Abstracts · hos patienter med ileostomi eller kolostomi 10.00 KAFFEPAUSE - mød dine forskerkolleger 10.40 KEY NOTE SPEAKERS - Chairman: Professor Lone Skov Professor Inge Marie

AbstractsForskningens Dag 2017 Herlev og Gentofte Hospital

Forskningens Dag16. november 2017Store Auditorium • Herlev-matriklenAlle ansatte er velkomne - ingen tilmelding

9.00 VELKOMST v/ vicedirektør Steen Werner Hansen 9.15 MUNDTLIGE PRÆSENTATIONER - Chairman: Professor Inge Marie Svane Anna-Karin Numé: Post-discharge risk of fall-related injuries among adult

patients with syncope Lina Khoury: A prospective Randomized Control Trial of Patient-initiated care

consultations for Patients with Psoriasis Maria Lerche Mace: Fibroblast growth factor 23 regulates PTH levels through

FGF receptor signaling in vivo in normocalcemia, but not at low calcium Rune Martens Andersen: Incidens og risikofaktorer for parastomal buledannelse

hos patienter med ileostomi eller kolostomi

10.00 KAFFEPAUSE - mød dine forskerkolleger

10.40 KEY NOTE SPEAKERS - Chairman: Professor Lone Skov Professor Inge Marie Svane, leder af Center for Cancer Immun Terapi: Immuno-combos i cancerbehandlingen Professor Stig E. Bojesen, Klinisk Biokemisk Afdeling: Risikostratificeret Screening: Metoder og Evidens Professor Flemming Pociot, Steno Diabetes Center Copenhagen: Er epigenetik en betydende faktor ved type 1 diabetes?

11.45 POSTERPRÆSENTATIONER OG FROKOST - på Balkonen og i Store Mødesal

13.15 MUNDTLIGE PRÆSENTATIONER - Chairman: Professor Gunnar Gislason Rasmus Bo Hasselbalch: The Copenhagen Triage Algorithm is superior to a tradi-

tional triage algorithm Hafsa Ismail: Prognostic Factors in Malignant Melanoma Kristiane Aasen Engebretsen: Prevalence of atopic dermatitis in infants by

domestic water hardness and season of birth Christina Friese: Immune Checkpoint Blockade to Improve Tumor-Infiltrating

Lymphocytes for Adoptive Cell Therapy in Metastatic Ovarian Cancer

14.00 KAFFEPAUSE OG SMS-AFSTEMNING 14.20 FINALE FOR SEKS UDVALGTE POSTERS MED SMS-AFSTEMNING

15.15 PRISOVERRÆKKELSER OG AFSLUTNING v/ Steen Werner Hansen

Herlev og Gentofte Hospital

Arrangør: Forskningsrådet på Herlev og G

entofte Hospital

KEYNOTE SPEAKERE ved FORSKNINGENS DAG 16. NOVEMBER 2017 på HERLEV OG GENTOFTE HOSPITAL

- Chairman Steen Werner

På Herlev og Gentofte Hospital har vi flere excellente forskningsmiljøer, som gerne vil dele deres erfaringer med os – her følger en kort præsentation af hver enkelt.

Forskningsgruppe T1D Biology på Steno Diabetes Center Copenhagen

Er epigenetik en betydende faktor ved type 1 diabetes?

Flemming Pociot og hans forskningsgruppe forsker i type 1-diabetes med særlig fokus på de tidlige stadier af sygdomme.

Professor Stig E. Bojesen

Professor Inge Marie Svane

Klinisk Biokemisk afdeling

Risikostratificeret Screening: Metoder og Evidens

Vores egen forskningsindsats bygger primært på undersøgelser af store befolknings- og patientgrupper, hvor vi udforsker sygdomsmekanismer og forsøger at identificere, beskrive og kvalificere biomarkører fra blod, der kan have betydning for screening, diagnostik, prognose og behandlingsvalg.

Professor Flemming Pociot

Center for Cancer Immun Terapi

Immuno-combos i cancerbehandlingen

Center for Cancer Immunterapi blev dannet i 2006 med det formål at forene basal og klinisk forskning i cancer immunologi og immunterapi. Vi har fokus på translationel forskning med afdækning af immun-mekanismer og afprøvning af immunstrategier i klinikken. CCIT er førende i Europa indenfor den særlige T-celleterapi baseret på tumor-infiltrerende T-celler og har afdækket nye immunmekanismer der danner grundlag for udvikling af immunregulerende cancervacciner.

FORSKNINGENS DAG 2017på Herlev og Gentofte Hospital

ABSTRACTS

Nr. NAVN AFDELING TITEL

M1 Anna-Karin Numé HjertemedicinskPost-discharge risk of fall-related injuries among adult patients with syncope: a nationwide cohort study

M2 Lina R. Khoury Hud- og Allergiafd. A prospective Randomized Control Trial of Patient-initiated care consultations for Patients with Psoriasis

M3 Maria Lerche Mace Nefrologisk

Fibroblast growth factor 23 (FGF23) regulates PTH levels through FGF receptor signaling in vivo in normocalcemia, but not at low calcium

M4 Rune Martens Andersen GastroenhedenIncidens og risikofaktorer for parastomal buledannelse hos patienter med ileostomi eller kolostomi

M5 Rasmus Bo Hasselbalch HjertemedicinskThe Copenhagen Triage Algorithm is superior to a traditional triage algorithm: a cluster-randomized study

M6 Hafsa IsmailKlinisk Biokemisk

Afdeling Prognostic Factors in Malignant Melanoma

M7Kristiane Aasen Engebretsen Hud- og Allergi

Prevalence of atopic dermatitis in infants by domestic water hardness and season of birth: Cohort study

M8 Christina Friese CCIT

Immune Checkpoint Blockade to Improve Tumor-Infiltrating Lymphocytes for Adoptive Cell Therapy in Metastatic Ovarian Cancer

A1 Agnes Schmidt Davidsen HjertemedicinskThe development of the mean pulmonary artery pressure during the first 14 days of life

A2 Anders Nordholm NefrologiskThe contralateral kidney is protected against fibrosis in unilateral ureter obstructed (UUO) rats

A3 Anne Mørup-Petersen OrtopædkirurgiskKnee osteoarthritis patients can provide useful information about knee range of motion

A4

Ann-Marie Schoos v/Morten Arendt Rasmussen

Børne- og Ungeafd. COPSAC

Sensitization trajectories in childhood revealed by using a cluster analysis.

A5 Asja KunøeBørne- og Ungeafd.

COPSACEffects of inhaled corticosteroids during the first 6 years of life on height and bone mineral content

A6 Astrid SevelstedBørne- og Ungeafd.

COPSACTime trends of chronic immune disorders in the Danish population

A7 Bjarke Borregaard Medici Medicinsk afd.Changes in prescription practices when treating hypothyroidism between 2001 and 2015 – A register based study.

A8 Asbjørn Hasselager

Copenhagen Academy for Medical Education

and Simulation International Delphi consensus on the assessment of laypersons' Paediatric Basic Life Support Skills

A9 Bojan Kovacevic GastroenhedenFirst clinical results with a novel EUS-guided through-the-needle microbiopsy forceps for improved diagnostics of pancreatic cysts

A10 Camilla Groth Børne- og Ungeafd.Predictors for the clinical course of Tourette syndrome: a longitudinal study

A11 Caroline A. Gjørup Plastikkirurgisk Melanoma-related limb lymphoedema

B12 Carsten R HamannHud- og Allergi & Hjertemedicinsk

The effects of season and weather on healthcare utilization among patients with atopic dermatitis: A population-based study

B13Christian Fuglesang S. Jensen v/Peter Østergren Urologisk

Male infertility problems of patients with sperm morphology between 5-14%

B14 Christina Kruuse * NeurologiskWeb-Based Tele-Rehabilitation in Stroke Patients – A Randomized Controlled Pilot Study *

B15 Christoffer Blegvad Hud- og Allergi Autoimmune Disease in Children and Adolescents with Psoriasis: A Cross-Sectional Study in Denmark


ABSTRACTS

B16 Emilie Pi FogtmannGynækologisk

Obstetrisk The influence of gestational age on intelligence, attention, and executive function in 5-year-old children: a cohort study

B17 Evelina Martinenaite CCIT Targeting arginase in tumor microenvironment

B18 Flora Lind Sigvardt Hjertemedicinsk Perikarditis

B19 Frederik Dalgaard HjertemedicinskRisk Factors and a Novel Risk Score of Predicting Pacemaker Implantation in Patients with Atrial Fibrillation

B20Hanne Winther Frederiksen

Medicinsk - Forskningsenhed for

Klinisk Sygepleje

Major inequities in uptake of secondary prevention following acute coronary syndrome among migrants compared to Danish born

B21 Hugin Reistrup

Gastroenheden, Center for Perioperativ

Optimering Watchful waiting ved ventral- og ingvinalhernier

B22 Jeanne Avlastenok Urologisk A descriptive study of experienced burden by spouses living with men undergoing androgen deprivation therapy for prostate

C23 Jens Heller FrederiksenBørne- og Ungeafd.

COPSACPersonalized prevention of childhood asthma by high-dose vitamin D supplement in pregnancy based on genotype

C24Joachim Hjalde Halmsted Olsen


Optimering

The effect of type of anesthesia on urinary retention and mortality after open inguinal hernia repair: a systematic review and meta-analysis

C25 Jonathan ThorsenBørne- og Ungeafd.

COPSAC Succession of the vaginal microbiota during pregnancy and birth

C26 Julie Anna SlavenskyGynækologisk

Obstetrisk AfdelingBinge drinking in early pregnancy and the association with fetal growth

C27 Julie S.H. SølbergHud- og Allergiafd.

Videncenter for Allergi The tape-strip technique: How far into the skin do we come?

C28 Julie Westerlin Kjeldsen CCIT

Combination therapy with Nivolumab and PD-L1/IDO peptide vaccine to patients with metastatic melanoma. A clinical trial in progress.

C29 Kasper Mølgaard Jensen HæmatologiskDevelopment of a Chimeric Antigen Receptor T cell Therapy Platform at Herlev Hospital

C30Katrine Lyders Johansen v. Mette Mou Garborg

Afdeling for Ergoterapi og Fysioterapi

Modificeret ”Functional Reach” test er reliabel til hospitalsindlagte patienter med apopleksi

C31

Katrine Lyders Johansen v.Katrine Sejberg Rasmussen


Move it to improve it (Mitii) – Betydning af virtual reality træning for patienter med apopleksi - en eksplorativ interviewundersøgelse

C32 Katrine T. CallesenHud- og Allergi, Allergiklinikken

Does common enzymatic activity predict cross-reactivity? – a study of phospholipase A1 in different species

C33Klara Kvorning Ternov v/Peter Busch Østergren Urologisk

Herlev Enzalutamid versus Abirateron Toksicitet studie (HEAT): et studie protokol

D34 Lars H. BlomHud- og Allergiafd.

Allergiklinikken

Circulating allergen-specific Th2 lymphocytes: CCR4+ rather than CLA+ is the predominant phenotype in peanut allergic subjects

D35 Line Schmidt


OptimeringRecurrence after inguinal hernia repair in women: a systematic review

D36 Lise Andersen Anæstesiologisk

Transition fra intensivafdelingen til sengeafdelingen – oplevelset af patienter, pårørende, intensiv- og sengeafdelingssygeplejersker

D37 Magnus Pedersen CCITAdoptive Cell Therapy with Tumor-infiltrating Lymphocytes for Patients with Metastatic Ovarian Cancer: A Pilot Study.

D38Maria Anna Bruusgaard-Mouritsen

Hud- og Allergiafd. Videncenter for Allergi Naturlige ingredienser i kosmetik

D39 Maria Axtoft Munk Pedersen Børne- og Ungeafd.

A Danish version of the McMaster Family Assessment Device for children and adolescents with type 1 diabetes: A validation and clinical relevance


ABSTRACTS

D40 Maria Buhl BorgstrømGynækologisk-

obstetrisk Afdeling

Donation af æg - Et kvalitativt studie af kvinders motiv for og holdninger til ægdonation samt deres oplevelser på fertilitetsklinikken

D41 Maria Rothgart Petersen Afdeling for Ergoterapi

og Fysioterapi

sekunders rejse-sætte-sig test til patienter i testosteronsænkende behandling for prostatacancer

D42 Marianne Krogsgaard GastroenhedenLiving with a parastomal bulge – patients’ experiences of symptoms

D43Marie Christine Wulff Westergaard CCIT

Tumor-reactive T cell subsets in the microenvironment of ovarian cancer

D44 Martin Schultz Hjertemedicinsk TRIAGE III – A cluster-Randomized trial on the effect of introducing a prognostic biomarker in Emergency medicine

E45Mathias Aagaard Christensen Hjertemedicinsk

Secondary stroke prophylaxis in atrial fibrillation patients with chronic kidney disease

E46 Mette Schmidt UrologiskOvergang fra superviseret til selvstændig træning: erfaringer fra mænd med prostatacancer

E47UDGÅR Mia Thorup Lundsager CCIT

PD-L1-specific T cells can be activated by interferon-y and have an anti-tumor effect

E48 Moïra DionBørne- og Ungeafd.

COPSAC Early life gut microbiome evolution tracked by CRISPR typing

E49 Morten Nielsen Onkologisk CCIT

Preclinical Development of Tumor-Infiltrating Lymphocyte (TIL) based Adoptive Cell Transfer (ACT) immunotherapy for patients with sarcoma and the potential benefit of anti-CD137 stimulation

E50 Nikolai Dyrberg LoftHud- og

allergiafdelingen Associations between functional polymorphisms and response to biological treatment in Danish patients with psoriasis

E51 Pia Elisabeth NørrisgaardBørne- og Ungeafd.

COPSAC

Vitamin D high-dose supplementation in pregnancy reduces developmental dental defects (Molar Incisor Hypomineralization) in off-spring

E52Rebecca K Vinding * & Astrid Sevelsted

Børne- og Ungeafd. COPSAC

Fish-oil supplementation in pregnancy causes a proportional increase in lean mass, bone mass and fat mass at 6 years: A Randomized, Controlled, Double-Blind, Clinical Trial

E53 Rikke WiingreenBørne- og Ungeafd. & Neonatalklinikken, RH

Dose-effect association between gestational age and school difficulties - a Danish population-based register study.

E54 Rune Sort Anæstesiologisk

Peripheral nerve block anaesthesia is superior to spinal anaesthesia concerning postoperative pain control in primary ankle fracture surgery: results from the randomised “AnAnkle Trial”

E55 Sanam Nusrat Tahir HjertemedicinskImportance of dosage among long-term digoxin users with Atrial Fibrillation – Results from nationwide registries

F56 Shamaila Munir Ahmad HæmatologiskThe inhibitory checkpoint, PD-L2, is a target for effector T cells: Novel possibilities for immune therapy

F57 Shiraz ShahBørne- og Ungeafd.

COPSACEarlyVir: The early life gut virome and what it means for the development of auto immune diseases

F58 Siv Fonnes


Optimering

The pharmacokinetics of fosfomycin and metronidazole after intraperitoneal administration in patients undergoing appendectomy for uncomplicated appendicitis

F59 Siv Fonnes


Optimering

The safety of intraperitoneal administration of fosfomycin, metronidazole, and rhGM-CSF in patients undergoing appendectomy for appendicitis: a phase II clinical trial

F60Stina Öberg & Kristoffer Andresen


Optimering

Gradual decline in prevalence of chronic pain after laparoscopic groin hernia repair: a nationwide cross-sectional questionnaire study

F61 Stine Møller Sildorf Børne- og Ungeafd.Poor metabolic control in children with type 1 diabetes and psychiatric comorbidity.

F62 Suzanne F Herling Anæstesiologisk

“Exploration of reflections and motivations during the citation process conducted by interdisciplinary authors of scientific papers– a qualitative interview study”.


ABSTRACTS

F63 Tarunveer Singh AhluwaliaBørne- og Ungeafd.

COPSACUncovering novel genes, pathways and potential drug targets for severe childhood asthma

F64 Tilde Rasmussen


OptimeringCharacterization of abdominal surgical diseases associated with Yersinia infections: a systematic review

F65 Tilde Rasmussen


Optimering Long-term complications of appendectomy: a systematic review

F66 Yuki Andersen Hud- og Allergi Autoimmune diseases in adults with atopic dermatitis

FORSKNINGENS DAG 16. november 2017

M 1

Abstract-titel:

Post-discharge risk of fall-related injuries among adult patients with syncope: a nationwide cohort study Præsenteres af: Anna-Karin Numé

Stillingsbetegnelse: Klinisk assistent Forfatter(e):

Anna-Karin Numé* MD Afdeling:

Hjertemedicinsk Afdeling, Gentofte

Medforfatter(e) og afdeling:

N Carlson†, ‡; TA Gerds§; E Holm||; J Pallisgaard*; KB Sondergaard*; ML Hansen*; M Vinther¶; J Hansen*; G Gislason*, †; C Torp-Pedersen††; MH Ruwald* *Department of Cardiology, Copenhagen University Herlev Gentofte Hospital; †The Danish Heart Foundation, Copenhagen; ‡Department of Internal Medicine, Holbaek Hospital; §Department of Public Health, Section of Biostatistics, University of Copenhagen; ||Department of Internal Medicine, Nykobing Falster Hospital; ¶Department of Cardiology, Rigshospitalet; ††Departments of Cardiology and Clinical Epidemiology, Aalborg University Hospital

E-mail adresse: [email protected] / [email protected]

Abstract Introduction: Syncope could be related to high risk of falls and injury in adults, but documentation is sparse. We examined the association between syncope and subsequent fall-related injuries in a nationwide cohort. Methods: By individual-level linkage of nationwide registries, all residents ≥18 years with a first-time diagnosis of syncope were identified from 1997 through 2012. Syncope patients were matched 1:1 with individuals from the general population by year of birth and sex. The absolute 1-year risk of fall-related injuries, defined as fractures and traumatic head injuries requiring hospitalization, was calculated using the Aalen-Johansen estimator. Ratios of the absolute 1-year risk of fall-related injuries (ARR) were assessed by multiple absolute risk regression analysis. Results: We identified 125,763 patients with syncope: median age 65 years (IQR 46-78). At 1 year, follow-up was complete for 99.8% where a total of 8394 (6.7%) patients sustained a fall-related injury requiring hospitalization, of which 1606 (19.1%) suffered hip fracture. In the matched reference group, 4049 (3.2%) persons had a fall-related injury. The 1-year ARR of a fall-related injury was 1.79 (95% confidence interval 1.72-1.87, P<0.001) in patients with syncope compared with the reference group; however, increased ARR was not exclusively in older patients. Factors independently associated with increased ARR of fall-related injuries in the syncope population were: injury in past 12 months, 2.39 (2.26-2.53), injury in relation to the syncope episode, 1.62 (1.49-1.77), and depression, 1.37 (1.30-1.45). Conclusions: Patients with first-time syncope were at 80% increased risk of severe fall-related injuries within the year following discharge.


M 2

Abstract-titel:

A prospective Randomized Control Trial of Patient-initiated care consultations for Patients with Psoriasis Præsenteres af: Lina R. Khoury

Stillingsbetegnelse: Ph.d.-studerende Forfatter(e):

L.R. Khoury Afdeling:

Hud- og allergiafdelingen


T. Møller2, C. Zachariae1 and L.Skov1 1Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Denmark 2University Hospitals Centre for Health Care Research, Rigshospitalet, University of Copenhagen, Denmark

E-mail adresse: [email protected]

Abstract Background Treatment and care of moderate to severe psoriasis often requires lifetime consultations by dermatologist with close monitoring of systematic treatment. Objectives To investigate the effect of patient-initiated care consultations (PICC) for patients with psoriasis in dermatology outpatient clinic. Methods A prospective randomized controlled trial was set up. Patients in well controlled systemic treatment were randomized to either 1) the PICC group where patients received one yearly scheduled consultation by dermatologist, but were able to initiate consultations when needed or 2) the control group where patients received consultation routinely every 12-16 weeks. Primary outcome was DLQI. Other outcome was safety with treatment management, patient adherence- and satisfaction with healthcare assessed at baseline and after 52-weeks. Results 150 patients were included in the study, of which 58% were treated with biologicals, 37.3% methotrexate and 4.7% acitretin. After week 52 no statistical significance mean change difference between groups were detected in DLQI 0.28 (95% CI, -0.35 to 0.9) and PASI -0.24 (95% CI, -0.84 to 0.36). Patients in the PICC group requested 64.2% fewer appointments than the control group, mean±SD 2.46±0.13 consultations vs 5.05±0.61, (p=0.001). Adherence and safety with treatment management was not different between groups on progression or serious advent (p=0.329), change in psoriasis treatment (p=>0.000) or clinical measurement. Conclusion PICC offers some clinical benefits compared with routine care, giving patient more flexibility and less dependence on doctors and clinical visits. The intervention adds no harm to monitoring systematic treatment and patients report high quality of life and satisfaction with healthcare.


M 3

Abstract-titel:

Fibroblast growth factor 23 (FGF23) regulates PTH levels through FGF receptor signaling in vivo in normocalcemia, but not at low calcium

Præsenteres af: Maria Lerche Mace

Stillingsbetegnelse: Klinisk assistent Forfatter(e):

Maria Lerche Mace Afdeling:

Nefrologisk Afd b, Herlev og Gentofte Hospital


Eva Gravesen 2, Anders Nordholm 1,2, Klaus Olgaard 2 & Ewa Lewin1 1 Nefrologisk Afd B, Herlev og Gentofte Hospital 2 Rigshospitalet Københavns Universitet


Abstract Background: The regulation of PTH secretion is primarily mediated by extracellular calcium. Recently, the phosphatonin fibroblast growth factor (FGF) 23 has been shown to inhibit PTH levels, but the physiological function of this regulation is not clarified. Our aim was to study FGF23’s regulation of PTH levels in vivo. Methods: Wistar rats were randomized to FGF receptor inhibition (FGFRi) (40mg PD173074) or vehicle. Acute hypocalcemia was induced by a continuous intravenous EGTA infusion (40mM, 3ml/h) in vehicle and FGFRi rats. Increasing doses (0.1, 1, and 10 µg) of recombinant (r) FGF23 were given to vehicle and FGFRi rats. Plasma (p) Ca++, phosphate, FGF23 and PTH were measured. Results: Acute FGFRi resulted in a decrease in p-FGF23 (364±22 to 154±18 pg/ml, p<0.05) and a concomitant increase in p-PTH (134±34 to 685±285 pg/ml, p<0.01). The PTH secretory response was challenged by acute severe hypocalcemia (p-Ca++ 1.37±0.01 to 0.98±0.03 mmol/l, p<0.01). Again at normocalcemia PTH increased in FGFRi rats (85±13 to 182±10 pg/ml), while the maximal PTH secretion at low p-Ca++ was not different in FGFRi rats vs. vehicle rats (347±61 vs. 316±22 pg/ml). Exogenous rFGF23 0.1 µg inhibited rapidly PTH levels in normal rats at 20 min (137±71 to 10±4 pg/ml, p<0.05). In FGFRi rats 0.1 µg rFGF23 did not suppress PTH levels (270±50 vs. 347±62 pg/ml). Same results were found for higher doses of rFGF23. Conclusion: FGF23 regulates PTH tonus in vivo via the FGF receptor. The inhibitory effect of FGF23 on PTH is present at normal range of plasma Ca++, but not at low Ca++ levels, when increased PTH secretion is needed.


