Biomedical subjects

L Pedersen

Publications and source records attributed to L Pedersen.

At least 19 recordsLinked to original sources

PubMed2007

Birth outcome in women treated with azathioprine or mercaptopurine during pregnancy: A Danish nationwide cohort study.

BACKGROUND: Data on birth outcome after exposure to azathioprine or mercaptopurine during pregnancy is sparse. AIM: To examine the risk of adverse birth outcome among newborns of women exposed to azathioprine or mercaptopurine during pregnancy. METHODS: Data on drug use and births were obtained from Danish population registries. We included 76 exposed pregnancies in 69 women. Of these, we used 64 pregnancies exposed 30 days before conception or during the first trimester to examine the risk of congenital abnormalities, and 65 pregnancies exposed during the entire pregnancy to examine preterm birth and low birth weight at term. Their birth outcomes were compared with outcomes among women who did not fill prescriptions for azathioprine or mercaptopurine during pregnancy. RESULTS: Azathioprine- or mercaptopurine-exposed women had a higher risk of adverse birth outcomes than unexposed controls. However, when the comparison was limited to newborns of women with the same types of underlying disease, relative risks for spontaneous and induced preterm birth, low birth weight at term, and congenital abnormalities were 1.1 (95% CI: 0.5-2.4), 4.0 (95% CI: 1.5-10.8), 1.7 (95% CI: 0.3-8.7) and 1.1 (95% CI: 0.5-2.9), respectively. CONCLUSION: Our results suggest that adverse birth outcomes were caused by the underlying disease rather than by use of azathioprine or mercaptopurine.

Abnormalities, Drug-Induced↗

PubMed2006

Use of nonsteroidal anti-inflammatory drugs and risk of oral cancer: a cohort study.

Epidemiologic data regarding the chemopreventive potential of nonsteroidal anti-inflammatory drugs (NSAIDs) against oral cancer are sparse. We found a relative risk for oral cancer of 1.2 (95% CI, 1.0-1.6) among 169,589 Danish NSAID users (> or =2 prescriptions), with no apparent trends in subgroups. Our study provided no clear evidence that NSAIDs may protect against oral cancer.

Adolescent↗

PubMed2006

Newer cyclo-oxygenase-2 selective inhibitors, other non-steroidal anti-inflammatory drugs and the risk of acute pancreatitis.

BACKGROUND: Case reports have suggested that the use of newer cyclo-oxygenase-2 selective inhibitors may cause acute pancreatitis, but there has been no formal study of the association. AIM: To assess the relationship between the use of cyclo-oxygenase-2 inhibitors and other non-steroidal anti-inflammatory drugs, and risk of acute pancreatitis. METHODS: A population-based case-control study was conducted using hospital discharge and prescription data from Denmark. Using conditional logistic regression with adjustment for multiple covariates, we estimated the relative risk of acute pancreatitis for use of the cyclo-oxygenase-2 inhibitors celecoxib and rofecoxib and for other non-steroidal anti-inflammatory drugs. RESULTS: A total of 3083 cases of acute pancreatitis and 30 830 population controls were identified. For current use the relative risk estimate for celecoxib was 1.4 (95% CI: 0.8-2.3) and for rofecoxib was 1.3 (95% CI: 0.7-2.3). The overall relative risk for other non-steroidal anti-inflammatory drugs was 2.7 (95% CI: 2.4-3.0) with a substantial variation in risk between the individual drugs. The highest relative risk was for diclofenac (odds ratio 5.0, 95% CI: 4.2-5.9) and the lowest for naproxen (odds ratio 1.1, 95% CI: 0.7-1.7). CONCLUSION: Cyclo-oxygenase-2 selective inhibitors are associated with a lower risk of acute pancreatitis than most other non-steroidal anti-inflammatory drugs.

Acute Disease↗

PubMed2006

Use of postmenopausal hormone replacement therapy and risk of non-Hodgkin's lymphoma: a Danish population-based cohort study.

