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  • 151.
    Abbass, Allan
    et al.
    Dalhousie University, Canada.
    Bernier, Denise
    Dalhousie University, Canada.
    Kisely, Steve
    University of Queensland, Australia.
    Town, Joel
    Dalhousie University, Canada.
    Johansson, Robert
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Dalhousie University, Canada.
    Sustained reduction in health care costs after adjunctive treatment of graded intensive short-term dynamic psychotherapy in patients with psychotic disorders2015Inngår i: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 228, nr 3, s. 538-543Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this pilot study was to evaluate the changes in symptom severity and long-term health care cost after intensive short-term dynamic psychotherapy (ISTDP) individually tailored and administered to patients with psychotic disorders undergoing standard psychiatric care. Eleven therapists with different levels of expertise delivered an average of 13 one-hour sessions of graded ISTDP to 38 patients with psychotic disorders. Costs for health care services were compiled for a one-year period prior to the start of ISTDP (baseline) along with four one-year periods after termination. Two validated self-report scales, the Brief Symptom Inventory and the Inventory of Interpersonal Problems, were administered at intake and termination of ISTDP. Results revealed that health care cost reductions were significant for the one-year post-treatment period relative to baseline year, for both physician costs and hospital costs, and the reductions were sustained for the follow-up period of four post-treatment years. Furthermore, at treatment termination self-reported symptoms and interpersonal problems were significantly reduced. These preliminary findings suggest that this brief adjunctive psychotherapy may be beneficial and reduce costs in selected patients with psychotic disorders, and that gains are sustained in long-term follow-up. Future research directions are discussed. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

  • 152.
    Abbass, Allan
    et al.
    Dalhousie University, Canada.
    Johansson, Robert
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Rasic, Daniel
    Dalhousie University, Canada.
    Town, Joel M.
    Dalhousie University, Canada.
    Johansson, Robert
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Long-term healthcare cost reduction with Intensive Short-term Dynamic Psychotherapy in a tertiary psychiatric service2015Inngår i: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 64, s. 114-120Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To evaluate whether a mixed population of patients treated with Intensive Short-term Dynamic Psychotherapy (ISTDP) would exhibit reduced healthcare costs in long-term follow-up. Methods: A quasi-experimental design was employed in which data on pre- and post-treatment healthcare cost were compared for all ISTDP cases treated in a tertiary care service over a nine year period. Observed cost changes were compared with those of a control group of patients referred but never treated. Physician and hospital costs were compared to treatment cost estimates and normal population cost figures. Results: 1082 patients were included; 890 treated cases for a broad range of somatic and psychiatric disorders and 192 controls. The treatment averaged 7.3 sessions and measures of symptoms and interpersonal problems significantly improved. The average cost reduction per treated case was $12,628 over 3 follow-up years: this compared favorably with the estimated treatment cost of $708 per patient. Significant differences were seen between groups for follow-up hospital costs. Conclusions: ISTDP in this setting appears to facilitate reductions in healthcare costs, supporting the notion that brief dynamic psychotherapy provided in a tertiary setting can be beneficial to health care systems overall. (C) 2015 Elsevier Ltd. All rights reserved.

  • 153.
    Abberud, Madelene
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
    Time to first antibiotic administration in The Alfred Emergency and Trauma Centre for suspected febrile neutropenia: a retrospective chart review2012Independent thesis Advanced level (professional degree), 20 poäng / 30 hpOppgave
    Abstract [en]

    Introduction: Febrile neutropenia (FN) is a frequent complication of chemotherapy use in cancer patients. There is evidence to suggest that the time to antibiotic administration is associated with increase survival and effective clinical outcome. The Australian consensus guidelines for the management of FN in adult cancer patients recommends treatment within 30 minutes to patients with features of systemic compromise. A study performed at The Alfred Hospital in 2010 revealed a median time of 145 minutes to first antibiotic administration. A new guideline was therefore developed and education was implemented. This study was conducted to evaluate the intervention. Aim: To determine time to first antibiotic prescribing and administration for patients with suspected FN presenting to the Alfred Emergency and Trauma centre. Materials and Methods: The electronic medical record of 112 episodes of suspected FN presenting between March and August 2012 were reviewed.  Data were retrospective collected according to a FN data spreadsheet. An observational study were also performed at  The Alfred Emergency and Trauma centre during October and November 2012 to determine time to first antimicrobial prescribing, because this data could not be collected from the electronic medical record. Results: The median time from presentation to antibiotic prescribing was 68 minutes. The median time from presentation to antibiotic administration was 121 minutes. Conclusions: The implementation of the new guidelines has reduced the time with 16.6%, but the target first antibiotic administration within 30 minutes has not been reached.

  • 154.
    Abbey, Susan E.
    et al.
    University of Toronto, Canada.
    De Luca, Enza
    University Health Network, University of Toronto, Canada.
    Mauthner, Oliver E.
    University Health Network, University of Toronto, Canada.
    McKeever, Patricia
    Bloorview Research Institute, Bloorview Kids Rehab, Canada.
    Shildrick, Margrit
    Queen's University, Belfast, Northern Ireland.
    Poole, Jennifer M.
    Ryerson University, Canada.
    Gewarges, Mena
    University Health Network, University of Toronto, Canada.
    Ross, Heather J.
    University Health Network, University of Toronto, Canada.
    Qualitative interviews versus standardised self-report questionnaires in assessing qualityb of life in heart transplant recipients2011Inngår i: The Journal of Heart and Lung Transplantation, ISSN 1053-2498, E-ISSN 1557-3117, Vol. 30, nr 8, s. 963-966Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Quality of life (QoL) studies in heart transplant recipients (HTRs) using validated, quantitative, self-report questionnaires have reported poor QoL in approximately 20% of patients. This consecutive mixed methods study compared self-report questionnaires, the Medical Outcomes Study 36-item Short Form Health Survey (MOS SF-36) and the Atkinson Life Satisfaction Scale, with phenomenologically informed audiovisual (AV) qualitative interview data in 27 medically stable HTRs (70% male; age 53 ± 13.77 years; time since transplant 4.06 ± 2.42 years). Self-report questionnaire data reported poor QoL and more distress compared with previous studies and normative population samples; in contrast, 52% of HTRs displayed pervasive distress according to visual methodology. Using qualitative methods to assess QoL yields information that would otherwise remain unobserved by the exclusive use of quantitative QOL questionnaires.

  • 155. Abbo, Catherine
    et al.
    Ekblad, Solvig
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Waako, Paul
    Okello, Elialilia
    Muhwezi, Wilson
    Musisi, Seggane
    Psychological distress and associated factors among the attendees of traditional healing practices in Jinja and Iganga districts, Eastern Uganda: a cross-sectional study.2008Inngår i: Int J Ment Health Syst, ISSN 1752-4458, Vol. 2, nr 1, s. 16-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Psychological distress and associated factors among the attendees of traditional healing practices in Jinja and Iganga districts, Eastern Uganda: a cross-sectional study.

    Abbo C, Ekblad S, Waako P, Okello E, Muhwezi W, Musisi S.

    Karolinska Institutet, Department of Clinical Neuroscience, Section of Psychiatry, Stockholm, Sweden. cathya180@gmail.com.

    ABSTRACT: BACKGROUND: Mental health problems are a major public health concern worldwide. Evidence shows that African communities, including Uganda, use both modern and traditional healing systems. There is limited literature about the magnitude of psychological distress and associated factors among attendees of traditional healing practices. This study aimed to determine the prevalence and associated factors of psychological distress among attendees of traditional healing practices in two districts in Uganda. METHODS: Face-to-face interviews with the Lusoga version of the Self Reporting Questionnaire (SRQ-20) were carried out with 400 patients over the age of 18 years attending traditional healing in Iganga and Jinja districts in Eastern Uganda. Patients were recruited consecutively in all the traditional healers' shrines that could be visited in the area. Persons with 6 or more positive responses to the SRQ were identified as having psychological distress. Prevalence was estimated and odds ratios of having psychological distress were obtained with multiple logistic regression analysis. RESULTS: 387 questionnaire responses were analyzed. The prevalence of psychological distress in connection with attendance at the traditional healers' shrines was 65.1%. Having a co-wife and having more than four children were significantly associated with psyclogical distress. Among the socioeconomic indicators, lack of food and having debts were significantly associated with psychological distress. The distressed group was more likely to need explanations for ill health. Those who visited both the healer and a health unit were less likely to be distressed. CONCLUSION: This study provides evidence that a substantial proportion of attendees of traditional healing practices suffer from psychological distress. Associated factors include poverty, number of children, polygamy, reason for visiting the healer and use of both traditional healing and biomedical health units. These findings may be useful for policy makers and biomedical health workers for the engagement with traditional healers.

  • 156. Abbott, A. L.
    et al.
    Adelman, M. A.
    Alexandrov, A. V.
    Barnett, H. J. M.
    Beard, J.
    Bell, P.
    Björck, Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Kärlkirurgi.
    Blacker, D.
    Buckley, C. J.
    Cambria, R. P.
    Comerota, A. J.
    Connolly, E. S., Jr.
    Davies, A. H.
    Eckstein, H. H.
    Faruqi, R.
    Fraedrich, G.
    Gloviczki, P.
    Hankey, G. J.
    Harbaugh, R. E.
    Heldenberg, E.
    Kittner, S. J.
    Kleinig, T. J.
    Mikhailidis, D. P.
    Moore, W. S.
    Naylor, R.
    Nicolaides, A.
    Paraskevas, K. I.
    Pelz, D. M.
    Prichard, J. W.
    Purdie, G.
    Ricco, J. B.
    Riles, T.
    Rothwell, P.
    Sandercock, P.
    Sillesen, H.
    Spence, J. D.
    Spinelli, F.
    Tan, A.
    Thapar, A.
    Veith, F. J.
    Zhou, W.
    Why the United States Center for Medicare and Medicaid Services (CMS) Should not Extend Reimbursement Indications for Carotid Artery Angioplasty/Stenting2012Inngår i: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 43, nr 3, s. 247-251Artikkel i tidsskrift (Fagfellevurdert)
  • 157. Abbott, A. L.
    et al.
    Adelman, M. A.
    Alexandrov, A. V.
    Barnett, H. J. M.
    Beard, J.
    Bell, P.
    Björck, Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Kärlkirurgi.
    Blacker, D.
    Buckley, C. J.
    Cambria, R. P.
    Comerota, A. J.
    Connolly, E. Sander
    Davies, A. H.
    Eckstein, H. -H
    Faruqi, R.
    Fraedrich, G.
    Gloviczki, P.
    Hankey, G. J.
    Harbaugh, R. E.
    Heldenberg, E.
    Kittner, S. J.
    Kleinig, T. J.
    Mikhailidis, D. P.
    Moore, W. S.
    Naylor, R.
    Nicolaides, A.
    Paraskevas, K. I.
    Pelz, D. M.
    Prichard, J. W.
    Purdie, G.
    Ricco, J. -B
    Riles, T.
    Rothwell, P.
    Sandercock, P.
    Sillesen, H.
    Spence, J. D.
    Spinelli, F.
    Tan, A.
    Thapar, A.
    Veith, F. J.
    Zhou, Wei
    Why the United States Center for Medicare and Medicaid Services (CMS) should not extend reimbursement indications for carotid artery angioplasty/stenting2012Inngår i: International Journal of Angiology, ISSN 0392-9590, E-ISSN 1827-1839, Vol. 31, nr 1, s. 85-89Artikkel i tidsskrift (Fagfellevurdert)
  • 158.
    Abbott, Allan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Faculty of Health Science and Medicine, Bond University, Gold Coast, Queensland, Australia.
    Evidence base and future research directions in the management of low back pain2016Inngår i: World Journal of Orthopedics, ISSN 2218-5836, E-ISSN 2218-5836, Vol. 7, nr 3, s. 156-161Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Low back pain (LBP) is a prevalent and costly condition. Awareness of valid and reliable patient history taking, physical examination and clinical testing is important for diagnostic accuracy. Stratified care which targets treatment to patient subgroups based on key characteristics is reliant upon accurate diagnostics. Models of stratified care that can potentially improve treatment effects include prognostic risk profiling for persistent LBP, likely response to specific treatment based on clinical prediction models or suspected underlying causal mechanisms. The focus of this editorial is to highlight current research status and future directions for LBP diagnostics and stratified care.

