FORSKNINGENS DAG 2016

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18. august 2016

Program og abstracts

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Kongrescenter Herning 7400 Herning

Afholdt af

Center for Forskning og Uddannelse Gl. Landevej 61

7400 Herning

www.vest.rm.dk/forskning cfu@rm.dk

Organisationskomité

Forskningskoordinerende ledende overlæge, Annette Haagerup, CFU. Forskningsformidler, Gritt

Bennedsen, CFU. Uddannelseskoordinator, Janet Hansen, CFU. Forsker Karin Biering, Arbejdsmedicinsk Klinik.

Forskningsmedarbejder, Morten Hollænder Beeck, CFU. Seniorforsker, Bodil Bjørnshave Noe, CFU.

Sekretær, Susanne Risom Simonsen, CFU.

Den videnskabelige bedømmelseskomité

Forskningskoordinerende ledende overlæge, Annette Haagerup. 1. reservelæge Maiken Stilling.

Overlæge Finn Friis Lauszuz. Professor Susanne Wulff Svendsen. Overlæge Jesper Nørgaard Bech og forsker Karin Biering.

Den videnskabelige priskomité

Overlæge Finn Friis Lauszuz. Professor Susanne Wulff Svendsen. Overlæge Jesper Nørgaard Bech.

Forsker Karin Biering og lægefaglig direktør Jens Friis Bak.

Chairmen Session 1:

Professor, dr.med. Jørgen Bjerggaard Jensen, Urinvejskirurgisk Afdeling K, HEV Overlæge ph.d., klinisk lektor Jesper Nørgaard Bech, Medicinsk Afdeling, HEV Session 2:

Professor, ledende overlæge Torben Bæk Hansen, Universitetsklinik for hånd-, hofte- og knækirurgi, HEV Professor, overlæge, dr.med. Therese Ovesen, Øre-næse-hals afdelingen, HEV

Session 3:

Professor, overlæge, ph.d. Susanne Wulff Svendsen, Arbejdsmedicinsk Klinik, HEV

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Kære konferencedeltager

Sundhedsvidenskabelig forskning er en forudsætning for patientbehandling af højeste kvalitet og en væsentlig parameter for et hospitals omdømme. I Hospitalsenheden Vest har vi over en årrække haft en støt stigende forskningsaktivitet på tværs af specialer, fag, matrikler og insitutioner. Det er på alle måder glædeligt.

Med stor faglighed, kreativitet og evne til samarbejde publicerede vores dygtige forskere også i 2015-16 nyskabende forskningsresultater både nationalt og internationalt. Det er de resultater og den indsats, vi fejrer i dag.

Center for Forskning og Uddannelse har sammen med et videnskabeligt bedømmelsesudvalg tilrette- lagt dagens program og er for anden gang vært for konferencen. Det er med stor glæde vi byder vel- kommen til Forskningen Dag 2016.

Rigtig god fornøjelse!

Annette Haagerup

Forskningskoordinerende ledende overlæge Center for Forskning og Uddannelse

Hospitalsenheden Vest

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Abstract-

nr. Tid Titel på præsentationen Navn

1 10.15 The Effect of Sodium Nitrite Infusion on Renal Variables, Brachial and Central Blood Pressure During Enzyme Inhibition by Allopurinol, Enalapril or Acetazolamide in Healthy Subjects.

- A Randomized, Double-Blinded, Placebo-Controlled, Cross-Over Study

Jeppe Bakkestrøm Rosenbæk

2 10.27 Higher UHMWPE wear rate in cementless compared with cemented cups with the Saturne® Dual-Mobility system.

Steffan Tabori Jensen

3 10.39 Hukommelses- og koncentrationsproblemer ved arbejdsrelateret stress

Anita Eskildsen 4 10.51 Prospective evaluation of a decision support system

providing advice on ventilator settings of: inspiratory oxygen, delivered pressure or volume and frequency

Nilanjan Dey

5 11.03 Impairment of lung function during adjuvant oxaliplatin treatment in patients with colorectal cancer. A prospective trial.

June Ejlersen

6 11.15 Comparison of white light, photodynamic diagnosis (PDD) and narrow-band imaging (NBI) in detection of flat dysplasia and Carcinoma in Situ (CIS) at transurethral resection of the bladder: an international study.

Ditte Drejer

7 11.27 Retrospective survey of self expandable metallic stents in the treatment of acute, malignant colonic obstruction.

Anders Krøll Knudsen

11.39 - 11.50 Pause

Session 1 - orale præsentationer

Chair: Professor, dr.med. Jørgen Bjerggaard Jensen og overlæge ph.d., klinisk lektor Jesper Nørgaard Bech 09.30 - 10.00 Ankomst

10.00 - 10.15 Velkomst ved Annette Haagerup, CFU

Indlæg ved Allan Flyvbjerg, Dekan ved Health, AU

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8 13.15 The antiplatelet effect of aspirin declines during the 24-hour dosing interval

Morten Würtz 9 13.27 Effekt på cardio-vaculære risikofaktorer af

livsstilsintervention over for nydebuterede skizofrene patienter

Hans Jørgen Søgaard 10 13.39 Neck-shoulder pain and work status among

former sewing machine operators – a 14 years follow up study

Emma Lise Jakobsen

11 13.51 Clinical course and prognosis of musculoskeletal pain in patients referred for physiotherapy: does

symptom diagnosis matter?

David Høyrup Christiansen

14.03 - 14.10 Pause

12 14.10 Poster 1: Balanceorganet stimuleres af MR scanne- rens magnetfelt

Louise Devantier 13 14.15 Poster 2: Atrial fibrillation detected by external loop

recording for seven days or two-day Holter recording

Michala Herskind Sejr

14 14.20 Poster 3: The significance of blood pressure mea- surement evaluated by stiffness index in pregnancy in diabetic and control women

Ingvild Holm Tjessem 15 14.25 Poster 4: Calcium signaling and molecular adhesion

processes may hold the key to genetic risk for Autism.

- A molecular pathway analysis on two independent samples.

Antonio Drago

16 14.30 Poster 5: Tele-patient-reported outcomes (telePRO) Liv Marit Valen

Session 2 - orale præsentationer

Chair: Professor, ledende overlæge Torben Bæk Hansen og professor, dr.med. Therese Ovesen

Session 3 - posterpræsentationer

Chair: Professor, overlæge, ph.d. Susanne Wulff Svendsen og overlæge, ph.d., lektor Ole May

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17 14.35 Poster 6: Betydningen af alder og præoperativ hel- bredsrelateret livskvalitet (HRQoL) for patientoplevet udbytte i forbindelse med hofte- og knæalloplastik- operation, et kohortestudie.

Peter Kloster Aalund

18 14.40 Poster 7: Breast cancer patients treated with chemo- therapy reports more unmet supportive care needs in the early treatment phase, than patients treated only with radiotherapy

Mikael Birkelund Jensen-Johansen

19 14.45 Poster 8: Obstructive sleep apnea and blood pressure in hypertensive patients with CKD2 and healthy subjects

Bodil Gade Hornstrup 20 14.50 Poster 9: Trampoline injuries and safety in children:

- A retrospective study and follow up phone interview Thi Anh Nhi Huynh 21 14.55 Poster 10: Gastrointestinal symptoms among pa-

tients with neurofibromatosis type 1

Cecilie Ejerskov 22 15.00 Poster 11: Learning and coping strategies improve

maintenance of exercise capacity in cardiac rehabilitation - a partial result from the randomised LC-RE- HAB trial

Vibeke Lynggaard

23 15.05 Poster 12: Brug af internettet til videnssøgning inden besøg i børneambulatoriet

Ida Kangas 24 15.10 Poster 13: No evidence of chloride nephrotoxicity

using urinary excretion of NGAL as biomarker between 155 mmolar chloride infusion with 98 mmolar chloride in patients undergoing primary uncemented hip replacement.