Use of postmenopausal hormone replacement therapy (HRT) has been hypothesised to be associated with a reduced risk of non-Hodgkin's lymphoma (NHL), but the epidemiologic evidence is conflicting. To examine the risk of NHL in HRT users aged 40 and older, we conducted a cohort study in the County of North Jutland, Denmark (population 0.5 million) using data from population-based health registries for the period 1989-2002. We computed age-standardised NHL incidence rates and used Cox regression analysis to compute the relative risk (RR) and corresponding 95% confidence intervals (CI) of NHL among HRT users compared with non-users, adjusting for age and calendar period. The number of prescriptions redeemed (1, 2-4, 5-9, 10-19, or 20 or more prescriptions) was used as a proxy for duration of HRT. We identified 40 NHL cases among HRT users during 179 838 person-years of follow-up and 310 NHL cases among non-users during 1 247 302 person-years of follow-up. The age-standardised incidence rates of NHL were 25.7 per 100,000 among HRT users and 24.2 per 100,000 among non-users, yielding an adjusted RR of 0.99 (95% CI: 0.71-1.39). Our data did not support an association between HRT use and risk of NHL.

Adult↗

PubMed2006

Incidence and prognosis of non-typhoid Salmonella bacteraemia in Denmark: a 10-year county-based follow-up study.

The aim of this study was to examine the incidence and prognosis of non-typhoid Salmonella bacteraemia in a well-defined population in which complete follow-up investigations had been performed. All patients with non-typhoid Salmonella bacteraemia from 1994 through 2003 in North Jutland County, Denmark, were eligible for the study. Annual incidence rates were calculated for 10-year age groups. The North Jutland County Bacteraemia Database (inclusion of subjects), medical hospital records, the Prescription Registry (redemption of prescription drugs), and the Central Population Registry (deaths) were used as data sources. The outcomes were mortality within 30 and 180 days of the first non-typhoid-Salmonella-positive blood sample. Cox proportional-hazards regression analysis was performed, first with age and comorbidity as evidenced by Charlson index scores, and second with selected clinical and laboratory prognostic variables potentially related to non-typhoid Salmonella bacteraemia per se. A total of 111 non-typhoid Salmonella bacteraemia patients were included in the study. The incidence rate (mean 2.3/100,000 person-years) increased steadily from 1.9/100,000 person-years in the 40-49-year age group to 14.6/100,000 person-years in those >90 years. Twelve (11%) and 24 (22%) patients died within 30 and 180 days, respectively. Cox regression analyses showed that increasing age and, to a higher degree, increasing levels of comorbidity were independently associated with an unfavourable outcome, whereas none of the clinical or laboratory variables studied were strong independent prognostic factors. In conclusion, the presence of comorbid diseases and old age were independently associated with mortality, whereas clinical and laboratory variables were less important.

Adolescent↗

PubMed2006

Antipsychotics and risk of first-time hospitalization for myocardial infarction: a population-based case-control study.

BACKGROUND: Use of antipsychotics has been linked with an adverse cardiovascular risk factor profile and an increased risk of dysrhythmia and sudden cardiac death. However, detailed data on the association between use of antipsychotics and development of atherosclerotic disease are limited. OBJECTIVE: To examine risk of hospitalization for myocardial infarction (MI) amongst users of antipsychotics compared with non-users. DESIGN AND SUBJECTS: A population-based case-control study using data from hospital discharge registries in the counties of North Jutland, Viborg and Aarhus, Denmark, and the Danish Civil Registration System. We identified 21,377 cases of first-time hospitalization for MI and 106,885 sex- and age-matched non-MI population controls in the period 1992-2004. All prescriptions for antipsychotics filled prior to the date of admission for MI were retrieved from population-based prescription databases. We used conditional logistic regression to adjust for a wide range of covariates. RESULTS: Current users of atypical [adjusted relative risk: 0.98, 95% confidence interval (CI): 0.88-1.09] and typical antipsychotics (adjusted relative risk: 0.99, 95% CI: 0.96-1.03) had no increased overall risk of being admitted to hospital for MI when compared with non-users of antipsychotics. These findings were consistent in all examined subgroups. Further, we found no association between the cumulative dose of antipsychotics and the risk of hospitalization for MI. CONCLUSION: These findings do not support the hypothesis that use of antipsychotics and in particular atypical antipsychotics is associated with increased risk of MI.

Aged↗

PubMed2006

Reported symptoms, diagnostic delay and stage of colorectal cancer: a population-based study in Denmark.

