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Lars Frølund

Publications and source records attributed to Lars Frølund.

11 recordsLinked to original sources
PubMed2006

[Sentinel surveillance of risk of severe reactions associated with specific immunotherapy. A method for quality assurance of procedures with rare, but serious adverse effects].

INTRODUCTION: Whether procedures are "out of control" or "in control" is a central concept in quality assurance. It is essential to stay "in control" concerning treatment. Often this is simple, when risk is known and can be discussed before treatment has been agreed upon. The situation becomes more difficult when a treatment with a well-known risk gets out of control due to an increase in side effects. This happened during 2003, when an increase in notified serious adverse events after specific allergy vaccination (SAV) was observed. MATERIALS AND METHODS: A sentinel survey was established in five allergy clinics with experience in SAV. The numbers of monthly side effects and injections were reported, and the results were returned. RESULTS: No serious reactions were observed, and therefore the maximal risk of a serious reaction was estimated. On the basis of a total of 7,538 injections, of which 44% were grass ALK 225 injections, the maximal risk was < 0.05% for all injections and < 0.1% for antigrass injections (97.5% CI). CONCLUSION: Sentinel surveillance of SAV led to the re-establishment of an "in control" situation. At present the official system for notification of side effects, the Danish Medicines Agency, and the Danish Allergy Society are not able to respond fast enough and adequately enough to gain control of the situation, and we suggest that in all high-risk and high-volume procedures sentinel surveillance should be performed by the doctors close to the patients and in charge of the procedures instead of by a centralised surveillance entity.

Adverse Drug Reaction Reporting Systems↗
PubMed2003

IgG antibodies against microorganisms and atopic disease in Danish adults: the Copenhagen Allergy Study.

BACKGROUND: Seropositivity to food-borne and orofecal microorganisms (hepatitis A virus, Helicobacter pylori, and Toxoplasma gondii ), which are considered to be markers of poor hygiene, has been reported to be associated with a lower prevalence of atopy. In contrast, colonization of the gut with Clostridium difficile, a potential intestinal bacterial pathogen, in early childhood may be associated with a higher prevalence of atopy. OBJECTIVE: The objective of this study was to investigate the association between atopy and exposure to 2 groups of food-borne and orofecal microorganisms: (1) markers of a poor hygiene and (2) intestinal bacterial pathogens. METHODS: A cross-sectional population-based study of 15- to 69-year-olds living in Copenhagen, Denmark, was carried out in 1990 to 1991. Atopy was defined as a positive test result for specific IgE to at least 1 of 6 inhalant allergens. Exposure to microorganisms was assessed as IgG seropositivity to microorganisms. RESULTS: Seropositivity to 2 or 3 markers of poor hygiene (hepatitis A virus, H pylori, and T gondii ) was associated with a lower prevalence of atopy (adjusted odds ratio, 0.5; 95% CI, 0.3 to 0.8). In contrast, seropositivity to 2 or 3 intestinal bacterial pathogens (C difficile, Campylobacter jejuni, and Yersinia enterocolitica ) was associated with a higher prevalence of atopy (adjusted odds ratio, 1.7; 95% CI, 1.2 to 2.6). CONCLUSION: Exposure to markers of poor hygiene was associated with a lower prevalence of atopy, whereas exposure to intestinal bacterial pathogens was associated with a higher prevalence of atopy. These findings raise the hypothesis that different groups of food-borne and orofecal microorganisms may have different effects on the risk of atopy.

Adolescent↗
PubMed2002

[Increasing prevalence of specific IgE against aeroallergens in an adult Danish population--two cross-sectional studies in 1990 and 1998].

BACKGROUND: There is evidence that the prevalence of respiratory allergy has increased in children in many countries. However, this evidence is largely based on questionnaire data, and little is known about similar trends in adults. We investigated whether the prevalence of specific IgE to aeroallergens had increased in an adult general population over an 8-year period. MATERIAL AND METHODS: Two cross-sectional surveys were carried out in 1990 and 1998. A screening questionnaire on respiratory symptoms sent to random samples of 15-41-year-old subjects living in Copenhagen (Denmark) preceded both surveys. Random samples of responders were invited to a health examination, which included assessment of specific IgE to six common aeroallergens. Totals of 312 (74.6% of those invited) and 482 (53.4% of those invited) subjects were examined in 1990 and 1998, respectively. Serum samples from both surveys were analysed in 1999. RESULTS: The prevalence of specific IgE to at least one allergen increased significantly from 1990 to 1998 (26.5% versus 33.9%; odds ratio adjusted for sex, age, and season of examination, 1.63; 95% confidence interval, 1.15-2.32). This increase remained unexplained after adjustment for changes in questionnaire variables on life-style and home environment. The clinical significance of this increase was underlined by a corresponding increase in the prevalence of allergic rhinitis symptoms associated with specific IgE positivity. DISCUSSION: We found that the prevalence of specific IgE positivity to aeroallergens increased in an adult Danish general population from 1990 and 1998.

Adolescent↗
PubMed2002

[Length of stay in medical departments. Similarities and differences in Denmark].