  • 159.
    Abbott, Allan
    Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Physiotherapeutic rehabilitation and lumbar fusion surgery2010Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Over the last two decades, the economic costs and rates of lumbar fusion surgery for chronic low back pain has risen dramatically in western industrialized countries. Data from the Swedish National Spine Register suggest that 25% of patients experience unimproved pain and up to 40% are not satisfied with the outcome of lumbar fusion surgery. Thus, there is a definite need to optimize the selection and management of patients to improve lumbar fusion outcomes. Aim: To investigate the role of biopsychosocial factors in explaining disability and health related quality of life in chronic low back pain patients before and after lumbar fusion surgery and to evaluate the effectiveness of post-operative rehabilitation regimes. Methods: At total of 107 patients were recruited, aged 18 to 65 years, selected for lumbar fusion due to 12 months of symptomatic back and/or leg pain due to spinal stenosis, degenerative/isthmic spondylolisthesis or degenerative disc disease. Measures of disability, health related quality of life, pain, mental health, fear of movement/(re)injury, self-efficacy, outcome expectancy, pain coping styles, work status, health care use, analgesic use and sickness leave were collected with self-rated questionnaires at baseline (Studies I-IV), 3, 6, 12 months (Study II) and 2-3 years after surgery (Studies II-III). In Studies II-IV, patients were randomised to psychomotor therapy (N=53) or exercise therapy (N=54) implemented during the first 3 post-operative months. Semi-structured interviews were conducted 3-6 months after surgery on 20 patients including 10 from each rehabilitation group to investigate experiences of back problems before and after surgery, post-operative recovery and expectations of rehabilitation analysed in terms of the International Classification of Functioning, Disability and Health (Study IV). Results: Approximately 50% of the variability in baseline disability and 40% of the variability in baseline health related quality of life could be explained by psychological variables. In particular, catastrophizing, control over pain, self-efficacy and outcome expectancy had significant mediation roles (Study I). For the short and long term outcome of lumbar fusion surgery, post-operative psychomotor therapy is significantly more effective than exercise therapy with approximately 10-20% better outcome in measures of disability, fear of movement/(re)injury, pain catastrophizing, self-efficacy, outcome expectancy sickness leave, health care utilization and return to work (Study II). A model with good outcome predictive performance which significantly predicts disability, back pain and health related quality of life outcomes 2-3 year after lumbar fusion surgery, was shown to involve pre-operative screening of disability, leg pain intensity, mental health, fear of movement/(re)injury, outcome expectations, catastrophizing, control over pain and the implementation of post-operative psychomotor therapy (Study III). Lumbar fusion patient s experiences of back problems before and after the operation as well as experiences of recovery and outcome expectations correspond well with the content of outcomes measures used in the study suggesting good content validity (Study IV). Conclusion: Psychological factors strongly influence levels of disability and health related quality of life in lumbar fusion candidates as well as predicts post-operative outcomes. Early post-operative rehabilitation focusing on cognition, behaviour and motor control is recommended for improved lumbar fusion outcomes.

  • 160.
    Abbott, Allan
    Karolinska Institute, Sweden.
    The Coping Strategy Questionnaire2010Inngår i: Journal of Physiotherapy, ISSN 1836-9553, E-ISSN 1836-9561, Vol. 56, nr 1, s. 63-63Artikkel i tidsskrift (Annet vitenskapelig)
  • 161.
    Abbott, Allan
    et al.
    Department of Physical Therapy, Neuro R1:07, Karolinska University Hospital, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Huddinge, Sweden; Institute of Health and Sport, Bond University, Queensland, Australia.
    Ghasemi-Kafash, Elaheh
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Huddinge, Sweden.
    Dedering, Åsa
    Department of Physical Therapy, Neuro R1:07, Karolinska University Hospital, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Huddinge, Sweden.
    The validity of using an electrocutaneous device for pain assessment in patients with cervical radiculopathy2014Inngår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 30, nr 7, s. 500-506Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this study was to evaluate the validity and preference for assessing pain magnitude with electrocutaneous testing (ECT) compared to the visual analogue scale (VAS) and Borg CR10 scale in men and women with cervical radiculopathy of varying sensory phenotypes. An additional purpose was to investigate ECT sensory and pain thresholds in men and women with cervical radiculopathy of varying sensory phenotypes. This is a cross-sectional study of 34 patients with cervical radiculopathy. Scatterplots and linear regression were used to investigate bivariate relationships between ECT, VAS and Borg CR10 methods of pain magnitude measurement as well as ECT sensory and pain thresholds. The use of the ECT pain magnitude matching paradigm for patients with cervical radiculopathy with normal sensory phenotype shows good linear association with arm pain VAS (R(2) = 0.39), neck pain VAS (R(2) = 0.38), arm pain Borg CR10 scale (R(2) = 0.50) and neck pain Borg CR10 scale (R(2) = 0.49) suggesting acceptable validity of the procedure. For patients with hypoesthesia and hyperesthesia sensory phenotypes, the ECT pain magnitude matching paradigm does not show adequate linear association with rating scale methods rendering the validity of the procedure as doubtful. ECT for sensory and pain threshold investigation, however, provides a method to objectively assess global sensory function in conjunction with sensory receptor specific bedside examination measures.

  • 162.
    Abbott, Allan
    et al.
    Physiotherapist, Department for Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
    Halvorsen, Marie
    Physiotherapist, Department for Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
    Dedering, Åsa
    Physiotherapist, Department for Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
    Is there a need for cervical collar usage post anterior cervical decompression and fusion?: A randomized control pilot trial2013Inngår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 29, nr 4, s. 290-300Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Anterior cervical discectomy and fusion (ACDF) is a common surgical intervention for radiculopathy resulting from degenerative cervical spine conditions. Post-surgical cervical collar use is believed to reduce post-operative pain, provide the patient with a sense of security during activities of daily living and even reduce rates of non-fusion. This prospective randomized controlled pilot trial investigates trial design feasibility in relation to prospective physical, functional, and quality of life-related outcomes of patients undergoing ACDF with interbody cage, with (n = 17) and without (n = 16) post-operative cervical collar usage. Results show that the sample provides sufficient statistical power to show that the use of a rigid cervical collar during 6 post-operative weeks is associated with significantly lower levels of neck disability index after 6 weeks and significantly lower levels of prospective neck pain. To investigate causal quality of life or fusion rate outcomes, sample size needs to be increased at least fourfold and optimally sixfold when accounting for data loss in prospective follow-up. The study suggests that post-surgical cervical collar usage may help certain patients cope with initial post-operative pain and disability.

  • 163.
    Abbott, Allan
    et al.
    Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology, Division of Orthopaedics, Karolinska University Hospital, Karolinska Institute, Stockholm , Sweden.
    Hedlund, Rune
    Department of Orthopaedics, Institute for Clinical Science, University of Gothenburg, Gothenburg, Sweden.
    Tyni-Lenné, Raija
    Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
    Patient’s experience post-lumbar fusion regarding back problems, recovery and expectations in terms of the international classification of functioning, disability and health.2011Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, nr 15-16, s. 1399-1408Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE:

    To describe within the context of the International Classification of Functioning, Disability and Health (ICF), patient's experiences post-lumber fusion regarding back problems, recovery and expectations of rehabilitation and to contrast with the content of outcome measures and the ICF low back pain (LBP) core sets.

    METHODS:

    The study has a cross-sectional and retrospective design and involves 20 lumbar fusion patients. Using the ICF, qualitative content analysis of semi-structured interviews 3-6 months post-surgery was performed. This was compared with the ICF related content of the Oswestry Disability Index (ODI), Medical Outcome Study Short Form 36 (SF-36), European Quality of Life Questionnaire (EQ5D) and the ICF LBP core sets.

    RESULTS:

    Patient's experiences were most frequently linked to psychological, sensory, neuromusculoskeletal and movement related body function chapters of the ICF. The most frequently linked categories of activity and participation were mobility, domestic activities, family relationships, work, recreation and leisure. Environmental factors frequently linked were the use of analgesics, walking aids, family support, social security systems, health care systems and labour market employment services.

    CONCLUSIONS:

    This study highlights important ICF related aspects of patient's experiences post-lumber fusion. The use of the comprehensive ICF core sets is recommended in conjunction with ODI, SF-36 and the EQ5D for a broader analysis of patient outcomes post-lumbar fusion.

  • 164.
    Abbott, Allan
    et al.
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden; Bond University, Australia.
    Kjellman, Görel
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Multidimensional assessment of pain related disability after surgery for cervical disc disease2013Inngår i: APA Conference 2013: New moves, Australian Physiotherapy Association , 2013, s. 2-2Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Questions: Given only 25% of patients, 10 year post-surgery for cervical disc disease report clinically meaningful improvements in functional disability, what are the biopsychosocial factors associated with continued long-term disability? What are the implications for physiotherapy practice?

    Design: Cross-sectional observational study.

    Participants: Ninety patients who had undergone anterior discectomy and fusion (ACDF) surgery 10-13 years prior.

    Outcome Measures: The Neck Disability Index (NDI), ACDF surgery type, surgical fusion status, patient age and Part 1 of the West Haven-Yale multidimensional pain inventory Swedish version (MPI-S) were entered into a statistical model. Part 1 of the MPI-S contains 5 subscales: pain severity, interference, life control, affective distress and support.

