116 research outputs found
Extracurricular scientific production among medical students has increased in the past decade
Temporal changes in cardiovascular disease and infections in dialysis across a 22-year period:a nationwide study
Abstract Background Cardiovascular diseases (CVD) and infections are recognized as serious complications in patients with end stage kidney disease. However, little is known about the change over time in incidence of these complications. This study aimed to investigate temporal changes in CVD and infective diseases across more than two decades in chronic dialysis patients. Methods All patients that initiated peritoneal dialysis (PD) or hemodialysis (HD) between 1996 and 2017 were identified and followed until outcome (CVD, pneumonia, infective endocarditis (IE) or sepsis), recovery of kidney function, end of dialysis treatment, death or end of study (December 31st, 2017). The calendar time was divided into 5 periods with period 1 (1996â2000) being the reference period. Adjusted rate ratios were assessed using Poisson regression. Results In 4285 patients with PD (63.7% males) the median age increased across the calendar periods from 65 [57â73] in 1996â2000 to 69 [55â76] in 2014â2017, (pâ<â 0.0001). In 9952 patients with HD (69.2% males), the overall median age was 71 [61â78] without any changes over time. Among PD, an overall non-significant decreasing trend in rate ratios (RR) of CVD was found, (pâ=â0,071). RR of pneumonia increased significantly throughout the calendar with an almost two-fold increase of the RR in 2014â2017 (RR 1.71; 95% CI 1.46â2.0), (pâ<â 0.001), as compared to the reference period. The RR of IE decreased significantly until 2009 (RR 0.43; 95% CI 0.21â0.87), followed by a return to the reference level in 2010â2013 (RR 0.87; 95% CI 0.47â1.60 and 2014â2017 (RR 1.1; 95% CI 0.59â2.04). A highly significant (pâ<â 0.001) increase in sepsis was revealed across the calendar periods with an almost 5-fold increase in 2014â2017 (RR 4.69 95% CI 3.69â5.96). In HD, the RR of CVD decreased significantly (pâ<â 0.001) from 2006 to 2017 (RR 0.85; 95% CI 0.79â0.92). Compared to the reference period, the RR for pneumonia was high during all calendar periods (pâ<â 0.05). The RR of IE was initially unchanged (pâ=â0.4) but increased in 2010â2013 (RR 2.02; 95% CI 1.43â2.85) and 2014â2017 (RR 3.39; 95% CI 2.42â4.75). No significant changes in sepsis were seen. Conclusion Across the two last decades the RR of CVD has shown a decreasing trend in HD and PD patients, while RR of pneumonia increased significantly, both in PD and in HD. Temporal trends of IE in HD, and particularly of sepsis in PD were upwards across the last decades
Low immediate scientific yield of the PhD among medical doctors
BACKGROUND: We studied the scientific yield of the medical PhD program at all Danish Universities. METHODS: We undertook a retrospective observational study. Three PhD schools in Denmark were included in order to evaluate the postdoctoral research production over more than 18Â years through individual publications accessed by PubMed. RESULTS: A total of 2686 PhD-graduates (1995â2013) with a medical background were included according to registries from all PhD schools in Denmark. They had a median age of 35Â years (interquartile range (IQR), 32â38) and 53Â % were women at the time of graduation. Scientific activity over time was assessed independently of author-rank and inactivity was measured relative to the date of graduation. Factors associated with inactivity were identified using multivariable logistic regression. 88.6Â % of the PhD theses were conducted in internal medicine vs. 11.4Â % in surgery. During follow-up (median 6.9Â years, IQR 3.0â11.7), PubMed data searches identified that 87 (3.4Â %) of the PhD graduates had no publication after they graduated from the PhD program, 40Â % had 5 or less, and 90Â % had 30 or less. The median number of publications per year after PhD graduation was 1.12 (IQR 0.61â1.99) papers per year. About 2/3 of the graduates became inactive after 1Â year and approximately 21Â % of the graduates remained active during the whole follow-up. Female gender was associated with inactivity: adjusted odds ratio 1.59 (95Â % confidence interval 1.24â2.05). CONCLUSIONS: The scientific production of Danish medic PhD-graduates was mainly produced around the time of PhD-graduation. After obtaining the PhD-degree the scientific production declines suggesting that scientific advance fails and resources are not harnessed
Major bleeding complications and persistence with oral anticoagulation in non-valvular atrial fibrillation:Contemporary findings in real-life Danish patients
Familial clustering of venous thromboembolism:a Danish nationwide cohort study
