Aarhus University Research Articles

Global longitudinal strain as a predictor of mortality in patients with cardiogenic shock

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Aarhus University Dagmar Marshalls Fond. Background The assessment of left ventricular (LV) function through transthoracic echocardiography (TTE) is essential for guiding diagnosis and treatment in cases of cardiogenic shock (CS). Myocardial global longitudinal strain (GLS) provides an objective and reproducible measure of systolic function, independently predicting outcomes in acute heart failure, regardless of left ventricular ejection fraction (LVEF). However, whether assessment of GLS can predict mortality in patients with CS remains unknown. Purpose In this study, we aimed to evaluate the prognostic significance of GLS in patients with CS. Methods Data from cardiac intensive care unit (CICU) patients admitted between 2007 and 2018 with CS who received vasoactive agents and/or mechanical circulatory support were analysed. GLS (as absolute values) and biplane LVEF were measured via TTE performed within 24 hours of CICU admission. Patients with CS were categorised based on the GLS quartile: mild (GLS >9.7%), moderate (7.0% < GLS <9.6%), severe (5.0% < GLS < 6.9%), and very severe (GLS ≤ 4.9%). CICU and in-hospital mortality were compared across GLS categories, and the relationship between GLS and mortality was assessed using multivariable logistic regression. Results The study included 626 patients with a median age of 68.6 years, a median LVEF of 31% (IQR 24 to 40%), and a median GLS of 7.0% (IQR 5.0 to 9.7%). In-hospital mortality was 29.1%. As GLS deteriorated, there was an increasing need for vasopressors (P<0.001). Patients with progressively lower GLS exhibited significantly higher CICU and in-hospital mortality across the GLS quartiles (Figure A; P<0.001). Patients in the severe (adjusted OR 2.67; p<0.001) and very severe category (adjusted OR 3.54; P<0.001) had significantly increased risk of in-hospital death compared with mild category. In multivariable analysis, every 1% decrease in GLS corresponded to a 14% higher risk of in-hospital mortality (P<0.001). Finally, GLS outperformed LVEF for discrimination of in-hospital mortality (P=0.002), and when both measurements were included in the same multivariable model, only GLS remained significant. When patients were divided according to whether they had GLS and/or LVEF below the median value, patients with low GLS had higher mortality irrespective of the LVEF (Figure B). Conclusion In patients with CS, GLS assessment surpasses LVEF in its prognostic value and improves risk stratification. Routine evaluation of GLS should be considered for patients with CS.Figure AFigure B

Changes in exercise capacity in people with Cystic Fibrosis after one year of Elexacaftor/Tezacaftor/Ivacaftor treatment – A Danish prospective cohort

BackgroundCystic Fibrosis (CF) is an inherited multiorgan disease that causes lung damage and early death. People with CF (pwCF) experience diminished exercise capacity compared to the general population. This is due to an accelerated decline in lung function resulting from recurrent lung infections, declining lung function and nutritional challenges. Since 2020 the CFTR-modulator Elexacaftor/Tezacaftor/Ivacaftor (ETI) has been approved for pwCF aged 12 and above in Denmark. Initial experiences with the medication have shown promising results, including improved lung function and disease stability. To date a limited number of studies have evaluated the impact of CFTR-modulators on exercise capacity in pwCF. ObjectiveThe study aims to assess the impact of one year of ETI treatment, without any further intervention, on exercise capacity measured through cardiopulmonary exercise test (CPET) in pwCF aged 12 years and above. MethodsA Danish prospective registry cohort study including pwCF from CF-Center Copenhagen, Copenhagen University Hospital and CF-Center Aarhus, Aarhus University Hospital. Participants underwent CPET before initiating ETI and at follow up one year later. Primary outcomes were VO₂ peak (ml/kg/min), secondary outcomes were VO2 peak (ml/min), VO2 peak (% pred), watt-max, HR-max and saturation at max. The difference between baseline and follow-up was assessed using a paired-sample t-test and regression analyses were applied to relevant outcomes. ResultsWe included 229 pwCF in the analyses. An increase in oxygen uptake, VO₂ peak (ml/kg/min) from baseline to follow-up was observed; 0.6, 95% CI [0.06; 1.09] p = 0.03. Moreover, significant increase was noted for all other CPET outcomes. Regression analysis showed that changes in FEV₁% pred and BMI could explain some of the differences, 0.05 ml/kg/min, 95% CI [0.01, 0.1] p = 0.02 and -0.5 ml/kg/min, 95% CI [-0.8, -0.2] p = 0.002 respectively. ConclusionAmong Danish pwCF we found a significant, but not clinically relevant, increase in oxygen uptake, after one year of ETI treatment.

