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Obituary:Researcher and expert advisor Søren Wium-Andersen (1941-2025)
No full textSøren Wium-Andersen has passed away at the age of 83 years in Hillerød, Denmark. His early research career at the Freshwater Biological Laboratory, University of Copenhagen, focused on the harmful eco-physiological effects of heavy metals, particularly copper and chromium, on phytoplankton.His most influential limnological contribution came in 1971, when he published the first demonstration that the small rosette species Lobelia dortmanna predominantly acquires CO2 through its roots. This was shown using split-chamber incubations with added ¹ ⁴C-CO2. Follow-up studies together with Jens Møller Andersen revealed high concentrations of CO2 in sediments of oligotrophic Lake Grane Langsø, as well as striking contrasts in sediment redox conditions: high under plant stands due to root oxygen release, and low in unvegetated sediments.Søren Wium-Andersen also pioneered studies on allelopathy in aquatic plants. In collaboration with organic chemists, he isolated and identified compounds from charophytes and angiosperms that inhibited phytoplankton growth. During a two-year posting as leader of the Marine Biological Station at Phuket Sound, Thailand, he found time to publish three papers on the phenology and growth dynamics of mangrove trees. After returning to Denmark, he contributed further studies on phytoplankton physiology, lake acidification and the primary production of eelgrass and its epiphytes in Øresund.After sixteen years in academia, he shifted in 1986 to a career as Expert Advisor in nature and environmental issues at DANIDA, the Danish International Development Agency. Over the following decades, he held postings in Asia and Africa until his retirement. Alongside this work, he remained an informed and outspoken critic of environmental pollution in Denmark and Europe, particularly concerning heavy metals and pesticides. He publicly exposed cases of industrial waste dumping by major Danish companies (Cheminova and Collstrop) and drew attention to copper and zinc accumulation in farmland soils from liquid manure accompanying intensive pig production. He was an outspoken critique of the intensive forest management and unsustainable hunting of waterfowl.Søren Wium-Andersen will be remembered as an innovative limnologist, a dedicated environmental advisor, and a fearless voice against pollution and unsustainable management of nature and biodiversity
Physical work demands and risk of rheumatoid arthritis, systemic sclerosis, and systemic lupus erythematosus. A Danish longitudinal cohort study
No full textObjectivesThis study assesses the association between physical work demands and rheumatoid arthritis (RA), systemic sclerosis (SSc), and systemic lupus erythematosus (SLE) among men and women.MethodsThis nationwide, register-based study included more than 1.0 million women and 1.1 million men with employment born between 1960 and 1999 from the Danish Occupational Cohort with eXposure data (DOC∗X). Information on physical work demands was obtained from a job exposure matrix (JEM) and measured as recent physical work demands, accumulated physical work demands, and years with high physical work demands since workforce entry. The populations were followed from 1997 to 2018. Poisson regression models were used to estimate the IRRs for developing RA, SSc, and SLE, identified in the Danish National Patient Registry.ResultsMen in occupations with high recent physical work demands (4th quartile vs. 1st quartile: 1.36, 95 % CI 1.31–1.42), higher accumulated physical work demands, and more years with high physical work demands, had a higher risk of diagnosis of RA, while this was not the case for women. Accumulated physical work demands and more years with high physical work demands were associated with a small increased risk of diagnosis of SSc and SLE among men. In women, high physical work demands were associated with a reduced risk of diagnosis of SLE, while the results on SSc were inconsistent.ConclusionThese findings support an association between higher physical work demands and diagnosis of RA and possibly, albeit to a lesser extent, SLE and SSc in men, but not in women.Objectives: This study assesses the association between physical work demands and rheumatoid arthritis (RA), systemic sclerosis (SSc), and systemic lupus erythematosus (SLE) among men and women. Methods: This nationwide, register-based study included more than 1.0 million women and 1.1 million men with employment born between 1960 and 1999 from the Danish Occupational Cohort with eXposure data (DOC∗X). Information on physical work demands was obtained from a job exposure matrix (JEM) and measured as recent physical work demands, accumulated physical work demands, and years with high physical work demands since workforce entry. The populations were followed from 1997 to 2018. Poisson regression models were used to estimate the IRRs for developing RA, SSc, and SLE, identified in the Danish National Patient Registry. Results: Men in occupations with high recent physical work demands (4th quartile vs. 1st quartile: 1.36, 95 % CI 1.31–1.42), higher accumulated physical work demands, and more years with high physical work demands, had a higher risk of diagnosis of RA, while this was not the case for women. Accumulated physical work demands and more years with high physical work demands were associated with a small increased risk of diagnosis of SSc and SLE among men. In women, high physical work demands were associated with a reduced risk of diagnosis of SLE, while the results on SSc were inconsistent. Conclusion: These findings support an association between higher physical work demands and diagnosis of RA and possibly, albeit to a lesser extent, SLE and SSc in men, but not in women.</p
