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  • 251.
    Dumarkaite, Austeja
    et al.
    Vilnius Univ, Lithuania.
    Truskauskaite-Kuneviciene, Inga
    Vilnius Univ, Lithuania.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Karolinska Inst, Sweden.
    Kazlauskas, Evaldas
    Vilnius Univ, Lithuania.
    The Effects of Online Mindfulness-Based Intervention on Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder Symptoms: A Randomized Controlled Trial With 3-Month Follow-Up2022Inngår i: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 13, artikkel-id 799259Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives:& nbsp;Mindfulness-based interventions have recently been shown to be a promising option for treating posttraumatic stress. The current study aimed to investigate the effects of an online mindfulness-based intervention on ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) symptoms at a 3-month follow-up.& nbsp;Methods:& nbsp;An RCT design with three measurement points (pre-intervention, post-intervention, and 3-month follow-up) was used to investigate the effects of an 8-week online mindfulness intervention. In total, 53 traumatized young adults (M-age = 23.21, SDage = 2.81; 84.9% female) participated in the study: 17 in the intervention group and 36 in the waiting list control group.& nbsp;Results:& nbsp;Intervention group and waiting list control group comparison revealed that the intervention was effective for reducing CPTSD disturbances in self-organization symptoms (d = -0.84 [-1.44; -0.24]), specifically, negative self-concept (d = -0.66 [-1.25; -0.07]) and disturbances in relationships (d = -0.87 [-1.47; -0.27]), at 3-month follow-up. There were no between-group effects for PTSD symptoms from pre-test to follow-up.& nbsp;Conclusion:& nbsp;This is one of the first RCT studies to report follow-up effects of an online mindfulness-based intervention for ICD-11 PTSD or CPTSD symptoms. Our study yielded that the effects of mindfulness-based internet intervention on CPTSD symptoms tend to retain over time.

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  • 252.
    Ebert, D. D.
    et al.
    University of Erlangen Nurnberg, Germany.
    Donkin, L.
    University of Sydney, Australia; Vrije University of Amsterdam, Netherlands.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Karolinska Institute, Sweden.
    Andrews, G.
    University of New South Wales, Australia.
    Berger, T.
    University of Bern, Switzerland.
    Carlbring, P.
    Stockholm University, Sweden.
    Rozenthal, A.
    Stockholm University, Sweden.
    Choi, I.
    University of Sydney, Australia.
    Laferton, J. A. C.
    Psychol Hsch Berlin, Germany.
    Johansson, Robert
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten. Karolinska Institute, Sweden.
    Kleiboer, A.
    Vrije University of Amsterdam, Netherlands.
    Lange, A.
    University of Amsterdam, Netherlands.
    Lehr, D.
    Leuphana University of Luneburg, Germany.
    Reins, J. A.
    Leuphana University of Luneburg, Germany.
    Funk, B.
    Leuphana University of Luneburg, Germany.
    Newby, J.
    University of New South Wales, Australia.
    Perini, S.
    Macquarie University, Australia.
    Riper, H.
    Vrije University of Amsterdam, Netherlands.
    Ruwaard, J.
    Vrije University of Amsterdam, Netherlands.
    Sheeber, L.
    Oregon Research Institute, OR 97403 USA.
    Snoek, F. J.
    Vrije University of Amsterdam, Netherlands; University of Amsterdam, Netherlands.
    Titov, N.
    Macquarie University, Australia; Macquarie University, Australia.
    Unlu Ince, B.
    Vrije University of Amsterdam, Netherlands.
    van Bastelaar, K.
    Vrije University of Amsterdam, Netherlands.
    Vernmark, Kristofer
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    van Straten, A.
    Vrije University of Amsterdam, Netherlands.
    Warmerdam, L.
    Vrije University of Amsterdam, Netherlands.
    Salsman, N.
    Xavier University, OH 45207 USA.
    Cuijpers, P.
    Vrije University of Amsterdam, Netherlands.
    Does Internet-based guided-self-help for depression cause harm? An individual participant data meta-analysis on deterioration rates and its moderators in randomized controlled trials2016Inngår i: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 46, nr 13, s. 2679-2693Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background: Almost nothing is known about the potential negative effects of Internet-based psychological treatments for depression. This study aims at investigating deterioration and its moderators within randomized trials on Internet-based guided self-help for adult depression, using an individual patient data meta-analyses (IPDMA) approach.

    Method: Studies were identified through systematic searches (PubMed, PsycINFO, EMBASE, Cochrane Library). Deterioration in participants was defined as a significant symptom increase according to the reliable change index (i.e. 7.68 points in the CES-D; 7.63 points in the BDI). Two-step IPDMA procedures, with a random-effects model were used to pool data.

    Results: A total of 18 studies (21 comparisons, 2079 participants) contributed data to the analysis. The risk for a reliable deterioration from baseline to post-treatment was significantly lower in the intervention v. control conditions (3.36 v. 7.60; relative risk 0.47, 95% confidence interval 0.29-0.75). Education moderated effects on deterioration, with patients with low education displaying a higher risk for deterioration than patients with higher education. Deterioration rates for patients with low education did not differ statistically significantly between intervention and control groups. The benefit-risk ratio for patients with low education indicated that 9.38 patients achieve a treatment response for each patient experiencing a symptom deterioration.

    Conclusions: Internet-based guided self-help is associated with a mean reduced risk for a symptom deterioration compared to controls. Treatment and symptom progress of patients with low education should be closely monitored, as some patients might face an increased risk for symptom deterioration. Future studies should examine predictors of deterioration in patients with low education.

  • 253.
    Edebol-Carlman, Hanna
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Rode, Julia
    Örebro universitet, Institutionen för medicinska vetenskaper.
    König, Julia
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Repsilber, Dirk
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Hutchinson, Ashley N.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Thunberg, Per
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Medical Physics.
    Persson, Jonas
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Kiselev, Andrey
    Örebro universitet, Institutionen för naturvetenskap och teknik.
    Pruessner, Jens C.
    McGill Centre for Studies in Ageing, Department of Psychology, Psychiatry, Neurology and Neurosurgery, Douglas Institute, McGill University, Montréal, Canada.
    Brummer, Robert Jan
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Probiotic mixture containing Lactobacillus helveticus, Bifidobacterium longum and Lactiplantibacillus plantarum affects brain responses to an arithmetic stress task in healthy subjects: A randomized clinical trialManuskript (preprint) (Annet vitenskapelig)
  • 254.
    Edgren, Gustaf
    et al.
    Karolinska Inst, Dept Med Epidemiol & Biostat, Box 281, SE-17177 Stockholm, Sweden..
    Hjalgrim, Henrik
    Statens Serum Inst, Dept Epidemiol Res, 5 Artillerivej, DK-2300 Copenhagen S, Denmark..
    Rostgaard, Klaus
    Statens Serum Inst, Dept Epidemiol Res, 5 Artillerivej, DK-2300 Copenhagen S, Denmark..
    Lambert, Paul
    Univ Leicester, Dept Hlth Sci, Adrian Bldg,Univ Rd, Leicester LE1 7RH, Leics, England. Uppsala Univ, Dept Immunol Genet & Pathol, Akad Sjukhuset, SE-75185 Uppsala, Sweden..
    Wikman, Agneta
    Karolinska Univ Hosp, Dept Clin Immunol & Transfus Med, C2 66 Huddinge, SE-17777 Stockholm, Sweden..
    Norda, Rut
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Klinisk immunologi.
    Titlestad, Kjell-Einar
    Odense Univ Hosp, Dept Clin Immunol, Sondre Blvd 29, DK-5000 Odense, Denmark..
    Erikstrup, Christian
    Aarhus Univ Hosp, Dept Clin Immunol, Palle Juul Jensens Blvd 99, DK-8000 Aarhus, Denmark. Stanford Univ, Sch Med, Stanford, CA 94305 USA..
    Ullum, Henrik
    Copenhagen Univ Hosp, Dept Clin Immunol, Blegdamsvej 9, DK-2100 Copenhagen, Denmark..
    Melbye, Mads
    Statens Serum Inst, Dept Epidemiol Res, 5 Artillerivej, DK-2300 Copenhagen S, Denmark..
    Busch, Michael P.
    Blood Syst Res Inst, 270 Masonic Ave, San Francisco, CA 94118 USA. Univ Calif San Francisco, San Francisco, CA USA..
    Nyren, Olof
    Karolinska Inst, Dept Med Epidemiol & Biostat, Box 281, SE-17177 Stockholm, Sweden..
    Transmission of Neurodegenerative Disorders Through Blood Transfusion A Cohort Study2016Inngår i: Annals of Internal Medicine, ISSN 0003-4819, E-ISSN 1539-3704, Vol. 165, nr 5, s. 316-+Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The aggregation of misfolded proteins in the brain occurs in several neurodegenerative disorders. Aberrant protein aggregation is inducible in rodents and primates by intracerebral inoculation. Possible transfusion transmission of neurodegenerative diseases has important public health implications. Objective: To investigate possible transfusion transmission of neurodegenerative disorders. Design: Retrospective cohort study. Setting: Nationwide registers of transfusions in Sweden and Denmark. Participants: 1 465 845 patients who received transfusions between 1968 and 2012. Measurements: Multivariable Cox regression models were used to estimate hazard ratios for dementia of any type, Alzheimer disease, and Parkinson disease in patients receiving blood transfusions from donors who were later diagnosed with any of these diseases versus patients who received blood from healthy donors. Whether excess occurrence of neurodegenerative disease occurred among recipients of blood from a subset of donors was also investigated. As a positive control, transmission of chronic hepatitis before and after implementation of hepatitis C virus screening was assessed. Results: Among included patients, 2.9% received a transfusion from a donor diagnosed with one of the studied neurodegenerative diseases. No evidence of transmission of any of these diseases was found, regardless of approach. The hazard ratio for dementia in recipients of blood from donors with dementia versus recipients of blood from healthy donors was 1.04 (95% CI, 0.99 to 1.09). Corresponding estimates for Alzheimer disease and Parkinson disease were 0.99 (CI, 0.85 to 1.15) and 0.94 (CI, 0.78 to 1.14), respectively. Hepatitis transmission was detected before but not after implementation of hepatitis C virus screening. Limitation: Observational study design, underascertainment of the outcome, and possible insufficient statistical power. Conclusion: The data provide no evidence for the transmission of neurodegenerative diseases and suggest that if transmission does occur, it is rare.

