Abstract:
:Biological rhythms are essential for the regulation of many life processes. Disturbances of the circadian rhythm are known to affect human health, performance and well-being and the negative consequences are numerous and widespread. Cognitive dysfunction, fatigue, pain, sleep disturbances and mood disorders, such as anxiety and depression, are common problems arising around the time of surgery or in the course of a cancer diagnosis and subsequent treatment period. The importance of investigating prevention or treatment possibilities in these populations is significant due to the extent of the problems and the derived consequences on morbidity and mortality. Genetic predisposition to these problems is also an issue in focus. In this thesis we initially investigated whether the specific clock gene genotype PER(5/5) was associated with the development of postoperative cognitive dysfunction one week after non-cardiac surgery. We did not find any association, although this could have been due to the size of the study. Yet, if PER3(5/5) is associated with a higher incidence of postoperative cognitive dysfunction, the risk seems to be only modestly increased and by less than 10%. Melatonin is a hormone with well-known chronobiotic and hypnotic effects. In addition, exogenous melatonin is also known to have anxiolytic, analgesic, antidepressant and positive cognitive effects. Based on the lack of studies investigating these effects of melatonin, we conducted the MELODY trial in which we investigated the effect of 6 mg oral melatonin on depressive symptoms, anxiety, sleep, cognitive function and fatigue in patients with breast cancer in a three month time period after surgery. Melatonin had an effect on reducing the risk of developing depressive symptoms and also increased sleep efficiency perioperatively and total sleep time postoperatively. No effect was found on anxiety, sleep quality, sleepiness, general well-being or pain, however melatonin seemed to positively influence the ability to complete trial participation compared to placebo. Postoperative cognitive dysfunction was not a problem in this limited population. With regard to safety in our study, melatonin treatment for three months did not cause any serious adverse effects. Finally, we systematically reviewed the literature on the prophylactic or therapeutic effect of melatonin for depression or depressive symptoms in adult patients and assessed the safety of melatonin in these studies. The quantity, size and quality of trials investigating this question were not high and there was no clear evidence of an effect, although some studies were positive. In conclusion, further research is warranted with regard to the prophylactic effect and treatment effect of melatonin in depression, depressive symptoms, cognitive disturbances and symptom clusters of cancer patients in general. In addition, more hypothesis-generating studies with regard to the genetic heritability of POCD are needed.
journal_name
Dan Med Jjournal_title
Danish medical journalauthors
Hansen MVsubject
Has Abstractpub_date
2014-09-01 00:00:00pages
B4914issue
9issn
2245-1919pii
B4914journal_volume
61pub_type
杂志文章abstract:INTRODUCTION:A routine follow-up urine sample (FUS) in the form of a midstream urine sample (MSU) is recommended after treatment for urinary tract infection (UTI) according to the Danish Paediatric Society (DPS) and "Lægehåndbogen" published by Danish Regions. We studied the effect of FUS with a focus on patients witho...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2015-01-01 00:00:00
abstract::Strategies to reduce the burden of blood pressure attributable diseases require knowledge of secular trend in PBP and its determinants. The issues were investigated in the Copenhagen City Heart Study. The design of CCHS is a repeated measures study. Such designs are uniquely suited to studying changes of an outcome an...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2017-03-01 00:00:00
abstract:INTRODUCTION:Cell-free DNA testing (cfDNA testing) in maternal plasma has recently been implemented in Danish healthcare. Prior to that we wanted to evaluate the preferences among pregnant women, partners and health professionals regarding cfDNA testing compared with invasive prenatal diagnostics. METHODS:Responders w...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2018-05-01 00:00:00
abstract:INTRODUCTION:When patients are transferred from intensive care units (ICUs) to general wards with a tracheostomy in situ, there is a risk of suboptimal care and increased morbidity. The aim of this study was to elucidate the management of patients with a tracheostomy in situ at discharge from the ICU to the ward. MATE...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2012-08-01 00:00:00
abstract:INTRODUCTION:Severely painful or dysfunctional destroyed wrists can be reconstructed by fusion, interposition of soft-tissue or by arthroplasty using artificial materials. Total and partial wrist arthroplasty (T/PWA) has been used on a regular basis since the 1960's. The objective of this study was to review the litera...
journal_title:Danish medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2014-05-01 00:00:00
abstract:INTRODUCTION:Colorectal cancer is a common malignant disease, caused by different aetiologies and molecular pathways. Heterogeneous results have been published regarding the association of microsatellite instability and clinicopathological features. The aim of this study was to compare clinicopathological features of m...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2016-02-01 00:00:00
abstract::The overall aim of this thesis was to validate the new concept of the Fertility Assessment and Counselling (FAC) Clinic at Rigshospitalet. The intention was to: explore the prognostic value of fertility risk factors by a risk score and provide an estimate of female fecundity, to quantify the impact of oral contracepti...