    Results: Seventy-three patients answered the questionnaires. Non-linear categorical regression modeling (CATREG) of the selected predictive variables explained 76.1% of the variance in NDI outcomes 10-13 years post ACDF. Of these predictors, MPI-S affective distress subscale (β = 0.635, p = <0.001) and pain severity subscale (β = 0.354, p = <0.001) were significant individual predictors of NDI ratings.

    Conclusion: This is the first study to investigate potential factors associated with prolonged functional disability greater than 10 years post-surgery for cervical disc disease. The results suggest the importance of not only pain severity but also screening affective distress as a potential barrier to physical functioning in patients previously operated for cervical disc disease. Future research on the utility of affect-focused body awareness therapy and pain coping strategies for post-surgical patients with continuing pain and physical disability is indicated.

    Key Practice Points:

    •  The screening of pain severity and affective distress is of importance for patients presenting with continuing physical disability after previous surgery for cervical disc disorders

    •  Affect-focused body awareness therapies and pain coping strategies may be a potential treatment alternative for patients with continuing pain and physical disability.

  • 165.
    Abbott, Allan
    et al.
    Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden; Bond University, Gold Coast, Australia.
    Möller, Hans
    Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden.
    Gerdhem, Paul
    Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden.
    CONTRAIS: CONservative TReatment for Adolescent Idiopathic Scoliosis: a randomised controlled trial protocol2013Inngår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 14, artikkel-id 261Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:

    Idiopathic scoliosis is a three-dimensional structural deformity of the spine that occurs in children and adolescents. Recent reviews on bracing and exercise treatment have provided some evidence for effect of these interventions. The purpose of this study is to improve the evidence base regarding the effectiveness of conservative treatments for preventing curve progression in idiopathic scoliosis.

    Methods/design:

    Patients: Previously untreated girls and boys with idiopathic scoliosis, 9 to 17 years of age with at least one year of remaining growth and a curve Cobb angle of 25–40 degrees will be included. A total of 135 participants will be randomly allocated in groups of 45 patients each to receive one of the three interventions.Interventions: All three groups will receive a physical activity prescription according to the World Health Organisation recommendations. One group will additionally wear a hyper-corrective night-time brace. One group will additionally perform postural scoliosis-specific exercises.Outcome: Participation in the study will last until the curve has progressed, or until cessation of skeletal growth. Outcome variables will be measured every 6 months. The primary outcome variable, failure of treatment, is defined as progression of the Cobb angle more than 6 degrees, compared to the primary x-ray, seen on two consecutive spinal standing x-rays taken with 6 months interval. Secondary outcome measures include the SRS-22r and EQ5D-Y quality of life questionnaires, the International Physical Activity Questionnaire (IPAQ) short form, and Cobb angle atend of the study.

    Discussion:This trial will evaluate which of the tested conservative treatment approaches that is the most effective for patients with adolescent idiopathic scoliosis.

    Trial registration: NCT01761305

  • 166.
    Abbott, Allan
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Schröder, Karin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Enthoven, Paul
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Nilsen, Per
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Effectiveness of implementing a best practice primary healthcare model for low back pain (BetterBack) compared with current routine care in the Swedish context: an internal pilot study informed protocol for an effectiveness-implementation hybrid type 2 trial2018Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, nr 4, artikkel-id e019906Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction Low back pain (LBP) is a major health problem commonly requiring healthcare. In Sweden, there is a call from healthcare practitioners (HCPs) for the development, implementation and evaluation of a best practice primary healthcare model for LBP.

    Aims (1) To improve and understand the mechanisms underlying changes in HCP confidence, attitudes and beliefs for providing best practice coherent primary healthcare for patients with LBP; (2) to improve and understand the mechanisms underlying illness beliefs, self-care enablement, pain, disability and quality of life in patients with LBP; and (3) to evaluate a multifaceted and sustained implementation strategy and the cost-effectiveness of the BetterBack☺ model of care (MOC) for LBP from the perspective of the Swedish primary healthcare context.

    Methods This study is an effectiveness-implementation hybrid type 2 trial testing the hypothesised superiority of the BetterBack☺ MOC compared with current routine care. The trial involves simultaneous testing of MOC effects at the HCP, patient and implementation process levels. This involves a prospective cohort study investigating implementation at the HCP level and a patient-blinded, pragmatic, cluster, randomised controlled trial with longitudinal follow-up at 3, 6 and 12 months post baseline for effectiveness at the patient level. A parallel process and economic analysis from a healthcare sector perspective will also be performed. Patients will be allocated to routine care (control group) or the BetterBack☺ MOC (intervention group) according to a stepped cluster dogleg structure with two assessments in routine care. Experimental conditions will be compared and causal mediation analysis investigated. Qualitative HCP and patient experiences of the BetterBack☺ MOC will also be investigated.

    Dissemination The findings will be published in peer-reviewed journals and presented at national and international conferences. Further national dissemination and implementation in Sweden and associated national quality register data collection are potential future developments of the project.

  • 167.
    Abbott, Allan
    et al.
    Department of Physical Therapy, Karolinska University Hospital; Department of Clinical Science, Intervention and Technology, Division of Orthopaedics, Karolinska Institute, Stockholm, Sweden.
    Tyni-Lenné, Raija
    Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
    Hedlund, Rune
    Department for Orthopaedics, Institute for Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Early rehabilitation targeting cognition, behaviour and motor function after lumbar fusion: A randomized controlled trial2010Inngår i: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 35, nr 8, s. 848-857Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Study Design - Open label randomized controlled trial with 3-, 6-, 12-month, and 2- to 3-year follow-up.

    Objective - To investigate the effectiveness of a psychomotor therapy focusing on cognition, behavior, and motor relearning compared with exercise therapy applied during the first 3 months after lumbar fusion.

    Summary of Background Data - Postoperative management after lumbar fusion commonly focuses on analgesic pain control and activities of daily living. After 3 months, exercise therapy is often implemented. No randomized controlled trial has investigated early rehabilitation techniques conducted during the first 3 months after surgery.

    Methods - The study recruited 107 patients, aged 18 to 65 years, selected for lumbar fusion because of 12 months of symptomatic spinal stenosis, spondylosis, degenerative/isthmic spondylolisthesis, or degenerative disc disease. The exercise therapy group received a home program focusing on pain contingent training of back, abdominal, and leg muscle functional strength and endurance, stretching, and cardiovascular fitness. The psychomotor therapy group received a home program and 3 outpatient sessions focusing on modifying maladaptive pain cognitions, behaviors, and motor control. Rated questionnaires investigating functional disability, pain, health-related quality of life, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, and coping were assessed at 3, 6, 12 months, and 2 to 3 years after surgery.

    Results - Follow-up rates were 93% at 12 months and 81% at 2 to 3 years after surgery. Psychomotor therapy improved functional disability, self-efficacy, outcome expectancy, and fear of movement/(re)injury significantly more than exercise therapy at respective follow-up occasions. Similar results occurred for pain coping but group differences were nonsignificant at 2 to 3 years follow-up. Potentially clinical relevant higher reoperation rates occurred after psychomotor therapy but rates were within normal ranges.

    Conclusion - The study shows that postoperative rehabilitation can be safely implemented during the first 3 months after lumbar fusion and should include measures to modify psychological as well as motor functions.

  • 168.
    Abbott, Allan
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet. Department of Physical Therapy, Karolinska University Hospital, Huddinge, Stockholm, Sweden; Division of Orthopaedics, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
    Tyni-Lenné, Raija
    Department of Physical Therapy, Karolinska University Hospital, Huddinge, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Hedlund, Rune
    Department for Orthopaedics, Institute for Clinical Sciences, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Leg pain and psychological variables predict outcome 2-3 years after lumber fusion surgery2011Inngår i: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 20, nr 10, s. 1626-1634Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Prediction studies testing a thorough range of psychological variables in addition to demographic, work-related and clinical variables are lacking in lumbar fusion surgery research. This prospective cohort study aimed at examining predictions of functional disability, back pain and health-related quality of life (HRQOL) 2-3 years after lumbar fusion by regressing nonlinear relations in a multivariate predictive model of pre-surgical variables. Before and 2-3 years after lumbar fusion surgery, patients completed measures investigating demographics, work-related variables, clinical variables, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, mental health and pain coping. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate predictor variables and address predictive model validity. The most parsimonious and stable subset of pre-surgical predictor variables explained 41.6, 36.0 and 25.6% of the variance in functional disability, back pain intensity and HRQOL 2-3 years after lumbar fusion. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical straight leg raise significantly predicted back pain. Post-operative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL. For the median dichotomised classification of functional disability, back pain intensity and HRQOL levels 2-3 years post-surgery, the discriminative ability of the prediction models was of good quality. The results demonstrate the importance of pre-surgical psychological factors, leg pain intensity, straight leg raise and post-operative psychomotor therapy in the predictions of functional disability, back pain and HRQOL-related outcomes.

  • 169.
    Abbott, Allan
    et al.
    Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology, Division of Orthopaedics, Karolinska Institute, Stockholm, Sweden.
    Tyni-Lenné, Raija
    Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
    Hedlund, Rune
    Institute for Clinical Sciences, Department for Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.
    The influence of psychological factors on pre-operative levels of pain intensity, disability and HRQOL in lumbar spinal fusion surgery patients2010Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 96, nr 3, s. 213-221Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES:

    To assess the extent to which perceived pain and psychological factors explain levels of disability and health-related quality of life (HRQOL) in patients scheduled for lumbar fusion surgery, and to test the hypothesis that relationships between pain intensity, mental health, fear of movement/(re)injury, disability and HRQOL are mediated by cognitive beliefs and appraisals.

    DESIGN:

    Cross-sectional, correlation study.

    SETTING:

    Orthopaedic outpatient setting in a tertiary hospital.

    PARTICIPANTS:

    One hundred and seven chronic back pain patients scheduled for lumbar fusion surgery.

    MEASURES:

    Visual analogue scale for pain intensity, Short Form 36 mental health subscale, Tampa Scale for Kinesiophobia, Back Beliefs Questionnaire, Self-efficacy Scale, Coping Strategy Questionnaire, Oswestry Disability Index and European Quality of Life Questionnaire.

    RESULTS:

    The group effect of multiple mediators significantly influenced the relationships between pain intensity and mental health, fear of movement/(re)injury, functional disability and HRQOL. Pain catastrophising significantly mediated the relationship between pain intensity and mental health, control over pain significantly mediated the relationship between mental health and functional disability, self-efficacy and pain outcome expectancy significantly mediated the relationship between mental health and HRQOL, and self-efficacy also significantly mediated the relationship between pain intensity, fear of movement/(re)jury and functional disability. The model explained 28, 30, 52 and 42% of the variation in mental health, fear of movement/(re)injury, functional disability and HRQOL, respectively.

