Moller H.U.,Viborg Hospital
Developments in ophthalmology | Year: 2011
The International Committee for Classification of Corneal Dystrophies (IC3D) has provided an update of our knowledge on corneal dystrophies. This chapter gives the summary of clinical findings, onset, course, genetics, nosology, light and electron microscopy as well as immunohistochemistry for 25 different entities included as corneal dystrophies in this survey. A category number from 1 through 4 is assigned, reflecting the level of evidence supporting the existence of a given dystrophy. Copyright © 2011 S. Karger AG, Basel.
Andersen L.V.,Aarhus University Hospital |
Lip G.Y.H.,University of Birmingham |
Lindholt J.S.,Viborg Hospital |
Lindholt J.S.,University of Southern Denmark |
Frost L.,Aarhus University Hospital
Journal of Thrombosis and Haemostasis | Year: 2013
Objectives: The aim of this review is to focus on risk factors, risk-modifying drugs and prognosis for upper limb arterial thromboembolism, and the relationship between upper limb arterial thromboembolism and atrial fibrillation (AF). Methods: We searched MEDLINE for studies on the epidemiology of upper limb thromboembolism from 1965 to June 2012. We also searched for contemporary, phase III randomized trial data on systemic (non-stroke) thromboembolism comparing warfarin with new oral anticoagulants (OACs) in patients with atrial fibrillation published after the year 1999. Results: The incidence of upper limb thromboembolectomy was 3.3 per 100 000 person-years among men and 5.2 per 100 000 person-years among women; the risk of limb amputation, stroke and death after thromboembolectomy was increased. There was an increased risk of thromboembolectomy of the upper limb in patients with AF diagnosed with hypertension (hazard ratio [HR] 2.2-2.9), myocardial infarction (HR 2.9-3.9), heart failure (HR 1.6-1.9), and stroke (HR 2.2-3.8). For those diagnosed with diabetes mellitus, the risk was non-significantly increased by 1.2-1.4. Females had a 1.8-fold (95% confidence interval [CI] 1.5-2.3) fold increased risk of thromboembolectomy as compared with men. The risk reduction for systemic embolism with new OACs as compared with warfarin in patients with AF is similar to that seen with warfarin (odds ratio 0.79, 95% CI 0.38-1.64). Conclusions: Age, female sex, AF, hypertension, diabetes, myocardial infarction, heart failure and stroke are most common risk factors for thromboembolectomy of the upper limb. The availability of new OACs holds promise for reducing the risk of systemic thromboembolism, but specific data are still limited. © 2013 International Society on Thrombosis and Haemostasis.
Bank S.,Viborg Hospital |
Christensen K.,University of Aarhus |
Kristensen L.H.,Viborg Hospital |
Prag J.,Viborg Hospital
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2013
The main purpose of this paper was to estimate the cost per quality-adjusted life year (QALY) saved by identifying Fusobacterium necrophorum in throat swabs followed by proper antibiotic treatment, to reduce the incidence of Lemierre's syndrome and peritonsillar abscesses (PTA) originating from a pharyngitis. The second purpose was to estimate the population size required to indicate that antibiotic treatment has an effect. Data from publications and our laboratory were collected. Monte Carlo simulation and one-way sensitivity analysis were used to analyse cost-effectiveness. The cost-effectiveness analysis shows that examining throat swabs from 15- to 24-year-olds for F. necrophorum followed by antibiotic treatment will probably be less costly than most other life-saving medical interventions, with a median cost of US8,795 per QALY saved. To indicate a reduced incidence of Lemierre's syndrome and PTA in Denmark, the intervention probably has to be followed for up to 5 years. Identifying F. necrophorum in throat swabs from 15- to 24-year-olds followed by proper antibiotic treatment only requires a reduction of 20-25 % in the incidence of Lemierre's syndrome and PTA to be cost-effective. This study warrants further examination of the effect of antibiotic treatment on the outcome of F. necrophorum acute and recurrent pharyngitis, as well as the effect on Lemierre's syndrome and PTA. © 2012 Springer-Verlag.
Bank S.,Viborg Hospital |
Jensen A.,University of Aarhus |
Hansen T.M.,Viborg Hospital |
Soby K.M.,Viborg Hospital |
Prag J.,Viborg Hospital
Emerging Infectious Diseases | Year: 2010
Actinobaculum schaalii can cause urinary tract infections and septicemia but is difficult to identify by cultivation. To obtain a fast diagnosis and identify A. schaalii, we developed a TaqMan real-time quantitative PCR. Routine urine samples were obtained from 177 hospitalized patients and 75 outpatients in Viborg County, Denmark, in 2008-2009. The PCR detected A. schaalii in 22% of samples from patients >60 years of age. This assay showed that A. schaalii is more common than implied by routine cultivation. In 90% of PCR-positive urine samples, other common uropathogens were identified. This finding suggests that A. schaalii is a common, undetected, bacterial pathogen. Our results suggest that A. schaalii may be a more common pathogen than previously thought, especially in patients with unexplained chronic urinary tract infections, who are often treated with trimethoprim or ciprofloxacin, to which A. schaalii is resistant.
Nielsen H.L.,Viborg Hospital |
Nielsen H.L.,University of Aalborg
New Microbes and New Infections | Year: 2015
This is the first report of Actinomyces europaeus bacteraemia in a 53-year-old man. The bacteraemia was the result of a breast abscess. Identification was established by matrix-assisted desorption ionization-time of flight mass spectrometry and confirmed by 16S rRNA gene sequencing. The patient was treated with surgical drainage and penicillin for 4 weeks; the patient did not experience any relapse during 6 months of follow-up. © 2015 The Author.