Expert Nordic perspectives on the potential of novel inhalers to overcome unmet needs in the management of obstructive lung disease.

The effective self-management of obstructive lung disease is dependent upon the patient achieving good inhaler technique. However, many current inhalers are complicated to use, which may lead to handling difficulties. These difficulties can cause clinically relevant errors, whereby pharmacotherapy fails to achieve adequate lung deposition and therapeutic effect.

Direct and indirect economic and health consequences of COPD in Denmark: a national register-based study: 1998-2010.

Objective: Chronic obstructive pulmonary disease (COPD) is among the leading causes of morbidity and mortality worldwide, but longitudinal studies of the economic consequences of COPD are scarce. This Danish study evaluated for the first time ever the economic consequences of COPD of an entire nation before and after the diagnosis.

Setting: Records from the Danish National Patient Registry (1998-2010), direct and indirect costs, including frequency of primary and secondary sector contacts and procedures, medication, unemployment benefits and social transfer payments were extracted from national databases.

Economic and health consequences of COPD patients and their spouses in Denmark--1998-2010.

Objective: Chronic Obstructive Pulmonary Disease (COPD) is among the leading causes of morbidity and mortality worldwide, but longitudinal studies of the economic consequences of COPD are scarce. This study evaluated the economic consequences of COPD patients in Denmark and their spouses at a national level before and after initial diagnosis.

Methods: Using records from the Danish National Patient Registry (1998-2010), 171,557 patients with COPD and 86,260 spouses were identified; patients were compared with 664,821, and the spouses with 346,524, all controls were randomly selected and matched for age, gender and residence.

New Danish reference values for spirometry.

Introduction: International recommendations state that reference values for lung function should derive from cross-sectional studies of healthy nonsmokers and be renewed from time to time because of cohort effect and newer, more accurate, technical equipment. In 1986, the Danish Lung Society published reference values for spirometry based on 570 individuals aged 30-70 years.

Objectives: To produce new reference values for lung function and to extend the existing values by including individuals between 20 and 30 years of age and older than 70 years of age.

Expression of CCR2 on monocytes and macrophages in chronically inflamed skin in atopic dermatitis and psoriasis.

Monocytes form a significant component of the inflammatory reaction taking place in the skin of atopic dermatitis and psoriasis. Chemokines are pivotal in mediating the attraction of leucocytes to sites of inflammation. The CC-chemokine, monocyte chemotactic protein 1 (MCP-1/CCL2), is expressed by keratinocytes in both atopic dermatitis and psoriasis.

TARC augments TNF-alpha-induced CTACK production in keratinocytes.

Thymus- and activation-regulated chemokine (TARC)/CCL17 and cutaneous T cell-attracting chemokine (CTACK)/CCL27 are both pivotal mediators of the inflammatory reaction of atopic dermatitis (AD). TARC attracts CCR4 positive T cells known to be mainly of Th2 subtype whereas CTACK attracts skin-homing T cells of both Th1 and Th2 subtype that express CCR10. We found that CTACK can be induced in cultured human keratinocytes by tumor necrosis factor-alpha (TNF-alpha), but not by TARC alone.

The quality of routine oral anticoagulant therapy in a large geographical area. A survey of 310,300 inhabitants.

Introduction: To identify all patients undergoing routine oral anticoagulant therapy (OAT) in a large geographic area as well as the quality of OAT.

Methodology: In the admission area of Aarhus County Hospital, Denmark (310,300 inhabitants), we conducted a population-based prospective observational study 1 April 1997 to 31 March 1998, using the Laboratory Information System to identify all patients and their related International Normalized Ratio (INR)-values as well as their monitoring physician. Main outcome measures were, incidence rate, point prevalence and the quality of OAT based on measurement of the time (in days) of INR-values within therapeutic interval (TI) of OAT.

Accuracy of magnetic resonance imaging in the diagnosis of deep vein thrombosis in asymptomatic patients with injuries of the lower extremity. A pilot study.

This is a prospective comparative study of magnetic resonance imaging (MRI) of the deep veins versus contrast venography in consecutive patients treated for various injuries to their lower extremities, showing no clinical symptoms of deep vein thrombosis. The majority of examinations referred to in this study were performed according to the following methodology: First, the patient was subjected to MRI. Subsequently, within a 24-h interval, he/she was subjected to contrast venography.

