Development and validation of a methylation-specific droplet digital PCR multiplex for lung cancer detection.

Biomarkers are increasingly used in cancer management, including lung cancer. The use of circulating tumour DNA (ctDNA) detection has attracted significant interest as a non-invasive, highly specific, and sensitive strategy. In this study, we developed and validated a methylation-specific droplet digital PCR (ddPCR) multiplex assay with five tumour-specific methylation markers identified by in silico analysis for lung cancer detection across various clinical settings.

BREATHEIN: Better understanding obstructive REspiratory Airway disease Treatment and HEalth: a nationwide INvestigative survey in Denmark-a study protocol.

Introduction: Understanding patient perspectives on asthma and chronic obstructive pulmonary disease (COPD) is limited, with no prior studies employing such a large-scale, proactive survey to systematically target individuals with a confirmed prescription for inhalation medication. This study aims to explore how patients with asthma or COPD manage their lives, including treatment experiences, symptoms and impacts on daily life.

Methods And Analysis: A nationwide survey will be launched in January 2025, targeting adults (≥18 years) in Denmark diagnosed with asthma or COPD and prescribed or dispensed inhalation medication between 1 October 2023 and 30 September 2024.

Indwelling peritoneal and pleural catheters in the management of malignant and non-malignant ascites and pleural effusion: experiences from a Danish tertiary center.

Recurrent pleural effusions and ascites significantly impair quality of life, particularly in patients with advanced malignant and non-malignant disease. Traditional management often relies on repeated hospital-based procedures, which provide temporary symptom relief but place a considerable burden on patients and healthcare systems. This retrospective cohort study evaluates the safety, effectiveness, and clinical outcomes of indwelling pleural and peritoneal catheters (IPCs and IPeCs) in 63 patients treated at Lillebaelt Hospital Vejle between October 2019 and October 2024.

Angiotensin-converting enzyme genotypes and sarcoidosis: Correlation with susceptibility, progression and treatment response.

Introduction:  Previous research has yielded conflicting results regarding the association between ACE genotypes and both susceptibility to sarcoidosis and disease prognosis. While some studies have found no significant impact of the ACE genotype on sarcoidosis susceptibility, others have suggested that the DD genotype may be associated with an increased risk of developing the disease and a poor prognosis. This study aimed to evaluate the influence of ACE genotypes on the susceptibility to sarcoidosis, prognosis and treatment response in patients with pulmonary sarcoidosis in Denmark.

Swyer James MacLeod Syndrome: A rare cause of recurrent respiratory infections case report.

Swyer-James-MacLeod Syndrome (SJMS) is a rare pulmonary disorder that is often underdiagnosed or misdiagnosed, leading to delays in appropriate management. We present a case of a woman in her fifties with an unusual presentation of COVID-19 with recurrent respiratory infections and unilateral hyperlucent lung who was diagnosed with SJMS. This case report highlights the importance of considering SJMS in patients with recurrent respiratory infections and unilateral hyperlucent lung, shedding light on the treatment and management for this rare condition.

Financial burden of productivity loss in severe asthma and impact of biologic therapy.

Background: Severe asthma leads to considerable productivity loss; however, patients' financial impact and the potential reversal through biologic therapy remain unexplored.

Research Question: What is the financial burden of productivity loss among employed individuals with severe asthma, and does it change during biologic therapy?

Study Design And Methods: Employed individuals from the Danish Severe Asthma Register (2016-2022) were included. Salary data were sourced from national registries, while productivity loss was measured using the Workplace Productivity and Activity Impairment (WPAI) Questionnaire at baseline and after a minimum of four months of biologic therapy.

Biologic Prescription Patterns and Biomarker Determinants of First-Line Dupilumab in Danish Adult Patients With Severe Asthma and Comorbid Atopic Dermatitis.

Background: Asthma and atopic dermatitis are common type-2 (T2)-driven diseases that often coexist, although different T2 biomarkers indicate disease severity in each condition. Multiple biologics target T2 inflammation, but only dupilumab has been approved for both diseases. Little is known about patients with severe asthma and comorbid atopic dermatitis, particularly regarding how this comorbidity influences the choice of biologic for severe asthma.

Educational attainment and employment status in lung cancer patients: a nationwide study.

Purpose: Lung cancer remains the leading cause of cancer-related deaths globally, with low-dose computed tomography (LDCT) screening widely implemented in several countries. However, current screening eligibility, based largely on the National Lung Cancer Screening Trial and NELSON trial outcomes, does not account for socioeconomic risk factors such as education and employment status, which may impact lung cancer incidence and outcomes.

