Biomedical subjects

B Danneskiold-Samsøe

Publications and source records attributed to B Danneskiold-Samsøe.

At least 19 recordsLinked to original sources

PubMed2006

Delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) of hip joint cartilage: better cartilage delineation after intra-articular than intravenous gadolinium injection.

PURPOSE: To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection. MATERIAL AND METHODS: In 10 patients (50% males, mean age 58 years) with clinical and radiographic hip osteoarthritis (OA; Kellgren score II-III), MRI of the hip was performed twice on a clinical 1.5T MR scanner: On day 1, before and 90-180 min after 0.3 mmol/kg body weight i.v. Gd-DTPA and, on day 8, 90-180 min after ultrasound-guided i.a. injection of a 4 mmol/l Gd-DTPA solution. Coronal STIR, coronal T1 fat-saturated spin-echo, and a cartilage-sensitive gradient-echo sequence (3D T1 SPGR) in the sagittal plane were applied. RESULTS Both the post-i.v. and post-i.a. Gd-DTPA images showed significantly higher signal-to-noise (SNR) and contrast-to-noise (CNR) in the joint cartilage compared to the non-enhanced images (P < 0.002). I.a. Gd-DTPA provided significantly higher SNR and CNR compared to i.v. Gd-DTPA (P < 0.01). Furthermore, a better delineation of the cartilage in the synovial/cartilage zone and of the chondral/subchondral border was observed. CONCLUSION: The dGEMRIC MRI method markedly improved delineation of hip joint cartilage compared to non-enhanced MRI. The i.a. Gd-DTPA provided the best cartilage delineation. dGEMRIC is a clinically applicable MRI method that may improve identification of early subtle cartilage damage and the accuracy of volume measurements of hip joint cartilage.

Adult↗

PubMed2005

Learning effect of isokinetic measurements in healthy subjects, and reliability and comparability of Biodex and Lido dynamometers.

The aim of this study was to examine the learning effect during a set of isokinetic measurements, to evaluate the reliability of the Biodex System 3 PRO dynamometer, and to compare the Biodex System 3 PRO and the Lido Active dynamometers on both extension and flexion over the elbow and the knee at 60 degrees s(-1). Thirteen (nine women, four men) healthy participants were measured five times using the Biodex and once using the Lido dynamometer. The intervals between the first four tests were 20 min, and 1 week between tests 4 and 5. Between Biodex and Lido measurements there was a 20 min time interval. When comparing the first five measurements (Biodex), no systematic effect over time and an excellent reliability were found with respect to elbow and knee flexion and extension. No difference in muscle strength (Nm) between the Biodex and Lido was observed for knee flexion (P = 0.59), knee extension (P = 0.18) and elbow extension (P = 0.63). However, elbow flexion showed a 14.8% (95% CI: 11.2-18.4%; P = 0.0001) higher peak torque on Biodex. In conclusion, no learning effect was observed and the Biodex proved to be a highly reliable isokinetic dynamometer. A difference was observed when comparing Biodex and Lido on elbow flexion, but the difference did not outrange the expected variation found with a typical isokinetic measurement, which is why both sets of equipment seem applicable in clinical practice.

Adolescent↗

PubMed2005

Effect of static stretching of quadriceps and hamstring muscles on knee joint position sense.

OBJECTIVES: To evaluate if a stretch regimen consisting of three 30 second stretches would alter joint position sense (JPS). METHODS: A blinded, randomised, cross over design with a washout time of 24 hours was used with 20 healthy volunteers. JPS was estimated from the ability to reproduce the same position in one knee (target versus estimated angle) expressed as the difference between target and estimated angle (constant error, CE). Measurements were repeated three times in a sitting and a prone position on the dominant leg measured before and immediately after the static stretch. The static stretch consisted of a 30 second stretch followed by a 30 second pause, repeated three times. RESULTS: At baseline, the mean (SD) CE was -2.71 (3.57) degrees in the sitting position. No difference (p = 0.99) in CE between stretching and control was observed (0.00; 95% confidence interval -0.98 to 0.99). At baseline, the CE was -3.28 (4.81) degrees in the prone position. No difference (p = 0.89) in CE between stretching and control was observed (0.12; 95% confidence interval -1.52 to 1.76). CONCLUSION: A static stretch regimen had no effect on JPS in healthy volunteers.

Adult↗

PubMed2005

Collagen structure in skin from fibromyalgia patients.

