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5 results on '"Laurits Elgaard"'

1. Severe traumatic injury is associated with profound changes in DNA methylation

Author

Trine O. Eskesen, Kristian Almstrup, Laurits Elgaard, Tobias Arleth, Mathilde L. Lassen, Andreas Creutzburg, Alice Herrlin Jensen, Niklas Breindahl, Felicia Dinesen, Malene Vang, Erik Sørensen, Anders Wallin Paulsen, Tatiana Nielsen, Lars S. Rasmussen, Martin Sillesen, and Jacob Steinmetz

Subjects
Medicine, Genetics, QH426-470
Abstract

Abstract Whether DNA methylation changes follow human physical trauma is uncertain. We aimed to investigate if severe trauma was associated with DNA methylation changes. In a prospective, observational, clinical study, we included severely injured adults and adults undergoing elective surgery (controls). Blood was obtained from trauma patients (n = 60) immediately- and 30-45 days post-trauma, and from surgical patients (n = 57) pre-, post-, and 30-45 days post-surgery. Epigenome-wide DNA methylation profiling was performed and analyzed for significant differentially methylated CpGs and -regions (DMRs) within and between groups. Within the trauma group we identified 10,126 significant differentially methylated CpGs and 1169 DMRs. No significant differential methylation was found in the surgical group. In the trauma group, differentially methylated sites were enriched in genes and pathways involved in blood coagulation and inflammatory response. Severe trauma was associated with profound alterations in the DNA methylome of circulating leucocytes, and differential methylation was located in trauma-relevant genes.

Published
2024
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2. Symptoms presented during emergency telephone calls for patients with spontaneous subarachnoid haemorrhage

Author

Asger Sonne, Sarita Egholm, Laurits Elgaard, Niklas Breindahl, Alice Herrlin Jensen, Vagn Eskesen, Freddy Lippert, Frans Boch Waldorff, Nicolai Lohse, and Lars Simon Rasmussen

Subjects
Spontaneous subarachnoid haemorrhage, Emergency medical service, Emergency medical dispatch, Symptoms, Headache, Telephone, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background A spontaneous subarachnoid haemorrhage (SAH) is one of the most critical neurological emergencies a dispatcher can face in an emergency telephone call. No study has yet investigated which symptoms are presented in emergency telephone calls for these patients. We aimed to identify symptoms indicative of SAH and to determine the sensitivity of these and their association (odds ratio, OR) with SAH. Methods This was a nested case–control study based on all telephone calls to the medical dispatch center of Copenhagen Emergency Medical Services in a 4-year time period. Patients with SAH were identified in the Danish National Patient Register; diagnoses were verified by medical record review and their emergency telephone call audio files were extracted. Audio files were replayed, and symptoms extracted in a standardized manner. Audio files of a control group were replayed and assessed as well. Results We included 224 SAH patients and 609 controls. Cardiac arrest and persisting unconsciousness were reported in 5.8% and 14.7% of SAH patients, respectively. The highest sensitivity was found for headache (58.9%), nausea/vomiting (46.9%) and neck pain (32.6%). Among conscious SAH patients these symptoms were found to have the strongest association with SAH (OR 27.0, 8.41 and 34.0, respectively). Inability to stand up, speech difficulty, or sweating were reported in 24.6%, 24.2%, and 22.8%. The most frequent combination of symptoms was headache and nausea/vomiting, which was reported in 41.6% of SAH patients. More than 90% of headaches were severe, but headache was not reported in 29.7% of conscious SAH patients. In these, syncope was described by 49.1% and nausea/vomiting by 37.7%. Conclusion Headache, nausea/vomiting, and neck pain had the highest sensitivity and strongest association with SAH in emergency telephone calls. Unspecific symptoms such as inability to stand up, speech difficulty or sweating were reported in 1 out of 5 calls. Interestingly, 1 in 3 conscious SAH patients did not report headache. Trial registration NCT03980613 ( www.clinicaltrials.gov ).

Published
2021
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4. Correction to: Symptoms presented during emergency telephone calls for patients with spontaneous subarachnoid haemorrhage

Author

Freddy Lippert, Lars S. Rasmussen, Vagn Eskesen, Alice Herrlin Jensen, Niklas Breindahl, Frans Boch Waldorf, Asger Sonne, Nicolai Lohse, Sarita Egholm, and Laurits Elgaard

Subjects
medicine.medical_specialty, business.industry, RC86-88.9, Correction, Medical emergencies. Critical care. Intensive care. First aid, Subarachnoid Hemorrhage, Critical Care and Intensive Care Medicine, Telephone, Spontaneous subarachnoid haemorrhage, Case-Control Studies, Emergency medicine, Emergency Medicine, Medicine, Humans, Emergencies, business, Emergency Service, Hospital
Abstract