Andreas Nygaard Jørgensen

15.15 - 15.50 Kaffepause og postergalleri

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25 15.50 A hospital fighting malnutrition. Better food and nu- tritional care to hospitalised patients: a pilot study

Alexander Erichsen 26 16.02 Increased migration and more revisions of MOTEC

compared with ELECTRA cups. A 2-year RSA study of trapeziometacarpal prostheses

Maiken Stilling

27 16.14 Episiotomy affects the risk of OASIS in vacuum-assi-

sted deliveries Ninna Sønderby

Lund 28 16.26 Effect of a 3 months training program after THA fol-

lowing a femoral neck fracture (- 1 year follow up)

Christina Frølich 29 16.38 2-Year results of the Sigma unicompartmental

knee arthroplasty

Daan Koppens

16.50 - 17.00 Pause

17.00 - 17.45 Inviteret foredrag:

Universitetsklinik - hvorfor, hvordan og hvad nu?

ved professor, ledende overlæge Torben Bæk Hansen

17.45 - 17.55 Afslutning

17.55 - 18.30 Pause, postergalleri og velkomstdrink

18.30 - Festmiddag og prisoverrækkelse

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I forbindelse med Forskningens Dag 2016 uddeles to forskningspriser. En til bedste orale præsenta- tion og en til bedste posterpræsentation.

Priserne består af 5000 kr., som kan bruges til forskningsrelaterede aktiviteter efter eget ønske.

Priskomitéen består af:

Overlæge Finn Friis Lauszuz. Professor Susanne Wulff Svendsen. Overlæge Jesper Nørgaard Bech.

Forsker Karin Biering og lægefaglig direktør Jens Friis Bak.

Bedømmelseskriterier:

Den videnskabelige bedømmelseskomite har besluttet, at følgende kriterier vægtes i bedømmelsen af de videnskabelig indlæg på Forskningens Dag. Bedømmelseskriterierne gælder såvel orale som poster præsentationer.

• videnskabelig kvalitet

• videnskabelig originalitet

• klinisk anvendelighed

• god visuel og oral formidling

• klart formål og klar konklusion

• overholdelse af tid

Konferencens deltagere har mulighed for at afgive elektroniske bedømmelser efter hvert indlæg. I den samlede bedømmelse vægtes bedømmelserne fra konferencens deltagere og den videnskabelige bedømmelseskomite med hver 50%. Priskomitéen træffer den endelige afgørelse om uddeling af årets forskerpriser.

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Titel

The Effect of Sodium Nitrite Infusion on Renal Variables, Brachial and Central Blood Pressure During Enzyme Inhibition by Allopurinol, Enalapril or Acetazolamide in Healthy Subjects.

A Randomized, Double-Blinded, Placebo-Controlled, Cross-Over Study Forfatter

Jeppe Bakkestrøm Rosenbæk Læge, ph.d.-studerende

Universitetsklinik for Nyresygdomme og Blodtryksforhøjelse, Medicinsk Forskningsafsnit Abstract

Background: Sodium nitrite (NaNO₂) causes vasodilation, presumably by enzymatic conversion to nitric oxide (NO). Several enzymes with nitrite reducing capabilities have been discovered in vitro, but their relative importance in vivo has not been investigated. We aimed to examine the effects of NaNO₂ on hemo- dynamics, fractional sodium excretion (FE_Na), free water clearance (C_H2O) and GFR, following pre-inhibition of xanthine oxidase, angiotensin-converting enzyme and carbonic anhydrase.

Methods: In a double-blinded, placebo-controlled, cross-over study, 16 healthy subjects were treated, in a randomized order, with placebo, allopurinol 150 mg twice daily (x 2), enalapril 5 mg x 2, or acetazolamide 250 mg x 2. After four days of treatment and standardized diet the subjects were examined at our lab.

During administration of 240 μg NaNO₂/kg/hour for two hours, we measured brachial and central blood pressure (BP), plasma and urine osmolality, GFR by Cr-EDTA clearance, FE_Na and urinary excretion rate (UER) of cyclic guanosine monophosphate (cGMP) and nitrite and nitrate (NO_x). Subjects were supine and orally water-loaded throughout the examination day.

Results: After 90-120 min of NaNO₂ infusion we observed an increase in FE_Na, heart rate, UER of NO_x, and a decrease in C_H2O, UER of cGMP, and brachial systolic BP irrespective of pretreatment. We observed a consistent trend towards a reduction in central systolic BP, which was only significant after allopurinol. An increase in GFR was only observed after placebo.

Conclusion: This study shows a BP lowering and natriuretic effect of NaNO₂ regardless of preceding enzyme inhibition. GFR was increased by NaNO₂ infusion, when no enzymes where inhibited. The decrease in UER of cGMP indicates little or no conversion of nitrite to NO, thus the effect of NaNO₂ does not seem to be mediated by NO generation.

Øvrige forfattere

2. Erling Bjerregaard Pedersen, Universitetsklinik for Nyresygdomme og Blodtryksforhøjelse, Medicinsk Forskningsafsnit, Hospitalsenheden Vest og Aarhus Universitet

3. Jesper Nørgaard Bech, Universitetsklinik for Nyresygdomme og Blodtryksforhøjelse, Medicinsk Forsk- ningsafsnit, Hospitalsenheden Vest og Aarhus Universitet

Evt hovedvejledere el. vejledere

Hovedvejleder: Jesper Nørgaard Bech, overlæge, ph.d., klinisk lektor, Universitetsklinik for Nyresygdom- me og Blodtryksforhøjelse, Medicinsk Forskningsafsnit, Hospitalsenheden Vest og Aarhus Universitet

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Titel

Higher UHMWPE wear rate in cementless compared with cemented cups with the Saturne® Dual-Mobility system.

Forfatter

Steffan Tabori Jensen 1. reservelæge

Ortopædkirurgisk afdeling, HEV

Abstract

Background: Displaced medial femoral neck fracture (FNF) may be treated with primary arthroplasty.

Dual-mobility articulations have advantages on stability and range of motion, however polyethylene (PE) wear on two articulating sides might lead to excessive wear.

Purpose: To investigate PE wear rate of primary DM cups in patients with acute FNF.

Materials and methods: From 2005-2011, 414 consecutive patients were operated with Saturne DM cups, 28mm femoral metal heads, UHMWPE. Cementless cups were coated with hydroxyapatite (HA).

239 cups were cemented and 175 were press-fit by choice of the surgeon. In 2012, at minimum 1-year follow-up, 155 patients were dead and the remaining 259 were invited for clinical follow-up. 80 patients were evaluated with standard radiographs for analysis of cup placement, 2D wear and wear rate (Po- lyWare software 3D Pro). Mean age at time of surgery was 80 (range 30-98) years.

Results: At a mean follow-up of 3.5 (1.4 – 7.7) years the mean 2D wear was 0.82 (sd 0.38, 0.3-2.2) mm and 2D wear rate was 0.29 (sd 0.21, 0.1-1.2). Wear rate of 0.35 (sd 0.22) in cementless cups were higher (p=0.045) than 0.16 (sd 0.07) in cemented cups. Patients with cementless cups were younger (78 vs. 81 years, p=0.005). Mean cup inclination was 44 (26-65) degrees and mean cup anteversion 17 (-12-47).

There was no correlation between cup inclination and wear (p>0.34) and no difference in wear between gender (p>0.33). There was no correlation between age at time of surgery and wear (p>0.06). Cup inclination was similar (p=0.13) for cemented and cementless cups.

Conclusion: At short term follow-up, we found a higher wear rate in cementless HA coated cups compa- red with cemented cups. In general mean 2D wear and wear rate in these old and low demand patients was high and above the osteolysis threshold (0.1mm).

Øvrige forfattere

Morten Homilius, Christina Frølich, Søren Bøvling, Torben Bæk Hansen, Maiken Stilling Department of Orthopedics, Hospital Unit West, Denmark

Hovedvejleder: ph.d, professor, overlæge Torben Bæk Hansen, Department of Orthopedics, Hospital Unit West, Denmark.

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Titel

Hukommelses- og koncentrationsproblemer ved arbejdsrelateret stress Forfatter

Anita Eskildsen

Psykolog, phd studerende, Arbejdsmedicinsk Klinik Abstract

Patients on sick leave due to work-related stress often present with cognitive impairments. This prospective cohort study examined the long-term consequences of prolonged work-related stress in terms of cognitive functioning during a period of one year.