M 4

Abstract-titel:

Incidens og risikofaktorer for parastomal buledannelse hos patienter med ileostomi eller kolostomi Præsenteres af: Rune Martens Andersen

Stillingsbetegnelse: Fysioterapeut, ph.d.-studerende Forfatter(e):

Rune M. Andersen Afdeling:

Gastroenheden, Herlev og Gentofte Hospital


Tobias W. Klausen, Hæmatologisk Afdeling, Herlev og Gentofte Hospital Anne K. Danielsen, Gastroenheden, Herlev og Gentofte Hospital Anders Vinther, Afdeling for Ergoterapi og Fysioterapi, Herlev og Gentofte Hospital Ismail Gögenur, Kirurgisk Afdeling, Sjællands Universitetshospital Thordis Thomsen, Abdominalcentret, Rigshospitalet


Abstract Introduktion: Patienter med stomi i Region Hovedstaden følges i stomiklinikker op til et år efter deres operation. I Stomidatabasen i Region Hovedstaden er klinisk data indsamlet rutinemæssigt siden 2007. Parastomale buler er en komplikation til stomi, der forventes at forekomme hyppigt, men præcist estimat kendtes ikke. Studiets formål var at undersøge incidens og risikofaktorer for parastomal buledannelse hos patienter med ileostomi eller kolostomi. Metode: I et registerstudie-design blev data fra Stomidatabasen linket med data fra Dansk Anæstesi database. Den kumulative incidens over det første år fra operation blev plottet med Kaplan-Meier estimat, hvor død og tilbagelægning af stomi blev håndteret som ’competing risks’. Risikofaktorer blev undersøgt med justering for potentielle confoundere. Resultater: I en studiepopulation med 5019 observationer var den kumulative incidens (med competing risks) 36 % ved 400 dage efter operation. Alder, kolostomi, hankøn, alkoholforbrug og laparoskopi var forbundet med en øget risiko for parastomal buledannelse. Sammenlignet med cancer var inflammatorisk tarmsygdom forbundet med en nedsat risiko for parastomal buledannelse, mens diverticulitis var forbundet med øget risiko. Placering af peristomalt net og placering af stomi gennem separat incision var også forbundet med nedsat risiko. Der blev hverken fundet øget eller nedsat risiko for parastomal buledannelse for BMI, ASA score, rygning, akut kirurgi og præoperativ stomimarkering. Konklusion: Parastomal buledannelse ses hos en ud af tre patienter med en stomi allerede efter det første år. Estimater for risikofaktorer skal primært ses som hypotesegenererende. Forebyggende tiltag synes relevante at undersøge, da parastomal buledannelse er en hyppig komplikation, og eksisterende behandlingsmuligheder har begrænsninger.


M 5

Abstract-titel:

The Copenhagen Triage Algorithm is superior to a traditional triage algorithm: a cluster-randomized study Præsenteres af: Rasmus Bo Hasselbalch

Stillingsbetegnelse: Forskningsassistent Forfatter(e):

Rasmus Bo Hasselbalch Afdeling:

Kardiologisk afdeling


Mia Pries-Heje1, Martin Schultz1, Louis Lind Plesner1, Lisbet Ravn2, Morten Lind2, Rasmus Greibe3, Birgitte Nybo Jensen4, Thomas Høi-Hansen1, Nicholas Carlson5,8, Christian Torp-Pedersen6, Lars S. Rasmussen7, Kasper Iversen1,2 1 Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen, Denmark 2 Department of Emergency Medicine, Herlev-Gentofte Hospital, Copenhagen, Denmark 3 Department of Cardiology, Bispebjerg Hospital, Copenhagen, Denmark 4 Department of Emergency Medicine, Bispebjerg Hospital, Copenhagen, Denmark 5 Department of Cardiology, Gentofte Hospital, Copenhagen, Denmark 6 Department of Health, Science and Technology, Aalborg University and Department of Cardiology and Epidemiology/Biostatistics, Aalborg University Hospital 7 Department of Anaesthesia, Center of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Denmark 8 The Danish Heart Foundation, Copenhagen, Denmark


Abstract Background Systematic triage systems for risk assessment are used by emergency departments (ED) worldwide, and are characterized by detailed flow-charts that leave limited room for clinical evaluation. The Copenhagen Triage Algorithm (CTA) is a simplified system aiming to reintroduce clinical assessment into triage. Methods We compare CTA to a local adaptation of Adaptive Process Triage (ADAPT) in a large two center cluster randomized crossover study. We use 30-day mortality with a margin of 0.5% to determine non-inferiority, and also assess whether CTA better predicts 30-day mortality by ROC analysis. Findings We included 45,977 patient visits, well matched on baseline characteristics. Of these, 23 415 (50·9%) were triaged using CTA, and 22 562 (49·1%) were triaged with ADAPT. 30-day mortality among patients triaged with CTA and ADAPT were 3·35% and 3·28%, respectively (p=0·683), a difference of 0·07% (95% CI: -0·26-0·40), which met the non-inferiority criteria. We observed comparable results for mortality at 48 hours (0·63% and 0·68%, p=0·58 for CTA and ADAPT, respectively) and 90 days (6·18 % and 6·36 %, p=0·41 for CTA and ADAPT, respectively). We also observed that CTA patients triaged at significantly lower levels (p<0·001) and that CTA was superior in predicting 30-day mortality, with an AUC of 0·670 (95% CI 0·650-0·690) compared to 0·638 for ADAPT (95% CI 0·618-0·659) (p=0·028). Conclusion A novel triage system based on vital values and clinical assessment by an ED nurse was non-inferior to a traditional triage algorithm as evaluated by short term mortality, and superior in predicting 30-day mortality.


M 6

Abstract-titel:

Prognostic Factors in Malignant Melanoma

Præsenteres af: Hafsa Ismail

Stillingsbetegnelse: Reservelæge, ph.d.-studerende Forfatter(e):

Hafsa Ismail Afdeling:

Klinisk Biokemisk Afdeling


Hafsa Ismail, Klinisk Biokemisk Afdeling Jens H. Petersen, Klinisk Biokemisk Afdeling Børge G. Nordestgaard, Klinisk Biokemisk Afdeling Annette H. Chakera, Plastikkirurgsik Afdeling Lisbet R. Hölmich, Plastikkirurgisk Afdeling Stig E. Bojesen, Klinisk Biokemisk Afdeling


Abstract Introduction Malignant melanoma (also called melanoma), a cancer primarily involving the skin, affects ≈ 2,500 individuals in Denmark each year, and it is now the sixth most common cancer. Despite treatment advances in recent years, the number of deaths due to melanoma has not decreased, and early detection is essential to improve survival after a melanoma diagnosis. YKL-40 is a protein in the body and a biological marker of inflammation, and small studies have shown that high levels of YKL-40 lead to a poor chance of disease recovery in melanoma patients. Telomeres consist of repetitive DNA located at the ends of chromosomes. In a study with >64,000 individuals from the general population we have shown that the length of telomeres can be used as a biological marker of death from cancer. Aim To investigate whether the level of YKL-40 in the body and the length of telomeres can be used as biological markers of survival in melanoma patients. Methods/materials Blood sample examinations combined with questionnaire data from >3,000 melanoma patients in Denmark collected since 2008 and followed until today in Danish health registries. Perspectives If our study shows that YKL-40 and telomere length are useful as early markers of disease survival, then measurements of YKL-40 and telomere length in the blood at the time of diagnosis can potentially lead to improved prognostication with earlier detection of recurrent disease and enhanced utilization of existing treatment options. In the long term this could possibly lead to improved survival in melanoma patients.


M 7

Abstract-titel:

Prevalence of atopic dermatitis in infants by domestic water hardness and season of birth: Cohort study Præsenteres af: Kristiane Aasen Engebretsen

Stillingsbetegnelse: PhD-studerende og introduktionslæge Forfatter(e):

Kristiane Aaen Engebretsen Afdeling:



Kristiane A. Engebretsen, a,b Peter Bager,c Jan Wohlfahrt, c Lone Skov, b, Claus Zachariae, b Anne-Marie Nybo Andersen, d Mads Melbye, c and Jacob Pontoppidan Thyssen, a,b From athe National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup; bthe Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup; cthe Department of Epidemiology Research, Statens Serum Institut, Copenhagen; and dDepartment of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen.


Abstract Background: Atopic dermatitis (AD) appears to be more common in regions with hard domestic water and in children with a fall/winter birth. However, it is unknown whether a synergistic effect exists. Objective: We sought to evaluate the association between domestic water hardness and season of birth, respectively, with onset of AD within the first 18 months of life in a large Danish birth cohort. Methods: Of children from the Danish National Birth Cohort, 52,950 were included. History of physician-diagnosed AD and population characteristics were obtained from interviews. Birth data were obtained from the Civil Registration System, and domestic water hardness data were obtained from the Geological Survey of Denmark and Greenland. The relative prevalence (RP) of AD was calculated by using log-linear binomial regression. Results: The prevalence of AD was 15.0% (7,942/52,950). The RP of AD was 5% (RPtrend, 1.05; 95% CI, 1.03-1.07) higher for each 58 increase in domestic water hardness (range, 6.60-35.90 German degrees of hardness [118-641 mg/L]). Although the RP of AD was higher in children with a fall (RP, 1.24; 95% CI, 1.17-1.31) or winter (RP, 1.18; 95% CI, 1.11-1.25) birth, no significant interaction was observed with domestic water hardness. The population attributable risk of hard domestic water on AD was 2%. Conclusion: We observed that early exposure to hard domestic water and a fall/winter birth was associated with an increase in the relative prevalence of AD within the first 18 months of life. Although the 2 exposures did not interact synergistically, a dose-response relationship was observed between domestic water hardness and AD.


M 8

Abstract-titel:

Immune Checkpoint Blockade to Improve Tumor-Infiltrating Lymphocytes for Adoptive Cell Therapy in Metastatic Ovarian Cancer Præsenteres af: Christina Friese

Stillingsbetegnelse: ph.d.-studerende Forfatter(e):

Christina Friese1 Afdeling:

Center for Cancer Immunterapi, Hæmatologisk Afdeling


Troels Holz Borch1,2, Marie Christine Wulff Westergaard1, Magnus Pedersen1,2, Marco Donia1,2, Inge Marie Svane1,2, Özcan Met1,2,3 1Center for Cancer Immune Therapy (CCIT), Department of Hematology, Herlev Hospital, Herlev, Denmark. 2Department of Oncology, Herlev Hospital, Herlev, Denmark. 3Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.


Abstract Introduction Adoptive T-cell therapy (ACT) based on tumor-infiltrating lymphocytes (TILs) takes advantage of pre-existing tumor-reactive T cells present within the tumor, which are isolated from tumor lesions, expanded ex vivo and re-infused into the patient. In metastatic melanoma, objective response rates of up to 50% including complete tumor regression in 10-20% of the patients have been reported from several independent centers. Despite the great potential of TIL therapy in metastatic melanoma, response rates in other types of cancers such as metastatic ovarian cancer have been lower. Within the tumor microenvironment, regulatory cells and expression of co-inhibitory immune checkpoint molecules can lead to the inactivation of TILs. Thus, approaches that directly manipulate co-stimulatory pathways within the initial tumor fragment cultures might improve the expansion of tumor-resident TILs enriched for tumor specificity. Methods In this study, we hypothesized that the blockade of the CTLA-4 co-stimulatory pathway in ovarian tumor fragments enhances CD8+ T-cell output and TIL tumor reactivity. Ipilimumab (anti-CTLA-4 antibody) was added during the initiation of the TIL expansion process and the phenotype and functionality were analyzed by flow cytometry, ELISpot, xCelligence and Luminex Multiplex assays. Results Preliminary data show that blockade of CTLA-4 added during the initiation of TIL cultures increased the rate of CD8+ TIL expansion and possibly also the tumor reactivity of the expanded product. Conclusion Our data suggest, that Ipilimumab could potentially improve TIL products with respect to phenotype and functionality. This method offers a practical way to manipulate the ex vivo tumor microenvironment to develop protocols to expand optimally enhanced TILs for ACT for metastatic ovarian cancer.


A 1

Abstract-titel:

The development of the mean pulmonary artery pressure during the first 14 days of life Præsenteres af: Agnes Schmidt Davidsen

Stillingsbetegnelse: Forskningsårsstuderende Forfatter(e):

Agnes Schmidt Davidsen Afdeling:

Hjertemedicinsk S104


Anna Axelsson Raja, S104 Kasper Iversen, S104


Abstract Introduction It has been assumed, that mean pulmonary artery pressure (mPAP) falls in the transition from fetal circulation after birth and keeps falling. This hypothesis has however never been tested. Pulmonary artery acceleration time (PAAT) on echocardiography, correlates inversely with, and can be used as a non-invasive surrogate for, pulmonary artery pressures. Methods Healthy newborns, aged 1-14 days from the Copenhagen Baby Heart study were included. The following equation: mPAP (mmHg)=48-0.28 PAAT (m/s), which is derived in older children, was applied for the estimation of mPAP. Results We included 762 neonates (female 48%). A patent foramen ovale was seen in 82% and a patent ductus arteriosus in 48%. Estimated mPAP was 30.1±3.1 mmHg at day 1, with nadir at day 3 (26.5±4.2 mmHg) whereafter it increased gradually to 29.2±4.0 mmHg at day 14 (p<0.0001). A tricuspid pressure gradient could be obtained from tricuspid regurgitation (TR) in 87 (11.4%) children (median gradient 15.4 mmHg (IQR 12.1 to 21.8). Newborns with TR had a lower mPAP than those without a TR (27.2 ±4.6 mmHg vs. 28.9±4.1 mmHg, p= 0.0003). There was no difference in mPAP between children with and without a patent ductus arteriosus (28.8±4.0 vs. 28.5±4.4 mmHg, p=0.22). Conclusion Contrary to previous assumptions, mPAP increased gradually from day 3 to 14. Our results may indicate that pulmonary pressure decreases later than previously believed. The small amount of children having a TR is noteworthy, considering that a TR is usually used to estimate pulmonary artery pressures on echocardiography.


A 2

Abstract-titel:

The contralateral kidney is protected against fibrosis in unilateral ureter obstructed (UUO) rats Præsenteres af: Anders Nordholm

Stillingsbetegnelse: PhD studerende, reservelæge Forfatter(e):

Anders Nordholm Afdeling:

Departments of Nephrology, Herlev Hospital, Uni. of Copenhagen


Maria Mace (1), Eva Gravesen (2), Klaus Olgaard (2) & Ewa Lewin (1) 1: Department of Nephrology, Herlev Hospital, Uni of Copenhagen & 2: Department of Nephrology, Rigshospitalet, Uni. of Copenhagen


Abstract Introduction: Emerging concepts propose that circulating factors released from an injured kidney might cause kidney fibrosis. We examined genes related to fibrosis and Wnt in the contralateral, untouched kidney (CON) to unilateral obstructed kidney (OBS) in UUO rats with unilateral nephrectomized (UNX) and normal (N) rats. Methods: UUO rats (n=48) were studied at 0, 2, 4, 6 hr, 1, 3, 4 and 10 days (D) in parallel with UNX control rats (n=30) and normal rats (n=6). Plasma ActivinA and Sclerostin and kidney expression of Klotho, BMP7, TGF-β, Periostin, Sclerostin, DKK-1 and ActivinA were examined. Results: ActivinA mRNA was undetectable in N-kidney, CON, and UNX, but induced in OBS (Baseline:0.09±0.01, D3:1.38±0.22, D10:2.94±0.55, p<0.01). P-ActivinA increased in UUO compared to UNX (B:217±14, UNX 10D:254±18, UUO 10D:413±44, p<0.001) indicating release from the injured kidney. P-sclerostin was similarly increased (B:142±18, UNX 10D:284±42, UUO 10D:313±60, p<0.05) but kidney mRNA was undetectable. DKK-1mRNA was unchanged. In OBS-kidney there was down-regulation of anti-fibrotic Klotho + BMP7 at day1 (p<0.001) but not at 0-6hr. Additionally OBS-kidney showed up-regulation of pro-fibrotic TGF-β + Periostin from day1 (p<0.01). All genes were similar in CON, UNX and N-kidneys at all time points. Conclusion: A rapid decrease in anti-fibrotic factors and an increase in pro-fibrotic factors are observed in OBS-kidney. Induction of ActivinA in OBS-kidney may contribute to p-levels and could represent a circulating factor that drives kidney fibrosis. However, gene expressions of pro-and anti-fibrotic factors in the CON-kidney are maintained normal, indicating protection against circulating fibrotic factors.


A 3

Abstract-titel:

Knee osteoarthritis patients can provide useful information about knee range of motion Præsenteres af: Anne Mørup-Petersen

Stillingsbetegnelse: Reservelæge, PhD.stud.

Forfatter(e):

Anne Mørup-Petersen

Afdeling:

Ortopædkirurgisk Afdeling, Herlev og Gentofte Hospitaler, Gentofte Matriklen


Pætur Mikal Holm (Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals), Christina Holm (Department of Orthopaedic Surgery, Rigshospitalet), Tobias Wirenfeldt Klausen (Department of Hematology, Hospital Herlev Hospital), Søren T. Skou (Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals), Michael Rindom Krogsgaard (Department of Orthopaedic Surgery, Copenhagen University Hospital Bispebjerg), Mogens Berg Laursen (Department of Orthopaedic Surgery, Aalborg University Hospital), Anders Odgaard (Department of Orthopaedic Surgery, Copenhagen University Hospital Gentofte).


Abstract: Introduction: Knee arthroplasty surgery does not always require extensive patient follow-up. For patients with good function, follow-up examination mainly focuses on range of motion (ROM). If ROM could be reported reliably by the patient, attendance for follow-up might be replaced by phone calls, emails or even register surveys. We investigated whether a new, simple, illustration-based scale enables patients to report their own passive knee range of motion in 15° increments. Methods: Through an iterative process we created a 2-item scale with 11 illustrations of knee motion neutral for age, sex and race. Reliability was tested in 105 knee arthritis patients (mean age 70.8 years) at different treatment stages. Passive ROM was measured with a long goniometer by a physiotherapist and an orthopaedic resident, both blinded. Results: Patients found our scale quick and easy to use. They handed in 100 correctly completed questionnaires. The mean difference between patients’ reports and measurement was 0.66° (SD 12.4°) for flexion and -1.10° (SD 11.6°) for extension. For patients reporting flexion > 110° (n=64), 95% were confirmed by goniometer measurement. For knee flexion < 110° (n=30), the patient-reported ROM had a sensitivity of 90% and a specificity of 87%. If flexion limit was set at 100° the according values were 95 and 81%. For extension deficits > 10° (n=39) we found a sensitivity of 83% and a specificity of 71%. Values were 100 and 66% for a 15° limit. Conclusion: Patient-reported ROM is a feasible and for some purposes reliable alternative to professional ROM measurement.


A 4

Abstract-titel:

Sensitization trajectories in childhood revealed by using a cluster analysis Præsenteres af: Morten Arendt Rasmussen

Stillingsbetegnelse: Associate Professor

Forfatter(e):

Ann-Marie Schoos (COPSAC) Afdeling:

COPSAC


Bp Chawes (COPSAC) Hans Bisgaard (COPSAC)


Abstract Sygdomsbiologi er et komplekst system hvor årsag og virkning sjældent er af binær karakter. For fuldt ud at forstå disse komplekse biologiske systemer er det nødvendigt med en multivariat tilgang. Grundet den teknologiske fremmarch er det nu muligt at kvantitativt karakterisere næsten alt tænkeligt; det være sig fuld genom, transcriptom over immune-regulering til metaboliter mv. På trods af dette faktum foregår langt det meste sygdomsforskning ved statistisk sammenligning af enkelte markøres sammenhæng med sygdom; En tilgang som neglisherer præmissen om den komplekse biologi. Denne præsentation vil med udgangspunkt i de minutiøst karakteriserede børn i COPSAC kohorterne demonstrerer hvorledes biologiske systemer karakteriseret ved mange variable også statistisk kan analyseres i én integreret model. En model som er biologisk forståelig og reproducerbar. Som case benyttes sensibilisering målt ved 14 allergen-specifikke IgE’er i 398 børn ved 6-, 18 måneder, 4- og 6 år. Sensibilisering til specifikke allergener gennem barndommen forekommer sjældent alene men indgår som en brik i et mønster der karakteriserer den generelle sensibiliserings profil. Vi præsenterer en model som afdækker denne profil, og viser at denne model er relevant i relation til udvikling af astma og atopisk dermatitis, samt at modellen er fuldstændig reproducerbar i en uafhængig Svensk kohorte på 3051 børn (1). ref: 1) Schoos, A.M.M., Chawes, B.L., Melén, E., Bergström, A., Kull, I., Wickman, M., Bønnelykke, K., Bisgaard, H. and Rasmussen, M.A., 2017. Sensitization trajectories in childhood revealed by using a cluster analysis. Journal of Allergy and Clinical Immunology.


A 5

Abstract-titel:

Effects of inhaled corticosteroids during the first 6 years of life on height and bone mineral content Præsenteres af: Asja Kunøe

Stillingsbetegnelse: MD, PhD-student Forfatter(e):

Asja Kunøe Afdeling:

COPSAC, Børne- og Ungeafdelingen - Herlev Hospital


Astrid Sevelsted, Bo L. Chawes, Jakob Stokholm, Klaus Bønnelykke, Hans Bisgaard Copenhagen Prospective Studies on Asthma in Childhood (COPSAC), Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.


