Herlev Gentofte University Hospital

Herlev, Denmark

Herlev Gentofte University Hospital

Herlev, Denmark
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Schreiber Pedersen L.,Herlev Gentofte University Hospital | Lose G.,Herlev Gentofte University Hospital | Hoybye M.T.,The Interdisciplinary Center | Jurgensen M.,University of Lübeck | And 3 more authors.
International Urogynecology Journal | Year: 2017

Introduction and hypothesis: The aim of the study was to evaluate the predictors and reasons for help-seeking behavior among women with urinary incontinence (UI) in Germany and Denmark. Methods: This international postal survey was conducted in 2014. In each country, 4,000 women of at least 18 years of age were randomly selected. The questionnaires included validated items regarding help-seeking behavior and the ICIQ-UI SF. UI was defined as any involuntary loss of urine. Binary logistic regression analysis was used to assess factors predicting help-seeking behavior. Reasons for seeking or not seeking help were evaluated in terms of the severity of UI and as the most frequently reported. Results: Of 1,063 Danish women with UI, 25.3% had consulted a physician compared with 31.4% of 786 German women with UI (p = 0.004). The severity and duration of UI, and actively seeking information regarding UI, were significant independent predictors of help-seeking behavior. Women with slight/moderate UI did not seek help because they did not consider UI as a problem, whereas of women with severe/very severe UI, German women reported that other illnesses were more important and Danish women reported that they did not have enough resources to consult a physician. Conclusions: Only a small proportion of women with UI had consulted a physician, and the driving forces for help-seeking behavior were severity and duration of UI and actively seeking information regarding UI. Public information campaigns might enhance consultation rates providing that passively receiving and actively seeking information have the same effects on help-seeking behavior. We show for the first time that reasons for not consulting a physician for UI vary depending on the severity of the UI. © 2017 The International Urogynecological Association


Munk T.,Herlev Gentofte University Hospital | Bruun N.,Municipality of Ballerup | Nielsen M.A.,Herlev Gentofte University Hospital | Thomsen T.,Copenhagen University
Nutrition in Clinical Practice | Year: 2017

Background: The aim of this study was to investigate if a protein-enriched menu in conjunction with individualized dietary counseling would increase energy and protein intake in hospitalized patients at nutrition risk compared with providing the protein-enriched menu as a stand-alone intervention. Method: Data from medical and surgical hospitalized patients were prospectively collected and compared with a historical intervention group (HIG). Primary outcome was the number of patients achieving >75% of energy and protein requirements. Secondary outcomes included mean energy and protein intake (adjusted for body weight [ABW]), readmission rate, and the number of patients with a baseline intake <50% of energy and protein requirement, who increased to ≥50%. Results: In the intervention group (IG), 92% vs 76% in the HIG reached >75% of energy requirements (P = .04); 90% in the IG vs 66% in the HIG reached >75% of protein requirements (p = <0.01). The IG had a significantly higher mean intake of energy and protein compared with the HIG: ABW, 31 kcal kg-1 vs 25 kcal kg-1 (P < .01) and 1.2 g protein kg-1 vs 0.9 g protein kg-1 (P < .001). More than 85% of the patients with a baseline <50% of the EP requirement achieved ≥75% of the energy and protein requirement. No difference between readmission rates was found. Conclusion: Providing a protein-enriched menu in conjunction with individualized dietary counseling significantly increased protein and energy intake in hospitalized patients at nutrition risk. © 2017 American Society.