Enhanced autopsy triage (EA-Triage) in drug-related deaths: integrating quick toxicological analysis and postmortem computed tomography.

The objective was to assess the diagnostic accuracy of an enhanced autopsy triage (EA-Triage) setup consisting of postmortem computed tomography (PMCT), simulated quick toxicological analysis (sQTA), external examination, and case information in determining cause of death (COD) in persons with past or current use of illegal drugs (drug-related deaths). Information on drug-related deaths selected for medico-legal autopsy in 2020-2021 at the Department of Forensic Medicine, Aarhus University, Denmark, was analyzed retrospectively. The included cases underwent conventional autopsy, PMCT, and systematic toxicological analysis. A board-certified forensic pathologist, who was blinded to the internal examination and COD from the medico-legal autopsy, determined COD based on the EA-Triage setup. 154 cases with a median age of 40.6 years (range 17-70 years, 82% males) were included. The COD determined by medico-legal autopsy and that determined by EA-Triage matched in 113 cases (73%), including those with an unknown COD. EA-Triage and medico-legal autopsy determined unknown COD in 45 (29%) and 5 cases (3%), respectively. Excluding cases with an unknown COD, EA-Triage predicted COD in 109 cases (71%); of those, 72 (66%) had no unexplained case circumstances or suspicion of a criminal act. In these 72 cases, the CODs determined by EA-Triage and medico-legal autopsy matched in 71 cases (99%), and the sensitivity and specificity for detecting lethal intoxication were 100% and 90%, respectively. EA-Triage showed strong diagnostic accuracy for determining COD in drug-related deaths. This method may be suitable for enhancing preautopsy triage and guiding police investigations at an early stage.

ECR Spotlight – Mads Kuhlmann Andersen

ECR Spotlight is a series of interviews with early-career authors from a selection of papers published in Journal of Experimental Biology and aims to promote not only the diversity of early-career researchers (ECRs) working in experimental biology but also the huge variety of animals and physiological systems that are essential for the ‘comparative’ approach. Mads Kuhlmann Andersen is an author on ‘ The freeze-avoiding mountain pine beetle (Dendroctonus ponderosae) survives prolonged exposure to stressful cold by mitigating ionoregulatory collapse’, published in JEB. Mads Kuhlmann conducted the research described in this article while a postdoc in Heath MacMillan's lab at Department of Biology, Carleton University, Ottawa, ON, Canada. He is now a postdoc in the lab of Johannes Overgaard at Department of Biology, Aarhus University, Denmark, investigating comparative physiology and integrative biology with a main interest in how animals respond, adjust and adapt to different thermal environments.

Percutaneous intramedullary screw or rush pin fixation of unstable ankle fractures in patients with fragile soft tissue - retrospective study of 80 cases.

The standard surgical procedure for unstable ankle fractures is fixation of the lateral malleolus with a plate and screws. This method has a high risk of complications, especially among patients with fragile skin conditions. The aim of this study was to estimate the re-operation rates and identify complications in patients with an unstable ankle fracture, surgically treated with an intramedullary screw or rush pin. We identified all patients who were surgically treated with either a 3.5-mm screw or rush pin at Aarhus University Hospital, Denmark, from 2012 to 2018. Major complications were re-operations within three months. We included 80 patients, of which 55 (69%) were treated with a 3.5-mm intramedullary screw and 25 (31%) with a rush pin. The majority of the study population was female (59) and the mean age was 75 (range 24 to 100) years. Of the 80 patients included, 41 patients had more than 2 comorbidities. Three patients underwent re-operation within three months due to either fracture displacement or hardware cutout. Radiographs obtained after six weeks showed that nine patients had loss of reduction. Additionally, four patients had superficial wound infections and six patients had delayed wound healing. Intramedullary fixation of distal fibula fractures with either a screw or rush pin has low re-operation rates. However, the high proportion of patients with radiological loss of reduction is concerning.