INTRODUCTION: The relation between the length of stay after admission to a medical ward, the available resources, and the quality of the results is not well established. There is no documentation that allocation of resources results in improved quality. In Denmark we have recently focused on the quality of cancer treatment and have allocated resources without any evidence that it will improve survival, whereas less attention has been paid to less prestigious diseases. Length of stay can be an indicator of quality, as we operate with an efficient work process as a goal. But it is not a goal by itself, as only when coupled with cure or improvement in the disease can it be worth aiming at. We therefore compared the length of stay in Danish Departments of Internal Medicine to look for differences or similarities. MATERIAL AN METHODS: The homepage of the Danish National Board of Health, www.tal.dk (now terminated) was visited and data drawn for analyses. RESULTS: Six days seems to be the average length of stay in most departments, with some extreme deviations. A tendency towards a short stay in the department of Cardiology and a long term stay in the Geriatric Department was found as expected, but again extreme deviations were seen. DISCUSSION: No typical pattern was seen in the length of stay. A short stay is not attractive in itself, only when combined with a high quality of care and a healthy economy. Conversely, too short a stay can be risky if it is because of overcrowding and this must be prevented.

Denmark↗
PubMed2002

[Lung cancer: survival rate differences in Danish counties. Survival analysis of 33.838 patients during the period 1984-1998].

INTRODUCTION: The quality of care for Nordic cancer patients has been considered to be low in Denmark. Our quality problem was believed to be caused by the structure of our secondary health care. But there may be other explanations for the poor survival in Denmark, and the comparison with the other Nordic countries may be flawed by confounding factors, such as smoking habits and spread of cancer at the time of diagnosis. We therefore, analysed differences in regional survival after diagnosis of carcinoma of the lung in Denmark to look for signs of similar flaws. MATERIALS AND METHODS: A sample from the National Cancer Registry of all cases of carcinoma of the lung, diagnosed in 1984-1995. Persons older than 80 were excluded. Age and spread of cancer were included in a Cox analysis. RESULTS: Survival was dependent on residence. Within the first five months of diagnosis, survival was significantly poorer in Copenhagen City and better in the counties of Aarhus, Aalborg, and Viborg. At five months, the differences had diminished and only the counties of Fyn and Sønderjylland differed from the nationel average in a negative way. DISCUSSION: Better results were achieved than previously expected in some Danish counties. Interpretation of the Nordic results should be more critical and include possible confounders, such as smoking and spread of cancer at diagnosis. The Danish problem with cancer may be because of the delay of patient and doctor in the primary health care, together with an extreme life-style, including too much urban life and tobacco smoking.

Adult↗
PubMed2002

The association between contact allergy and hand eczema in 2 cross-sectional surveys 8 years apart.

Hand eczema is a recurrent chronic skin disease related to contact allergy and atopic dermatitis. When possible, efforts should be redoubled to eliminate provoking factors. Our objective was to assess changes in the prevalence of self-reported hand eczema and to evaluate the association between contact allergy and hand eczema among adult Danes before and after nickel exposure regulation in Denmark. In 1990 and 1998, random samples of 15-41-year-old persons were examined in 2 cross-sectional studies of the general population in Copenhagen, Denmark. The studies included questionnaires, patch and prick testing. From 1990 to 1998 the prevalence of a history of hand eczema increased significantly. This increase did not appear to be fully explained by changes in the prevalence of flexural eczema, prick test reactivity, patch test reactivity, and nickel allergy. In 1990, nickel allergy and allergic nickel contact dermatitis were significantly associated with a history of hand eczema among women. In 1998, these associations were not found. It can be concluded that, from 1990 to 1998, the prevalence of a history of hand eczema rose significantly. It was indicated that it might be possible to prevent the hand eczema related to nickel allergy by exposure regulation, public education or both.

Adolescent↗
PubMed2002

Have oral contraceptives reduced the prevalence of acne? a population-based study of acne vulgaris, tobacco smoking and oral contraceptives.

BACKGROUND: The prevalence of acne among adolescents appears to vary geographically. This study was therefore undertaken to describe the prevalence rate of acne among Danish adolescents and to study the possible influence of oral contraceptives (OC) and tobacco smoking on disease prevalence and severity. Both have been suggested to influence acne and are therefore potential confounders in studies of acne prevalence. METHODS: A random sample of 186 15- to 22-year-old subjects participating in a population-based study of allergic diseases in Copenhagen County were also examined for acne. Questionnaire data on demographic variables, acne problems, smoking status and use of OC were recorded, and acne was graded according to the Leeds scale. RESULTS: The prevalence of clinical acne (Leeds score >1) was 40.7% for men and 23.8% for women (odds ratio, OR, acne vs. no acne: 0.46, 95% confidence interval, CI: 0.24-0.85). Acne was perceived as a personal problem by 37.6% of all subjects, and this was associated with clinical acne (OR: 5.5, 95% CI: 2.7-10.9). The use of OC was associated with a significantly lower prevalence of acne (OR: 0.32, 95% CI: 0.11-0.86), while the use of tobacco smoking was not significantly associated with acne (OR: 0.54, 95% CI: 0.17-1.78). CONCLUSION: In congruence with recent reports from other countries, the prevalence rate of acne among adolescents was found to be lower than previously described in older reports. In this population, the use of OC was associated with a lower prevalence of acne.

Acne Vulgaris↗