Abstract Introduction Inhaled corticosteroids (ICS) are the preferred therapy for management of asthma in children. Infants and young children might be particularly susceptible to the potential clinical side effects on growth, which rarely have been studied in this age group. The aim of this study was to investigate the effect of ICS treatment on growth until the age of 6 years. Methods Children in the Copenhagen Prospective Studies on Asthma in Childhood were followed from birth, N=1100. The cumulative dose of ICS for each participant was calculated and stratified in three groups of ICS: low, medium and high-dose. Multiple linear regression and ANOVA models were applied to analyze the effect of ICS on height and bone mineral content (BMC). Analyses were adjusted for covariates with a significant association to height and BMC. Results For the cumulative dose of ICS (log2 transformed) till age 6, no significant dose-response association to height was observed (-0.04 [95%CI, -0.3; 0.18], p-value 0.7). Similarly, the stratified analyses showed no statistically difference in height between the stratum of children with the highest exposure to ICS compared to the stratum with no or very low exposure (-0.2cm [95% CI, -1.0; 0.6], p=0.6). Similar results were seen concerning BMC. The effects of ICS did not vary significantly according to sex. Conclusion We did not find evidence that ICS treatment during the first 6 years of life has long term effects on height or BMC.


A 6

Abstract-titel:

Time trends of chronic immune disorders in the Danish population

Præsenteres af: Astrid Sevelsted

Stillingsbetegnelse: Post doc Forfatter(e):

Astrid Sevelsted, Katrine Grau, Hans Bisgaard Afdeling:

COPSAC


Astrid Sevelsted, Katrine Grau, Hans Bisgaard (alle COPSAC)


Abstract Introduction Asthma and other disorders with complex aetiology involving abnormal inflammation are reported to have increased parallel, especially in westernized countries. The aim of this study is to explore the temporal changes in hositalisation rates for asthma and selected chronic immune disorders using the Danish national patient registry. Methods We investigated all children born in Denmark and registered as such in the Danish Medical Birth Registry after January 1973. There are three time variables to consider: (1) age, (2) birth year, and (3) year of diagnosis. When investigating one time variable only one of the other time variables can be taken into account. Change in exposures relevant during pregnancy, around birth and in infancy may manifest as different incidence in different birth cohorts. Changes in exposures relevant around time of diagnosis and changes in diagnosing and treatment practice may manifest in different incidence over calendar time. Results We find relevant interaction between age and year of diagnosis, i.e. an age-period-interaction. For asthma there were pratically no effect of age in the 70s-80s, but from the mid 90s the risk is markely increased in the first life years. The effect is more pronounced when excluding outpatients. Effects of birth year should therefor be stratified by age and year of diagnosis. Risk of pre-school asthma increased in 70s and 80s birthyears. Later asthma is constant. Connective tissue disorders and juvenile arthritis increased in later birthyears. Discussion We find some support for increasing prevalence, and importantly we find relevant age-period-interaction.


A 7

Abstract-titel:

Changes in prescription practices when treating hypothyroidism between 2001 and 2015 – A register based study. Præsenteres af: Bjarke Borregaard Medici,

Stillingsbetegnelse: ph.d. studerende, læge Forfatter(e):

Birte Nygaard Afdeling:

Medicinsk afdeling, Herlev


Jeppe Lerche la Cour1, Mia Klinten Grand2, Volkert Siersma2, Håkon Sandholdt2, Dagny Ros Nicolaisdottir2, Bent Lind3, Niels de Fine Olivarius2, Christen Lykkegaard Andersen2. 1Center for Endocrinology and Metabolism, Department internal Medicine Herlev and Gentofte Hospitals, 2The Research Unit for General Practice, Institute of Public Health, University of Copenhagen. 3Department of Clinical biochemistry, Copenhagen University Hospital Hvidovre, Denmark.


Abstract Background Within the last decade increasing attention has been drawn to health, quality of life and the early detection and treatment of disease. This has led to intensified case finding for various medical conditions including hypothyroidism. A falling Thyroid Stimulating Hormone (TSH) threshold upon initiation of Levothyroxine (T4) treatment has been reported in the UK between 2001- 2009 (Taylor et al. JAMA, 2014). Such changes in clinical practice may lead to less benefit from therapy and risk of overtreatment. Objective To investigate changes in clinical practice among general practitioners in the Copenhagen area when initiating treatment for hypothyroidism Methods Retrospective study of all CopLab TSH measurements (n=3,5mio) performed between 2001 and 2015 merged with the Danish Prescription Database and Diagnose registry at Statistics Denmark. Results In all 961.778 persons with 3.494.507 TSH measurements were included. The number of TSH measurements per year increased from 110.000 to 290.000, while the median TSH before T4 therapy decreased from 10 mU/l to 6,8 mU/l with an increasing probability for initiating T4 therapy at any TSH level from 2001 to 2015.These changes were found across all age groups. Conclusion This study performed on a vast primary care population demonstrates a significant falling threshold for initiating T4 therapy between 2001 and 2015. The study also reveals that intensified case finding from the 2010 level to the 2015 level did not lead to any further discoveries of hypothyroidism suggesting that few hypothyroid persons remain undiagnosed.


A 8

Abstract-titel:

International Delphi consensus on the assessment of laypersons’ Paediatric Basic Life Support Skills Præsenteres af: Asbjørn Hasselager

Stillingsbetegnelse: Læge, PhD studerende Forfatter(e):

Asbjørn Hasselager Afdeling:

Copenhagen Academy for Medical Education and Simulation (CAMES)


Torsten Lauritsen, Department of Paediatric Anaesthesia. Rigshospitalet Tim Kristensen. Department of Children and Adolescence Medicine and CAMES. Herlev Hospital Cathrine Bohnstedt. Pediatrics and Adolescent Medicine. Rigshospitalet Claus Sønderskov. RedMitBarn - Firstaiders Doris Østergaard. Copenhagen Academy for Medical Education and Simulation (CAMES), Herlev Martin Grønnebæk Tolsgaard. Department of Obstetrics. Rigshospitalet and CAMES


Abstract UDENFOR KONKURENCE Introduction: Assessment of laypersons’ Paediatric Basic Life support (PBLS) skills is important to ensure effective PBLS competencies in resuscitation attempts. Limited evidence exists on which skills are essential. We aimed to establish international consensus on how to assess laypersons’ PBLS and foreign body airway obstruction management (FBAOM) skills. Methods: A Delphi consensus survey was conducted. Of 84 invited experts, 28 agreed to participate. During the first round experts suggested items to assess PBLS and FBAOM skills. In the second round, items received comments from and were rated by 26 experts (93%) on a 5-point scale (1= not relevant - 5 = essential). Revised items were anonymously presented in a third round for comments and 23 (82%) completed a re-rating. Items with a score >3 by >80% of the experts in the third round were included in an assessment instrument. Results: The first round identified 19 and 15 items to assess PBLS and FBAOM skills, respectively. Ratings and comments resulted in nine and eight essential assessment items for PBLS and FBAOM skills, respectively. PBLS items focussed on airway management and included: “Responsiveness”, ”Call for help”, “Open airway”, ”Check breathing”, “Rescue breaths”, “Compressions”, “Ventilations“, “Time factor” and “Use of AED”. FBAOM items included: “Identify different stages of foreign body airway obstruction”, “Identify consciousness”, “Call for help”, “Back blows“, “Chest thrusts /abdominal thrusts according to age”, “Identify loss of consciousness and change to CPR”, “Assessment of breathing” and “Ventilation”. Conclusion: We established international consensus on how to assess laypersons’ PBLS and FBAOM skills.


A 9

Abstract-titel:

First clinical results with a novel EUS-guided through-the-needle microbiopsy forceps for improved diagnostics of pancreatic cysts

Præsenteres af: Bojan Kovacevic

Stillingsbetegnelse: PhD stud. / klinisk assistent Forfatter(e):

Bojan Kovacevic Afdeling:

Gastro Unit, Division of Endoscopy, Herlev and Gentofte Hospital


Charlotte Vestrup Rift 2, John Gásdal Karstensen 1,3, Pia Klausen 1, Anders Toxværd 4, Evangelos Kalaitzakis 1, Jan Henrik Storkholm 5, Carsten Palnæs Hansen 5, Jane Preuss Hasselby 2, Peter Vilmann1 1 Gastro Unit, Division of Endoscopy, Herlev and Gentofte Hospital 2 Department of Pathology, Rigshospitalet 3 Department of Gastrointestinal surgery, Slagelse Hospital 4 Department of Pathology, Herlev and Gentofte Hospital 5 Department of Gastrointestinal surgery, Rigshospitalet


Abstract Introduction The incidence of pancreatic cysts is on the rise. These lesions represent a diagnostic dilemma as some of them harbor malignancy or have the potential for malignant transformation. Recently, a novel biopsy forceps (Moray™) has become available, allowing for EUS-guided procurement of microbiopsy material from the cyst wall through a 19 G needle. The aim of this study was to evaluate the use of the micro-forceps in a clinical setting. Methods The study included patients with pancreatic cysts referred for EUS evaluation and subsequent fine-needle aspiration (FNA). After puncture of the cyst, the microbiopsy forceps was introduced through the needle and microbiopsies were obtained from the wall of the cyst under EUS guidance. In addition to routine histological preparation, the material was stained using immunohistochemistry (IHC) in order to further sub-classify IPMN. Microbiopsies from neoplastic cysts underwent NGS analysis, testing for mutations in selected regions of 50 cancer-associated genes. Results The forceps was used in 23 consecutive patients. We found a technical success rate of 82.6% (n = 19). Biopsies were generally of good quality and showed IPMN in 12 patients (52.2%). Two patients were diagnosed with SCN (8.7%) and there was one case with a pseudocyst (4.3%). Material from one patient was insufficient for analysis (4.3%). Only one mild adverse event was recorded (4.3%). Conclusion The use of the novel microbiopsy forceps seems safe with acceptable rates of technical success. Microbiopsies offer sufficient material for diagnosis, as well as supplementary analyses. However, prospective studies are warranted before larger scale clinical implementation.


A 10

Abstract-titel:

Predictors for the clinical course of Tourette syndrome: a longitudinal study Præsenteres af: Camilla Groth

Stillingsbetegnelse: Læge Ph.d. Forfatter(e):

Camilla Groth Afdeling:

Børne og Ungeafdeling


Nanette Mol Debes og Liselotte Skov, Børne og Unge afdelingen, Herlev Hospital Theis Lange, Afdelingen for Biostistik, Københavns Universitet


Abstract Introduction: Tourette syndrome is a chronic childhood neurodevelopmental disorder characterized by motor and vocal tic and frequent comorbidities. The clinical presentation is very heterogeneous. Prognostic issues are difficult to predict for the clinical course of the individual child. This large prospective longitudinal study explores clinical childhood predictors for the clinical course of tics and comorbidities of Tourette syndrome in early adulthood. Methods: The clinical cohort was recruited at the Danish National Tourette Clinic. Data was collected at baseline (n=314, age 5-19) and at follow-up (n=227, age 11-26) 6 years later to examine the development in expression of tics and comorbidities. Childhood clinical factors were selected as possible predictors for the clinical course of tics and comorbidities in early adulthood, represented by four binary clinical outcomes; tic severity and diagnoses of obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD) or emotional disorders. Results: The strongest predictors of high tic scores, present OCD or ADHD diagnoses in early adulthood were the corresponding tic severity (OR: 1.09), OCD severity (OR: 1.08) and ADHD severity (OR: 1.13) for every scale point in childhood. Future emotional disorders were predicted by being female (OR: 3.94) and by the childhood ADHD severity (OR: 1.11). Furthermore psychosocial factors as teasing and special education and genetic factors were also predictive for the clinical course. Conclusion: We identified strong clinical predictors of TS-associated outcomes in early adulthood which are directly applicable to clinical TS populations and may help to guide new patients, plan early interventions and implement preventive measures.


A 11

Abstract-titel:

Melanoma-related limb lymphoedema

Præsenteres af: Caroline A. Gjørup

Stillingsbetegnelse: Læge, ph.d.-studerende Forfatter(e):

Caroline A. Gjørup1, Helle W. Hendel2, Kristoffer Drzewiecki3, Karin Dahlstrøm1, Tobias W. Klausen4, Mogens Grønvold5, Lisbet R. Hölmich1 Afdeling:

Plastikkirurgisk Afd., Herlev Hospital


1Dept. of Plastic Surgery, Herlev Gentofte Hospital, 2Dept. of Clinical Physiology and Nuclear Medicine, PET-center, Herlev Gentofte Hospital, 3Dept. of Plastic Surgery, Breast Surgery and Burns Treatment, Rigshospitalet, 4Dept. of Hematology, Herlev Gentofte Hospital, 5Dept. of Public Health, University of Copenhagen, & Dept. of Palliative Medicine, Bispebjerg Hospital


Abstract Aim/background: A focus of the study Health-related quality of life and surgical morbidity in melanoma patients was to describe melanoma-related limb lymphoedema (LE) and the effect of LE on health-related quality of life (HRQoL) in melanoma patients. Material and Method: This cross-sectional study consisted of a questionnaire, a clinical examination and DXA scan of the study participants. The inclusion criteria were confirmed primary cutaneous melanoma, age 18-75, no previous or current evidence of metastatic disease, wide local excision (WLE) and unilateral axillary or inguinal sentinel lymph node biopsy (SLNB) and/or complete lymph node dissection (CLND) at least one year prior to the study. Health-related quality of life was evaluated with official cancer generic and symptom specific questionnaires. The clinical diagnosis of LE was based on the history, patients’ symptoms and clinical findings. DXA scans of the limbs were performed to describe the volume and tissue composition (fat mass and lean mass). Results: Of the 431 patients included (68% of eligible patients), 109 patients (25%) had clinical melanoma-related limb lymphoedema. The majority of LE was classified as mild with the increase in volume particularly attributed to an increase in fat mass. The negative impact of LE on HRQoL in melanoma patients was statistically and clinically significant in multiple domains including global health status, role, and social functioning, pain, fatigue, financial difficulties and body image. Conclusion: The study emphasises the importance of increasing awareness, and improving prevention and treatment of LE in melanoma patients.


B 12

Abstract-titel:

The effects of season and weather on healthcare utilization among patients with atopic dermatitis: A population-based study

Præsenteres af: Carsten R Hamann

Stillingsbetegnelse: Physician, PhD Student Forfatter(e):

Carsten R Hamann

Afdeling:

Department of Dermatology and Allergy; Department of Cardiology


Carsten R. Hamann MD1,2; Yuki M.F. Andersen MD1,2; Kristiane A. Engebretsen MD1,2,3; Lone Skov MD, PhD, DMSc1,2,3; Alexander Egeberg MD, PhD1,2; Jacob P. Thyssen MD, PhD, DMSc1,2,3 1) Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark 2) Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark 3) National Allergy Research Centre, Herlev and Gentofte Hospital, Hellerup, Denmark E-mail adresse: [email protected]

Abstract Background: Triggers for atopic dermatitis (AD) flares include changes in ultraviolet irradiation, humidity and temperature. Objectives: To identify the relationships between weather data and healthcare utilization in AD patients. Methods: Using nationwide healthcare registries, clinic (1994-2012) and hospital visits (1977-2012) for AD treatment were calculated as well as monthly totals of topical corticosteroid (TCS) (1996-2012) and calcineurin inhibitor (TCI) prescriptions (2003-20012) filled by AD patients. We calculated monthly averages of temperature, atmospheric pressure, cloud cover and hours of bright sunlight and compared these variables to healthcare utilization endpoints (2000-2012) using linear regression models. Results: Healthcare utilization among AD patients was highest in winter/spring. Temperature was the environmental variable that had the strongest correlation with healthcare utilization: lower temperature correlated with higher clinic/hospital visits (p=0.004), as well as TCS (p<0.001) and TCI prescriptions (p<0.001). Hours of bright sunlight was inversely correlated with TCI prescriptions (p<0.001). Percent cloud cover was positively associated with clinic/hospital visits (p=0.031) and TCI prescriptions (p<0.001). Limitations: Lack of data on humidity, pollen or pollution. Conclusions: AD healthcare utilization markers changed significantly with season. A decline in temperature appeared to be a reliable predictor for AD flares, but a causative role could not be determined with certainty.


B 13

Abstract-titel:

Male infertility problems of patients with sperm morphology between 5-14% Præsenteres af: Christian Fuglesang S. Jensen v/Peter Østergren

Stillingsbetegnelse: Læge, Klinisk Assistent Forfatter(e):

Christian F. S. Jensen, Omar Khan, Zainab G. Nagras, Jens Sønksen, Mikkel Fode, Tariq Shah and Dana A. Ohl

Afdeling:

Urologisk afdeling


Christian F. S. Jensen MD 1+3, Omar Khan BS 1, Zainab G. Nagras MD 1, Jens Sønksen MD, PhD 3, Mikkel Fode MD, PhD 3, Tariq Shah PhD 2 and Dana A. Ohl MD 1 Departments of 1 Urology and 2 Obstetrics and Gynecology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, United States, 48109; 3 Department of Urology, Herlev University Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark


Abstract Introduction In 2010 WHO changed the lower reference limit for sperm morphology from 15 to 4%. The change was based on 5th percentile cut point in a meta-analysis of published series of fertile men. This retrospective study investigates if patients referred for evaluation with sperm morphologies between 5-14% have identifiable etiologies of male factor infertility. Methods IRB approval was obtained to review records for patients referred to the University of Michigan between May 2012- May 2014 whom had a sperm morphology of 5-14%. Semen analysis, hormone levels, and other information related to an infertility diagnosis were recorded into a de-identified database. This information was used to group the patients into different categories including no known infertility diagnosis, presence of varicocele, hypogonadism, intercourse related infertility, sperm mixed antiglobulin reaction (MAR) (>50%), or other causes. Results A total of 253 patients were included. Of these men, 96/253 (38%) had a varicocele; 44/253 (17%) hypogonadism; 4/253 (2%) intercourse problems; 11/253 (4%) sperm antibodies on MAR testing, and 15/253 (6%) various other problems. In all, nearly 67% of the subjects were identified to have a potential contributing etiology of male infertility. 83/253 (33%) patients had no problems identified. Conclusion This study demonstrates that 67% of men in infertile couples, who have strict sperm morphology between 5-14%, have a potential contributing male factor diagnosis. These results could indicate that the new lower reference value for sperm morphology has been set too low. Applying the 5% cut point may result in missing potentially treatable causes of male factor infertility.


B 14

Abstract-titel:

Web-Based Tele-Rehabilitation in Stroke Patients – A Randomized Controlled Pilot Study Præsenteres af: Christina Kruuse

Stillingsbetegnelse: Overlæge Forfatter(e):

Afdeling:

Neurologisk afd


M. B. Poulsen; J. Badawey; M. Anhøj; E. Rostrup; K. Ellemann; B. W. Larsson; H. Larsson; T. Weineke; H. K. Iversen; J. B. Nielsen; C. Kruuse 1Dept Neurology, Herlev Hospital, University of Copenhagen, Herlev, Denmark, 2Neurovascular Research Unit, Dept Neurology, Herlev Hospital, University of Copenhagen, Herlev, Denmark, 3Functional Imaging Unit; Dept Clinical Physiology, Rigshospitalet Glostrup, Copenhagen, Denmark, 4Dept Neurology, Roskilde Hospital, Roskilde, Denmark, 5Dept. Physiotherapy, Metropolitan University, Copenhagen, Denmark, 6Rigshospitalet, Copenhagen, Denmark, 7Glostrup


Abstract DELTAGER UDENFOR KONKURRENCE Introduction: Post-stroke rehabilitation following hospital discharge may be challenged by patient fatigue, lack of community resources for daily training, or long distance to training facilities. We aimed to investigate the feasibility and effects of 16 weeks training using the web-based rehabilitation program Move It To Improve It (Mitii) initiated either within 2 weeks from stroke or four months post stroke. Methods: In a randomized controlled cross-over study running from August 2013 through July 2015 stroke patients were randomized to 16 weeks of either Mitii training add-on to conventional training or conventional training alone. Cross-over was done at 16 weeks. Patients were evaluated at baseline, 16 and 32 weeks by functional activity scores (mRS, ADL, Barthel), physical assessment (NIHSS, motor assessment scale), cognitive tests and general well-being (WHO-5). Results: 35 patients (13 women) were included; 18 in early phase Mitii training group and 17 in late phase Mitii training group. Mean age 62.9 (range 43-77) and 63.6 (range 35-77) in early and late Mitii training groups, respectively. No serious adverse events were experienced. Initial results show patients improved over time, with no significant difference between treatments groups at 16 weeks. Remaining results are awaiting analysis. Conclusion: Early Mitii training was feasible and safe in stroke patients. There was however no significant difference in primary endpoints at 16 weeks, further results are awaiting final assessments. Web-based tele-rehabilitation at home could be an additional training option in stroke, though a larger randomized study on the subject should be performed for further assessment.


B 15

Abstract-titel:

Autoimmune Disease in Children and Adolescents with Psoriasis: A Cross-Sectional Study in Denmark Præsenteres af: Christoffer Blegvad

Stillingsbetegnelse: Læge, klinisk assistent, ph.d. studerende Forfatter(e):

Christoffer Begvad Afdeling:

Hud- og allergiafdelingen, Herlev og Gentofte Hospital


A Egeberg 1, TE Tind Nielsen 1,3, GH Gislason 2, C Zachariae 1, A-M Nybo Andersen 3 & L Skov 1 1)Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Denmark 2)Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Denmark 3) Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark


Abstract Introduction: Psoriasis is an immune-mediated inflammatory disease, which in studies among adults have been shown to cluster with autoimmune disease. The aim of this study was to investigate possible associations between selected autoimmune diseases and psoriasis in children and adolescents. Methods: The study population consisted of all individuals living in Denmark and aged less than 18 years as of December 31st 2012. Individuals with at register diagnosis of psoriasis were compared with those without such a diagnosis in a cross-sectional design, and the associations with a diagnosis of at least one of nine pre-selected autoimmune diseases were examined. Logistic regression models were used to calculate odds ratios and results were adjusted for age, sex, and healthcare consumption. Results: We identified 1,925 children with psoriasis and 1,194,712 without such a diagnosis. Children with psoriasis were predominantly female (54.7% vs. 48.8%). Psoriatic arthritis (adjusted OR 10.08; 7.97-12.74), rheumatoid arthritis (adjusted OR 6.61; 2.75-15.87), and vitiligo (adjusted OR 4.76; 1.71-13.20) showed strong associations with psoriasis. Moreover, presence of psoriasis was associated with increased risk of multiple concurring autoimmune diseases compared with people without psoriasis. Some of our results are limited by the fact that the studied diseases are rare in children. Conclusion: Psoriasis in children and adolescents was associated with increased risk of selected autoimmune diseases. Clinicians should keep this in mind with focus on extra-cutaneous symptoms.