We tested a group of patients with work-related stress with a comprehensive neuropsychological test battery at two occasions – when seeking professional help at baseline and one year later. At both occasions, we compared the performance of patients with healthy controls matched pairwise on sex, age and length of education.

At baseline, patients generally showed mildly reduced performances across all the measured domains of the neuropsychological test battery compared to controls. After one year and when correcting for practice effects, patients had improved on measures of prospective memory and processing speed. However, patients continued to perform worse compared to controls on all tests, though only half of the compari- sons reached statistical significance (p<.05). The effect sizes of the differences between the two groups at one-year follow-up were small to medium.

In conclusion, even though former patients with prolonged work-related stress improve during a year, they continue to perform worse than controls after one year. In the acute phase the largest impairments were related to executive function and mental speed but at follow-up memory impairments also became apparent.

Øvrige forfattere

Lars Peter Andersen¹, Anders Degn Pedersen², Sanne Kjær Vandborg³, and Johan Hviid Andersen¹

1) Danish Ramazzini Centre, Department of Occupational Medicine, The Regional Hospital West Jutland – University Research Clinic, Herning, Denmark,

2) Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus C, Denmark, and 3) Clinic for OCD and Anxiety Disorders, Aarhus University Hospital, Risskov, Denmark

Hovedvejleder: Johan Hviid Andersen

Medvejledere: Lars Peter Andersen, Anders Degn Pedersen

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Titel

Prospective evaluation of a decision support system providing advice on ventilator settings of:

inspiratory oxygen, delivered pressure or volume and frequency Forfatter

Nilanjan Dey Overlæge

Anæsthesi og Intensiv

Abstract

Introduction: Selecting and adapting appropriate settings of mechanical ventilation can be difficult and time consuming.The Beacon Caresystem (Mermaid Care, Denmark) is a commercial version of a previously published [1] physiological-model based system for advising on mechanical ventilation.

Objectives: This study investigates the changes in oxygenation, ventilation and acid-base status in patients used for 8 hours.

Methods: Patients are recruited from 4 intensive care units in Denmark. Informed consent and ethical approval was obtained in all cases. A mix of patients recruited ranging from mild to moderate ARDS, to those in weaning. The study included 25 patients. All p-values are calculated using paired t-test.

Results: 15 patients were in pressure support and 10 in volume control modes. Average values of venti- lation, oxygenation and acid-base status across all patients at the start and end of using the system were obtained .Inspired oxygen did not change with insignificant reduction in Fi02 from 38.2 ± 7.0% to 36.4 ± 8.6 (p = 0.18).A small reduction in arterial oxygen partial pressure (from 12.1 ± 2.4 kPa to 10.9 ± 2.2 kPa, p = 0.06)and saturation (97.2 ± 1.5 to 95.9 ± 1.4, p < 0.01) . Ventilation on average reduced, with tidal volumes falling from 586 ± 201 ml to 536 ± 166 ml (p = 0.06),little change in average respiratory frequency (from 20.0 ± 9.3 breaths/min to 20.7 ± 8.5 breaths/min, p > 0.5).The reduction in ventilation induced a decrease in average plateau pressure (from 20.5 ± 6.1 cmH2O to 17.3 ± 5.2 cmH2O, p < 0.01),modified acid base status only slightly (pH from 7.428 ± 0.044 to 7.402 ± 0.041, p < 0.05; PaC02 from 5.3 ± 1.0kPa to5.7±0.6kPa,p<0.05; FETC02 from4.5±0.8%to4.8±0.7%, p = 0.06).

Conclusions: These results indicate that the Beacon Caresystem provides advice which is rational and tailored to the individual patient’s physiology.

Øvrige forfattere

S.E. Rees, D.C. Lodahl, A. Ciubotariu, J. Pilypaite, R.R. Winding, D.S. Karbing.

SE Rees og D .S Karbing are affiliated to Mermaid care.

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Titel

Impairment of lung function during adjuvant oxaliplatin treatment in patients with colorectal cancer. A prospective trial.

Forfatter June Ejlersen Overlæge, Ph.d.

Nuklearmedicinsk afd.

Abstract

Background: Forty-seven cases (38 men and 9 women) of pulmonary toxicity caused by oxaliplatin have previously been published, but the issue has not been investigated in a prospective setting. Our purpose was to assess how oxaliplatin affects the pulmonary function in colorectal cancer patients during adjuvant treatment.

Methods: Forty patients (median age 57.5 years, range 33-74) radically resected for colorectal cancer, underwent three pulmonary function tests during post-surgery adjuvant treatment with oxaliplatin.

Results: Mean±sd haemoglobin corrected diffusion capacity (DLCOc) in the entire patient cohort were 7.65±2.24 at baseline, 7.11±2.11 during and 7.12±1.99 three months after oxaliplatin treatment (p=0.0002). The decrease was similar in men (n=22, p=0.02) and women (n=18, p=0.01), but most promi- nent in smokers (n=23, p=0.0005) and in patients exposed to occupational dust (n=21, p=0.0009). Besides a small decrease in the FEV1/FVC ratio (p=0.03), all other pulmonary parameters remained constant and no clinical signs of pulmonary failure were observed during the study period.

Conclusion: A decline in DLCOc was detected in a majority of the examined patients, but none reported any clinical symptoms of pulmonary distress. The subtle decrease in DLCOc does not appear to be an isolated predictor of PT. Our data suggest that smoking and dust exposure might aggravate the effect of oxaliplatin on DLCOc. Routine pulmonary function test in patients treated with oxaliplatin is not recommended, but it is important to be aware of the early signs of pulmonary toxicity.

Published in Current Drug Safety, 2016.

Øvrige forfattere

Nina Keldsen, onkologisk afd., HEV.

Maria Louise Jöhnk, børne/unge psykiatri, Viborg

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Titel

Comparison of white light, photodynamic diagnosis (PDD) and narrow-band imaging (NBI) in detection of flat dysplasia and Carcinoma in Situ (CIS) at transurethral resection of the bladder: an international study.

Forfatter

Ditte Drejer. Reservelæge, PhD studerende.

Urinvejskirurgisk Afd.

Aarhus Universitets Hospital / Hospitalsenheden Vest, Holstebro Abstract

Introduction & Objectives

The use of fluorescence cystoscopy (PDD) is used worldwide and several studies have shown the supe- riority of photo dynamic diagnosis regarding detection of tumors, carcinoma in situ and flat dysplasia compared to white light. In the present study another optical modality, Narrow Band Imaging, NBI was investigated in a high risk patient population in order to compare NBI to findings of white light and PDD.

Thus, the study was designed as an international multicenter study to compare white light, PDD and NBI regarding identification of flat lesions.

Material & Methods

171 patients from four different urological departments in Denmark and Norway were included, in a period from November 2014 to January 2016. Photodynamic diagnosis was used at the transurethral resection when recommended according to the EAU guidelines, and procedures were performed by experienced surgeons only. Each patient was first examined with conventional white light cystoscopy and afterwards both NBI and subsequent PDD were used in further bladder mapping and all suspicious areas were regi- stered on a bladder chart and biopsied.

Results

87 Patients had a visible primary tumor in the bladder. 136 patients were biopsied in at least one modality because of suspicion of carcinoma in situ (482 biopsies/3.5 biopsy per patient).

23 (13,5%) patients had CIS or dysplasia.

Both NBI and PDD had a significantly higher sensitivity regarding CIS and dysplasia compared to white light (95,7 %. 95,7 % vs 65,2% (p <0.01)). NBI and white light had a higher specificity compared to PDD (52%. 56,8% and 48%) but not significantly. Per biopsy NBI showed a tendency of a higher positive predic- tive value (23,7%) in comparison to white light and PDD (19% and 22,2% (not significant)).

Conclusion.

In the present study, NBI was found to be a safe alternative to PDD regarding diagnosis of CIS in a high risk population. Both modalities were significantly better compared to white light alone.

Øvrige forfattere

Béji S.², Lam G.W.2, Jensen J.B.¹

1) Department of Urology, Holstebro and Aarhus University Hospital, Denmark 2) Department of Urology, Herlev Hospital, Denmark

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Titel

Retrospective survey of self expandable metallic stents in the treatment of acute, malignant colonic obstruction.