The distribution and amount of collagen in skin from a non-tender-point area from fibromyalgia patients was assessed by quantitative analysis of amino acids and by electron and light microscopy. Skin biopsies were obtained from the front of the thigh of 27 females who fulfilled the American College of Rheumatology criteria of fibromyalgia and from eight control subjects who were matched for gender, age and physical activity. Amino acids were determined by high-performance liquid chromatography. Electron and light microscopic investigations were carried out to examine tissue structure. Among the collagen-related amino acids, the mean number of hydroxyproline residues per 1,000 residues was 52.5 and 63.4 in fibromyalgia patients and control subjects, respectively (p = 0.050); proline residues were 81.7 and 110.0 (p = 0.006); and hydroxylysine residues were 14.7 and 10.1 (p = 0.002). The total amount of skin protein in proportion to dry tissue weight was 83.4% and 72.6% in fibromyalgia and controls, respectively (p = 0.037). The overall microscopic picture was normal. The lamellar structure of the perineurium and a deficiency in collagen packing in the endoneurium was observed more frequently and to a larger extent in fibromyalgia patients than in controls. In conclusion, there are some differences between the amino acid composition of skin proteins in fibromyalgia patients compared with controls. The amount of collagen may be lower in skin from fibromyalgia patients, and collagen packing in the endoneurium may be less dense.

Amino Acids↗

PubMed2004

The effect of calcium and vitamin D3 supplementation on the healing of the proximal humerus fracture: a randomized placebo-controlled study.

The purpose of this study was to (1) quantify the healing process of the human osteoporotic proximal humerus fracture (PHF) expressed in terms of callus formation over the fracture region using BMD scanning, and (2) quantify the impact of medical intervention with vitamin D3 and calcium on the healing process of the human osteoporotic fracture. The conservatively treated PHF was chosen in order to follow the genuine fracture healing without influence of osteosynthetic materials or casts. Thirty women (mean age = 78 years; range = 58-88) with a PHF, osteoporosis or osteopenia (based on a hip scan, WHO criteria), and not taking any drugs related to bone formation, including calcium or vitamin D supplementation, were randomly assigned to either oral 800 IU vitamin D3 plus 1 g calcium or placebo, in a double-blind prospective study. We measured biochemical, radiographic, and bone mineral density effect parameters to evaluate the impact on the healing process. Scanning procedures of the fractured shoulder included use of a fixation device to obtain the highest possible precision. Double scans of the fractured shoulder revealed a coefficient of variation (CV) on BMD measurements that improved from 2.8% immediately after fracture occurrence to 1.7% at 12 weeks (P = 0.003) approaching the 1.2% levels observed over the healthy shoulder. BMD was similar in the two groups at baseline (active 0.534 g/cm2 vs. placebo 0.518 g/cm2), and both increased over the 12-week observation period, with peak levels in week 6. By week 6 BMD levels were higher in the active group (0.623 g/cm2) compared with the placebo group (0.570 g/cm2, P = 0.006). Thirty seven percent of the patients presented with vitamin D levels below 30 nmol/l, indicative of mild vitamin D insufficiency. In conclusion, we have demonstrated that it is possible to quantify callus formation of the PHF with sufficiently high precision to demonstrate the positive influence of vitamin D3 and calcium over the first 6 weeks after fracture. Whether this results in more stable fractures, extends to other fracture types, or applies to other osteogenic bone agents such as bisphosphonates remains to be examined.

Absorptiometry, Photon↗

PubMed2003

Silicate antibodies in Danish women with silicone breast implants.

OBJECTIVES: To use a new immunological assay to evaluate silicate antibody levels in women with and without silicone breast implants (SBIs). METHODS: Women (n=186) were identified through Danish population-based registers and categorized into six groups defined by prior breast surgery (breast implantation/breast reduction/no breast surgery) and by the presence or absence of prior hospital diagnoses of soft-tissue rheumatism (muscular rheumatism, ICD-8 codes 717.90 and 717.99). The women underwent blood tests, a silicate antibody assay and a clinical examination. Severity of rheumatic symptoms/signs was scored from 1 (none) to 5 (severe). RESULTS: The level of silicate antibodies was not significantly different between the three groups with prior soft-tissue rheumatism (P > 0.5), with the lowest value among women with SBIs. Among women who had no prior diagnosis of soft-tissue rheumatism, silicate antibody levels were highest in women with SBIs (P < 0.01). No significant correlations were observed between silicate antibody levels and symptom severity scores. CONCLUSIONS: Silicate antibodies were not consistently associated with SBIs and were not correlated with rheumatic symptoms. The clinical relevance of these antibodies remains questionable.

