Publications by authors named "Povlsen J"

Background: Bacteraemia and infective endocarditis (IE) are rare but severe complications of transcatheter aortic valve implantation (TAVI). Limited data exist on the incidence and microbiological profile of early bacteraemia in this population. This study aimed to evaluate the 6-month incidence of bacteraemia, IE and associated mortality following TAVI.

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  • * A study utilizing Danish registries analyzed 4,748 patients with infective endocarditis before and after the POET trial publication, examining changes in hospital length of stay (LOS) and outcomes like mortality and relapse of bacteremia.
  • * Results showed a significant decrease in median LOS by 8 days post-POET publication, with no significant change in mortality rates but a notable reduction in relapse of bacteremia from 3.5% to 1.6%.
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Peritoneal dialysis adoption and technique survival is affected by limitations related to peritoneal membrane longevity and metabolic alterations. Indeed, almost all peritoneal dialysis fluids exploit glucose as an osmotic agent that rapidly diffuses across the peritoneal membrane, potentially resulting in metabolic abnormalities such as hyperglycemia, hyperinsulinemia, obesity, and hyperlipidemia. Moreover, glucose-degradation products generated during heat sterilization, other than glucose itself, induce significant morphological and functional changes in the peritoneum leading to ultrafiltration failure.

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Background: Evaluation of left ventricle (LV) systolic function in patients with aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) is challenging, as LV ejection fraction (LVEF) and global longitudinal strain are afterload dependent. LV global work indices (GWIs) estimate the afterload corrected systolic function.

Objectives: The purpose of this study was to evaluate changes in and prognostic implications of GWIs in subtypes of AS patients before and 1 month after TAVI.

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Step-down oral antibiotic therapy is associated with a non-inferior long-term outcome compared with continued intravenous antibiotic therapy in the treatment of left-sided infective endocarditis. We aimed to analyze whether step-down oral therapy compared with continued intravenous antibiotic therapy is also associated with a non-inferior outcome in patients with large vegetations (vegetation length ≥ 10 mm) or among patients who underwent surgery before step-down oral therapy. We included patients without presence of aortic root abscess at diagnosis from the POET (Partial Oral Antibiotic Endocarditis Treatment) study.

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  • The study aimed to evaluate the impact of mandatory preoperative dental screening (PDS) on the risk of infective endocarditis (IE) in patients undergoing transcatheter aortic valve implantation (TAVI), contrasting those who received mandatory PDS with those who did not.
  • Among 1,133 patients analyzed, the incidence of IE was similar between those who underwent mandatory PDS and those who did not, with 2.7% overall developing IE during the follow-up period, showing no significant difference in all-cause mortality.
  • The findings suggest that implementing mandatory PDS does not reduce the incidence of IE or improve overall mortality rates in TAVI patients, casting doubt on its
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Aims: The NatIonal Danish endocarditis stUdieS (NIDUS) registry aims to investigate the mechanisms contributing to the increasing incidence of infective endocarditis (IE) and to discover risk factors associated to the course, treatment and clinical outcomes of the disease.

Methods: The NIDUS registry was created to investigate a nationwide unselected group of patients hospitalized for IE. The National Danish healthcare registries have been queried for validated IE diagnosis codes (International Classification of Disease, 10 edition [ICD-10]: DI33, DI38, and DI398).

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Background And Aims: In the Partial Oral Treatment of Endocarditis (POET) trial, stabilized patients with left-sided infective endocarditis (IE) were randomized to oral step-down antibiotic therapy (PO) or conventional continued intravenous antibiotic treatment (IV), showing non-inferiority after 6 months. In this study, the first guideline-driven clinical implementation of the oral step-down POET regimen was examined.

Methods: Patients with IE, caused by Staphylococcus aureus, Enterococcus faecalis, Streptococcus spp.

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  • Peritoneal dialysis is recommended as a first-line treatment for kidney replacement, especially for vulnerable patients, but it often requires assistance that can involve family or specialized caregivers in institutional settings.
  • A group of nephrologists from 13 European countries shared their insights on implementing assisted peritoneal dialysis, discussing the challenges and solutions that can help establish effective programs.
  • The findings indicate that assisted peritoneal dialysis isn't a fixed approach and can be tailored to individual needs, allowing for flexible care options that can ultimately lead to greater patient autonomy.
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Background: Linezolid in combination with rifampicin has been used in treatment of infective endocarditis especially for patients infected with staphylococci.

Objectives: Because rifampicin has been reported to reduce the plasma concentration of linezolid, the present study aimed to characterize the population pharmacokinetics of linezolid for the purpose of quantifying an effect of rifampicin cotreatment. In addition, the possibility of compensation by dosage adjustments was evaluated.

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Introduction: The use of faecal microbiota transplantation (FMT) to eradicate intestinal carriage of multidrug-resistant organisms (MDRO) has been described in case reports and small case series. Although few in numbers, these patients suffer from recurrent infections that may exacerbate both the patients' comorbidities and their healths. In the current study, we hypothesized that FMT for MDRO-related urinary tract infections (UTIs) reduces hospitalisations and associated costs.

