Bispebjerg Hospital is one of the hospitals in the Capital Region of Denmark. Along with a number of other hospitals and the University of Copenhagen (the Faculty of Health Sciences), Bispebjerg Hospital forms part of the Copenhagen University Hospital. The hospital is a teaching hospital for medical students from Copenhagen University..
It remains undetermined whether gastrointestinal bleeding (GIB) associated with direct oral anticoagulant (DOAC) or vitamin K antagonists (VKA) is more severe. In Danish nationwide registries, we identified patients with atrial fibrillation (AF) treated with anticoagulation with gastrointestinal bleeding (GIB). Logistic regression models were used to compare GIB severity between DOAC and VKA users, defined by 1. red blood cell transfusion or in-hospital death and 2. endoscopies. From 2012–2018, 6,784 anticoagulated AF patients with GIB were identified; 3,724 patients VKA users and 3,060 DOAC (apixaban, dabigatran or rivaroxaban) users. The proportion of upper GIB was 49
This update and revision of the international guideline for urticaria was developed in accordance with the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is an initiative of the Global Allergy and Asthma Excellence Network (GA(2)LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), with the participation of 210 delegates from 107 national and international societies, from 59 countries. The consensus conference was held on December 6th, 2024. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease, defined by a rapid appearance of wheals, angioedema, or both. The lifetime prevalence of acute urticaria is estimated to be approximately 20%. Chronic urticaria, categorized as either chronic spontaneous urticaria or chronic inducible urticaria, is disabling, impairs quality of life, and affects performance at work and school, however, novel therapies are available. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.
INTRODUCTION:Patients who have undergone curative surgery for non-small cell lung cancer (NSCLC) often experience long-term reduced quality of life (QoL), high symptom burden, risk of physical deconditioning and comorbidity. Current Danish rehabilitation offers are heterogeneous and not specifically tailored to the disease-specific needs and no long-term targeted support is currently available. Previously, singing-delivered as a structured training modality-has conferred both physiological and psychological improvements in chronic obstructive pulmonary disease, which may likely be transferable to NSCLC, as the two conditions share overlapping symptoms and characteristics. We aim to explore whether a singing-based intervention improves physical function, QoL and symptom burden 6-18 months postsurgery in NSCLC. Moreover, we aim to explore the underpinning physiological mechanisms of singing. METHODS AND ANALYSIS:We will conduct a multicentre randomised controlled trial, comparing 10 weeks' online-delivered structured singing training to usual care. Trial outcomes include primary outcome, physical capacity (measure: Six-Minute Walking Test), and secondary outcomes, QoL and symptoms (measures: St. George's Respiratory Questionnaire (SGRQ); the European Organisation for Research and Treatment of Cancer Questionnaire (QLQ-C30; QLQ-LC13); Hospital Anxiety and Depression Scale (HADS) and airway physiology (measure: forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)). Explorative outcomes include aerobic fitness/maximal oxygen uptake (VO2-max); exercise-induced adaptations; respiratory muscle strength and control; inflammatory biomarkers. ANALYSIS:Descriptive statistics, stratified analyses, regression models and association and independence between objective and subjective outcomes. ETHICS AND DISSEMINATION:The trial was approved by the Committee on Health Research Ethics (SJ-1027) and the Danish Act on Processing of Personal Data (p-2024-19634). Results will be reported in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER:NCT07460999.
