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M Davidsen

Publications and source records attributed to M Davidsen.

29 records · Page 2Linked to original sources

Disease activity courses in a regional cohort of Crohn's disease patients.

BACKGROUND: The study was a follow-up of an inception cohort of 373 patients with Crohn's disease. METHODS: Annual assessments, life table analyses, and Markov chain analyses, estimating the probability for remission and relapse with time, and working capacity were carried out. RESULTS: The clinical course of Crohn's disease differs markedly over time, from ever-relapsing cases to a quiescent course with remission for several years, interrupted by years with relapse. No predictive factors have been found for the subsequent course with regard to age, sex, extent of disease at diagnosis, and treatment in the year of diagnosis. The relapse rate within the year of diagnosis and the following 2 years, however, does correlate positively (p = 0.00001) with the relapse rate in the following 5 years. Furthermore, the relapse rate for 1 year during the disease course influences the relapse rate the following year, indicating a disease pattern over time with waves of at least 2 years' duration. A slight tendency towards burning out was found. The disease course reflected in working capacity for the patients showed that a minor part--up to 15% after 15 years--will become incapable and obtain disablement pension, while 75% of the patients each year are fully capable of work. Within 10 years 50% of the patients will not have experienced any year with impaired capacity for work.

Activities of Daily Living↗

Course of ulcerative colitis: analysis of changes in disease activity over years.

BACKGROUND/AIMS: The course and prognosis of ulcerative colitis (UC) are often reported in terms of mortality and cancer risk. This study examined the clinical course in terms of morbidity. METHODS: A total of 1161 patients with UC were followed up from diagnosis up to 25 years. Actuarial analysis and Markov chain analysis were used to estimate the probabilities of remission and relapses during the disease course. RESULTS: The distribution of disease activity was remarkably constant each year, with about 50% of patients in clinical remission. After 10 years, the colectomy rate was 24%. The cumulative probability of a relapsing course is 90% after 25 years of follow-up. The course of disease changed between remission and relapse without significant predictors, except for disease activity in foregoing years. In years 3-7 after diagnosis, 25% of patients were in remission; 18% had activity every year; and 57% had intermittent relapses. Activity in the first 2 years after diagnosis significantly correlated with having an increased probability of 5 consecutive years of disease activity (P = 0.00001). The probability of maintaining working capacity after 10 years was 92.8% (range, 90.8%-94.8%). CONCLUSIONS: About half of patients with UC will be in remission at any time, although 90% have an intermittent course. Relapses are unpredictable except that disease activity in foregoing years indicates with 70%-80% probability that the disease will continue the following year. Although UC is troublesome, most patients' lives are relatively little influenced by it.

Adolescent↗

Snoring and risk of stroke and ischaemic heart disease in a 70 year old population. A 6-year follow-up study.

BACKGROUND: A number of studies have demonstrated an association between habitual snoring and cardiovascular morbidity and mortality. Control for the influence of potential confounders has been inadequate. To clarify the issue we examined the association between snoring and future risk of ischaemic heart disease (IHD) and stroke while controlling for the potential influence of major cardio- and cerebrovascular risk factors. METHODS: In all, 804 70 year old males and females were classified according to snoring habits. Alcohol and tobacco consumption, blood pressure, body mass index, social group, plasma lipids (triglycerides, cholesterol, high density lipoprotein), fasting blood glucose, plasma epinephrine and norepinephrine were determined at baseline. RESULTS: Over a 6-year period (1984-1990) 88 suffered an IHD episode, 60 had a stroke and 180 died. A slightly higher stroke incidence was found among snorers (relative risk [RR] = 1.8; (95% confidence interval: 1.1-3.6). When adjustments were made for the above confounders, no associations could be found between snoring and IHD, stroke or all-cause mortality. CONCLUSIONS: In a 70 year old population, snoring is not associated with an increased risk of IHD, stroke or all-cause mortality.

Aged↗

Frequency of glucocorticoid resistance and dependency in Crohn's disease.

The outcome of the first steroid treatment course was prospectively studied in a regional cohort of 196 patients with Crohn's disease diagnosed 1979-1987. The immediate outcome after 30 days, and the prolonged outcome 30 days after treatment had stopped, are described. In all 109 patients treatment was analysed. Complete remission was obtained in 48%, partial remission in 32%, and no response in 20% within 30 days of treatment. Among primary responders (complete and partial remission), 55% remained in prolonged response after treatment had finished, while 45% relapsed or could not be withdrawn from treatment within one year. Localisation of disease, age, sex or clinical symptoms did not significantly correlate with outcome, which can be summarised as prolonged steroid response in 44%, steroid dependency in 36%, and steroid resistant in 20% of the patients.

