Profiles of orofacial dysfunction in different diagnostic groups using the Nordic Orofacial Test (NOT-S)—A review

Objective. The Nordic Orofacial Test-Screening (NOT-S) was developed as a comprehensive method to assess orofacial function. Results from the screening protocol have been presented in 11 international publications to date. This study reviewed these publications in order to compile NOT-S screening data and create profiles of orofacial dysfunction that characterize various age groups and disorders. Materials and methods. NOT-S results of nine reports meeting the inclusion criteria were reviewed. Seven of these studies not only provided data on the mean and range of total NOT-S scores, but also on the most common domains of orofacial dysfunction (highest rate of individuals with dysfunction scores), allowing the construction of orofacial dysfunction profiles based on the prevalence of dysfunction in each domain of NOT-S. Results. The compiled data comprised 669 individuals, which included healthy control subjects (n = 333) and various patient groups (n = 336). All studies reported differences between individuals with diagnosed disorders and healthy control subjects. The NOT-S data could measure treatment effects and provided dysfunction profiles characterizing the patterns of orofacial dysfunction in various diagnoses. Conclusions. This review corroborates previous results that the NOT-S differentiates well between patients and healthy controls and can also show changes in individuals after treatment. NOT-S could be used as a standard instrument to assess orofacial dysfunction, evaluate the outcomes of oral habilitation and rehabilitation and improve comparability in clinical practice and research.     

A national study on conditional survival,excess mortality and second cancer after high dose therapy with autologous stem cell transplantation for non‐Hodgkin lymphoma

This national population‐based study aimed to investigate conditional survival and standardized mortality ratios (SMR) after high‐dose therapy with autologous stem‐cell transplantation (HDT‐ASCT) for non‐Hodgkin lymphoma (NHL), and to analyse cause of death, relapses and second malignancies. All patients ≥18 years treated with HDT‐ASCT for NHL in Norway between 1987 and 2008 were included (n = 578). Information from the Cause of Death Registry and Cancer Registry of Norway were linked with clinical data. The 5‐, 10‐ and 20‐year overall survival was 61% (95% confidence interval [CI] 56–64%), 52% (95%CI 48–56%) and 45% (95%CI 40–50%), respectively. The 5‐year survival conditional on having survived 2, 5 and 10 years after HDT‐ASCT was 81%, 86% and 93%. SMRs were 12·3 (95%CI 11·0–13·9), 4·9 (95%CI 4·1–5·9), 2·4 (95%CI 1·8–3·2) and 1·0 (95%CI 0·6–1·8) for the entire cohort and for patients having survived 2, 5 and 10 years after HDT‐ASCT respectively. Of the 281 deaths observed, 77% were relapse‐related. Treatment‐related mortality was 3·6%. The 10‐year cumulative incidence of second malignancies was 7·9% and standardized incidence ratio was 2·0 (95%CI 1·5–2·6). NHL patients treated with HDT‐ASCT were at increased risk of second cancer and premature death. The mortality was still elevated at 5 years, but after 10 years mortality equalled that of the general population.     

Adenosine 5'-monophosphate-activated protein kinase regulation of fatty acid oxidation in skeletal muscle

AMP-activated protein kinase (AMPK) is master regulator of energy balance through suppression of ATP-consuming anabolic pathways and enhancement of ATP-producing catabolic pathways. AMPK is activated by external metabolic stresses and subsequently orchestrates a complex downstream signaling cascade that mobilizes the cell for efficient energy production. AMPK has emerged as a key kinase driving lipid oxidation in skeletal muscle, and this function has important implications for exercise adaptations as well as metabolic defects associated with obesity.     

Intra-arterial nimodipine for severe cerebral vasospasm after aneurysmal subarachnoid haemorrhage – neurological and radiological outcome

ObjectivesCerebral vasospasm is a known complication to aneurysmal subarachnoid haemorrhage, which can lead to severe morbidity. Intra-arterial vasodilation therapy is widely used as a last resort treatment in patients with symptomatic refractory cerebral vasospasm but there is limited data about the outcome. The purpose of this study is to evaluate the neurological and radiological outcome in patients treated with intra-arterial nimodipine in relation to cerebral infarction, procedure-related complications and clinical outcome.MethodsPatients with refractory cerebral vasospasm treated with intra-arterial nimodipine during 2009–2020 at Sahlgrenska University Hospital were retrospectively reviewed. Neurological outcome (modified Rankin Scale) at 30 days and 6 months, development of cerebral infarction after intra-arterial nimodipine treatment and procedure-related complications were studied.ResultsForty-eight patients were treated with intra-arterial nimodipine. A good outcome (modified Rankin Scale 0–2) was seen in 25% (n = 12) of the patients after 30 days and in 47% (n = 22) of the patients after six months. Infarction related to the vasospastic vessel after treatment with intra-arterial nimodipine was seen in 60% (n = 29) of the patients. A total of 124 procedures with intra-arterial nimodipine were performed where complications were seen in 10 (21%) patients in 10 (8%) procedures. Four (8%) patients died within 30 days.ConclusionsA majority of patients developed an ischaemic cerebral infarction in spite of intra-arterial nimodipine treatment. However, a good clinical recovery was seen in almost half of the patients after 6 months. Minor complications occurred in one out of five patients.     