journal_title:Danish medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2016-10-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to examine the use of quantitative fluorescein angiographic analysis as a means of estimating rates of perfusion of the retina in eyes with a circulatory deficit secondary to carotid artery stenosis. MATERIAL AND METHODS:The study included 21 eyes with ocular ischaemic syndrome (...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2013-10-01 00:00:00
abstract:INTRODUCTION:The aim was to illustrate current use of temporary pacing (TP) in Denmark by replicating a questionnaire study from 1986 and to compare the results of the two studies. MATERIAL AND METHODS:The questionnaire was sent to Danish hospitals treating patients with acute myocardial infarction (AMI). To illustrat...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2012-02-01 00:00:00
abstract:INTRODUCTION:Treatment of infections in neonates with gentamicin is a balance between optimising bactericidal effect and minimising adverse effects. Previously, at the Neonatal Intensive Care Unit (NICU) at Kolding Hospital, Denmark, neonates suspected of having infections were treated daily with gentamicin 5 mg/kg for...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2017-06-01 00:00:00
abstract:INTRODUCTION:There is no consensus among hip surgeons in Denmark on how to follow up patients after total hip arthroplasty (THA). Agreement on the need for radiographic examinations is also lacking. The purpose of this study was to evaluate if routine outpatient post-operative radiographs, obtained three and 12 months ...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2013-04-01 00:00:00
abstract:INTRODUCTION:This study reports our experience with microscopic phonosurgery (PS) of benign lesions of the vocal folds. MATERIAL AND METHODS:During the five-year period from 2003 to 2007, a total of 97 patients had PS for vocal fold polyps (n = 63), vocal fold cysts (n = 17), vocal fold nodules (n = 12) or vocal fold ...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2013-02-01 00:00:00
abstract:INTRODUCTION:The use of positron emission tomography with 2-deoxy-2-18F-fluoro-D-glucose integrated with CT (18F-FDG-PET/CT) in oncology is common. Unexpected incidental findings are occasionally recognised and can represent clinically relevant lesions or conditions. This study aims to assess the occurrence, clinical s...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2020-09-07 00:00:00
abstract:INTRODUCTION:Danish healthcare seeks to improve cancer survival through improved diagnostics, rapid treatment and increased focus on cancer prevention and early help-seeking. In neuro-oncology, this has resulted in the Integrated Brain Cancer Pathway (IBCP). The paper explores how the pathway works in the initial phase...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2012-05-01 00:00:00
abstract:INTRODUCTION:Since the introduction of the quadrivalent human papillomavirus vaccine, young girls and women have reported a broad range of symptoms. These have been described as possible adverse effects of the vaccine. In this study, we describe demographic characteristics, symptomatology, clinical and laboratory test ...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2017-07-01 00:00:00
abstract:INTRODUCTION:Our aim was to study the association between pregnant women's referral status for occupational risk assessment, and their risk of preterm delivery (< 37 weeks), low birth weight (LBW) (< 2,500 g) and small for gestational age (SGA). METHODS:In a cohort study, 1,202 deliveries among pregnant women referred...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2015-08-01 00:00:00
abstract::The epidemiology and prognosis of ''fainting'' or syncope has puzzled physicians over the years. Is fainting dangerous? This is a question often asked by the patient--and the answer is ''it depends on a lot of things''. The diverse pathophysiology of syncope and the underlying comorbidites of the patients play an esse...
journal_title:Danish medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Active surveillance - an initial observational strategy - offers a tailored management of patients with localised prostate cancer. The aim of the strategy is to appoint patients with potentially lethal prostate cancer to curatively intended treatment, while patients with slowly evolving tumours are spared fr...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2015-02-01 00:00:00
abstract:INTRODUCTION:Due to the coronavirus disease 2019 (COVID-19) exposure in Denmark, first-line referral centres were established to handle all patients suspected of COVID-19 or other upper respiratory tract infection. Here we report the first experiences from a first-line referral centre from Amager-Hvidovre Hospital, sit...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2020-08-07 00:00:00
abstract::Bariatric surgery (e.g. Roux-en-Y gastric bypass (RYGB)) has proven the most effective way of achieving sustainable weight losses and remission of type 2 diabetes (T2D). Studies indicate that the effectiveness of RYGB is mediated by an altered gastrointestinal tract anatomy, which in particular favours release of the ...
journal_title:Danish medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2016-11-01 00:00:00
abstract:INTRODUCTION:Recently, we established that a group of obese children and adolescents had a higher blood pressure (BP) than a healthy control group. In the present study, we investigate whether the higher BP in the obese group was influenced by BP cuff sizes. METHODS:A total of 104 obese patients aged 10-18 years were ...
journal_title:Danish medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:2016-01-01 00:00:00
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journal_title:Danish medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:Despite rehabilitation programmes offered to all patients with newly diagnosed type 2 diabetes in Denmark, a number of patients either never accomplish good diabetes regulation or the regulation deteriorates with time. Therefore, new approaches are needed. The aim of the present study is to examine whether...
journal_title:Danish medical journal
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2013-12-01 00:00:00
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journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2012-11-01 00:00:00
abstract:INTRODUCTION:Patients living alone or having a low socioeconomic status are likely to quit cardiac rehabilitation. We aimed to compare patients being offered extended rehabilitation (ERP) with those being offered standard rehabilitation (SRP) as concerns 1) attendance rates and 2) achievement of treatment goals at 12 m...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2013-03-01 00:00:00
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journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2018-06-01 00:00:00
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journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2015-03-01 00:00:00
abstract:INTRODUCTION:The Danish Adult Diabetes Database (DADD) annually reports a quality indicator for lipid-lowering treatment of type 2 diabetes mellitus (T2DM) patients. This retrospective cohort study aims to A) investigate the reasons for inadequate or lacking lipid-lowering treatment and to B) assess the validity of the...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2018-09-01 00:00:00
abstract:INTRODUCTION:With the increasing use of cross-sectional imaging, the incidence of non-symptomatic pancreatic cystic neoplasms is increasing. Surgical management of pancreatic cystic neoplasms possess significant risks of perioperative morbidity and mortality. Our aim was to evaluate endoscopic ultrasound (EUS)-guided a...
journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2020-08-01 00:00:00
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journal_title:Danish medical journal
pub_type: 杂志文章
doi:
更新日期:2012-03-01 00:00:00