Adolescent↗

[Long-term prognosis of patients with ulcerative colitis].

A regional inception cohort of 1161 ulcerative colitis patients was followed from diagnosis to the end of 1987. Follow-up rate for death and occurrence of cancer was 99.9%. Median observation time 11.7 years, range 0-26 years. One hundred and forty-one deaths were observed, 26 due to ulcerative colitis or complications thereof. No significant excess mortality was found after the first year, but in the year of diagnosis the relative risk of death was 2.4 (p < 0.001). The cumulative colectomy rate was 32.4% 25 years after diagnosis. The initial extent of disease significantly influenced the colectomy probability, being 35% in total colitis, 19% in substantial colitis and 9% in distal colitis within the first five years after diagnosis. Six patients developed colorectal cancer within the observation period. Compared to the expected number of 6.6 the relative risk for patients with ulcerative colitis was 0.9. The calculated cumulative cancer incidence was 3.1% after 25 years (95% confidence limits 0.0-6.8). The calculated lifetime risk (0 to 74 years) for development of colorectal cancer was 3.5% for the patients compared to 3.7% for the Danish population. We conclude that with an active approach to medical and surgical treatment as was practiced here, those patients who are left with their colon intact bear no significantly increased risk of colo-rectal malignancy.

Adolescent↗

Intestinal cancer risk and mortality in patients with Crohn's disease.

BACKGROUND: It is important to know about mortality, risk of intestinal cancer, and surgical intervention as well as possible predictive factors for patients with Crohn's disease. These prognostic parameters were estimated by regular follow-up of a complete, regional incidence cohort of 373 patients. METHODS: Annual assessments of clinical conditions were the basis for statistical evaluation with life table analysis, calculations of relative risk, and lifetime cancer risk. RESULTS: Survival curves for the total group of patients with Crohn's disease and the background population did not differ. However, a subgroup of patients aged 20-29 years at diagnosis (P = 0.04) and a subgroup of patients with extensive small bowel disease (P = 0.03) showed slightly increased mortality within the first 5 years. Cancer in small and/or large bowel occurred in 3 patients vs. an expected 1.8(P = NS). Small bowel cancer was found in 2 patients vs. the 0.04 expected (P = 0.001). Lifetime risk of intestinal cancer was 4.1% compared with 3.8% for the Danish population in general (P = NS). Probability of surgical resection within 15 years after diagnosis was 70%. The initial extent of disease significantly influenced the probability for resection, which was 78% in ileocecal enteritis and 44% in all other localizations within 5 years after diagnosis. CONCLUSIONS: The overall mortality and life-time risk of cancer in patients with Crohn's disease was not found increased, although the risk of rare small bowel cancer was significantly increased.

Adolescent↗

Sexual behaviour and attitudes of Danish middle-aged men-methodological considerations.

A Danish cohort-investigation of health risk-factors (started in 1976) included descriptions of the sexuality of the participants. This paper examines the validity/representativity of the results of the sexological investigation of the male participants, when in 1987 they were 51 years old. Remaining results will be published in separate articles about each main theme. The participants, 439 men, completed a questionnaire concerning sexuality (behaviour, attitudes and experience) and had their serum-LH and serum-free testosterone measured. Thereafter 100 of the 439 men were interviewed. The present examination shows that the participants are representative of same-aged men from all over Denmark concerning the sexological results. The answer ratio of the questionnaire was 70-95% and the non-responders of the questionnaire gave different interview answers than the rest. Complemented with their answers (answer ratio of nearly 100%) the interview results are more representative than the results of the questionnaire. The interview information is in this study considered more valid than the information obtained by the questionnaire--because the former more frequently than the latter contain answers embarrassing to the participants (e.g. high frequency of masturbation) or difficult for them to recall. The interview thereby adds vital information to that of the questionnaire.

Attitude↗

Climacteric complaints and their relation to menopausal development--a retrospective analysis.