PubMed | University of Aalborg, Herlev Gentofte University Hospital and Copenhagen University
Type: | Journal: The international journal of cardiovascular imaging | Year: 2017

The extra-cardiac work-up in infective endocarditis (IE) comprises a search for primary and secondary infective foci. Whether


Boesen L.,Herlev Gentofte University Hospital | Norgaard N.,Herlev Gentofte University Hospital | Logager V.,Herlev Gentofte University Hospital | Balslev I.,Herlev Gentofte University Hospital | Thomsen H.S.,Herlev Gentofte University Hospital
Urologia Internationalis | Year: 2017

Introduction: The aim of the study was to compare the prostate cancer (PCa) detection rate of systematic transrectal ultrasound-guided biopsies (TRUS-bx) and multiparametric-MRI targeted biopsies (mp-MRI-bx) in a repeat biopsy setting and evaluate the clinical significance following an “MRI-targeted-only” approach. Materials and Methods: Patients with prior negative biopsies underwent prostatic multiparametric-MRI that was scored using the Prostate Imaging Reporting and Data System (PI-RADS) classification. All underwent both repeated TRUS-bx and mp-MRI-bx using image fusion of any PI-RADS ≥3 lesion. Biopsy results from TRUS-bx, mp-MRI-bx, and the combination were compared. Results: PCa was detected in 89 out of 206 (43%) patients. Of these, 64 (31%) and 74 (36%) patients were detected using mp-MRI-bx and TRUS-bx, respectively. Overall, mp-MRI-bx detected fewer patients with low-grade (Gleason score [GS] 3 + 3) cancers (14/64 vs. 41/74) and more patients with intermediate/high-grade cancers (GS ≥3 + 4) (50/64 vs. 33/74) using fewer biopsy cores compared with TRUS-bx (p < 0.001). Using an “MRI-targeted-only” approach in men with PI-RADS ≥3 lesions reduced the number of men requiring repeated biopsies by 50%, decreased low-grade cancer diagnoses by 66%, and increased intermediate/high-grade cancer diagnoses by 52%. Conclusions: MRI-targeted biopsies have a high detection rate for significant PCa in patients with prior negative transrectal ultrasound-guided biopsies and preferentially detect intermediate/high-grade compared with low-grade tumors. © 2017 S. Karger AG, Basel


Hansen A.S.,Herlev Gentofte University Hospital | Butt J.H.,Herlev Gentofte University Hospital | Holm-Yildiz S.,Herlev Gentofte University Hospital | Karlsson W.,Herlev Gentofte University Hospital | Kruuse C.,Herlev Gentofte University Hospital
Frontiers in Neurology | Year: 2017

Background: Decreased endothelial function (EF) may be a prognostic marker for stroke. Measuring pharmacological effects on EF may be of interest in the development of personalized medicine for stroke prevention. In this study, we assessed the reliability of repeated EF measurements using a pulse amplitude tonometry technology in acute stroke patients. Similarly, reliability was tested in healthy subjects devoid of vascular disease to estimate reactivity and reliability in a younger non-stroke population. Materials and methods: EF was assessed using the EndoPAT2000 in 20 healthy volunteers (men 50%, mean age 35.85 ± 3.47 years) and 21 stroke patients (men 52%, mean age 66.38 ± 2.85 years, and mean NIHSS 4.09 ± 0.53) under standardized conditions. EF was measured as the reactive hyperemia index (RHI), logarithm of RHI (lnRHI), and Framingham RHI (fRHI). Measurements were separated by 1.5 and 24 h to assess same-day and day-to-day reliability, respectively. Results: Fair to moderate correlations of measurements [intraclass correlation coefficient (ICC)same-day 0.29 and ICCday-to-day 0.52] were detected in healthy subjects. In stroke patients, we found moderate to substantial correlation of both same-day and day-to-day repeated measurements (ICCsame-day 0.40 and ICCday-to-day 0.62). fRHI compared with RHI and lnRHI showed best reliability. Conclusion: Repeated measurements of fRHI in stroke patients show moderate reliability on same-day and substantial on day-to-day measurements. Likewise, in healthy subjects there was substantial reliability on day-to-day measurement, but only moderate on same-day measurements. In general, day-to-day correlation of repeated EF measurements was far better than that of same-day measurements, which ranged from poor to moderate depending on the specific outcome measure of EF. A possible carryover effect should be considered if same-day repeated testing of drug effects is applied in future studies. © 2017 Hansen, Butt, Holm-Yildiz, Karlsson and Kruuse.


