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Article ; Online: Minimal important change thresholds change over time after knee and hip arthroplasty.

Harris, Lasse K / Troelsen, Anders / Terluin, Berend / Gromov, Kirill / Ingelsrud, Lina H

2024 Volume 169, Page(s) 111316

Abstract: Objectives: The minimal important change (MIC) reflects what patients, on average, consider the smallest improvement in a score that is important to them. MIC thresholds may vary across patient populations, interventions used, posttreatment time points ... ...

Abstract	Objectives: The minimal important change (MIC) reflects what patients, on average, consider the smallest improvement in a score that is important to them. MIC thresholds may vary across patient populations, interventions used, posttreatment time points and derivation methods. We determine and compare MIC thresholds for the Oxford Knee Score and Oxford Hip Score (OKS/OHS) at 3 months postoperatively to 12- and 24-month thresholds in patients undergoing knee or hip arthroplasty. Study design and setting: This cohort study used data from patients undergoing total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA), or total hip arthroplasty (THA) at a public hospital between February 2016 and February 2023. At 3, 12, and 24 months postoperatively, patients responded to the OKS/OHS and a 7-point anchor question determining experienced changes in knee or hip pain and functional limitations. We used the adjusted predictive modeling method that accounts for the proportion improved and the reliability of the anchor question to determine MIC thresholds and their mean differences between time points. Results: Complete data were obtained from 695/957 (73%), 1179/1703 (69%), and 1080/1607 (67%) patients undergoing TKA, 474/610 (78%), 438/603 (73%), and 355/507 (70%) patients undergoing UKA, and 965/1315 (73%), 978/1409 (69%), and 1059/1536 (69%) patients undergoing THA at 3, 12, and 24 months, respectively. The median age ranged from 68 to 70 years and 55% to 60% were females. The proportions improved ranged between 83% and 95%. The OKS/OHS MIC thresholds were 0.1, 4.2, and 5.1 for TKA, 1.8, 5.6, and 3.4 for UKA, and 1.3, 6.1, and 6.0 for THA at 3, 12, and 24 months postoperatively, respectively. The reliability ranged between 0.64 and 0.82, and the MIC values increased between three and 12 months but not between 12 and 24 months. Conclusion: Any absence of deterioration in pain and function is considered important at 3 months after knee or hip arthroplasty. Increasing thresholds over time suggest patients raise their standards for what constitutes a minimal important improvement over the first postoperative year. Besides improving our understanding of patients' views on postoperative outcomes, these clinical thresholds may aid in interpreting registry-based treatment outcome evaluations.
Language	English
Publishing date	2024-03-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	639306-8
ISSN	1878-5921 ; 0895-4356
ISSN (online)	1878-5921
ISSN	0895-4356
DOI	10.1016/j.jclinepi.2024.111316
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Article ; Conference proceedings ; Online: Biosensor Systems for Process Control in Biotechnolgy

Scheper, Th. / Anders, K. D. / Freitag, R. / Hundeck, H. G. / Müller, W. / Schelp, C. / Bückmann, A. F. / Reardon, K. F.

2024

Abstract: ... measuring the intracellular NAD(P)H-content in immobilized cells), an optrode with immobilized ...

Abstract	Three different types of biosensor systems will be presented in this paper: a microbial optrode (measuring the intracellular NAD(P)H-content in immobilized cells), an optrode with immobilized coenzymes and enzymes (measuring the fluorescence of molecular weight increased NADH/NADPH), an enzymethermistor system (measuring the heat evolved during enzymatic or microbial reactions) and a automized immunoanalysis system. The application of these sensor systemswill be discussed.
Language	English
Publishing date	2024-01-16
Publisher	GBF Gesellschaft für Biotechnologische Forschung mbH, Braunschweig
Publishing country	de
Document type	Article ; Conference proceedings ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Microvascular free flap coverage of complex soft tissue defects after revision total knee arthroplasty: a cross-sectional observation study.