    CONCLUSIONS:

    This study highlights the strong influence and mediation roles of psychological factors on pain, mental health, fear of movement/(re)injury, disability and HRQOL in patients scheduled for lumber fusion. Future research should focus on screening as well as pre- and post-operative interventions based on these psychological factors for the potential improvement of lumber fusion surgery outcomes.

    Copyright 2010 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  • 170.
    Abbott, Allan
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Tynni-Lenne, Raija
    Karolinska Institute, Stockholm, Sweden.
    Hedlund, Rune
    Karolinska Institute, Stockholm, Sweden.
    Early physiotherapeutic rehabilitation following lumbar spinal fusion surgery2009Inngår i: Oral Presentations: Cervical Spine: The Surgical Treatment of Painful Disorders, Springer, 2009, Vol. 18, Supplement 4, s. S409-S410Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Background: Physiotherapy after lumbar spinal fusion surgery is traditionally focused on physical exercise. Too few studies have investigatedthe efficacy of modern lumbar stabilization exercise regimes. Benefits have been shown for combining traditional physical exercise with a psychosocial intervention. No randomised controlled study has evaluated thecombined biopsychosocial effect of modern lumbar stabilization exercisesand cognitive behavioural intervention compared to traditional physical exercise starting immediately after lumbar spinal fusion.

    Purpose: To investigate the effectiveness of modern physiotherapy(MPT) compared to a traditional physiotherapy (TPT) starting immediately after lumber spinal fusion.

    Study design/setting: Randomized controlled clinical trial.

    Patient sample, inclusion period and follow-up: Patients between 18 and 65 years, selected for lumbar spinal fusion due to at least 12 months of CLBP symptoms caused by spinal stenosis, spondylosis, spondylolisthesis or degenerative disc disease were included in the study between 2005 and 2007. A total of 107 patients were randomly allocated to the MPT group (n = 53) and TPT group (n = 54). The TPT group was prescribed daily home based pain contingent training of traditional physical exercises for back, abdominal and leg muscles. The MPT group was prescribed daily home based training of lumbar stabilization exercises combined with 90 min of cognitive behavioural intervention at 3, 6 and 9 weeks after the operation. The patients outcomes were followed up at 3, 6, 12 months and 2–3 years

    Outcome measures: Oswestry disability index (ODI), pain intensity, HRQOL, kinesiophobia, anxiety/depression, self-efficacy, outcome expectancy, use of coping strategies, work status, sickness leave and health care use.

    Methods: Analysis of mean differences between groups.

    Results: 2–3 year follow-up showed that the MPT group had significantly lower percentage scores in ODI = 18.2 (P = 0.008), kinesiophobia= 30.0 (P = 0.001), catastrophizing = 21.8 (P = 0.006) and higher self-efficacy = 64.6 (P = 0.019) compared to TPT group’s ODI = 28.1, kinesiophobia = 41.9, catastrophizing = 31.3 and self-efficacy = 55.5. The MPT group had significantly more employment, less health care use (P = 0.035) and less long-term sickness leave (P = 0.040).

    Conclusions: This study provides evidence for the benefits of combining lumbar stabilization exercise and cognitive behavioural intervention starting immediately after lumbar fusion.

  • 171.
    Abbott, Allan
    et al.
    Karolinska University Hospital, Stockholm, Sweden.
    Tynni-Lenné, R
    Karolinska University Hospital, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden.
    Hedlund, R
    Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
    The effectiveness of physiotherapeutic rehabilitation and issues of outcome prediction after lumber fusion surgery.2011Inngår i: Proceedings of the WCPT Congress, Amsterdam Netherlands. / [ed] Physiotherapy, World Confederation of Physical Therapy , 2011, Vol. 97 (Suppl 1), s. 20-Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Purpose: The primary purpose was to analyse the short and long term effectiveness of physiotherapeutic rehabilitation programs performed during the first 3 month after lumbar fusion surgery. A secondary purpose was to analyse factors predicting long-term disability, back pain and health related quality of life (HRQOL) outcomes after lumbar fusion.

    Relevance: The study provides evidence for the effectiveness of early physiotherapy after lumbar fusion. Furthermore improved knowledge of predictive factors can help physiotherapist in the screening of lumbar fusion candidates and the individualised implementation of pre-surgical and post-surgical interventions.

    Participants: A total of 107 patients were recruited from the Karolinska University Hospital's Orthopaedic Clinic, Stockholm, Sweden. The inclusion criteria were: men and women aged between 18 and 65 years with a >12 month history of back pain and/or sciatica; a primary diagnosis of spinal stenosis, degenerative or isthmic spondylolisthesis or degenerative disc disease; selected for lumbar fusion with or without decompression; competence in the Swedish language. The criteria for exclusion were: previous lumbar fusion, rheumatoid arthritis and ankylosing spondylitis.

    Methods: An open book randomised controlled trial with pre-surgical and post-surgical measures at 3, 6, 12 and 24-36 months was performed to investigate the effectiveness of a psychomotor therapy focusing on cognition, behaviour and motor relearning compared to exercise therapy focusing on strength and conditioning, applied during the first 3 months after lumbar fusion. Randomisation allocated 53 patients to psychomotor therapy and 54 patients to exercise therapy. The Oswestry disability index (ODI) was the primary outcome measure. Secondary measures included the Visual analogue scale for back pain (VAS), European quality of life questionnaire (EQ5D), as well as other clinical, psychological and work related variables.

    Analysis: A total of 78 patients were needed assuming a power = 80%. Patient compliance was analysed and an intention to treat principle applied to data analysis. For statistical comparison between the 2 independent groups, analysis of covariance was used. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate pre-surgical predictor variables and address predictive model validity.

    Results: Follow-up rates were 93% at 12 months and 81% at 24-36 months after surgery. Psychomotor therapy improved functional disability, self-efficacy, outcome expectancy and fear of movement/(re)injury significantly more than exercise therapy at respective follow-up occasions. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical lasegue test significantly predicted back pain. The implementation of post-operative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL.

    Conclusions: The study shows that post-operative rehabilitation can be safely implemented during the first 3 months after lumbar fusion and should include measures to modify psychological as well as motor functions. The study also demonstrates the importance of pre-surgical psychological factors, leg pain intensity, the lasegue test and post-operative psychomotor therapy in the predictions of functional disability, back pain and HRQOL related outcomes.

    Implications: Physiotherapist should screen patients pain, psychological factors and neuromusculoskeletal system pre-surgically and rehabilitate patients with early psychomotor therapy after lumbar fusion.

  • 172.
    Abbott, Allan
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Tynni-Lenné, Raija
    Karolinska Institute, Stockholm, Sweden.
    Hedlund, Rune
    Gothenburg University, Gothenburg, Sweden.
    Early rehabilitation targeting cognition, behaviour and motor function after lumbar fusion: A randomised controlled trial2010Inngår i: Abstracts: Oral Presentations, 2010, s. 186-186Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Study Design: Open label randomised controlled trial with 3, 6, 12 month and 2-3 year follow-up.

    Objective. To investigate the effectiveness of a psychomotor therapy focusing on cognition, behaviour and motor relearning compared to exercise therapy applied during the first 3 months after lumbar fusion.

    Methods: The study recruited 107 patients, aged 18 to 65 years, selected for lumbar fusion due to 12 months of symptomatic spinal stenosis, degenerative/isthmic spondylolisthesis or degenerative disc disease. The exercise therapy group received a home program focusing on pain contingent training of back, abdominal and leg muscle functional strength and endurance, stretching and cardiovascular fitness. The psychomotor therapy group received a home program and 3 outpatient sessions focusing on modifying maladaptive pain cognitions, behaviours and motor control. Patient-rated questionnaires investigating functional disability, pain, health related quality of life, functional self-efficacy, outcome expectancy, fear of movement/(re)injury and copingwere assessed at baseline, 3, 6, 12 months and 2-3 years after surgery.

    Results: Follow-up rates were 93% at 12 months and 81% at 2-3 years after surgery. Psychomotor therapy improved functional disability, self-efficacy, outcome expectancy and fear of movement/(re)injury significantly more than exercise therapy at respective follow-up occasions. Similar results occurred for pain coping but group differences were non-significant at 2-3 year follow-up.

    Conclusions: The study shows that post-operative rehabilitation can be effectively implemented during the first 3 months after lumbar fusion and should include measures to modify psychological aswell as motor functions.