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Background: In the POET (Partial Oral Endocarditis Treatment) trial, oral step-down therapy was noninferior to full-length intravenous antibiotic administration. The aim of the present study was to perform pharmacokinetic/pharmacodynamic analyses for oral treatments of infective endocarditis to assess the probabilities of target attainment (PTAs).

Methods: Plasma concentrations of oral antibiotics were measured at day 1 and 5.

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The impact of left ventricle (LV) hypertrophy (LVH) regression on contractility-associated measures, the extent of residual cardiac dysfunction and prognostic implications after the initial remodeling process after transcatheter aortic valve replacement (TAVR) has not been investigated. We aimed to assess whether greater LV mass regression from pre-TAVR to 12-months after TAVR was associated with increased systolic function; and assess the prognostic value of residual LVH, systolic function and contractility-associated measures 12-months after TAVR. A total of 439 symptomatic patients were included and examined by echocardiography.

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Background: Valve surgery guidelines for infective endocarditis (IE) are unchanged over decades and nationwide data about the use of valve surgery do not exist.

Methods: We included patients with first-time IE (1999-2018) using Danish nationwide registries. Proportions of valve surgery were reported for calendar periods (1999-2003, 2004-2008, 2009-2013, 2014-2018).

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  • A study examined factors predicting early mortality in patients starting dialysis, finding that the first-year mortality rate was 19.33%.
  • Key independent predictors of death included advanced age, preexisting health conditions, and signs of inflammation or fluid overload at dialysis initiation.
  • Among patients who could choose their dialysis method, those opting for peritoneal dialysis (PD) and those receiving in-center hemodialysis (HD) had similar survival rates after 12 months.
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Background: Availability of assisted PD (asPD) increases access to dialysis at home, particularly for the increasing numbers of older and frail people with advanced kidney disease. Although asPD has been widely used in some European countries for many years, it remains unavailable or poorly utilized in others. A group of leading European nephrologists have therefore formed a group to drive increased availability of asPD in Europe and in their own countries.

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In this case report, a 41-year-old nullipara obtained pregnancy one and a half year after a simultaneous pancreas and kidney transplantation (SKP). After SKP, the woman had no need for insulin and no hypertension. Her kidney function was stable during pregnancy and no insulin was needed.

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Purpose: Self-assessed poor health status is associated with increased risk of mortality in several cardiovascular conditions, but has not been investigated in patients with endocarditis. We examined health status and mortality in patients with endocarditis.

Methods: This is a re-specified substudy of the randomized POET endocarditis trial, which included 400 patients.

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Objective: To assess the prevalence and severity of anaemia in patients with left-sided infective endocarditis (IE) and association with mortality.

Methods: In the Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis trial, 400 patients with IE were randomised to conventional or partial oral antibiotic treatment after stabilisation of infection, showing non-inferiority. Haemoglobin (Hgb) levels were measured at randomisation.

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Background: In patients with end-stage kidney disease (ESKD), home dialysis offers socio-economic and health benefits compared with in-centre dialysis but is generally underutilized. We hypothesized that the pre-dialysis course and institutional factors affect the choice of dialysis modality after dialysis initiation (DI).

Methods: The Peridialysis study is a multinational, multicentre prospective observational study assessing the causes and timing of DI and consequences of suboptimal DI.

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Background: To ensure high quality standards in chronic care of type 2 diabetes, it is paramount to ensure regular measurement of clinical risk factors. For prevention of diabetic kidney disease, testing for albuminuria and kidney function is vital. The majority of individuals with type 2 diabetes in Denmark are treated in general practice, and given the recent development of kidney-protective treatments, a renewed focus on renal risk factors is important.

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Background: Despite early referral of uraemic patients to nephrological care, suboptimal dialysis initiation (SDI) remains a common problem associated with increased morbimortality. We hypothesized that SDI is related to pre-dialysis care.

Methods: In the 'Peridialysis' study, time and reasons for dialysis initiation (DI), clinical and biochemical data and centre characteristics were registered during the pre- and peri-dialytic period for 1583 end-stage kidney disease patients starting dialysis over a 3-year period at 15 nephrology departments in the Nordic and Baltic countries to identify factors associated with SDI.

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A multitargeted strategy to treat the consequences of ischemia and reperfusion (IR) injury in acute myocardial infarction may add cardioprotection beyond reperfusion therapy alone. We investigated the cardioprotective effect of mild hypothermia combined with local ischemic preconditioning (IPC) or remote ischemic conditioning (RIC) on IR injury in isolated rat hearts. Moreover, we aimed to define the optimum timing of initiating hypothermia and evaluate underlying cardioprotective mechanisms.

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  • The study aimed to analyze how common impaired left ventricular global longitudinal strain (LVGLS) is in elderly patients with symptomatic aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) and its impact on survival.
  • Among 411 patients treated over five years, 75% showed impaired LVGLS, while 60% had preserved left ventricular ejection fraction (LVEF).
  • Impaired LVGLS greater than -14% was identified as a significant independent predictor of all-cause mortality, indicating that even with preserved LVEF, reduced LVGLS signals a higher risk of death post-procedure.
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