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Århus, Denmark

Agency: Cordis | Branch: FP7 | Program: CP-FP | Phase: HEALTH.2013.1.3-2 | Award Amount: 7.79M | Year: 2014

Immune system response is the most complex barrier to long-term success of tissue transplants/implants from allogeneic and bio-artificial sources. While newly developed tissue transplant procedures are not yet performed frequently enough for robust analysis of adverse immune responses in humans, corneal transplantation (CT) is a well-established allogeneic tissue transplant with >100,000 full- and partial-thickness procedures performed annually. Adverse immune responses occur in up to 30% of CT recipients causing rejection and failure. The high levels of CT clinical activity and immune complications create an ideal opportunity to comprehensively profile immune responses associated with adverse tissue transplant outcomes and to develop new approaches for their prevention or early diagnosis. VISICORT is a multi-disciplinary project with expertise in basic immunology, bio-sampling, systems biology/immune profiling, bioinformatics, clinical tissue transplantation and cell therapy. It will complete the first systematic immune profiling of biological samples from animal and human CT recipients with diverse outcomes. Clinical data and bio-specimens from over 700 CT recipients at 5 leading transplant centres will be centrally collated and distributed to cutting-edge university- and SME-based laboratories for multi-platform profiling and integrated bioinformatics analyses. Profiling data will generate better understanding of adverse immune reactions to tissue transplants. This knowledge will be used to develop novel biomarker-based surveillance strategies and, coupled with SME-based expertise in cell product development, will also inform the design and initiation of an optimised clinical trial strategy of immunomodulatory stromal stem cell therapy in high-risk human CT recipients. VISICORT research will strongly impact multiple EU research/scientific communities, patient cohorts and SMEs and will have high commercialisation value for the biopharmaceutical and biotechnology industries.

Atherosclerotic cardiovascular disease (CVD), including acute myocardial infarction (AMI), is caused by well-known risk factors. They constitute important therapeutic targets, but their predictive value is disputed. We evaluated the effectiveness of the risk scoring system (SCORE) and thresholds for pharmacotherapy re-commended in the European guidelines on CVD prevention. The medical records of 605 consecutive patients hospitalized for a first AMI were reviewed. Patients with pre-existing CVD, diabetes, or incomplete information on risk factors were excluded. Those not treated with statin before AMI were risk stratified based on risk factors. A SCORE ≥ 5% or ≥ 10% was considered to qualify for preventive medication in young adults (age ≤ 60 years) or elderly (age > 60 years), respectively. Before AMI, 40 (9%) used statin. Among non-statin users, only five of the 109 young adults had a SCORE ≥ 5%, and 23 of the 284 elderly had a SCORE ≥ 10%. Among women, only three elderly qualified for treatment. More than four times more patients would have qualified for treatment with the high-risk country chart used in 2011. The incremental value of the novel high-density lipoprotein adjusted SCORE charts was limited. Few patients admitted with a first AMI used statin. Among non-statin users, SCORE and the recommended thresholds for pharmacotherapy identified no women and less than one out of ten men who untreated were destined for an AMI before 61 years of age. The preventive potential of a traditional risk factor-based health check is limited. not relevant. not relevant. Source

Christensen A.M.,Aarhus Universitetshospital
Danish medical journal

Infection markers are appreciated supplements in the clinical diagnosis of ear, nose and throat (ENT) infections. We aimed to examine the differential diagnostic usefulness of C-reactive protein (CRP), white blood cell count (WBC) and absolute neutrophil count (ANC) according to severity of middle ear and tonsillar infections. This was a retrospective study including all patients admitted to the ENT Department, Aarhus University Hospital, from January 2001 to December 2008 and diagnosed with acute otitis media, mastoidismus, acute mastoiditis, acute tonsillitis, peritonsillar abscess, parapharyngeal abscess and necrotizing fasciitis. A total of 1,773 patients were included. Between the tonsil subgroups, significant differences were found in CRP (p < 0.001), WBC (p < 0.001) and ANC (p < 0.001) levels. However, sensitivities and specificities related to differential diagnostics were low. In the middle ear group, no differences in CRP (p = 0.84), WBC (p = 0.46), and ANC (p = 0.72) levels were found. The number of CRP levels above the reference value was significantly higher than the corresponding number of WBC and ANC levels. A trend (non-significant) was found towards lower parameter levels in acute tonsillitis and peritonsillar abscess patients who grew Staphylococcus aureus compared with patients infected with other bacteria. CRP and ANC levels were related to severity of tonsillar-derived infections, but no such relation was found in infections with middle ear origin. None of the infection markers studied were useful for differential diagnostics. not relevant. not relevant. Source

The Toronto Extremity Salvage Score (TESS) questionnaire is a self-administered questionnaire designed to assess physical disability in patients having undergone surgery of the extremities. The aim of this study was to validate a Danish translation of the TESS. The TESS was translated according to international guidelines. A total of 22 consecutive patients attending the regular outpatient control programme were recruited for the study. To test their understanding of the questionnaires, they were asked to describe the meaning of five randomly selected questions from the TESS. The psychometric properties of the Danish version of TESS were tested for validity and reliability. To assess the test-retest reliability, the patients filled in an extra TESS questionnaire one week after they had completed the first one. Patients showed good understanding of the questionnaire. There was a good internal consistency for both the upper and lower questionnaire measured by Cronbach's alpha. A Bland-Altman plot showed acceptable limits of agreement for both questionnaires in the test-retest. There was also good intraclass correlation coefficients for both questionnaires. The validity expressed as Spearman's rank correlation coefficient comparing the TESS with the QLQ-C30 was 0.89 and 0.90 for the questionnaire on upper and lower extremities, respectively. The psychometric properties of the Danish TESS showed good validity and reliability. not relevant. not relevant. Source

A systematic review of the literature on modafinil as adjunctive treatment to antidepressants in patients with major depression and residual symptoms of fatigue and drowsiness is presented. Several open-labelled studies have shown good results on treatment with modafinil. However, only a few randomised controlled clinical trials exist. These have methodological weaknesses and their results are contradictory. If modafinil is used in highly selected patients with severe fatigue its potential interactions with antidepressants must be borne in mind. Furthermore, discontinuation of the drug should be tried after a couple of months, as one study suggests that the effect wears off. In addition, the drug is rather expensive. Source

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