  • 255.
    Edqvist, Jon
    et al.
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Lundberg, Christina
    Univ Gothenburg, Sweden.
    Andreasson, Karin
    Univ Gothenburg, Sweden.
    Bjorck, Lena
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Dikaiou, Pigi
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Ludvigsson, Johnny
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för barns och kvinnors hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Lind, Marcus
    Univ Gothenburg, Sweden; NU Hosp Grp, Sweden.
    Adiels, Martin
    Univ Gothenburg, Sweden.
    Rosengren, Annika
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Severe COVID-19 Infection in Type 1 and Type 2 Diabetes During the First Three Waves in Sweden2023Inngår i: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 46, nr 3, s. 570-578Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE Type 2 diabetes is an established risk factor for hospitalization and death in COVID-19 infection, while findings with respect to type 1 diabetes have been diverging. RESEARCH DESIGN AND METHODS Using nationwide health registries, we identified all patients aged >= 18 years with type 1 and type 2 diabetes in Sweden. Odds ratios (ORs) describe the general and age-specific risk of being hospitalized, need for intensive care, or dying, adjusted for age, socioeconomic factors, and coexisting conditions, compared with individuals without diabetes. Machine learning models were used to find predictors of outcomes among individuals with diabetes positive for COVID-19. RESULTS Until 30 June 2021, we identified 365 (0.71%) and 11,684 (2.31%) hospitalizations in 51,402 and 504,337 patients with type 1 and 2 diabetes, respectively, with 67 (0.13%) and 2,848 (0.56%) requiring intensive care unit (ICU) care and 68 (0.13%) and 4,020 (0.80%) dying (vs 7,824,181 individuals without diabetes [41,810 hospitalizations (0.53%), 8,753 (0.11%) needing ICU care, and 10,160 (0.13%) deaths). Although those with type 1 diabetes had moderately raised odds of being hospitalized (multiple-adjusted OR 1.38 [95% CI 1.24-1.53]), there was no independent effect on ICU care or death (OR of 1.21 [95% CI 0.94-1.52] and 1.13 [95% CI 0.88-1.48], respectively). Age and socioeconomic factors were the dominating features for predicting hospitalization and death in both types of diabetes. CONCLUSIONS Type 2 diabetes was associated with increased odds for all outcomes, whereas patients with type 1 diabetes had moderately increased odds of hospitalization but not ICU care and death.

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  • 256.
    Edvardsson, Berit
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    "Det är inte mig det är fel på, det är huset": en studie av prognosfaktorer och bemötande med fokus på sjuka hus-syndromet2015Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [sv]

    Bakgrund: Sick Building Syndrome, SBS, är fortfarande 2015 ett tillstånd som vållar mycket diskussion. Symtomen kan grupperas i slemhinnesymtom, hudsymtom och allmänna symtom. I definitionen ingår att personen/ personerna som fått symtom har exponerats för dålig inomhusluft i en speciell byggnad. När personen inte är i byggnaden så förbättras eller försvinner symtomen. Många olika faktorer kan orsaka eller medverka till uppkomst eller försämringar av SBS-symtom, som t.ex. luftens innehåll av olika ämnen, luftflöden, temperatur, buller, fukt och mögel. Utbredd enighet finns om att fukt och mögel i byggnaderna påverkar eller ger upphov till symtom hos vissa personer som exponeras där. Psykosociala faktorer som arbetets organisation och krav och individuella faktorer som kön och personlighet påverkar också.

    Syfte: Hypotesen är att faktorer som tidigare hälsa, åtgärder på arbetet, tid, behandling, personlighet och copingresurser alla kan påverka prognosen för SBS-patienterna. Syftet med avhandlingen är att undersöka hur symtomen påverkar arbetsförmågan och om patienterna återhämtar sig från SBS-symtomen. Ett annat syfte är att undersöka bemötande och de erfarenheter som SBS-symtomen gett en grupp av informanter med SBS. För att förstå om personlighet mätt med självbild och coping hade någon betydelse för progressionen av SBS-symtom och arbetsförmåga gjordes jämförelser av personlighet mellan en patientgrupp med SBS, en patientgrupp med handeksem, en patientgrupp med elkänslighet och en normalpopulation.

    Metod:  En uppföljningsenkät skickades till 239 patienter med SBS-symtom som under åren 1986–1998 blivit undersökta och bedömda på Universitets-sjukhuset i Umeå, Sverige. Frågorna innehöll social och medicinsk status, nuvarande symtom, behandlingar, åtgärder på arbetsplatsen, coping och självbild och svarsfrekvensen var 79,1%. Prognos och riskfaktorer för prognos beräknades för SBS-patienterna. Mätningar av personlighetsfaktorer gjordes med instrumentet Structural analysis of Social Behaviour, SASB, och coping mättes med Coping Resources Inventory, CRI. Likadana uppföljningsenkäter skickades till en grupp patienter med handeksem och patienter med upplevd elkänslighet. Svarsfrekvensen var 68% respektive 73% och enkätsvaren har sedan analyserats och jämförts genom beräknngar av prognos med fokus på självbild och coping för SBS-patienterna och handeksempatienterna. Jämförelser gjordes också mellan de tre olika grupperna och en kontrollgrupp vad gäller självbild och coping. För att undersöka erfarenheterna av SBS-symtomen och bemötandet genomfördes kvalitativa intervjuer med 10 informanter som hade eller hade haft SBS-symtom. Fem av dem hade diagnostiserats en längre tid tillbaka medan de andra fem hade haft SBS-symtomen en kortare period. Semi-strukturerade intervjuformulär användes vid intervjuerna och anlyserades med kvalitativ innehållsanalys.

    Resultat: Graden och svårigheten av SBS-symtomen minskade över tid trots att nästan hälften av SBS-patienterna beskrev att symtomen var mer eller mindre oförändrade efter 7 år eller mer. Risken att ha symtom vid uppföljningen var större för de patienter som remitterats sent efter symtomdebut men även för de som hade kort uppföljningstid. Risken att inte ha någon arbetsförmåga vid uppföljningen var signifikant ökad om det var mer än ett års skillnad mellan symtomdebut och första läkarbesöket p.g.a. SBS-symtomen eller om patienten vid första undersökningen hade fler än 5 SBS-symtom. Dagliga aktiviteter som t.ex. bussåkning förvärrade också symtomen för patienterna. Informanternas upplevelser av SBS-symtomen från början visar en influensaliknande bild med rinnande näsa och ögon, heshet, hosta och huvudvärk. Informanterna agerar för att klara av situationen när symtomen förvärras. Genom hela processen upplever de en brist på bekräftelse och stöd från arbetsgivare, primärvård, företagshälsovård och fastighetsförvaltare.

    Alla tre patientgrupperna hade högre värden i spontan och positiv självbild i jämförelse med en kontrollgrupp. De hade också alla lägre värden i kontroll medan patienterna med handeksem och de med elkänslighet hade högre värden i sin negativa självbild. När det gäller coping skilde sig inte patientgrupperna från kontrollgruppen utom i CRI kognitiv där SBS-patienterna hade hög poäng i motsats till handeksempatienterna som hade låg poäng i samma domän. De elkänsliga patienterna hade i stället höga poäng i domänen andlig/filosofisk. Självbild eller copingförmåga var inte associerade med SBS-symtom eller symtom av handeksem vid uppföljningen och deras personlighet påverkade inte arbetsförmågan. Tidigare atopisk dermatit var en signifikant risk för kvarvarande symtom men inte för arbetsförmågan hos handeksempatienterna.

    Slutsats: En grupp av patienter som tidigare diagnostiserats för symtom från inomhusmiljön har kroniska symtom och påverkan på sitt sociala liv. Över tid minskar symtomen. Resultaten pekar på att ett tidigt omhändertagande är av vikt. SBS-symtomen är från början svåra att upptäcka för alla inblandade och kunskap om hur symtomen kan uppstå i dagligt liv kan bidra till bredare förståelse. Erfarenheterna från personer med SBS visar på avsaknad av bekräftelse och stöd från vården, företagshälsan, arbetsgivare och fastighetsförvaltare. Sambandet mellan symtom och inomhusmiljö får inte glömmas bort. Stöd och bekräftelse innebär också kunskap om skyldigheter för arbetsgivare och fastighetsförvaltare.

    Skillnad i självbild i jämförelse med en kontrollgrupp ses hos patientgrupperna med symtom som är delvis oförklarade men också hos handeksempatienter med ett väletablerat tillstånd. Det kan innebära att patienter med kroniska tillstånd överlag kan avvika från den allmänna populationen. Patienterna visar som grupp en hög positiv och hög spontan självbild som kan leda till svårigheter att sätta gränser. Detta kan leda till en mental stress och i förlängningen också ge en ökad känslighet/sårbarhet för miljöfaktorer.

     