  • 173. Abbott, Anne L.
    et al.
    Adelman, Mark A.
    Alexandrov, Andrei V.
    Barber, P. Alan
    Barnett, Henry J. M.
    Beard, Jonathan
    Bell, Peter
    Björck, Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Kärlkirurgi.
    Blacker, David
    Bonati, Leo H.
    Brown, Martin M.
    Buckley, Clifford J.
    Cambria, Richard P.
    Castaldo, John E.
    Comerota, Anthony J.
    Connolly, E. Sander, Jr.
    Dalman, Ronald L.
    Davies, Alun H.
    Eckstein, Hans-Henning
    Faruqi, Rishad
    Feasby, Thomas E.
    Fraedrich, Gustav
    Gloviczki, Peter
    Hankey, Graeme J.
    Harbaugh, Robert E.
    Heldenberg, Eitan
    Hennerici, Michael G.
    Hill, Michael D.
    Kleinig, Timothy J.
    Mikhailidis, Dimitri P.
    Moore, Wesley S.
    Naylor, Ross
    Nicolaides, Andrew
    Paraskevas, Kosmas I.
    Pelz, David M.
    Prichard, James W.
    Purdie, Grant
    Ricco, Jean-Baptiste
    Ringleb, Peter A.
    Riles, Thomas
    Rothwell, Peter M.
    Sandercock, Peter
    Sillesen, Henrik
    Spence, J. David
    Spinelli, Francesco
    Sturm, Jonathon
    Tan, Aaron
    Thapar, Ankur
    Veith, Frank J.
    Wijeratne, Tissa
    Zhou, Wei
    Why Calls for More Routine Carotid Stenting Are Currently Inappropriate An International, Multispecialty, Expert Review and Position Statement2013Inngår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 44, nr 4, s. 1186-1190Artikkel i tidsskrift (Fagfellevurdert)
  • 174. Abbott, Anne L
    et al.
    Adelman, Mark A
    Alexandrov, Andrei V
    Barnett C C, Henry J M
    Beard, Jonathan
    Bell, Peter
    Björck, Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Kärlkirurgi.
    Blacker, David
    Buckley, Clifford J
    Cambria, Richard P
    Comerota, Anthony J
    Connolly, E Sander
    Davies, Alun H
    Eckstein, Hans-Henning
    Faruqi, Rishad
    Fraedrich, Gustav
    Gloviczki, Peter
    Hankey, Graeme J
    Harbaugh, Robert E
    Heldenberg, Eitan
    Kittner, Steven J
    Kleinig, Timothy J
    Mikhailidis, Dimitri P
    Moore, Wesley S
    Naylor, Ross
    Nicolaides, Andrew
    Paraskevas, Kosmas I
    Pelz, David M
    Prichard, James W
    Purdie, Grant
    Ricco, Jean-Baptiste
    Riles, Thomas
    Rothwell, Peter
    Sandercock, Peter
    Sillesen, Henrik
    Spence, J David
    Spinelli, Francesco
    Tan, Aaron
    Thapar, Ankur
    Veith, Frank J
    Zhou, Wei
    Why the US Center for Medicare and Medicaid Services Should Not Extend Reimbursement Indications for Carotid Artery Angioplasty/Stenting2012Inngår i: Angiology, ISSN 0003-3197, E-ISSN 1940-1574, Vol. 63, nr 8, s. 639-644Artikkel i tidsskrift (Fagfellevurdert)
  • 175. Abbott, Anne L.
    et al.
    Adelman, Mark A.
    Alexandrov, Andrei V.
    Barnett, Henry J. M.
    Beard, Jonathan
    Bell, Peter
    Björck, Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Kärlkirurgi.
    Blacker, David
    Buckley, Clifford J.
    Cambria, Richard P.
    Comerota, Anthony J.
    Connolly, E. Sander
    Davies, Alun H.
    Eckstein, Hans-Henning
    Faruqi, Rishad
    Fraedrich, Gustav
    Gloviczki, Peter
    Hankey, Graeme J.
    Harbaugh, Robert E.
    Heldenberg, Eitan
    Kittner, Steven J.
    Kleinig, Timothy J.
    Mikhailidis, Dimitri P.
    Moore, Wesley S.
    Naylor, Ross
    Nicolaides, Andrew
    Paraskevas, Kosmas I.
    Pelz, David M.
    Prichard, James W.
    Purdie, Grant
    Ricco, Jean-Baptiste
    Riles, Thomas
    Rothwell, Peter
    Sandercock, Peter
    Sillesen, Henrik
    Spence, J. David
    Spinelli, Francesco
    Tan, Aaron
    Thapar, Ankur
    Veith, Frank J.
    Zhou, Wei
    Why the United States Center for Medicare and Medicaid Services should not extend reimbursement indications for carotid artery angioplasty/stenting2012Inngår i: VASCULAR, ISSN 1708-5381, Vol. 20, nr 1, s. 1-7Artikkel i tidsskrift (Annet vitenskapelig)
  • 176.
    Abbott, Rebecca
    et al.
    Northwestern Univ, IL 60611 USA.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    West, Janne
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Tekniska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Elliott, James M.
    Northwestern Univ, IL 60611 USA; Univ Queensland, Australia; Zurich Univ Appl Sci, Switzerland.
    Åslund, Ulrika
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Karlsson, Anette
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Dahlqvist Leinhard, Olof
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Radiofysikavdelningen US. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    The qualitative grading of muscle fat infiltration in whiplash using fat and water magnetic resonance imaging2018Inngår i: The spine journal, ISSN 1529-9430, E-ISSN 1878-1632, Vol. 18, nr 5, s. 717-725Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND CONTEXT: The development of muscle fat infiltration (MFI) in the neck muscles is associated with poor functional recovery following whiplash injury. Custom software and time-consuming manual segmentation of magnetic resonance imaging (MRI) is required for quantitative analysis and presents as a barrier for clinical translation. PURPOSE: The purpose of this work was to establish a qualitative MRI measure for MFI and evaluate its ability to differentiate between individuals with severe whiplash-associated disorder (WAD), mild or moderate WAD, and healthy controls. STUDY DESIGN/SETTING: This is a cross-sectional study. PATIENT SAMPLE: Thirty-one subjects with WAD and 31 age-and sex-matched controls were recruited from an ongoing randomized controlled trial. OUTCOME MEASURES: The cervical multifidus was visually identified and segmented into eighths in the axial fat/water images (C4-C7). Muscle fat infiltration was assessed on a visual scale: 0 for no or marginal MFI, 1 for light MFI, and 2 for distinct MFI. The participants with WAD were divided in two groups: mild or moderate and severe based on Neck Disability Index % scores. METHODS: The mean regional MFI was compared between the healthy controls and each of the WAD groups using the Mann-Whitney U test. Receiver operator characteristic (ROC) analyses were carried out to evaluate the validity of the qualitative method. RESULTS: Twenty (65%) patients had mild or moderate disability and 11 (35%) were considered severe. Inter- and intra-rater reliability was excellent when grading was averaged by level or when frequency of grade II was considered. Statistically significant differences (pamp;lt;.05) in regional MFI were particularly notable between the severe WAD group and healthy controls. The ROC curve, based on detection of distinct MFI, showed an area-under-the curve of 0.768 (95% confidence interval 0.59-0.94) for discrimination of WAD participants. CONCLUSIONS: These preliminary results suggest a qualitative MRI measure for MFI is reliable and valid, and may prove useful toward the classification of WAD in radiology practice. (C) 2017 Elsevier Inc. All rights reserved.

  • 177.
    Abbott, Rebecca
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Straker, Leon
    Curtin Health Innovation Research Institute, Curtin University, Perth, Australia.
    Mathiassen, Svend Erik
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Patterning of children's sedentary time at and away from school2013Inngår i: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 21, s. E131-E133Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective:

    Sedentary behavior in children is positively associated with an increased risk of both obesity and insulin resistance. Children spend a considerable portion of their awake time in sedentary behavior; however, the pattern of accumulation is not known. Thus the objective of this study was to describe the patterning of sedentary behavior of children at and away from school.

    Design and Methods:

    The patterns of sedentary time in a sample of 53 children (28 girls) aged 10-12 years during school-term time were examined. Children wore an accelerometer for 1 week. Total sedentary time, prolonged sequences (bouts) of sedentary time, and frequency of active interruptions to sedentary were examined on school days and weekends and within school time and non-school time on school days.

    Results:

    The data did not support our hypothesis that children accumulated more sedentary time on school days when compared with weekend days (mean [SD]: 64.4% [5.3] vs. 64.9% [9.0], P = 0.686). However, when comparing school time with non-school time on school days, children accumulated more sedentary time at school (66.8% [7.3] vs. 62.4% [5.2], P < 0.001) and spent more time at school in sustained sedentary sequences, that is, uninterrupted sedentary time for 30 min or more (75.6 min [45.8] vs. 45.0 min [26.8], P < 0.002). The children also recorded less breaks per sedentary hour within school time when compared with non-school time (8.9 h−1 vs. 10.2 h−1, P < 0.001).

    Conclusion:

    Reducing total sedentary time spent both in and out of school remains an important challenge. Interrupting sedentary time more often in the “working” (school) day could also reap important musculoskeletal and metabolic health rewards for children.

  • 178.
    Abbott, T. E. F.
    et al.
    Queen Mary Univ London, England.
    Ahmad, T.
    Queen Mary Univ London, England.
    Phull, M. K.
    Barts Hlth NHS Trust, England.
    Fowler, A. J.
    Guys and St Thomass NHS Fdn Trust, England.
    Hewson, R.
    Barts Hlth NHS Trust, England.
    Biccard, B. M.
    Univ Cape Town, South Africa.
    Chew, Michelle
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken US.
    Gillies, M.
    Univ Edinburgh, Scotland.
    Pearse, R. M.
    Queen Mary Univ London, England.
    The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis2018Inngår i: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 120, nr 1, s. 146-155Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained amp;gt;= 1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32-0.77); Pamp;lt;0.01], but no difference in complication rates [OR 1.02 (0.88-1.19); P = 0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62-0.92); Pamp;lt;0.01; I-2 = 87%] and reduced complication rates [OR 0.73 (0.61-0.88); Pamp;lt;0.01; I-2 = 89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.

  • 179. Abbud-Filho, Mario
    et al.
    Adams, Patricia L
    Alberú, Josefina
    Cardella, Carl
    Chapman, Jeremy
    Cochat, Pierre
    Cosio, Fernando
    Danovitch, Gabriel
    Davis, Connie
    Gaston, Robert S
    Humar, Atul
    Hunsicker, Lawrence G
    Josephson, Michelle A
    Kasiske, Bertram
    Kirste, Günter
    Leichtman, Alan
    Munn, Stephen
    Obrador, Gregorio T
    Tibell, Annika
    Wadström, Jonas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Transplantationskirurgi.
    Zeier, Martin
    Delmonico, Francis L
    A report of the Lisbon Conference on the care of the kidney transplant recipient2007Inngår i: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 83, nr 8, s. S1-S22Artikkel, forskningsoversikt (Fagfellevurdert)
  • 180.
    Abd Al Qahar Al-Kubaisy, Waqar
    et al.
    MARA University of Technology, Sungai Buloh, Malaysia; MARA University of Technology UiTM, Malaysia.
    Jawad Obaid, Kadhim
    MARA University of Technology, Sungai Buloh, Malaysia.
    Aini Mohd Noor, Nor
    MARA University of Technology, Sungai Buloh, Malaysia; MARA University of Technology UiTM, Shah Alam, Selangor, Malaysia.
    Shamsidah Binti Nik Ibrahim, Nik
    MARA University of Technology, Sungai Buloh, Malaysia.
    Albu-Kareem Al-Azawi, Ahmed
    Östergötlands Läns Landsting.
    Hepatitis C virus prevalence and genotyping among hepatocellular carcinoma patients in Baghdad2014Inngår i: Asian Pacific Journal of Cancer Prevention, ISSN 1513-7368, Vol. 15, nr 18, s. 7725-7730Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Hepatocellular carcinoma (HCC) is the third most common cause for cancer death in the world, now being especially linked to chronic hepatitis C virus (HCV) infection. This case-control study consisting of 65 HCC patients and 82 patients with other malignant tumours as controls was conducted to determine the association of HCV markers with HCC. Serum of each participant was obtained for detection of HCV Ab and RNA by DNA enzyme immunoassay (DEIA). Twenty six per cent (26.0%) of HCC patients had positive anti-HCV which was significantly greater than the control group (p=0.001). HCC patients significantly have a risk of exposure to HCV infection almost 3 times than the control group (OR=2.87, 95% C.I=1.1-7). Anti-HCV seropositive rate was significantly (p=0.03) higher among old age HCC patients and increases with age. Males with HCC significantly showed to have more than 9 times risk of exposure to HCV infection (OR=9.375, 95 % CI=1.299-67.647) than females. HCV-RNA seropositive rate was (70.8%) significantly higher among HCC patients compared to (22.2%) the control group (p=0.019). The most prevalent genotype (as a single or mixed pattern of infection) was HCV-1b. This study detected a significantly higher HCV seropositive rate of antibodies and RNA in HCC patients.