OBJECTIVE: The primary prognostic factor for colorectal cancer (CRC) is stage. Any association between symptoms, diagnostic delay and stage may have implications for the clinical course of the disease. We examined the association between symptoms and diagnostic delay and between symptoms and stage, and assessed whether the associations differed for colon cancer (CC) and rectal cancer (RC). PATIENTS AND METHODS: Population-based prospective observational study based on 733 Danish CRC patients. Diagnostic delay and patients' reported symptoms were determined through questionnaire-interviews. Dukes' stage was obtained from medical records and pathology forms. Diagnostic delay was categorized into three delay groups: < or = 60, 61-150 and > 150 days. Stage was classified into nonadvanced (Dukes' A and B) or advanced (Dukes' C and D) cancers. We calculated the frequency of the most frequently reported initial symptom or symptom complex for CC and RC patients, and evaluated the frequency of patients with different initial symptoms/symptom complexes in the three delay groups. For the most frequent initial symptoms/symptom complexes, we calculated the frequencies according to stage, and estimated the relative risk of having an advanced stage, with 95% confidence intervals. RESULTS: The most frequent initial symptoms/symptom complexes were very vague symptoms for CC and rectal bleeding for RC. For both CC and RC, rectal bleeding was significantly associated with nonadvanced stage. The relative risk of having an advanced cancer was 0.6 for monosymptomatic rectal bleeding and 0.7 for rectal bleeding combined with other symptoms. CONCLUSIONS: Initial symptoms of CC were often very vague, making it difficult to identify a precise start date. The most frequent initial symptom/symptom complex for RC - rectal bleeding - was better defined. Rectal bleeding was significantly associated with nonadvanced CC and RC and a significantly decreased relative risk of having an advanced cancer.

Colonic Neoplasms↗

PubMed2005

The risk of a second cancer after hospitalisation for venous thromboembolism.

Although venous thromboembolism (VTE) is common in patients with cancer, it is not known if it is associated with risk of a second malignancy. Using the Danish Cancer Registry and National Registry of Patients, we studied a population-based cohort of 6285 patients with cancer who had an episode of VTE. The risk of a second cancer was compared with that among 30 713 cancer patients without VTE, matched for age, sex, cancer site and year of diagnosis. Overall, the relative risk for a second cancer diagnosis was 1.3 (95% confidence interval (CI) 1.1-1.4). However, the excess risk varied with the time from the initial cancer diagnosis to the thrombotic event. If the thrombotic episode occurred within the first year, the relative risk for a second cancer was 1.0 (95% CI 0.9-1.3), but if the VTE occurred more than 1 year after the initial cancer, the overall relative risk for a second cancer was 1.4 (95% CI 1.2-1.7), with strong associations for cancers of the digestive organs, ovary and prostate. The association between VTE and subsequent incident cancer extends to patients who already have had a cancer diagnosis.

Aged↗

PubMed2005

Hormone use for menopausal symptoms and risk of breast cancer. A Danish cohort study.

Numerous studies and meta-analyses have shown that hormone replacement therapy (HRT) for menopausal symptoms increases the risk of developing breast cancer, estimated to be 2.3% for each year of use. The influence of different oestrogen-progestin regimens has still not been fully evaluated. Using longitudinal data from the population-based prescription database of the county of North Jutland, Denmark, and the Danish Cancer Registry, we examined the risk of developing breast cancer in relation to HRT in a cohort of 78,380 women aged 40-67 years from 1989 to 2002. A total of 1462 cases of breast cancer were identified during a mean follow-up of 10 years. Use of HRT did not increase the risk of breast cancer in women aged 40-49 years. Restricting the cohort to 48,812 women aged 50 years or more at entry, of whom 15 631 were HRT users, we found an increased risk associated with current use of HRT (relative risk 1.61, 95% confidence interval 1.38-1.88). The risk increased with increasing duration of use and decreased with time since last HRT prescription, reaching unity after 5 years. No material risk difference was observed among the various HRT-regimens. This population-based cohort study provides further confirmation that HRT increases the risk of developing breast cancer in women aged 50 years or more.

Adult↗

PubMed2005

Survival trends among Danish patients undergoing coronary angiography for known or suspected ischaemic heart disease: a population based follow up study, 1992-2000.

