Biomedical subjects

Anders Foldspang

Publications and source records attributed to Anders Foldspang.

12 recordsLinked to original sources

PubMed2007

How can we identify low- and high-risk patients among unselected patients with possible acute coronary syndrome?

OBJECTIVE: Prognosis among patients admitted with possible acute coronary syndrome (ACS) may differ from that of patients with definite ACS. The aim of this study was to identify risk factors for mortality among unselected patients and to use the statistical model to identify patients at low or high mortality risk. METHODS: From April 1, 2000, to March 31, 2002, we identified all consecutive patients aged 30 to 69 years admitted to the 2 coronary care units covering the municipality of Aarhus, Denmark (population, 138,290). ACS was considered a possible diagnosis if the physician at admission (1) had noted the presence or absence of chest pain, (2) performed a 12-lead electrocardiogram, and (3) measured markers of myocardial necrosis. In 1576 consecutive patients these criteria were fulfilled. RESULTS: By logistic regression, predictors of mortality were age 60 and older, ST elevation, right bundle-branch block, arrhythmia, elevated markers of myocardial necrosis, and the diagnosis of ACS. The predictive validity of the model, as indicated by receiver operating characteristic curve area, was 85.7%, 87.8%, and 80.1% for 7-, 30-, and 365-day mortality, respectively. CONCLUSIONS: Mortality may be predicted with high precision based on a statistical model. Identification of survivors by the use of a statistical model was superior as compared to simply ruling out the clinical diagnosis of ACS.

Adult↗

PubMed2006

Prevention of low back pain in female eldercare workers: randomized controlled work site trial.

STUDY DESIGN: Randomized controlled trial. OBJECTIVE: To evaluate the effectiveness of an ergonomic and psychosocial intervention in reducing low back pain (LBP) among health care workers. SUMMARY OF BACKGROUND DATA: LBP and injuries are reported frequently among health care workers worldwide. Improvement of person-transfer techniques is the preferred tool in the prevention of both. Although popular, to our knowledge, any effect has not been documented in controlled trials. METHODS: Study participants were eldercare workers from 19 eldercare groups randomly assigned to the transfer technique, stress management, or reference arm. A total of 163 individuals (79% of the source population) participated in both baseline and follow-up after 2 years. Outcome was intra-individual change in rating of LBP during the past 3 and 12 months. RESULTS: We found no difference in LBP in any of the intervention arms over the study period. CONCLUSION: The study showed no effect of a transfer technique or stress management program targeting LBP. Thus, there is a need for discussing other priorities in the prevention of LBP among health care workers.

Aged↗

PubMed2006

Prevalent musculoskeletal pain as a correlate of previous exposure to torture.

AIM: To research possible associations between previous exposure to specific torture techniques and prevalent pain in the head and face, back, and feet. METHODS: 221 refugees, 193 males and 28 females, previously exposed to torture in their home country, were subject to a clinical interview at a rehabilitation clinic for torture victims. The interview focused on exposure to torture and somatic symptoms prevalent at examination. RESULTS: The mean number of times imprisoned was 2.3; the mean number of months imprisoned was 19.7; the mean duration from initial imprisonment to final release was 3.7 years; and the mean duration from final release to preliminary interview was 8.4 years. The most frequent physical torture method reported was beating (92.3%) and the main mental torture method was deprivation (84.6%). Pain in the head and face was found to be strongly associated with torture against head and face (OR 3.89, 95% CI 1.49-10.20) and with the cumulative number of physical torture methods exposed to. Pain in the back was associated with sexual torture (OR 2.75, 95% CI 1.07-7.12). Besides beating of the lower extremities (OR 5.98, 95% CI 2.47-14.48), the strongest predictor for pain in the feet was general abuse of the whole body (OR 5.64, 95% CI 1.93-16.45). CONCLUSION: In spite of many factors being potentially co-responsible for prevalent pain, years after the torture took place it presents itself as strongly associated with specific loci of pain, with generalized effects, and with somatizing.