Adult↗

PubMed2003

Doppler ultrasound and magnetic resonance imaging of synovial inflammation of the hand in rheumatoid arthritis: a comparative study.

OBJECTIVE: To compare the quantitative and qualitative information obtained by Doppler ultrasound (US) measurements of the wrist joints and the small joints of the hand with the information obtained by postcontrast magnetic resonance imaging (MRI) and to correlate the imaging results with clinical observations in patients with rheumatoid arthritis (RA). METHODS: Twenty-nine consecutive RA patients were studied; 196 joints (29 wrist and 167 finger joints) were examined by both US and MRI. Parameters of inflammation were the color fraction and the resistance index (RI) obtained with color Doppler US and the thickness of enhanced synovium (in mm) and the MRI score obtained with postcontrast MRI. Clinical examination and measurements of the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level were performed on the same day as the imaging studies. RESULTS: There was a highly significant association between US indices of inflammation and postcontrast MRI scores. The mean values for both the color fraction and the RI were significantly different in the group without joint swelling compared with the other groups. The mean RI values were significantly different in the group without joint tenderness compared with the other groups. The mean thickness of enhanced synovium on postcontrast MRI was significantly different between the group without joint swelling and the other groups, but this difference was statistically significant only for the comparison of the group without joint tenderness versus the group with maximum tenderness. No association between the MRI or US estimates of inflammation and values on the visual analog scale for pain, Health Assessment Questionnaire, duration of morning stiffness, ESR, or CRP was found. CONCLUSION: Estimates of synovial inflammatory activity by Doppler US and postcontrast MRI were comparable. Estimation of synovial inflammatory activity by the RI and color fraction parameters of US appears to be a promising method of detecting and monitoring inflammatory activity in patients with RA.

Adult↗

PubMed2003

Postural sway in normal subjects aged 20-70 years.

So far, no population-based reference material of postural sway has been presented in the literature. This study evaluated postural control by measuring posturographic parameters, with the aim of establishing useful standards with regard to gender, age, body weight, cigarette smoking, alcohol consumption and articular hypermobility. This was performed in an age-stratified random sample of 195 subjects from the Copenhagen City Heart Study, of whom, 133 agreed to participate. Measurement of postural sway was performed the Balance Master Pro(R). Outcome parameters were average angular velocity, target sway area, per cent maximum stability and per cent ankle strategy. Using SAS Proc Mixed, backward stepwise elimination was performed and 95% prediction intervals were obtained. Sway increased with increasing difficulty of the test (P<0.001) and with increasing age (P<0.001). No differences were found between the sexes. Ankle-strategy did not change with age, but decreased with increasing body weight, and increased in subjects reporting a consumption of modest amounts of alcohol (P<0.001), or with the finding of increased hypermobility (P = 0.006). The present material may be used as a reference in further studies of postural control.

Adult↗

PubMed2003

Bone mineral density in fibromyalgia patients--correlation to disease activity.

OBJECTIVE: To compare bone mass (BMD) in women with fibromyalgia (FM) with healthy females, and to evaluate whether self-reported pain and lack of functional capacity correlate to reduced BMD in FM patients. METHODS: Thirty-one FM patients (20 pre- and 11 postmenopausal) and fourty-one healthy women (30 pre- and 10 postmenopausal) were enrolled in the study. BMD of the lumbar spine and the femoral neck was measured by a DEXA (Norland) scanner. Self reported pain was measured on a Visual Analog Scale (VAS). The Activity of Daily Living (ADL) component of the Fibromyalgia Impact Questionnaire (FIQ-ADL) was used as measure for physical capacity. RESULTS: BMD-lumbar spine and BMD-femoral neck did not differ significantly between FM patients and controls, though premenopausal FM patients tended to have lower BMD-femoral neck (p = 0.09). Self reported pain and FIQ-ADL among FM patients correlated with BMD-femoral neck (r(s) = -0.52, p = 0.003); (r(s) = -0.31, p = 0.09). CONCLUSION: Premenopausal FM patients tended to have lower BMD of hip than controls. Self reported pain correlated negatively to BMD. Thus, the severity of FM might have a negative impact on bone mass.

Adult↗

PubMed2003

Effects of treatment with etanercept (Enbrel, TNRF:Fc) on rheumatoid arthritis evaluated by Doppler ultrasonography.