Exploring vascular contributions to cognitive impairment and dementia (ENIGMA): protocol for a prospective observational study

BackgroundPost-stroke cognitive impairment (PSCI) is common. However, the underlying pathophysiology remains largely unknown. Understanding the role of microvascular changes and finding markers that can predict PSCI, could be a first step towards better screening and management of PSCI. Capillary dysfunction is a pathological feature of cerebral small vessel disease and may play a role in the mechanisms underlying PSCI. Extracellular vesicles (EVs) are secreted from cells and may act as disease biomarkers. We aim to investigate the role of capillary dysfunction in PSCI and the associations between EV characteristics and cognitive function one year after acute ischemic stroke (AIS) and transient ischemic attack (TIA).MethodsThe ENIGMA study is a single-centre prospective clinical observational study conducted at Aarhus University Hospital, Denmark. Consecutive patients with AIS and TIA are included and followed for one year with follow-up visits at three and 12 months. An MRI is performed at 24 h and 12 months follow-up. EV characteristics will be characterised from blood samples drawn at 24 h and three months follow-up. Cognitive function is assessed three and 12 months after AIS and TIA using the Repeatable Battery for the Assessment of Neuropsychological Status.DiscussionUsing novel imaging and molecular biological techniques the ENIGMA study will provide new knowledge about the vascular contributions to cognitive decline and dementia.Trial registrationThe study is retrospectively registered as an ongoing observational study at ClinicalTrials.gov with the identifier NCT06257823.

Incidental [18F]FDG-avid focuses in parotid glands on PET/CT

Background The number of unexpected focal [18F]FDG-avid findings (incidentalomas) within the parotid gland (PGI) continues to increase with the expanding use of PET/CT scanning. The prevalence of malignancy in PGIs is uncertain and appropriate management is unsettled. Aims We aimed to explore the underlying pathologies associated with PGI. Materials and methods A retrospective review of all patients with parotid gland incidentaloma(s) treated at the Ear-Nose-Throat Department, Aarhus University Hospital, Denmark in the period 2012–2021, was performed. Results In total, 94 patients with one (n = 86) or two (n = 8) PGI(s) were included. In patients with one PGI, 72 (84%) focuses were benign, two (2%) focuses were malignant (both malignant melanoma metastases), and 12 (14%) focuses were undiagnosed. In patients with two PGIs, all 12 lesions with pathological examinations were benign (4 PGIs were undiagnosed). The median SUVmax found in benign lesions was higher (12.0) compared to malignant lesions (5.5) (p = .043). Conclusions and significance The prevalence of malignancy was low (2/94, 2.4%) in PGIs. Based on our findings, PGI in patients without a history of parotid malignancy, who undergo PET/CT scanning for reasons other than head and neck cancer (including malignant melanoma), may be managed similarly to patients with asymptomatic parotid gland tumors.

Team performance during vacuum-assisted vaginal delivery: video review of obstetric multidisciplinary teams.