Adolescent↗

PubMed2006

Can the development of new dental caries in Danish schoolchildren be predicted from surveillance data in the School Dental Service?

BACKGROUND: Dental screening programmes for Danish children generally target all children, irrespective of their individual caries risk. The standard screening interval is approximately 12 months. A valid systematic screening tool based on routine information sources is however indispensable, if more selective screening strategies should be developed to target the children at highest risk. OBJECTIVE: To estimate the precision with which Danish schoolchildren at high risk for developing dental caries within 1 year can be identified based on information from routine registers. METHODS: Based on data from the Danish National Board of Health's Recording System for the Danish Child Dental Services and from the Central Office of Civil Registration, 3705 schoolchildren aged 7-12 years were followed through 1994-1996. Dental health information as of 1994 and changes 1994-1995 were applied in multiple logistic regressions together with social data as of 1995 to estimate the individual 1-year (1995-1996) risk of developing caries. RESULTS: In 1995, 37.4% of the children had a DMFS index above 0, and during the following year 21.8% of all children developed new caries. The individual child's 1-year caries risk could be estimated relatively accurately at baseline as indicated by the area (76%) under the receiver operating characteristic curve. About 40% of children with an estimated risk of 20% and above developed new caries, whereas 90% of the rest of the children did not do so. CONCLUSION: Based on information from Danish routine registers children at low caries risk may be identified relatively precisely. This may form the basis for the continuous development and targeting of high-risk strategies, in which the screening for caries among children of estimated low risk may be postponed at least 1 year.

Area Under Curve↗

PubMed2006

Prevalent pain and pain level among torture survivors: a follow-up study.

AIM: To estimate change over nine months and over two years, as concerns the prevalence and level of pain in the head, back and feet, among previously tortured refugees settled in Denmark, and to compare associations between torture methods and the prevalence of pain at baseline and at follow-up. METHODS: Sixty-nine refugees previously exposed to torture in their home country were interviewed at a Danish rehabilitation clinic. Fifty-four accepted to be re-interviewed after nine months, and 47 were interviewed again 14 months later. Interviews focussed on the history of exposure to physical and mental torture and on pain in the head, back and feet at baseline and at follow-up. RESULTS: The mean cumulative duration of imprisonment was 1.7 years, and on the average more than 10 years elapsed between torture and examination. The most frequent physical torture method reported was beating (97%), whereas the main mental torture method was threats of death (97%). The prevalence of pain reported at the follow-up interviews did not differ significantly from that reported at baseline (pain in the head, 81% at baseline and 77% at 23-month follow-up; back, 78% and 81%; feet, 59% and 70%). The same pattern was found when examining the level of pain as indicated by Visual Analogue Scales. Pain in the feet at follow-up was associated with previous exposure to beating against the feet. Pain in the back at baseline and pain in the head at follow-up were associated with suffocation. CONCLUSION: More than ten years after the torture took place, survivors of torture continue to suffer from pain associated with the type of torture they had been subjected to. This presents a considerable challenge to future evidence-based development of effective treatment programmes.

Adult↗

PubMed2005

Seeking asylum in Denmark: refugee children's mental health and exposure to violence.

AIMS: The aim of this study was to compare profiles of present mental health and previous exposure to violence among refugee children from the Middle East, whose asylum seeking families either did or did not obtain permission to stay in Denmark. METHODS: Shortly after arrival in Denmark, the parents of 311 Middle-Eastern children answered a structured interview on their children's exposure to organized violence and their mental health. The families were followed-up as concerns receipt of a residence permit. RESULTS: At arrival in Denmark, the children's patterns of previous exposure to violence and present mental health was generally similar irrespective of the family getting a residence permit, as was the case for 90 families (60.4%) with 190 children (61.1%). In both groups an overwhelming majority, eight to nine out of 10 children, had been exposed to conditions of war and had stayed in a refugee camp, and seven out of 10 had witnessed violence. Half of the children had a tortured parent. Considerably more children of families who did not get a residence permit had lost a parent (30.6% versus 13.7%; P<0.001). In both groups about two-thirds suffered from anxiety and about 30% from sleep problems, and children whose families did not later on get a residence permit more often appeared sad or miserable (43.8% versus 27.9%; P<0.005). CONCLUSIONS: The asylum-granting decision process seems to have divided the children into two groups with only superficial disparity as concerns their previous exposure to violence and their present mental health. There seems to be good reason to systematically integrate evidence on the children of refugee families in the treatment of applications for permission to stay.