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  • 257.
    Eichentopf, Luzie
    et al.
    Heidelberg Univ, Germany.
    Hiemke, Christoph
    Univ Med Ctr Mainz, Germany; Arbeitsgemeinschaft Neuropsychopharmakol & Pharma, Germany.
    Conca, Andreas
    Arbeitsgemeinschaft Neuropsychopharmakol & Pharma, Germany; Sanit Agcy South Tyrol, Italy.
    Engelmann, Jan
    Johannes Gutenberg Univ Mainz, Germany.
    Gerlach, Manfred
    Arbeitsgemeinschaft Neuropsychopharmakol & Pharma, Germany; Univ Hosp Wurzburg, Germany.
    Havemann-Reinecke, Ursula
    Arbeitsgemeinschaft Neuropsychopharmakol & Pharma, Germany; Univ Gottingen, Germany.
    Hefner, Gudrun
    Arbeitsgemeinschaft Neuropsychopharmakol & Pharma, Germany; Vitos Clin Forens Psychiat, Germany.
    Florio, Vincenzo
    Comprensorio Sanitario Bolzano, Italy.
    Kuzin, Maxim
    Arbeitsgemeinschaft Neuropsychopharmakol & Pharma, Germany; Univ Zurich, Switzerland.
    Lieb, Klaus
    Univ Med Ctr Mainz, Germany.
    Reis, Margareta
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för klinisk kemi och farmakologi. Linköpings universitet, Medicinska fakulteten. Skane Univ Hosp, Sweden.
    Riemer, Thomas G.
    Charite Univ Med Berlin, Germany; Free Univ Berlin, Germany; Humboldt Univ, Germany.
    Serretti, Alessandro
    Univ Bologna, Italy.
    Schoretsanitis, Georgios
    Arbeitsgemeinschaft Neuropsychopharmakol & Pharma, Germany; Univ Zurich, Switzerland; Zucker Hillside Hosp, NY USA; Zucker Sch Med Northwell Hofstra, NY USA.
    Zernig, Gerald
    Arbeitsgemeinschaft Neuropsychopharmakol & Pharma, Germany; Med Univ Innsbruck, Austria; Psychotherapy & Court Certified Witness, Austria.
    Gruender, Gerhard
    Heidelberg Univ, Germany; Arbeitsgemeinschaft Neuropsychopharmakol & Pharma, Germany.
    Hart, Xenia M.
    Heidelberg Univ, Germany; Arbeitsgemeinschaft Neuropsychopharmakol & Pharma, Germany.
    Systematic review and meta-analysis on the therapeutic reference range for escitalopram: Blood concentrations, clinical effects and serotonin transporter occupancy2022Inngår i: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 13, artikkel-id 972141Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Introduction: A titration within a certain therapeutic reference range presupposes a relationship between the blood concentration and the therapeutic effect of a drug. However, this has not been systematically investigated for escitalopram. Furthermore, the recommended reference range disagrees with mean steady state concentrations (11-21 ng/ml) that are expected under the approved dose range (10-20 mg/day). This work systematically investigated the relationships between escitalopram dose, blood levels, clinical effects, and serotonin transporter occupancy.Methods: Following our previously published methodology, relevant articles were systematically searched and reviewed for escitalopram.Results: Of 1,032 articles screened, a total of 30 studies met the eligibility criteria. The included studies investigated escitalopram blood levels in relationship to clinical effects (9 studies) or moderating factors on escitalopram metabolism (12 studies) or serotonin transporter occupancy (9 studies). Overall, the evidence for an escitalopram concentration/effect relationship is low (level C).Conclusion: Based on our findings, we propose a target range of 20-40 ng/ml for antidepressant efficacy of escitalopram. In maintenance treatment, therapeutic response is expected, when titrating patients above the lower limit. The lower concentration threshold is strongly supported by findings from neuroimaging studies. The upper limit for escitaloprams reference range rather reflects a therapeutic maximum than a tolerability threshold, since the incidence of side effects in general is low. Concentrations above 40 ng/ml should not necessarily result in dose reductions in case of good clinical efficacy and tolerability. Dose-related escitalopram concentrations in different trials were more than twice the expected concentrations from guideline reports.

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  • 258.
    Eklund, Mona
    et al.
    Malmö högskola, Fakulteten för hälsa och samhälle (HS).
    Erlandsson, Lena-Karin
    Persson, Dennis
    Hagell, Peter
    Rasch analysis of an instrument for measuring occupational value: Implications for theory and practice2009Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 16, nr 2, s. 118-128Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study investigated psychometric properties of an instrument for assessing perceived occupational value, the 26-item OVal-pd. Data from 225 Swedish subjects with and without known mental illness were analysed regarding fit to the Rasch measurement model (partial credit model), differential item functioning (DIF), and functioning of the OVal-pd four-category response scale. The reliability (index of person separation, analogous to Cronbach's alpha) was good (0.92) but there were signs of overall and item level (six items) misfit. There was DIF between people with and without mental illness for three items. Iterative deletion of misfitting items resulted in a new 18-item DIF-free scale with good overall and individual item fit and maintained reliability (0.91). There were no disordered response category thresholds. These observations also held true in separate analyses among people with and without mental illness. Thus, the first steps of ensuring that occupational value can be measured in a valid and reliable way have been taken. Still, occupational value is a dynamic construct and the aspects that fit the construct may vary between contexts. This has implications for, e.g., cross-cultural research and calls for identification of a core set of culture-free items to allow for valid cross-cultural comparisons.

  • 259.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Personality disorder: a disease in disguise2018Inngår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 123, nr 4, s. 194-204Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Personality disorders (PDs) can be described as the manifestation of extreme personality traits that interfere with everyday life and contribute to significant suffering, functional limitations, or both. They are common and are frequently encountered in virtually all forms of health care. PDs are associated with an inferior quality of life (QoL), poor health, and premature mortality. The aetiology of PDs is complex and is influenced by genetic and environmental factors. The clinical expression varies between different PD types; the most common and core aspect is related to an inability to build and maintain healthy interpersonal relationships. This aspect has a negative impact on the interaction between health-care professionals and patients with a PD. From being discrete and categorical disease entities in previous classification systems, the current concept of PD, reflected in the newly proposed ICD-11, is a dimensional description based on the severity of the disturbed functioning rather than on the type of clinical presentation. Insight about the characteristics of PDs among medical practitioners is limited, which is partly because persons do not seek health care for their PD, but instead for other medical issues which are obscured by their underlying personality problems. What needs to be emphasized is that PDs affect both the clinical presentation of other medical problems, and the outcome of these, in a negative manner and that the integrated effects of having a PD are a shortened life expectancy. Accordingly, PDs need to be recognized in clinical practice to a greater extent than previously.

    Fulltekst (pdf)
    FULLTEXT01
  • 260.
    Eldh, Ann Catrine
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning. Dalarna Univ, Sch Hlth & Social Sci, Falun, Sweden..
    Wallin, Lars
    Dalarna Univ, Sch Hlth & Social Sci, Falun, Sweden.;Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Nursing, Stockholm, Sweden..
    Fredriksson, Mio
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning.
    Vengberg, Sofie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning.
    Winblad, Ulrika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning.
    Halford, Christina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning.
    Dahlström, Tobias
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning.
    Factors facilitating a national quality registry to aid clinical quality improvement: findings of a national survey2016Inngår i: BMJ Open, E-ISSN 2044-6055, Vol. 6, nr 11, artikkel-id e011562Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: While national quality registries (NQRs) are suggested to provide opportunities for systematic follow-up and learning opportunities, and thus clinical improvements, features in registries and contexts triggering such processes are not fully known. This study focuses on one of the world's largest stroke registries, the Swedish NQR Riksstroke, investigating what aspects of the registry and healthcare organisations facilitate or hinder the use of registry data in clinical quality improvement. Methods: Following particular qualitative studies, we performed a quantitative survey in an exploratory sequential design. The survey, including 50 items on context, processes and the registry, was sent to managers, physicians and nurses engaged in Riksstroke in all 72 Swedish stroke units. Altogether, 242 individuals were presented with the survey; 163 responded, representing all but two units. Data were analysed descriptively and through multiple linear regression. Results: A majority (88%) considered Riksstroke data to facilitate detection of stroke care improvement needs and acknowledged that their data motivated quality improvements (78%). The use of Riksstroke for quality improvement initiatives was associated (R-2=0.76) with 'Colleagues' call for local results' (p=<0.001), 'Management Request of Registry data' (p=<0.001), and it was said to be 'Simple to explain the results to colleagues' (p=0.02). Using stepwise regression, 'Colleagues' call for local results' was identified as the most influential factor. Yet, while 73% reported that managers request registry data, only 39% reported that their colleagues call for the unit's Riksstroke results. Conclusions: While an NQR like Riksstroke demonstrates improvement needs and motivates stakeholders to make progress, local stroke care staff and managers need to engage to keep the momentum going in terms of applying registry data when planning, performing and evaluating quality initiatives.

    Fulltekst (pdf)
    fulltext
  • 261.
    Elma, Ömer
    et al.
    Vrije Univ Brussel, Belgium; Univ Hosp Brussels, Belgium.
    Brain, Katherine
    Univ Newcastle, Australia; Hunter Integrated Pain Serv, Australia.
    Dong, Huan-Ji
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    The Importance of Nutrition as a Lifestyle Factor in Chronic Pain Management: A Narrative Review2022Inngår i: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 11, nr 19, artikkel-id 5950Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    In everyday clinical practice, healthcare professionals often meet chronic pain patients with a poor nutritional status. A poor nutritional status such as malnutrition, unhealthy dietary behaviors, and a suboptimal dietary intake can play a significant role in the occurrence, development, and prognosis of chronic pain. The relationship between nutrition and chronic pain is complex and may involve many underlying mechanisms such as oxidative stress, inflammation, and glucose metabolism. As such, pain management requires a comprehensive and interdisciplinary approach that includes nutrition. Nutrition is the top modifiable lifestyle factor for chronic non-communicable diseases including chronic pain. Optimizing ones dietary intake and behavior needs to be considered in pain management. Thus, this narrative review reports and summarizes the existing evidence regarding (1) the nutrition-related health of people experiencing pain (2) the underlying potential mechanisms that explain the interaction between nutrition and chronic pain, and (3) the role of nutrition screening, assessment and evaluation for people experiencing pain and the scope of nutrition practice in pain management. Future directions in the nutrition and chronic pain field are also discussed.

    Fulltekst (pdf)
    fulltext
  • 262.
    Elwer, Sofia
    et al.
    Umeå universitet, Allmänmedicin.
    Alex, Lena
    Umeå universitet, Institutionen för omvårdnad.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Gender (in)equality among employees in elder care: implications for health2012Inngår i: International Journal for Equity in Health, E-ISSN 1475-9276, Vol. 11, nr 1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Gendered practices of working life create gender inequalities through horizontal and vertical gender segregation in work, which may lead to inequalities in health between women and men. Gender equality could therefore be a key element of health equity in working life. Our aim was to analyze what gender (in) equality means for the employees at a woman-dominated workplace and discuss possible implications for health experiences.

    Methods: All caregiving staff at two workplaces in elder care within a municipality in the north of Sweden were invited to participate in the study. Forty-five employees participated, 38 women and 7 men. Seven focus group discussions were performed and led by a moderator. Qualitative content analysis was used to analyze the focus groups.

    Results: We identified two themes. "Advocating gender equality in principle" showed how gender (in) equality was seen as a structural issue not connected to the individual health experiences. "Justifying inequality with individualism" showed how the caregivers focused on personalities and interests as a justification of gender inequalities in work division. The justification of gender inequality resulted in a gendered work division which may be related to health inequalities between women and men. Gender inequalities in work division were primarily understood in terms of personality and interests and not in terms of gender.

    Conclusion: The health experience of the participants was affected by gender (in) equality in terms of a gendered work division. However, the participants did not see the gendered work division as a gender equality issue. Gender perspectives are needed to improve the health of the employees at the workplaces through shifting from individual to structural solutions. A healthy-setting approach considering gender relations is needed to achieve gender equality and fairness in health status between women and men.