B 16

Abstract-titel:

The influence of gestational age on intelligence, attention, and executive function in 5-year-old children: a cohort study Præsenteres af: Emilie Pi Fogtmann


Emilie Pi Fogtmann Afdeling:

Gynækologisk Obstetrisk Afdeling, Herlev Hospital


Frederik Jager Bruun, Gynækologisk Obstetrisk Afdeling, Herlev Hospital Julie Anna Slavensky, Gynækologisk Obstetrisk Afdeling, Herlev Hospital Erik Lykke Mortensen, professor, Institut for Folkesundhedsvidenskab, Københavns Universitet Ulrik Schiøler Kesmodel, professor og overlæge, Gynækologisk Obstetrisk Afdeling, Herlev Hospital


Abstract Objective: To assess the influence of gestational age (GA), late preterm birth (34-<37 weeks GA), and very to moderately preterm birth (<34 weeks GA) on intelligence, attention, and executive function in 5-year-old Danish children. Methods: A cohort of 1776 children who had completed neuropsychological tests at the age of five and with complete information on GA was sampled from the Lifestyle During Pregnancy Study. The tests included an assessment of intelligence, attention, executive function. Exhaustive information on family and background factors was obtained, and maternal intelligence tests carried out. Multiple linear regression analyses were conducted with adjustment for important confounders including maternal intelligence and parental education. Results: In the very to moderately preterm group, the mean difference in full-scale, verbal, and performance IQ was -10.6 points (95% confidence interval -19.4, -1.8), -7.4 (-13.4, -1.5), and -11.7 (-21.9, -1.5), respectively, when compared to the term group and adjusted for potential confounders. For the teacher-assessed Global Executive Composite, the mean difference in this preterm group was 5.3 (2.4, 8.3) compared to the term (higher score meanings more difficulties). For attention measures and parent-assessed executive function, no statistically significant results were obtained. No associations between late preterm birth and cognitive difficulties were shown. Adjusting for birth weight weakened any association. Maternal intelligence and parental education proved to be weak confounders. Conclusion: This study suggests a clear trend towards significantly lower intelligence and poorer executive function in children born very or moderately preterm. No such associations were found among the children born late preterm.


B 17

Abstract-titel:

Targeting arginase in tumor microenvironment

Præsenteres af: Evelina Martinenaite

Stillingsbetegnelse: PhD student Forfatter(e):

Evelina Martinenaite Afdeling:

CCIT, Hæmatologisk afdeling, Herlev Hospital


Rasmus Erik Johansson Mortensen1, Morten Hansen1, Morten Orebo Holmström1,2, Shamaila Munir Ahmad1, Özcan Met1,3,4, Marco Donia1,3, Inge Marie Svane1,3, Mads Hald Andersen1, 4 1 Center for Cancer Immune Therapy (CCIT), Department of Hematology, Copenhagen University Hospital, Herlev, Denmark; 2 Department of Hematology, Zealand University Hospital, Roskilde, Denmark; 3 Department of Oncology, Copenhagen University Hospital Herlev, Herlev, Denmark; 4 Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark


Abstract Introduction Cancer progression is associated with an increased immune suppression at the tumor site. Arginase is an enzyme that reduces arginine availability to the tumor infiltrating immune cells and thus reduces T cell functionality in the tumor. While some cancer cells can express arginase, it has also been shown to be produced by immune inhibitory cells, such as myeloid derived suppressor cells (MDSCs) and is associated with poor prognosis. Methods and Results In this study, we set out to target arginase expressing immune suppressive cells at the tumor site by the means of identifying and activating T cells capable of recognize arginase derived peptide epitopes. We found spontaneous immune responses against multiple arginase-derived peptides in both cancer patients and healthy individuals by IFNγ ELISPOT. We were able to identify a hot-spot region in the arginase protein sequence which appears to contain multiple T cell-recognized epitopes. Furthermore, we were able to expand arginase specific T cells by stimulating cancer patient PBMCs with peptide loaded dendritic cells (DCs). We then isolated and expanded peptide-specific cells by magnetic bead isolation of T cells producing IFNγ in response to peptide stimulation. We demonstrated the specificity and reactivity of arginase specific T cells as these secreted IFNγ in response to upregulated arginase production in DCs and B cells compared to Mock controls. Conculusion We show that arginase expressing cells can be targeted by arginase specific T cells, which makes it a promising approach to effectively target arginase producing tumors and inhibitory immune cells such as M2 macrophages and MDSCs in cancer immunotherapy.


B 18

Abstract-titel:

Perikarditis

Præsenteres af: Flora Lind Sigvardt, stud.med.

Stillingsbetegnelse: Forkningsstuderende Forfatter(e):

Flora Lind Sigvardt Afdeling:

Hjertemedicinsk, Gentofte Hospital


Christian Madelair, Morten Lock Hansen, Gunnar Gislason.


Abstract Introduktion: Perikarditis med idiopatisk ætiologi rammer ofte mænd, hvor det initiale forløb er uden videre komplikationer og symptomerne aftager efter få dage, hvorimod ændringer i elektrokardiogrammet kan eftervises flere uger efter. Behandlingen er symptomatisk og medicineringen er ofte NSAID over en uge til tre måneder og/eller colchicin, Valid diagnostisk undersøgelse indebærer en invasiv vævsprøve fra hjertesækken, hvorfor dette ofte ikke prioriteres og ætiologien forbliver ukendt. Metode: En deskriptiv analyse af studiepopulationen baseret på optegnelser i registrene fra Danmarks Statistik. Herefter et retrospektivt registerstudie fra perioden 31.december 1995 til og med 31.december 2016. Studiepopulationen udgøres af 17422 patienter med førstegangsperikarditis. Resultater: Studiet præsenterer de deskriptive værdier hos studiepopulationen i Danmark, hvor median alderen er 52 år og 68.3% er mænd og den kumulative incidensrate for hjertesvigt over 13.6 år er 5,2% (95% konfidensinterval: 4,8%-5,6%) til sammenligning er prævalensen for hjertesvigt i almen befolkningen 2%. Ved startificering af data i alderskvartiler er den nederste kvartil 0-36 år 79.1% mænd. Konklusion: Patienter indlagt med perikarditis har en kumulativ incidensrate for hjertesvigt på 5,2% og er hyppigst mænd. Videre undersøgelse af studiepopulationen er efterspurgt for yderligere analyse af risikofaktorer.


B 19

Abstract-titel:

Risk Factors and a Novel Risk Score of Predicting Pacemaker Implantation in Patients with Atrial Fibrillation Præsenteres af: Frederik Dalgaard

Stillingsbetegnelse: Klinisk Assistent & PhD-studerende Forfatter(e):

Frederik Dalgaard Afdeling:

Hjertemedicinsk forskning 1, Herlev & Gentofte Hospital


Tommi Bo Lindhardt, Gunnar Hilmar Gislason, Jannik Langtved Pallisgaard, Martin Huth Ruwald Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Kildegaardsvej 28, 2900 Hellerup, Denmark


Abstract Introduction Patients with atrial fibrillation (AF) can develop symptomatic bradycardia leading to permanent pacemaker (PPM) implantation. The aim was to identify risk factors and develop a risk score to predict PPM implantation in patients with AF. Methods By using individual-level linkage of data from Danish nationwide registries, all patients with new onset AF from 2000 to 2014 were identified. Adjusted multivariate Cox regression analysis were used to identify risk factors of PPM and a risk score was created. Results A total of 180,175 patients with AF were included in the study. Median follow-up time was 3.7 years. Median age (Interquartile range) was 75 (65-82), 52.5% were men and there were 9,929 (5.5%) PPM implantations. Risk factors for PPM were identified and assigned risk points proportional to its risk regression coefficient: Age 60-69 (5 points), age >69 (8 points), ischemic heart disease (1 point), valvular AF (2 points), prior syncope (4 points), congenital heart disease (6 points), men with heart failure (1 point), and heart failure with age <60 (5 points) or age 60-69 (1 point). Risk points were divided into 8 groups: 0, 1-3, 4-5, 6, 7-8, 9, 10-11, ≥12 points. Patients with ≥12 risk points had and 8-fold increased risk for PPM (Hazard Ratio = 7.8 (95% Confidence interval: 7.0-8.8) compared with patients of zero points. C-statistics for the risk score was 0.67. Conclusion The risk factors for PPM and the risk score are useful tools for clinicians who initiate and evaluate heart rhythm monitoring of the AF patient.


B 20

Abstract-titel:

Major inequities in uptake of secondary prevention following acute coronary syndrome among migrants compared to Danish born Præsenteres af: Hanne Winther Frederiksen,

Stillingsbetegnelse: Ph.d.-studerende Forfatter(e):

Hanne Winther Frederiksen, Afdeling:

Medcinsk afdeling , Forskningsenheden for Klinisk Sygepleje, HGH


Ann-Dorthe Zwisler, REHPA,Syddansk Univesitet, Søren Paaske Johnsen, Klinisk Epidemiologisk Afdeling, AArhus Universitet,Buket Ôztürk, Klinsik Epidemiologisk Afdeling, Aarhus Universitet, Tove Lindhardt Damsgaard, Medicinsk Afdeling, Forskningsenheden for klinisk Sygepleje, HGH, Marie Nørredam, Forskningscenter for Migration, Etnicitet og Sundhed (MESU), Københavns Universitet.


Abstract Introduction The aim of this study is to assess uptake of pharmacological and non-pharmacological secondary prevention interventions following acute coronary syndrome (ACS) among migrants to Denmark compared to the native-born Danish population, taking differences in comorbidity and sociodemographic factors into account. Methods and Results In this large cohort study we selected the population (N = 33,199) from nationwide registers, and followed each individual among migrants and Danish–born Danes six months after ACS. We identified the initiation and risk of discontinuation of pharmacological secondary prevention and the initiation and number of contacts for non-pharmacological secondary prevention interventions in the Register of Medicinal Products Statistics and the National Patient Register, and adjusted them for comorbidity and sociodemographic factors. Non-Western migrants were less likely to initiate ADP- and ACE-inhibitors (0.78, CI: 0.69; 0.88, and 0.79, CI: 0.71; 0.89) and patient education (0.83, CI: 0.74; 0.94). Further, non-Western migrants had a higher risk of discontinuation of pharmacological secondary prevention (Statins: 1.64, CI: 1.45; 1.86, ADP-inhibitors: 1.72, CI: 1.50; 1.97, β-blockers: 1.52, CI: 1.40; 1.64, and ACE-inhibitors: 1.72, CI: 1.46; 2.02), and fewer contacts for physical exercise and patient education (p <0.001 and p = 0.011). Conclusion We identified major differences between migrants and Danish-born patients in the initiation of secondary prevention interventions and in discontinuation of pharmacological secondary prevention. Statistically significant ifferences were also found for number of contacts for non-pharmacological secondary prevention, albeit the clinical importance of this finding is yet to be determined. Differences could not be explained by differences in comorbidity or sociodemographic factors.


B 21

Abstract-titel:

Watchful waiting ved ventral- og ingvinalhernier

Præsenteres af: Hugin Reistrup

Stillingsbetegnelse: Forskningsårsstuderende, stud.med. Forfatter(e):

Hugin Reistrup Afdeling:

Center for Perioperativ Optimering, Gastroenheden D, Kirurgisk S k i H l G f H i l


Dennis Bregner Zetner, Center for Perioperativ Optimering, Gastroenheden D, Kirurgisk Sektion, Herlev og Gentofte Hospital Kristoffer Andresen, Center for Perioperativ Optimering, Gastroenheden D, Kirurgisk Sektion, Herlev og Gentofte Hospital Jacob Rosenberg, Center for Perioperativ Optimering, Gastroenheden D, Kirurgisk Sektion, Herlev og Gentofte Hospital


Abstract Introduktion Operation for hernie er blandt de hyppigst udførte kirurgiske indgreb i Danmark med ca. 15.000 operationer årligt, men spørgsmålet om hvornår ventral- og ingvinalhernier bør henvises til kirurgisk vurdering har været uklart. Formålet med denne statusartikel var at give anbefalinger til, hvornår hernierne bør henvises til kirurgisk vurdering eller blot kan følges med watchful waiting. Metode For at fremlægge den nyeste evidens på området blev der søgt efter publikationer omhandlende watchful waiting ved ventralhernier og/eller ingvinal- og femoralhernier i PubMed. Disse publikationer blev sammenholdt med publikationer fra Dansk Herniedatabase og European Hernia Society. Outcomes var fordele/ulemper ved watchful waiting beskrevet ved crossover-rate, risiko for akutte operationer, risiko for inkarceration, postoperative komplikationer og livskvalitet. Resultater Et kohortestudie om incisional- og umbilikal-/epigastrielle hernier viste crossover-rater på hhv. 19% og 16%, og et kohortestudie om incisionalhernier 33%. Risikoen for inkarceration var ca. 4-8%. Tre randomiserede kliniske studier om ingvinalhernier viste crossover-rater på hhv. 35% efter 3 år, 68% efter 10 år og 72% efter 7,5 år. Risikoen for akut operation var hhv. 2,3% efter 3 år, 2,4% efter 7 år og 2,5% efter 7,5 år. Af patienter opereret for ingvinalhernier med indsættelse af mesh estimeres det, at 10-12% efterfølgende har kroniske smerter. Konklusion Watchful waiting medfører operation hos 1/3 af patienter med ventralhernier og 2/3 med ingvinalhernier primært pga. progression af smerter. Ved asymptomatiske og minimalt symptomatiske ventral- og ingvinalhernier bør man overveje at følge patienten med en watchful waiting strategi. Watchful waiting anbefales dog ikke hos kvinder med lyskenære hernier.


B 22

Abstract-titel:

A descriptive study of experienced burden by spouses living with men undergoing androgen deprivation therapy for prostate cancer Præsenteres af: Jeanne Avlastenok

Stillingsbetegnelse: klinisk sygeplejespecialist Forfatter(e):

Avlastenok J Afdeling:

urologisk afdeling H


Rud K, Føns L, Østergren P Urologisk afdelingH


Abstract Introduction: Since 2013 men with prostate cancer undergoing androgen deprivation therapy (ADT) have been offered a supervised group-based exercise program as standard of care at our department. While this program focuses on patient experienced quality of life previous studies have shown that a cancer disease may negatively impact QoL of the entire family. The objective of this study was to investigate the prevalence of experienced burden by the partners of men with prostate cancer undergoing ADT and attending a structured hospital based exercise program. Methods: Spouses of men with prostate cancer undergoing ADT and participating in our structured exercise program were invited to participate. Burden was evaluated by 5 selected questions of an 18-questions family burden questionnaire. The relatives were given the questionnaire 3 times. Results: 70 spouses participated from August 2014 to October 2015. Questionnaires from 56 were available for the final analysis . They were all women with a mean age of 69 years. 46% spouses reported at some point during follow-up that their partner’s disease affected their own health and 50% reported that it affected their daily mood. 41% of the women reported to have a worsened QoL and 45% said they were burdened with more practical work because of their partner’s disease. 20%of the spouses reported to have a better QoL than 3 months before Conclusions: The main finding of this study is that an overwhelming proportion of spouses (>40%) experience that their partner’s prostate cancer disease affects their own health, daily mood and overall QoL.


C 23

Abstract-titel:

Personalized prevention of childhood asthma by high-dose vitamin D supplement in pregnancy based on genotype Præsenteres af: Jens Heller Frederiksen

Stillingsbetegnelse: Prægraduate Forfatter(e):

Jens Heller Frederiksen Afdeling:

COPSAC, Dansk Børne Astma Center, Herlev hospital børneafdeling


Klaus Bønnelykke, Bo Chawes, Hans Bisgaard COPSAC, Dansk Børne Astma Center, Herlev hospitals børneafdeling


Abstract Introduction Recent studies performed at Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) and in the US, demonstrate a protective effect of high-dose vitamin D supplementation during pregnancy on asthmatic symptoms in the offspring. Here, we investigate for the first time if the genetic constitution of the mother and child influences this protective effect. Methods The study is based on the COPSAC2010 mother-child cohort, where 736 mothers and their children participated in a randomized controlled trial of high-dose vitamin D supplementation during the third trimester of pregnancy. The children were followed prospectively from birth to 3 years of age with extensive clinical assessments. The risk of developing asthma was analyzed by a cox proportional hazard regression model and stratified according to 6 genetic variants related to the metabolism of vitamin D. Finally an interaction analysis was performed. Results 581 children were included in the primary analysis of which 104 (18%) were diagnosed with asthma before age 3 years. Two child genotypes (rs1544410 and rs731236) showed significant interaction with vitamin D supplementation (adjusted p-value < 0.01). Conclusion We found a higher protective effect on early asthma from high-dose vitamin D supplementation in children with certain gene variants related to vitamin D metabolism. These results raise the possibility of “precision” prevention by targeting vitamin D supplementation towards mothers and children with a certain genotype.


C 24

Abstract-titel:

The effect of type of anesthesia on urinary retention and mortality after open inguinal hernia repair: a systematic review and meta-analysis

Præsenteres af: Joachim Hjalde Halmsted Olsen

Stillingsbetegnelse: Research year student, medical student. Forfatter(e):

Joachim Hjalde Halmsted Olsen Afdeling:

Center for perioperative optimization, Department of Surgery


Stina Öberg, Kristoffer Andresen, Jacob Rosenberg Center for perioperative optimization, Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.


Abstract Introduction Inguinal hernia repair is the most common abdominal surgical procedure in Denmark counting approximately 12,000 operations per year. Guidelines recommend local anaesthesia for open hernia repair since it results in fewer postoperative complications compared with regional anaesthesia and is more cost effective than general anaesthesia. However, the majority of repairs in Denmark are performed under general anaesthesia whereas regional anaesthesia is common in several other countries. Urinary retention is a postoperative complication that seems to depend widely on the applied anaesthesia, but a systematic review is lacking. The aim of this study was to compare postoperative urinary retention and mortality after local, regional, and general anaesthesia in adult patients that had undergone the Lichtenstein open inguinal hernia repair. Methods This systematic review follows the PRISMA-guideline and a protocol will be registered at PROSPERO. A systematic search was carried out on the 11th of September 2017 in the following databases: Cochrane, Pubmed, and Embase. Randomized controlled trials, and cohort studies written in Danish, English, Norwegian, or Swedish were included. Outcomes of interest are postoperative urinary retention and 90 days mortality in patients that have undergone elective Lichtenstein repair of a unilateral inguinal hernia. Data will be extracted independently by two authors. Results Data extraction will be carried out in the fall of 2017 and the synthesis will be finished in October 2017. There will be a qualitative synthesis of the findings and also meta-analyses if heterogeneity is low. Conclusion Results and conclusions will be presented at the Research Day.


C 25

Abstract-titel:

Succession of the vaginal microbiota during pregnancy and birth

Præsenteres af: Jonathan Thorsen

Stillingsbetegnelse: Læge, ph.d. studerende Forfatter(e):

Rasmussen, M.A.*, Thorsen, J.*, Bisgaard H., Stokholm J. Afdeling:

COPSAC, Dansk BørneAstma Center, Gentofte Hospital


Dominguez-Bello, M.G., Blaser, M. J. NYU Medical Center, New York Mortensen, M., Brejnrod, A., Sørensen S.J. Section for microbiology, Dept of Biology, Uni. Copenhagen


Abstract Introduction The mother’s vaginal microbiome represents the first foreign organisms from the outside world to which the child is exposed while passing through the birth canal. Little is known about the composition of the vaginal microbiome at birth or its determinants and development from earlier stages of pregnancy. Methods Using 16S rRNA gene amplicon sequencing, we investigated the vaginal microbiome of 57 women from the COPSAC2010 mother-child cohort in pregnancy week 24, 36 and at birth after rupture of membranes, but before childbirth. We further compared this composition with the microbiome of the gut and the airways of the 1-week old child. Results The vaginal composition changed dramatically at birth with higher diversity, affected taxonomic distribution and new OTUs introduced, but still carrying the specific signature of the individual mother. The relative abundance of most bacterial taxa increased stepwise from pregnancy week 24 through week 36 until birth at the expense of gradually declining relative abundance of Lactobacillus. Vertical transfer from mother to child was modest; the strongest transfer associations to the gut were for order Clostridiales followed by Lactobacillales and Enterobacteriales. Conclusion The vaginal microbiome at birth resembles the vaginal microbiome during pregnancy with higher diversity and less Lactobacillus, but only to a modest degree predicts the composition in the child at one week of age.


C 26

Abstract-titel:

Binge drinking in early pregnancy and the association with fetal growth Præsenteres af: Julie Anna Slavensky

Stillingsbetegnelse: Prægraduat forskningsårsstuderende Forfatter(e):

Julie Anna Slavensky Afdeling:

Gynækologisk Obstetrisk Afdeling


Professor, overlæge Ulrik Schiøler Kesmodel, Gynækologisk Obstetrisk Afdeling


Abstract Introduction: Very few studies have investigated the effect of alcohol binge drinking and different alcohol drinking patterns in early pregnancy on fetal growth. The objective of this study was to assess the potential effect of binge drinking and different drinking patterns (timing and number of binge drinking episodes) in early pregnancy on fetal growth estimated by birth weight and birth length. Methods: From March 1 to August 31 2000, 1836 pregnant Danish women from Aarhus University Hospital and Fredericia Hospital were included in the study and interviewed around the early second trimester about their drinking habits during their pregnancy. Information on anthropometric measures at birth was obtained from the Danish Medical Birth Registry. The potential effect of binge-drinking and different drinking patterns was estimated using a multivariate general linear model adjusted for potential confounders that were selected a priori based on the currently available scientific literature. Results: The women who reported any binge drinking gave birth to children with a reduction in birth length of -0.02 cm (95% CI: -0.23; 0.18) and an increase in birth weight of 0.2 g (95% CI: -42.8; 43.2). Number of binge episodes and timing of these episodes were also not associated with fetal growth. Conclusions: The study suggests that binge drinking and different drinking patterns in early pregnancy do not affect fetal growth. We found no statistically significant association between alcohol binge drinking, number of binge drinking episodes or timing of binge drinking and birth weight and birth length.


C 27

Abstract-titel:

The tape-strip technique: How far into the skin do we come?