Hamrouni, Nizar / Højvig, Jens H / Knudsen, Ulrik K / Skovgaard, Kurt K / Jensen, Lisa T / Bonde, Christian T / Odgaard, Anders

Acta orthopaedica

2024 Volume 95, Page(s) 186–191

Abstract: Background and purpose: Soft tissue defects after total knee arthroplasties (TKA) represent a major orthopedic challenge with amputation as a feared outcome. Microvascular free flap coverage (FFC) can increase limb salvage rates, but complications ... ...

Abstract	Background and purpose: Soft tissue defects after total knee arthroplasties (TKA) represent a major orthopedic challenge with amputation as a feared outcome. Microvascular free flap coverage (FFC) can increase limb salvage rates, but complications related to the procedure are yet to be explored further. We aimed to review a single-center experience with FFC for soft tissue defects related to revision total knee arthroplasty. Methods: Through a retrospective chart review from 2006 to 2021, we identified all patients who had FFC of a knee with an existing TKA. Typically, patients underwent 2-stage revision arthroplasty. To identify areas of intervention, we divided the entire regimen into 2 phases divided by the free flap surgery (pre- and post-free flap). Results: We identified 18 patients with a median age at free flap surgery of 69 years (range 39-85), who were followed for a median of 5.1 years (range 2 months to 10.6 years). The median duration from primary TKA to their final operation was 17.5 months (range 19 days to 7 years). Patients underwent a mean of 7.6 surgical procedures on their knee with 3.6 orthopedic revisions prior to the FFC and 0.6 after. Soft tissue coverage was achieved in all patients and no patients underwent amputation. One-third of patients experienced early complications at recipient site after free flap surgery. There were no donor site complications. Conclusion: Microvascular FFC of complex soft tissue defects after revision total knee arthroplasty proved achievable in all patients with successful limb salvage in all patients.
MeSH term(s)	Humans ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/methods ; Free Tissue Flaps ; Retrospective Studies ; Cross-Sectional Studies ; Treatment Outcome ; Reoperation
Language	English
Publishing date	2024-04-17
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	2180677-9
ISSN	1745-3682 ; 1745-3674
ISSN (online)	1745-3682
ISSN	1745-3674
DOI	10.2340/17453674.2024.40183
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Article ; Online: Mental health problems, health risk behaviors, and prevention: A qualitative interview study on perceptions and attitudes among elite male soccer players.

Kvillemo, Pia / Nilsson, Anders / Strandberg, Anna K / Björk, Karl / Elgán, Tobias H / Gripenberg, Johanna

Frontiers in public health

2023 Volume 10, Page(s) 1044601

Abstract: Background: The purpose of this study was to investigate the perception of mental health problems and health risk behaviors among Swedish male elite soccer players and their attitudes toward possible prevention strategies.: Method: Twenty elite ... ...

Abstract	Background: The purpose of this study was to investigate the perception of mental health problems and health risk behaviors among Swedish male elite soccer players and their attitudes toward possible prevention strategies. Method: Twenty elite soccer players, aged 15-30 years, were recruited through purposive sampling and interviewed Results: The informants reported positive feelings in relation to playing soccer, good health, and few health risk behaviors. Risk factors included a large income, excessive free time, and the need for excitement. Stress and mental health problems were linked to performance pressure, social media, and injuries. Hesitation to talk openly about personal problems due to concerns about negative consequences and the "macho culture" was highlighted as barriers to admit and seek help for personal problems. Some statements indicated openness and the club's efforts to destigmatize personal problems. Positive attitudes toward prevention and suggestions for various measures were prominent. Conclusion: Future research and implementation of interventions should focus on the prevention of health risk behaviors and alleviation of stress and performance pressure, as well as continue the efforts to destigmatize mental health problems and raise awareness among coaches of the importance of their communication and behavior for players' mental health and performance. This could be achieved by developing strategic and systematic policy work, information, and dialogue among players and coaches, in addition to individual digital or face-to-face support, provided by professionals outside the soccer context.
MeSH term(s)	Humans ; Male ; Soccer/injuries ; Soccer/psychology ; Mental Health ; Health Risk Behaviors ; Athletes/psychology ; Qualitative Research
Language	English
Publishing date	2023-01-05
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2022.1044601
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Article ; Online: Re-examining prophylactic cranial irradiation in small cell lung cancer: a systematic review and meta-analysis.