  • 181.
    Abd Mohammed, Mena
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Dental treatment under general anesthesia for children in the county of Västerbotten2012Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 182.
    Abdal Hadi, Jehan
    Högskolan i Kalmar, Naturvetenskapliga institutionen.
    Hur skiljer sig traditionella från nyare generationer antipsykotika åt vad gäller biverkningen viktökning?2008Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Antipsykotiska läkemedel är basen för behandling av schizofreni, en psykisk sjukdom som uppträder redan hos unga människor. Symtomen vid schizofreni brukar delas in i positiva symtom (hallucinationer, vanföreställningar, paranoida tankar), negativa symtom (koncentrationssvårigheter, nedsatt språk- och tankeförmåga, minskat intresse för omgivningen, och initiativlöshet), samt kognitiva symtom (minnesproblem, problem med uppmärksamhet och koncentration).

    Antipsykotiska läkemedel delas in i typiska (den äldre generationen) och atypiska (den nyare generationen) antipsykotika. För båda grupperna antipsykotiska läkemedel finns det risk för biverkningar. De vanligaste biverkningarna vid behandling med den äldre generationen antipsykotika är extrapyramidala biverkningar. En biverkning som förefaller mer specifik för de nya atypiska preparaten är viktökning, vilken även kan orsaka utveckling av många allvarliga sjukdomstillstånd.

    Syftet med detta arbete var att jämföra typiska och atypiska antipsykotiska läkemedel med avseende på utveckling av viktökning.

    För att få svar på min frågeställning har en litteraturstudie av fem vetenskapliga artiklar genomförts. De vetenskapliga artiklarna har hittats genom databassökningar i PubMed, medan övriga fakta har hämtats från andra källor.

    Resultatet av de vetenskapliga artiklarna visar att det finns skillnader mellan traditionella och nyare generationer antipsykotika vad gäller tendens att orsaka viktökning. Med några undantag, är flera antipsykotiska läkemedel, som tillhör den nyare generationen, associerade med högre risk för utveckling av viktökning jämfört med den äldre generationen antipsykotika. Viktökning orsakas mest av klozapin, följt av olanzapin och risperidon. Quetiapin orsakar, i likhet med haloperidol, mindre viktökning.

    På grund av detta faktum, forskar man numera kring orsakerna till denna skillnad för att förbättra biverkningsprofilen hos framtida antipsykotika.

    2008:F2

  • 183.
    Abdalla, Hana
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Diab, Asim
    Department of Neurology, University of Texas Southwestern Medical Center, Dallas, USA.
    Forslund, Tony
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Bakhiet, Moiz
    Department of Medicine, Divisions of lnfectious Diseases, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
    Stendahl, Olle
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Sundqvist, Tommy
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Expression of inducible nitric oxide synthases and nitrotyrosine during the course of Haemophilus influenzae type b meningitis in ratManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Bacterial meningitis continues to be a major health problem and despite great advances in antimicrobial therapy the fatality rate remains high. There is increasing evidence that leukocyte-endothelial interactions are involved in CNS damage during bacterial meningitis. Once leukocytes have entered the CSF they cause injury by releasing toxic molecules such as nitric oxide (NO) and reactive oxygen species (ROS). The induction of iNOS was examined by assessing intracerebral mRNA expression and protein production during the course of Haemophilus influenzae type b (Hib) meningitis in the rat. Induction of iNOS mRNA was detected 12h postinoculation (pi), followed by a gradual reduction. The increased number of intracerebral iN OS expressing cells was detected at 12h pi. followed by further elevation to peak expression at 72h pi. The iNOS positive tissue also bound antibodies specific for nitrotyrosine. The expression of iNOS and NO production, as shown by nitrotyrosine expression, correlated with disease severity, suggesting that activation of iNOS may play an important role in Haemophilus irifluenzae type b meningitis.

  • 184.
    Abdalla, Hana
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Forslund, Tony
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Schön, Thomas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Stendahl, Olle
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Sundqvist, Tommy
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Effects of CNI-1493 on human granulocyte functions2006Inngår i: Immunobiology, ISSN 0171-2985, E-ISSN 1878-3279, Vol. 211, nr 3, s. 191-197Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    During acute bacterial infections such as sepsis and meningitis, activation of inflammatory mediators such as nitric oxide (NO) plays a crucial role in both pathogenesis and host defense. We have previously reported that CNI-1493, a macrophage deactivator, reduced mortality in infant rats infected with Haemophilus influenzae type b (Hib) with associated decrease in the number of granulocytes in the infected tissue. The aim of the present study was to investigate how CNI-1493 affects granulocytes and macrophages in vitro. Murine macrophages (RAW 264.7) pre-incubated with CNI-1493 prior to activation with lipopolysaccharide (LPS)/interferon gamma (IFNγ) had decreased NO production measured as NO2/NO3 levels and reduction in inducible NO-synthase (iNOS) expression. Reactive oxygen species (ROS) production was increased in formylmethionyl-leucyl-phenylalanine (FMLP)-stimulated granulocytes following CNI-1493 treatment, whereas F-actin content, motility and chemotaxis were decreased under the same conditions. The effects of CNI-1493 on both NO production in LPS/IFNγ-activated macrophages and ROS production, F-actin content, motility and chemotaxis in granulocytes, may contribute to the reduced inflammatory response and increased survival in Hib-infected animals treated with CNI-1493.

  • 185.
    Abdalla, Maie
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Suez Canal University, Egypt.
    Landerholm, Kalle
    Ryhov County Hospital, Sweden.
    Andersson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Andersson, Roland
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Ryhov County Hospital, Sweden.
    Myrelid, Pär
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Risk of Rectal Cancer After Colectomy for Patients With Ulcerative Colitis: A National Cohort Study2017Inngår i: Clinical Gastroenterology and Hepatology, ISSN 1542-3565, E-ISSN 1542-7714, Vol. 15, nr 7, s. 1055-1060, artikkel-id e2Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND amp; AIMS: Patients with ulcerative colitis (UC) have an increased risk of rectal cancer, therefore reconstruction with an ileal pouch-anal anastomosis (IPAA) generally is preferred to an ileorectal anastomosis (IRA) after subtotal colectomy. Similarly, completion proctectomy is recommended for patients with ileostomy and a diverted rectum, although this approach has been questioned because anti-inflammatory agents might reduce cancer risk. We performed a national cohort study in Sweden to assess the risk of rectal cancer in patients with UC who have an IRA, IPAA, or diverted rectum after subtotal colectomy.

    METHODS: We collected data from the Swedish National Patient Register for a cohort of 5886 patients with UC who underwent subtotal colectomy with an IRA, IPAA, or diverted rectum from 1964 through 2010. Patients who developed rectal cancer were identified from the Swedish National Cancer Register. The risk of rectal cancer was compared between this cohort and the general population by standardized incidence ratio analysis.

    RESULTS: Rectal cancer occurred in 20 of 1112 patients (1.8%) who received IRA, 1 of 1796 patients (0.06%) who received an IPAA, and 25 of 4358 patients (0.6%) with a diverted rectum. Standardized incidence ratios for rectal cancer were 8.7 in patients with an IRA, 0.4 in patients with an IPAA, and 3.8 in patients with a diverted rectum. Risk factors for rectal cancer were primary sclerosing cholangitis in patients with an IRA (hazard ratio, 6.12), and colonic severe dysplasia or cancer before subtotal colectomy in patients with a diverted rectum (hazard ratio, 3.67).

    CONCLUSIONS: In an analysis of the Swedish National Patient Register, we found that the risk for rectal cancer after colectomy in patients with UC is low, in relative and absolute terms, after reconstruction with an IPAA. An IRA and diverted rectum are associated with an increased risk of rectal cancer, compared with the general population, but the absolute risk is low. Patients and their health care providers should consider these findings in making decisions to leave the rectum intact, perform completion proctectomy, or reconstruct the colon with an IRA or IPAA.

  • 186.
    Abdallah Athumani, Ngenya
    Örebro universitet, Institutionen för hälsovetenskaper.
    Characterization of tick-born encephalitis and West Nile virus non-structural 5 protein interactions with host factors involved in immune evasion and cellular apoptosis.2016Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 187. Abdallah, Qasem M. A.
    et al.
    Phillips, Roger M.
    Johansson, Fredrik
    Stockholms universitet, Naturvetenskapliga fakulteten, Institutionen för genetik, mikrobiologi och toxikologi.
    Helleday, Thomas
    Stockholms universitet, Naturvetenskapliga fakulteten, Institutionen för genetik, mikrobiologi och toxikologi.
    Cosentino, Laura
    Abdel-Rahman, Hamdy
    Etzad, Jasarat
    Wheelhouse, Richard T.
    Kiakos, Konstantinos
    Bingham, John P.
    Hartley, John A.
    Patterson, Laurence H.
    Pors, Klaus
    Minor structural modifications to alchemix influence mechanism of action and pharmacological activity2012Inngår i: Biochemical Pharmacology, ISSN 0006-2952, E-ISSN 1356-1839, Vol. 83, nr 11, s. 1514-1522Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Alchemix is an exemplar of a class of anthraquinone with efficacy against multidrug resistant tumours. We have explored further the mechanism of action of alchemix and investigated the effect of extending its side arm bearing the alkylating functionality with regard to DNA binding and activity against multidrug resistant cancer cells. Increasing the distance between the intercalating chromophore and the alkylating functionality of ICT2901 (propyl), ICT2902 (butyl) and ICT2903 (pentyl), led to a higher number of DNA alkylation sites, more potent topoisomerase II inhibition and generated more apoptotic and necrotic cells when analysed in p53-proficient HCT116 cells. Intriguingly, alchemix, the compound with the shortest distance between its intercalative chromophore and alkylating functionality (ethyl), did not conform to this SAR. A different toxicity pattern against DNA repair defective CHO cell lines as well as arrest of cells in Cl supports a somewhat distinct mode of action by alchemix compared with its analogues. Importantly, both alchemix and ICT2901 demonstrated greater cytotoxic activity against anthraquinone-resistant MCF-7/adr cells than wild-type MCF-7 cells. Subtle synthetic modification in this anthraquinone series has led to significant changes to the stability of DNA-compound complexes and cellular activity. Given that the failure of chemotherapy in the clinic is often associated with MDR, the results of both alchemix and ICT2901 represent important advances towards improved therapies.