Risk of pancreatic cancer after eradication treatment of <i>Helicobacter pylori</i>
No full textObjectivesHelicobacter pylori infection seems to increase the risk of developing pancreatic cancer, but it is unknown whether eradication treatment of this bacterium changes this risk. We hypothesized that the increased risk of pancreatic cancer among individuals infected with Helicobacter pylori decreases over time after eradication treatment.MethodsThis multinational and population-based cohort study, using prospectively collected nationwide register data from 1995 to 2019, included all adults who received eradication treatment for Helicobacter pylori in Denmark, Finland, Iceland, Norway, or Sweden. Standardized incidence ratios (SIR) with 95 % confidence intervals (95 %CI) were calculated by dividing the incidence rates of pancreatic cancer in the eradication treatment cohort by that of the entire populations of the corresponding age, sex, calendar year, and country. The main outcome was changes in SIR over time after eradication treatment.ResultsDuring up to 24 years of follow-up of 661,827 participants and 5494,255 person-years in the eradication treatment cohort, 2331 participants developed pancreatic cancer. The risk of pancreatic cancer was increased during the first 1–5 years after eradication treatment (SIR 1.14, 95 % CI 1.07–1.21), after which it decreased and became similar to the level of the background population 6–10 years (SIR 0.99, 95 % CI 0.92–1.07) and 11–24 years (SIR 1.00, 95 % CI 0.92–1.08) after eradication treatment.ConclusionThe elevated risk of developing pancreatic cancer among individuals with Helicobacter pylori infection seems to decrease after eradication treatment, reaching the risk estimates of the background population.Objectives Helicobacter pylori infection seems to increase the risk of developing pancreatic cancer, but it is unknown whether eradication treatment of this bacterium changes this risk. We hypothesized that the increased risk of pancreatic cancer among individuals infected with Helicobacter pylori decreases over time after eradication treatment. Methods This multinational and population-based cohort study, using prospectively collected nationwide register data from 1995 to 2019, included all adults who received eradication treatment for Helicobacter pylori in Denmark, Finland, Iceland, Norway, or Sweden. Standardized incidence ratios (SIR) with 95 % confidence intervals (95 %CI) were calculated by dividing the incidence rates of pancreatic cancer in the eradication treatment cohort by that of the entire populations of the corresponding age, sex, calendar year, and country. The main outcome was changes in SIR over time after eradication treatment. Results During up to 24 years of follow-up of 661,827 participants and 5494,255 person-years in the eradication treatment cohort, 2331 participants developed pancreatic cancer. The risk of pancreatic cancer was increased during the first 1–5 years after eradication treatment (SIR 1.14, 95 % CI 1.07–1.21), after which it decreased and became similar to the level of the background population 6–10 years (SIR 0.99, 95 % CI 0.92–1.07) and 11–24 years (SIR 1.00, 95 % CI 0.92–1.08) after eradication treatment. Conclusion The elevated risk of developing pancreatic cancer among individuals with Helicobacter pylori infection seems to decrease after eradication treatment, reaching the risk estimates of the background population.</p
Bystander Intervention on Toxic Behavior in Online Gaming:A Naturalistic Observational Study
No full textPenile prosthesis infection and diabetes mellitus:a systematic review and meta-analysis
No full textBackgroundThe preoperative glycemic control of diabetic patients may increase the risk of penile prosthesis (PP) infection, but the published literature remains controversial.AimTo systematically review and meta-analyze available evidence on the impact of diabetes mellitus (DM) and glycemic control on PP infection. The study was completed under the auspices of the European Society for Sexual Medicine Surgical Academy.MethodsAn comprehensive Medline, Embase, and Cochrane search was performed including the keywords: (“penile prosthesis” and “diabetes mellitus”). Only English-language articles published between January 1, 1969 and May 31, 2024 were included.OutcomesThe primary outcome measure was the risk of PP infection in diabetic patients. The secondary outcome measure was the contribution of glycemic control on PP infection rate.ResultsOut of 182 retrieved articles, 11 were included in the study, summarizing 10 024 subjects with a mean age of 59.7 years, and a mean follow-up of 37.2 months. Overall, a PP infection rate of 4.3[3.9-4.8]% was observed. The PP infection