Gaebe, Karolina / Erickson, Anders W / Li, Alyssa Y / Youssef, Andrew N / Sharma, Bhagyashree / Chan, Kelvin K W / Lok, Benjamin H / Das, Sunit

EClinicalMedicine

2024 Volume 67, Page(s) 102396

Abstract: Background: Patients with small cell lung cancer (SCLC) are at high risk for brain metastases. Prophylactic cranial irradiation (PCI) is recommended in this population to reduce the incidence of brain metastases and prolong survival. We aimed to ... ...

Abstract	Background: Patients with small cell lung cancer (SCLC) are at high risk for brain metastases. Prophylactic cranial irradiation (PCI) is recommended in this population to reduce the incidence of brain metastases and prolong survival. We aimed to assesses the efficacy of PCI in this population in the era of routine brain imaging. To our knowledge, this is the first systematic review and meta-analysis to examine the use among patients who were radiographically confirmed not to have brain metastases after completion of first-line therapy. Methods: In this systematic review and meta-analysis, cohort studies and controlled trials reporting on the use of PCI for patients SCLC were identified in EMBASE, MEDLINE, CENTRAL, and grey literature sources. The literature search was conducted on November 12, 2023. Summary data were extracted. Random-effects meta-analyses pooled hazard ratios (HR) for the primary outcome of overall survival between PCI and no intervention groups. This study is registered with the Open Science Framework, DOI:10.17605/OSF.IO/BC359, and PROSPERO, CRD42021249466. Findings: Of 4318 identified records, 223 were eligible for inclusion. 109 reported on overall survival in formats amenable to meta-analysis; PCI was associated with longer survival in all patients with SCLC (HR 0.59; 95% CI, 0.55-0.63; p < 0.001; n = 56,770 patients), patients with limited stage disease (HR 0.60; 95% CI, 0.55-0.65; p < 0.001; n = 78 studies; n = 27,137 patients), and patients with extensive stage disease (HR 0.59; 95% CI, 0.51-0.70; p < 0.001; n = 28 studies; n = 26,467 patients). Between-study heterogeneity was significant when pooled amongst all studies (I2 = 73.6%; 95% CI 68.4%-77.9%). Subgroup analysis did not reveal sources of heterogeneity. In a subgroup analysis on studies that used magnetic resonance imaging to exclude presence of brain metastases at restaging among all patients, overall survival did not differ significantly between patients who did or did not receive PCI (HR 0.74; 95% CI, 0.52-1.05; p = 0.08; n = 9 studies; n = 1384 patients). Interpretation: Our findings suggested that administration of PCI is associated with a survival benefit, but not when considering studies that radiographically confirmed absence of brain metastases, suggesting that the survival benefit conferred by PCI might be therapeutic rather than prophylactic. Funding: No funding.
Language	English
Publishing date	2024-01-03
Publishing country	England
Document type	Journal Article
ISSN	2589-5370
ISSN (online)	2589-5370
DOI	10.1016/j.eclinm.2023.102396
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Article ; Online: Psychometric properties of the dissociative subtype of posttraumatic stress disorder scale: replication and extension in two German-speaking samples.

Danböck, Sarah K / Hettegger, Sabrina E / Anders, Sofia / Franke, Laila K / Liedlgruber, Michael / Miedl, Stephan F / Gashi, Arlinda / Kurapov, Anton / Weber, Rainer-Christian / Ehring, Thomas / Wilhelm, Frank H

European journal of psychotraumatology

2023 Volume 14, Issue 2, Page(s) 2238492

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Humans ; Stress Disorders, Post-Traumatic/diagnosis ; Medically Unexplained Symptoms ; Psychometrics ; Dissociative Disorders/diagnosis ; Anxiety Disorders
Language	English
Publishing date	2023-08-18
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2586642-4
ISSN	2000-8066 ; 2000-8066
ISSN (online)	2000-8066
ISSN	2000-8066
DOI	10.1080/20008066.2023.2238492
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Article ; Online: Effects of magnesium, phosphate, or zinc supplementation in intensive care unit patients-A systematic review and meta-analysis.