  • 263.
    Elwer, Sofia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Alex, Lena
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hammarström, Anne
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Gender (in)equality among employees in elder care: implications for health2012Inngår i: International Journal for Equity in Health, E-ISSN 1475-9276, Vol. 11, nr 1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Gendered practices of working life create gender inequalities through horizontal and vertical gender segregation in work, which may lead to inequalities in health between women and men. Gender equality could therefore be a key element of health equity in working life. Our aim was to analyze what gender (in) equality means for the employees at a woman-dominated workplace and discuss possible implications for health experiences.

    Methods: All caregiving staff at two workplaces in elder care within a municipality in the north of Sweden were invited to participate in the study. Forty-five employees participated, 38 women and 7 men. Seven focus group discussions were performed and led by a moderator. Qualitative content analysis was used to analyze the focus groups.

    Results: We identified two themes. "Advocating gender equality in principle" showed how gender (in) equality was seen as a structural issue not connected to the individual health experiences. "Justifying inequality with individualism" showed how the caregivers focused on personalities and interests as a justification of gender inequalities in work division. The justification of gender inequality resulted in a gendered work division which may be related to health inequalities between women and men. Gender inequalities in work division were primarily understood in terms of personality and interests and not in terms of gender.

    Conclusion: The health experience of the participants was affected by gender (in) equality in terms of a gendered work division. However, the participants did not see the gendered work division as a gender equality issue. Gender perspectives are needed to improve the health of the employees at the workplaces through shifting from individual to structural solutions. A healthy-setting approach considering gender relations is needed to achieve gender equality and fairness in health status between women and men.

    Fulltekst (pdf)
    Gender (In)Equality among Employees in Elder Care
  • 264.
    Elwin, Marie
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Description and measurement of sensory symptoms in autism spectrum2016Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Unusual responses to sensory stimuli have been reported in nearly all children with autism spectrum conditions (ASC). A few studies on adults indicate that the sensory and perceptual problems persist into adulthood. Sensory symptoms have not been included in the diagnostic criteria for ASC but in the new diagnostic manual (DSM-5, 2013) hyper- or hyporeactivity or unusual sensory interests were included in the diagnostic criteria for ASC. Sensory phenomena are mostly investigated in studies involving children and the scales used to measure sensory reactivity have been constructed on the basis of the scientific literature and parents’ reports. The experiences of adults with ASC are not well understood and have not been systematically used to develop measures.

    The overall aim of the thesis was to capture the first-hand experiences of and perspectives on sensory reactivity and translate them into a self-rating scale. To fulfil this overarching aim the personal sensory experiences of adults with ASC were investigated and the variations and range of atypical sensory phenomena explored and described in two qualitative studies (study I and II). The analyses of the firstperson descriptions enabled the development of items for a scale. These were reduced in steps and the final scale which was named the Sensory Reactivity in Autism Spectrum scale (SR-AS) comprised 32 items in four subscales: high awareness/ hyperreactivity, low awareness/hyporeactivity, strong sensory interests and sensory/motor. The SR-AS was validated using content and factor analyses. Its discriminative validity was then investigated as well as its reliability in the form of internal consistency (study III). In the final step the scale was used to identify clusters of atypical sensory functioning in adults with ASC by hierarchical cluster analysis (study IV). Three different sensory clusters were found.

    The main contribution of this thesis is its presentation of individual experience and perspectives and the creation of an clinical tool to measure atypical sensory reactivity frequently experienced by people with ASC. The ways in which the SR-AS can be used comprise assessment of individual sensory patterns for self-knowledge and awareness, to enable the development of coping strategies and to provide information on environmental adjustments required. In diagnostic processes where other criteria for ASC are fulfilled the SR-AS can be used for assessing sensory symptoms according to the DSM-5.

    Fulltekst (pdf)
    Introductory chapter
    Download (pdf)
    Omslag
    Download (pdf)
    Spikblad
  • 265.
    Elwin, Marie
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Psychiatric Research centre, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Ek, Lena
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Schröder, Agneta
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Psychiatric Research centre, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Kjellin, Lars
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Psychiatric Research centre, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Autobiographical Accounts of Sensing in Asperger Syndrome and High-Functioning Autism2012Inngår i: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 26, nr 5, s. 420-429Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Sensory experiences in Asperger syndrome (AS) or high-functioning autism (HFA) were explored by qualitative content analysis of autobiographical texts by persons with AS/HFA. Predetermined categories of hyper- and hyposensitivity were applied to texts. Hypersensitivity consists of strong reactions and heightened apprehension in reaction to external stimuli, sometimes together with overfocused or unselective attention. It was common in vision, hearing, and touch. In contrast, hyposensitivity was frequent in reaction to internal and body stimuli such as interoception, proprioception, and pain. It consists of less registration, discrimination, and recognition of stimuli as well as cravings for specific stimuli. Awareness of the strong impact of sensitivity is essential for creating good environments and encounters in the context of psychiatric and other health care.

  • 266.
    Elwin, Marie
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Schröder, Agneta
    Örebro universitet, Institutionen för hälsovetenskaper.
    Ek, Lena
    Department of Psychology, Lund University, Lund, Sweden.
    Wallsten, Tuula
    Centre for Clinical Research, Uppsala University, the County Hospital, Västerås, Sweden.
    Kjellin, Lars
    Örebro universitet, Institutionen för hälsovetenskaper.
    Sensory clusters of adults with and without autism spectrum conditionsManuskript (preprint) (Annet vitenskapelig)
  • 267.
    Emilson, Christina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Åsenlöf: Fysioterapi.
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Åsenlöf: Fysioterapi.
    Demmelmaier, Ingrid
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Bergman, Stefan
    Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, Göteborgs universitet.; Spenshult Research and Development Centre, Halmstad, Sweden..
    Association between health care utilization and musculoskeletal pain: A 21-year follow-up of a population cohort2020Inngår i: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 20, nr 3, s. 533-543Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and aims: Few studies have reported the long-term impact of chronic pain on health care utilization. The primary aim of this study was to investigate if chronic musculoskeletal pain was associated with health care utilization in the general population in a 21-year follow-up of a longitudinal cohort. The secondary aim was to identify and describe factors that characterize different long-term trajectories of health care utilization.

    Methods: A prospective cohort design with a baseline sample of 2,425 subjects (aged 20-74). Data were collected by self-reported questionnaires, and three time points (1995, 2007, and 2016) were included in the present 21-year follow up study. Data on health care utilization were dichotomized at each time point to either high or low health care utilization. High utilization was defined as >5 consultations with at least one health care provider, or >= 1 consultation with at least 3 different health care providers during the last 12 months. Low health care utilization was defined as <= 5 consultations with one health care provider and <3 consultations with different health care providers. The associations between baseline variables and health care utilization in 2016 were analyzed by multiple logistic regression. Five different trajectories for health care utilization were identified by visual analysis, whereof four of clinical relevance were included in the analyses.

    Results: Baseline predictors for high health care utilization at the 21-year follow-up in 2016 were chronic widespread pain (OR: 3.2, CI: 1.9 5.1), chronic regional pain (OR:1.8, CI: 1.2-2.6), female gender (OR: 2.0, CI: 1.4-3.0), and high age (OR: 1.6, CI:0.9-2.9). A stable high health care utilization trajectory group was characterized by high levels of health care utilization, and a high prevalence of chronic pain at baseline and female gender (n =23). A stable low health care utilization trajectory group (n=744) was characterized by low health care utilization, and low prevalence of chronic pain at baseline. The two remaining trajectories were: increasing trajectory group (n =108), characterized by increasing health care utilization, chronic pain at baseline and female gender, and decreasing trajectory group (n=107) characterized by decreasing health care utilization despite a stable high prevalence of chronic pain over time.

    Conclusions: The results suggest that chronic pain is related to long-term health care utilization in the general population. Stable high health care utilization was identified among a group characterized by female gender and a report of chronic widespread pain.

    Fulltekst (pdf)
    fulltext
  • 268.
    Emilsson, Louise
    et al.
    Örebro universitet, Institutionen för läkarutbildning. Primary Care Res Unit, Värmlands Nysäter, Värmland County Council, Karlstad, Sweden.
    James, Stefan
    Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
    Ludvigsson, Jonas F.
    Region Örebro län. Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Ischaemic heart disease in first-degree relatives to coeliac patients2014Inngår i: European Journal of Clinical Investigation, ISSN 0014-2972, E-ISSN 1365-2362, Vol. 44, nr 4, s. 359-364Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Coeliac disease (CD) has been linked to an increased risk of ischaemic heart disease (IHD). We examined the risk of IHD in first-degree relatives and spouses to coeliac patients to ascertain the genetic contribution to IHD excess risk.

    Study design and setting: Coeliac disease was defined as having a biopsy-verified villous atrophy (Marsh grade 3) in 1969-2008 (n=29096). Coeliac patients were matched to 144522 controls. Through Swedish registers, we identified all first-degree relatives and spouses to coeliac patients and their controls, in total 87622 unique coeliac relatives and 432655 unique control relatives. Our main outcome measure was IHD defined according to relevant international classification of disease codes in the Swedish Inpatient Registry or in the Cause of Death Registry. Hazard ratios (HR) and confidence intervals (CI) were estimated through Cox regression adjusted for sex, age-group and calendar year at study entry of the relative.

    Result: During a median follow-up of 108 years, 2880 coeliac relatives and 13817 control relatives experienced IHD. First-degree relatives of coeliac patients were at increased risk of IHD (HR=105; 95% CI=100-109, P-value=004), while spouses were at no increased risk (HR=099; 95% CI=087-112). The excess risk of IHD in coeliac first-degree relatives aged 40-59years was 70/100000 person-years.

    Conclusion: First-degree relatives to coeliac patients seem to be at an increased risk of IHD but the excess risk is so small that it has little clinical relevance.

  • 269.
    Emilsson, Össur Ingi
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning. Department of Respiratory Medicine, Akademiska sjukhuset, Uppsala, Sweden..
    The burden and impact of chronic cough in severe disease2022Inngår i: CURRENT OPINION IN SUPPORTIVE AND PALLIATIVE CARE, ISSN 1751-4258, Vol. 16, nr 4, s. 183-187Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Purpose of review: Chronic cough is common in severe diseases, such as COPD, interstitial lung disease, lung cancer and heart failure, and has a negative effect on quality of life. In spite of this, patients with cough sometimes feel their cough is neglected by healthcare workers. This review aims to briefly describe cough mechanisms, highlight the burden chronic cough can be for the individual, and the clinical impact of chronic cough.