Adolescent↗

PubMed2005

Vitamin D and calcium supplementation prevents severe falls in elderly community-dwelling women: a pragmatic population-based 3-year intervention study.

BACKGROUND AND AIMS: We evaluated the effect of two programs for the prevention of falls leading to acute hospital admission in a population of elderly community-dwelling Danish residents. METHODS: This was a factorial, pragmatic, intervention study. We included 9605 community-dwelling city residents aged 66+ years. We offered a prevention program consisting of a daily supplement of 1000 mg of elemental calcium as calcium carbonate and 400 IU (10 microg) of vitamin-D3 to a total of 4957 participants. The remaining 5063 participants were offered home safety inspection with dietary and health advice, or no intervention. RESULTS: The Calcium and Vitamin D program was followed by 50.3% and the Environmental and Health Program by 46.4%. According to a multivariate analysis including age, marital status and intervention program, female residents who followed the Calcium and Vitamin D Program had a 12% risk reduction in severe falls (RR 0.88; 95% CI 0.79-0.98; p < 0.05; NNT 9). CONCLUSIONS: The present study supports the hypothesis that vitamin D and calcium supplementation prevent falls leading to acute hospitalization in community-dwelling elderly females in a northern European region known to be deficient in vitamin D.

Accidental Falls↗

PubMed2004

Correlates of falling during 24 h among elderly Danish community residents.

OBJECTIVES: To identify dietary, medical, and environmental correlates of falling during the last 24 h among elderly community residents. The limited accuracy of recall of falls in the elderly in previous studies was the reason for a 24-h time frame. METHODS: The study composes 4281 community residents aged 66+ years. The statistical analyses included Pearson's chi(2) test and multiple logistic regression. RESULTS: Mutually independent correlates of falls were a family history of fracture (OR, 3.0; 95% CI: 1.3-7.1); osteoarthrosis of the knee (OR, 2.9; 95% CI: 1.3-6.2); dizziness (OR, 4.1; 95% CI: 1.9-8.9); a diet not including sour dairy products (OR, 3.0; 95% CI: 1.4-6.3) or fish (OR, 3.4; 95% CI: 1.5-7.5); drinking tea (OR, 5.8; 95% CI 2.15-15.30); needing help for shopping (OR, 3.9; 95% CI: 1.6-9.3); and for administration of medicine (OR, 9.0; 95% CI: 2.0-40.6). Independent environmental correlates were vinyl on the floor in the bathroom (OR, 6.6; 95% CI: 2.1-20.9) and using indoor footwear without soles (OR, 5.5; 95% CI: 2.3-13.4). CONCLUSION: The present analyses suggest that several factors are associated to the risk of falling among elderly community residents. It appears relevant for further studies to test if modifications of the potential risk factors identified may reduce falls among community dwelling older persons.

Accidental Falls↗

PubMed2003

Vitamin D and calcium supplementation prevents osteoporotic fractures in elderly community dwelling residents: a pragmatic population-based 3-year intervention study.