  • 188.
    Abdel Ghani, Rania Mahmoud
    et al.
    Faculty of Nursing, Cairo University.
    Berggren, Vanja
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Parturient needs during labor: Egyptian women’s perspective toward childbirth experience, a step toward an excellence in clinical practice2011Inngår i: Journal of Basic and Applied Scientific Research, ISSN 2090-4304, Vol. 1, nr 12, s. 2935-2943Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:

    Every woman giving birth has expectations. Identifying women’s expectations, wishes, needs and fears enable the health care provider(s) to work toward a common goal of safe and positive childbirth experience.

    Aim:

    The aim was to determine women’s preferences and needs during labor.

    Design:

    Analytic- cross sectional study.

    Setting:

    El Kasr- Aini, - Cairo- University Maternity Hospitals.

    Sample:

    A random sample of 400 women were recruited in the present study with the following criteria; age ranged between 20-30 years old, can read and write, primigravida, nulliparous woman with singleton low risk pregnancies, in the third trimester, up to 37 weeks of gestational age, no previous abortion and free from any medical complains.

    Procedure:

    Data collection took place in the antenatal clinic, each interview administrated questionnaire took a time between 10-15 minutes. Mothers completed the questionnaire in the antenatal clinics during their waiting for medical examination.

    Results:

    Twenty two need requirements emerged from the women's perspective. The highest ranked needs for parturient women during labor are; maintaining privacy through all procedures of 86.5%, accessibility of nurses demonstrate empathy of 67.5%, availability to ventilate and expressing fear and anxiety of 57.5%, quick response to request of 67.5%, frequent monitoring of 52.8%, accessibility of caring medical staff of 47.2% and short delivery of 52.8%.

    Conclusion:

    Despite good general coverage of labor care among women, there were clear variations in the type of management given to them or needed by them. This study confirms that different factors predict the multidimensionality of childbirth satisfaction.

  • 189. Abdel Ghani, Rania Mahmoud
    et al.
    Khalaf, Atika
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Westergren, Albert
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Berggren, Vanja
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    A structured evidence-based approach to decrease cardiovascular complications among pregnant women with rheumatic disease: a pilot randomized controlled trial2010Inngår i: An annual Research Day in King Khalid University, 2010Konferansepaper (Fagfellevurdert)
  • 190.
    Abdel Ghani, Rania Mahmoud
    et al.
    Faculty of Nursing, Cairo University.
    Khalaf, Atika
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Westergren, Albert
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Berggren, Vanja
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Abdel Fadeel, Nagwa
    Faculty of Nursing, Cairo University.
    A structured evidence-based approach to decrease cardiovascular complications among pregnant women with reumatic disease: a pilot randomized controlled trial2010Inngår i: Journal of Medicine and Biomedical Science, ISSN 2078-0273, nr 1, s. 8-15Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Recent reports from the developing world have documented rheumatic fever (RE) incidence rates as high as 206/100 000 and Rheumatic Heart Disease (RHD) prevalence rates as high as 18.6/1000. The high frequency of RHD in the developing world necessitates aggressive prevention and control measures. Aim: The aim of the study was to examine the effect of intensive antenatal follow up program on decreasing cardiovascular complications among rheumatic pregnant woman. Design: Randomized controlled trial. Setting: This study was conducted at El Kasr-EL Aini, maternity hospital- Cairo- University Hospitals. Sample: A total of 100 rheumatic pregnant women that attended the antenatal clinic at El Kasr-EL Aini, maternity hospital who could read and write, had functional class I and II cardiac disease, primigravida, nullipara with single fetus were recruited to this study and assigned randomly into two groups. Procedure: Women who met the inclusion criteria were interviewed and baseline assessment was done. The intervention was an intensive antenatal follow up program for decreasing cardiovascular complications among rheumatic pregnant woman. Patients in the study group (SG) were offered an intervention at three levels, basic, intermediate and comprehensive. Evaluation of the program was carried out in term of assessment of maternal and neonatal outcome. Results: There were several significant differences between the study group (SG) and control group (CG). In the SG, antepartum complications was less common, gestational age at birth was higher, postnatal hospital stay shorter, birth weight higher, more had vaginal deliveries with episiotomy, fewer had caesarean section, forceps deliveries and termination of pregnancy, and cardiac class was better at follow up as compared to the CG. Conclusion: The difficult issues in pregnancy complications by cardiac disease are best managed through a team approach. Establishing a pre-pregnancy plan will foster a better therapeutic relationship between all parties and allow for better understanding of the patient’s beliefs regarding pregnancy, her disease and attitude towards medications.

  • 191.
    Abdel Rehim, Abbi
    et al.
    Stockholms universitet, Naturvetenskapliga fakulteten, Institutionen för analytisk kemi.
    Abdel Rehim, Mohamed
    Stockholms universitet, Naturvetenskapliga fakulteten, Institutionen för analytisk kemi.
    Screening and determination of drugs in human saliva utilizing microextraction by packed sorbent and liquid chromatography-tandem mass spectrometry2013Inngår i: BMC Biomedical chromotography, ISSN 0269-3879, E-ISSN 1099-0801, Vol. 27, nr 9, s. 1188-1191Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study presents a new method for collecting and handling saliva samples using an automated analytical microsyringe and microextraction by packed syringe (MEPS). The screening and determination of lidocaine in human saliva samples utilizing MEPS and liquid chromatography-tandem mass spectrometry (LC-MS/MS) were carried out. An exact volume of saliva could be collected. The MEPS C-8-cartridge could be used for 50 extractions before it was discarded. The extraction recovery was about 60%. The pharmacokinetic curve of lidocaine in saliva using MEPS-LC-MS/MS is reported.

  • 192.
    Abdeldaim, Guma
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk bakteriologi.
    Herrmann, Björn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk bakteriologi.
    Korsgaard, J.
    Köpenhamns Universitet.
    Olcén, P.
    Örebro Universitet, klinisk mikrobiologi.
    Blomberg, Jonas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk virologi.
    Strålin, Kristoffer
    Örebro Universitet, klinisk mikrobiologi.
    Is quantitative PCR for the pneumolysin (ply) gene useful for detection of pneumococcal lower respiratory tract infection?2009Inngår i: Clinical Microbiology and Infection, ISSN 1198-743X, E-ISSN 1469-0691, Vol. 15, nr 6, s. 565-570Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The pneumolysin (ply) gene is widely used as a target in PCR assays for Streptococcus pneumoniae in respiratory secretions. However, false-positive results with conventional ply-based PCR have been reported. The aim here was to study the performance of a quantitative ply-based PCR for the identification of pneumococcal lower respiratory tract infection (LRTI). In a prospective study, fibreoptic bronchoscopy was performed in 156 hospitalized adult patients with LRTI and 31 controls who underwent bronchoscopy because of suspicion of malignancy. Among the LRTI patients and controls, the quantitative ply-based PCR applied to bronchoalveolar lavage (BAL) fluid was positive at >/=10(3) genome copies/mL in 61% and 71% of the subjects, at >/=10(5) genome copies/mL in 40% and 58% of the subjects, and at >/=10(7) genome copies/mL in 15% and 3.2% of the subjects, respectively. Using BAL fluid culture, blood culture, and/or a urinary antigen test, S. pneumoniae was identified in 19 LRTI patients. As compared with these diagnostic methods used in combination, quantitative ply-based PCR showed sensitivities and specificities of 89% and 43% at a cut-off of 10(3) genome copies/mL, of 84% and 66% at a cut-off of 10(5) genome copies/mL, and of 53% and 90% at a cut-off of 10(7) genome copies/mL, respectively. In conclusion, a high cut-off with the quantitative ply-based PCR was required to reach acceptable specificity. However, as a high cut-off resulted in low sensitivity, quantitative ply-based PCR does not appear to be clinically useful. Quantitative PCR methods for S. pneumoniae using alternative gene targets should be evaluated.

  • 193.
    Abdeldaim, Guma
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk bakteriologi.
    Herrmann, Björn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk bakteriologi.
    Mölling, Paula
    Holmberg, Hans
    Blomberg, Jonas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk virologi.
    Olcén, Per
    Strålin, Kristoffer
    Usefulness of real-time PCR for lytA, ply, and Spn9802 on plasma samples for the diagnosis of pneumococcal pneumonia2010Inngår i: Clinical Microbiology and Infection, ISSN 1198-743X, E-ISSN 1469-0691, Vol. 16, nr 8, s. 1135-1141Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In the present study, we evaluated rapid real-time PCR assays for ply, Spn9802, and lytA applied to plasma samples for the detection of Streptococcus pneumoniae in patients with community-acquired pneumonia (CAP). In a prospective study of CAP aetiology, an EDTA plasma sample was collected together with blood culture in 92 adult CAP patients and 91 adult controls. Among the 92 CAP patients, lytA PCR was positive in eight (9%), Spn9802 PCR was positive in 11 (12%) and ply PCR was positive in 19 (21%) cases. Of 91 controls, the ply PCR was positive in eight cases (9%), but no positive cases were noted by Spn9802 or lytA PCRs. Ten CAP patients had pneumococcal bacteraemia. Compared to blood culture, PCR for lytA, Spn9802 and ply had sensitivities of 70% (7/10), 60% (6/10) and 70% (7/10), and specificities of 96% (79/82), 94% (77/82) and 85% (70/82) respectively. With blood culture and/or culture of representative sputum, and/or urinary antigen detection, S. pneumoniae was identified in 31 CAP patients. Compared to these tests in combination, PCR for lytA, Spn9802 and ply showed sensitivities of 26% (8/31), 32% (10/31) and 42% (13/31), and specificities of 100% (61/61), 98% (60/61) and 90% (55/61) respectively. We conclude that Spn9802 and lytA PCRs may be useful for the rapid detection of bacteraemic pneumococcal pneumonia, whereas ply PCR is not specific enough for routine use and blood PCR with small plasma volumes is not useful for the detection of nonbacteraemic pneumococcal pneumonia.

  • 194.
    Abdeldaim, Guma M. K.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi och infektionsmedicin, Klinisk bakteriologi.
    Herrmann, Björn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi och infektionsmedicin, Klinisk bakteriologi.
    PCR detection of haemophilus influenzae from respiratory specimens2013Inngår i: PCR Detection of Microbial Pathogens / [ed] Mark Wilks, Humana Press, 2013, 2, s. 115-123Kapittel i bok, del av antologi (Fagfellevurdert)
    Abstract [en]

    The detection of Haemophilus influenzae by conventional methods like culture is time-consuming and may give false-negative results, especially during ongoing antibiotic treatment. Therefore, non-culture based methods that are sensitive, specific, and rapid are valuable for early diagnosis and effective therapy. Here we describe a quantitative real-time PCR assay based on the outer membrane P6 gene omp6, to detect H. influenzae and its application on respiratory tract specimens.