Præsenteres af: Julie S.H. Sølberg

Stillingsbetegnelse: Phd.-studerende Forfatter(e):

Julie S.H. Sølberg1, Afdeling:

Department of Dermatology and Allergy, The National Allergy Research Centre


(Julie S.H. Sølberg1),Nina H. Ulrich1, Dorrit Krustrup2, Malin G. Ahlström1, Jacob P. Thyssen1, Anne-Sofie Ø. Gadsbøll3, Charlotte M. Bonefeld3, Torkil Menne1, Eva Balslev2, Jeanne D. Johansen1. 1) Department of Dermatology and Allergy, The National Allergy Research Centre, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark. 2) Department of Pathology, Copenhagen University Hospital Herlev-Gentofte, Herlev, Denmark. 3) Faculty of Health and Medical Sciences, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.


Abstract Introduction Within the last decade, tape-stripping has become a popular sampling method in dermatological research. A tape-sample collects skin cells from epidermis and researchers subsequently use it to purify various biologic substances from the outer skin layers e.g. proteins. Even though the use of the tape-strip method has become increasingly popular, there is a need for standardized studies investigating how far down into the skin layers you go when using tape strips. Methods To investigate this, we performed a clinical histology study in patients with atopic dermatitis and healthy subjects. Each patient was tape-stripped at four different locations, corresponding to a control and 3 test areas with an increasing number of tapes, and one 4mm punch biopsy was taken from each site. Two different types of tape were used. Histology was performed on all biopsies and the remaining layers of stratum corneum were counted. Results We found that tapes both with an acrylic-based adhesive and a rubber-based adhesive successfully remove stratum corneum. However, the tape with a rubber-based adhesive removed stratum corneum after fewer subsequent rounds of tape stripping compared with the acrylic-based tape. Conclusion Skin cells from stratum corneum can be obtained when using the tape-strip sampling method. Though the number of subsequent tape-strippings is increased, it does not seem like cells from the stratum granulosum or the deeper layers of epidermis can be collected by this sampling-method. Tape with a rubber-based adhesive removes stratum corneum with fewer subsequent tape-strippings compared with tape with an acrylic-based adhesive.


C 28

Abstract-titel:

Combination therapy with Nivolumab and PD-L1/IDO peptide vaccine to patients with metastatic melanoma. A clinical trial in progress.

Præsenteres af: Julie Westerlin Kjeldsen

Stillingsbetegnelse: MD, Phd-studerende Forfatter(e):

Julie Westerlin Kjeldsen, Mads Hald Andersen, Inge Marie Svane Afdeling:

Center for Cancer Immunterapi (CCIT)


Mads Hald Andersen, CCIT Inge Marie Svane, CCIT


Abstract Introduction: Huge advances have been made in the treatment of metastatic melanoma (MM); especially immunotherapy is promising. Combination of Ipilimumab and Nivolumab is to date the most effective treatment, but over 50% experience grade 3/4 adverse events. New effective combinations with less toxicity are strongly needed. It is known that cancer cells induce tolerance against the immune system. Two well-known mechanisms are brought through overexpression of PD-L1 and IDO on the tumor cells, which inhibits T-cell activation. We have identified spontaneous T-cell reactivity against PD-L1 and IDO in the tumor microenvironment and in the blood of patients with MM. Both IDO and PD-L1 reactive T-cells can kill cancer cells and immune regulatory cells in vitro. Thus boosting specific T-cells that recognize IDO and PD-L1 may directly modulate immune regulation. Due to distinct mechanisms of action, combination of treatment with an antibody targeting PD-1 and a vaccine with peptides against PD-L1 and IDO may have a synergistic effect. Methods: A clinical phase I/II trial design is used. 6 patients with MM will be included to test tolerability. If the treatment is feasible 24 patients will further be included. The objectives are to describe anti-tumor immune responses and objective responses using RECIST 1.1. Patients are treated with biweekly infusions of Nivolumab until progression. The PD-L1/IDO peptide vaccine is given biweekly for the first 6 vaccines and thereafter every fourth week up to 1 year. Patients will be followed with diagnostic imaging every 12 weeks. Conlusions: Recruitment will begin in October 2017.


C 29

Abstract-titel:

Development of a Chimeric Antigen Receptor T cell Therapy Platform at Herlev Hospital Præsenteres af: Kasper Mølgaard Jensen(1)

Stillingsbetegnelse: Civilingeniør Forfatter(e):

Kasper Mølgaard Jensen(1) Afdeling:

Hæmatologisk Afdeling L


Robert Holt (2), Inge Marie Svane (1),(3), Özcan Met (1),(3),(4) (1) Center for Cancer Immune Therapy (CCIT), Department of Hematology, Herlev Hospital, Herlev Denmark. (2) Department of Medical Genetics, University of British Columbia, Vancouver, Canada. (3) Department of Oncology, Herlev Hospital, Herlev Denmark. (4)Department of Immunogy and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.


Abstract Introduction Adoptive cell transfer (ACT) of genetically modified T cells is a promising approach to cancer immunotherapy. One approach is to engineer T cells with a chimeric antigen receptor (CAR) that recognize tumor associated antigens. The treatment of B-cell malignancies by ACT of anti-CD19 CAR T cells (CART19) has proven to be a highly successful therapeutic modality in several clinical trials with up to 90% of patients achieving complete remission. However, to date the clinical results have been much less encouraging in CAR-therapy against solid tumors. We will engage in a two way approach for establishing clinical scale production of CART19 cells for the treatment of hematological malignancies and implement a high throughput screening platform using transient CAR expression. Transient CAR T cell products function as a platform for evaluating therapeutic potential, cellular changes, novel tumor targets, and potentially as a low risk therapeutic platform. Stable CAR T cells are the foundation for a future clinical setting using CAR T cells at Herlev Hospital. Methods: Transient and stable CARs were generated through mRNA or lentiviral modification of T cells. T cells were then screened for CAR-expression and stability through flow cytometry and tested for cytotoxic effect using 51Cr-release-, xCelligence-, intracellular cytokine secretion-, and ELISpot-assays. Results: Preliminary data show that both transient and stable CAR T cells express a variety of cytolytic cytokines against CD19+ cancer cells. In addition, both transient and stable CAR T cells were capable of killing CD19+ cancer cells with up to 80% specific lysis. Conclusion: A two way platform utilizing transient and stable CAR T cell products can be used for bridging laboratory advancements and the clinical setting, thus establishing the foundation for CAR T cell therapies at Herlev Hospital.


C 30

Abstract-titel:

Move it to improve it (Mitii) – Betydning af virtual reality træning for patienter med apopleksi - en eksplorativ interviewundersøgelse Præsenteres af: Katrine Sejberg Rasmussen

Stillingsbetegnelse: Ergoterapeut Forfatter(e):

Katrine Lyders Johansen Afdeling:



Karina Lund, Katrine Sejberg Rasmussen, Cecilie Ring Folman, Afdeling for Ergoterapi og Fysioterapi, Herlev og Gentofte Hospital Anders Vinther, Afdeling for Ergoterapi og Fysioterapi samt Patientforløn og Organisation, Herlev og Gentofte Hospital. Anne Kjærgaard Danielsen. Seniorforsker. Gastroenheden & Patientforløb og Organisation, Herlev og Gentofte Hospital. Christina Kruuse. Overlæge. Klinisk forskningslektor, Neurovaskulær Forskningsenhed, Neurologisk afdeling. Herlev og Gentofte Hospital. Jens Bo Nielsen. Professor. Institut for Neurovidenskab og Helene Elsass Center, Københavns Universitet.


Abstract Baggrund Patienter med apopleksi har behov for intensiv og længerevarende genoptræning. Virtual reality (VR) programmer giver nye selvtræningsmuligheder. Move it to improve it (Mitii) er et VR-program, som giver mulighed for individuel webbaseret selvtræning, hvor patienterne kan superviseres telefonisk. Mitii er afprøvet i et forskningsprojekt til voksne patienter med apopleksi på bl.a. Neurologisk afdeling, Herlev og Gentofte Hospital. Formål At belyse hvordan patienter med apopleksi og deres pårørende oplevede at træne med Mitii Design Eksplorativ interviewundersøgelse Materiale og metode Semistrukturerede individuelle interviews med patienterne og semistrukturerede fokusgruppeinterviews med deres pårørende. Patienterne og deres pårørende er rekrutteret fra forskningsprojektet ”Effekt af web-baseret individuel træning efter apopleksi, et randomiseret single cross-over studie” blandt de patienter, der har gennemført 16 ugers superviseret selvtræning med Mitii. Resultater Tolv patienter er interviewet samt otte ægtefæller med fire i hvert fokusgruppeinterview. Resultater viser, at patienterne oplevede ejerskab til deres eget genoptræningsforløb samt handlekraft til selv at kunne gøre en ekstra indsats. Den daglige træning blev en naturlig del af deres hverdag og gav dem frihed til selv at planlægge, hvornår træningen skulle udføres. Flere af de pårørende har haft en afgørende rolle for gennemførelsen af træningsløbet. Tekniske udfordringer med udstyret og Mitii-programmet har fyldt meget. Patienter og pårørende oplevede et stort behov for en tættere kontakt til de fagprofessionelle. Konklusion Superviseret selvtræning giver patienter og pårørende handlemuligheder til at kunne påvirke og støtte op omkring genoptræningsforløbet efter en apopleksi.


C 31

Abstract-titel:

Modificeret ”Functional Reach” test er reliabel til hospitalsindlagte patienter med apopleksi Præsenteres af: Mette Mou Garborg

Stillingsbetegnelse: Fysioterapeut Forfatter(e):

Katrine Lyders Johansen Afdeling:



Mette Mou Garborg, Afdeling for Ergoterapi og Fysioterapi, Herlev og Gentofte Hospital Signe Wildenskov, Afdeling for Ergoterapi og Fysioterapi, Herlev og Gentofte Hospital. Anders Vinther, Afdeling for Ergoterapi og Fysioterapi samt Patientforløn og Organisation, Herlev og Gentofte Hospital


Abstract Baggrund Fokus i genoptræning hos moderat til svært ramte patienter med apopleksi er oftest på den siddende balance med rækkeøvelser, som udfordrer balancen. Der er behov for måleredskaber, som kan opfange små ændringer fx en øget rækkeafstand og som er lette at anvende i klinikken. Måleredskabet ”Functional Reach” modificeret med patienten i siddende udgangsstilling (mFRT) fremfor stående er et muligt redskab til evaluering af dette. Formål At undersøge den relative og absolutte reliabilitet af mFRT til hospitalsindlagte patienter med apopleksi. Design Intertester reliabilitetsstudie Materiale og metode 54 patienter (mænd, n=34) i alderen 36-92 år blev testet samme dag af to uafhængige testere. Patienterne udførte to testsessioner (3 testforsøg) med hver tester med en times pause imellem. I alt indgik 5 testere i projektet og relativ reliabilitet blev beregnet med Intraclass correlation coefficient (ICC1,1) og den absolute reliabilitet blev beregnet som Standard error of measurement med 95 % CI (SEM95) og Smallest Real Difference (SRD). Resultater ICC-værdierne var 0.95 (95% CI 0.91-0.97) i første testsession og og 0.96 (95% CI 0.93-0.98) i anden testsession. SEM95 varierede fra 5.7cm i første testsession til 5.1cm i anden testsession og SRD varierede fra 8.0cm i første testsession til 7.2cm i anden testsession. Konklusion Den relative reliabilitet var høj i begge testsessioner med ICC-værdier over 0.9. Den absolutte reliabilitet viser, at for at der er tale om en reel forandring skal patienterne forandre sig mere end 5.7cm på gruppeniveau og mere end 8cm på individniveau.


C 32

Abstract-titel:

Does common enzymatic activity predict cross-reactivity? – a study of phospholipase A1 in different species Præsenteres af: Katrine T. Callesen

Stillingsbetegnelse: PhD studerende Forfatter(e):

Katrine T. Callesen Afdeling:

Allergy Clinic, Herlev and Gentofte University Hospital, Copenhagen, Denmark


Anders Ingemann Larsen (a), Thomas H. Blicher (a), Tommy Gehring (a), Ditte S. Brinch (a), Lars K. Poulsen (b) and Bettina M. Jensen (b) a) Novozymes A/S b) Allergy Clinic, Herlev and Gentofte University Hospital, Copenhagen, Denmark


Abstract Introduction The enzyme Phospholipase A1 cleaves phospholipids into fatty acids, an ability used in the food industry, where the enzyme often originates from microorganisms (mPLA1s). Phospholipase A1 is also one of the major allergens found in wasp venom (named Ves v 1). No sequence homology has been found between mPLA1s and Ves v 1, however, it is not known whether the common enzymatic activity could cause cross-reactivity and thereby an allergic reaction to mPLA1s in wasp allergics. Our aim was to test for possible cross-reactions between sIgE towards Ves v 1(sIgE-Vesv1) and three mPLA1s. Methods Serum from 10 wasp allergics (sIgE-Vesv1 from 1.57 kU/l to 1734 kU/l) was used for inhibition studies. From each, 125 μl serum was incubated with 125 μl of either saline solution (negative control), 50 μg/ml ALK802 Soluprick solution (positive control) or one of three mPLA1s, each in three concentrations (5 μg/ml, 50 μg/ml (n=10) and 500 μg/ml (n=7)). The level of sIgE-Vesv1 was measured by the i211 ImmunoCAP and %inhibition was calculated. Inhibition by mPLA1s would indicate cross-reactivity. Results The positive control caused 62.5±28.6% (n=10) inhibition of sIgE-Vesv1. This was lower than expected but was found to be caused by a few sera where the fraction of sIgE-Vesv1 was <6% of all sIgE towards wasp venom. No inhibition was found in any of the sera tested for all concentrations of the three mPLA1s. Conclusion Our results illustrate no IgE cross-reactivity between phospholipase A1 from wasp and from microorganisms despite their common enzymatic activity.


C 33

Abstract-titel:

Herlev Enzalutamid versus Abirateron Toksicitet studie (HEAT): et studie protokol Præsenteres af: Klara Kvorning Ternov

Stillingsbetegnelse: Læge, Klinisk assistent Forfatter(e):

Klara Kvorning Ternov Afdeling:

Urologisk afdeling H


Peter Busch Østergren, Klinisk assistent, Læge, Urologisk afdeling Herlev Hospital og Gentofte Hospital Caroline Kistorp, Klinisk forsknings lektor, overlæge, Ph.d., Medicinsk Endokrinologisk afdeling O, Herlev og Gentofte Hospital Henriette Lindberg, Overlæge, Ph.d., Onkologisk afdeling R, Herlev og Gentofte Hospital Rasmus Bisbjerg, overlæge, Urologisk afdeling H, Herlev og Gentofte Hospital Ingegerd Balslev, Overlæge, Patologisk afdeling P, Herlev og Gentofte Hospital Estrid Høgdall, Professor, Cand Pharm., Ph.D., Dr. Med., Patologisk afdeling P, Herlev og Gentofte Hospital Steffen Grann Jensen, Cand. Scient. Ph.D., Patologisk afdeling P, Herlev og Gentofte Hospital Ganesh Palapattu, Professor, overlæge, Department of Urology, University of Michigan Health system, Ann Arbor, USA. Jens Sønksen, Professor, ph.d., overlæge, Dr. Med., Urologisk afdeling H, Herlev og Gentofte Hospital


Abstract Introduktion Mænd med metastatisk kastrationsresistent prostatacancer (mCRPC), hvor kræften progredierer trods underliggende kastrationsbehandling, behandles oftest med supplerende antihormon-behandling; enzalutamid eller abirateron. Sidstnævnte gives sammen med prednisolon. Præparaterne anses for ligeværdige, på trods af at de aldrig er blevet sammenlignet i et randomiseret forsøg. Vi vil sammenligne abirateron + prednisolon versus enzalutamid i forhold til, hvorvidt behandlingerne påvirker behandlingsrelateret træthed, metaboliske forandringer og livskvalitet. Ydermere tyder tidligere studier på, at ca. 10-30% af mænd med mCRPC er resistente overfor abirateron og/eller enzalutamid afhængeligt af, om de har en androgenreceptor-mutation. Formålet med substudiet er at undersøge den prædiktive og prognostiske værdi af androgenreceptor-mutationer. Metode HEAT studiet er et open-label, klinisk, randomiseret lægemiddelsforsøg. Patienter med mCRPC, hvor der er en indikation for supplerende antihormonbehandling, randomiseres til enten abirateron + prednisolon eller enzalutamid i forholdet 1:1. Deltagerne undersøges ved baseline, 12 uger efter behandlingsopstart samt ved sygdomsprogression. Det primære effektmål er ændring i behandlingsrelateret træthed vurderet ud fra det validerede spørgeskema Facit-Fatigue. Sekundære effektmål er ændring i faste-blodsukker, hjertemarkører, se-lipider, procentvis abdominalt fedt målt ved DXA-scanning og glukosemetabolisme målt ved oralt glukosebelastningstest (OGTT). Ændringen i livskvalitet vurderes med spørgeskema FACT-P. I substudiet sammenlignes overlevelse samt sygdomsprogression med følgende genetiske biomarkører fra baseline samt ved sygdomsprogression: punktmutationer i androgenreceptoren i cellefrit DNA og androgen splicevarianter i mRNA fra cirkulerende tumorceller. Konklusion Studiet undersøger, om enzalutamid har en gunstigere bivirkningsprofil end abirateron + prednisolon i forhold til overståede parametre. Ydermere undersøges, om mutationer i androgenreceptoren er sammenkædet med dårligere prognose og resistens for præparaterne.


D 34

Abstract-titel:

Circulating allergen-specific Th2 lymphocytes: CCR4+ rather than CLA+ is the predominant phenotype in peanut allergic subjects Præsenteres af: Lars H. Blom

Stillingsbetegnelse: PhD Forfatter(e):

Lars H. Blom Afdeling:

Allergy Clinic


Lars H. Blom1#, Nanna Juel-Berg1,2#, Lau Fabricius Larsen1, Kirsten S. Hansen1,2, and Lars K. Poulsen1 #Both authors contributed equally to this work 1.Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital Herlev-Gentofte, Denmark 2.Department of Pediatrics, Copenhagen University Hospital Herlev-Gentofte, Denmark


Abstract Background Early exposure to peanut through a dysfunctional skin barrier may result in sensitization to peanut while oral exposure is suggested to promote tolerance induction. To better understand the mechanism of food allergen sensitization and the importance of exposure route we aimed to investigate the gut, airway and skin homing phenotype of circulating human peanut-specific Th cells of peanut allergic and non-allergic subjects. Methods 45×106 PBMCs (5-7.5×106 cells/mL) from peanut allergic (n=9) and non-allergic (n=13) subjects were stimulated with an in the absence of 100 mg/mL peanut extract for 14-16h. Peanut-responsive CD4+ T cells were identified by CD154 expression by flow cytometry. Results The CD154+ peanut-specific CD4+ T cells of peanut allergic subjects and non-allergic showed a primary Th2 (IL-4 and IL-5) and Th1 (IFN-γ) profile, respectively. Compared to controls, peanut-responsive T cells of peanut allergic subjects had increased expression of the Th2 skin and airway homing chemokine receptor CCR4 (8% vs 24%), but not the signature skin homing antigen CLA (12% vs 14%) or the other skin homing chemokine receptor CCR10 (7% vs 13%). Interestingly, the main subpopulation of peanut-specific highly differentiated (IL-4+IL-5+) Th2 cells of the peanut allergic patients lacked CLA (<1%) and weakly (11%) co-expressed CCR4. Furthermore, CCR4 was expressed in particular by the conventional IL-4+IL-5- Th2 cells. Conclusion Using the tissue homing potential of the circulating pool of peanut-responsive Th2 cells from peanut allergic subjects as a surrogate of the tissue located Th cells, we could find indications that peanut sensitization might occur through both the skin and the airways.


D 35

Abstract-titel:

Recurrence after inguinal hernia repair in women: a systematic review

Præsenteres af: Line Schmidt

Stillingsbetegnelse: Scholarstipendiat, stud.med Forfatter(e):

Line Schmidt Afdeling:

Center for Perioperativ Optimering, Gastroenheden, Kirurgisk Sektion, Herlevog Gentofte Hospital


Stina Öberg, Center for Perioperativ Optimering, Gastroenheden, Kirurgisk Sektion, Herlev og Gentofte Hospital Kristoffer Andresen, Center for Perioperativ Optimering, Gastroenheden, Kirurgisk Sektion, Herlev og Gentofte Hospital Jacob Rosenberg, Center for Perioperativ Optimering, Gastroenheden, Kirurgisk Sektion, Herlev og Gentofte Hospital


Abstract Introdcution Guidelines from European Hernia Society recommend an endoscopic approach for women with inguinal hernia due to higher risk of a concomitant femoral hernia. Femoral hernias might be overseen during an open inguinal hernia repair. Therefore, the risk of recurrence is higher for women after open repair compared with men. Differences regarding pelvic and inguinal anatomy between males and females could mean that postoperative outcomes after inguinal surgery may very well differ between the two sexes. However, guidelines for inguinal hernia management in women are based on low level evidence and no systematic reviews or randomized controlled trials specifically address inguinal hernia repair in women. The aim of this systematic review was to investigate recurrence rate or reoperation for recurrence in adult female patients, who have undergone primary inguinal repair, considering different methods of repair used. Methods This systematic review followed PRISMA-guidelines. Pubmed, EMBASE, and Cochrane databases were searched systematically for studies describing recurrence or reoperation for recurrence after primary inguinal hernia repair in male and female patients. In total, 1889 studies will be screened based upon abstract and title. After abstract-screening, only studies where it is possible to extract relevant data for female patients will be included for full-text screening. Screening, data extraction, and bias assessment will be performed by two independent authors. Results Screening and data-collection for this study is currently ongoing. The systematic review will be completed and ready for presentation at end of October 2017. Conclusions Conclusions will be presented at “Forskningens Dag” at Herlev Hospital


D 36

Abstract-titel:

Transition fra intensivafdelingen til sengeafdelingen – oplevelset af patienter, pårørende, intensiv- og sengeafdelingssygeplejersker.

Præsenteres af: Lise Andersen


Handesten, Suzanne Forsyth Herling Handesten, Suzanne Forsyth Herling

Afdeling:

Anæstesiologisk afdeling


Lise Andersen, Helene Brix, Liz Daugaard, Heidi Knudsen, Rie Handesten, Suzanne Forsyth Herling Intensiv afdeling 104 & anæstesiologisk afdelings forskningsenhed.