Forfatter

Anders Krøll Knudsen

Reservelæge (Hoveduddannelse)

Kirurgisk afdeling Hospitalsenheden Vest, Kirurgisk afd. Aarhus Universitetshospital, THG Abstract

Aim:

To evaluate the use of self expandable metallic stents (SEMS) as a treatment for acute, malignant colonic obstruction. Both as a mean of palliative treatment and as a bridge to surgery (BTS) with the in- tent of performing delayed curative laparoscopic resection with primary end-to-end colon anastomosis.

Method and material:

A single center, retrospective study of patients, who were given a SEMS as treatment for acute, malignant colonic obstruction. 52 patients were included between 2011-14.

Results:

In the BTS group successful relievement of obstruction was achieved in 94%. 91% were later operated laparoscopicly and 79% given a primary anastomosis. Patients were operated at a median of 27 days after SEMS placement. Of the 32 patients, 6% suffered perforation due to the SEMS. In the palliative group success was achieved in 89% of the patients. 39% later experienced complications at a median of 47 days.

Conclusion:

SEMS placement allows for a high rate of subacute, laparoscopic, one-stage resection with primary anastomosis. It is associated with an acceptable risk of mortality and morbidity and a low risk of permanent stoma compared to two-stage surgery. As a mean of palliation, SEMS treatment shows less promise and should only be used as a last resort and/or if life expectancy is not more than 2 month.

Øvrige forfattere

Anders Husted Madsen PhD, overlæge Kirurgisk afdeling Hospitalsenheden Vest

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Titel

The antiplatelet effect of aspirin declines during the 24-hour dosing interval Forfatter

Morten Würtz

Læge, ph.d. / Introduktionsstilling i Intern Medicin Medicinsk afdeling, Hospitalsenheden Vest, Herning Abstract

Low-dose aspirin is considered to inhibit platelets for 24 hours. However, many patients suffer recurrent heart attacks despite aspirin treatment, and the majority of events seem to occur at the end of the dosing interval. Platelet inhibition by aspirin may decline particularly rapid in patients with a fast renewal of platelets, i.e. a high platelet turnover. Therefore, we investigated 1) if platelet inhibition by aspirin declines through 24 hours and 2) if platelet inhibition by aspirin declines particularly rapid in individuals with increased platelet turnover.

Methods:

We included 150 patients with coronary artery disease and 50 healthy volunteers. We treated all participants with aspirin 75 mg daily. No other antithrombotic drugs were allowed. Using whole blood platelet aggregometry (Multiplate Analyzer), we measured platelet aggregation 1 and 24 hours after aspirin intake. Immature platelets were measured as a marker of platelet turnover. Thromboxane B2 was measured as a marker of cyclooxygenase-1 activity.

Results:

Platelet aggregation increased by 25% (p<0.0001) from 1 to 24 hours after aspirin intake with a corre- sponding increase in cyclooxygenase-1 activity (p<0.0001). Participants with high aggregation levels at 24 hours (upper tertile) tended to have a higher platelet turnover than patients with low aggregation levels (lower tertile) (p = 0.06).

Conclusion:

The antiplatelet effect of aspirin declined substantially from 1 to 24 hours after asirin intake. Individu- als with increased platelet turnover seemed to regain platelet function particularly rapid. We conlcude that low-dose aspirin does not inhibit platelets optimally during the standard 24-hour dosing interval.

Twice-daily dosing may afford better cardiovascular protection, especially in patients with a high platelet turnover.

Øvrige forfattere

Steen Dalby Kristensen, professor, overlæge, dr.med.

Anne-Mette Hvas, professor, overlæge, ph.d.

Erik Lerkevang Grove, afdelingslæge, ph.d.

1. Afdeling for Hjertesygdomme, Aarhus Universitetshospital 2. Afdeling for Blodprøver og Biokemi, Aarhus Universitetshospital

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Titel

Effekt på cardio-vaculære risikofaktorer af livsstilsintervention over for nydebuterede skizofrene patien- ter

Forfatter

Hans Jørgen Søgaard

Overlæge, klinisk lektor, ph.d., dr.med.

Psykiatrisk Forskningsenhed Vest Abstract

Baggrund: Skizofrene patienter dør gennemsnitlig 15-20 år før almenbefolkningen, og specielt pga.

kardio-vascuære sygdomme og diabetes. Årsagerne er flere: 1) Fælles gen mellem diabetes og skizofreni, 2) Skizofrene patienter søger i mindre grad undersøgelse og behandling ved symptomer på fysisk lidelse, 3) Skizofrene patienter lever en mere usund livsstil med indtagelse af usunde kalorierer og nedsat fysisk aktivitet. Tidligere livsstilsinterventioner af ca. 1 års varighed har vist ringe effekt.

Metode: OPUS-afdelingerne i Regionspsykiatrien Vest og Randers har igennem 2½ år kørt et livsstils- projekt med henblik på forbedring af nydebuterede skizofrene patienters livsstil i et naturalistisk studie.

136 patienter er fulgt med et antal observationer varierende fra 1-19 med henblik på en lang tække kardio-vasculære risikofaktorer, livsstil, misbrug og livskvalitet. over 2½ år. Analyserne er foretaget med longitudinal analyses med fixed og random effects med lineære og kvadratiske modeller.

Resultater: Allerede ved baseline udviste patienterne forøgede risikofaktorer på alle parametre. Interven- tionen viste effekt, men først efter 1½-2 år. Forløbene viste sig at være kvadratiske, - forværring i begydel- sen efterfulgt af fordring.

Konklusion: Hidtidige undersøgelser af ca. 1 års varighed har været for korte til påvisning af effekt, idet effekten først indtræder efter 1½-2år. Det hjælper at blive ved i overensstemmelse med tidligere erfaring, at forandring tager tid ved skizofreni.

Øvrige forfattere

Overlæge, Anne Grethe Viuff, sygeplejerske Kirsten Vandborg, studerende Jakob Viuff, læge Dorte Friis, sygeplejerske Peter Hjorth og professor Povl Munk-Jørgensen

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Titel

Neck-shoulder pain and work status among former sewing machine operators – a 14 years follow up study

Forfatter

Emma Lise Jakobsen Forskningsårsstuderende

Arbejdsmedicinsk Klinik Herning Abstract

Knowledge on reemployment prognosis of workers leaving jobs with physical risk factors for neck-shoulder pain is sparse. The aim of this study is to investigate the long-term employment status for Danish sewing machine operators who lost their jobs because of outsourcing, especially to what extend former neck-shoulder pain had an impact on the women’s unemployment.

Baseline data on neck-shoulder pain were collected in 1994-95 for 243 sewing machine operators. In 1996 the participants lost their jobs because of outsourcing of the industry to other countries. Until 2008, complete register-data of public transfer incomes was retrieved.

The overall picture for type of incomes changed markedly after 1996, indicating a shift from mainly self-support to more unstable and often changing incomes in several years after. Overall, during 12 years after the outsourcing, the fraction of time spent as unemployed had a median of 20%, (range 0%-98%).

16.5% had received disability pension, while 21.0% retired. Some participants reached other employment in textile industry. Among other jobs achieved, health care and laundry work came out to be the most frequent, followed by child care and industrial manual jobs. Unadjusted, neck-shoulder pain increased the risk for a poorer occupational prognosis with crude OR 2.60 (1.30-5.20) for being at work less than 50% of the time 1996-2008. However, when adjusting for age and chronic diseases, the association decreased to an adjusted OR of 1.64 (0.77-3.50).

The results emphasize the importance of prevention strategies against unemployment, not only for those with work-related neck-shoulder pain but for the entire group of outsourced workers. The overall unstable picture of the occupational situation in the years after outsourcing indicates that estimates like re- turn-to-work might be too simple in dealing with work status.

Øvrige forfattere

Cand. Scient.san., ph.d. Karin Biering, Arbejdsmedicinsk Klinik Herning Overlæge, ph.d. Anette Kærgaard, Arbejdsmedicinsk Klinik Herning

Cand.Scient., ph.d. Annett Dalbøge Andersen, Arbejdsmedicinsk Klinik Aarhus Professor, overlæge, ph.d. Johan Hviid Andersen, Arbejdsmedicinsk Klinik Herning.