Methods And Patients: This study used data from the Danish National Patient Register to examine educational attainment and employment status among 109,940 lung cancer patients diagnosed between 1994 and 2018, compared to a randomly selected matched general population cohort.

Maximizing Lung Cancer Screening in High-Risk Population Leveraging ML-Developed Risk-Prediction Algorithms: Danish Retrospective Validation of LungFlag.

Background: Early detection of lung cancer (LC) is crucial for curative treatment, but current screening methods face challenges due to high costs and poor adherence. Artificial intelligence tools, such as the LungFlag model, uses routine clinical data for innovative risk stratification. This study validates LungFlag in Danish high-risk populations to assess its potential in LC screening.

Clinical response and remission in patients treated with dupilumab for severe asthma: Results from the nationwide Danish Severe Asthma Register.

Background: Randomized clinical trials have demonstrated that dupilumab reduces exacerbations and maintenance oral corticosteroids (mOCS) use in patients with uncontrolled and severe asthma. However, evidence in real-life settings is limited.

Objective: This study aimed to evaluate the proportion of patients achieving a clinical response and remission after treatment with dupilumab and identify predictors of response.

Prevalence, Change and Burden of Systemic Corticosteroid Use in Type 2 Inflammation Associated Diseases Over 25 Years - A Nationwide Danish Study.

Background: Systemic corticosteroid use in type 2 inflammation-associated diseases including asthma, atopic dermatitis, allergic rhinitis, and chronic rhinosinusitis has been associated with adverse outcomes, and corticosteroid-sparing treatments are available.

Objective: Assess temporal changes in systemic corticosteroid use and the impact of type 2 inflammation multimorbidity (eg multiple concurrent type 2 inflammation-associated diseases) and specialist assessment on systemic corticosteroid exposure.

Methods: Using nationwide databases, all Danish adults with asthma, atopic dermatitis, allergic rhinitis, or chronic rhinosinusitis, based on hospital diagnoses or redeemed prescriptions between 1997 and 2021 were included in an open, serial cross-sectional cohort.

Analgesic Effect of Cocaine and Lidocaine/Xylometazoline in Healthy Volunteers Undergoing Awake Nasal Intubation: A Randomized Controlled Crossover Trial.

Background: Several drugs may be used to minimize pain during nasal intubation in awake patients. We hypothesized that the analgesic effect of cocaine would be at least as good (non-inferior) as that of lidocaine with xylometazoline rated as maximum pain felt during awake nasal intubation of healthy volunteers.

Methods: We conducted an outcome assessor blinded, randomized, triple crossover, non-inferiority study following approval from the local research ethics committee and the national medicine agency.

Surveillance With Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography of Patients With Stage I-to-III Lung Cancer After Completion of Curative treatment (SUPE_R): A Randomized Controlled Trial.

Introduction: Post-treatment surveillance is recommended for NSCLC owing to a high risk of recurrence, but evidence on the optimal surveillance method is lacking. This trial evaluates fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ([F]FDG PET/CT) versus contrast-enhanced CT (ceCT) for surveillance in patients with NSCLC.

Methods: In this multicenter, randomized controlled trial (SUPE_R, ClinicalTrials.

ctDNA can detect minimal residual disease in curative treated non-small cell lung cancer patients using a tumor agnostic approach.

Background: Circulating tumor DNA (ctDNA) has the potential to become a reliable biomarker for identifying minimal residual disease (MRD) and predicting recurrence in patients with non-small cell lung cancer (NSCLC) following curative treatment. However, there is a lack of studies that investigate the clinical validity of ctDNA using a tumor-agnostic approach, which can provide significant clinical benefits.

Methods: We analyzed samples from 45 NSCLC patients recruited in a prospective national multicenter study, all of whom had undergone curative treatment.

Medical consultation to identify somatic disorders and abnormal paraclinical findings in hospitalized psychiatric patients is feasible and worthwhile.

Purpose: While psychiatric treatment mostly focuses on mental health, comorbid somatic conditions are frequent and often undertreated. This study aimed to bridge the gap by assessing the feasibility of medical consultations for psychiatric inpatients and to identify somatic and lifestyle-related conditions, as well as abnormal paraclinical findings. Secondly, we aimed to identify psychiatric treatments and diagnoses associated with metabolic outcomes.

Urban-rural differences in pneumonia risk in patients with chronic obstructive pulmonary disease: a nationwide register-based study.

Background: Urban-rural differences in treatment within chronic obstructive pulmonary disease (COPD) have been documented in Denmark, and we aim to investigate such differences in the risk of pneumonia.