rate increased according to baseline HbA1c levels, and the latter result was confirmed following adjustment for age and trial duration (P < .0001). Accordingly, PP infection rate was more than 2-times higher when trials with a mean HbA1c ≥ 8% were compared to the rest of the sample (9.1[7.5;11.0] vs 3.8[3.2;4.5]%; Q = 43.18; P < .0001).Clinical implicationsOptimization of the preoperative glycemic control may reduce PP infection rate in diabetic patients.Strengths and limitationsThe present study provides evidence supporting a significant increased risk of PP infection for patients with DM and pre-operative HbA1c ≥ 8%. Analysis was primarily derived from retrospective studies, which represent a significant source of bias. The exclusion of those studies including less than 70% of diabetic patients can represent a further source of bias.ConclusionThe present study shows a significant association between pre-operative HbA1c and PP infection rate. Further studies are advisable in order to better clarify the best threshold of HbA1c that is acceptable prior to implant surgery in diabetic patients.BACKGROUND: The preoperative glycemic control of diabetic patients may increase the risk of penile prosthesis (PP) infection, but the published literature remains controversial. AIM: To systematically review and meta-analyze available evidence on the impact of diabetes mellitus (DM) and glycemic control on PP infection. The study was completed under the auspices of the European Society for Sexual Medicine Surgical Academy. METHODS: An comprehensive Medline, Embase, and Cochrane search was performed including the keywords: ("penile prosthesis" and "diabetes mellitus"). Only English-language articles published between January 1, 1969 and May 31, 2024 were included. OUTCOMES: The primary outcome measure was the risk of PP infection in diabetic patients. The secondary outcome measure was the contribution of glycemic control on PP infection rate. RESULTS: Out of 182 retrieved articles, 11 were included in the study, summarizing 10 024 subjects with a mean age of 59.7 years, and a mean follow-up of 37.2 months. Overall, a PP infection rate of 4.3[3.9-4.8]% was observed. The PP infection rate increased according to baseline HbA1c levels, and the latter result was confirmed following adjustment for age and trial duration (P < .0001). Accordingly, PP infection rate was more than 2-times higher when trials with a mean HbA1c ≥ 8% were compared to the rest of the sample (9.1[7.5;11.0] vs 3.8[3.2;4.5]%; Q = 43.18; P < .0001). CLINICAL IMPLICATIONS: Optimization of the preoperative glycemic control may reduce PP infection rate in diabetic patients. STRENGTHS AND LIMITATIONS: The present study provides evidence supporting a significant increased risk of PP infection for patients with DM and pre-operative HbA1c ≥ 8%. Analysis was primarily derived from retrospective studies, which represent a significant source of bias. The exclusion of those studies including less than 70% of diabetic patients can represent a further source of bias. CONCLUSION: The present study shows a significant association between pre-operative HbA1c and PP infection rate. Further studies are advisable in order to better clarify the best threshold of HbA1c that is acceptable prior to implant surgery in diabetic patients.</p
Plasma levels of lipoprotein(a) in persons with HIV compared to the general population
No full textOBJECTIVE: Elevated lipoprotein(a) increases the risk of cardiovascular disease, and previous research suggests that lipoprotein(a) levels are higher in patients with chronic inflammatory diseases. Knowledge about lipoprotein(a) in persons with HIV (PWH) is sparse. We aimed to assess if living with HIV is associated with high levels of lipoprotein(a). METHODS: From the Copenhagen Comorbidity in HIV infection (COCOMO) study, we included 789 PWH matched on sex and age with 3156 controls from the Copenhagen general population study. All participants underwent uniform physical examinations, blood sampling and responded to questionnaires regarding lifestyle and health. Lipoprotein(a) was measured using isoform-insensitive immunoturbidimetric assays. High levels of lipoprotein(a) were defined as plasma levels >50 mg/dl. RESULTS: Living with HIV was not associated with high levels of lipoprotein(a) [adjusted odds ratio (aOR) 0.98 [95% CI: 0.80 to 1.21], P = 0.88]. Furthermore, none of the examined clinical and demographic factors - including age, sex, diabetes, statin therapy, cholesterol levels, renal function and HIV specific risk factors were significantly associated with elevated lipoprotein(a) levels as well as and none of the examined clinical or demographic risk factors were found to be significantly associated with elevated lipoprotein(a) levels. CONCLUSION: In this study, living with HIV was not independently associated with high levels of lipoprotein(a) and none of the examined clinical or demographic risk factors were found to be significantly associated with elevated lipoprotein(a) levels.</p
Healthcare Costs Associated With Anabolic Steroid Use:A Cohort Study