Medvejleder: Cand. Scient.san., ph.d. Karin Biering, Arbejdsmedicinsk Klinik Herning - Medvejleder: Overlæge, ph.d. Anette Kærgaard, Arbejdsmedicinsk Klinik Herning

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Titel

Clinical course and prognosis of musculoskeletal pain in patients referred for physiotherapy:

Does symptom diagnosis matter?

Forfatter

David Høyrup Christiansen Forsker

Arbejdsmedicinsk Klinik, Universitets Klinik

Abstract

Objective: To describe the clinical course in patients with musculoskeletal disorders referred to physiothe- rapy, to identify prognostic factors for a patient-rated satisfactory outcome, and to analyse any additional prognostic influence resulting from the diagnoses of their primary symptoms.

Methods: A prospective cohort study of newly referred patients (n=2,706). Data was collected in 30 physiotherapy practices by questionnaire prior to the first consultation, at 6 weeks, 3- and 6 months, and from clinical records and registry data. The main outcome was their Patient Acceptable Symptom State (whether their current symptoms are acceptable). Potential predictors were analysed using backwards longitudinal GEE regression modelling. To assess the influence of primary symptom diagnosis, models with and without the inclusion of primary symptom diagnosis were compared.

Results: The percentage of patients’ reporting their symptoms as acceptable was 32% at 6 weeks, in- creasing to 43% and 52% at 3 and 6 months, respectively. Higher probability of satisfactory outcome was associated with place of residence, being retired, no compensation claim, less frequent pain, shorter du- ration of pain, lower levels of disability and fear avoidance, better mental health and being a non smoker.

Discriminative ability of the model was modest, with area under the curve being 0.63 (95% CI 0.62-0.65).

Adding primary symptom diagnosis only marginally improved the model 0.64 (95% CI 0.62-0.66).

Conclusion: Only half of the patients rated their symptoms as acceptable at 6 months. Although satisfac- tory outcome was difficult to predict at an individual patient level, there were a number of prognostic factors that were associated with this outcome. Those factors may be of interest when making a prognosis in musculoskeletal physiotherapy patients, whereas symptoms diagnosis seems less important.

Øvrige forfattere

Nils-Bo de Vos Andersen, Nære sundhed, Kvalitet og lægemidler, Region Midtjylland

Peter Kent, School of Physiotherapy and Exercise Science, Curtin University, Western Australia, og Institut for Idræt og Biomekanik - Syddansk Universitet

Jakob Hjort, Institut For klinisk Medicin, Health Aarhus Universitet

(20)

Titel

Balanceorganet stimuleres af MR scannerens magnetfelt

Poster: 1 Forfatter

Louise Devantier

Læge, ph.d.-studerende

Øre-næse-hals afdelingen, Regionshospitalet Holstebro Abstract

Introduktion: Studier har vist at et kraftigt magnetfelt kan stimulere balanceorganet.

Funktionel MR-scanning bruges i stigende grad til at visualisere hjerne- aktivitet induceret af forskellige typer af stimuli.

Vi vil validere funktionel MR-scanning som billeddannende teknik ved at undersøge, hvordan balanceorganet og hjerneaktiviteten påvirkes af MR-scannerens kraftige magnetfelt.

Materiale/metode: 3 raske forsøgspersoner indgik i studiet.

Testet for vestibulær dysfunktion med head impuls test samt head shake test. Alle testet i 3T MR-scanning påsat video-nystagmography briller. Øjenbevægelserne er registreret udenfor scanneren, med hovedet kørt først ind i scanneren og med benene kørt først ind i scanneren.

Sidste nævnte for at se betydningen af magnetfeltets polaritet.

Resultater: Ingen af de 3 forsøgspersoner havde nystagmus udenfor MR-scanneren. Alle 3 forsøgspersoner udviklede en robust nystagmus inde i MR-scanneren. Retningen på nystagmus var afhæng af magnetfeltets polaritet.

Diskussion: MR-scannerens magnetfelt påvirker balanceorganet og fremkaldte en robust nystagmus på alle forsøgspersoner.

Nystagmus er afhængig af magnetfeltets polaritet.

Betydningen af dette for funktionel MR-scanning er fortsat uafklaret.

Øvrige forfattere

Louise Devantier^1,2,3, Jens-Jacob Mølby-Henriksen⁴, Måns Magnusson⁵, Michael Pedersen³, Therese Ovesen^1,2

1) Institut for Klinisk Medicin, Aarhus Universitet, 2) Øre-næse-halsafdeling, Regionshospitalet Holstebro, 3) Comparative Medicine Lab, Aarhus Universitet,

5) Øre-næse-halskirurgisk afdeling, Aalborg Universitetshospital, 5) Øre-næse-halskirugisk afdeling, Lunds Universitetshospital.

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Titel

Atrial fibrillation detected by external loop recording for seven days or two-day Holter recording - a comparison in patients with ischemic stroke or transient ischemic attack

Poster: 2 Forfatter

Michala Herskind Sejr Læge og ph.d.-studerende

Kardiologisk Forskningsafsnit, Medicinsk Afdeling Herning Abstract

Atrial fibrillation (AF) is the most common cardiac cause of ischemic stroke and transient ischemic attacks (TIA) and detection of AF has important therapeutic consequences. The optimal method for AF detection in patients with stroke/TIA is not defined.

Aim: To compare the diagnostic value of 7-day external loop recording (ELR) to 2-day Holter recording to detect AF in patients with ischemic stroke/TIA and with no prior AF.

Material and methods: Consecutive patients with stroke/TIA within one week were included from April 2014 to January 2015. Inclusion criteria were age ≥ 60 years, no AF on ECG and no history of AF. Endpoint was AF exceeding 30 seconds. The 2-day Holter recording and the 7-day ELR were started simultaneously.

Results: We included 191 patients, mean (s.d.) age was 71.1 (7.6) years and 57% were male. The 7-day ELR and 2-day Holter detected the same three patients with AF. The ELR detected another six patients with AF, four of them after the 2-day Holter monitor recording period. AF prevalence 2-day Holter: 1.6

% (3/191) versus 7-day ELR: 4.7 % (9/191), the difference is statistically significant (p=0.031 Exact McNe- mar). Considering Holter as gold standard, two ELR AF findings were false positives (3/191 versus 7/191, p= 0.125).

Conclusion: We found that a 7-day ELR analysis detects more patients with AF than a 2-day Holter recor- ding. Excluding false positive findings on ELR, this difference was not statistically significant. More than 4 in 5 patients with automatic AF detections in ELR had false positive episodes, underlining the importance of validating these automatically recorded episodes by experienced physicians before taking clinical consequences hereof.

Øvrige forfattere

Jens Cosedis Nielsen, professer, Hjertesygdomme, Århus Universitetshospital Dorte Damgaard, overlæge, Neurologisk Afdeling, Århus Universitetshospital

Birgitte Forsom Sandal, ledende overlæge, Neurologisk Afdeling, Hospitalsenheden Vest Ole May, overlæge, Kardiologisk Forskningsafsnit, Medicinsk Afdeling,Hospitalsenheden Vest Evt hovedvejledere el. vejledere

Jens Cosedis Nielsen, professer, Hjertesygdomme, Århus Universitetshospital Dorte Damgaard, overlæge, Neurologisk Afdeling, Århus Universitetshospital

(22)

Titel

The significance of blood pressure measurement evaluated by stiffness index in pregnancy in diabetic and control women

Poster: 3 Forfatter

Ingvild Holm Tjessem Reservelæge

Gynækologisk-obstetrisk afd, Herning Abstract

Background: The detection of blood pressure (BP) changes based on reliable measurements in diabetic pregnancy is invaluable. The procedures need a quality check when concluding that antihypertensive treatment may not be worthwhile in mild to moderate hypertension during pregnancy. The ambulatory arterial stiffness index (AASI) is proposed as an indirect measure of arterial wall elasticity associated with target organ damage.

Aim: To evaluate the performance of blood pressure measurements and AASI with respect to re- no-vascular co-morbidity diabetic pregnancy and controls.