OBJECTIVE: To determine, from population based clinical data, changes in the survival of Danish patients examined by coronary angiography for known or suspected ischaemic heart disease (IHD) during the 1990s. DESIGN: Follow up study. SETTING: The departments of cardiology at Rigshospitalet, Copenhagen University Hospital, and Skejby Hospital, Aarhus University Hospital, Denmark. PATIENTS: Patients with IHD (n = 7021) who underwent first time coronary angiography in 1992, 1996, or 2000. MAIN OUTCOMES MEASURES: Three year survival was compared between cohorts and with that of the general population. Cox proportional hazards regression was used to estimate mortality ratios adjusted for differences in patient characteristics. RESULTS: Survival improved substantially--for example, adjusted mortality ratio was 0.69 (95% confidence interval (CI) 0.55 to 0.87) when comparing patients from 2000 with patients from 1992. The absolute standardised survival rates after three years of follow up were 87.1% (95% CI 85.4% to 88.8%), 89.9% (95% CI 88.5% to 91.3%), and 91.2% (95% CI 90.3% to 92.1%) among patients examined in 1992, 1996, and 2000, respectively. The improvement was not explained by the improvement in overall survival in the general population during the study period. CONCLUSIONS: The survival of Danish patients with known or suspected IHD appears to have improved substantially during the 1990s.

Adult↗

PubMed2005

Long-term effects of migraine on cognitive function: a population-based study of Danish twins.

OBJECTIVE: To investigate the cognitive functioning of migraineurs vs nonmigraineurs in a large population-based sample of middle-aged twins where headache diagnoses were established by neurologists. METHODS: Twins identified through the population-based Danish Twin Registry participated in face-to-face structured interviews, which included cognitive tests and two previously validated questions screening for migraine. Twins who screened positive for migraine and their co-twins were invited to participate in a telephone-based interview conducted by neurologists, who established headache diagnoses according to the International Headache Society criteria. Cognitive scores on fluency, digit span, delayed word recall, and symbol digit substitution test were compared between migraineurs and nonmigraineurs. Comparisons within monozygotic and dizygotic same sex twin pairs discordant for migraine were also performed. RESULTS: Of the 1,789 twins who were eligible for inclusion in the present study, 1,393 (77.8%) were interviewed. A diagnosis of migraine was established in 536 twins (migraine without aura n = 347; migraine with aura n = 157). Average scores on cognitive tests in twins with migraine or one of the migraine subtypes did not differ from those of nonmigraineurs in any of the tests. Comparisons within twin pairs discordant for migraine produced highly comparable results. Adjustment for possible confounders and stratification by cumulated number of lifetime attacks did not influence the results. CONCLUSIONS: A lifetime diagnosis of migraine was not associated with cognitive deficits in middle-aged subjects.

Aged↗

PubMed2005

Metronidazole and risk of acute pancreatitis: a population-based case-control study.

BACKGROUND: Use of metronidazole has been suggested to be associated with an increased risk of acute pancreatitis in case reports. AIM: To examine this issue within a proper epidemiological design. METHODS: We identified 3083 incident cases of acute pancreatitis from Hospital Discharge Registries in three Danish counties and 30 830 matched population controls. From prescription databases, we extracted information on use of metronidazole with or without concomitant use of proton-pump inhibitors and/or amoxicillin, macrolides or tetracycline. RESULTS: Adjusted odds ratios for acute pancreatitis in study subjects who redeemed a prescription for metronidazole within 30, 31-180, or 181-365 days before hospitalization or index date among controls were 3.0 [95% confidence interval (CI): 1.4-6.6], 1.8 (95% CI: 1.2-2.9) and 1.1 (95% CI: 0.6-1.8), respectively. Among subjects with a concomitant prescription for proton-pump inhibitors and/or amoxicillin, macrolides or tetracycline within 30, 31-180, or 181-365 days before hospitalization, or index date among controls, adjusted odds ratios were 8.3 (95% CI: 2.6-26.4), 2.7 (95% CI: 1.4-5.5), and 1.7 (95% CI: 0.6-4.8), respectively. CONCLUSION: Metronidazole may increase the risk of acute pancreatitis. However, the risk seems mainly to increase when metronidazole is used in combination with other drugs used for Helicobacter pylori eradication.

