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  • 51.
    Hanberger, Håkan
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Infectious Diseases. Östergötlands Läns Landsting, Centre for Medicine, Department of Infectious Diseases in Östergötland.
    Garcia-Rodriguez, J-A
    Gobernado, M
    Goossens, H
    Nilsson, Lennart
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Struelens, MJ
    French and Portuguese ICU Stud,
    French and Portuguese ICU, Study Groups
    Antibiotic suseptibility among aerobic gram-negative bacilli in intensive care units in 5 European countries. 1999In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 281, p. 67-71Article in journal (Refereed)
  • 52.
    Hanberger, Håkan
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Infectious Diseases. Östergötlands Läns Landsting, Centre for Medicine, Department of Infectious Diseases in Östergötland.
    Nilsson, Lennart
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Intensivvårdsavdelningen en het zon för antibiotikaresistens.1999In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 96, p. 1276-1277Article in journal (Other (popular science, discussion, etc.))
  • 53.
    Hanberger, Håkan
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Infectious Diseases. Östergötlands Läns Landsting, Centre for Medicine, Department of Infectious Diseases in Östergötland.
    Nilsson, Lennart
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Claesson, B
    Kärnell, A
    Larsson, P
    Rylander, M
    Svensson, E
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Sörberg, M
    Sörén, L
    New species-related MIC breakpoints for early detection of development of resistance among Gram-negative bacteria in Swedish intensive care units. 1999In: Journal of Antimicrobial Chemotherapy, ISSN 0305-7453, E-ISSN 1460-2091, Vol. 44, p. 611-619Article in journal (Refereed)
  • 54. Helgesen, F
    et al.
    Andersson, S-O
    Gustavsson, O
    Varenhorst, Eberhard
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Urology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Urology in Östergötland.
    Gobén, B
    Carnock, S
    Carlsson, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Holmberg, L
    Johansson, J-E
    Follow-up prostate cancer patients by on-demand contacts with a specialist nurse.2000In: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 34, p. 55-61Article in journal (Refereed)
  • 55.
    Hensing, Gunnel
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Sickness absence and psychiatric disorder: epidemiological findings and methodological considerations1997Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Psychiatric disorder is an important health problem among people of working age, with consequences for work capacity and sickness absence. Increased knowledge of sickness absence and psychiatric disorder is important for early detection of psychiatric disorders and appropriate rehabilitation measures.

    The occurrence of psychiatric sick-leave (sick-leave spells >7 days) during the years 1985, 1986 and 1987 was analysed in the county of Östergotland (400 000 inhabitants). Women working in male-dominated occupational groups, such as industrial work and as craftsmen, had the highest incidence. Men working in extremely female-dominated occupational groups, social workers and secretaries, had the highest incidence among all men. Occupational groups with an equal sex distribution had the lowest psychiatric sick-leave. More women were sick-listed, but men had more sick-leave days. There were small sex differences in the pattern of sickleave diagnosis.

    The role of psychiatric disorder for sick-leave in all diagnoses (not only psychiatric) was analysed in a stratified sample of 292 women selected from a population-based study of the female general population ofGoteborg (425 000 inhabitants). Women with psychiatric disorders according to a research interview had higher general sickness absence over ten years (1981-1990) both regarding spells and length, also when stratified for age, functional capacity, physical health, marital status, motherhood and socio-economic group. Single women with children did not have any increased sick-leave unless they had a psychiatric disorder. Women with psychiatric disorders also had an increased number of sick-leave days in diseases of the locomotor system, the digestive system and in mental illness. Women with alcohol problems had high sick-leave due to· diseases of the locomotor system. Eighty-nine per cent of the women with psychiatric disorders were sick-listed at least once 1989-1990 but only 16% were sick-listed with mental illness. Unrecognised psychiatric disorder is suggested as an explanation.

    In the methodological studies, critical evaluations of population at risk, sick-leave measures and estimation of person-time were made. Five sick-leave measures; frequency, length, duration, cumulative incidence and incidence rate, were defined and tested in a pilot study. Results from the pilot study showed that women with 1-7 sick-leave days over a year had a better self-reported health than women without any sick-leave and those with more than 8 days. Methods for assessing recurrency, duration and intensity within an epidemiological framework need to be developed.