Vesterlund, Gitte K / Jensen, Thomas S / Ellekjaer, Karen L / Møller, Morten H / Thomsen, Thordis / Perner, Anders

Acta anaesthesiologica Scandinavica

2023 Volume 67, Issue 3, Page(s) 264–276

Abstract: Background: Low-serum levels of magnesium, phosphate, and zinc are observed in many intensive care unit (ICU) patients, but clinical equipoise exists regarding supplementation strategies. We aimed to assess the desirable and undesirable effects of ... ...

Abstract	Background: Low-serum levels of magnesium, phosphate, and zinc are observed in many intensive care unit (ICU) patients, but clinical equipoise exists regarding supplementation strategies. We aimed to assess the desirable and undesirable effects of supplementation with magnesium, phosphate, or zinc in adult ICU patients. Methods: We conducted a systematic review with meta-analysis of randomised clinical trials assessing the effects of supplementation with magnesium, phosphate, or zinc in adult ICU patients. Primary outcomes were mortality and duration of mechanical ventilation. We registered the protocol, followed the Preferred Reporting Items for Systematic Review and Meta-Analysis statement, used the Cochrane risk of bias 2 tool, and the grading of recommendations, assessment, development and evaluation (GRADE) approach for assessing the certainty of the evidence. Results: We identified no low risk of bias trials. For magnesium supplementation, we included three trials (n = 235); the relative risk (RR) for mortality was 0.54, 95% confidence interval (CI) 0.30-0.96 compared to no supplementation (very low certainty of evidence). For zinc supplementation, two trials were included (n = 168); the RR for mortality was 0.73, 95% CI 0.41-1.28 compared to control. No trials assessed the effects of phosphate supplementation on mortality. For outcomes other than mortality, only zero or one trial was available. Conclusions: In adult ICU patients, the certainty of evidence for the effects of supplementation with magnesium, phosphate, or zinc was very low. High-quality trials are needed to assess the value of supplementation strategies in these patients.
MeSH term(s)	Adult ; Humans ; Magnesium ; Zinc/therapeutic use ; Phosphates ; Critical Care ; Intensive Care Units
Chemical Substances	Magnesium (I38ZP9992A) ; Zinc (J41CSQ7QDS) ; Phosphates
Language	English
Publishing date	2023-01-06
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	80002-8
ISSN	1399-6576 ; 0001-5172
ISSN (online)	1399-6576
ISSN	0001-5172
DOI	10.1111/aas.14186
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Article ; Online: Retinopathy of prematurity: Metabolic risk factors.

Fu, Zhongjie / Nilsson, Anders K / Hellstrom, Ann / Smith, Lois E H

eLife

2022 Volume 11

Abstract: At preterm birth, the retina is incompletely vascularized. Retinopathy of prematurity (ROP) is initiated by the postnatal suppression of physiological retinal vascular development that would normally occur in utero. As the neural retina slowly matures, ... ...

Abstract	At preterm birth, the retina is incompletely vascularized. Retinopathy of prematurity (ROP) is initiated by the postnatal suppression of physiological retinal vascular development that would normally occur in utero. As the neural retina slowly matures, increasing metabolic demand including in the peripheral avascular retina, leads to signals for compensatory but pathological neovascularization. Currently, only late neovascular ROP is treated. ROP could be prevented by promoting normal vascular growth. Early perinatal metabolic dysregulation is a strong but understudied risk factor for ROP and other long-term sequelae of preterm birth. We will discuss the metabolic and oxygen needs of retina, current treatments, and potential interventions to promote normal vessel growth including control of postnatal hyperglycemia, dyslipidemia and hyperoxia-induced retinal metabolic alterations. Early supplementation of missing nutrients and growth factors and control of supplemental oxygen promotes physiological retinal development. We will discuss the current knowledge gap in retinal metabolism after preterm birth.
MeSH term(s)	Animals ; Pregnancy ; Female ; Infant, Newborn ; Humans ; Retinopathy of Prematurity/etiology ; Retinopathy of Prematurity/pathology ; Retinopathy of Prematurity/therapy ; Retinal Neovascularization/metabolism ; Premature Birth ; Disease Models, Animal ; Oxygen/metabolism ; Risk Factors
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2022-11-24
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2687154-3
ISSN	2050-084X ; 2050-084X
ISSN (online)	2050-084X
ISSN	2050-084X
DOI	10.7554/eLife.80550
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Article: Variation in Psychometric Testing in General Practice - A Nationwide Cohort Study.

