatment for prophylaxis against Aspergillus infection in lung transplant recipients does not appear to be warranted.
Scandinavian Journal of Immunology, 2002
The pathogenetic role of autoantibodies in multiple sclerosis (MS) is uncertain. CD5+ B cells com... more The pathogenetic role of autoantibodies in multiple sclerosis (MS) is uncertain. CD5+ B cells commonly produce autoantibodies, but CD5 expression has also been implicated in B-cell tolerance. We studied B-cell subsets, anti-myelin protein antibody-secreting cells in cerebrospinal fluid (CSF) and a panel of serum autoantibodies in patients with clinically isolated syndromes (CIS), suggestive of MS and patients with clinically definite MS (CDMS). Patients with CDMS had a higher percentage of CD5- B cells in CSF than did control subjects (P = 0.02). CIS patients with immunoglobulin G (IgG) oligoclonal bands in CSF or multiple lesions on magnetic resonance imaging (MRI) had a higher percentage of CD5- B cells in CSF than did the remaining CIS patients (P = 0.03). The percentage of CD5- and CD80+ B cells correlated positively and the percentage of CD5+ B cells correlated negatively with the number of CSF cells secreting anti-myelin basic protein (anti-MBP) antibodies. The prevalence of serum autoantibodies was comparable in the three patient groups. We conclude that intrathecal expansion of CD5- B cells appears to be more characteristic in MS patients, and CD5+ B cells may be associated with a lower prevalence of anti-myelin antibody production.
Scandinavian Journal of Gastroenterology, 2013
Objective. The correlation between plasma Chromogranin A concentrations and changes in tumor size... more Objective. The correlation between plasma Chromogranin A concentrations and changes in tumor size evaluated by computed tomography (CT)as a gold standard -was evaluated. Material and methods. One hundred and sixteen patients with CgA-producing ileo-cecal neuroendocrine tumors were evaluated by events, which were recorded when a CT was followed by another CT 1 -12 months later. Change in tumor size was defined as regression, progression, or stable disease using RECIST criteria 1.1. Of 426 events, there were 97 with progression, 279 with stable disease, and 50 with regression. Based on the ROC curves a cutoff value of 25% change was selected to discriminate between increased, decreased, or unchanged CgA concentrations in plasma, using a sensitive radioimmunoassay with well-defined epitope specificity. Results. In the 97 events showing tumor progression diagnostic sensitivity and specificity of an increased CgA concentration were 86% and 86%, respectively. The positive and negative predictive values were 64% and 85%, respectively. In the 279 events with unchanged tumor size the diagnostic sensitivity and specificity of an unchanged CgA concentration were 73% and 86%, and the positive and negative predictive values were 91% and 63%, respectively. In the 50 events showing tumor regression, diagnostic sensitivity and specificity of a decrease in CgA concentration were 78% and 91%, the positive and negative predictive values being 55% and 97%. Conclusions. CgA concentrations in plasma have a high diagnostic accuracy in monitoring patients with ileo-cecal neuroendocrine tumors. In particular, an increase in plasma CgA concentration was useful to indicate tumor progression.
Scandinavian Journal of Gastroenterology, 2010
To evaluate contrast-enhanced ultrasound (CEUS) and compare it to ultrasound (US) and 64-slice-CT... more To evaluate contrast-enhanced ultrasound (CEUS) and compare it to ultrasound (US) and 64-slice-CT (64-CT) for diagnosing, staging and evaluation of resectability of pancreatic cancer. US, CEUS and 64-CT were performed in 49 consecutive patients with pancreatic head tumors and with suspected cancer. After evaluation 44 patients had pancreatic head adenocarcinoma and 5 had chronic pancreatitis, all confirmed by histology. The sensitivity of US, CEUS and 64-CT for diagnosing malignant pancreatic head tumors was 89%, 86% and 93%, respectively, and the overall accuracy was 82%, 86% and 88% respectively. There was no significant difference in the malignant tumor size measurement between US and CEUS (p = 0.3619) or between US and 64-CT (p = 0.2129), but a significant difference was seen in the size measured by CEUS and 64-CT (p = 0.0197). The CEUS measurements on the tumor size were smaller. The overall accuracy for M staging of the patients who had surgery for adenocarcinoma was 86% and 90% for US + CEUS and 64-CT, respectively. By performing the CEUS and 64-CT we additionally found, respectively, 35% and 45% non-resectable patients of a group of patients, who were considered resectable on the primary radiological image material. CEUS may be a useful diagnostic tool in the diagnosis and staging of pancreatic head tumors. For the assessment of resectability CEUS did not prove useful. However, CEUS seemed very useful as an additional instrument in the detection of non-resectable patients already considered resectable on primary radiological image material.
Neurology, 2000
... Copenhagen:University of Copenhagen, 1998. ↵ Mortensen EL, Gade A. On the relation between de... more ... Copenhagen:University of Copenhagen, 1998. ↵ Mortensen EL, Gade A. On the relation between demographic variables and neuropsychological test performance. Scand J Psychol 1993;34:305–317. CrossRef. ↵ Spreen O, Benton AL. ...
Multiple Sclerosis, 2005
The objectives of this study were (1) to determine how cerebrospinal fluid (CSF) neurofilament he... more The objectives of this study were (1) to determine how cerebrospinal fluid (CSF) neurofilament heavy chain (NfHSMI34 and NfHSMI35) levels relate to clinical outcome in optic neuritis (ON) and multiple sclerosis (MS) relapse patients treated with high dose oral methylprednisolone; and (2) to correlate neurofilament and myelin basic protein (MBP) concentrations, particularly as the latter was previously associated with clinical disability. Fifty subjects participated in two double-blind, randomized, placebo-controlled clinical trials. Eight/18 patients in the ON trial and 15/32 subjects in the MS attack trial were treated with oral methylprednisolone. In the MS attack trial group, CSF NfHSMI34 and NfHSMI35 measured at week 3 and DCSF NfHSMI34 levels from baseline to week 3 were predictive of clinical outcome at week 8 and 52. In the ON group, no such association was seen. When both groups were combined, baseline CSF NfHSMI34 and NfHSMI35 correlated positively with baseline enhancing l...
Journal of Neuroimmunology, 1995