OBJECTIVE: to estimate and visualise the efficacy of treatment with etanercept (Enbrel) in patients with rheumatoid arthritis (RA) using colour Doppler and spectral Doppler ultrasonography to determine the possible changes in synovial perfusion during a one year observation period. METHODS: Eleven patients from the European multicentre trial of the efficacy and safety of etanercept were included in this study when transferred into the open label, long term safety, and efficacy study. Before a scheduled dosage increase to 50 mg/week they were examined clinically, serologically, and by ultrasonography using the colour Doppler pixels and the spectral Doppler resistance index (RI) as indicators of inflammation. The patients were re-examined at two weeks and at one year follow up RESULTS: The clinical activity decreased significantly from baseline to week 2, but no significant changes were seen from baseline to one year. The number of coloured pixels in each region of interest decreased from baseline to week 2 with a median reduction of 60% (p=0.005). This effect on the perfusion in the synovium could not be found after one year of treatment. During the initial treatment we detected an increase in synovial RI by spectral Doppler. The median increase in peripheral resistance from baseline to week 2 as estimated by the mean RI was 22.6% (p=0.005). The increase in peripheral resistance was maintained to some extent after one year (mean RI increased by 18.8% p=0.074). CONCLUSION: Ultrasonography seems to be a promising tool for the detection of treatment response using spectral Doppler and pixel estimation.

Adult↗

PubMed2002

Bone mineral density measurement over the shoulder region.

The purpose of this study was to (1). establish a method for measuring bone mineral density (BMD) over the shoulder region; (2). compare the relationship between shoulder BMD levels with hip BMD and body mass index (BMI); and (3). discuss the relevance of the shoulder scan as an early indicator of osteoporosis compared with hip scans, the latter representing a weight-bearing part of the skeleton. We developed a scanning procedure, including a shoulder fixation device, and determined the most appropriate software in order to establish a reference material with the highest possible precision. Duplicate scans of the dominant side shoulder on 80 healthy, non-osteoporotic Danish women revealed a coefficient of variation (CVSD) on BMD measurements of 1.7%, with no difference between young and old subjects. Shoulder BMD values were significantly lower than hip BMD values (P <0.00001). Both hip and shoulder values decreased with age (P <0.001). The difference between hip and shoulder BMD levels increased significantly with increased body mass index (BMI) (P <0.002). The positive relationship between the increased hip/shoulder BMD differential with BMI supports the conclusion that the shoulder is subject to the least relative influence of weight and stress loading because of migration of calcium to weight and stress-bearing areas. Since the effect of this migration could mask local osteoporotic bone loss, shoulder BMD measurement is likely to minimize false indicators of healthy bone in women with high BMI, and might therefore be a relevant early stage indicator of osteoporosis.

Absorptiometry, Photon↗

PubMed2002

Self-reported symptoms among Danish women following cosmetic breast implant surgery.

The aim of this study was to examine self-reported symptomatology and to identify distinctive characteristics among women with silicone breast implants (SBI). Using the Danish hospital and population registers we identified three groups of women with a hospital diagnosis of muscular rheumatism (a nonspecific soft-tissue diagnostic code) who had previously undergone SBI surgery (n = 28), breast reduction surgery (n = 29) or no breast surgery (n = 27); and three groups of women without a diagnosis of muscular rheumatism who had undergone SBI surgery (n = 21), breast reduction surgery (n = 27) or no breast surgery (n = 56). All study subjects completed a self-administered questionnaire focusing on sociodemographic factors, lifestyle habits, somatic symptoms and psychological symptoms. Women with SBI and women with breast reduction with no previous diagnosis of muscular rheumatism had similar patterns of reporting for most symptoms and characteristics. They reported significantly more somatic symptoms and psychological distress, including somatisation, obsessive-compulsiveness and depression, than women with no breast surgery. No significant differences in self-reported symptomatology and characteristics were observed among the three groups of women with a previous diagnosis of muscular rheumatism. Overall, women with prior muscular rheumatism reported more symptoms than those without. We concluded that self-reported somatic symptoms among women with SBI were similar to those of controls. Women with cosmetic breast surgery appear to have distinctive psychological characteristics. Our study emphasises the importance of taking the psychological profile and previous history of rheumatic diseases into account when examining women with SBI.

Adult↗

PubMed2001

[Biochemical changes in fibromyalgia. Can serum hyaluronic acid be used diagnostically?].

AIM: To assess the levels of hyaluronic acid (HA) in Danish patients with fibromyalgia (FM). METHODS: Serum levels of HA were determined in 53 patients with established FM and 55 control samples with a radiometric assay (Pharmacia). Values were correlated to clinical parameters of disease severity (duration of disease, tender point scales, visual analogue scales). RESULTS: There were no differences in the HA levels of patients and controls. In all the patients, except one, values were within the reference intervals. Nor was there an association between HA levels and clinical findings. CONCLUSIONS: Patients with FM do not generally have increased serum levels of HA, and other serum measurements have not been helpful in the diagnosis of FM. Some biochemical changes have been described in FM, however, and these have mainly been observed in the spinal fluid.