Vacuum extraction is generally considered an operator-dependent task, with most attention directed toward the obstetrician's technical abilities (1-3). Little is known about the effect of the team and non-technical skills on clinical outcomes in vacuum-assisted delivery. This study aimed to investigate whether the non-technical skills of obstetricians were correlated with their level of clinical performance via the analysis of video recordings of teams conducting actual vacuum extractions. We installed between two or three video cameras in each delivery room at Aarhus University Hospital and Horsens Regional Hospital and obtained 60 videos of teams managing vacuum extraction. Appropriate consent was obtained. Two raters carefully reviewed the videos and assessed the teams' non-technical skills using the Assessment of Obstetric Team Performance (AOTP) checklist, rating all items on a Likert scale score from 1 to 5 (1 = poor; 3 = average; and 5 = excellent). This resulted in a total score ranging from 18 to 90. Two different raters independently assessed the teams' clinical performance (adherence to clinical guidelines) using the TeamOBS-Vacuum-Assisted Delivery (VAD) checklist, rating each item (0 = not done, 1 = done incorrectly; and 2 = done correctly). This resulted in a total score with the following ranges (low clinical performance: 0-59; average: 60-84; and high: 85-100). Interrater agreement was analyzed using intraclass correlation (ICC), and the risk of high or low clinical performance was analyzed on a logit scale to meet the assumption of normality. Teams that received excellent non-technical scores had an 81% probability of achieving high clinical performance, whereas this probability was only 12% among teams with average non-technical scores (p < 0.001). Teams with a high clinical performance often had excellent behavior in the non-technical items of "team interaction," "anticipation," "avoidance fixation," and "focused communication." Teams with a low or average clinical performance often neglected to consider analgesia, had delayed abandonment of the attempted vaginal delivery and insufficient use of appropriate fetal monitoring. Interrater reliability was high for both rater-teams, with an ICC for the non-technical skills of 0.83 (95% confidence interval [CI]: 0.71-0.88) and 0.84 for the clinical performance (95% CI: 0.74-0.90). Although assisted vaginal delivery by vacuum extraction is generally considered to be an operator-dependent task, our findings suggest that teamwork and effective team interaction play crucial roles in achieving high clinical performance. Teamwork helped the consultant anticipate the next step, avoid fixation, ensure adequate analgesia, and maintain thorough fetal monitoring during delivery.

ECR Spotlight – Amanda Bundgaard

ECR Spotlight is a series of interviews with early-career authors from a selection of papers published in Journal of Experimental Biology and aims to promote not only the diversity of early-career researchers (ECRs) working in experimental biology but also the huge variety of animals and physiological systems that are essential for the ‘comparative’ approach. Amanda Bundgaard is an author on ‘ Are reactive oxygen species always bad? Lessons from hypoxic ectotherms’, published in JEB. Amanda is a postdoc in the lab of Angela Fago at Aarhus University, Denmark, investigating metabolism in oxygen deprivation.

Enhancing dental and medical students’ self-regulated learning through multiple choice questions: An evaluative study using machine learning

This article reports a mixed methods study that uses machine learning and thematic analysis to investigate student evaluation of multiple-choice questions (MCQ). The focus is on medical and dental students' experience of self-regulated learning and motivation. We evaluate two systems developed at Aarhus University: "MED MCQ" used by medical students and "MCQ anatomy" used by dental students. We evaluate through two surveys in SurveyXact with responses from 126 medical students and 70 dental students. We use topic modelling over free text responses. The machine-learning model identifies two groups of students who, in different ways, both experience the system as motivating and facilitating their learning process. The students experience increased self-regulated learning by being able to choose the form of presentation of questions and answer questions independently of the instructor. The article discusses how educators and developers can use MCQs to promote student learning and how to analyze open-ended questions. We discuss the potential for using machine learning and integrating MCQ systems into teaching.

Introduction

This volume of Acta ad archaeologia et artium historiam pertinentia gathers selected contributions from the workshop City, Hinterland, and Environment: Urban Resilience in the Late Roman and Early Islamic Period. Held at the University of Bergen September 23-25, 2019. Papers approach the topic from a variety of angles, including cultural and socioeconomic hinterlands and environments, in their discussions of urban resilience. The meeting was part of the project Globalization, Urbanization and Urban Religion in the Eastern Mediterranean in the Roman and Early Islamic periods funded by Nordforsk (grant no. NOSHSWS-2 00052/NOS-HS), with a workshop on globalization taking place at the University of Helsinki in December 2018, and one on urban religion at Aarhus University in May 2019.

