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Aalborg, Denmark

Fynne L.,Neurogastroenterology Unit | Luft F.,Aarhus University Hospital | Gregersen H.,Sino Danish Center for Education and Research | Buntzen S.,Aarhus University Hospital | And 4 more authors.
Colorectal Disease | Year: 2013

Aim: Systemic sclerosis (SSc) is a generalized connective tissue disease that affects smooth muscle cells. Patients with SSc often have faecal incontinence caused by fibrotic degeneration of the internal anal sphincter (IAS). The functional lumen imaging probe (FLIP) is a novel method that allows the segmental biomechanical properties of the anal canal to be dynamically evaluated. The aim of the present study was to compare the segmental biomechanical properties of the anal canal in incontinent SSc patients and healthy controls. We hypothesized that the FLIP would reveal weaknesses of the IAS in the SSc patients. Method: We performed FLIP distensions, endoanal ultrasonography and standard anal manometry on 14 incontinent SSc patients [11 women, median age 60 years (range 35-80)] and 15 healthy volunteers [12 women, median age 54 years (range 33-67)]. The anal canal was divided into three parts for the biomechanical analysis: upper (surrounded by the IAS and the puborectalis), middle (IAS and external anal sphincter) and lower (external sphincter only). Results: The middle anal canal was the segment most resistant to distension in all of the subjects, but it was less resistant in the SSc patients than in the controls (P < 0.01). Correspondingly, the endoanal ultrasonography showed that the IAS of the SSc patients was thinner than normal (P < 0.05), and the anal resting and squeeze pressures were lower (P < 0.05). Only minor distensibility differences were found in the upper anal canal. No changes were found in the lower anal canal. Conclusion: Faecal incontinence in SSc patients is associated with poor IAS function, causing increased distensibility of the middle anal canal. © 2012 The Authors Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland. Source

Norgaard M.,Aarhus University Hospital | Farkas D.K.,Aarhus University Hospital | Pedersen L.,Aarhus University Hospital | Erichsen R.,Aarhus University Hospital | And 4 more authors.
British Journal of Cancer | Year: 2011

Background:Little is known about the risk of colorectal cancer among patients with irritable bowel syndrome (IBS).Methods:We conducted a nationwide cohort study using data from the Danish National Registry of Patients and the Danish Cancer Registry from 1977 to 2008. We included patients with a first-time hospital contact for IBS and followed them for colorectal cancer. We estimated the expected number of cancers by applying national rates and we computed standardised incidence ratios (SIRs) by comparing the observed number of colorectal cancers with the expected number. We stratified the SIRs according to age, gender, and time of follow-up.Results:Among 57 851 IBS patients, we identified 407 cases of colon cancer during a combined follow-up of 506 930 years (SIR, 1.14 (95% confidence interval (CI): 1.03-1.25) and 115 cases of rectal cancer, corresponding to a SIR of 0.67 (95% CI: 0.52-0.85). In the first 3 months after an IBS diagnosis, the SIR was 8.42 (95% CI: 6.48-10.75) for colon cancer and 4.81 (95% CI: 2.85-7.60) for rectal cancer. Thereafter, the SIRs declined and 4-10 years after an IBS diagnosis, the SIRs for both colon and rectal cancer remained below 0.95.Conclusion:We found a decreased risk of colorectal cancer in the period 1-10 years after an IBS diagnosis. However, in the first 3 months after an IBS diagnosis, the risk of colon cancer was more than eight-fold increased and the risk of rectal cancer was five-fold increased. These increased risks are likely to be explained by diagnostic confusion because of overlapping symptomatology. © 2011 Cancer Research UK All rights reserved. Source

Graversen C.,Mechanical Sense
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference | Year: 2010

The analgesic effect of morphine is highly individual, calling for objective methods to predict the subjective pain relief. Such methods might be based on alteration of brain response caused by morphine during painful stimuli. The study included 11 healthy volunteers subjectively quantifying perception of painful electrical stimulations in the esophagus. Brain evoked potentials following stimulations were recorded from sixty-four electroencephalographic channels at baseline and ninety minutes after morphine administration. Marginals obtained from discrete wavelet coefficients for each channel were used as input to an optimized support vector machine classifying between baseline and after morphine administration. The electroencephalographic channel leading to the best performance was further analyzed to identify brain alterations caused by morphine. Marginals from volunteers with no analgesic effect were examined for differences in comparison to volunteers with effect. The single-channel classification showed best performance at electrode P4 with 84.1 % of the traces classified correctly. When combining features from the 6 best performing channels, the multichannel classification increased to 92.4 %. The most discriminative feature was a decrease in the delta band (0.5 - 4 Hz) after morphine for volunteers with analgesic effect. Volunteers with no effect of morphine showed an increase in the delta band after drug administration. As only a proportion of patients benefit from opioid treatment, the new approach may help to identify non-responders and guide individualized tailored analgesic therapy. Source

Graversen C.,Mechanical Sense
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference | Year: 2011

Evoked brain potentials averaged over multiple sweeps provide a valuable objective measure of abnormal pain processing due to sensitization of the central nervous system. However, the average procedure cancel out important information regarding phase resetting and non-phase locked oscillations. Hence, assessment of the pain processing could be optimized by analyzing single-sweeps. To develop improved methods to assess single-sweeps, we applied a new approach in one healthy volunteer participating in a placebo controlled study of widespread hyperalgesia induced by perfusion of acid and capsaicin in the esophagus. The evoked potentials were recorded during electrical stimulations in the rectosigmoid colon. Features from the single-sweeps were extracted by a multivariate matching pursuit algorithm with Gabor atoms, and features were discriminated by a support vector machine with a linear kernel. The classification performance for the optimal number of atoms was 95% when discriminating the sensitization response from the placebo response, which was above change level compared to the performance when discriminating the two baseline responses (P < 0.001). The discriminative capacity was increased power in the delta, theta, and alpha frequency bands. This result corresponds to previous characteristics seen in chronic pain patients who exhibit central sensitization. The new approach to classify single-sweeps on a single subject basis might in the future prove to be a useful tool in assessing mechanisms in central sensitization, and could be applied to improve enriched enrollment of study subjects in clinical trial units. Source

Dinning P.G.,University of New South Wales | Arkwright J.W.,CSIRO | Gregersen H.,Mechanical Sense | Gregersen H.,University of Bergen | And 2 more authors.
Neurogastroenterology and Motility | Year: 2010

Abnormal motor patterns are implicated in many motility disorders. However, for many regions of the gut, our knowledge of normal and abnormal motility behaviors and mechanisms remains incomplete. There have been many recent advances in the development of techniques to increase our knowledge of gastrointestinal motility, some readily available while others remain confined to research centers. This review highlights a range of these recent developments and examines their potential to help diagnose and guide treatment for motility disorders. © 2010 Blackwell Publishing Ltd. Source

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