Acute Disease↗

PubMed2005

Population-based study of short- and long-term survival from colorectal cancer in Denmark, 1977-1999.

BACKGROUND: Survival rates for patients with colorectal cancer have been lower in Denmark than in other European countries. The aim of this study was to examine temporal trends in relative survival from colorectal cancer between 1977 and 1999. METHODS: All patients diagnosed with colorectal cancer between 1977 and 1999 were identified using the nationwide population-based Danish Cancer Registry. Patients were linked with the Danish Central Population Registry to obtain data on survival to December 2002, and to select ten population controls per patient. RESULTS: A total of 69 562 patients with colorectal cancer were identified, of whom 49.2 per cent were men. Six-month relative survival after diagnosis increased from 69.7 per cent in 1977-1982 to 77.7 per cent in 1995-1999. Five-year relative survival rates increased from 37.8 to 46.8 per cent respectively. Women had slightly higher 5-year relative survival than men throughout the study period. Rectal tumours were associated with better survival than colonic tumours until 2 years after diagnosis, after which tumour location had no impact on survival. CONCLUSION: Relative survival of patients with colorectal cancer has improved in Denmark between 1977 and 1999, most probably reflecting better management of the disease.

Adolescent↗

PubMed2004

COX-2-selective inhibitors and the risk of upper gastrointestinal bleeding in high-risk patients with previous gastrointestinal diseases: a population-based case-control study.

BACKGROUND: Clinical trials have suggested that cyclo-oxygenase-2-selective inhibitors are associated with a lower risk of upper gastrointestinal bleeding than are non-selective, non-aspirin, non-steroidal anti-inflammatory drugs. This has not yet been confirmed in studies of patients with an increased susceptibility to upper gastrointestinal bleeding. AIM: To examine the risk of upper gastrointestinal bleeding in high-risk patients who filled prescriptions for cyclo-oxygenase-2 inhibitors or other non-steroidal anti-inflammatory drugs. METHODS: A population-based case-control study was performed in the Danish county of North Jutland from 1 January 2000 to 31 December 2002. From the County Hospital Discharge Registry and the Civil Registration System, we identified incident cases with upper gastrointestinal bleeding (n = 780) and randomly selected controls (n = 2906), respectively. All cases and controls had previous gastrointestinal diseases. Data on drug exposure were obtained from the countywide Prescription Database. RESULTS: Thirty-five cases (4.5%) filled prescriptions for cyclo-oxygenase-2 inhibitors within 30 days of the date of upper gastrointestinal bleeding, compared with 79 controls (2.7%). Adjusted odds ratios for upper gastrointestinal bleeding according to prescription for celecoxib, rofecoxib and non-steroidal anti-inflammatory drugs were 1.3 [95% confidence interval (CI), 0.7-2.8], 2.1 (95% CI, 1.2-3.5) and 3.3 (95% CI, 2.4-4.4), respectively. CONCLUSIONS: In patients with increased susceptibility to gastrointestinal adverse events, a lower risk of upper gastrointestinal bleeding was observed in users of cyclo-oxygenase-2 inhibitors compared with users of other non-aspirin, non-steroidal anti-inflammatory drugs.

Adolescent↗

PubMed2004

The risk of congenital abnormalities in children fathered by men treated with azathioprine or mercaptopurine before conception.

BACKGROUND: Immunosuppressive therapy with azathioprine and mercaptopurine is commonly used in patients with various chronic diseases. The few existing data on the reproductive safety of these drugs after paternal use before conception are inconclusive. AIM: To examine the risk of congenital abnormalities in children fathered by men exposed to azathioprine or mercaptopurine before conception. METHODS: This was a Danish population-based cohort study, based on data from the Prescription Database, the Medical Birth Registry and the Hospital Discharge Registry of North Jutland County, Denmark. Fifty-four exposed pregnancies, in which the father filed a prescription for azathioprine or mercaptopurine (between 1 January 1991 and 31 December 2001) before conception, were included. The controls comprised 57 195 pregnancies with no paternal azathioprine or mercaptopurine use. RESULTS: Four children with congenital abnormalities (underlying paternal diseases: glomerulonephritis and severe skin disease) were found in 54 exposed pregnancies (7.4%), compared with 2334 (4.1%) in controls. The adjusted odds ratio for congenital abnormalities in children fathered by men treated with azathioprine or mercaptopurine was 1.8 (95% confidence interval, 0.7-5.0). CONCLUSIONS: Our data may indicate that paternal use of azathioprine or mercaptopurine before conception is associated with an increased risk of congenital abnormalities. However, more data are needed to determine whether the association is causal.