Abstract Formål Vi undersøgte, hvordan patienter oplevede overflytning fra intensivafdeling til sengeafdelingen på Herlev Hospital, samt undersøgte hvorledes sygeplejesker opfattede denne transition m.h.p. et forbedringspotientiale. Metode Vi foretog semistrukturerede interview med 10 patienter, 4 medtog en pårørende, 10 sygeplejersker fra ITA, og 10 sygeplejersker fra sengeafdelinger på Herlev Hospital. Transskriberede interviews blev organiseret og analyseret i NVivo, diskuteret indgående i projektgruppen og gennemarbejdet ud fra metodetilgangen beskrevet i ”Interpretive description” af Sally Thorne. Resultater Patienterne bevægede sig fra et højtteknologisk miljø præget af svag paternalisme fra personalet, og kendetegnet ved afmagt og hjælpeløshed hos patienterne til et miljø, hvor pleje og behandling i højere grad var rettet mod egenomsorg og autonomi. Pårørende udtrykte usikkerhed om patienten var stabil nok til at være på en sengeafdeling de første dage efter ITA opholdet. ITA sygeplejerskerne var bekymret særligt for varetagelsen af opgaver forbundet med at sikre respiration og cirkulation. ITA sygeplejersken arbejdede ud fra et ”worst case senario” i kontrast til sengeafdelingssygeplejerskerne,

der gik til den nye patient med et ”best case senario” perspektiv. Sygeplejersker fra sengeafdelingen fandt det vigtigt at forventningsafstemme med patienterne og i særdeleshed deres pårørende for at informere om, hvad sengeafdelingen kunne tilbyde med det formål at forebygge konflikter i overgangen. Konklusion Transitionen fordrer en øget opmærksomhed fra sygeplejerskerne om, hvor patienterne og deres pårørende befinder sig i denne overgang, i hvor høj grad patienterne er parate til at genvinde deres autonomi, samt en større indsigt i de dele af indlæggelsesforløbet, der ikke foregår i egen afdeling.


D 37

Abstract-titel:

Adoptive Cell Therapy with Tumor-infiltrating Lymphocytes for Patients with Metastatic Ovarian Cancer: A Pilot Study. Præsenteres af: Magnus Pedersen

Stillingsbetegnelse: Læge, ph.d. studerende Forfatter(e):

Se nedenfor Afdeling:

Se nedenfor


Magnus Pedersen (1,2), Marie C. W. Westergaard (1), Morten Nielsen (1,2), Troels H. Borch (1,2), Lars G. Poulsen (3), Helle Hendel (4), Trine Juhler-Nøttrup (5), Pernille Andersen (6), Özcan Met (1,2,7), Marco Donia (1,2), Inge Marie Svane (1,2). 1: Center for Cancer Immune Therapy, Dept of Hematology & Oncology, Herlev Hospital. 2: Dept of Oncology, Herlev Hospital. 3: Dept of Gynecology and Obstetrics, Herlev Hospital. 4: Dept of Clinical Physiology and Nuclear Medicine, Herlev Hospital. 5: Dept of Oncology, Rigshospitalet,. 6: Dept of Clinical Immunology and Stem Cell Facility, Herlev Hospital. 7: Dept of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. E-mail adresse: [email protected]

Abstract Background Metastatic ovarian cancer (OC) is often diagnosed at an advanced stage and the majority of patients will experience recurrent/progressive disease with a poor prognosis. Adoptive cell therapy (ACT) with tumor-infiltrating lymphocytes (TIL) has shown impressive results in malignant melanoma, but has only been investigated scarcely in other cancers. This pilot study has tested TIL based ACT in patients with metastatic OC. Methods Six patients with platinum-resistant metastatic OC were treated with an infusion of TIL preceded by standard lymphodepleting chemotherapy (Cyclophosphamide 60 mg/kg for 2 days, Fludarabine 25 mg/m2 for 5 days) and followed by stimulation with a continuous decrescendo IL-2 infusion for up to 5 days. Stem cell harvest was performed before TIL therapy. Primarily, the feasibility and tolerability of the treatment was assessed. Secondarily, potential immune responses against tumor cells were monitored and objective response of the treatment was described. Results Only expected and manageable toxicities related to the treatment were observed. Patients had stable disease (SD) for a minimum of 3 months with 4 patients experiencing progressive disease (PD) at this time point. Two patients had SD for 5 months. Modest antitumor reactivity was observed in expanded TIL, but not in peripheral blood lymphocytes (PBL) collected after treatment. Conclusions ACT with TIL and decrescendo IL-2 is feasible and tolerable in patients with metastatic OC with expected and manageable toxicities. Methods of altered TIL expansion or combining TIL therapy with checkpoint inhibitors could possible enhance the mainly transient clinical responses observed in this pilot study.


D 38

Abstract-titel:

Naturlige ingredienser i kosmetik

Præsenteres af: Maria Anna Bruusgaard-Mouritsen

Stillingsbetegnelse: Læge, ph.d-studerende Forfatter(e):

Maria Anna Bruusgaard-Mouritsen Afdeling:

Videncenter for Allergi, Gentofte Hospital


Jeanne Duus Johansen, Videncenter for Allergi, Gentofte Hospital Lene Heise Garvey, Klinik for Allergi, Gentofte Hospital


Abstract Introduktion: Et stigende antal mennesker diagnosticeres i dag med allergi. En del tilfælde skyldes ingredienser i kosmetiske produkter såsom fugtighedscremer, solcremer og sæbe/shampoo - produkter som de fleste bruger dagligt til plejende og hygiejniske formål. Mange efterspørger i dag ”naturlige” og økologiske produkter – også i kosmetik. Forbrugerne mistænker ofte ikke, at indholdsstoffer, som er ”naturlige”, som for eksempel fødevareproteiner, også sagtens kan fremkalde allergi. Formålet med dette projekt er at identificere fødevareproteiner, der i udbredt grad benyttes i kosmetik, og som potentielt kunne være hidtil oversete allergenkilder. Metode: Alle produkter i TÆNKs database fra app´en ”Kemiluppen” blev gennemgået. Produkternes ingredienser blev indlæst og optalt i statistikprogrammet SAS. Resultater: Databasen indeholdt i alt 10067 produkter med 208000 ingredienser fordelt på 4432 forskellige ingredienser. Alle ingredienser, der indgik i mindst 30 produkter, i alt 128 forskellige ingredienser, blev kortlagt. Heraf var henholdsvis kokos, aloe, shea, kanel og solsikke de fem hyppigste. Konklusion: Der ses en udbredt anvendelse af både naturlige og økologiske ingredienser i kosmetiske produkter. Det er kendt, at en del af disse ingredienser kan udløse allergi, når de spises, mens de allergifremkaldende effekter ved kontakt med huden er relativt uudforskede. Ingredienserne planlægges testet i kliniske studier blandt eksempatienter med uforklarlig allergi. Herved vil man potentielt kunne påvise årsager til allergier, der ellers ville have været overset i klinikken og dermed hjælpe mange allergipatienter med at undgå specifikke indholdsstoffer.


D 39

Abstract-titel:

A Danish version of the McMaster Family Assessment Device for children and adolescents with type 1 diabetes: A validation and clinical relevance

Præsenteres af: Maria Axtoft Munk Pedersen

Stillingsbetegnelse: Forskningsårsstuderende, Stud. Med. Forfatter(e):

Maria Axtoft Munk Pedersen Afdeling:

Department of Paediatrics, Herlev University Hospital


Lene Juel Kristensen: Department of Psychology and Behavioural Sciences, Aarhus University Stine Møller Sildorf: Department of Paediatrics, Herlev University Hospital Svend Kreiner: Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences Jannet Svensson: Department of Paediatrics, Herlev University Hospital Anne Hvarregaard. Mose: Department of Pediatrics, Aarhus University Hospital Niels Birkebaek: Department of Pediatrics, Aarhus University Hospital Mikael Thastum: Department of Psychology and Behavioural Sciences, Aarhus University E-mail adresse: [email protected]

Abstract Introduction: Living with childhood type 1 diabetes (T1D) can have stressful impact on family functioning. Malfunctioning and conflicts potentially affects treatment outcome and increases the risk of of severe short- and long-term complications. As family function is changeable through interventions a valid measure for family function is of great clinical interest. We aimed to validate the Danish version of the Family Assessment Device (FAD), general function scale (GF). Method: Danish adolescents (age 12-18 years old) with T1D and their parents were invited to respond the 12 items FAD questionnaire. Validations of the questionnaires were assessed by using Graphical Long Linear Rasch Model (GLLRM) and reliability was assessed using Monte Carlo simulation. Results: Of all invited 614 completed the web-study. We found the GF subscale to be un-valid measuring three unidimensional scales within General Functioning. Further the scale measured correlated but different dimensions indicating that different meanings were understood by the parties. Targeting didn’t match the population. Conclusion: The Danish version of the General functioning scale of FAD is not valid and reliable. It measures different dimension for the adolescents and their parents. The findings underscore the difficulties of using questionnaires in clinical settings and research.


D 40

Abstract-titel:

Donation af æg Et kvalitativt studie af kvinders motiv for og holdninger til ægdonation samt deres oplevelser på fertilitetsklinikken

Præsenteres af: Maria Buhl Borgstrøm

Stillingsbetegnelse: Sygeplejerske. Cand.scient.san. Forfatter(e):

Maria Buhl Borgstrøm Afdeling:

Gynækologisk-obstetrisk Afdeling, Herlev og Gentofte Hospital


Kandidatspeciale Vejleder: Professor Lone Schmidt, dr.med.,ph.d.


Abstract Introduktion: I 2016 blev den danske lovgivning ændret for at øge antallet af ægdonorer. For at kunne imødekomme ægdonorernes forventninger og målrette behandlingen samt vejledningen til ægdonorerne, er det en forudsætning at opnå en større viden om dem. Foreløbig findes der ingen danske studier med udgangspunkt i ægdonorernes perspektiv. Formålet med studiet er at undersøge hvordan kvinder som donerer æg til infertile par, beskriver deres motiver for og holdninger til ægdonation, samt deres oplevelser på fertilitetsklinikken. Metode: Ved strategisk og kriterie bestemt udvælgelse blev seks ægdonorer med donorstatus som henholdsvis anonym, anonym udvidet eller åben, rekrutteret fra Fertilitetsklinikken på Herlev Hospital. Individuelle og semi-strukturerede interviews blev gennemført og analyseret ved Graneheim & Lundmans kvalitative indholdsanalyse. Resultater: Af analysen fremkom fem temaer: ”Balance i livet”, ”Donerer æg for at hjælpe andre”, ”Bevidst afstandtagen”, ”Sårbarhed og ægdonation” samt ”Plads til forbedring”. Derudover et tværgående tema: ”Sociale interaktioner”. Konklusion: Resultaterne viste, at motivet for at donere æg havde mange facetter, men det altoverskyggende motiv var muligheden for at hjælpe andre. Betydningen af den finansielle kompensation var ikke entydig. Kvindernes holdning omkring ægdonation blev beskrevet som en bevidst afstand fra de donerede æg, rollen som mor samt til modtagerparret. Sårbarhed blev af ægdonorerne oplevet i mødet med sundhedspersonalet og i oplevelser undervejs i behandlingen. Der var plads til forbedring, hvad angik vejledningen til kvinderne omkring valg af donorstatus, samt i relation til en usikkerhed de oplevede omkring anvendelsen af deres æg. På tværs blev set, at der igennem hele ægdonationsprocessen foregår mange sociale interaktioner.


D 41

Abstract-titel:

Reliabilitet af Graded Cycling Test med Talk Test og 30 sekunders rejse-sætte-sig test til patienter i testosteronsænkende behandling for prostatacancer

Præsenteres af: Maria Rothgart Petersen Stillingsbetegnelse: Fysioterapeut og cand.scient.san

Forfatter(e):

Maria Rothgart Petersen Afdeling:



Anne-Mette Ragle, fysioterapeut, Afdeling for Ergoterapi og Fysioterapi Peter Østergren, læge og ph.d., Urologisk afdeling Anders Vinther, forskningsfysioterapeut og ph.d., Afdeling for Ergoterapi og Fysioterapi


Abstract Introduktion Testosteronsænkende behandling anvendes til patienter med prostatacancer for at nedsætte sygdomsprogression. Lavt testosteronniveau er forbundet med bivirkninger fx nedsat insulinfølsomhed og øget risiko for type 2 diabetes og hjertekarsygdomme. Patienter tilbydes derfor holdbaseret træning og testes med Graded Cycling Test med Talk Test (GCT-TT) og 30 sekunders rejse-sætte-sig test (30s-CST) for at monitorere og dokumentere effekt. Kendskab til testenes reliabilitet er nødvendig for at afgøre om en målt effekt kan regnes som udtryk for en reel forbedring. Reliabiliteten er ikke tidligere undersøgt hos denne patientgruppe. Metode 60 patienter i testosteronsænkende behandling for prostatacancer. Deltagerne udførte GCT-TT og 30s-CST med en kort pause imellem. Efter en pause på 1 time blev de to tests gentaget. Intraclass Correlation Coefficient (ICC2.1), Standard Error of Measurement (SEM95) og Smallest Real Difference (SRD) blev beregnet. Resultater Relativ reliabilitet for 30s-CST (ICC2.1) var 0.97 [95% CI: 0.94-0.98] med lille måleusikkerhed: SEM95%: 1,9 gentagelser og SRD: 2,6 gentagelser. GCT-TT: ICC2.1 var 0.88 [0.81-0.93], SEM95%: 22,7 Watt og SRD: 32,2 Watt. Konklusion For patienter i testosteronsænkende behandling for prostatacancer er reliabiliteten for 30s-CST høj og med 95% sandsynlighed er der tale om en reel forbedring ved 2 gentagelser for en gruppe af patienter og 3 gentagelser for indivividuelle patienter. For GCT-TT er reliabiliteten god. En forbedring på over 22,7 Watt er udtryk for en reel forbedring på gruppeniveau mens individuelle patienter skal forbedre sig 3 trin (45Watt) før der er tale om sikker forandring. GCT-TT egner sig dermed bedre til at måle forandring hos grupper end hos individuelle patienter.


D 42

Abstract-titel:

Living with a parastomal bulge – patients’ experiences of symptoms

Præsenteres af: Marianne Krogsgaard

Stillingsbetegnelse: Forskningssygeplejerske, Ph.d studerende Forfatter(e):

Marianne Krogsgaard + nedenstående medforfattere Afdeling:

Gastroenheden, Herlev og Gentofte Hospital


Thordis Thomsen, Abdominalcentret Rigshospitalet Anders Vinther,Fysioterapien, Herlev og Getofte Hospital Ismail Gögenur, Kirurgisk Afdeling, Sjællands Universitetshospital Gudrun Kaldan, Forskningsenheden 7831, Rigshospitalet Anne Kjærgaard Danielsen, Gastroenheden, Herlev og Gentofte Hospital


Abstract Introduction. Parastomal bulging is the most common complication of stoma formation. Symptom burdens reported by health professionals vary from asymptomatic to high symptom load, however patients´ experiences of symptoms are lacking. Aim and objectives. To investigate experienced symptoms of parastomal bulging in relation to an ileostomy or colostomy. Method. Twenty patients participated in five semi-structured focus group interviews. Analysis was performed using a phenomenological-hermeneutic approach. Findings (results). The bulge caused different unfamiliar bodily sensations that interacted with patients’ everyday lives. Some but not all of these sensations were modifiable. As the bulge and the ostomy changed size and shape, patients had to adjust and readjust stoma care continuously. The physical change called for patients’ awareness and posed a threat to patients´ control of the ostomy and challenged stoma self-care. The bulge caused a bodily asymmetry that deformed the patients’ bodies in a way that exceeded the perceived alteration already caused by the stoma. To cover the physical disfigurement, new clothing-solutions, garment wear and creativity were essential in every-day life. Patients gradually adapted to the bulge over time. Easy access to professional help was crucial in order to find the best appliance and garment solution in relation to the bulge. Conclusions. Various symptoms related to the parastomal bulge affected patients’ everyday lives in different ways and underpinned that an individualized approach is important when addressing patients’ problems and complaints. Research into non-surgical treatments and patient perspectives is limited and highly warranted to improve clinical outcome..


D 43

Abstract-titel:

Tumor-reactive T cell subsets in the microenvironment of ovarian cancer Præsenteres af: Marie Christine Wulff Westergaard


Marie Christine Wulff Westergaard Afdeling:

Center for Cancer Immune Therapy


R Andersen1,2, JW Kjeldsen1, M Pedersen1,2, C Friese1, T Hasselager3, H Lajer4, M Donia*1,2, I M Svane*1,2 1Center for Cancer Immune Therapy, Department of Hematology, Herlev Hospital, University of Copenhagen, Denmark. 2Department of Oncology, Herlev Hospital, University of Copenhagen, Denmark 3Department of Pathology, Herlev Hospital, University of Copenhagen, Denmark 4Department of Gynecology, Rigshospitalet, University of Copenhagen, Denmark *contributed equally to this work


Abstract Non-melanoma solid malignancies are frequently infiltrated with T cells and the recent successes of adoptive cell transfer (ACT) immunotherapy with tumor infiltrating lymphocytes (TILs) in melanoma warrant testing of this treatment strategy in other cancer types. In this preclinical study, we investigated whether clinical-grade TILs could be manufactured from tumor specimens of patients with ovarian cancer. Tumor specimens were obtained from 33 individual patients with ovarian cancer. Minimally expanded TILs (Young TILs) were successfully established from all patients. Young TILs contained a very high frequency of CD3+ cells (92%, range [43-98]) with a variable CD4/CD8 ratio (2.6, range [0.003-38.64]). TILs could be further expanded to clinical numbers with the rapid expansion protocol (REP), reaching a median fold expansion over 1500 (1660, range [440-5544]). Importantly, recognition of autologous tumor antigens was demonstrated in TILs obtained from >50% of patients (19 of 31) across different ovarian cancer histologies, including rare variants such as ovarian carcinosarcomas. These findings support the hypothesis that patients with ovarian cancer can benefit from ACT with TILs, and led to the initiation of a pilot clinical trial at our institution (clinicaltrials.gov identifier: NCT02482090).Skriv dit abstract her , max 250 ord


D 44

Abstract-titel:

TRIAGE III – A cluster-Randomized trial on the effect of introducing a prognostic biomarker in Emergency medicine Præsenteres af: Martin Schultz

Stillingsbetegnelse: Læge, PhD studerende Forfatter(e):

Martin Schultz Afdeling:

Cardiologisk afd. S


Line Jee hartmann Rasmussen, Forskningscenter, Hvidovre Jesper Eugen-Olsen, Forskningscenter, Hvidovre Thomas Kallemose, Forskningscenter, Hvidovre Theis Lange, Biostatistik institut, KU Lisbet Ravn, Akut afdelingen, Herlev-Gentofte BIrgitte Nybo, Akufafdelingen, Bispebjerg Lars Køber, Kardiologisk afdeling, RH Lars Rasmussen, Anæstesiologisk afdeling, RH Kasper Iversen, Kardiologisk afd S, Herlev-Gentofte Line E-mail adresse: [email protected]

Abstract Introduction: Safe and fast risk stratification is essential in the emergency departments. Several biomarkers that carry prognostic information about the patient’s health have been identified. Adding information from prognostic biomarkers may improve clinical assessment and early risk stratification of acutely admitted patients. Elevated levels of the biomarker suPAR are associated with the presence and severity of acute and chronic conditions and strongly associated with mortality. Low suPAR levels are associated with a good prognosis. The TRIAGE III trial investigates the concept: does prognostic information conveyed by a biomarker result in improved early risk assessment leading to reduced mortality. Methods: The TRIAGE III trial is a prospective, cluster-randomized interventional trial. In six interventional periods of three weeks, suPAR was included as a standard blood test at admission, which we compared to six control periods without suPAR measurement. Prior to the trial, the doctors were informed of the prognostic capacities of suPAR. Results: will be published in 2018 Conclusion: will be published in 2018


E 45

Abstract-titel:

Secondary stroke prophylaxis in atrial fibrillation patients with chronic kidney disease Præsenteres af: Mathias Aagaard Christensen


Mathias Aagaard Christensen Afdeling:

Kardiologisk afdeling, Herlev-Gentofte Hospital


Mathias Aagaard1, MB; Emil Loldrup Fosbøl2, MD PhD; Anders Nissen Bonde1; Gunnar H. Gislason1, MD, PhD; Anna Gundlund1, MD 1: Cardiology Department S, Forskning 1, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark 2: Department of Cardiology, University Hospital of Copenhagen, Rigshospitalet


Abstract Abstract – 234 words (max 250) Introduction: Oral anticoagulation (OAC) therapy as secondary stroke prophylaxis in atrial fibrillation (AF) patients with impaired kidney function remains an unexplored area and poses a clinical treatment dilemma. Methods: Using nationwide registries, we identified Danish AF patients with available data on serum creatinine who presented with first-time ischemic stroke from 2005–2011. Post-stroke OAC therapy were examined for those with impaired (eGFR<35 mL/min) and normal (eGFR≥35 mL/min) kidney function. Post-stroke, long-term outcomes were assessed for patients with and without renal impairment by multivariable Cox regression models comparing those in OAC therapy with those not in OAC therapy. Results: Of 3312 AF patients presenting with ischemic stroke, 248 patients had renal impairment (median age 83 years (interquartile range (IQR) 78-88), 58.9% were women, and 31.1% received post-stroke OAC therapy). 3064 had normal kidney function (median age 79 years, IQR 70-85, 49.3% were women, and 47.0% received post-stroke OAC therapy). OAC therapy versus no OAC therapy was only associated with better outcomes for those with normal kidney function: Adjusted hazard ratio (HR) for thromboembolic events for patients with normal kidney function: 0.73, 95% confidence interval (CI) 0.62-0.86 and adjusted HR for thromboembolic events for patients with impaired kidney function 1.55, 95% CI 0.81-2.98. Conclusion: Contrary to patients with normal kidney function, OAC therapy was not associated with better outcomes than no antithrombotic therapy for AF patients with renal impairment who had suffered from an ischemic stroke.