Treatment and referral patterns of patients with atopic dermatitis from the Danish primary care system to the tertiary care system

AbstractBackgroundPatients with atopic dermatitis (AD) are mostly managed by general practitioners (GPs) and practicing dermatologists (PDs) in Denmark. In cases of severe and refractory AD, the primary physician can refer the patient to a specialised dermatology department.ObjectivesAim of the study was to investigate treatment at the time of referral to a specialised dermatology department and the cause stated by the GP in a Danish cohort of AD patients referred to the Department of Dermatology, Aarhus University Hospital from 2019 to 2021.MethodsOne hundred and thirty cases were randomly selected via diagnosis codes for AD. Information regarding the cause for referral and treatment given at time of referral was obtained from medical records. 18 cases were excluded due to missing referral in the patients' medical records, other diagnosis than AD or treatment initiation before 2019. The final cohort consisted of 112 cases. Differences between patients referred from GP and PD were analysed with Fisher's exact test.ResultsMost cases were referred by PDs (45.5%) and GPs (24.1%). GPs primarily referred due to acute flare‐ups in need of treatment (40.7%), and PDs due to lacking disease control (64.7%), (p‐values &lt; 0.0018). GPs generally included more descriptive information in their referrals than PDs, however, only the difference in mentioning sleep disturbance was significant (p‐value = 0.0144). Topical corticosteroids were the preferred treatments before referral regardless of the referring doctor, with no statistical differences. Topical calcineurin inhibitors were significantly more used among PD‐referred patients compared to GP‐referred patients (p‐value = 0.0018). Systemic therapy was initiated in 45 patients (40.2%) at the tertiary hospital with no differences between referral from either GPs or PDs.ConclusionsThe study identified few differences in the referral pattern of AD to a tertiary treatment center from GPs and PDs. No major deviations from Danish guidelines were found.

Perceptions on Use of Opioids in Palliative Care of Dyspnoea in Patients with Fibrotic interstitial lung disease and Chronic Obstructive Pulmonary Disease: A Qualitative Study.

Many patients with chronic obstructive pulmonary disease and fibrotic interstitial lung disease suffer from severe dyspnea and reduced quality of life, despite receiving optimal disease-modifying treatment for their illness. Studies have suggested that these patients may benefit from treatment with low-dose opioids. However, many patients decline opioid treatment. This has led to patients not receiving proper palliative treatment of their lung disease. To identify potential barriers that prevent patients from receiving adequate palliative care with opioids and enable doctors to address patients' concerns. A qualitative study based on semi-structured interviews. Interviews were transcribed and thematic analysis was done using NVivo. Patients were recruited when scheduled for out-patient follow-up at Center for Rare Lung Diseases or at the COPD clinic, Aarhus University Hospital. Eligible patients were 18years of age, did not currently receive opioids or had ever received opioids for dyspnea. A total of 28 patients participated. One patient was excluded before final analysis of 27 patients. Four themes were identified: Fear of side-effects, Need for more information, Stigma of opioids association with severe illness and dying, and No discernible barriers. Furthermore, three sub-themes to Fear of side-effects were identified: Fear of addiction, concern for sedative effect, and fear for loss of mobility due to inability to drive a car. The most expressed concern was Fear of side-effects, especially addiction. Pre-conceived notions about opioids prevent some patients with chronic obstructive lung disease or interstitial lung disease from receiving palliative care for breathlessness.

ECR Spotlight – Igor Noll Guagnoni

ECR Spotlight is a series of interviews with early-career authors from a selection of papers published in Journal of Experimental Biology and aims to promote not only the diversity of early-career researchers (ECRs) working in experimental biology but also the huge variety of animals and physiological systems that are essential for the ‘comparative’ approach. Igor Noll Guagnoni is an author on ‘ Cardiovascular responses and the role of the neurohumoral cardiac regulation during digestion in the herbivorous lizard Iguana iguana’, published in JEB. Igor conducted the research described in this article while a master’s student in Luiz Henrique Florindo's lab at São Paulo State University (UNESP), São José do Rio Preto, Brazil. Igor is now a PhD student in the lab of Luiz Henrique Florindo at São Paulo State University, Brazil, and Tobias Wang’s lab at Aarhus University, Denmark, investigating cardiorespiratory physiology applied to animal conservation and evolution.