PubMed | Hvidovre Hospital, University of Leipzig, Herlev Gentofte University Hospital, Varde Heart Center and 7 more.
Type: | Journal: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology | Year: 2016

Early identification of patients who could benefit from early re-intervention after catheter ablation is highly warranted. Our aim was to investigate the association between post-procedural burden of supraventricular ectopic complexes (SVEC) and the risk of long-term atrial fibrillation (AF) recurrence.A total of 125 patients undergoing catheter ablation for AF were included. Patients underwent 7-day Holter recordings immediately post-procedural. The number of SVEC in post-procedural Holter recordings was categorized into quartiles: 0-72, 73-212, 213-782 and783 SVEC/day. Long-term AF recurrence was defined as a combined endpoint of AF1min during follow-up Holter recordings, cardioversion or hospitalization for AF after a 3-month blanking period and within 24months of follow-up. High post-procedural supraventricular ectopy burden was associated with an increased risk of long-term AF recurrence in a dose-dependent manner (783 SVEC: HR 4.6 [1.9-11.5], P<0.001) irrespective of AF recurrence during the blanking period or other risk factors. In patients with early AF recurrence<90days after catheter ablation ectopy burden was also highly predictive of long-term AF recurrence (SVEC213: HR 3.0 [1.3-6.7], P=0.007). Correspondingly, patients with early AF recurrence but low ectopy burden remained at low risk of long-term AF recurrence after the blanking period.Our results indicate that post-procedural ectopy burden is highly associated with long-term AF recurrence and could be a potent risk marker for selection of patients for early re-ablation. Development of future ablation risk stratification and strategies should include focus on post-procedural ectopy burden.


Tolstrup C.K.,Herlev & Gentofte University Hospital | Lose G.,Copenhagen University | Klarskov N.,Copenhagen University
International Urogynecology Journal and Pelvic Floor Dysfunction | Year: 2016

Introduction and hypothesis: Uterine prolapse is a common health problem and the number of surgical procedures is increasing. No consensus regarding the surgical strategy for repair of uterine prolapse exists. Vaginal hysterectomy (VH) is the preferred surgical procedure worldwide, but uterus-preserving alternatives including the Manchester procedure (MP) are available. The objective was to evaluate if VH and the MP are equally efficient treatments for uterine prolapse with regard to anatomical and symptomatic outcome, quality of life score, functional outcome, re-operation and conservative re-intervention rate, complications and operative outcomes. Methods: We systematically searched Embase, PubMed, the Cochrane databases, Clinicaltrials and Clinical trials register using the MeSh terms “uterine prolapse”, “uterus prolapse”, “vaginal prolapse” “pelvic organ prolapse”, “prolapsed uterus”, “Manchester procedure” and “vaginal hysterectomy”. No limitations regarding language, study design or methodology were applied. In total, nine studies published from 1966 to 2014 comparing the MP to VH were included. Results: The anatomical recurrence rate for the middle compartment was 4–7 % after VH, whereas recurrence was very rare after the MP. The re-operation rate because of symptomatic recurrence was higher after VH (9–13.1 %) compared with MP (3.3–9.5 %) and more patients needed conservative re-intervention (14–15 %) than after MP (10–11 %). After VH, postoperative bleeding and blood loss tended to be greater, bladder lesions and infections more frequent and the operating time longer. Conclusions: This review is in favour of the MP, which seems to be an efficient and safe treatment for uterine prolapse. We suggest that the MP might be considered a durable alternative to VH in uterine prolapse repair. © 2016 The International Urogynecological Association


PubMed | University of Exeter, Team Danmark, Frederikssund Municipality, Copenhagen University and Herlev Gentofte University Hospital
Type: | Journal: British journal of sports medicine | Year: 2016