  • 195.
    Abdeldaim, Guma M. K.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi och infektionsmedicin, Klinisk bakteriologi.
    Stralin, Kristoffer
    Olcen, Per
    Blomberg, Jonas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi och infektionsmedicin, Klinisk virologi.
    Molling, Paula
    Herrmann, Björn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi och infektionsmedicin, Klinisk bakteriologi.
    Quantitative fucK gene polymerase chain reaction on sputum and nasopharyngeal secretions to detect Haemophilus influenzae pneumonia2013Inngår i: Diagnostic microbiology and infectious disease, ISSN 0732-8893, E-ISSN 1879-0070, Vol. 76, nr 2, s. 141-146Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A quantitative polymerase chain reaction (PCR) for the fucK gene was developed for specific detection of Haemophilus influenzae. The method was tested on sputum and nasopharyngeal aspirate (NPA) from 78 patients with community-acquired pneumonia (CAP). With a reference standard of sputum culture and/or serology against the patient's own nasopharyngeal isolate, H. influenzae etiology was detected in 20 patients. Compared with the reference standard, fucK PCR (using the detection limit 10(5) DNA copies/mL) on sputum and NPA showed a sensitivity of 95.0% (19/20) in both cases, and specificities of 87.9% (51/58) and 89.5% (52/58), respectively. In a receiver operating characteristic curve analysis, sputum fucK PCR was found to be significantly superior to sputum P6 PCR for detection of H. influenzae CAP. NPA fucK PCR was positive in 3 of 54 adult controls without respiratory symptoms. In conclusion, quantitative fucK real-time PCR provides a sensitive and specific identification of H. influenzae in respiratory secretions.

  • 196.
    Abdeldaim, Guma M. K.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk bakteriologi.
    Strålin, Kristoffer
    Department of Infectious Diseases, Örebro University Hospital.
    Kirsebom, Leif A.
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Biologiska sektionen, Institutionen för cell- och molekylärbiologi, Mikrobiologi.
    Olcén, Per
    Department of Clinical Microbiology, Örebro University Hospital.
    Blomberg, Jonas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk virologi.
    Herrmann, Björn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk bakteriologi.
    Detection of Haemophilus influenzae in respiratory secretions from pneumonia patients by quantitative real-time polymerase chain reaction2009Inngår i: Diagnostic microbiology and infectious disease, ISSN 0732-8893, E-ISSN 1879-0070, Vol. 64, nr 4, s. 366-373Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A quantitative real-time polymerase chain reaction (PCR) based on the omp P6 gene was developed to detect Haemophilus influenzae. Its specificity was determined by analysis of 29 strains of 11 different Haemophilus spp. and was compared with PCR assays having other target genes: rnpB, 16S rRNA, and bexA. The method was evaluated on nasopharyngeal aspirates from 166 adult patients with community-acquired pneumonia. When 104 DNA copies/mL was used as cutoff limit for the method, P6 PCR had a sensitivity of 97.5% and a specificity of 96.0% compared with the culture. Of 20 culture-negative but P6 PCR-positive cases, 18 were confirmed by fucK PCR as H. influenzae. Five (5.9%) of 84 nasopharyngeal aspirates from adult controls tested PCR positive. We conclude that the P6 real-time PCR is both sensitive and specific for identification of H. influenzae in respiratory secretions. Quantification facilitates discrimination between disease-causing H. influenzae strains and commensal colonization.

  • 197.
    Abdeldaim, Guma M. K.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk bakteriologi.
    Strålin, Kristoffer
    Olcén, Per
    Blomberg, Jonas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk virologi.
    Herrmann, Björn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk bakteriologi.
    Toward a quantitative DNA-based definition of pneumococcal pneumonia: a comparison of Streptococcus pneumoniae target genes, with special reference to the Spn9802 fragment2008Inngår i: Diagnostic microbiology and infectious disease, ISSN 0732-8893, E-ISSN 1879-0070, Vol. 60, nr 2, s. 143-150Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The current shift from phenotypically toward genotypically based microbial diagnosis is not unproblematic. A novel quantitative real-time polymerase chain reaction (PCR) assay based on the Spn9802 DNA fragment was therefore developed for detection of Streptococcus pneumoniae. Out of 44 bacterial species, only S. pneumoniae and Streptococcus pseudopneumoniae were positive in Spn9802 PCR. In an evaluation on nasopharyngeal aspirates from 166 patients with community-acquired pneumonia, the assay was positive in 49 of 50 culture-positive cases. Of 19 culture-negative but Spn9802 PCR-positive cases, 12 were confirmed as S. pneumoniae by rnpB sequence analysis. With an expanded reference standard, including culture and rnpB sequencing, Spn9802 had a sensitivity of 94% and a specificity of 98%. A cutoff for clinically significant positivity was 10(4) DNA copies/mL, giving 71% sensitivity and 100% specificity. In conclusion, Spn9802 real-time PCR is highly sensitive and specific. The quantification it provides enables differentiation between pneumococcal pathogenicity and commensalism.

  • 198.
    Abdeldaim, Guma M. K.
    et al.
    Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Department of Clinical Mycobacteriology, National Center for Diseases Control, Benghazi, Libyan Arab Jamahiriya.
    Strålin, Kristoffer
    Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
    Olcén, Per
    Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
    Blomberg, Jonas
    Section of Clinical Virology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Mölling, Paula
    Region Örebro län. Department of Laboratory Medicine.
    Herrmann, Björn
    Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Quantitative fucK gene polymerase chain reaction on sputum and nasopharyngeal secretions to detect Haemophilus influenzae pneumonia2013Inngår i: Diagnostic microbiology and infectious disease, ISSN 0732-8893, E-ISSN 1879-0070, Vol. 76, nr 2, s. 141-146Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A quantitative polymerase chain reaction (PCR) for the fucK gene was developed for specific detection of Haemophilus influenzae. The method was tested on sputum and nasopharyngeal aspirate (NPA) from 78 patients with community-acquired pneumonia (CAP). With a reference standard of sputum culture and/or serology against the patient's own nasopharyngeal isolate, H. influenzae etiology was detected in 20 patients. Compared with the reference standard, fucK PCR (using the detection limit 10(5) DNA copies/mL) on sputum and NPA showed a sensitivity of 95.0% (19/20) in both cases, and specificities of 87.9% (51/58) and 89.5% (52/58), respectively. In a receiver operating characteristic curve analysis, sputum fucK PCR was found to be significantly superior to sputum P6 PCR for detection of H. influenzae CAP. NPA fucK PCR was positive in 3 of 54 adult controls without respiratory symptoms. In conclusion, quantitative fucK real-time PCR provides a sensitive and specific identification of H. influenzae in respiratory secretions.

  • 199.
    Abdeldaim, Guma
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk bakteriologi.
    Strålin, Kristoffer
    Department of Infectious Diseases, Örebro University Hospital, Örebro.
    Korsgaard, Jens
    Department of Chest Diseases, Aarhus University Hospital, Aalborg, Denmark.
    Blomberg, Jonas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk virologi.
    Herrmann, Björn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk bakteriologi.
    Multiplex quantitative PCR for detection of lower respiratory tract infection and meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis2010Inngår i: BMC Microbiology, ISSN 1471-2180, E-ISSN 1471-2180, Vol. 10, s. 310-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background. Streptococcus pneumoniae and Haemophilus influenzae cause pneumonia and as Neisseria meningitidis they are important agents of meningitis. Although several PCR methods have been described for these bacteria the specificity is an underestimated problem. Here we present a quantitative multiplex real-time PCR (qmPCR) for detection of S. pneumoniae (9802 gene fragment), H. influenzae (omp P6 gene) and N. meningitidis (ctrA gene). The method was evaluated on bronchoalveolar lavage (BAL) samples from 156 adults with lower respiratory tract infection (LRTI) and 31 controls, and on 87 cerebrospinal fluid (CSF) samples from meningitis patients.

    Results. The analytical sensitivity was not affected by using a combined mixture of reagents and a combined DNA standard (S. pneumoniae/H. influenzae/N. meningitidis) in single tubes. By blood- and BAL-culture and S. pneumoniae urinary antigen test, S. pneumoniae and H. influenzae were aetiological agents in 21 and 31 of the LTRI patients, respectively. These pathogens were identified by qmPCR in 52 and 72 of the cases, respectively, yielding sensitivities and specificities of 95% and 75% for S. pneumoniae, and 90% and 65% for H. influenzae, respectively. When using a cut-off of 105 genome copies/mL for clinical positivity the sensitivities and specificities were 90% and 80% for S. pneumoniae, and 81% and 85% for H. influenzae, respectively. Of 44 culture negative but qmPCR positive for H. influenzae, 41 were confirmed by fucK PCR as H. influenzae. Of the 103 patients who had taken antibiotics prior to sampling, S. pneumoniae and H. influenzae were identified by culture in 6% and 20% of the cases, respectively, and by the qmPCR in 36% and 53% of the cases, respectively. In 87 CSF samples S. pneumoniae and N. meningitidis were identified by culture and/or 16 S rRNA in 14 and 10 samples and by qmPCR in 14 and 10 samples, respectively, giving a sensitivity of 100% and a specificity of 100% for both bacteria.

    Conclusions. The PCR provides increased sensitivity and the multiplex format facilitates diagnosis of S. pneumoniae, H. influenzae and N. meningitidis and the assay enable detection after antibiotic treatment has been installed. Quantification increases the specificity of the etiology for pneumonia.

  • 200.
    Abdeldaim, Guma
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi och infektionsmedicin, Klinisk bakteriologi. Benghazi Univ, Fac Med, Dept Med Microbiol & Parasitol, Benghazi, Libya..
    Svensson, Erik
    Statens Serum Inst, Int Reference Lab Mycobacteriol, Copenhagen, Denmark..
    Blomberg, Jonas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi och infektionsmedicin, Klinisk virologi.
    Herrmann, Björn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk mikrobiologi och infektionsmedicin, Klinisk bakteriologi.
    Duplex detection of the Mycobacterium tuberculosis complex and medically important non-tuberculosis mycobacteria by real-time PCR based on the rnpB gene2016Inngår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 124, nr 11, s. 991-995Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A duplex real-time PCR based on the rnpB gene was developed for Mycobacterium spp. The assay was specific for the Mycobacterium tuberculosis complex (MTB) and also detected all 19 tested species of non-tuberculous mycobacteria (NTM). The assay was evaluated on 404 clinical samples: 290 respiratory samples and 114 from tissue and other nonrespiratory body sites. M. tuberculosis was detected by culture in 40 samples and in 30 samples by the assay. The MTB assay showed a sensitivity similar to Roche Cobas Amplicor MTB-PCR (Roche Molecular Systems, Pleasanton, CA, USA). There were only nine samples with non-tuberculous mycobacteria detected by culture. Six of them were detected by the PCR assay.

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