    Recent findings: Chronic cough is likely caused by different mechanisms in different diseases, which may have therapeutic implications. Chronic cough, in general, has a significant negative effect on quality of life, both with and without a severe comorbid disease. It can lead to social isolation, recurrent depressive episodes, lower work ability, and even conditions such as urinary incontinence. Cough may also be predictive of more frequent exacerbations among patients with COPD, and more rapid lung function decline in idiopathic pulmonary fibrosis. Cough is sometimes reported by patients to be underappreciated by healthcare.

    Summary: Chronic cough has a significant negative impact on quality of life, irrespective of diagnosis. Some differences are seen between patients with and without severe disease. Healthcare workers need to pay specific attention to cough, especially patients with severe disease.

  • 270.
    Eneroth, Mari
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Arbets- och organisationspsykologi.
    Gustafsson Sendén, Marie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Personlighets-, social- och utvecklingspsykologi.
    Gustafsson, Karin Schenck
    Wall, Maja
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Arbets- och organisationspsykologi.
    Fridner, Ann
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Arbets- och organisationspsykologi. Karolinska Institute, Sweden.
    Threats or violence from patients was associated with turnover intention among foreign-born GPs - a comparison of four workplace factors associated with attitudes of wanting to quit one's job as a GP2017Inngår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 35, nr 2, s. 208-213Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: General practitioners (GPs) are crucial in medical healthcare, but there is currently a shortage of GPs in Sweden and elsewhere. Recruitment of GPs from abroad is essential, but foreign-born physicians face difficulties at work that may be related to turnover intention, i.e. wanting to quit one's job. The study aims to explore the reasons to why foreign-born GPs may intend to quit their job. Design: Survey data were used to compare four work-related factors that can be associated with turnover intentions; patient-related stress, threats or violence from patients, control of work pace, and empowering leadership, among native-born and foreign-born GPs. These work-related factors were subsequently examined in relation to turnover intention among the foreign-born GPs by means of linear hierarchical regression analyses. The questionnaire consisted of items from the QPS Nordic and items constructed by the authors. Setting: A primary care setting in a central area of Sweden. Subjects: Native-born (n = 208) and foreign-born GPs (n = 73). Results: Turnover intention was more common among foreign-born GPs (19.2% compared with 14.9%), as was the experience of threats or violence from patients (22% compared with 3% of the native-born GPs). Threats or violence was also associated with increased turnover intention. Control of work pace and an empowering leadership was associated with reduced turnover intention.

  • 271.
    Eneroth, Mari
    et al.
    Stockholm University.
    Gustafsson Sendén, Marie
    Stockholm University.
    Schenck Gustafsson, Karin
    Karolinska Institutet.
    Wall, Maja
    Stockholm Univeristy.
    Fridner, Ann
    Stockholm Univeristy / Karolinska Institutet.
    Threats or violence from patients was associated with turnover intention among foreign-born GPs - a comparison of four workplace factors associated with attitudes of wanting to quit one's job as a GP2017Inngår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 35, nr 2, s. 208-213Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: General practitioners (GPs) are crucial in medical healthcare, but there is currently a shortage of GPs in Sweden and elsewhere. Recruitment of GPs from abroad is essential, but foreign-born physicians face difficulties at work that may be related to turnover intention, i.e. wanting to quit one's job. The study aims to explore the reasons to why foreign-born GPs may intend to quit their job. Design: Survey data were used to compare four work-related factors that can be associated with turnover intentions; patient-related stress, threats or violence from patients, control of work pace, and empowering leadership, among native-born and foreign-born GPs. These work-related factors were subsequently examined in relation to turnover intention among the foreign-born GPs by means of linear hierarchical regression analyses. The questionnaire consisted of items from the QPS Nordic and items constructed by the authors. Setting: A primary care setting in a central area of Sweden. Subjects: Native-born (n = 208) and foreign-born GPs (n = 73). Results: Turnover intention was more common among foreign-born GPs (19.2% compared with 14.9%), as was the experience of threats or violence from patients (22% compared with 3% of the native-born GPs). Threats or violence was also associated with increased turnover intention. Control of work pace and an empowering leadership was associated with reduced turnover intention.

  • 272.
    Engelheart, Stina
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Nutritional status in a functional perspective: A study in a cohort of older people in home health care2021Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    High age is a risk factor for most acute and chronic diseases, injuries and function disabilities, and hence, an important risk factor for nutritional problems. A great deal of elderly health care in Sweden are performed in the patient’s home environment and home health care has been transformed to more advanced medical care the last decades.

    The aim of this thesis was to comprehensively describe the nutritional status and its change over time in a population of older people receiving home health care. The aim includes to propose a framework for investigating and analysing the nutritional status in older people.

    Nutritional status was studied at enrolment in home health care and regularly followed up for three years. Patients that were 65 years or older and needed home health care for at least three months between 2012 and 2017 were asked to join the study, resulting in 69 participants (64%women).

    Data collection and analysis of the nutritional status was based on the proposed model for assessing the nutritional status in a comprehensive functional perspective (paper 1). The model comprises four domains that affect the nutritional status and functional outcome in a bidirectional way. In paper 2 we concluded that malnutrition, sarcopenia, frailty and dehydration are highly prevalent in the population and the most important indicators were loss of appetite and dehydration. This was confirmed in paper 3, were nutritional status was analysed with a statistical approach. A total of 103 indicators of nutritional status were reduced to 19 that were suggested to be primary investigated. Also, the paper empirically confirmed the relationship within as well as between the domains suggested in paper 1. Finally, we studied meal pattern, being a part of one of the domains (paper 4). We found indications that presence of at least one large meal (high energy intake) per day had more impact on the total daily energy and protein intake than more eating occasions during the day. 

    Fulltekst (pdf)
    Nutritional status in a functional perspective: A study in a cohort of older people in home health care
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  • 273.
    Engelheart, Stina
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Andrén, Daniela
    Örebro universitet, Handelshögskolan vid Örebro Universitet.
    Repsilber, Dirk
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Bertéus Forslund, Heléne
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg.
    Brummer, Robert Jan
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Nutritional status in older people: an explorative analysisManuskript (preprint) (Annet vitenskapelig)
  • 274.
    Engelheart, Stina
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Bertéus Forslund, Heléne
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg.
    Brummer, Robert Jan
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Ljungqvist, Olle
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Dehydration and loss of appetite: key nutrition features in olderpeople receiving home health careManuskript (preprint) (Annet vitenskapelig)
  • 275.
    Engman, Maria
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Genus och medicin. Linköpings universitet, Hälsouniversitetet.
    Wijma, Klaas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Medicinsk psykologi. Linköpings universitet, Hälsouniversitetet.
    Wijma, Barbro
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Barn- och ungdomspsykiatri. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Long-term coital behaviour in women treated with cognitive behaviour therapy for superficial coital pain and vaginismus2010Inngår i: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 39, nr 3, s. 193-202Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of the present study was to investigate long-term coital behaviour in women treated with cognitive behaviour therapy (CBT) for superficial coital pain and vaginismus. Data were taken from a questionnaire concerning long-term coital behaviour sent to 59 women who presented to Linköping University Hospital because of superficial coital pain, had been diagnosed with vaginismus, and had been treated with CBT. Data were also traced from therapy records: mean follow-up time was 39 months, the women had suffered for an average of almost 4 years, and required a mean of 14 treatment sessions. Forty-four of the 59 women returned the questionnaire, for a response rate of 74.6%. At follow-up, 81% of the treated women had had intercourse. A majority (61%) rated their ability to have intercourse without pain as 6 or higher (on a scale from 0-10), and 61% rated their ability to enjoy intercourse as 6 or higher (on a scale from 0-10). The proportion of women with positive treatment outcome at follow-up ranged from 81% (able to have intercourse) to 6% (able to have pain-free intercourse). An ability to have intercourse at end of therapy was maintained at follow-up. Two-thirds of the women reported high fulfillment of individual treatment goals. At follow-up, the women estimated a significantly higher self-worth as sex partners, and as women and human beings, than before treatment. Twelve per cent of the original sample had healed after a few assessment sessions and without treatment.

  • 276.
    Enroth, Stefan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik och genomik. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Hallmans, Göran
    Umea Univ, Dept Biobank Res, SE-90187 Umea, Sweden..
    Grankvist, Kjell
    Umea Univ, Dept Med Biosci, Clin Chem, SE-90185 Umea, Sweden..
    Gyllensten, Ulf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk genetik och genomik. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Effects of Long-Term Storage Time and Original Sampling Month on Biobank Plasma Protein Concentrations2016Inngår i: EBioMedicine, E-ISSN 2352-3964, Vol. 12, s. 309-314Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The quality of clinical biobank samples is crucial to their value for life sciences research. A number of factors related to the collection and storage of samples may affect the biomolecular composition. We have studied the effect of long-time freezer storage, chronological age at sampling, season and month of the year and on the abundance levels of 108 proteins in 380 plasma samples collected from 106 Swedish women. Storage time affected 18 proteins and explained 4.8-34.9% of the observed variance. Chronological age at sample collection after adjustment for storage-time affected 70 proteins and explained 1.1-33.5% of the variance. Seasonal variation had an effect on 15 proteins and month (number of sun hours) affected 36 proteins and explained up to 4.5% of the variance after adjustment for storage-time and age. The results show that freezer storage time and collection date (month and season) exerted similar effect sizes as age on the protein abundance levels. This implies that information on the sample handling history, in particular storage time, should be regarded as equally prominent covariates as age or gender and need to be included in epidemiological studies involving protein levels.