Sauvé-Kapandji operation for disorders of the distal radioulnar joint after Colles' fracture. Good results in 12 patients followed for 1.5-4 years.

Controversies continue concerning the treatment of the posttraumatic caput ulna syndrome. We have treated 12 patients, mean age 42 (23-77) years, with arthrodesis ad modum Sauvé-Kapandji of the distal articulation between the radius and ulna, combined with resection of the ulnar neck. Before the operation, all patients had persistent ulnar wrist pain and restricted pronation-supination movement.

Effects of diabetes, insulin treatment, and osmolality on contractility of isolated rat resistance arteries.

The effects of osmolality, diabetes, and insulin-treatment on microvascular contractility were examined in mesenteric resistance arteries (internal diameter approximately 250 microns) isolated from streptozotocin-induced diabetic rats, streptozotocin-induced diabetic rats treated with 1-3 U insulin/day during the week before being killed, and age- and sex-matched control rats. Vessels were mounted in a microvascular myograph for isometric tension recording and responses were generated in physiological salt solutions with varying amounts of glucose or mannitol added. The passive response (expressed as the diameter the vessels would maintain if relaxed and exposed to a transmural pressure of 100 mmHg), the maximal response to noradrenaline, and the response produced by partial depolarization with 50 mmol/l potassium were not dependent on glucose or mannitol concentrations of the bathing medium; also, these responses were not dissimilar in vessels from the three groups of rats tested.

A comparative analysis of burn injuries at two burns centres in Denmark.

In order to compare the epidemiology of burns and predisposing factors to burns at two burn centres representing the cities of Aarhus and Copenhagen, Denmark, a prospective study was set up at the University Department of Orthopedic Surgery and Traumatology, Aarhus and the Centre of Plastic Surgery and Burns Unit, Hvidovre Hospital, Denmark. Several significant differences in the epidemiology of burns in the two populations were found. Considering the social circumstances, the situation in Aarhus was characterized by the fact that most patients lived in their own houses, had a larger family and a larger family income.

Platelet-derived growth factor release and antiplatelet treatment with low-dose acetylsalicylic acid.

Platelet-derived growth factor (PDGF) and beta-thromboglobulin (beta-TG) are released from alpha granules during platelet activation. PDGF may play a role in the development of atherosclerosis and the late restenosis after percutaneous transluminal coronary angioplasty (PTCA). The effect of acetylsalicylic acid (ASA) on PDGF release was studied in healthy volunteers before and twelve hours after ingestion of 300 mg ASA.

Distribution of hydroxylated vitamin D metabolites [25OHD3 and 1,25(OH)2D3] in domestic pigs: evidence that 1,25(OH)2D3 is stored outside the blood circulation?

1. The distribution of 25-hydroxycholecalciferol (25OHD3) and 1,25-dihydroxycholecalciferol [1,25(OH)2D3] in various organs from domestic pigs was examined by HPLC. 2.

A PvuII polymorphism of the low density lipoprotein receptor gene is not associated with plasma concentrations of low density lipoproteins including LP(a).

Lipoprotein(a) [Lp(a)] is a low density lipoprotein (LDL), in which apolipoprotein B-100 (apo B-100) is attached to apolipoprotein(a) [apo(a)], a glycoprotein of variable size. Lp(a) may be as atherogenic as LDL. In normal populations, Lp(a) concentrations in plasma are largely determined by the apo(a) gene locus on chromosome 6, but regulation of synthesis and catabolism of Lp(a) is poorly understood.

Sauvè-Kapandji operation for disorders of the distal radioulnar joint.

A series of 13 patients is reported in which a Sauvè-Kapandji procedure consisting of arthrodesis of the articulation between the radius and ulna combined with resection of the collum ulnae was used to treat posttraumatic caput ulnae syndrome. Among the nine female and four male patients whose median age was 42 years (range: 23 to 77 years), nine sustained a distal fracture that had healed with shortening of the radius or with subluxation of the caput ulnae. Median postoperative observation time was 16 months (range: six to 27 months).

CA 125 measurements in ovarian cancer patients during their first postoperative week.

Cancer antigen 125 (CA 125) was measured in 17 patients with ovarian carcinoma before their primary operation and during the first week after surgery. The purpose was to correlate the change in the antigen level with the patient's survival. Before surgery normal (16-30 U ml-1 CA 125 values were measured in four patients and 13 had increased (75-11.

Bursting strength of experimental colonic anastomoses. A methodological study.

