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  1. Article ; Online: Duration of critically low oxygen delivery is associated with acute kidney injury after cardiac surgery.

    Rasmussen, Sebastian R / Kandler, Kristian / Nielsen, Rikke V / Cornelius Jakobsen, Peter / Knudsen, Nikoline N / Ranucci, Marco / Christian Nilsson, Jens / Ravn, Hanne B

    Acta anaesthesiologica Scandinavica

    2019  Volume 63, Issue 10, Page(s) 1290–1297

    Abstract: ... Patients undergoing coronary artery bypass graft surgery ± valve repair were included n = 1968. Oxygen ...

    Abstract Background: Acute kidney injury is a serious complication following cardiac surgery associated with mortality. Restricted oxygen delivery is a potential risk factor for acute kidney injury. The aim of this study was to investigate the impact of the duration of low oxygen delivery (<272 mL
    Methods: Patients undergoing coronary artery bypass graft surgery ± valve repair were included n = 1968. Oxygen delivery was monitored during cardiopulmonary bypass. Data were explored using multiple regression analyses regarding association between low oxygen delivery and renal replacement therapy (RRT), acute kidney injury (AKI) and post-operative peak serum creatinine (PPSC).
    Results: Post-operative peak serum creatinine, incidence of acute kidney injury, and need for dialysis increased in a dose-dependent manner in relation to duration of a mean oxygen delivery <272 mL
    Conclusion: A low oxygen delivery during cardiopulmonary bypass was in a dose-dependent manner associated with an increased risk of renal injury.
    MeSH term(s) Acute Kidney Injury/etiology ; Aged ; Aged, 80 and over ; Arterial Pressure ; Cardiac Surgical Procedures/adverse effects ; Cardiopulmonary Bypass ; Creatinine/blood ; Female ; Humans ; Male ; Middle Aged ; Oxygen/administration & dosage ; Oxygen/adverse effects ; Time Factors
    Chemical Substances Creatinine (AYI8EX34EU) ; Oxygen (S88TT14065)
    Language English
    Publishing date 2019-09-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 80002-8
    ISSN 1399-6576 ; 0001-5172
    ISSN (online) 1399-6576
    ISSN 0001-5172
    DOI 10.1111/aas.13457
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  2. Article ; Online: Lithium in Drinking Water and Incidence of Suicide

    Nikoline N. Knudsen / Jörg Schullehner / Birgitte Hansen / Lisbeth F. Jørgensen / Søren M. Kristiansen / Denitza D. Voutchkova / Thomas A. Gerds / Per K. Andersen / Kristine Bihrmann / Morten Grønbæk / Lars V. Kessing / Annette K. Ersbøll

    International Journal of Environmental Research and Public Health, Vol 14, Iss 6, p

    A Nationwide Individual-Level Cohort Study with 22 Years of Follow-Up

    2017  Volume 627

    Abstract: Suicide is a major public health concern. High-dose lithium is used to stabilize mood and prevent suicide in patients with affective disorders. Lithium occurs naturally in drinking water worldwide in much lower doses, but with large geographical ... ...

    Abstract Suicide is a major public health concern. High-dose lithium is used to stabilize mood and prevent suicide in patients with affective disorders. Lithium occurs naturally in drinking water worldwide in much lower doses, but with large geographical variation. Several studies conducted at an aggregate level have suggested an association between lithium in drinking water and a reduced risk of suicide; however, a causal relation is uncertain. Individual-level register-based data on the entire Danish adult population (3.7 million individuals) from 1991 to 2012 were linked with a moving five-year time-weighted average (TWA) lithium exposure level from drinking water hypothesizing an inverse relationship. The mean lithium level was 11.6 μg/L ranging from 0.6 to 30.7 μg/L. The suicide rate decreased from 29.7 per 100,000 person-years at risk in 1991 to 18.4 per 100,000 person-years in 2012. We found no significant indication of an association between increasing five-year TWA lithium exposure level and decreasing suicide rate. The comprehensiveness of using individual-level data and spatial analyses with 22 years of follow-up makes a pronounced contribution to previous findings. Our findings demonstrate that there does not seem to be a protective effect of exposure to lithium on the incidence of suicide with levels below 31 μg/L in drinking water.
    Keywords drinking water ; lithium ; suicide ; individual-level data ; spatial analysis ; Denmark ; exposure assessment ; Medicine ; R
    Subject code 333
    Language English
    Publishing date 2017-06-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Lithium in Drinking Water and Incidence of Suicide: A Nationwide Individual-Level Cohort Study with 22 Years of Follow-Up.

    Knudsen, Nikoline N / Schullehner, Jörg / Hansen, Birgitte / Jørgensen, Lisbeth F / Kristiansen, Søren M / Voutchkova, Denitza D / Gerds, Thomas A / Andersen, Per K / Bihrmann, Kristine / Grønbæk, Morten / Kessing, Lars V / Ersbøll, Annette K

    International journal of environmental research and public health

    2017  Volume 14, Issue 6

    Abstract: Suicide is a major public health concern. High-dose lithium is used to stabilize mood and prevent suicide in patients with affective disorders. Lithium occurs naturally in drinking water worldwide in much lower doses, but with large geographical ... ...