No full textAnabolic androgenic steroid (AAS) use is associated with various health risks, yet its impact on healthcare expenditures remains insufficiently explored. This nationwide register-based study examined direct healthcare costs among 1183 males sanctioned for AAS use in Denmark between 2006 and 2017, compared with 59 150 age- and sex-matched controls from the general population. Healthcare costs were calculated across primary care, hospital services, and prescription drugs, with up to 10 years of follow-up. AAS users had significantly higher total healthcare costs, with a mean excess of 3299 euros (EUR) per person (95% CI: 1857–4742; p < 0.0001) over the follow-up period, corresponding to approximately EUR 537 per AAS user per year. This represents a 45% increase over controls, whose average total costs were EUR 7393 per person. The cost difference was primarily driven by hospital care but was also evident in primary care and prescription medication use. Cumulative cost differences increased steadily over time and remained consistent across most diagnostic categories. AAS users were relatively young and otherwise expected to have low healthcare use, suggesting a notable health burden in this group. These findings add real-world evidence on the healthcare implications of AAS use and highlight a sustained cost difference between AAS users and controls over a prolonged period. Continued follow-up may be necessary to fully capture long-term costs, particularly as some complications may appear years after use.</p
Pre-Anaesthesia Assessments of Adults Undergoing Elective Surgery:A Scoping Review
No full textINTRODUCTION: Pre-anaesthesia (PA) assessments aim to ensure that anaesthesia is administered as safely and efficiently as possible, minimising risks and improving patient care. While the goal remains the same, the content, delivery, setup and evaluation of PA assessments have evolved over the years, driven by technological opportunities and healthcare systems' needs. Hence, the objective of this study was to systematically review and map the literature regarding pre-anaesthesia approaches and outcomes.METHOD: A scoping review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews checklist, using the five main steps described by Arksey and O'Malley and refined by Levac.RESULTS: Of the initial 3909 studies, 383 in full-text were assessed for eligibility, resulting in 112 included studies. The studies were conducted from 1979 onwards, across more than 35 countries. These data represented 369,709 aggregate patients and 2522 healthcare professionals. Common themes amongst the included studies were implementation of a PA clinic, reduction of cancellation rates, information and teaching activities (both patients and clinicians), and optimisation and improvement of the PA assessment using information technology.CONCLUSION: This review highlights the evolving nature of PA practices, shaped by diverse historical and clinical contexts. While many efforts have aimed to improve efficiency, reduce cancellations and enhance safety and satisfaction, emerging technologies offer new potential to further streamline assessments. Despite extensive focus on patient education, active patient involvement in the PA process remains underexplored. A forward-looking strategy should integrate flexible, personalised elements-such as frailty scoring-while fostering patient engagement and shared decision-making to optimise outcomes.</p
C-reactive protein and prospective cardiometabolic risk:observational and Mendelian randomization study of ischemic stroke and all-cause death
No full textBACKGROUND AND OBJECTIVES: Elevated C-reactive protein (CRP) is a well-established marker of low-grade systemic inflammation often accompanying cardiometabolic diseases like type 2 diabetes. We sought to determine if plasma CRP concentrations can be used as a predictive marker of risk for ischemic stroke and all-cause death in the general population, and to investigate whether elevated plasma CRP has a causal effect on ischemic stroke and all-cause death.METHODS: Observational and one-sample Mendelian randomization analyses were performed in 113,491 individuals from the Copenhagen City Heart Study and the Copenhagen General Population Study. Two-sample Mendelian randomization analyses were performed in up to 575,531 individuals with publicly available data from the CHARGE CIWG, UKBB, FinnGen, and MEGASTROKE.RESULTS: Observationally in the Copenhagen studies, higher CRP concentrations associated with stepwise higher risk of ischemic stroke and all-cause death with the highest hazard ratios of 1.51(95% confidence interval: 1.34, 1.71) and 1.69(1.60, 1.79), respectively. The cumulative incidence of ischemic stroke at age 72 was 57% higher and the cumulative incidence of all-cause death at age 80 was 62% higher in individuals with a plasma CRP ≥ 2 mg/L compared to individuals with a plasma CRP < 2 mg/L. One- and two-sample Mendelian randomization analyses did not support a causal effect of CRP on risk of ischemic stroke, nor of CRP on risk of all-cause death, with odds ratios in studies combined of 1.01(0.98, 1.05) and 1.01(0.98, 1.05), respectively.CONCLUSION: In this observational and one- and two-sample Mendelian randomization study, we found that elevated CRP concentrations above the population median of 1.4 mg/L predicted risk of ischemic stroke and all-cause death. There was no causal genetic effect of C-reactive protein on risk of stroke or all-cause death.</p