BACKGROUND: Identification of risk factors for venous thromboembolism (VTE) is of utmost importance to improve current prophylactic regimes and treatment guidelines. The extent to which a family history contributes to the risk of VTE needs further exploration.OBJECTIVES: To examine the relative rate of VTE in first-degree relatives compared with the general population.METHODS: By crosslinking Danish nationwide registries we identified patients with VTE between 1978 and 2012, and their familial relations. The first member in a family to acquire VTE was defined as the proband. All first-degree relatives to probands were followed from the VTE date of the proband and until an event (VTE), death, emigration, 100 year birthday or end of study: 31st of December 2012, whichever came first. The relative rate of VTE was estimated by standardized incidence ratios (SIR) using time-dependent Poisson regression models, with the general population as a fixed reference.RESULTS: We identified 70,767 children of maternal probands, 66,065 children of paternal probands, and 29,183 siblings to sibling probands. Having a maternal proband or a paternal proband were associated with a significantly increased VTE rate of 2.15 (CI: 2.00-2.30) and 2.06 (CI: 1.92-2.21), respectively. The highest estimate of VTE was observed among siblings (adjusted SIR of 2.60 [CI: 2.38-2.83]). Noteworthy, the rate of VTE increased for all first-degree relatives when the proband was diagnosed with VTE in a young age (⤠50 years).CONCLUSION: A family history of VTE was associated with a significantly increased rate of VTE among first-degree relatives compared with the general population.</p
Outcomes associated with familial versus nonfamilial atrial fibrillation:a matched nationwide cohort study
BACKGROUND: We examined allâcause mortality and longâterm thromboembolic risk (ischemic stroke, transient ischemic attack, systemic thromboembolism) in patients with and without familial atrial fibrillation (AF). METHODS AND RESULTS: Using Danish nationwide registry data, we identified all patients diagnosed with AF (1995â2012) and divided them into those with familial AF (having a firstâdegree family member with a prior AF admission) and those with nonfamilial AF. We paired those with and without familial AF according to age, year of AF diagnosis, and sex in a 1:1 match. Using cumulative incidence and multivariable Cox models, we examined the risk of longâterm outcomes. We identified 8658 AF patients (4329 matched pairs) with and without familial AF. The median age was 50Â years (interquartile range 43â54 years), and 21.4% were women. Compared with nonfamilial AF patients, those with familial AF had slightly less comorbid illness but similar overall CHA (2) DS (2)âVASc score (P=0.155). Median followâup was 3.4Â years (interquartile range 1.5â6.5 years). Patients with familial AF had risk of death and thromboembolism similar to those with nonfamilial AF (adjusted hazard ratio 0.91 [95% CI 0.79â1.04] for death and 0.90 [95% CI 0.71â1.14] for thromboembolism). CONCLUSIONS: Although family history of AF is associated with increased likelihood for development of AF, once AF developed, longâterm risks of death and thromboembolic complications were similar in familial and nonfamilial AF patients
Prestroke and Poststroke Antithrombotic Therapy in Patients With Atrial Fibrillation:Results From a Nationwide Cohort
Non-vitamin K antagonist oral anticoagulation usage according to age among patients with atrial fibrillation:Temporal trends 2011-2015 in Denmark
Among atrial fibrillation (AF) patients, Danish nationwide registries (2011â2015) were used to examine temporal trends of initiation patterns of oral anticoagulation (OAC) treatment according to age. Overall, 43,299 AF patients initiating vitamin K antagonists (VKA) (42%), dabigatran (29%), rivaroxaban (13%), or apixaban (16%) were included with mean age (SD) 72.1 (11.3), 71.5 (11.0), 74.3 (11.1), and 75.3 (11.1) years, respectively. Patients aged âĽ85 years comprised 15%. Trend tests showed increase in patients âĽ85 years initiating OAC (pâ<â0.0001). VKA usage decreased from 92% to 24% (pâ<â0.0001). This decrease was independent of age. Dabigatran was the most common non-VKA OAC (NOAC) (40% users), but usage decreased from 2014 until study end (6%) (pâ<â0.0001). Apixaban was the most used OAC at study end (41%), in particular among those âĽ85 years (44%). Compared with patients aged <65 years, the odds ratios associated with initiating VKA, dabigatran, rivaroxaban, or apixaban for patients aged âĽ85 years were 0.81 (95% CI 0.75â0.86), 0.65 (95% CI 0.60â0.70), 1.52 (95% CI 1.38â1.67), and 2.09 (95% CI 1.89â2.30), respectively. In conclusion, substantial increase in NOAC usage has occurred. Increasing age was associated with upstart of rivaroxaban or apixaban with reference to age <65 within the specific agent
Association between statin use and outcomes in patients with coronavirus disease 2019 (COVID-19):a nationwide cohort study
Add-on therapy in metformin-treated patients with type 2 diabetes at moderate cardiovascular risk:a nationwide study
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