    Abstract Suicide is a major public health concern. High-dose lithium is used to stabilize mood and prevent suicide in patients with affective disorders. Lithium occurs naturally in drinking water worldwide in much lower doses, but with large geographical variation. Several studies conducted at an aggregate level have suggested an association between lithium in drinking water and a reduced risk of suicide; however, a causal relation is uncertain. Individual-level register-based data on the entire Danish adult population (3.7 million individuals) from 1991 to 2012 were linked with a moving five-year time-weighted average (TWA) lithium exposure level from drinking water hypothesizing an inverse relationship. The mean lithium level was 11.6 μg/L ranging from 0.6 to 30.7 μg/L. The suicide rate decreased from 29.7 per 100,000 person-years at risk in 1991 to 18.4 per 100,000 person-years in 2012. We found no significant indication of an association between increasing five-year TWA lithium exposure level and decreasing suicide rate. The comprehensiveness of using individual-level data and spatial analyses with 22 years of follow-up makes a pronounced contribution to previous findings. Our findings demonstrate that there does not seem to be a protective effect of exposure to lithium on the incidence of suicide with levels below 31 μg/L in drinking water.
    Language English
    Publishing date 2017-06-10
    Publishing country Switzerland
    Document type Journal Article
    ISSN 1660-4601
    ISSN (online) 1660-4601
    DOI 10.3390/ijerph14060627
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  4. Article ; Online: Lithium in drinking water and the incidence of bipolar disorder: A nation-wide population-based study.

    Kessing, Lars V / Gerds, Thomas A / Knudsen, Nikoline N / Jørgensen, Lisbeth F / Kristiansen, Søren M / Voutchkova, Denitza / Ernstsen, Vibeke / Schullehner, Jörg / Hansen, Birgitte / Andersen, Per K / Ersbøll, Annette K

    Bipolar disorders

    2017  Volume 19, Issue 7, Page(s) 563–567

    Abstract: ... to 2013 (N=14 820) and 10 age- and gender-matched controls from the Danish population (N= 140 311 ...

    Abstract Objective: Animal data suggest that subtherapeutic doses, including micro doses, of lithium may influence mood, and lithium levels in drinking water have been found to correlate with the rate of suicide. It has never been investigated whether consumption of lithium may prevent the development of bipolar disorder (primary prophylaxis). In a nation-wide population-based study, we investigated whether long-term exposure to micro levels of lithium in drinking water correlates with the incidence of bipolar disorder in the general population, hypothesizing an inverse association in which higher long-term lithium exposure is associated with lower incidences of bipolar disorder.
    Methods: We included longitudinal individual geographical data on municipality of residence, data from drinking water lithium measurements and time-specific data from all cases with a hospital contact with a diagnosis of mania/bipolar disorder from 1995 to 2013 (N=14 820) and 10 age- and gender-matched controls from the Danish population (N= 140 311). Average drinking water lithium exposure was estimated for all study individuals.
    Results: The median of the average lithium exposure did not differ between cases with a diagnosis of mania/bipolar disorder (12.7 μg/L; interquartile range [IQR]: 7.9-15.5 μg/L) and controls (12.5 μg/L; IQR: 7.6-15.7 μg/L; P=.2). Further, the incidence rate ratio of mania/bipolar disorder did not decrease with higher long-term lithium exposure, overall, or within age categories (0-40, 41-60 and 61-100 years of age).
    Conclusion: Higher long-term lithium exposure from drinking water was not associated with a lower incidence of bipolar disorder. The association should be investigated in areas with higher lithium levels than in Denmark.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bipolar Disorder/epidemiology ; Child ; Child, Preschool ; Denmark/epidemiology ; Drinking Water/chemistry ; Environmental Exposure/statistics & numerical data ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Lithium ; Lithium Compounds/analysis ; Longitudinal Studies ; Male ; Middle Aged ; Research Design ; Young Adult
    Chemical Substances Drinking Water ; Lithium Compounds ; Lithium (9FN79X2M3F)
    Language English
    Publishing date 2017-07-17
    Publishing country Denmark
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1472242-2
    ISSN 1399-5618 ; 1398-5647
    ISSN (online) 1399-5618
    ISSN 1398-5647
    DOI 10.1111/bdi.12524
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5604: Show issues Location:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Body water distribution and risk of cardiovascular morbidity and mortality in a healthy population: a prospective cohort study.

    Knudsen, Nikoline Nygård / Kjærulff, Thora Majlund / Ward, Leigh Cordwin / Sæbye, Ditte / Holst, Claus / Heitmann, Berit Lilienthal

    PloS one

    2014  Volume 9, Issue 2, Page(s) e87466

    Abstract: ... changes in body water distribution. A random subset (n = 2120) of Danes aged 41-71 years, examined in 1993 ...

