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Svendborg, Denmark

Milano G.,Center Antoine Lacassagne | Uesaka K.,Shizuoka Cancer Center | Al-Batran S.-E.,UCT | Pfeiffer P.,OUH | And 2 more authors.
European Oncology and Haematology | Year: 2013

The European Society for Medical Oncology 15th World Congress of Gastrointestinal Cancer satellite symposium was held in Barcelona to discuss the oral fluoropyrimidine S-1. S-1 is a combination of three pharmacological compounds: tegafur, gimeracil and oteracil potassium. Tegafur is a prodrug of 5-fluorouracil (5-FU), an oral fluoropyrimidine, and has been developed as a replacement for infusional 5-FU therapy. S-1-based chemotherapy has become first-line treatment for unresectable advanced gastric cancer in Japan. It has also shown efficacy in the treatment of colorectal cancer, and a recent Japanese phase III clinical trial in pancreatic cancer showed that adjuvant treatment with S-1 substantially increases overall survival rates compared with treatment with the standard post-operative drug gemcitabin. Following a clinical trial in Western patients, S-1 has been approved in Europe and offers a tolerable and convenient treatment regimen with a tolerable safety profile. © Touch medical media 2013.

Kleppa E.,University of Oslo | Holmen S.D.,University of Oslo | Lillebo K.,University of Oslo | Kjetland E.F.,University of Oslo | And 5 more authors.
Sexually Transmitted Infections | Year: 2015

Objectives: It has been hypothesised that ectopy may be associated with increased susceptibility to sexually transmitted infections (STIs). In this cross-sectional study, we wanted to explore the association between STIs (including HIV) and cervical ectopy. Methods: We included 700 sexually active young women attending randomly selected high schools in a rural district in KwaZulu-Natal, South Africa. The district is endemic of HIV and has a high prevalence of STIs. We did computer-assisted measurements of the ectocervical area covered by columnar epithelium (ectopy) in colposcopic images and STI analyses on cervicovaginal lavage and serum samples. All participating women answered a questionnaire about sexual behaviour and use of contraceptives. Results: The mean age was 19.1 years. Ectopy was found in 27.2%, HIV in 27.8%, chlamydia in 25.3% and gonorrhoea in 15.6%. We found that age, parity, chlamydia and gonorrhoea, years since menarche, years since sexual debut and number of sexual partners were associated with ectopy. In multivariate analysis with chlamydia infection as the dependent variable, women with ectopy had increased odds of having chlamydia infection (adjusted OR 1.78, p=0.033). In women under 19 years of age, we found twofold higher odds of being HIV-positive for those with ectopy (OR 2.19, p=0.014). Conclusions: In conclusion, cervical ectopy is associated with Chlamydia trachomatis infection and HIV in the youngest women. © 2015, BMJ Publishing Group. All rights reserved.

Dobloug G.C.,University of Oslo | Antal E.A.,OUH | Sveberg L.,OUH | Garen T.,University of Oslo | And 5 more authors.
European Journal of Neurology | Year: 2015

Background and purpose: Knowledge about the occurrence of sporadic inclusion body myositis (sIBM) in the general population is limited. Here, our aim was to identify and characterize every sIBM patient living in southeast Norway (population 2.64 million) from 2003 to 2012. Method: Two sIBM case finding strategies were applied. First, all hospital databases in southeast Norway were screened to identify cases with sIBM-compatible International Classification of Diseases 10 (ICD-10) codes. These cases were then manually chart reviewed. Secondly, all muscle histology reports encoded with inflammation were independently reviewed. Finally, cases were classified according to the 1997 and the 2011 European Neuro-Muscular Centre (ENMC) Research Diagnostic Criteria for sIBM. Results: The combined case finding strategy identified 3160 patients with sIBM compatible ICD-10 codes, and a largely overlapping cohort of 500 patients having muscle biopsies encoded with inflammation. Detailed retrospective review of chart and histology data showed that 95 patients met the 2011 ENMC sIBM criteria and 92 met the 1997 criteria. Estimated point prevalence of sIBM was 33/1 000 000, equal with both criteria sets. Mean age at diagnosis was 66.9 years and mean diagnostic delay was 5.6 years. Chart review revealed higher frequencies of dysphagia (94% vs. 65%) and anti-Sjøgren syndrome A antibodies (39% vs. 12%) in female sIBM patients (n = 40) than in males. Coexisting rheumatic diseases were present in 25% of sIBM cases, with Sjøgren's syndrome in 10%. Conclusion: An estimated point prevalence of sIBM seven times higher than previously observed in Europe is reported. Our data show considerable diagnostic delay, a major challenge with new sIBM treatments in the pipeline. © 2014 EAN.