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  • 277.
    Ericsson, Anna
    et al.
    University of Gothenburg, Sweden.
    Palstam, Annie
    University of Gothenburg, Sweden.
    Larsson, Anette
    University of Gothenburg, Sweden.
    Lofgren, Monika
    Danderyd Hospital Stockholm, Sweden.
    Bileviciute-Ljungar, Indre
    Danderyd Hospital Stockholm, Sweden.
    Bjersing, Jan
    University of Gothenburg, Sweden.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Kosek, Eva
    Karolinska Institute, Sweden.
    Mannerkorpi, Kaisa
    University of Gothenburg, Sweden.
    Resistance exercise improves physical fatigue in women with fibromyalgia: a randomized controlled trial2016Inngår i: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 18, nr 176Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Fibromyalgia (FM) affects approximately 1-3 % of the general population. Fatigue limits the work ability and social life of patients with FM. A few studies of physical exercise have included measures of fatigue in FM, indicating that exercise can decrease fatigue levels. There is limited knowledge about the effects of resistance exercise on multiple dimensions of fatigue in FM. The present study is a sub-study of a multicenter randomized controlled trial in women with FM. The purpose of the present sub-study was to examine the effects of a person-centered progressive resistance exercise program on multiple dimensions of fatigue in women with FM, and to investigate predictors of the potential change in fatigue. Methods: A total of 130 women with FM (age 22-64 years) were included in this assessor-blinded randomized controlled multicenter trial examining the effects of person-centered progressive resistance exercise compared with an active control group. The intervention was performed twice a week for 15 weeks. Outcomes were five dimensions of fatigue measured with the Multidimensional Fatigue Inventory (MFI-20). Information about background was collected and the women also completed several health-related questionnaires. Multiple linear stepwise regression was used to analyze predictors of change in fatigue in the total population. Results: A higher improvement was found at the post-treatment examination for change in the resistance exercise group, as compared to change in the active control group in the MFI-20 subscale of physical fatigue (resistance group Delta -1.7, SD 4.3, controls Delta 0.0, SD 2.7, p = 0.013), with an effect size of 0.33. Sleep efficiency was the strongest predictor of change in the MFI-20 subscale general fatigue (beta = -0.54, p = 0.031, R-2 = 0.05). Participating in resistance exercise (beta = 1.90, p = 0.010) and working fewer hours per week (beta = 0.84, p = 0.005) were independent significant predictors of change in physical fatigue (R-2 = 0.14). Conclusions: Person-centered progressive resistance exercise improved physical fatigue in women with FM when compared to an active control group.

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    fulltext
  • 278.
    Ericsson Hallin, Therése
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Five-year follow-up after an outbreak of Cryptosporidium hominis in Östersund2017Independent thesis Basic level (professional degree), 20 poäng / 30 hpOppgave
  • 279.
    Ericsson, Henrik
    et al.
    Department of Food Hygiene, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden.
    Danielsson-Tham, Marie-Louise
    Department of Food Hygiene, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden.
    Tham, Wilhelm
    Department of Food Hygiene, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Uppsala, Sweden.
    Listeria monocytogenes serovar 4b strains divided into two groups using polymerase chain reaction (PCR) and restriction enzyme analysis (REA)1995Inngår i: Proceedings of the XII Interenational Symposium on Problems of Listeriosis, Canning Bridge: Promaco Conventions , 1995, s. 421-421Konferansepaper (Fagfellevurdert)
  • 280. Ericzon, Bo-Goran
    et al.
    Wilczek, Henryk E.
    Larsson, Marie
    Stangou, Arie J.
    Wijayatunga, Priyantha
    Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.
    Suhr, Ole
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    To transplant or not to transplant - Lessons learned from 20 years global collaboration in liver transplantation for hereditary transthyretin amyloidosis2013Inngår i: Hepatology, ISSN 0270-9139, E-ISSN 1527-3350, Vol. 58, s. 1011A-1011AArtikkel i tidsskrift (Annet vitenskapelig)
  • 281.
    Eriksson, Axel
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Increased incidence of inflammatory bowel disease after the outbreak of Cryptosporidium hominis in Östersund? - Data from the Swedish Quality Registry for inflammatory bowel disease, SWIBREG2018Independent thesis Basic level (professional degree), 20 poäng / 30 hpOppgave
  • 282.
    Eriksson, B.
    et al.
    Karolinska Inst, Sweden.
    Wandell, P.
    Karolinska Inst, Sweden.
    Dahlström, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Nasman, P.
    KTH Royal Inst Technol, Sweden.
    Lund, L. H.
    Karolinska Univ Hosp, Sweden.
    Edner, M.
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Comorbidities, risk factors and outcomes in patients with heart failure and an ejection fraction of more than or equal to 40% in primary care- and hospital care-based outpatient clinics2018Inngår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 36, nr 2, s. 207-215Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim of this study is to describe patients with heart failure and an ejection fraction (EF) of more than or equal to 40%, managed in both Primary- and Hospital based outpatient clinks separately with their prognosis, comorbidities and risk factors. Further to compare the heart failure medication in the two groups. Design: We used the prospective Swedish Heart Failure Registry to include 9654 out-patients who had HF and EF amp;gt;= 40%, 1802 patients were registered in primary care and 7852 in hospital care. Descriptive statistical tests were used to analyze base line characteristics in the two groups and multivariate logistic regression analysis to assess mortality rate in the groups separately. Setting: The prospective Swedish Heart Failure Registry. Setting: The prospective Swedish Heart Failure Registry. Subjects: Patients with heart failure and an ejection fraction (EF) of more than or equal to 40%. Main outcome measures: Comorbidities, risk factors and mortality. Results: Mean-age was 77.5 (primary care) and 70.3 years (hospital care) p amp;lt; 0.0001, 46.7 vs. 36.3% women respectively (p amp;lt; 0.0001) and EF amp;gt;= 50% 26.1 vs. 13.4% (p amp;lt; 0.0001). Co-morbidities were common in both groups (97.2% vs. 92.3%), the primary care group having more atrial fibrillation, hypertension, ischemic heart disease and COPD. According to the multivariate logistic regression analysis smoking, COPD and diabetes were the most important independent risk factors in the primary care group and valvular disease in the hospital care group. All-cause mortality during mean follow-up of almost 4 years was 315% in primary care and 27.8% in hospital care. One year-mortality rates were 7.8%, and 7.0% respectively. Conclusion: Any co-morbidity was noted in 97% of the HF-patients with an EF of more than or equal to 40% managed at primary care based out-patient clinics and these patients had partly other independent risk factors than those patients managed in hospital care based outpatients clinics. Our results indicate that more attention should be payed to manage COPD in the primary care group.

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  • 283.
    Eriksson, Carl
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Epidemiological and therapeutic aspects of Inflammatory Bowel Disease2018Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Introduction: The two main forms of inflammatory bowel disease (IBD) are Crohn’s disease and ulcerative colitis. These are chronic inflammatory disorders, mainly affecting the gastrointestinal tract.

    Aims: The overall aims of this thesis were to study the epidemiology of ulcerative colitis in Örebro, Sweden; to examine certain aspects of anaemia in IBD; and to determine the clinical effectiveness of medical treatments.

    Material and methods: Cohort studies with the sampling frame defined by the geographic boundaries of the primary catchment area of Örebro University Hospital (Papers I‒III), or by the entire IBD population in Sweden registered in the Swedish national quality registry for IBD (SWIBREG; paper IV), were performed to determine the epidemiology of ulcerative colitis, the incidence and prevalence of anaemia in IBD, and the clinical effectiveness of thiopurine drugs and vedolizumab in routine care.

    Results: A fivefold increase in the incidence and a tenfold increase in the prevalence of ulcerative colitis was observed in Örebro during the past 50 years. In parallel, the prognosis, in terms of risk for colectomy within 10 years from diagnosis, improved during the same time period. Earlier and more widespread use of thiopurine drugs may have contributed to the decrease in colectomies. Anaemia is common in IBD, particularly in Crohn’s disease. Vedolizumab, a new drug targeting leucocyte migration to the gut, appears to be well tolerated and effective in Swedish real-world IBD care.

    Conclusion: Ulcerative colitis is on the rise, and data from Örebro indicate that the number of IBD patients in Sweden already exceeds 70,000. Improved knowledge of long-term outcomes of medical therapy may have far-reaching implications for future IBD management.

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    Epidemiological and therapeutic aspects of Inflammatory Bowel Disease
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  • 284.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Henriksson, Ida
    Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Brus, Ole
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Zhulina, Yaroslava
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Nyhlin, Nils
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Tysk, Curt
    Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Karolinska Institutet, Stockholm, Sweden; University College London, London, United Kingdom.
    Incidence, prevalence, and clinical outcome of anaemia in inflammatory bowel disease: A population-based cohort studyManuskript (preprint) (Annet vitenskapelig)
  • 285.
    Eriksson, Carl
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Henriksson, Ida
    Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Brus, Ole
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Zhulina, Yaroslava
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Nyhlin, Nils
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology.
    Tysk, Curt
    Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Gastroenterology.
    Incidence, prevalence and clinical outcome of anaemia in inflammatory bowel disease: a population-based cohort study2018Inngår i: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 48, nr 6, s. 638-645Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: The incidence and short-term outcome of anaemia in inflammatory bowel disease (IBD) are largely unknown.

    AIM: To determine the incidence, prevalence and clinical outcome of anaemia in terms of resolution of anaemia within 12 months. We also planned to assess risk factors for anaemia in IBD.

    METHODS: A random sample of 342 patients was obtained from the population-based IBD cohort of Örebro University Hospital, Sweden, consisting of 1405 patients diagnosed between 1963 and 2010. Haemoglobin measurements recorded from 1 January 2011 to 31 December 2013 were extracted from the Clinical Chemistry data system.

    RESULTS: In Crohn's disease, the incidence rate of anaemia was 19.3 (95% CI: 15.4-23.7) per 100 person-years and the prevalence was 28.7% (CI: 22.0-36.2), compared with 12.9 (CI: 9.8-16.5) and 16.5% (CI: 11.2-22.9) for ulcerative colitis. Crohn's disease was associated with an increased incidence (OR = 1.60; CI: 1.02-2.51) and prevalence of anaemia (OR = 2.04; CI: 1.20-3.46) compared to ulcerative colitis. Stricturing disease phenotype in Crohn's disease (HR = 2.59; CI: 1.00-6.79) and extensive disease in ulcerative colitis (HR = 2.40; CI: 1.10-5.36) were associated with an increased risk of anaemia. Despite a higher probability of receiving specific therapy within 3 months from the diagnosis of anaemia, Crohn's disease patients had a worse outcome in terms of resolution of anaemia within 12 months (56% vs 75%; P = 0.03).

    CONCLUSIONS: Anaemia is a common manifestation of IBD even beyond the first years after the diagnosis of IBD. Crohn's disease is associated with both an increased risk and a worse outcome.