The present study had two objectives: (1) to register the prevalence of a number of climacteric complaints in a Danish general population cohort and (2) retrospectively to test the validity of an association between climacteric complaints, menopausal development, occurrence of life events and social background. A postal questionnaire sent to the 51-year-old female population living in four Copenhagen suburbs, (N = 597, response rate = 88%) included information on menstrual pattern and change, hormonal treatment, socioeconomic data and a 4-year retrospective annual registration of prevalence of a number of climacteric complaints and life events. Logistic regression analyses performed on a restricted sample (women who experienced a natural menopausal development) revealed prevalence of hot flushes, moodiness and fatigue to be significantly associated with transitions in menopausal status. Fatigue, moodiness and depression were strongly associated with socio-economic variables. Life events were only occasionally associated with prevalence of the studied complaints.

Affect↗

Colorectal cancer risk and mortality in patients with ulcerative colitis.

A regional inception cohort of 1161 ulcerative colitis (UC) patients was followed up from diagnosis to the end of 1987. The follow-up rate for death and occurrence of cancer was 99.9% (median observation time, 11.7 years; range, 0-26 years). One hundred forty-one deaths were observed, 26 caused by UC or complications thereof. No significant excess mortality was found after the first year, but in the year of diagnosis the relative risk of death was 2.4 (P < 0.001). The cumulative colectomy rate 25 years after diagnosis was 32.4%. The initial extent of disease significantly influenced the colectomy probability, being 35% in total colitis, 19% in substantial colitis, and 9% in distal colitis within the first 5 years after diagnosis. Six patients developed colorectal cancer within the observation period. Compared with the expected number of 6.6, the relative risk for patients with UC was 0.9. The calculated cumulative cancer incidence was 3.1% after 25 years (95% confidence limits, 0.0-6.8). The calculated lifetime risk (0-74 years) for development of colorectal cancer was 3.5% for UC patients compared with 3.7% for the Danish population. It is concluded that with an active approach to medical and surgical treatment, as practiced here, patients whose colons are left intact bear no significantly increased risk of colorectal malignancy.

Adolescent↗

Predictors of five-year functional ability in a longitudinal survey of men and women aged 75 to 80. The 1914-population in Glostrup, Denmark.

Data from a longitudinal study of aging-a Danish substudy within a Nordic comparative longitudinal Research on Ageing study (NORA)-is presented. The goal is to highlight easily measured factors, that are relevant to prevention and postponement of disability in the elderly. In a population-based, representative sample, the objectives were: to describe five-year outcome regarding death and functional ability to age 75 to 80, as well as individual changes in muscle strength, physical performance in simple function tests and self-reported physical activity, and relate "risk markers" to five-year outcome. Baseline values were obtained in 405 participants in the 1989-survey of the 1914-cohort in Copenhagen County. The 307 survivors were invited for the survey of 80-year olds in 1995. Outcome was measured as death, non-participation, decline, stability or improvement in two measures of mobility function (tiredness and dependency). Between ages 75 and 80, 24% died, 12% did not participate in the follow-up, 23% became tired performing mobility functions, 20% did not change but 21% became less tired; 19% became more dependent, 44% remained stable and only 2% improved in relation to dependency on help in mobility functions. "Stability" in mobility functions was related to ability to mount stairs, walking speed, mood and physical activity. Number of chronic diseases and low pulmonary function were only related to mobility in men. Among people who improved their function, many had rather low baseline-values, suggesting regression to the mean. Multiple logistic regression was conducted. The follow-up survey found that female participants were more physically active at baseline than non-participants. Five-year mortality was independently related to physical activity (RR = 0.41), pulmonary function in men (RR = 0.45/l increase) and muscle strength in women (RR = 0.65/N/kg increase). Dependency at follow-up in men was related to low physical activity at baseline (RR = 4.14), disability to mount a 50-cm step (RR = 4.07), two or more chronic diseases (RR = 3.36) and, only marginally significant, knee extension strength. In women only low physical activity was predictive (RR = 4.32). From baseline to follow-up, 34% of the population had reduced their physical activities. Knee extension strength was reduced from 6.0 to 4.4 N/kg in men, and from 4.2 to 3.3 N/kg in women. In the stair-mounting test, 44% could only attain one or more 10 cm steps lower than at baseline. A dose-response-relationship of declining muscle mass to functional limitations was observed in men and women at the age of 75 as well as the age of 80.

Activities of Daily Living↗