Kleppa E.,University of Oslo | Ramsuran V.,University of KwaZulu - Natal | Karlsen G.H.,University of Aarhus | Bere A.,Emory University | And 9 more authors.
PLoS ONE | Year: 2014

Background: Schistosoma haematobium is a waterborne parasite that may cause female genital schistosomiasis (FGS), characterized by genital mucosal lesions. There is clinical and epidemiological evidence for a relationship between FGS and HIV. We investigated the impact of FGS on HIV target cell density and expression of the HIV co-receptor CCR5 in blood and cervical cytobrush samples. Furthermore we evaluated the effect of anti-schistosomal treatment on these cell populations. Design: The study followed a case-control design with post treatment follow-up, nested in an on-going field study on FGS. Methods: Blood and cervical cytobrush samples were collected from FGS negative and positive women for flow cytometry analyses. Urine samples were investigated for schistosome ova by microscopy and polymerase chain reaction (PCR). Results: FGS was associated with a higher frequency of CD14+ cells (monocytes) in blood (11.5% in FGS+ vs. 2.2% in FGS-, p = 0.042). Frequencies of CD4 + cells expressing CCR5 were higher in blood samples from FGS+ than from FGS- women (4.7% vs. 1.5%, p = 0.018). The CD14+ cell population decreased significantly in both compartments after anti-schistosomal treatment (p = 0.043). Although the frequency of CD4+ cells did not change after treatment, frequencies of CCR5 expression by CD4+ cells decreased significantly in both compartments (from 3.4% to 0.5% in blood, p = 0.036; and from 42.4% to 5.6% in genital samples, p = 0.025). Conclusions: The results support the hypothesis that FGS may increase the risk of HIV acquisition, not only through damage of the mucosal epithelial barrier, but also by affecting HIV target cell populations, and that anti-schistosomal treatment can modify this. © 2014 Kleppa et al.

Mose T.,OUH | Damkier P.,University of Southern Denmark | Petersen M.,Svendborg Hospital | Antonsen S.,OUH
Therapeutic Drug Monitoring | Year: 2015

Background: Serum lithium is monitored to ensure levels within the narrow therapeutic window. This study examines the interlaboratory variation and inaccuracy of lithium monitoring in Denmark. Methods: In 16 samples consisting of (1) control materials (n 4), (2) pooled patient serum (n 5), and (3) serum from individual patients (n 7), lithium was measured in 19 laboratories using 20 different instruments. The lithium concentrations were targeted by a reference laboratory. Ion-selective electrode (n 5), reflective spectrophotometric (RSM, n 5), and spectrophotometric (n 10) methods were used. Results: Acceptable accuracy - interpreted as total differences from target values (bias) less than or equal to ±12% - was generally found in patient samples above 0.7 mmol/L. Below 0.7 mmol/L, 8 instruments had 2 or more patient samples exceeding a difference to the targeted reference value of >12%. Seven of these instruments had a systematic positive or negative bias and more so at lower lithium concentrations. Three poorly calibrated instruments were found in the ion-selective electrode group, 3 in the spectrophotometric group, and 2 in the RSM group. The instruments using reflectance spectrophotometry (RSM) were on average 21% positively biased when measuring control materials. However, this effect was not observed in patient samples. Conclusions: Large interlaboratory variation was found below 0.7 mmol/L because of 7 instruments with a poor accuracy and 1 with poor precision. Methods should be recalibrated or substituted. Controls below 0.7 mmol/L are recommended. © Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

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