Adult↗

PubMed2001

[Pool exercise therapy of rheumatoid arthritis].

Aquatic therapy is a subgroup of balneotherapy and consists of exercises in a hot water pool. It uses the physical properties of water to achieve better mobility for patients whose pain, lack of muscle strength, and joint deformities are inhibiting factors when exercising on land. Pool therapy shows positive effects as part of the treatment of rheumatoid arthritis patients, but too few studies with an acceptable design and a well-defined patient group have been carried out. The documentation available on aquatic therapy indicates that more large clinical, controlled, and randomised studies must be conducted.

Arthritis, Rheumatoid↗

PubMed2001

[Lateral humeral epicondylitis--"tennis elbow". I. Epidemiology, clinical picture and pathophysiology].

Lateral epicondylitis (LE) is a common overuse syndrome of unknown etiology. Studies imply that it is mostly a degenerative condition implying that the term "epicondylitis" is a misnomer. LE often occurs in middle-aged persons in connection with acute or chronic strain. Symptoms are mostly related to occupational tasks. Other conditions can cause pain in the lateral elbow region, and it is important to know the differential diagnosis in order to start the proper treatment. The diagnosis is mainly based on clinical findings but may be substantiated by other diagnostic techniques, such as magnetic resonance imaging. However, the specificity and the sensitivity of these techniques are unclarified.

Humans↗

PubMed2001

[Lateral humeral epicondylitis--"tennis elbow"].

There is a great variety of potential therapies in the treatment of lateral epicondylitis, surgical intervention being the most invasive. The most frequently applied therapies are corticosteroid injections, pain-relieving medication (NSAID) and physical therapy. Though many studies have been conducted, a "gold standard" in the treatment of LE is not available. Perhaps this is explained by a lack of methodological quality of many of these studies.

Glucocorticoids↗

PubMed2001

[Comparison of two different treatments of lateral humeral epicondylitis--"tennis elbow". A randomized controlled trial].

INTRODUCTION: Many therapeutic interventions have been used in the treatment of lateral epicondylitis (LE), but to date, no specific intervention has proved universally efficacious. The aim of this study was to compare local corticosteroid injections versus splinting in a randomized controlled design. MATERIAL AND METHODS: Sixteen patients were treated with injections, and fourteen with a wrist splint. The patients were evaluated at inclusion and after six weeks with grip strength and pain scores. The patient's global assessment was used as a main indicator of improvement. RESULTS: No differences were noticed between the two groups. Most patients improved. A questionnaire after > 1 year showed that some patients still had pain complaints. DISCUSSION: We conclude that injections were as effective as splinting in LE. Splinting is recommended in the early stages of the disorder because of its lack of adverse effects. In the long view diagnostics regarding LE have to be refined in order to differentiate patients who are expected to benefit from different treatments.

Adolescent↗

PubMed2001

A method to reduce the number of measured parameters when using isokinetic muscle strength as a clinical indicator in rheumatoid arthritis patients.

The aim of the study was to present a method enabling a reduction of the number of measurements when quantifying isokinetic muscle strength (IMS), and to describe an expression for IMS which is independent of measuring conditions. IMS is a measure of muscle strength used to categorise patients and to assess changes over time. IMS measurements involve one or several measures of peak torque at different chosen angular velocities. Comparisons between studies are difficult and an expression of IMS independent of measuring conditions is needed. Thirty-six women with rheumatoid arthritis were followed for 1 year. IMS was measured on five occasions on both knees at seven angular velocities, giving 10 sets of peak-torque data for each patient. The log[peak-torque]-angular-velocity diagram showed a linear relationship. From this, the peak-torque value at the chosen angular velocity of 30 degrees/s (IMS30) was estimated for each test and the uncertainties involved were quantified. IMS30 is a reliable parameter when comparing effort between knees, visits and patients, and may be based on three sets of data only. IMS may be expressed by a single value, IMS30, representing the fitted line in a log[peak-torque]-angular-velocity diagram. The regression line may be fitted by three or more angular velocities. In principle, IMS30 is independent of the chosen angular velocity, which makes it possible to use an estimated value as IMS30 to compare results, studies and centres in between.

Arthritis, Rheumatoid↗