    In conclusion, psychiatric disorder is an important factor in sickness absence, especially in the number of sick-leave days. The relation between psychiatric morbidity, environmental factors and individual coping behaviour for sickness absence is not clear, and further research is needed. Epidemiological and clinical research from a gender perspective is needed, with a focus on the health care and the social insurance systems. Prevention and rehabilitation programs should focus on the interplay between somatic illness, mental health and the use of health services and the sickness insurance.

  • 56.
    Hermansson, Ann-Charlotte
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    War-wounded refugees: A prospective study of well-being and social integration1996Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis is a prospective study of a culturally heterogenous group of war-wounded refugees, who arrived in Sweden in the late 1980s. The general aim was to describe the situation of warwounded refugees from medical, psychological and social perspectives after arrival and aftertwo years in Sweden and, if possible, to identify factors of significance for their well-being and social integration. The study group comprised 61 war-wounded patients admitted to somatic care. The patients were investigated during hospitalization, shortly after arrival in Sweden, andfollowed up after two years. The data collection covered medical, psychological and social conditions and was performed by personnel on the ward using interviews and rating scales. All data collection was performed with the help of interpreters.

    From clinical experience and a pilot study, it was expected that war-wounded refugees would be specially vulnerable. In addition, the literature on refugee migration and war trauma suggested that war-wounded refugees could be a high risk group for decreased well-being and adjustment difficulties in countries of resettlement. The type of injuries and medical complications observed in the study group were representative of small unit operations of war with poor access to early medical care. Characteristics of the refugees' background were:obstructed or interrupted schooling and working life; long periods of duty as guerillas, or other political activities; a high frequency of death and separation of family members; a high frequency of imprisonment and torture; unfavourable conditions prior to the flight. Thus, the group was heavily burdened with respect to risk factors for decreased well-being after resettlement. However, the quantitative data analysis showed that these factors had not had the influence expected on well-being following arrival or after two years in the host country.Instead, the analysis indicated that life circumstances and events related to the present situation, "here and now", were more important for their well-being and social integration. With respect to labour market attachment, the war-wounded group was found to follow wellthe expected labour market integration process for refugees. On group level, well-being had not improved after two years compared with well-being following arrival. The qualitative findings suggest that in this early stage of migration, the refugees are mourning their losses but are not observably occupied by working through the pre-migration war traumas.

  • 57.
    Hildén, Jan-Olof
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Anti-D antibodies: In vitro tests to predict the severity of hemolytic disease of the newborn1997Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The ability of different in vitro tests to predict the severity of hemolytic disease of the newborn (HDN) has been studied. When properly performed the traditional indirect antiglobulin titers (IAT) on maternal serum can be used to identify a low !iter group ~32 in which the fetus will not suffer from severe hemolytic disease and a high titer group ~1000 where all newboms will be affected. However, in the titer interval64-512, the prediction by IAT titers is poor and additional tests are needed. Widely used are determination of the anti-D concentration in maternal serum and measurement of the bilirubin concentration inamniotic fluid, the latter requiring amniocentesis (AMC). The negative predictive value using bilirubin measurements was 0.53 and using anti-D concentration determination 0.73. This shows that no further information is gained by adding amnion fluid examination if anti-D concentration determination is carried out. Moreover, as invasive procedures such as AMC may be dangerous to the fetus, it is preferable to use measurements of anti-D concentration, requiring only a venous blood sample from the mother.

    AutoAnalyzers have been used for 25 years and are still the main instrument for determining anti-D concentration. As this test is important in the prediction of HDN, there is an obvious need for a modern and reliable method of anti-D quantitation. A new method using flow cytometry was developed and found to give exactly the same classification as the AutoAnalyzer in 89% of cases. In the !I% that differed, the flow cytometer found more relevant cases than the AutoAnalyzer.

    The IgG subclass of the maternal anti-D can be of importance for the outcome in the newborn. To perform IgG subclassing of anti-D, a method using the gel technique was elaborated. Among severely affected cases, two or more subclasses were detected in 77%, compared to 20% in moderately or unaffected cases. When used as a complementary test in borderline cases having anti-D concentrations 0.6-1.4 jlg/mL_, no cases at risk of HDN would be missed and cases where additional invasive procedures must be performed would bereduced by about 60% (in the present series from 22to 9).