A spontaneous subarachnoid haemorrhage (SAH) is one of the most critical neurological emergencies a dispatcher can face in an emergency telephone call. No study has yet investigated which symptoms are presented in emergency telephone calls for these patients. We aimed to identify symptoms indicative of SAH and to determine the sensitivity of these and their association (odds ratio, OR) with SAH.This was a nested case-control study based on all telephone calls to the medical dispatch center of Copenhagen Emergency Medical Services in a 4-year time period. Patients with SAH were identified in the Danish National Patient Register; diagnoses were verified by medical record review and their emergency telephone call audio files were extracted. Audio files were replayed, and symptoms extracted in a standardized manner. Audio files of a control group were replayed and assessed as well.We included 224 SAH patients and 609 controls. Cardiac arrest and persisting unconsciousness were reported in 5.8% and 14.7% of SAH patients, respectively. The highest sensitivity was found for headache (58.9%), nausea/vomiting (46.9%) and neck pain (32.6%). Among conscious SAH patients these symptoms were found to have the strongest association with SAH (OR 27.0, 8.41 and 34.0, respectively). Inability to stand up, speech difficulty, or sweating were reported in 24.6%, 24.2%, and 22.8%. The most frequent combination of symptoms was headache and nausea/vomiting, which was reported in 41.6% of SAH patients. More than 90% of headaches were severe, but headache was not reported in 29.7% of conscious SAH patients. In these, syncope was described by 49.1% and nausea/vomiting by 37.7%.Headache, nausea/vomiting, and neck pain had the highest sensitivity and strongest association with SAH in emergency telephone calls. Unspecific symptoms such as inability to stand up, speech difficulty or sweating were reported in 1 out of 5 calls. Interestingly, 1 in 3 conscious SAH patients did not report headache. Trial registration NCT03980613 ( www.clinicaltrials.gov ).

Published
2021

5. Symptoms presented during emergency telephone calls for patients with spontaneous subarachnoid haemorrhage

Author

Lars S. Rasmussen, Vagn Eskesen, Asger Sonne, Frans Boch Waldorff, Nicolai Lohse, Laurits Elgaard, Alice Herrlin Jensen, Sarita Egholm, Niklas Breindahl, and Freddy Lippert

Subjects
medicine.medical_specialty, Nausea, Emergency medical dispatch, Critical Care and Intensive Care Medicine, Emergency medical service, Spontaneous subarachnoid haemorrhage, medicine, Emergency medical services, Humans, cardiovascular diseases, Original Research, Neck pain, RC86-88.9, business.industry, Telephone call, Unconsciousness, Headache, Medical emergencies. Critical care. Intensive care. First aid, Subarachnoid Hemorrhage/diagnosis, nervous system diseases, Telephone, Case-Control Studies, Symptoms, Emergency medicine, Emergency Medicine, Vomiting, Triage, Emergencies, medicine.symptom, Headaches, Emergency Service, Hospital, business, Visitation
Abstract

Background A spontaneous subarachnoid haemorrhage (SAH) is one of the most critical neurological emergencies a dispatcher can face in an emergency telephone call. No study has yet investigated which symptoms are presented in emergency telephone calls for these patients. We aimed to identify symptoms indicative of SAH and to determine the sensitivity of these and their association (odds ratio, OR) with SAH. Methods This was a nested case–control study based on all telephone calls to the medical dispatch center of Copenhagen Emergency Medical Services in a 4-year time period. Patients with SAH were identified in the Danish National Patient Register; diagnoses were verified by medical record review and their emergency telephone call audio files were extracted. Audio files were replayed, and symptoms extracted in a standardized manner. Audio files of a control group were replayed and assessed as well. Results We included 224 SAH patients and 609 controls. Cardiac arrest and persisting unconsciousness were reported in 5.8% and 14.7% of SAH patients, respectively. The highest sensitivity was found for headache (58.9%), nausea/vomiting (46.9%) and neck pain (32.6%). Among conscious SAH patients these symptoms were found to have the strongest association with SAH (OR 27.0, 8.41 and 34.0, respectively). Inability to stand up, speech difficulty, or sweating were reported in 24.6%, 24.2%, and 22.8%. The most frequent combination of symptoms was headache and nausea/vomiting, which was reported in 41.6% of SAH patients. More than 90% of headaches were severe, but headache was not reported in 29.7% of conscious SAH patients. In these, syncope was described by 49.1% and nausea/vomiting by 37.7%. Conclusion Headache, nausea/vomiting, and neck pain had the highest sensitivity and strongest association with SAH in emergency telephone calls. Unspecific symptoms such as inability to stand up, speech difficulty or sweating were reported in 1 out of 5 calls. Interestingly, 1 in 3 conscious SAH patients did not report headache. Trial registration NCT03980613 (www.clinicaltrials.gov).

Published
2021

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