Methods: A Danish register-based cross-sectional study including patients with an International Classification of Diseases 10 revision (ICD-10) diagnosis code of COPD (J.44) alive on the 31st of December 2018 (99,057 patients).

Exploring the potential of cell-free tumor DNA in bronchoscopic diagnosis of peripheral lung lesions-the DRILL study.

Background: Small lung lesions can represent early-stage lung cancer but are difficult to diagnose. The bronchoscopic approach has the lowest risk of complications; however, the diagnostic yield is generally lower compared to trans-thoracic biopsies. Cell-free tumor DNA (cftDNA) is fragmented DNA stemming from a tumor.

Supratherapeutic Inhaled Corticosteroid Use in Patients Initiating on Biologic Therapies for Severe Asthma: A Nationwide Cohort Study.

Background: In severe asthma, intensive ("supratherapeutic") doses of inhaled corticosteroids (ICS) are often used. The prevalence of supratherapeutic ICS use and its impact on corticosteroid-related comorbidities is poorly understood. We aimed to describe the prevalence of supratherapeutic ICS use in severe asthma, its relation to corticosteroid-related comorbidities, and changes in prescribed and redeemed ICS dose after 12 months of biologic therapy.

The impact of biologic therapy on work capacity and workforce attachment in patients with severe asthma.

Introduction: Severe asthma impacts work capacity, but little is known about the effects of biologic therapy on patients' ability to work. We aimed to assess the impact of biologic therapy for severe asthma on work capacity and workforce attachment.

Methods: This cohort study used the Danish Severe Asthma Register, comprising all Danish patients with severe asthma initiating biologic therapy.

Four decades of lung cancer: Trends in comorbidities and causes of death in a nationwide Danish cohort.

Background: Lung cancer remains the leading cause of cancer-related deaths globally, with gradual improvements in patient survival attributed to early detection through low-dose computed tomography screening and advances in oncological therapies. Despite these advancements, the management of comorbidities, particularly cardiovascular disease and chronic obstructive pulmonary disease, is critical due to their shared causal link with lung cancer - smoking. This study explores the prevalence of comorbidities among lung cancer patients in Denmark over four decades, using comprehensive national registry data.

Lung Cancer Detection Using Bayesian Networks: A Retrospective Development and Validation Study on a Danish Population of High-Risk Individuals.

Background: Lung cancer (LC) is the top cause of cancer deaths globally, prompting many countries to adopt LC screening programs. While screening typically relies on age and smoking intensity, more efficient risk models exist. We devised a Bayesian network (BN) for LC detection, testing its resilience with varying degrees of missing data and comparing it to a prior machine learning (ML) model.

Pre-biologic disease trajectories are associated with morbidity burden and biologic treatment response in severe asthma.

Background: Biologics can induce remission in some patients with severe asthma; however, little is known about pre-biologic disease trajectories and their association with outcomes from biological treatment. We aimed to identify long-term trajectories of disease progression in patients initiating biologics and investigate trajectory associations with disease burden and impact on biologic therapy efficacy.

Methods: Patients in the Danish Severe Asthma Register initiating biologic therapy between 2016 and 2022 were included and followed retrospectively in prescription databases starting 1995.

Alkaptonuria: a rare disease with multiorgan manifestation and a long-awaited diagnosis.

Alkaptonuria is a rare inherited disease resulting from a genetic variant leading to homogentisic acid accumulation in body tissues, causing a broad spectrum of symptoms. Our case involves a Caucasian male diagnosed in his 70s, who shares a constellation of symptoms and the diagnosis with his monozygotic twin brother. The symptoms include early-onset arthropathy, tendinopathy, osteopenia, discolouration of the auricular regions and fingers, scleral discolouration, secondary glaucoma, proteinuria, calcification of the mitral valve and black urethral and prostate stones.

Attendance rate and perceived relevance related to type, content, and delivery of current rehabilitation programmes after surgical resection for non-small cell lung cancer.

Background: Surgical resection is the preferred treatment for localised non-small cell lung cancer (NSCLC). Rehabilitation is central in the management of the associated impaired quality of life, high symptom burden, deconditioning, and social-existential vulnerability. Yet, optimal content and delivery of rehabilitation are not yet defined.

Pulmonologists-level lung cancer detection based on standard blood test results and smoking status using an explainable machine learning approach.

Lung cancer (LC) remains the primary cause of cancer-related mortality, largely due to late-stage diagnoses. Effective strategies for early detection are therefore of paramount importance. In recent years, machine learning (ML) has demonstrated considerable potential in healthcare by facilitating the detection of various diseases.