    HLA typing revealed the HLA DQB 1 a!lel *020 I to be four times more common in women with severe immunizations than in those with low levels of anti-D. Typing for this allel may be a means of identifying women with a high risk of developing severe immunizations.

  • 58.
    Hojgaard, I
    et al.
    Vastervik Hosp, Dept Surg, S-59381 Vastervik, Sweden Linkoping Univ Hosp, Fac Hlth Sci, Dept Biomed & Surg, Div Urol, S-58185 Linkoping, Sweden Linkoping Univ Hosp, Fac Hlth Sci, Clin Res Ctr, S-58185 Linkoping, Sweden.
    Fornander, Anne-Marie
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of health and environment.
    Nilsson, MA
    Tiselius, HG
    Vastervik Hosp, Dept Surg, S-59381 Vastervik, Sweden Linkoping Univ Hosp, Fac Hlth Sci, Dept Biomed & Surg, Div Urol, S-58185 Linkoping, Sweden Linkoping Univ Hosp, Fac Hlth Sci, Clin Res Ctr, S-58185 Linkoping, Sweden.
    Crystallization during volume reduction of solutions with a composition corresponding to that in the collecting duct: the influence of hydroxyapatite seed crystals and urinary macromolecules1999In: Urological research, ISSN 0300-5623, E-ISSN 1434-0879, Vol. 27, no 6, p. 417-425Article in journal (Refereed)
    Abstract [en]

    To examine the effect of hydroxyapatite (HAP) seed crystals and urinary macromolecules on the crystallization under conditions similar to those in the collecting duct,we evaporated 100 ml samples of salt solutions with an ion composition assumed to correspond to that in the collecting duct without and with HAP seed crystals. The crystallization in seeded solutions was assessed both with and without dialysed urine (dU). After evaporation the number and volume of crystals were recorded in a Coulter Multisizer and the crystal morphology examined with scanning electron microscopy (SEM) and X-ray crystallography. Addition of HAP crystals was apparently followed by an approximately 15-20% increase in heterogeneous nucleation of calcium oxalate (CaOx). In these experiments SEM and X-ray crystallography showed a high percentage of CaOx in the precipitate. In samples reduced to 40-69 ml, addition of dU to the collecting duct solution containing HAP seed resulted in a greater mean (SD) number of crystals, 3895 (1841) in samples with dU and 1785 (583) in samples without. This was mainly explained by an increased mean (SD) number of small crystals. The mean crystal volume was 17.8 (1.1) and 34.3 (9.1) in samples reduced to 40-69 mi with and without dU, respectively. This might reflect the inhibitory effect of dU on the growth and/or aggregation of the CaOx-CaP precipitate or a promoted nucleation resulting in a large number of small crystals. It is concluded that calcium phosphate formed above the collecting duct might induce heterogeneous nucleation of CaOx at lower levels of the renal collecting system, and that urinary macromolecules are powerful modifiers of these processes.

  • 59.
    Hojgaard, I
    et al.
    Vastervik Hosp, Dept Surg, S-59381 Vastervik, Sweden Linkoping Univ Hosp, Fac Hlth Sci, Dept Biomed & Surg, Div Urol, S-58185 Linkoping, Sweden Linkoping Univ Hosp, Fac Hlth Sci, Clin Res Ctr, S-58185 Linkoping, Sweden.
    Fornander, Anne-Marie
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of health and environment.
    Nilsson, MA
    Tiselius, HG
    Vastervik Hosp, Dept Surg, S-59381 Vastervik, Sweden Linkoping Univ Hosp, Fac Hlth Sci, Dept Biomed & Surg, Div Urol, S-58185 Linkoping, Sweden Linkoping Univ Hosp, Fac Hlth Sci, Clin Res Ctr, S-58185 Linkoping, Sweden.
    The effect of pH changes on the crystallization of calcium salts in solutions with an ion composition corresponding to that in the distal tubule1999In: Urological research, ISSN 0300-5623, E-ISSN 1434-0879, Vol. 27, no 6, p. 409-416Article in journal (Refereed)
    Abstract [en]