UNLABELLED: This study of 9605 community-dwelling residents supports that vitamin D and calcium supplementation may prevent osteoporotic fractures in elderly in a northern European region known to be deficient in vitamin D, especially during winter periods. INTRODUCTION: We evaluated the effect of two programs for the prevention of osteoporotic fractures leading to acute hospital admission in a population of elderly community-dwelling residents. MATERIALS AND METHODS: This was a factorial, cluster-randomized, pragmatic, intervention study. We included 9605 community-dwelling residents aged 66+ years. We offered a prevention program of a daily supplement of 1000 mg of elemental calcium as calcium carbonate and 400 IU (10 microg) of vitamin D3 to a total of 4957 participants. Another program with evaluation and suggestions for the improvement of the domestic environment was offered to a total of 5063 participants. Both programs included revision of the resident's current pharmaceutical treatment. We achieved information on osteoporotic fractures in the study population from the Danish Hospital Registration Database. We defined osteoporotic fractures as low energy fractures of the proximal humerus, distal forearm, vertebral column, pelvis, cervical femur, and intertrochanteric femur. RESULTS: Active participation was 50.3% in the Calcium and Vitamin D Program and 46.4% in the Environmental and Health Program. We observed a 16% reduction in fracture incidence rate (relative risk [RR], 0.84; CI, 0.72-0.98; p < 0.025) among male and female residents offered the Calcium and Vitamin D Program (intention-to-prevent analysis). CONCLUSIONS: This study supports that vitamin D and calcium supplementation may prevent osteoporotic fractures in community-dwelling elderly people in a northern European region known to be deficient in vitamin D, especially during winter periods.

Aged↗

PubMed2003

Postpartum urinary incontinence.

BACKGROUND: The aim of the present study was to identify prepregnancy, pregnancy and delivery correlates of urinary incontinence postpartum (PP UI) as reported by women in a cross-sectional population sample. METHODS: A questionnaire-based cross-sectional survey was carried out in 1998 in a random population sample of 3900 20- to 59-year-old women. The present study includes 376 women who had their last delivery during 1993-96. RESULTS: UI immediately after childbirth and 6 months thereafter was reported by 23.4% and 2.7%, respectively. PP UI was strongly associated with UI both before and during the present pregnancy, explaining 37.5% and 51.7% of postpartum UI, respectively. Eight percent experienced their first UI episode ever immediately after the delivery. Among women undergoing a cesarean section 8.8% reported postpartum UI, as contrasted with 24.9% in other women. Postpartum UI was positively associated with perineal suturing but un-associated with labor augmentation, episiotomy, birth weight, and breast-feeding. CONCLUSION: In the present study, which included a comprehensive causal model, postpartum UI could be explained first of all as the decline of pregnancy UI, secondly as a manifestation of a pre-existing tendency to react by UI, and finally as a consequence of the birth process itself.

Adult↗

PubMed2003

Proceedings of the National Institute of Diabetes and Digestive and Kidney Diseases International Symposium on Epidemiologic Issues in Urinary Incontinence in Women.

The Epidemiologic Issues in Urinary Incontinence: Current Databases and Future Collaborations Symposium included an international group of 29 investigators from 10 countries. The purpose of the symposium was to discuss the current understanding and knowledge gaps of prevalence, incidence, associated risk factors, and treatment outcomes for incontinence in women. During the symposium, investigators identified existing large databases and ongoing studies that provide substantive information on specific incontinence research questions. The investigators were able to form an international collaborative research working group and identify potential collaborative projects to further research on the epidemiology of urinary incontinence and bladder dysfunction.

Databases, Factual↗

PubMed2002

Does urinary incontinence occurrence depend on the menstrual cycle phase?

BACKGROUND: The aim was to study an eventual co-variation of menstrual cycle progression and urinary incontinence (UI) occurrence in 20-54-year-old-women, who have regular menstrual cycles, which are not influenced by exogenous sex hormones. METHODS: An age-stratified random sample of of 3900 women, aged 20-59 years, answered a questionnaire on UI. The present analysis included 821 women, who reported regular menstrual cycles un-intervened by sex hormone intake. RESULTS: Five percent of the women reported episodes of UI the day before they answered the questionnaire. Urinary incontinence was unassociated with menstrual cycle characteristics, such as time position from day one in the menstrual cycle, presence and amount of bleeding and the number of sanitary towels or tampons used. There was however, a borderline significant association (P = 0.08) with day 11-15 before the expected next menstrual bleeding. CONCLUSIONS: The present data allow for limited co-variation, if any, to exist in UI occurrence with the natural menstrual cycle phases, including the menstruation itself. A hypothesis of a moderate UI increase associated with ovulation however, merits attention.

Adult↗