Abstract WP200: Endovascular Therapy for Isolated Carotid Occlusion in the Neck

Background and Study Purpose: Existing guidelines on endovascular treatment (EVT) of acute ischemic stroke do not include isolated cervical internal carotid artery occlusions (CICAO). These occlusions are still treated, but the effect remains unclear. This study aimed to compare the baseline characteristics and treatment outcomes between patients with isolated CICAO and patients who underwent EVT due to occlusions mentioned in guidelines. Methods: A retrospective study was conducted on 1162 patients who underwent EVT due to ischemic stroke at Aarhus University Hospital between June 2017 and June 2022. Univariate analysis of outcomes and baseline characteristics were compared between patients with isolated CICAO and tandem occlusions or isolated CICAO and occlusion of the middle cerebral artery (M1)/intracerebral internal carotid artery (ICA-T). Results: 731 patients were eligible for inclusion. Patients with isolated CICAO were more likely male (67.8% vs 50.9%, p-value = 0.0009) and active smokers (42.2% vs 26.4%, p = 0.0016) compared to patients with M1/ICA-T occlusions where atrial fibrillation (35.5% vs. 23.5%, p = 0.0158) and an equal sex distribution was more frequently seen. The groups showed similar favorable outcomes and mortality. Notably, a statistically significant difference in mortality between patients with isolated CICAO (precent) and M1/ICA-T occlusions (percent) could not be excluded (p = 0.0584). Conclusion: Patients with isolated CICAO and M1/ICA-T occlusions seem to differ in sex, smoking status, and atrial fibrillation. This study did not find any differences between isolated CICAO and tandem occlusions. EVT appears beneficial in patients with isolated CICAO, however randomized-controlled trials are necessary to examine and compare the effect between occlusion sites.

Human papillomavirus genotypes and risk of persistence and progression in women undergoing active surveillance for cervical intraepithelial neoplasia grade 2

BackgroundIn recent years, active surveillance has been introduced as an alternative to excisional treatment in younger women with cervical intraepithelial neoplasia grade 2 (CIN2) since regression rates are high and because excisional treatment is associated with increased risk of preterm birth. However, early identification of women at increased risk of persistence/progression is important to ensure timely treatment. Evidence is limited on biomarkers that may be used to identify women at increased risk of persistence/progression. ObjectiveHere, we aimed to describe HPV type-specific persistence/progression in women undergoing active surveillance for CIN2. Study DesignWe conducted a historical cohort study on women aged 23-40 years diagnosed with CIN2 at Aarhus University Hospital, 2000-2010. Women were identified through the Danish Pathology Data Bank (DPDB) and were considered as undergoing active surveillance if they had a first record of a cervical biopsy within two years after index diagnosis and no LEEP prior to this. Archived tissue samples underwent HPV genotyping using the HPV SPF10-DEIA-LiPA25 system (DNA ELISA kit HPV SPF10 and RHA Kit HPV SPF10-LiPA25). Persistence/progression were defined as having a record of ≥CIN2 in the DPDB determined on the last and worst diagnosis on a biopsy or Loop Electrosurgical Excision Procedure (LEEP) specimen during follow-up. We estimated the relative risk (RR (95% CI)) of persistence/progression using a modified Poisson model. ResultsA total of 455 women were included. Two-thirds were ≤30 years (73.8%) at index diagnosis, and nearly half had a high-grade index cytology (48.8%). Overall, 52.2% of all women had ≥CIN2 during follow-up; 70.5% in HPV16 positive and 29.5% in those positive for other HPV types. HPV16 was associated with a significantly higher risk of persistence/progression (RR 1.64 (95% CI (1.37-1.95)) compared to non-HPV16. The risk persistence or progression was highest in HPV16-positive women with a high-grade index cytology compared to HPV16-positive women with a low-grade cytology (RR 1.29 (95% CI (1.03-1.61-)), whereas no differences were observed across age groups. ConclusionHighest risk of persistence/progression was observed among HPV16-positive women, particularly in those with an associated high-grade cytology. These findings suggest that early excisional treatment should be considered in this group of women.