E 46

Abstract-titel:

Overgang fra superviseret til selvstændig træning: erfaringer fra mænd med prostatacancer Præsenteres af: Mette Schmidt

Stillingsbetegnelse: Magister, ph.d.-studerende Forfatter(e):

Mette Schmidt Afdeling:

Urologisk Afdeling H


Julie Midtgaard, Universitetshospitalernes Center for Sundhedsfaglig Forskning, Rigshospitalet Anne-Mette Ragle,Fysioterapien, Afdeling for Ergoterapi og Fysioterapi, Herlev og Gentofte Hospital Jens Sønksen, Urologisk Afdeling, Herlev og Gentofte Hospital, Peter Østergren, Urologisk Afdeling, Herlev og Gentofte Hospital


Abstract Introduktion Superviseret træning anbefales i kliniske guidelines som en strategi til at modvirke bivirkninger ved kasterationsbehandling hos mænd med prostatacancer. Fastholdelse af træning efter deltagelse i et træningsforløb har vist sig at være svært. Studiets formål var at undersøge erfaringer med overgangen til selvstændig træning hos mænd med prostatacancer, der har deltaget i et hospitalsbaseret superviseret træningsprogram med henblik på at identificere, hvad der understøtter fastholdelse af træning. Metode Mænd med prostatacancer i kasterationsbehandling, der har færdiggjort et 12-ugers superviseret træningsprogram på Herlev & Gentofte Hospital, blev inviteret til at deltage 2-3 måneder efter deres programs afslutning. Træningen foregår i grupper og består af styrke- og konditionstræning og indeholder en struktureret overgang til et almindeligt fitnesscenter. Data blev indsamlet gennem semi-struktureret fokusgruppeinterview. Interviewene blev optaget med diktafon og video, transskriberet og analyseret med tematisk analyse. Resultater 29 mænd (gennemsnitsalder 71) deltog i 5 fokusgruppe interview. 25 mænd (86%) trænede fortsat efter at have afsluttet programmet. Selvstændig træning blev understøttet af fire komponenter, der understøttede opnåede træningsfærdigheder: 1) overgang til et fitnesscenter sikrede kendskab til træningsfaciliteter i et nyt miljø; 2) fortsættelse af træning sammen med ligesindede imødekom udfordringerne ved selvstændig træning i lokale fitnesscentre; 3) redskaber, f.eks. individuelt træningsskema, støttede overførsel af færdigheder til nye faciliteter; 4) fysiologisk test hos fysioterapeut gav feedback på og bekræftede træningsindsats. Konklusion Hospitalsbaseret, prostatacancerspecifikt, superviseret træning, der inkluderer redskaber og en struktureret overgang til et fitnesscenter, kan være med til at understøtte fastholdelse af selvstændig træning, særligt hvis træningen fortsætter sammen med ligesindede.


E 47

Abstract-titel:

PD-L1-specific T cells can be activated by interferon-y and have an anti-tumor effect Præsenteres af: Mia Thorup Lundsager

Stillingsbetegnelse: Phd-studerende Forfatter(e):

Mia Thorup Lundsager Afdeling:

Center for Cancer Immunterapi, IO Biotech


Mads Hald Andersen, Center for Cancer Immunterapi, IO Biotech


Abstract UDGÅR Introduction The programmed death-1 receptor (PD-1) and its ligand (PD-L1) play key roles in inducing immune tolerance in the tumor microenvironment, where PD-L1 is expressed by cancer cells and different immune regulatory cells. We have previously shown that the immune system has an anti-cancer mechanism that works via PD-L1-specific Tcells in vitro. Here we examined the function of PD-L1-specific Tcells in vivo. Methods Healthy C57Bl/6 mice were injected with IFNy and after 6 days the spleen was analysed by Elispot with ex vivo stimulation of a murine PD-L1-derived epitope (mPD-L1long). Vaccination with mPD-L1long in Montanide was done in C57Bl/6 mice to further enhance the response. A week after vaccination, spleen and draining lymph nodes was analyzed. C57Bl/6 mice was inoculated with B16F10 cells and vaccinated to test the anti-tumoral effect on tumor growth. Results A PD-L1-specific T cell response in the spleen was seen after two IFNy-injections, indicating a rapidly increase in PD-L1-specific Tcells. It was possible to further increase the PD-L1-specific response by one vaccination with mPD-L1long. We also found that mPD-L1long-vaccination delayed the tumor growth. Conclusion The results suggest that PD-L1-specific Tcells are already present and are activated due to a strong activation signal from their cognate targets (i.e. professional antigen-presenting cells) at inflammation sites. PD-L1-specific Tcells are easily expanded by vaccination and they have an anti-tumoral effect. Thus, PD-L1-specific Tcells are a particularly interesting example of the immune system’s ability to influence adaptive immune responses by directly reacting against the immune-suppressive mechanisms employed by cancerous cells.


E 48

Abstract-titel:

Early life gut microbiome evolution tracked by CRISPR typing

Præsenteres af: Moïra Dion

Stillingsbetegnelse: Visiting graduate student Forfatter(e):

Moïra Dion Afdeling:

COPSAC


Denise Tremblay (1), Shiraz Shah (2), Jakob Stokholm(2), Hans Bisgaard (2), and Sylvain Moineau (1) (1) Groupe de recherche en écologie buccale, Département de biochimie, de microbiologie et de bio-informatique, Faculté des sciences et de génie, Université Laval, Québec, Canada (2) Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University, Gentofte, Denmark


Abstract Introduction: Due to the accumulating evidence of its crucial role in human health, the human gut microbiota is extensively studied. A large and diverse population of bacteriophages, viruses infecting bacteria, also colonizes the gastrointestinal tract. However, very little is known about how they drive bacterial evolution. CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) loci, together with their cas genes, are found in nearly half of the bacterial genomes. They provide acquired immunity against bacteriophages, by incorporating spacers (short DNA sequences originating from bacteriophage genomes) in the locus. Due to their dynamic structure, CRISPRs may serve as a strain typing tool and a chronological archive of past phage-bacteria interactions. Methods: Part of the EarlyVir project, the two CRISPR loci (identified as CR1 and CR2) of 1769 Escherichia coli isolates were sequenced by Sanger sequencing. The strains originated from faeces samples (obtained at 1 week, 1 month and 1 year of age) from the COPSAC 2010 cohort. CRISPRs were analysed using the CRISPRDetect software. Results: Of the 1769 isolates, 63% had a CR1 locus and 28% had a CR2 locus. We observed a high spacers diversity, with loci displaying 5 to 25 spacers and detected spacers acquisition and deletion in some samples. Only 3% of all distinct spacers matched a known bacteriophage sequence. Conclusion: CRISPRs are a multifaceted tool to better understand strains differenciation. By combining CRISPR types and the cohort's health data, we aim at establishing correlations between the gut composition and health determinants, such as delivery mode, asthma and antibiotics.


E 49

Abstract-titel:

Preclinical Development of Tumor-Infiltrating Lymphocyte (TIL) based Adoptive Cell Transfer (ACT) immunotherapy for patients with sarcoma and the potential benefit of anti-CD137 stimulation

Præsenteres af: Morten Nielsen

Stillingsbetegnelse: Reservelæge Forfatter(e):

Morten Nielsen Afdeling:

Center for Cancer Immunterapi, Onkologisk afdeling


Morten Nielsen (1), Anders Krarup-Hansen (2), Dorrit Hovgaard (3), Michael Mørk Petersen (3), Anand Chainsukh Loya (4), Marie Christine Wulff Westergaard (1), Inge Marie Svane (1), Niels Junker (2) (1) Center for Cancer Immune Therapy, Department of Haematology and Department of Oncology, Herlev University Hospital, Herlev, Denmark; (2) Department of Oncology, Herlev University Hospital, Herlev, Denmark; (3) Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; (4) Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark E-mail adresse: [email protected]

Abstract Background: We investigated feasibility of expanding TILs from sarcomas, as well as performing functional in vitro analyses on these. Methods: Fresh tumor samples from sarcoma patients were obtained, and TILs were isolated and expanded in growth medium containing IL-2. In a sub study, we investigated the effect of adding an agonistic CD137 antibody (Urelumab, BMS) and/or an anti-CD3 antibody (OKT3) to the medium. Results: Tumor samples from 30 patients with various types of sarcomas were obtained, and we were able to expand a minimum of 40 million TILs from 27 of these. Mean expansion times were 32 days (14 - 61). 87,7 % (36,4 – 99,1) of these cells were CD3+, and of these, 66,7 % (16,3 – 99,1) were CD4+, and 21,8 % (0,1 – 50,6) were CD8+. Addition of anti-CD137 and/or OKT3 increased total yield of TILs; anti-CD137 skewed the phenotype significantly towards more CD8+ TILs and in some cases NK cells and γδ cells. TILs from 10 of 22 tested tumor samples from four different sarcoma subtypes (undifferentiated pleomorphic sarcoma, myxofibrosarcoma, myxoid liposarcoma and osteosarcoma) demonstrated reactivity against autologous tumor cells using IFNγ-Elispot. Conclusion: We were able to expand TILs from 90 % of the acquired tumor samples to numbers needed for possible future clinical ACT implementation. Approximately half of the TIL cultures showed some degree of in vitro tumor reactivity as determined by Elispot. Based on these results, we conclude that it is feasible to translate TIL based ACT into clinical testing in sarcoma patients.


E 50

Abstract-titel:

Associations between functional polymorphisms and response to biological treatment in Danish patients with psoriasis Præsenteres af: Nikolai Dyrberg Loft

Stillingsbetegnelse: Forskningsårstuderende Forfatter(e):

Nikolai Dyrberg Loft Afdeling:



Lone Skov (Hud- og allergiafdelingen, Gentofte hospital), Lars Iversen (Hudafdelingen, Århus), Robert Gniadecki (Hudafdelingen, Bispebjerg), Tomas Dam (Hudklinikken, Nykøbing falster), Ivan Brandslund (Klinisk immonulogisk og biokemisk, Lillebælt hospital), Hans J. Hoffmann (Lungemedicinsk, Århus), Malene R. Andersen (Klinisk biokemisk afdeling, Gentofte hospital), Ram B. Dessau (Klinisk mikrobiologisk, Slagelse ), Ann C. Bergmann (IRS-Center, Sønderjylland) Niels M. Andersen (IRS-Center, Sønderjylland), Paal Skytt Andersen (Mikrobiologi & Infektionskontrol, SSI) Steffen Bank (IRS-Center, Sønderjylland), Ulla Vogel (NFA, København) og Vibeke Andersen (IRS-Center, Sygehus Sønderjylland).


Abstract Introduction: Biological agents including anti-TNF (adalimumab, infliximab, etanercept) and anti-IL 12/23 (ustekinumab) are essential for treatment of patients with severe psoriasis. However, a significant propotion of the patients do no respond to a specific treatment. Pharmacogenetics might be a way to predict treatment response in thee individual patient. Methods: Using a candidate gene approach, 62 mainly functional single nucleotide polymorphisms (SNPs) in 44 different genes were evaluated in 478 Danish patients with psoriasis undergoing 376 series of anti-TNF treatment and 230 series of ustekinumab treatment. Associations between genetic variants and treatment outcomes (drug survival and PASI reduction) were assessed using logistic regression analyses (crude and adjusted for gender, age, psoriatic arthritis, and previous treatment). Results: After correction for multiple testing controlling the false discovery rate six SNPs (IL1B (rs1143623, rs1143627), LY96 (rs11465996), TLR2 (rs11938228, rs4696480), and TLR9 (rs352139)) were associated with response to anti-TNF treatment and 4 SNPs IL1B (rs1143623, rs1143627), TIRAP (rs8177374), and TLR5 (rs5744174) were associated with response to ustekinumab treatment (q < 0.20). Conclusion: The results suggest that genetic variants related to increased IL-1β levels may be unfavorable when treating psoriasis with either anti-TNF or ustekinumab, whereas genetic variants related to high IFN-γ levels may be favorable when treating psoriasis with ustekinumab.


E 51

Abstract-titel:

Vitamin D high-dose supplementation in pregnancy reduces developmental dental defects (Molar Incisor Hypomineralization) in off-spring

Præsenteres af: Pia Elisabeth Nørrisgaard

Stillingsbetegnelse: ph.d. studerende Forfatter(e):

Pia Elisabeth Nørrisgaard Afdeling:

COPSAC, Dansk BørneAstma Center, Børne- og Ungeafdelingen


Klaus Bønnelykke (1), Dorte Haubek (2), Hans Bisgaard (1) 1) COPSAC, Dansk BørneAstma Center, Børne- og Ungeafdelingen 2) Sektion for Pædodonti, Institut for Odontologi og Oral Sundhed, Aarhus Universitet


Abstract Introduction Vitamin D is an important component involved in tooth formation. Permanent teeth are formed in pregnancy and start to mineralize just before birth. Hence, if the vitamin D levels are deficient in pregnant women, teeth might not develop sufficient. Molar Incisor Hypomineralisation (MIH) is a dental defect, where the enamal appears porous and may crack with time. MIH affects up to 40% of children in the Western world and has a comprehensive treatment need. We assessed the effect of high-dose supplementation with vitamin D in pregnant women on MIH in their offspring. Methods 623 pregnant women from the COpenhagen Prospective Studies on Asthma in Childhood2010 cohort (COPSAC2010) were randomly assigned at 24 weeks of gestation to receive Vitamin D3 (2400 IU/d; n = 315) or matching placebo tablets (n = 308) as part of usual pregnancy care per day (400 IU/d of vitamin D3). A dental examination were performed when the children were 6 years. The effect of the intervention on MIH as a binear outcome was analyzed using logistic regression. Results 583 children had a dental examination, whereof 391 had one or more permanent molars. 21% of the children were affected with MIH. Children of mothers in the vitamin D group had a reduced the risk of MIH with almost 50% (OR 0.46; 95% CI: 0.26 - 0.79; p=0.001). Conclusion We found that a high-dose supplementation with vitamin D in pregnancy reduces developmental dental defects in their off-spring. This suggests substantial impact on dental health and health care finance.


E 52

Abstract-titel:

Fish-oil supplementation in pregnancy causes a proportional increase in lean mass, bone mass and fat mass at 6 years: A Randomized, Controlled, Double-Blind, Clinical Trial

Præsenteres af: Rebecca K Vinding / Astrid Sevelsted

Stillingsbetegnelse: MD/ MSc Forfatter(e):

Rebecca Kofod Vinding, Afdeling:

COPSAC-Gentofte hospital


Jakob Stokholm, MD, PhD, Astrid Sevelsted1, MSc, Tobias Sejersen1+2,MD, Bo Chawes1, MD, PhD, DMSc, Klaus Bønnelykke1, MD, PhD, Laura D Howe3, PhD, Martin Krakauer, MD, PhD,4 Thora Buhl, MD, PhD,4 Hans Bisgaard1, MD, DMSc; 1) COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark 2) Department of Pediatrics, Naestved Hospital, Naestved, Denmark. 3) MRC Integrative Epidemiology Unit at the University of Bristol, School of Social and Community Medicine, University of Bristol, Bristol, UK 4) Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, University Hospital of Copenhagen, Denmark. E-mail adresse: [email protected]

Abstract DELTAGER UDENFOR KONKURRENCE Introduction Some observational studies suggest that maternal fish and fish oil intake during pregnancy affect offspring growth during childhood, but the findings are ambiguous We examined the effect of fish oil supplementation in pregnancy on offspring anthropometrics and body composition during childhood in a large randomized trial. Methods A single-center, double blind, randomized controlled trial conducted among 736 pregnant women and their offspring, participating in the COPSAC2010-mother-child cohort.The pregnant women received either 2.4 g of fish oil or control daily from pregnancy week 24 until one week after birth. Height/length, weight, head and waist measurements were collected prospectively until 6 years. DXA scans were performed at 3.5 and 6 years. Results The fish oil supplementation resulted in significantly higher mean z-score BMI from 0-6 years compared to control: β-coefficient 0.14 [0.13; 0.15];p=0.006. At 6 years, supplementation was associated with a higher z-score BMI (mean difference fish oil vs. control: 0.19; [0.06; 0.32],p=0.004) and a larger waist circumference (0.64cm [0.02; 1.21],p=0.04), but not a higher proportion of children in risk of obesity (5% vs 5%, p=0.89). The DXA scan at age 6 years showed a higher fat free mass in the fish oil vs. control group (mean difference: 230g [37g; 421g],p=0.02) and a higher bone mineral content (11g (95% CI [3g;18g]),p=0.007), but no difference in total body fat percentage (0.19%, (95% CI [-0.66; 1.04]),p=0.66. Conclusion Fish oil supplementation from 24th week of pregnancy led to an increased BMI from 0-6 years of age, but not an increased risk of obesity, and a body composition at age 6 years characterized by a proportional increase in lean mass, bone mass and fat mass.


E 53

Abstract-titel:

Dose-effect association between gestational age and school difficulties - a Danish population-based register study.

Præsenteres af: Rikke Wiingreen

Stillingsbetegnelse: Forskningsårsstuderende 2016/2017 Forfatter(e):

Rikke Wiingreen, Gorm Greisen, Jannet Svensson, Bo Mølholm Hansen

Afdeling:

Børne- og Ungeafdelingen (HGH, Herlev) og Neonatalklinikken (RH)


Gorm Greisen - Neonatalklinkken, Rigshospitalet Jannet Svensson - Børne- og Ungeafdelingen, HGH, Herlev Bo Mølholm Hansen - Børne- og Ungeafdelingen, HGH, Herlev


Abstract Introduction: Several studies suggest a relationship between GA (gestational age) at birth and risk of school difficulties. Our study aimed to investigate the association between the entire range of GA’s and significant school difficulties measured as 1) More than nine hours per week special educational support and 2) Not completing the final exam after 10 years of compulsory school. Methods: A population-based register study including all children attending the Danish compulsory school in 2015/2016 and all live-born infants born in Denmark between 1992–1997. Data were collected and linked using multiple registers hold by Statistic Denmark. Multiple logistic regression analyses were used to estimate the association between GA and significant school difficulties, adjusted for explanatory variables. Results: For measurement 1) 615.789 children entered the analyses after exclusion of those with missing neonatal data. The risk of special educational support increased gradually across the entire range of gestation from 40 to ≤24 GA: The adjusted OR was 1.07 (95% CI 1.03-1.12) at 39 GA and 6.18 (95% CI 5.17-7.39) at GA < 28 wks. For measurement 2) the cohort consisted of 374.798 children after exclusion of those who died and/or had missing neonatal data. The risk of not completing the exam increased across the entire range of GA: The adjusted OR was 1.07 (95% CI 1.04-1.10) at 39 GA and 2.99 (95% CI 2.41-3.71) at GA < 28 wks. Conclusion: We confirmed a clear dose-effect association concerning significant school difficulties across the entire range of GA’s from 21 to 40 weeks.


E 54

Abstract-titel:

Peripheral nerve block anaesthesia is superior to spinal anaesthesia concerning postoperative pain control in primary ankle fracture surgery: results from the randomised “AnAnkle Trial”

Præsenteres af: Rune Sort

Stillingsbetegnelse: Læge Forfatter(e):

Sort R et al. Afdeling:

Anæstesiologisk Afdeling, Herlev Hospital


Brorson S; Ortopædkirurgisk Afd., Herlev Hospital Gögenur I; Kirurgisk Afd., Sjællands Universitetshospital, Køge Olsen LL; Anæstesiologisk Afd., Herlev Hospital Nielsen JK; Anæstesiologisk Afd., Herlev Hospital Hougaard S; Anæstesiologisk Afd., Hvidovre Hospital Foss NB; Anæstesiologisk Afd., Hvidovre Hospital Møller, AM; Anæstesiologisk Afd., Herlev Hospital


Abstract Background: Peripheral nerve blocks (PNB) are widely used for pain control in orthopaedic limb surgery. However, in acute fracture surgery, rebound pain following PNB might outweigh the benefits of longer analgesia. We aimed to investigate the effect of PNB anaesthesia compared with spinal anaesthesia (SA) on postoperative pain in acute ankle fracture surgery. Methods: AnAnkle Trial was a randomised, GCP-audited, open label trial with adults undergoing primary ankle fracture surgery. Randomisation was between PNB anaesthesia, with popliteal sciatic and mid-femoral saphenous blocks, and unilateral SA. Postoperatively, all received paracetamol and ibuprofen and patient controlled on-demand i.v. morphine (PCA). Pain scores from 0-10 and PCA morphine was registered for 27 hours after anaesthesia. Endpoints: an integrated pain score (IPS) and, secondarily, NRS AUC and total morphine analysed separately. Results: 150 participants. Groups were comparable regarding comorbidity, preoperative pain scores and baseline characteristics. General anaesthesia was necessary in five patients with PNB and none with SA. IPS was significantly higher in the SA group (p<.001). The secondary endpoints also yielded significant reductions in the PNB group. Discussion: The PNBs have longer duration of analgesia than SA and the pain levels and opioid need in the PNB group indicate considerable rebound pain when the blocks subside. Nonetheless, both IPS and the two components alone revealed an overall benefit with the PNBs. Conclusions: PNB anaesthesia provides superior postoperative pain control compared with SA for ankle fracture surgery. However, rebound pain following PNBs warrants attention in clinical practice.


E 55

Abstract-titel:

Importance of dosage among long-term digoxin users with Atrial

Fibrillation – Results from nationwide registries Præsenteres af: Sanam Nusrat Tahir


Sanam Nusrat Tahir Afdeling:

Kadiologisk afdeling


Anders Nissen Bonde Frederik Dalsgaard Jonas Bjerring Olesen Gunnar Gislason Martin Ruwald


Abstract Background Digoxin has never been studied in a randomized controlled trial of atrial fibrillation (AF) patients. Observational studies have demonstrated conflicting results regarding the safety of the drug. We sought to determine the trend in digoxin dosis, and access the risk of all-cause mortality associated with high dosage among long-term digoxin users. Methods Through individual-level linkage between nationwide registries, patients with AF, digoxin prescriptions and recent creatinine were identified from 1997 to 2013. High digoxin dosage was defined according to creatinine and age. Patients were followed for a maximum of 15 years, and dosage, age and creatinine were updated each year. Risk of all-cause mortality associated with high dosage was examined using cox proportional hazards models. Results 14.779 patients with AF and regular digoxin use were included in our analyses. 1241 patients were overdosed according to age and creatinine, whereas 1344 were underdosed. After two years of digoxin use 4.8% were overdosed, increasing to 9.3% after 15 years. High digoxin dosage was associated with increased risk of all-cause mortality during the first year of follow-up (hazard ratio 1.19, 95% confidence interval 1.01-1.39). Conclusion Our findings suggested increasing proportion of patients overdosed according to age and creatinine. Digoxin overdose was associated with increased risk of all-cause mortality.