We investigated whether musculoskeletal fitness of school children aged 8-10years was affected by frequent intense PE sessions.295 Danish school children aged 8-10years were cluster randomised to a small-sided ball game group (SSG) (n=96, four schools, five classes), a circuit strength training group (CST) (n=83, four schools, four classes) or a control group (CON, n=116, two schools, five classes).SSG or CST was performed 340 min/week over 10 months. Whole-body dual-energy X-ray absorptiometry (DXA) scans were used to determine areal bone mineral density (aBMD), bone mineral content (BMC) and lean body mass (LBM). Flamingo balance, standing long jump and 20-m sprint tests were used to determine muscular fitness.Analysis of baseline-to-10months change scores showed between-group differences in favour of the interventions in whole-body aBMD (SSG vs CON: 8mg/cmIn conclusion, 340min/week with SSG or CST over a full school year improves bone mineralisation and several aspects of muscular fitness of children aged 8-10years, suggesting that well-organised intense physical education classes can contribute positively to develop musculoskeletal health in young children.NCT02000492, post results.


PubMed | Herlev & Gentofte University Hospital and Copenhagen University
Type: Journal Article | Journal: International urogynecology journal | Year: 2016

Uterine prolapse is a common health problem and the number of surgical procedures is increasing. No consensus regarding the surgical strategy for repair of uterine prolapse exists. Vaginal hysterectomy (VH) is the preferred surgical procedure worldwide, but uterus-preserving alternatives including the Manchester procedure (MP) are available. The objective was to evaluate if VH and the MP are equally efficient treatments for uterine prolapse with regard to anatomical and symptomatic outcome, quality of life score, functional outcome, re-operation and conservative re-intervention rate, complications and operative outcomes.We systematically searched Embase, PubMed, the Cochrane databases, Clinicaltrials and Clinical trials register using the MeSh terms uterine prolapse, uterus prolapse, vaginal prolapse pelvic organ prolapse, prolapsed uterus, Manchester procedure and vaginal hysterectomy. No limitations regarding language, study design or methodology were applied. In total, nine studies published from 1966 to 2014 comparing the MP to VH were included.The anatomical recurrence rate for the middle compartment was 4-7% after VH, whereas recurrence was very rare after the MP. The re-operation rate because of symptomatic recurrence was higher after VH (9-13.1%) compared with MP (3.3-9.5%) and more patients needed conservative re-intervention (14-15%) than after MP (10-11%). After VH, postoperative bleeding and blood loss tended to be greater, bladder lesions and infections more frequent and the operating time longer.This review is in favour of the MP, which seems to be an efficient and safe treatment for uterine prolapse. We suggest that the MP might be considered a durable alternative to VH in uterine prolapse repair.


PubMed | Herlev Gentofte University Hospital and Northwestern University
Type: Journal Article | Journal: Journal of the American Academy of Dermatology | Year: 2016

Tobacco exposure might be a modifiable risk factor for atopic dermatitis (AD).We examine the associationbetween AD and exposure to tobacco smoke.We performed a systematic review and meta-analysis of observational studies (n=86) in MEDLINE, EMBASE, Scopus, and Cochrane Library (1823-2015). Quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS). A meta-analysis was performed using random-effects models to estimate pooled odds ratios (OR). Subset analyses were performed for different ages (children, adult), regions, study designs (cross-sectional, longitudinal), study sizes (<5000, 5000), study quality (NOS score <6, 6), and amount of smoking (mild, extensive).A diagnosis of AD was associated with higher odds of active smoking (OR 1.87, 95% confidence interval 1.32-2.63) and exposure to passive smoke (OR 1.18, 95% confidence interval 1.01-1.38), but not maternal smoking during pregnancy (OR 1.06, 95% confidence interval 0.80-1.40). The association between active smoking and AD remained significant in children and adults, all continents studied, and study sizes, but all were cross-sectional designs and had NOS score 6 or greater. Passive smoke was associated with AD in children and adults, cross-sectional studies, South/Central American and African studies, study size less than 5000, and NOS score less than 6.AD severity and distribution were not assessed.Active and passive exposure to smoke are associated with increased AD prevalence.

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