This study was performed to evaluate the validity of the bursting strength test of experimental anastomoses. By a combination of measuring the intraluminal physiological pressure during the test procedure with a radiological detection of the anastomosed intestinal segment until disruption it was demonstrated that the bursting pressure is a meaningful parameter since the maximum pressure equals the time of anastomotic leak. At day 6 60% of the tested segments disrupted outside the anastomotic line.

Reference values for vertebral heights in Scandinavian females and males.

Vertebral heights were measured on lateral spine radiographs covering T4-L5 in 113 healthy Caucasian volunteers (73 females aged 22-80 years, and 40 males aged 22-79 years). Vertebral heights were significantly higher in men than in women (p < 0.001).

Effects of short-term growth hormone treatment on PTH, calcitriol, thyroid hormones, insulin and glucagon.

We measured changes in serum insulin-like growth factor-1 (IGF-1), calcitriol, parathyroid hormone (PTH), thyroid hormones, insulin, and plasma glucagon in response to seven days of treatment with a pharmacological dosage of recombinant human growth hormone (r-hGH) (0.1 IU/kg sc twice daily) or placebo in 20 normal male volunteers to evaluate whether the effect of r-hGH on biochemical bone markers could be attributed to changes in these hormones. Serum IGF-1 (p < 0.

Effects of a short course of oral phosphate treatment on serum parathyroid hormone(1-84) and biochemical markers of bone turnover: a dose-response study.

To investigate the possible use of oral phosphate as an activator of bone remodeling in coherence treatment of osteoporosis, 82 postmenopausal females, aged 50-75 years, were randomized to treatment with oral phosphate (750, 1500, or 2550 mg/day) or placebo for 7 days and followed for 4 months thereafter. All patients had sustained at least one previous fracture of the distal forearm and had a bone mineral content of the contralateral forearm or bone mineral density of the lumbar spine lower than normal mean for age. Urinary phosphate/creatinine ratio increased in a dose-dependent fashion during treatment (P less than 0.

Differences in apolipoprotein (a) polymorphism in west Greenland Eskimos and Caucasian Danes.

Previous studies in Greenland suggest that death rates from ischemic heart disease [IHD] are lower in Eskimos than in Danes and other Caucasian populations. This has been explained by a high intake of n-3 polyunsaturated fatty acids with beneficial effects on blood lipids and hemostasis. In other populations, lipoprotein(a) [Lp(a)] is associated with IHD, plasma concentrations of Lp(a) being genetically determined to a major extent.

Postoperative infection and natural killer cell function following blood transfusion in patients undergoing elective colorectal surgery.

The frequency of infection in 197 patients undergoing elective colorectal surgery and having either no blood transfusion, transfusion with whole blood, or filtered blood free from leucocytes and platelets was investigated in a prospective randomized trial. Natural killer cell function was measured before operation and 3, 7 and 30 days after surgery in 60 consecutive patients. Of the patients 104 required blood transfusion; 48 received filtered blood and 56 underwent whole blood transfusion.

Generation of analytic plasma lipoprotein profiles using two prepacked superose 6B columns.

A simple, low-priced chromatographic system to generate plasma lipoprotein profiles from total human plasma was tested with plasma from normolipidemic subjects and patients with heterozygous familial hypercholesterolemia, hyper-alpha-lipoproteinemia, lipoprotein lipase deficiency, familial dysbetalipoproteinemia and familial lecithin-cholesterol-acyl-transferase deficiency. The system appears to be a good alternative to more expensive high-pressure liquid chromatography systems, notably in lipoprotein laboratories already provided with equipment for column chromatography. If a microplate photometer and a computer is available in the laboratory, the measurement of various lipids in 70-80 eluant fractions from the columns can be simplified.

Apolipoprotein E polymorphism in a Danish population compared to findings in 45 other study populations around the world.

Apolipoprotein E (apoE) phenotypes were determined in a random sample of 466 Danish men born in 1948. The frequencies of the common alleles of the apoE gene were (with 95% confidence intervals) epsilon 2 = 0.085 (0.

Epidemiology of acute knee injuries: a prospective hospital investigation.

During a 1-year period, data on all acute injuries treated at emergency departments were entered into a registry; of these injuries, 6% involved the knee joint. The patients were followed until a definite diagnosis was established. The rate of anterior cruciate ligament injuries and meniscus tears was, respectively, 0.