Methods: 151 women with type 1 diabetes (T1DM) were recruited for diurnal BP 3 times during pregnan- cy and once post partum. 50 non-diabetic women served as controls. BP was measured using a portable oscillometry monitor. AASI was calculated from the regression slope of diastolic on systolic BP. The robust- ness of AASI was evaluated with the square of the regression coefficients, the coefficient of determinati- on.

Results: Of the T1DM women, 33 had preeclampsia and 51 delivered before gestational week 36. Twenty had microalbuminuria and 15 macroalbuminuria; 74 women had simplex and 13 proliferative retinopathy.

AASI in T1DM increased with microvascular morbidity (retinopathy and proteinuria) in all trimesters; an association that was lost outside pregnancy. A high AASI was associated with a low coefficient of determi- nation; thus indicating that stiffer arteries mean increasing random variability in BP.

Conclusion: AASI showed a strong association with microvascular morbidity. The variation of BP depends on BP levels and from that fact stems the reduced capability to detect and reproduce BP changes with substandard methodology.

Øvrige forfattere Finn Lauszus Hanine Al-Far

Evt hovedvejledere el. vejledere Finn Lauszus

(23)

Titel

Calcium signaling and molecular adhesion processes may hold the key to genetic risk for Autism. A mo- lecular pathway analysis on two independent samples.

Poster: 4 Forfatter

Antonio Drago, Forsker

Psykiatrisk Forskningsenhed Vest Abstract

Background. Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by limited interest and lacking ability in social interactions, repetitive behavior and dysfunction in social communication. ASD runs in families and twin studies suggest a strong genetic basis for the disorder.

The definition of a genetic profile at risk for ASD is nevertheless currently lacking.

Methods. An investigation (Autism dataset 4 from the NIHM depository, n=2890) and a replication (Au- tismdataset 3 from the NIHM depository, n=1233) trio samples with GWAS data are included in the analysis. Phase1: A molecular pathway analysis is conducted (investigation sample) in order to test enrichment of specific GO terms including SNPs associated with Autism. Phase2: Identified pathways are tested for enrichment in the replication sample. Permutations test is undertaken to abate the risk of false positive findings. QQ-plots serve for quality assessment together with λ values. Plink and R serve for TDT and permutation tests.

Results. GO:0007417 was found to be enriched in the investigation sample. SNPs belonging to this path- way were found to be associated with Autism at a frequency that was higher than expected in the replication sample.

Conclusion. GO:0007417 (development of the nervous system) was found to be associated with Autism in the two triosamples. TMPRSS4, TRPC4 and PCDH9 harbored variations that were consistently found to be associated with Autism throughout the two independent samples, stressing the role of calcium

signaling and cell adhesion molecules in shaping the risk of Autism related disorders. The pathway and the variations found to be associated with Autism are described.

Øvrige forfattere

Prof. Uffe Birk Jensen, Department for Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark

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Titel

Tele-patient-reported outcomes (telePRO) in clinical practice – effect of patient-initiated versus fixed-in- terval telePRO based outpatient follow-up: study protocol for a pragmatic randomized controlled study Poster: 5

Forfatter

Liv Marit Valen Schougaard Ph.d.-studerende

AmbuFlex Abstract

Background: The traditional system of routine outpatient follow-up in chronic disease could be waste of time if patients are well. The use of patient-reported outcomes (PRO) in clinical practice might support more suitable follow-up activities. AmbuFlex is a PRO-system used in epilepsy outpatients in Central Den- mark Region. PRO questionnaires are sent to patients on scheduled dates. The clinicians use these data to decide whether a patient needs a visit or not (standard telePRO). However, greater patient involvement is desired by letting patients initiate contact. The aim of this study is to provide insight into the effects of patient-initiated telePRO follow-up (open access telePRO) on resource utilisation, quality of care and patient experiences.

Methods: The study is a pragmatic 2-arm randomized controlled trial. Participants are randomly assigned to one of two follow-up methods: a) Standard telePRO; or b) Open Access telePRO. Participants are epilepsy outpatients aged ≤15 years, referred to standard telePRO by a clinician, and web-responders recruited from the epilepsy clinic at Aarhus University Hospital in Central Denmark Region. Resource utilisation will be evaluated by calculating number of contacts as primary outcome. Secondary outcomes on quality of care includes; well-being (WHO-Five questionnaire), general health (SF-36), number of seizures, side effects and mortality. Patient experiences will be evaluated as health literacy (Health Literacy Questionnaire), self-efficacy (General Self-efficacy Scale), confidence, safety, and satisfaction. In addition, patient experiences will be evaluated using qualitative methods. Data are collected at baseline and 18 month post randomization. Inclusion of patients in the study started in January 2016.

Results: By June 2016, a total of 446 patients have been included; 257 in the open access arm and 189 in the standard arm.

Øvrige forfattere

Caroline Mejdahl, The Research Programme in Patient involvement, Aarhus University Hospital, Aarhus Klaus Hvam Petersen, AmbuFlex, Regional Hospital West Jutland, Herning

Anne Jessen, AmbuFlex, Regional Hospital West Jutland, Herning

Annette de Thurah, Department of Rheumatology, Aarhus University Hospital, Aarhus, Department of Clinical Medicine, Aar- hus University, Aarhus, The Research Programme in Patient involvement, Aarhus University Hospital, Aarhus

Per Sidenius, Department of Neurology, Aarhus University Hospital, Aarhus

Kirsten Lomborg, Department of Clinical Medicine, Aarhus University, Aarhus, Department of Public Health, Aarhus University, Aarhus, The Research Programme in Patient involvement, Aarhus University Hospital, Aarhus

Niels Henrik Hjollund, AmbuFlex, Regional Hospital West Jutland, Herning, Department of Clinical Epidemiology, Aarhus Uni- versity Hospital, Aarhus

Annette de Thurah, Department of Rheumatology, Aarhus University Hospital, Aarhus, Department of Clinical Medicine, Aar-

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Titel

Betydningen af alder og præoperativ helbredsrelateret livskvalitet (HRQoL) for patientoplevet udbytte i forbindelse med hofte- og knæalloplastikoperation, et kohortestudie.

Poster: 6 Forfatter

Peter Kloster Aalund

Fysioterapeut, stud. scient. san., udviklingsterapeut Neuro Ergo/Fys

Abstract

Formål: At undersøge betydningen af alder og præoperativ HRQoL for ændring mellem præ- og postope- rativ HRQoL i forbindelse med hofte- og knæalloplastikoperation (THA, TKA, UKA).

Baggrund: Hofte- og knæalloplastik er udbredte operationsmetoder med henholdsvis ca. 9500 og 8500 årlige operationer på landsplan. Operationerne betragtes som effektive og med høj succes rate vurderet på kliniske faktorer som komplikationer, mortalitet og proteseoverlevelse. Vurderet med patientrappor- terede oplysninger er der dog op mod 20 %, der ikke er tilfredse med resultatet, og nogle oplever deres tilstand som forværret efterfølgende. Det er vigtigt at finde frem, til hvorfor nogle oplever et forringet udbytte af operation, for at kunne rette særlig opmærksomhed mod dem.

Metode: Kohortestudie med 12 måneders follow-up. Data blev indsamlet via spørgeskema fra september 2008 til december 2013. 3063 patienter opereret ved Hospitalsenhed Vest indgik i undersøgelsen. Analy- ser blev foretaget med multipel lineær regression.

Resultater: Der fandtes en signifikant positiv association mellem alder og HRQoL-ændring for THA-ope- rerede ved både 3-4 og 12 måneders follow-up. For TKA- og UKA-opererede fandtes der ikke signifikant association mellem alder og HRQoL-ændring.

For associationen mellem præoperativ HRQoL og HRQoL-ændring fandtes signifikante negative associatio- ner for alle tre operationstyper ved henholdsvis 3-4 og 12 måneders follow-up.

Konklusion: Resultater viste mod forventning øgede HRQoL-ændringer med stigende alder for THA-pa- tienter. Der fandtes ikke signifikant betydning af alder for TKA og UKA. Desuden fandtes faldende

HRQoL-ændringer med stigende præoperativ HRQoL for både THA, TKA og UKA. Et højt HRQoL-niveau før operation så således ud til, at føre til lavt udbytte vurderet på dette parameter. Et forhold der kan være relevant at inddrage ved overvejelser for eller imod operation.