BACKGROUND:Smoking is associated with hidradenitis suppurativa (HS), but the clinical significance of smoking history is poorly understood. OBJECTIVES:To examine the impact of smoking history and change in smoking behaviour on disease severity and treatment outcomes in patients with HS. METHODS:Patients with hospital-diagnosed HS from two independent prospective cohorts, the Copenhagen Hidradenitis Suppurativa Cohort (HIS-COP) and the Danish Skin Cohort (DSC), were included. Data on Hurley stage, International Hidradenitis Suppurativa Severity Score System (IHS4), Dermatology Life Quality Index (DLQI), boil-associated pain and disease-related bother were extracted from HIS-COP to assess the association between smoking status at baseline and treatment outcomes. The DSC was used to assess the effect of change in smoking status on self-reported disease severity and DLQI. RESULTS:In HIS-COP (n = 787), current smoking (53.9%) was associated with being Hurley stage III relative to I (OR = 2.38, 95% CI: 1.02-5.56, p = 0.044), higher IHS4 (OR = 1.05, 95% CI: 1.01-1.10, p = 0.018), higher DLQI (OR = 1.06, 95% CI: 1.03-1.09, p < 0.001) and greater overall disease-related bother (OR = 1.14, 95% CI: 1.07-1.22, p < 0.001) relative to never smokers when adjusted for. Increasing pack years smoked and the number of cigarettes smoked per day were significantly associated with higher IHS4 (p < 0.01 and p < 0.05, respectively); however, after adjusting for age and sex, p > 0.05. Among patients initiated on tetracycline-class treatment, current smokers had a significantly smaller mean (SD) reduction in IHS4 (2.5 (3.2) vs. 4.7 (4.9), p < 0.001), DLQI (4.2 (6.2) vs. 6.0 (6.4), p < 0.05) and percentage reduction in overall disease-related bother (2.9 (4.0) vs. 4.3 (4.0), p < 0.05), compared to non-smokers at follow-up. Smoking cessation and initiation both showed a trend towards increased self-reported disease severity after 12 months follow-up; however, data were limited. CONCLUSIONS:Smoking is associated with greater disease severity, poorer quality of life and worse treatment outcomes among patients with HS.
BACKGROUND:Psoriasis is a chronic inflammatory skin disease, and the risk of developing cancer has been postulated due to the presence of several plausible underlying mechanisms. Understanding the association between psoriasis and cancer is imperative to the provision of optimal psoriasis care. OBJECTIVES:To examine the risk of developing cancer in individuals with psoriasis. METHODS:Population-based cohort studies were conducted in Denmark, England, Israel and Taiwan through the use of linked electronic health records. Individuals aged at least 18 years with a diagnosis of psoriasis in the country-specific study period were matched with up to six comparators with no record of psoriasis prior to the index date. Country-specific hazard ratios for the risk of cancer development overall and for 26 site-specific cancers between individuals with and without psoriasis were calculated through Cox regression. Country-specific estimates were pooled using random effects modelling. RESULTS:We included 702 022 individuals with psoriasis and 4 185 342 matched comparators. In models implicitly controlled for age, sex and calendar time by matching, there was a small association between psoriasis and cancer overall [pooled HR (pHR) 1.08, 95% confidence interval (CI) 1.04-1.13; I2 = 92.4%]. Adjustment for potential confounding factors resulted in a slight attenuation of risk (pHR 1.05, 95% CI 1.01-1.09; I2 = 81.2%). When restricted to those with moderate-to-severe psoriasis, the risk of cancer overall was slightly higher (pHR 1.16, 95% CI 1.04-1.28; I2 = 92.8%) than in confounder-adjusted models (pHR 1.09, 95% CI 1.03-1.15; I2 = 60.6%). Associations with psoriasis were present for oral cavity (pHR 1.29, 95% CI 1.12-1.47; I2 = 55.4%), pharynx (pHR 1.30, 95% CI 1.07-1.58; I2 = 58.4%), oesophagus (pHR 1.17, 95% CI 1.03-1.33; I2 = 56.6%), liver (pHR 1.53, 95% CI 1.33-1.77; I2 = 75.1%), pancreas (pHR 1.09, 95% CI 1.02-1.17; I2 = 0.0%), kidney (pHR 1.19, 95% CI 1.11-1.27; I2 = 0.0%), bladder (pHR 1.13, 95% CI 1.06-1.20; I2 = 28.7%) and keratinocyte cancers (pHR 1.37, 95% CI 1.16-1.63; I2 = 97.5%), and Hodgkin lymphoma (pHR 1.56, 95% CI 1.16-2.11; I2 = 69.7%), non-Hodgkin lymphoma (pHR 1.16, 95% CI 1.07-1.26; I2 = 35.5%) and leukaemia (pHR 1.18, 95% CI 1.08-1.29; I2 = 41.9%). Site-specific associations generally persisted, with slight risk exacerbations and additional associations for lung and ovarian cancers, when limited to people with moderate-to-severe psoriasis. CONCLUSIONS:Psoriasis was associated with an increased risk of developing 14 of 26 investigated site-specific cancers, including cancers with a poor prognosis, such as liver, lung and oesophageal cancer. Our findings can be used to reinforce cancer prevention strategies in psoriasis care.