Abnormalities, Drug-Induced↗

PubMed2004

The prognostic influence of multifocality in breast cancer patients.

The aim of this study was to investigate whether multifocality (MF) is a factor that has significant effect on overall survival when controlling for known prognostic factors. A cohort of 929 breast cancer patients operated between 1985 and 1990 was investigated. Of these, 158 (17%) patients had MF tumors and 771 had unifocal tumors. To investigate whether MF is an independent prognostic factor for overall survival in breast cancer, a Cox regression model was applied. Only tumor size, positive lymph nodes, histologic grade and receptor status had a significant effect on overall survival in the multivariate analysis. We found a positive correlation between tumor size and MF and between the number of positive lymph nodes and MF. In conclusion, MF had no significant effect on overall survival besides that which can be explained by other prognostic factors.

Adult↗

PubMed2003

Azathioprine, mercaptopurine and birth outcome: a population-based cohort study.

BACKGROUND: Data on the safety of azathioprine and mercaptopurine during pregnancy are very sparse. AIM: To examine the risk of adverse birth outcomes in women who took up prescriptions for azathioprine or mercaptopurine during pregnancy. METHODS: This is a Danish cohort study based on data from a population-based prescription registry, the Danish Birth Registry and the Hospital Discharge Registry. To examine the risk of congenital malformations, we included nine pregnancies exposed 30 days before conception or during the first trimester. To examine perinatal mortality, pre-term birth and low birth weight, we included 10 pregnancies exposed during the entire pregnancy. Eleven different exposed women were included in the study. Outcomes were compared with those of 19 418 pregnancies in which no drugs were prescribed to the mothers. RESULTS: Fifty-five per cent of the exposed women had inflammatory bowel disease and 45% other diseases. Adjusted odds ratios for congenital malformations, perinatal mortality, pre-term birth and low birth weight were 6.7 (95% confidence interval, 1.4-32.4), 20.0 (2.5-161.4), 6.6 (1.7-25.9) and 3.8 (0.4-33.3), respectively. CONCLUSIONS: Our results suggest that there is an increased risk of congenital malformations, perinatal mortality and pre-term birth in children born to women treated with azathioprine or mercaptopurine during pregnancy. More data are needed to determine whether the associations are causal or occur through confounding.

Abnormalities, Drug-Induced↗

PubMed2003

Mechanical properties of the skin: a comparison between two suction cup methods.

BACKGROUND/AIMS: The objective measure of mechanical properties of the skin is relevant to the clinician as well as to the researcher concerned with skin physiology. The lack of standardization among methods used to obtain visco-elastic data from the skin is however, apparent and represents an obstacle to comparison of the results derived from the various studies concerning the subject. METHODS: The mechanical properties of the ventral forearm were studied in 35 healthy volunteers. The Dermaflex and the DermaLab (Both Cortex Technology, Hadsund, Denmark) were compared. The results were analyzed with descriptive statistics and correlations using non-parametric methods. Measurement accuracy was assessed using coefficient of variation. Sub analysis was made in groups according to gender and age. RESULTS: The overall correlations between the two methods were moderate (r = 0.383-0.437). A greater coefficient of variation was found in the DermaLab machine. Significant differences were found between all values of both methods when comparing the mechanical properties of the skin in 30-39 years olds versus the group of 40-58 years olds. No differences were found between the genders. CONCLUSIONS: The results indicate that both methods are useful in the study of the mechanical aspects of the skin, especially for detecting age-related changes. The Dermaflex seems to produce more accurate for data. This is thought to be due to the conceptual design differences between the two methods. The methods measure related but not identical values of the mechanical properties of the skin, as reflected by the limited positive correlation between them.

Adolescent↗