Hovedvejleder: Torben Bæk Hansen, professor, overlæge, ph.d.

Faglig vejleder: Eva Natalia Glassou, cand. scient. san., bandagist

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Titel

Breast cancer patients treated with chemo-therapy reports more unmet supportive care needs in the early treatment phase, than patients treated only with radio-therapy.

Poster: 7 Forfatter

Mikael Birkelund Jensen-Johansen Psykolog, Phd

VIA University College Abstract

AimsThe purpose was to identify unmet supportive care needs in the early treatment phase of women treated for breast cancer and to investigate differences in needs between groups treated with chemo-therapy and radiation-therapy. If it is possible to identify early unmet needs, it may be possible to predict levels of unmet needs in the post-treatment phase and target an early rehabilitation to specific groups and with specific interventions.

Population

Over a six-month period, 123 Danish women treated with mastectomy or lumpectomy, were assessed for eligibility in the midst of their primary treatment period. Eighty-five percent agreed to participate and 100 women filled out the baseline questionnaire. Forty-five women were under treatment with radiation-therapy, forty-nine with chemo-therapy and four women were treated with both radiation- and chemotherapy.

Design and methods

As part of a large battery of self-administered questionnaires, the women filled out at home, the Suppor- tive Care Needs Survey (SCNS-SF34) together with demographic items (socioeconomic status, working hours, marital status etc.). The SCNS-SF34 includes 5 different domains of needs: Psychological-, Health system & information-, physical & daily living-, patient care & support-, and sexuality needs.

Analysis

The subscales of the SCNS revealed good reliability (Cronbach’s alpha: .79 - .96) and the summated scores were skewed and therefore log-transformed. An independent samples t-test was conducted to compare the need scores for radiotherapy-group (R-group) and chemotherapy group (C-group).

Results and interpretation

There was a significant difference between the C-group and R-group on physical and daily living needs [t(93)=-3,24, p=0,002] and sexuality needs [t(90)=-3,36, p=0,001], but the magnitude of the differences in the means were small (eta squared=0,10 & 0,11).

The women treated with radio-therapy showed significant less unmet needs than the women treated with chemotherapy.

Øvrige forfattere

Meldgaard, Anette, Henriksen, Jette, Villadsen, Ingrid Zerlang, Ida, Hospitalsenhed Vest

(27)

Titel

Obstructive sleep apnea and blood pressure in hypertensive patients with CKD2 and healthy subjects

Poster: 8 Forfatter

Bodil Gade Hornstrup Læge, Ph.D.-studerende

Universitetsklinik for Blodtryksforhøjelse og Nyresygdomme, Regionshospitalet Holstebro og AU Abstract

Background: High nocturnal blood pressure (BP) and non-dipping are important prognostic factors in the risk evaluation of cardiovascular disease in hypertensive patients. Many patients with chronic kidney disease (CKD) suffer from high nocturnal BP and non-dipping. This may be related to the presence of obstructive sleep apnea (OSA). In general, OSA is observed in 10-15% of men and 5-8% of women, only symptomatic in 2-4%.

Methods: Invitation to participate was sent to 238 hypertensive subjects with CKD2 and 300 healthy subjects. 95 hypertensive subjects with CKD2 responded and 76 were included. 116 healthy subjects responded and 54 were included. All participants underwent conventional 24h ambulatory BP and central BP monitoring, blood samples (creatinine, blood, cholesterol), and cardiorespiratory monitoring (Apnea Hypopnea Index, AHI).

Results: OSA was diagnosed in 31,6% of the hypertensive subjects with CKD2 and in 24,1% of the healthy subjects. This difference was not significant, but significantly more hypertensive subjects with CKD2 suffered from moderate to severe OSA (AHI>15). Hypertensive subjects with CKD2 were significantly older, more obese and had lower nocturnal BPdipping than healthy subjects. The hypertensive subjects with CKD2 had higher blood levels of triglycerides, lower levels of HDL and LDL, and lower eGFR, Only 13 (17%) of the subjects diagnosed with hypertension prior to participation had normal 24 h BP.

Conclusion: OSA was diagnosed in a larger part than expected among both hypertensive and healthy sub- jects. Selection bias could. Subjects with hypertension have less nocturnal dip in BP than healthy subjects.

This may be related to co morbidity in form of moderate to severe OSA.

Only 17% of the subjects with known hypertension were normotensive explain this. Reason for this can be unawareness on the importance of well-treated hypertension.

Øvrige forfattere

Jeppe Bakkestrøm Rosenbæk, læge, Ph.D.studerende, Medicinsk Afdeling, Regionshospitalet Holstebro og Universi- tetsklinik for Blodtryksforhøjelse og Nyresygdomme, Regionshospitalet Holstebro og Aarhus Universitet

Nikolai Hoffmann-Petersen, Nyremedicinsk afdeling, Aarhus Universitetshospital, Skejby og Universitetsklinik for Blodtryksforhøjelse og Nyresygdomme, Regionshospitalet Holstebro og Aarhus Universitet

Jesper Nørgaard Bech, overlæge, lektor, Ph.D., Medicinsk Afdeling, Regionshospitalet Holstebro og Universitetskli- nik for Blodtryksforhøjelse og Nyresygdomme, Regionshospitalet Holstebro og Aarhus Universitet

Erling Bjerregaard Pedersen, Professor, overlæge, Dr.Med., Medicinsk Afdeling, Regionshospitalet Holstebro og

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Titel

Trampoline injuries and safety in children: - A retrospective study and follow up phone interview Poster: 9

Forfatter

Thi Anh Nhi Huynh LægeAkutafdelingen, Herning

Abstract

Background: The leisure use of trampolines has increased and more injuries are seen in the Emergency Departments. Little is known about the relationship between safety precautions and injuries. This first Danish retrospective study aims to describe the types and mechanisms of injuries in children and safety pre-cautions taken in relation to the private use of trampolines.

Method: Patient lists and records of children under the age 18 years old from April 1st 2014 to Septem- ber 30th 2014 were revised and 113 patients were included. Demographic data and the types of injury (fracture vs. non- fracture) were revised. All patients or parents were contacted for a structured telepho- ne interview (n=100) to describe the safety precautions/equipment and mechanism of injury.

Results: The phone interview showed that 43 % of the children were observed by an adult and 53 % was not. 66,6 % of the patients under 6 years old (n=14) had observation from an adult where as 33,3 % (n= 7) had no observation. 47 % used a safety net whereas 52 % did not use a safety net.

The majority of injuries where seen when jumping more than 1 person on the trampoline at the same time in both groups. Of all patients 50,9 % of patients had a fracture injury and 49,1 % had a non-fracture injury. Most injuries were seen from May to July and in the age between 7-13 years old. Out of all patients with fractures 55,5% were girls and 53,5 % were boys. The most frequent fractures were seen in the upper- (65,5 %) and lower (34,5 %) extremities and most non-fracture injuries were located in the ankle and foot region (30,4 %).

Conclusion: This study described the types of injuries using private trampolines seen in the Emergency Department. Further studies are required to focus on safety precautions and to prevent and reduce trampoline injuries.

Øvrige forfattere

Malene Moeller Andersen (MD, Emergency Department, Regional Hospital of Herning ) Evt hovedvejledere el. vejledere

Hovedvejleder:

Jesper Bo Weile (MD, Emergency Department, Regional Hospital of Herning/Center for Akutforskning) Øvrige vejledere:

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Titel

Gastrointestinal symptoms among patients with neurofibromatosis type 1 Poster: 10

Forfatter

Cecilie Ejerskov

ph.d.-studerende, reservelæge

Center for Sjældne Sygdomme, AUH, Center for Forsk. og Uddannelse, HEV og Klinisk Institut Abstract

AimTo investigate the prevalence of gastrointestinal symptoms among children, adolescents and adults with neurofibromatosis type 1, NF1, compared with their unaffected relatives.