Revolutionizing agriculture: Unleashing the potential of AI and big data in soil health monitoring

Revolutionizing agriculture: Unleashing the potential of AI and big data in soil health monitoring In a recent interview, our editors delved into the world of soil health monitoring and the transformative role played by artificial intelligence (AI), big data, and machine learning, with Mogens H. Greve, Professor and Head of the Soil Section at the Institute of Agroecology, Aarhus University. Professor Mogens H. Greve, provided valuable insights into the evolving landscape of soil science and its intersection with cutting-edge technologies in this exclusive interview with Open Access Government. The integration of soil mapping and AI Greve, an experienced soil mapping expert, has reshaped the conventional viewpoint by underscoring the pivotal role of soil mapping within the realm of AI for soil health.

Cochlear Implantation in Children with Single-Sided Deafness: Preoperative Assessment and Device Use

Objectives: To characterize the first cohort of cochlear implanted pediatric patients with single-sided deafness (SSD) at Aarhus University Hospital, Denmark. Data includes etiology, age at implantation, balance testing, and language assessment prior to implantation as well as data log of Cochlear Implant usage. Methods: Clinical data from 34 children with SSD (21 females (62%) and 13 males (38%)), implanted with Cochlear Implant (CI) during 2018-2023, was analyzed. Results: Acquired prenatal and postnatal sensory disorders toxoplasmosis, rubella, cytomegalovirus and herpes simplex (TORCH) risk factors were associated with sensorineural hearing loss (SNHL) in 19 cases (56%). Congenital Cytomegalovirus (cCMV) DNA was diagnosed in 17 samples (50%). The cause of the SNHL remained unknown for 11 (32.4%) children. In 6 (66.7%) of the cases with unknown etiology, CT scan showed inner ear malformations (IEM). The mean (SD) age for implantation was 4.2 ± 3.5 years. For the children with congenital SNHL, the mean (SD) age for implantation was 2.6 ± 1.6 years. For the children with acquired SNHL, the mean (SD) age for implantation was 6.9 ± 4.3 years. Data log showed that children with SSD and CI wore their processor 6.2 ± 3.73 (1 SD) h/day. Conclusions: Further work is needed in order to assess how etiology, age at implantation, and device use affect outcome. Understanding of the long-term outcomes associated with CI in children with SSD can contribute to more thorough counselling on outcome expectations and the best auditory rehabilitation.

Predictors in the treatment of malignant central airway obstruction with silicone stents

PurposeTo examine the role of the silicone stent in palliation of malignant central airway obstruction and identify potential preprocedural predictors for postprocedural outcome.MethodsPatients treated with endoscopic insertion of tracheobronchial silicone stents for malignant central airway obstruction at Aarhus University Hospital from 2012 to 2022 were identified from electronic medical records. Statistical analyses were carried out to identify factors affecting Days Alive and Out of Hospital, complications and overall survival.Results81 patients underwent a total of 90 tracheobronchial stent insertions. Days Alive and Out of Hospital (DAOH) for the first 30 days were affected negatively by urgent intervention, p < 0.001, preprocedural non-invasive respiratory support, p < 0.001, and preprocedural intubation, p = 0.02. Post-procedural oncological treatment was associated with a significant improved DAOH, p = 0.04. Symptomatology and lesion characteristics were not significantly associated with any impact on DAOH. Overall survival was poor (mean survival was 158 days), and only significantly affected by severe degree of dyspnea, p = 0.02, and postprocedural oncological treatment, p < 0.001. Complication where registered in 25.6% of cases within the first 30 days was observed. Procedure-related mortality was 3.7%. Based on chart annotations by an ENT-surgeon, 95% of the patients experienced relief of symptoms following stent insertion.ConclusionsPalliative tracheobronchial airway stenting with silicone stents is found to have a beneficial impact, more research is required for identification of predictors for postprocedural outcome based on preprocedural classifications.

What is museology?

This article is an edited version of an inaugural lecture as professor of museology at Aarhus University, Denmark, on September 22, 2023. It targeted colleagues from Danish museums and universities and students.