The Feasibility of Cognitive Adaptation Training for Outpatients with Schizophrenia in Integrated Treatment

Cognitive adaptation training (CAT) has been tested as a psychosocial treatment, showing promising results. To date there are no reported tests of CAT treatment outside the United States. Thus, we decided to adjust CAT treatment and apply it to an Integrated Treatment setting in Denmark. In this article we describe and discuss the feasibility of using CAT treatment in a randomized clinical trial in Denmark. The treatment period was shorter and the patients were instructed in prompting for specific actions by using newer tools such as schedules in their mobile phones. Social functioning, symptoms and quality of life were assessed using instruments validated in a Danish context. It was judged that, after some adjustments to fit the Danish assertive community treatment, CAT treatment was feasible in a Danish setting.     

Drop-out and continuity of care for patients suffering from schizophrenia and schizophrenia-like psychosis evaluated by means of routine registration

For most patients suffering from schizophrenia or other chronic psychoses, uninterrupted contact with psychiatric services for a long period is necessary. By means of routine registrations in Copenhagen County, the use of services in 1995 for patients suffering from schizophrenia or other ICD-10 F2 diagnoses ( n = 1356) was analysed. Substantial interregional differences were found in admission to more than one psychiatric department, admission to more than one similar ward, interruption in treatment and loss of contact with the patient. More than 25% had contact with at least four treatment modalities during 1995, and the proportion of patients who experienced interruption in treatment at least once during the year varied between 19% and 37%. It is concluded that routine registration of psychiatric services is a suitable means for quality assurance and ought to be used regularly in analyses like the one presented here. In concert with the literature, it is concluded that the interregional differences indicate that compliance with treatment can be improved by better organization of the psychiatric treatment.     

Perceptions of Coercion in the Community: A Qualitative Study of Patients in a Danish Assertive Community Treatment Team

Assertive community treatment (ACT) has been claimed to be paternalistic and coercive, yet little is known about how patients experience the assertive aspects of ACT. To explore views on—and perceptions of—coercion of patients in Danish assertive community teams. In-depth interviews were conducted with six purposefully selected patients and analysed using thematic analysis. Patients reported lack of influence on treatment process and a poor alliance with case-mangers, not being recognised as an autonomous person, and experiences of staff crossing the line and intruding privacy, as most central to perceptions of coercion. A collaborative and mutually trusting relationship, commitment, persistence and availability of staff, and recognition of the need for social support and help with everyday activities, were most important for counteracting such experiences. Perceptions of coercion were not emphasised in patients’ account of their engagement with ACT, and generally only related to patients’ initial contact with ACT staff. The study suggests that developing mental health practices that enhance the formation of a therapeutic relationship with patients will minimize circumstances that induce perceptions of coercion. ACT, with its engaged and committed staff with sufficient time, focusing on social and practical issues, is successful in facilitating such a contact, as experienced by patients.     

Do we eat less fat, or just report so?

OBJECTIVE: To examine secular trends in diet reporting error. METHODS: Dietary information was obtained from 228 Danish men and women in 1987-88, and from 122 men and women in 1993-94. RESULTS: Bias in dietary reporting of energy and protein intake was assessed by comparing reported intake with intake data, estimated from 24 h nitrogen output, validated by administering P-aminobenzoic acid, and estimated 24 h energy expenditure. Total energy was under-reported more than energy from protein at both surveys, suggesting that energy from other nutrients, like fat and/or carbohydrate, must have been under-reported too. There was a greater under-reporting for energy than for protein in 1993-94 (29%) than in 1987-88 (15%). Obesity was positively associated with under-reporting, both in 1987-88 and in 1993-94. CONCLUSION: The higher macro-nutrient specific error in 1993-94 compared to 1987-88 may reflect a trend to increasingly omitting fat and/or carbohydrate-rich foods in dietary reporting. This may be a consequence of increased awareness of diet intake, which, in turn, may be related to intensified public health campaigns to reduce intake of fat and/or simple carbohydrate. These results may have consequences for our understanding of the apparent decline in dietary fat and associated health benefits.     

Prevention of secondary cases of meningococcal disease in Denmark

Close contacts of cases of meningococcal disease are at increased risk of disease themselves. We identified household-like contacts of index cases, to investigate whether relevant target groups are informed, receive and follow recommended chemoprophylaxis and vaccination, and to ascertain the time delay for implementation of these measures. A telephone interview of 172 households of index cases and a questionnaire survey among 634 parents of contacts of cases in institutions were carried out. Results were compared with reports from Medical Officers of Health. In 21% of the cases, Medical Officers reported fewer household-like contacts than were identified in this study. Written information was effective. However, 59% of households, and 36% of parents of contacts in institutions felt a lack of information about how the disease is acquired, the risk and signs of illness. For household-like contacts the coverage rate for chemoprophylaxis with an appropriate drug was 90% and for vaccination 59%. No secondary cases occurred among those treated with chemoprophylaxis, but among those not treated, there were two secondary cases. The study design provided a useful audit methodology to evaluate the completeness of implementation and the success of prophylactic measures for meningococcal disease.