In a study on 20 children we showed that symptoms of constipation were surprisingly common in children with NF1. Correspondingly, rectal diameters were abnormally large and a higher proportion than expected had prolonged colonic transit time. We hypothesize that among patients with NF1 there is a higher prevalence of gastrointestinal symptoms than within the general population. Thus, we have proceeded in a population based study on gastrointestinal symptoms.

Method

Patients with NF1 from the age of four years and their unaffected relatives are invited to participate in a questionnaire investigation. A total of 405 patients are currently eligible.

The questionnaire is a diagnostic questionnaire and encompasses the following main parameters based on the Rome III Criteria® of functional gastrointestinal disorders:

• Functional dyspepsia

• Irritable bowel syndrome

• Constipation Furthermore

• Disease severity and visibility of NF1 are assessed by a physician Results

At the time of writing 210 patients and 116 relatives have participated. The study will end by 1st July 2016 and results will be presented at Forskningens Dag 2016.

Øvrige forfattere

Ejerskov C^1,2,3, Krogh K^3,4, Oestergaard JR^1,3, Haagerup A^2,3

1Centre for Rare Diseases, Department of Paediatrics, Aarhus University Hospital, Denmark 2Centre for Research and Education, Regional Hospital West Jutland, Denmark

3Department of Clinical Medicine, Aarhus University Hospital, Denmark

4Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark Evt hovedvejledere el. vejledere

(30)

Titel

Learning and coping strategies improve maintenance of exercise capacity in cardiac rehabilitation - a partial result from the randomised LC-REHAB trial

Poster: 11 Forfatter

Vibeke Lynggaard

Cand.scient.san., Ph.d. studerende

Medicinsk Afdeling/Kardiologisk Forskningsafsnit Abstract

Background: Exercise in cardiac rehabilitation (CR) has potential to reduce mortality and morbidity.

However, not all cardiac rehabilitation patients maintain an improved level of exercise capacity. A patient education method, learning and coping strategies (LC), was developed to address this.

Purpose: To assess the effect of LC strategies on maintenance of exercise capacity in CR.

Methods: The trial was designed as an open 1:1 randomised controlled trial with LC strategies incor- porated in standard CR in the intervention arm versus standard CR in the control arm. Key points in LC strategies: situated and refletive education, individual clarifying interviews before and after program and participation of experienced patients as co-educators. The CR program in both arms was group based over 8 weeks with 24 training and 8 education sessions. A maximal symptom-limited exercise test on a bicycle starting with a work load of 25 watt and increased with 25 watt every 2nd minute was performed at baseline, just after the program and 3 month later.

Results: In total 825 patients with ischemic heart disease (IHD) or heart failure entered the analysis; 413 were randomised to the LC group (mean age 63 years, 76% male, 79% IHD) and 412 to the control group (mean age 63 years, 76% male, 78% IHD). There were no significant differences in any measured variables between groups at baseline. No difference in the relative increase in exercise capacity just after CR was found between the groups. However, the relative increase in exercise capacity from baseline was significantly higher after 3 month in the LC group (19.2%, SD 27.3%) compared to the control group (14.1%, SD 21.1) (p=0.0114).

Conclusion: The trial indicates that LC strategies incorporated in CR significantly improves maintenance of exercise capacity suggesting a potential to reduce mortality and morbidity among patients with ischemic heart disease or heart failure.

Øvrige forfattere

V. Lynggaard(1), C.V. Nielsen(2), O. May(1)

(1) Cardiovascular Research Unit, Department of Medicine, Regional Hospital West Jutland, Herning, Denmark

(2) Department of Public Health, Section of Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark

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Titel

Brug af internettet til videnssøgning inden besøg i børneambulatoriet

Poster: 12 Forfatter Ida Kangas 1. reservelæge Børneafdelingen Abstract

Formål/problemstilling

Formålet med undersøgelsen var at undersøge om forældre til børn, der blev henvist til undersøgelse i børneambulatoriet, søgte informationer på internettet forud for undersøgelsen, og om de forholdt sig kritisk til de informationer, de fandt. Desuden undersøgtes der for om der var forskel i søgning alt efter barnets alder, uddannelsesgrad, nummer på barnet i søskende rækkefølge og barnets diagnose.

Metode

Spørgeskemaundersøgelse udført blandt forældre til børn, der var visiteret til undersøgelse i Børneambu- latoriet, Regionshospitalet Herning.

Inklusionskriterierne i undersøgelsen var forældre til børn visiteret til undersøgelse. Eksklusionskriterier var forældre der tidligere i undersøgelsesperioden havde udfyldt spørgeskemaet og forældre med sprogli- ge vanskeligheder.

Resultater

Der deltog 269 forældre i undersøgelsen svarende til en deltager procent på 89,6%. 60% havde været 3 gange eller mere i ambulatoriet og 18% var nyhenviste.

21% havde søgt information på internettet for at vurdere om egen læge skulle kontaktes forud for henvisning. 80% havde søgt informationer andre steder end på internettet (egen læge, venner, familie m.v.).

36% havde søgt information på internettet om barnets symptomer fra henvisning til ambulant besøg.

Konklusion

De præliminære data tyder på at forældre til børn der har været set flere gange i ambulatoriet søger mindre på internettet end forældre til nyhenviste børn.

Desuden at forældre søger råd og vejledning både på internettet men også i høj grad hos egen læge og familie og venner. Kun 20% søger ikke på internettet i forbindelse med sygdom hos deres barn.

Charlotte Søndergaard, Ledende overlæge, Børneafdelingen

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Titel

No evidence of chloride nephrotoxicity using urinary excretion of NGAL as biomarker between 155 mmolar chloride infusion with 98 mmolar chloride in patients undergoing primary uncemented hip replacement.

Poster: 13 Forfatter

Andreas Nygaard Jørgensen PhD-studerende

Medicinsk Forskning Holstebro Abstract

Background: The use of fluids containing high amounts of chloride (Cl) reduced the need for renal-re- placement-therapy. Animal studies showed that Cl reduced renal blood flow. Thus, Cl might cause acute ischemic kidney injury. The purpose of the study was to measure whether chloride induced kidney damage in a clinical study using urinary excretion rate of neutrophil gelatinase associated lipocalin (u-NGAL) as biomarker for nephrotoxicity.

Methods: In a randomized, double-blinded, placebo-controlled study of patients undergoing primary uncemented hip replacement, thirty-eight were randomized to receive either isotonic saline (155 mmolar chloride) or plasma-lyte (98 mmolar chloride) 15ml/kg during the first hour and 5ml/kg the following two hours after start of surgery. Urine was collected in four periods: Period 1: 24 hours before surgery, Period 2: 4 hours from the start of surgery, Period 3: from end of period 2 to 7.30 the next day and Period 4: 24 hours 10-12 days later. In addition, spot urine samples were collected before surgery and before dis- charge. Blood was collected before surgery and at the end of period 2 and period 3. We measured urinary u-NGAL and plasma concentrations of chloride (p-Cl) and creatinine (p-Crea).

Results: U-NGAL (median values) was the same in the saline group and the plasma-lyte group in all four periods. Period 1: 15.92 (plasma-lyte)/15.60 (saline) ng/min (p=0.54); Period 2: 22.51/9.88 ng/min (p=0.68); Period 3: 10.95/6.44 ng/min (p=0.05); Period 4: 4.05/2.04 ng/min (p=0.05). In the saline group p-Cl (mean value) 110.5 mmol/l was significantly higher than in the plasma-lyte group 107.9 mmol/l (p = 0.004). P-Crea was the same in both groups.

Conclusion: No evidence of nephrotoxicity was detected between infusions of high and low concentra- tions of chloride in a clinical trial using urinary excretion of NGAL as marker of kidney damage.

Øvrige forfattere

Overlæge PhD Niels Peter Ekeløf; Department of Anesthesiology Holstebro

Professor, dr. med. Overlæge Erling B. Pedersen; University Clinic in Nephrology and Hypertension, Holstebro

Overlæge Søren Bøvling; Department of Orthopedic Surgery Holstebro

Overlæge PhD Jesper N. Bech; University Clinic in Nephrology and Hypertension Holstebro Evt hovedvejledere el. vejledere

Hovedvejleder: Overlæge PhD Jesper N. Bech; University Clinic in Nephrology and Hypertension Holstebro