  • 286.
    Eriksson, Carola
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Westman, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Hamberg, Katarina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Content of childbirth-related fear in Swedish women and men: analysis of an open-ended question2006Inngår i: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 51, nr 2, s. 112-118Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The content of childbirth-related fear as described by 308 women and 194 men was analyzed and compared in relation to intensity of fear. The content of fear was similarly described by women and men and concerned the following main categories: the labor and delivery process, the health and life of the baby, the health and life of the woman, own capabilities and reactions, the partner's capabilities and reactions, and the professionals' competence and behavior. Among women, the labor and delivery process was the most frequently reported among the 6 categories of fears, whereas the health and life of the baby was the most frequent among the men. Fears related to own capabilities and reactions were described significantly more often by women with intense fear than by women with mild to moderate fear. The greatest difference between men with intense versus mild to moderate fear was a more frequent expression of concern for the health and life of the woman. Both women and men had fears related to not being treated with respect and not receiving sufficient medical care. This finding suggests that part of the problem with childbirth-related fear is located within the health care system itself.

  • 287.
    Eriksson, D.
    et al.
    Karolinska Inst, Dept Med Solna, Ctr Mol Med, Stockholm, Sweden.;Metab & Diabet Karolinska Univ Hosp, Dept Endocrinol, Stockholm, Sweden..
    Bianchi, Matteo
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Landegren, Nils
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Autoimmunitet. Uppsala universitet, Science for Life Laboratory, SciLifeLab. Karolinska Inst, Dept Med Solna, Ctr Mol Med, Stockholm, Sweden..
    Nordin, Jessika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Dalin, Frida
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Dermatologi och venereologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab. Karolinska Inst, Dept Med Solna, Ctr Mol Med, Stockholm, Sweden..
    Mathioudaki, Argyri
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Eriksson, G. N.
    Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden..
    Hultin-Rosenberg, Lina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Dahlqvist, Johanna
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi.
    Zetterqvist, H.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Karlsson, Andreas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Hallgren, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Infektionssjukdomar. Uppsala universitet, Science for Life Laboratory, SciLifeLab. Karolinska Inst, Dept Med Solna, Ctr Mol Med, Stockholm, Sweden..
    Farias, F. H. G.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Murén, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Ahlgren, Kerstin M.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Autoimmunitet. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Lobell, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Autoimmunitet. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Andersson, G.
    Swedish Univ Agr Sci, Dept Anim Breeding & Genet, Uppsala, Sweden..
    Tandre, Karolina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Dahlqvist, S. R.
    Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden..
    Soderkvist, P.
    Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden..
    Rönnblom, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Hulting, A. -L
    Wahlberg, J.
    Linkoping Univ, Dept Endocrinol, Dept Med & Hlth Sci, Dept Clin & Expt Med, Linkoping, Sweden..
    Ekwall, O.
    Univ Gothenburg, Sahlgrenska Acad, Dept Pediat, Inst Clin Sci, Gothenburg, Sweden.;Univ Gothenburg, Dept Rheumatol & Inflammat Res, Inst Med, Sahlgrenska Acad, Gothenburg, Sweden..
    Dahlqvist, P.
    Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden..
    Meadows, Jennifer R. S.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Bensing, S.
    Metab & Diabet Karolinska Univ Hosp, Dept Endocrinol, Stockholm, Sweden.;Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden..
    Lindblad-Toh, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab. Broad Inst MIT & Harvard, Cambridge, MA USA..
    Kämpe, Olle
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Autoimmunitet. Uppsala universitet, Science for Life Laboratory, SciLifeLab. Karolinska Inst, Dept Med Solna, Ctr Mol Med, Stockholm, Sweden.;Metab & Diabet Karolinska Univ Hosp, Dept Endocrinol, Stockholm, Sweden..
    Pielberg, Gerli R.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Genomik.
    Extended exome sequencing identifies BACH2 as a novel major risk locus for Addison's disease2016Inngår i: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 286, nr 6, s. 595-608Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BackgroundAutoimmune disease is one of the leading causes of morbidity and mortality worldwide. In Addison's disease, the adrenal glands are targeted by destructive autoimmunity. Despite being the most common cause of primary adrenal failure, little is known about its aetiology. MethodsTo understand the genetic background of Addison's disease, we utilized the extensively characterized patients of the Swedish Addison Registry. We developed an extended exome capture array comprising a selected set of 1853 genes and their potential regulatory elements, for the purpose of sequencing 479 patients with Addison's disease and 1394 controls. ResultsWe identified BACH2 (rs62408233-A, OR = 2.01 (1.71-2.37), P = 1.66 x 10(-15), MAF 0.46/0.29 in cases/controls) as a novel gene associated with Addison's disease development. We also confirmed the previously known associations with the HLA complex. ConclusionWhilst BACH2 has been previously reported to associate with organ-specific autoimmune diseases co-inherited with Addison's disease, we have identified BACH2 as a major risk locus in Addison's disease, independent of concomitant autoimmune diseases. Our results may enable future research towards preventive disease treatment.

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  • 288.
    Eriksson, Marcus
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Self-rated health and its relation to pulse wave velocity2016Independent thesis Basic level (professional degree), 20 poäng / 30 hpOppgave
  • 289.
    Eriksson, Margaretha
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Födelseviktens betydelse för utveckling av kardiovaskulära riskfaktorer, sjukdom och död: män födda 1913 och följda framgent2003Annet (Annet vitenskapelig)
  • 290.
    Eriksson, Margaretha
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    The Impact of Birth Weight on Cardiovascular Risk Factors, Coronary Heart Disease and Prostate Cancer: Population-based Studies of Men Born in 1913 and Followed up Until Old Age2005Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Objectives. To study whether birth weight (BW) was correlated to cardiovascular risk factors, coronary heart disease (CHD), cardiovascular disease (CVD), and prostate cancer (PCA) at adult ages, whether a possible relationship depended on mediating factors from birth time, hereditary circumstances, and adult life variables, and what importance possible associations might have for the rate of the complaint in the general population.

    Material and methods. Population-based cohorts of men born in 1913 and followed up until old age. Risk of outcome was estimated using Cox’s and Poisson regressions. The results were transformed to population attributable risk percentage (PAR%) of the complaint that could be attributed to low or high BW, given causality between exposure and outcome.

    Results. After adjustment for the influence of covariates, systolic blood pressure at age 50 decreased by 3.7 mmHg per 1000 g increase in BW, the prevalence of antihypertensive treatment decreased by 32%, diabetes by 53%, serum total cholesterol decreased by 0.20 mmol L-1, and being in top quintile of serum cholesterol decreased by 23%. The adjusted risks were somewhat more marked relative to the crude risks. CHD and CVD incidence and mortality were virtually unaffected by BW. In the general population, the risk percentage attributable to a BW ≤3000 g was 18% for diabetes, 2.5% for cholesterol, and ≤1% for antihypertensive treatment and CHD and CVD incidence and mortality.

    PCA incidence and mortality risk increased by 62% and 82%, respectively, among those whose BW was ≥4250 g compared with those whose BW was 3001-4249 g. The risk percentages attributable to a BW ≥4250 g in the general population for PCA incidence and mortality were 7.8% and 10.8%.

    Conclusions. Low BW seemed to affect cardiovascular risk factors but not incidence and mortality from CHD and CVD. A high proportion of diabetes on the community level could be attributed to low BW, while the proportional burden of other cardiovascular complaints that could be attributed to low BW was modest. PCA incidence and mortality seemed to be affected by high BW.

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  • 291.
    Eriksson, Mats
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Lafolie, Pierre
    Klinisk Farmakologi, KI, Stockholm.
    Schierbeck, Mattias
    Hörling, Margareta
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Vem har ansvaret för hur journalgranskning får göras?”2020Inngår i: Dagens Medicin, Vol. 07, nr 15Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 292.
    Eriksson, Thérèse
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för samhälle och hälsa. Linköpings universitet, Medicinska fakulteten.
    Tropp, Hans
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Wiréhn, Ann-Britt
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för samhälle och hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Regionledningskontoret, Forskningsstrategiska enheten.
    Levin, Lars-Åke
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för samhälle och hälsa. Linköpings universitet, Medicinska fakulteten.
    A pain relieving reimbursement program? Effects of a value-based reimbursement program on patient reported outcome measures2020Inngår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 20, nr 1, artikkel-id 805Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Value-based reimbursement programs have become increasingly common. However, little is known about the effect of such programs on patient reported outcomes.Thus, the aim of this study was to analyze the effect of introducing a value-based reimbursement program on patient reported outcome measures and to explore whether a selection bias towards less complicated patients occurred. Methods This is a retrospective observational study with a before and after design based on the introduction of a value-based reimbursement program in Region Stockholm, Sweden. We analyzed patient level data from inpatient and outpatient care of patients undergoing lumbar spine surgery during 2006-2015. Patient reported outcome measures used was Global Assessment, EQ-5D-3L and Oswestry Disability Index. The case-mix of surgically treated patients was analyzed using medical and socioeconomic factors. Results The value-based reimbursement program did not have any effect on targeted or non-targeted patient reported outcome measures. Moreover, the share of surgically treated patients with risk factors such as having comorbidities and being born outside of Europe increased after the introduction. Hence, the value-based reimbursement program did not encourage discrimination against sicker patients. However, the income was higher among patients surgically treated after the introduction of the value-based reimbursement. This indicates that a value-based reimbursement program may contribute to increased inequalities in access to healthcare. Conclusions The value-based reimbursement program did not have any effect on patient reported outcome measures. Our study contributes to the understanding of the effects of a value-based reimbursement program on patient reported outcome measures and to what extent cherry-picking arises.

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  • 293. Escuder Miquel, Luisa
    et al.
    Emtner, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Ställberg, Björn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Zakrisson, Ann-Britt
    Interprofessionell samverkan för astma-KOL2018Inngår i: AllmänMedicin, ISSN 0281-3513, Vol. 39, nr 1, s. 38-41Artikkel i tidsskrift (Annet vitenskapelig)
  • 294.
    E:son Jennersjö, Pär
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Risk factors in type 2 diabetes with emphasis on blood pressure, physical activity and serum vitamin D2016Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Background

    Type 2 diabetes is a common chronic disease with a two-fold increased risk for cardiovascular morbidity and mortality and has an increasing prevalence worldwide. This thesis is based on a study conducted in primary health care in Östergötland and Jönköping, Sweden. The aim of the thesis was to evaluate new risk markers to identify patients with high risk of developing cardiovascular disease in middle-aged men and women with type 2 diabetes.