F 56

Abstract-titel:

The inhibitory checkpoint, PD-L2, is a target for effector T cells: Novel possibilities for immune therapy Præsenteres af: Shamaila Munir Ahmad

Stillingsbetegnelse: Phd Studerende Forfatter(e):

Shamaila Munir Ahmad Afdeling:

Department of Hematology


Evelina Martinenaite, Morten Holmström, Mia Aaboe Jørgensen, Özcan Met , Claudia Nastasi, Uffe Klausen, Marco Donia, Lars Møller Pedersen, Lars Munksgaard, Niels Ødum, Anders Woetmann, Inge Marie Svane and Mads Hald Andersen. Center for Cancer Immune Therapy (CCIT), Department of Hematology


Abstract Several clinical trials on checkpoint-protein blockers have suggested that the PD-1/PD-ligand (PD-L) pathway is important in hematological cancers. Here, we investigated whether PD-L2 might represent a target that induces specific T cells. We identified specific T-cell reactivity against two epitopes located in the signal peptide of PD-L2 from samples from patients with solid cancers as well as healthy individuals. Next we detected strong immune responses against PD-L2 in patients with Non-Hodgkin lymphoma (NHL). We characterized both CD8+ and CD4+ PD-L2-specific T cells. Interestingly, the epitope in PD-L2 that elicited the strongest response was equivalent to a potent HLA-A2-restricted epitope in PD-L1. Importantly, PD-L1-specific and PD-L2-specific T cells did not cross-react; therefore, they represent different T-cell antigens. Moreover, PD-L2-specific T cells reacted to autologous target cells depending on PD-L2 expression. These results suggested that activating PD-L2 specific T cells (e.g., by vaccination) might be an attractive strategy for treating hematological malignancies. Accordingly, a vaccine targeting PD-L2 should attract specific pro-inflammatory T cells to the tumour microenvironment. PD-L2 specific T cells can directly support anti-cancer immunity by killing of target cells, as well as indirectly boost anti-cancer immunity by releasing pro-inflammatory cytokines into the microenvironment in response to PD-L2-expressing immune supressive cells.


F 57

Abstract-titel:

EarlyVir: The early life gut virome and what it means for the development of auto immune diseases Præsenteres af: Shiraz Shah


Shiraz Shah Afdeling:

COPSAC


Shiraz Shah (COPSAC), Jakob Stockholm (COPSAC), Ling Deng (KU), Dennis Nielsen (KU), Aurelie Mathieu (INRA), Marie-Agnes Petit (INRA), Moïra Dion (ULaval), Sylvain Moinneau (ULaval), Hans Bisgaard (COPSAC).


Abstract Introduction: There’s increasing evidence now, that the specific bacteria which live in our intestines while we’re babies, play a vital role in training our immune systems to properly distinguish self from non-self, good from bad. Studies from the COPSAC2010 birth cohort have shown how c-section babies have a higher risk of developing asthma. This is because of changes in the gut microbiome, but we don't know how it works. In nature, half of all bacteria are killed every day by viruses that infect them, and we assume this must be true inside us as well. Thus it's easy to imagine how viruses in our gut, i.e. our gut virome, determines which bacteria we have, which in turn determines which auto-immune diseases we get. EarlyVir is a collaboration between COPSAC, UCPH, INRA in France and U. Laval in Canada, where we combine expertise on paediatrics, gut viromes, phage-host relationships and cutting edge science like CRISPR to get to the bottom of the problem. Methods: Gut viromes are being extracted from feces of COPSAC children and sequenced at UCPH. Virus-host pairs are determined experimentally by INRA, and by CRISPR sequencing in Canada. Results: Canada has finished sequencing CRISPRs from all E. coli strains isolated. 25% of feces samples have had viromes extracted and sequencing results are coming in now. Conclusion: When all data is ready, we combine it in a multivariate analysis at COPSAC to determine which viruses are important for the development of auto-immune disorders.


F 58

Abstract-titel:

The pharmacokinetics of fosfomycin and metronidazole after intraperitoneal administration in patients undergoing appendectomy for uncomplicated appendicitis

Præsenteres af: Siv Fonnes

Stillingsbetegnelse: Ph.d.-studerende, læge Forfatter(e):

Siv Fonnes Afdeling:

Center for Perioperativ Optimering, Gastroenheden, Herlev og G f H i l


Johan Juhl Weisser, Institut for Farmaci, Københavns Universitet Barbara Juliane Holzknecht, Klinisk Mikrobiologisk Afdeling, Herlev og Gentofte Hospital Magnus Arpi, Klinisk Mikrobiologisk Afdeling, Herlev og Gentofte Hospital Jacob Rosenberg, Center for Perioperativ Optimering, Gastroenheden, Herlev og Gentofte Hospital


Abstract Introduction We aimed to investigate the pharmacokinetics of fosfomycin and metronidazole after intraperitoneal administration of the combination of fosfomycin, metronidazole, and recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) in patients undergoing laparoscopic appendectomy for uncomplicated appendicitis. Methods We included eight otherwise healthy men undergoing laparoscopic appendectomy. The trial treatment was administered and left in the abdominal cavity. Trial drugs consisted of 4 g fosfomycin, 1 g metronidazole, and 50 µg rhGM-CSF in a total volume of 500.2 ml. Blood samples were collected prior to and ½, 1, 2, 4, 8, 12, and 24 hours after administration. High Pressure Liquid Chromatography-Mass Spectrometry was used for pharmacokinetic investigations. Antimicrobial susceptibility was investigated for intraoperatively collected specimens. Results The median Cmax for fosfomycin in plasma was 129 mg/l, median Tmax 1 hour, and median T½ 3.5 hours. The median Cmax for metronidazole in plasma was 13.6 mg/l, median Tmax 2 hours, and median T½ 7.7 hours. All aerobe bacteria were susceptible to fosfomycin and all anaerobe were susceptible to metronidazole. Conclusion Plasma concentrations of fosfomycin and metronidazole were lower than the intraperitoneally administrated concentrations, though, still within therapeutic range.


F 59

Abstract-titel:

The safety of intraperitoneal administration of fosfomycin, metronidazole, and rhGM-CSF in patients undergoing appendectomy for appendicitis: a phase II clinical trial

Præsenteres af: Siv Fonnes

Stillingsbetegnelse: Ph.d.-studerende, læge Forfatter(e):

Siv Fonnes Afdeling:

Center for Perioperativ Optimering, Gastroenheden, Herlev og G f H i l


Barbara Juliane Holzknecht, Klinisk Mikrobiologisk Afdeling, Herlev Hospital Magnus Arpi, Klinisk Mikrobiologisk Afdeling, Herlev Hospital Jacob Rosenberg, Center for Perioperativ Optimering, Gastroenheden, Herlev Hospital


Abstract Introduction We aimed to investigate the safety of intraperitoneal administration of the combination of fosfomycin, metronidazole, and recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) in patients undergoing laparoscopic appendectomy for uncomplicated appendicitis. Methods We conducted a prospective phase II clinical trial in 14 otherwise healthy men undergoing laparoscopic appendectomy for uncomplicated appendicitis. After appendectomy, trial treatment was administered intraperitoneally and left in the abdominal cavity. Treatment consisted of 4 g fosfomycin, 1 g metronidazole, and 50 µg rhGM-CSF (total volume 500.2 ml). We primarily evaluated safety through white blood cell counts four hours postoperatively compared with admission, where a toxic effect was predefined by a drop below the reference interval’s lower limit . Furthermore, we evaluated harms and adverse events, repeated biochemical markers, symptoms, vital signs, and length of stay. Patients were followed 30 days postoperatively. Results There was neither a significant decrease of the white blood cell counts from admission to postoperatively nor a drop below the reference interval. One third experienced harms including dizziness, discomfort when breathing deeply, no flatus, and bloating. Adverse events included diarrhoea in two patients after discharge and a hypotensive episode from 2-12 hours postoperatively in one patient. No serious adverse events or infectious complications occurred. Conclusion Intraperitoneal administration of the combination of fosfomycin, metronidazole, and rhGM-CSF was safe in otherwise healthy men undergoing appendectomy for uncomplicated appendicitis. There were few possible harms and adverse events but we were unable to assess if they were related to the intervention, anaesthesia, or surgery.


F 60

Abstract-titel:

Gradual decline in prevalence of chronic pain after laparoscopic groin hernia repair: a nationwide cross-sectional questionnaire study Præsenteres af: Stina Öberg & Kristoffer Andresen

Stillingsbetegnelse: Læge, PhD-studerende Forfatter(e):

Stina Öberg Afdeling:

Center for perioperative optimization, Department of Surgery, Herlev H i l U i i f C h D k


Kristoffer Andresen, Jacob Rosenberg Center for perioperative optimization, Department of Surgery, Herlev Hospital, University of Copenhagen, Denmark


Abstract Introduction Up to 6-7% develop chronic pain after laparoscopic groin hernia repair, depending on various factors. Chronic pain seems to decline with time, but the long-term time course after laparoscopic repair is unclear. The purpose of this study was to assess the prevalence of chronic pain 1-5 years after laparoscopic groin hernia repair. Methods This nationwide cross-sectional questionnaire study included adult patients with an inguinal or a femoral hernia. The patients were identified from the Danish Hernia Database, which has an almost 100% follow-up rate. Included patients had a laparoscopic groin hernia repair with mesh. Prevalence of chronic pain was assessed 1-5 years postoperatively by the validated inguinal pain questionnaire. The primary outcome was prevalence of chronic pain. Results In total, 1,383 groins were included after a response rate to the questionnaire of 66%. A decreasing prevalence of pain was seen, especially 3.5 years postoperatively. There were no statistically significant differences when comparing each postoperative year with the second postoperative year. However, the prevalence of chronic pain 3.5-5 years postoperatively was significantly lower (4.4%) compared with the prevalence of pain 1-3.5 years postoperatively (8.1%), P=0.014. Prevalence of pain that could not be ignored was still 5-6% in the fifth postoperative year. Significantly more females had pain (p<0.0005), and patients with pain were also significantly younger than patients without pain (p=0.001). Conclusion This large-scaled questionnaire study showed that the prevalence of chronic pain seems to decline 1-5 years after laparoscopic groin hernia repair, with a distinct decrease 3.5 years postoperatively.


F 61

Abstract-titel:

Poor metabolic control in children with type 1 diabetes and psychiatric comorbidity. Præsenteres af: Stine Møller Sildorf

Stillingsbetegnelse: MD, PhD. student Forfatter(e):

Stine Møller Sildorf Afdeling:

Børne- og ungeafdelingen E, Herlev og Gentofte Hospital


Daniel TH Dybdal (1,2), Statistiker Nina Breinegaard (3), Emilie B. Lindquist (4), Janne S Tolstrup (2), Kirsten A Boisen (5), Anne Mette Skovgaard (2), Grete K Teilmann (1) og Jannet Svensson(4). Affiliations:(1) Department of Paediatrics and Adolescent Medicine, Nordsjællands Hospital, Hillerød, Denmark, (2) National Institute of Public Health, University of Southern Denmark (3) Section of Biostatistics, Dept. of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen (4) Department of Paediatrics and Adolescent Medicine, Herlev Hospital, Denmark (5) Centre of Adolescent Medicine, Rigshospitalet, Denmark


Abstract Introduction: Type 1 diabetes (T1D) in childhood may have long-term consequences with increased morbidity and mortality including an excess risk of psychiatric disorders. Poor outcome is primarily driven by dysregulation of HbA1c. Psychiatric comorbidity is suspected to increase the odds of HbA1c deterioration. The aim of the present study was therefore to compare diabetes outcome in the pediatric population with and without a psychiatric disorder. Methods: In this prospective population-based study, we merged information from the national childhood diabetes register with the National Patient Register during the years 1996-2015. With the purpose, to identify all children (age 0-18 years old) diagnosed with T1D and psychiatric comorbidity. Psychiatric disorders were divided in to three subgroups; constitutional disorders, reactive disorders or both. We further distinguished between onset before T1D diagnosis, when followed at the pediatric department and after. Results: Altogether 4730 children were identified in both registers, of which 21.9% (1035/4730) were diagnosed with at least one psychiatric disorder. The psychiatric disorder was diagnosed prior to T1D in 175 children, while followed at a pediatric clinic in 575 children and after transfer to adult care in 285. HbA1c levels were higher in children with psychiatric comorbidity respectively; 2.1 mmol/mol (constitutional disorders); 3.1 mmol/mol (reactive disorders) and 5.4 mmol/mol (both) (p< 0.001). Those with reactive disorders had a tendency towards more episodes of severe hypoglycemia and ketoacidosis (p< 0.05). Conclusions: Psychiatric comorbidity in children with T1D affects treatment outcome. The findings suggest that psychiatric comorbidity increases the risk of long-term morbidity and mortality.


F 62

Abstract-titel:

“Exploration of reflections and motivations during the citation process conducted by interdisciplinary authors of scientific papers– a qualitative interview study”.

Præsenteres af: Suzanne F Herling


Afdeling:

Anæstesiologisk afdeling


Suzanne Forsyth Herling, post.doc, Karin Frydenlund Jespersen, Research coordinator, Ann Møller, Professor anæstesiologisk afdelings forskningsenhed.


Abstract The aim was to explore reference praxis and motivation for choosing specific references in scientific writing conducted by primary authors of scientific papers Methods We conducted 6 focus group interviews recruiting 20 health researchers as informants. Inclusion criteria were: first author of a scientific paper submitted or published within the last 24 months. The paper was on the table during interviews to stimulate reflection. An interview guide with 8 questions was used. All interviews were electronically recorded, transcribed verbatim, organized in NVivo and analyzed according to systematic text condensation by Malterud. Results At present we have conducted all interviews and are analyzing the preliminary results. Preliminary results indicate that citation bias may be present as researcher are motivated primarily by getting their paper accepted and are very pressed for time. First authors have several strategies for increasing their odds for successful publication by citing the journal they are submitting to, complying with reviewer or editors suggestions, crediting specific colleagues or institutions rather than conducting extensive literature searches to make sure the negative studies, smaller studies also are included and credited. The accessibility of papers has important implications as time is scarce. Little is said of good citing practice from senior to junior researcher as the first author embarks on their first paper. Conclusion Our results will portray the reflections of first authors of scientific papers as they decide what references to include in their papers and if indeed citation bias is considered or present.


F 63

Abstract-titel:

Uncovering novel genes, pathways and potential drug targets for severe childhood asthma: A study combining functional genomics and network medicine

Præsenteres af: Tarunveer Singh Ahluwalia

Stillingsbetegnelse: Senior Researcher Forfatter(e):

Tarunveer Singh Ahluwalia

Afdeling:

COPSAC (Copenhagen Prospective Studies on Asthma in Childhood)


T.S. Ahluwalia1, A. Sharma2, J. Waage1, B. Wang3, N. Grarup4, O. Pedersen4, T. Hansen4, A. Linneberg5, H. Bisgaard1, K. Bønnelykke1

1COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Ledreborg Allé 34, DK-2820 Copenhagen, Denmark 2Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA 3School of Computer Science and Technology, Xidian University,

E-mail adresse:

Abstract Asthma exacerbations are one of the most common cause of hospitalization in children. Albeit genome wide associations studies (GWAS) have previously identified few common genetic variants, studies focusing on low frequency gene variants from protein coding regions remain unexplored, especially for severe childhood asthma. Here, we investigated the association of common and low frequency variants mostly from the coding regions of the human genome with recurrent, severe exacerbations occurring between 2 and 6 years of age. We further investigated the connectivity among these genes/pathways using molecular interaction network (interactome) analysis. We performed a GWAS using the Illumina Human ExomeExpress array on a discovery dataset comprising of 1,204 childhood asthma exacerbation cases and 6,159 non-asthmatic adult controls and a replication on ~ 60,000 individuals of Danish origin. Single SNP association testing was done using logistic regression based additive genetic model and the gene based testing (multiple SNPs) using the metaSKAT method. With identified genes, we constructed a disease-gene network using the ‘COnnectivity sigNiFicance of dIsease geNEs’ (CONFINE) approach. Further we also examined the proximity of the interactome genes to current asthma drug targets through in silico drug bank database mining. We identified a novel locus at Chromosome 6 HLA region at genome-wide significance (p<5.0×10-8) through the single-SNP method and other novel loci through the gene-based method. We identified novel coding genetic variants associated with severe childhood asthma revealing a cross talk between actin cytoskeleton remodeling and immune response pathways and exposing new potential therapeutic drug targets.


F 64

Abstract-titel:

Characterization of abdominal surgical diseases associated with Yersinia infections: a systematic review Præsenteres af: Tilde Rasmussen


Tilde Rasmussen Afdeling:

Center for Perioperativ Optimering, Gastroenheden, Kirurgisk S k i H l G f H i l


Siv Fonnes, Center for Perioperativ Optimering, Gastroenheden, Kirurgisk Sektion, Herlev og Gentofte Hospital Amanda Brunchmann, Det Sundhedsvidenskabelige Fakultet, Københavns Universitet Barbara Holzknecht, Klinisk Mikrobiologisk Afdeling, Herlev og Gentofte Hospital Jacob Rosenberg, Center for Perioperativ Optimering, Gastroenheden, Kirurgisk Sektion, Herlev og Gentofte Hospital


Abstract Background and objectives Yersinia infection affects the terminal ileum and lymph nodes. Therefore it has been reported to mimic the symptoms of appendicitis. We aimed to systematically characterize the suspected or confirmed abdominal diseases and/or surgeries associated with Yersinia infection. Our aim was to identify which suspected or confirmed abdominal surgical diseases were associated with Yersinia infection. Methods This systematic review followed the PRISMA-guidelines and a protocol was registered at PROSPERO prior to data extraction (CRD42016053252). PubMed and EMBASE were last searched systematically on the 7th of September 2017. All types of studies written in Danish, English, German, Norwegian, or Swedish were included. We included articles with ≥5 participants with suspected or confirmed abdominal surgical diseases and/or undergoing abdominal surgery. The participants had to be tested for Yersinia species. Results We included 32 studies in this systematic review. All included studies reported on diseases or symptoms related to the right lower quadrant of the abdomen, as most studies concerned appendectomies (78%), appendicitis (31%), normal appendixes (25%), mesenteric lymphadenitis (25%), or terminal ileitis (19%). Conclusion Higher rates of Yersinia spp. especially Y. enterocolitica were found in patients with terminal ileitis. This review found that the Yersinia spp. may have a role as an appendicitis mimicking disease, however, geographical variation is present and generally higher rates are found in Northern Europe.


F 65

Abstract-titel:

Long-term complications of appendectomy: a systematic review

Præsenteres af: Tilde Rasmussen


Tilde Rasmussen Afdeling:

Center for Perioperativ Optimering, Gastroenheden, Kirurgisk S k i H l G f H i l


Siv Fonnes, Center for Perioperativ Optimering, Gastroenheden, Kirurgisk Sektion, Herlev og Gentofte Hospital Jacob Rosenberg, Center for Perioperativ Optimering, Gastroenheden, Kirurgisk Sektion, Herlev og Gentofte Hospital


Abstract Introduction Appendectomy is a common surgical procedure but the long-term consequences are largely unknown. Our aim was to systematically review the long-term complications of appendectomy for acute appendicitis. Methods This systematic review was reported according to the PRISMA guidelines. A protocol was registered on PROSPERO (CRD42017064662). The databases PubMed and EMBASE were searched for original reports on appendectomy with n ≥500 and follow-up >30 days. The surgical outcomes were ileus and incisional hernia; other outcomes were inflammatory bowel disease, cancer, fertility, and mortality. Results We included 37 studies. The pooled estimate of the ileus prevalence was 1.0% over a follow-up period of 4.6 years (range 0.5-15). Regarding incisional hernia, we found a pooled estimate of 0.7% prevalence within a follow-up period of 6.5 years (range 1.9-10). Ulcerative colitis had a pooled estimate of 0.15% prevalence in the appendectomy group and 0.19% in controls. The opposite pattern was found regarding Crohn’s disease with a pooled estimate of 0.20% prevalence in the appendectomy group and 0.12% in controls. No clear pattern was found regarding most of the examined cancers in appendectomy groups compared with background populations. Pregnancy rates increased after appendicitis compared with controls in most studies. Mortality was low after appendectomy. Conclusion Appendectomy had a low prevalence of long-term surgical complications. We did not find any significant other long-term complications, though the prevalence of Crohn’s disease was higher and the prevalence of ulcerative colitis was lower after appendectomy than in controls. Appendectomy did not impair fertility.


F 66

Abstract-titel:

Autoimmune diseases in adults with atopic dermatitis

Præsenteres af: Yuki Andersen


Yuki Andersen Afdeling:

Hud og Allergi


Alexander Egeberg- Hud og Allergi Gunnar Gislason- Hjertemedicinsk Lone Skov- Hud og Allergi Jacob P Thyssen- Hud og Allergi


Abstract Introduction An increased susceptibility to autoimmune disease has been shown in patients with atopic dermatitis (AD), but data remain scarce and inconsistent. The aim of this study was to examine the co-occurrence of selected autoimmune diseases in adult patients with AD. Methods Nationwide health registers were utilized. Adult patients with a hospital diagnosis of AD in Denmark between 1997-2012 were included as cases (n=8,112), and matched with controls (n=40,560). The occurrence of autoimmune diseases was compared in the two groups. Logistic regression was used to estimate odds ratios. Multivariable analyses were adjusted for age, sex, socio-economic status, smoking and an index for health utilization. Results AD was significantly associated with alopecia areata, vitiligo, chronic urticaria, celiac disease, chronic glomerulonephritis, Sjögren’s syndrome, systemic lupus erythematosus, ankylosing spondylitis, Crohn’s disease, ulcerative colitis, and rheumatoid arthritis. No significant associations were found between AD and endocrine, hematological, pulmonary, and neurologic autoimmune diseases. AD was furthermore associated with having multiple autoimmune comorbidities. Patients with a history of smoking had a significantly higher occurrence of autoimmune comorbidities compared to non-smokers. Conclusion The results suggest a susceptibility of autoimmune diseases in adult patients with AD, especially in smokers. Furthermore, the results support the notion that Th1 and Th2 dominated diseases are not mutually exclusive. Increased awareness of autoimmune comorbidities in patients with AD may be warranted and smoking should be discouraged.

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Abstracts · hos patienter med ileostomi eller kolostomi 10.00 KAFFEPAUSE - mød dine forskerkolleger 10.40 KEY NOTE SPEAKERS - Chairman: Professor Lone Skov Professor Inge Marie