Schou Pedersen, Henrik / Sparle Christensen, Kaj / Prior, Anders

Clinical epidemiology

2023 Volume 15, Page(s) 391–405

Abstract: Objective: Most mental disorders are diagnosed and treated in general practice. Psychometric tests may help the general practitioner diagnose and treat mental disorders like dementia, anxiety, and depression. However, little is known about the use of ... ...

Abstract	Objective: Most mental disorders are diagnosed and treated in general practice. Psychometric tests may help the general practitioner diagnose and treat mental disorders like dementia, anxiety, and depression. However, little is known about the use of psychometric tests in general practice and their impact on further treatment. We aimed to assess the use of psychometric tests in Danish general practice and to estimate whether variation in use is associated with the provided treatment and death by suicide in patients. Methods: This nationwide cohort study included registry data on all psychometric tests performed in Danish general practice in 2007-2018. We used Poisson regression models adjusted for sex, age, and calendar time to assess predictors of use. We used fully adjusted models to estimate the standardized utilization rates for all general practices. Results: A total of 2,768,893 psychometric tests were used in the study period. Considerable variations were observed among general practices. A positive association was seen between a general practitioner's propensity to use psychometric testing and talk therapy. Patients listed with a general practitioner with low use had an increased rate of redeemed prescriptions for anxiolytics [incidence rate ratio (95% confidence interval):1.39 (1.23;1.57)]. General practitioners with high use had an increased rate of prescriptions for antidementia drugs [1.25 (1.05;1.49)] and first-time antidepressants [1.09 (1.01;1.19)]. High test use was seen for females [1.58 (1.55; 1.62)] and patients with comorbid diseases. Low use was seen for populations with high income [0.49 (0.47; 0.51)] and high educational level [0.78 (0.75; 0.81)]. Conclusion: Psychometric tests were used mostly for women, individuals with a low socioeconomic status, and individuals with comorbid conditions. The use of psychometric tests depends on general practice and is associated with talk therapy, redemptions for anxiolytics, antidementia drugs, and antidepressants. No association was found between general practice rates and other treatment outcomes.
Language	English
Publishing date	2023-03-22
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494772-6
ISSN	1179-1349
ISSN	1179-1349
DOI	10.2147/CLEP.S396819
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Article ; Online: Kinetics of the serological response up to one year after tularemia.

Lindgren, Helena / Eklund, Johan / Eneslätt, Kjell / Sjöstedt, Anders

Frontiers in cellular and infection microbiology

2023 Volume 12, Page(s) 1072703

Abstract: Serological analysis is the predominant method used to diagnose tularemia, a zoonotic disease caused by the highly virulent ... ...

Abstract	Serological analysis is the predominant method used to diagnose tularemia, a zoonotic disease caused by the highly virulent bacterium
MeSH term(s)	Humans ; Aged ; Tularemia/microbiology ; Francisella tularensis ; Antibodies, Bacterial ; Immunoglobulin G ; Immunoglobulin M
Chemical Substances	Antibodies, Bacterial ; Immunoglobulin G ; Immunoglobulin M
Language	English
Publishing date	2023-01-06
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2619676-1
ISSN	2235-2988 ; 2235-2988
ISSN (online)	2235-2988
ISSN	2235-2988
DOI	10.3389/fcimb.2022.1072703
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