    Methods

    Data from the cohort study CArdiovascular Risk in type 2 DIabetes – a Prospective study in Primary care (CARDIPP) was used. In paper III data were also used from CARDIPP-Revisited where all participants in the CARDIPP study were invited four years after the baseline investigation for a re-investigation. In paper IV data were used from CAREFUL which is a control group of 185 subjects without diabetes. The investigation included a standard medical history including data on diabetes duration and on-going medication. Anthropometric data were recorded and both office and ambulatory blood pressure were measured. The patients filled out a detailed questionnaire and physical activity was measured by using waist-mounted pedometers. Pedometer-determined physical activity was classified in four groups: Group 1: <5000 steps/day (‘sedentary’); Group 2: 5000-7499 steps/day (‘low active’); Group 3: 7500-9999 steps/day (‘somewhat active’); Group 4: and ≥10 000 steps/day (‘active’). Blood samples were drawn for routine analyses and also frozen for later analyses. The investigations at the departments of physiology included echocardiography, measurements of the carotid intima-media thickness, applanation tonometry and measurements of  sagittal abdominal diameter.

    Results

    Paper 1:

    Patients with a non-dipping systolic blood pressure pattern showed higher left ventricular mass index and pulse wave velocity (PWV) compared with patients with ≥10% decline in nocturnal systolic blood pressure. Patients with <10% decline in nocturnal systolic blood pressure had higher BMI and sagittal abdominal diameter, lower GFR and higher albumin:creatinine ratio and also higher levels of NT-proBNP than patients with a dipping pattern of the nocturnal blood pressure.

    Paper 2:

    The number of steps/day were inversely significantly associated with BMI, waist circumference and sagittal abdominal diameter, levels of CRP, levels of interleukin-6 and PWV.

    Paper 3:

    At the 4-year follow-up the change in PWV (ΔPWV) from baseline was calculated. The group with the lowest steps/day had a significantly higher increase in ΔPWV compared with the group with the highest steps/day. The associations between baseline steps/day and ΔPWV remained after further adjustment in a multivariate linear regression statistically significant (p=0.005). 23% of the variation in the study could be explained by our model. Every 1000 extra steps at baseline reduced the change in ΔPWV by 0.103 m/s between baseline and follow-up.

    Paper 4:

    Low vitamin D levels were associated with significantly increased risk for premature mortality in men with type 2 diabetes. High levels of parathyroid hormone were associated with significantly increased risk for premature mortality in women with type 2 diabetes. These relationships were still statistically significant also when two other well-established risk markers for mortality, PWV and carotid intima-media thickness, were added to the analyses.

    Conclusions

    Ambulatory blood pressure recording can by addressing the issue of diurnal blood pressure variation, explore early cardiovascular organ damage and microvascular complications that goes beyond effects of standardised office blood pressure measurements. Pedometer-determined physical activity may serve as a surrogate marker for inflammation and subclinical organ damage in patients with type 2 diabetes. There is novel support for the durable vascular protective role of a high level of daily physical activity, which is independent of BMI and systolic blood pressure. The use of pedometers is feasible in clinical practice and provides objective information not only about physical activity but also the future risk for subclinical organ damage in middle-aged people with type 2 diabetes. Our results indicate that low vitamin D levels in men or high parathyroid hormone levels in women give independent prognostic information of an increased risk for total mortality.

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  • 295.
    Everaert, Karel
    et al.
    Ghent Univ Hosp, Belgium.
    Anderson, Peter
    Adelphi Real World, England.
    Wood, Robert
    Adelphi Real World, England.
    Andersson, Fredrik L.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Medicinska fakulteten. Ferring Pharmaceut AS, Denmark.
    Holm-Larsen, Tove
    Ghent Univ Hosp, Belgium.
    Nocturia is more bothersome than daytime LUTS: Results from an Observational, Real-life Practice Database including 8659 European and American LUTS patients2018Inngår i: International journal of clinical practice (Esher), ISSN 1368-5031, E-ISSN 1742-1241, Vol. 72, nr 6, artikkel-id e13091Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: Lower urinary tract symptoms (LUTS) encompass several diagnoses, including overactive bladder (OAB) and benign prostatic hyperplasia (BPH). Nocturia is a standalone symptom, but also included in OAB and BPH. Current discussion addresses whether the overlap of the diagnoses is too broad, leading to misdiagnosis. This study explored the differences in level, causes and consequences for patients with a diagnosis of daytime LUTS compared with a diagnosis of nocturia, and discussed whether people are being treated for the symptoms that truly bother them the most. Patients and methods: Data were drawn from a survey of physicians and patients in France, Germany, Spain, UK and USA. Physicians filled out patient record forms (PRFs) for patients with LUTS diagnosis. The patients completed the patient self-completion form (PSC). Three PRO questionnaires were included; the OAB-q SF, NI-Diary and WPAI. Patients were grouped based on the diagnoses assigned to them by their physicians in a real-life setting. Results: Eight thousand seven hundred and thirty eight patients had a LUTS diagnosis and 5335 completed a PSC. Patients diagnosed with night-time symptoms were significantly more bothered by their LUTS than only daytime LUTS patients (all questionnaires Pamp;lt;.0001). Patients with nocturia reported being tired "always" or "usually" more often than patients with daytime problems only (Pamp;lt;.0001). Only 13% of patients with nocturia had an initial sleep period of more than 2-3hours. Conclusion: In this population of real-life patients, those with a diagnosis of nocturia reported significantly higher impact on their quality of life than patients with a diagnosis of daytime LUTS only. The underlying causes of bother were related to sleep problems. It is essential that nocturia is understood, treated and monitored as a distinct problem from OAB and BPH, to ensure that patients are treated for their main symptom.

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  • 296.
    Falkhamn, Lukasz Mateusz
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Stenberg, Gunilla
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi.
    Enthoven, Paul
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Stålnacke, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Interdisciplinary multimodal pain rehabilitation in patients with chronic musculoskeletal pain in primary care: a cohort study from the Swedish quality registry for pain rehabilitation (SQRP)2023Inngår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, nr 6, artikkel-id 5051Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Chronic pain is a major public health issue. Mounting evidence suggests that interdisciplinary multimodal pain rehabilitation programs (IMMRPs) performed in specialist pain care are an effective treatment for patients with chronic pain, but the effects of such treatment if performed in primary care settings have been less studied. The aims of this pragmatic study were to (1) describe characteristics of patients participating in IMMRPs in primary care; (2) examine whether IMMRPs in primary care improve pain, disability, quality of life, and sick leave 1-year post discharge in patients with chronic pain; and (3) investigate if outcomes differ between women and men. Data from 744 (645 women and 99 men, age range 18-65 years) patients with non-malignant chronic pain included in the Swedish Quality Registry for Pain Rehabilitation Primary Care were used to describe patient characteristics and changes in health and sick leave. At 1-year follow-up, the patients had improved significantly (p < 0.01) in all health outcome measures and had reduced sick leave except in men, where no significant change was shown in physical activity level. This study indicates that MMRPs in primary care improved pain and physical and emotional health and reduced sick leave, which was maintained at the 1-year follow-up.

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  • 297. Falkmer, S
    et al.
    Samuelson, Gösta
    Sjölin, S
    Penicillaminbehandling vid Wilsons sjukdom: [Penicillamine treatment of Wilson's disease].1969Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 66, nr 20, s. 2097-105Artikkel i tidsskrift (Fagfellevurdert)
  • 298. Falkmer, S
    et al.
    Samuelson, Gösta
    Sjölin, S
    Penicillamine-induced normalization of clinical signs, and liver morphology and histochemistry in a case of Wilson's disease.1970Inngår i: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 45, nr 2, s. 260-8Artikkel i tidsskrift (Fagfellevurdert)
  • 299.
    Falkstedt, Daniel
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). Karolinska Institutet, Sweden; University of Strasbourg, France; Stockholm County Council, Sweden.
    Wolff, Valerie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). Karolinska Institutet, Sweden; University of Strasbourg, France; Stockholm County Council, Sweden.
    Allebeck, Peter
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). Karolinska Institutet, Sweden; University of Strasbourg, France; Stockholm County Council, Sweden.
    Hemmingsson, Tomas
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). Karolinska Institutet, Sweden; University of Strasbourg, France; Stockholm County Council, Sweden.
    Danielsson, Anna-Karin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). Karolinska Institutet, Sweden; University of Strasbourg, France; Stockholm County Council, Sweden.
    Cannabis, Tobacco, Alcohol Use, and the Risk of Early Stroke: A Population-Based Cohort Study of 45000 Swedish Men2017Inngår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 48, nr 2, s. 265-270Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and Purpose - Current knowledge on cannabis use in relation to stroke is based almost exclusively on clinical reports. By using a population-based cohort, we aimed to find out whether there was an association between cannabis use and early-onset stroke, when accounting for the use of tobacco and alcohol.

    Methods - The cohort comprises 49321 Swedish men, born between 1949 and 1951, who were conscripted into compulsory military service between the ages of 18 and 20. All men answered 2 detailed questionnaires at conscription and were subject to examinations of physical aptitude, psychological functioning, and medical status. Information on stroke events up to approximate to 60 years of age was obtained from national databases; this includes strokes experienced before 45 years of age.

    Results - No associations between cannabis use in young adulthood and strokes experienced 45 years of age or beyond were found in multivariable models: cannabis use >50 times, hazard ratios=0.93 (95% confidence interval [CI], 0.34-2.57) and 0.95 (95% CI, 0.59-1.53). Although an almost doubled risk of ischemic stroke was observed in those with cannabis use >50 times, this risk was attenuated when adjusted for tobacco usage: hazards ratio=1.47 (95% CI, 0.83-2.56). Smoking 20 cigarettes per day was clearly associated both with strokes before 45 years of age, hazards ratio=5.04 (95% CI, 2.80-9.06), and with strokes throughout the follow-up, hazards ratio=2.15 (95% CI, 1.61-2.88).

    Conclusions - We found no evident association between cannabis use in young adulthood and stroke, including strokes before 45 years of age. Tobacco smoking, however, showed a clear, dose-response shaped association with stroke.

  • 300.
    Fang, Fang
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Fall, Katja
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Valdimarsdottir, Unnur
    Center of Public Health Sciences, University of Iceland, Reykjavík, Iceland.
    Suicide and Cardiovascular Death after a Cancer Diagnosis REPLY2012Inngår i: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 367, nr 3, s. 277-277Artikkel i tidsskrift (Fagfellevurdert)
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