    Abstract Background: Early alterations in the cardiovascular structure and function may change normal body water distribution. The resulting fluid shifts may thus serve as an early marker for cardiovascular disease. However, studies examining this in healthy populations are absent.
    Objective: This study examined the association between the proportion of total body water that is extracellular water and subsequent development of non-fatal or fatal cardiovascular disease in a healthy population.
    Method: Bioelectrical impedance spectroscopy is an easy-to-use, non-invasive and relatively inexpensive technique to evaluate changes in body water distribution. A random subset (n = 2120) of Danes aged 41-71 years, examined in 1993-1994 for body water distribution by bioelectrical impedance spectroscopy was included. Cox-proportional hazard models and linear splines were performed. The ratio between resistance estimates from an infinite-frequency and from no-frequency (R∞/R0) was used as a surrogate measure of ratio between extracellular water and total body water. The outcome was 13.5 years of follow-up for cardiovascular morbidity and mortality.
    Results: A high proportion of total body water that is extracellular water was associated with increased risk of incident cardiovascular disease. A threshold effect was evident, with greatly increased risk of cardiovascular morbidity and mortality above R∞/R0 = 0.68. Below the threshold there seemed to be no additional benefit of having a low ratio.
    Conclusion: Our findings suggest that non-clinically evident oedema, measured as an increased proportion of total body water that is extracellular, above a threshold of 0.68, may be an early marker of pre-clinical cardiovascular disease. This simple, safe, cheap and easily obtainable measure of R∞/R0 from bioelectrical impedance may help the early identification of these otherwise clinically healthy individuals who are at an increased risk of future cardiovascular disease. However, more studies are needed before it can be concluded that bioelectrical impedance spectroscopy improves clinical risk prediction.
    MeSH term(s) Adult ; Aged ; Body Water/metabolism ; Cardiovascular Diseases/metabolism ; Cardiovascular Diseases/mortality ; Denmark/epidemiology ; Dielectric Spectroscopy/methods ; Electric Impedance ; Extracellular Space/metabolism ; Female ; Follow-Up Studies ; Health Status ; Humans ; Incidence ; Male ; Middle Aged ; Population Surveillance/methods ; Proportional Hazards Models ; Prospective Studies ; Registries/statistics & numerical data ; Risk Factors ; Survival Analysis ; Survival Rate
    Language English
    Publishing date 2014-02-03
    Publishing country United States
    Document type Journal Article
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0087466
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  6. Article ; Online: Body water distribution and risk of cardiovascular morbidity and mortality in a healthy population

    Nikoline Nygård Knudsen / Thora Majlund Kjærulff / Leigh Cordwin Ward / Ditte Sæbye / Claus Holst / Berit Lilienthal Heitmann

    PLoS ONE, Vol 9, Iss 2, p e

    a prospective cohort study.

    2014  Volume 87466

    Abstract: ... in body water distribution. A random subset (n = 2120) of Danes aged 41-71 years, examined in 1993-1994 ...

    Abstract Background Early alterations in the cardiovascular structure and function may change normal body water distribution. The resulting fluid shifts may thus serve as an early marker for cardiovascular disease. However, studies examining this in healthy populations are absent. Objective This study examined the association between the proportion of total body water that is extracellular water and subsequent development of non-fatal or fatal cardiovascular disease in a healthy population. Method Bioelectrical impedance spectroscopy is an easy-to-use, non-invasive and relatively inexpensive technique to evaluate changes in body water distribution. A random subset (n = 2120) of Danes aged 41-71 years, examined in 1993-1994 for body water distribution by bioelectrical impedance spectroscopy was included. Cox-proportional hazard models and linear splines were performed. The ratio between resistance estimates from an infinite-frequency and from no-frequency (R∞/R0) was used as a surrogate measure of ratio between extracellular water and total body water. The outcome was 13.5 years of follow-up for cardiovascular morbidity and mortality. Results A high proportion of total body water that is extracellular water was associated with increased risk of incident cardiovascular disease. A threshold effect was evident, with greatly increased risk of cardiovascular morbidity and mortality above R∞/R0 = 0.68. Below the threshold there seemed to be no additional benefit of having a low ratio. Conclusion Our findings suggest that non-clinically evident oedema, measured as an increased proportion of total body water that is extracellular, above a threshold of 0.68, may be an early marker of pre-clinical cardiovascular disease. This simple, safe, cheap and easily obtainable measure of R∞/R0 from bioelectrical impedance may help the early identification of these otherwise clinically healthy individuals who are at an increased risk of future cardiovascular disease. However, more studies are needed before it can be concluded that ...
    Keywords Medicine ; R ; Science ; Q
    Subject code 610
    Language English
    Publishing date 2014-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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