    The effect of pH changes on the crystallization in solutions with an ion composition assumed to correspond to that of urine in the distal part of the distal tubule was examined by recording the number and volume of crystals with a Coulter Multisizer and by studying the crystal morphology with scanning electron microscopy at different degrees of volume reduction. The experiments were carried out with 100 ml samples at different starting pH values without and with 20% of dialysed urine (dU). The number of crystals increased in response to the volume reduction. In solutions without dU, 100 or more crystals with a diameter in the range 2.4-45 mu m were observed already at a volume reduction of 40% when the initial pH was 7.28. For solutions with a pH of 5.80 and 6.45 the corresponding values were 60% and 80%, respectively. In the presence of dU, an appearance of crystals was recorded at volume reductions of less than 20%. In solutions with an initial pH of 5.80 and 6.45, the crystal number was greater with dU than without, such a difference was not recorded at pH 7.28. In samples containing dU, the mean crystal volume (MCV) varied very little when the sample volume was reduced. The same was found in solutions without dU when the initial pH was 5.80 and 7.28, whereas the MCV was greater in the samples with pH 6.45. Scanning electron microscopy of solutions reduced to 30-40% of the original volume showed that calcium phosphate had formed in solutions with a starting pH of 7.28 and 6.45. In solutions with pH 5.80 calcium oxalate crystals were observed with calcium phosphate.

  • 60.
    Holmberg, Håkan
    et al.
    Filosofiska fakulteten, IHM Linköpings Universitet.
    Carlsson, Per
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of health and environment.
    Kalman, Disa
    Varenhorst, Eberhard
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Urology in Östergötland.
    Impact on health service cost of medical technologies used in management of prostatic cancer1998In: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 32, no 3, p. 195-199Article in journal (Refereed)
  • 61.
    Holmlund, Gunilla
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    The polymorphism of the minisatellite system D2S441999Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The polymorphism of the minisatellite system D2S44 comprises all the polymorphisms typical for a minisatellite sequence; from variation in fragment length caused by a restriction site polymorphism or due to variation in the number of a repeated core sequence, to a core sequence polymorphism comprising four variants and variation in the order in which these variants are iterated in tandem. All these polymorphisms can be utilised in paternity investigations, and analysis of the order of variant repeats in parent-child combinations showed that the D2S44 incompatibilities found are due to a mutation in the parental allele.

    The length polymorphism comprise fragments between 1.4 and 12 kbp, forming two size clusters. Different internal orders of the variant core sequences with a conserved motif at one end of the alleles can be used to group the alleles into three types. Alleles belonging to these types can be considered to be of separate ancestry and are named ancestor alleles of the red, green and yellow type. The red allele type is mainly found in one of the size clusters and the green-type in the other, while the yellow-type alleles are found in both clusters. The presence of different types of ancestor alleles might be the reason for the bimodal distribution.

    Analysis of 30 mutations showed that short alleles gain repeats and long ones lose repeats. The three allele types also have their ·own individual mutation patterns. Mutations in the red- and the green-type alleles are found at on end of the alleles, and in the yellow-type alleles along the whole array. In five mutations with gains of repeats the gains had most probably been generated by intra-allelic duplications. In the remaining gain mutations the origin of the repeats is not known. There is thus no clear evidence for inter-allelic exchange and mutations in the D2S44 system may mainly be caused by an exchange of sequences between sister-chromatides.

    VNTR polymorphism was also found in the chimpanzee but with a tandem iteration of a different non-variant core sequence, positioned upstream relative to the tandem array in man. The gorilla seems not to contain tandem repeats.

    The D2S44 minisatellite system, with a vast number of fragment lengths comprises astonishingly little sequence polymorphism with only a few core sequence variants and only three main allele types compared to other minisatellites. In essence it is a true VNTR marker.

  • 62.
    Jenmalm, Maria
    et al.
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Björkstén, Bengt
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Exposure to cow's milk during the first 3 months of life is associated with increased levels of IgG subclass antibodies to beta-lactoglobulin to 8 years1998In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 102, p. 671-678Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Exposure to allergens early in life influences the development of allergen-specific immune responses. In animal models, the development of tolerance to proteins delivered to the gastrointestinal and the respiratory mucosa is influenced by age and genetic background. Late introduction of cow's milk in infants is associated with slower increase and lower peak IgG antibody responses to milk during early childhood, but the long-term effects have not been investigated, nor is the relation to atopic disease later in life clear.

    OBJECTIVE:

    The purpose of this study was to investigate the development of IgG subclass antibodies to beta-lactoglobulin in relation to early exposure to cow's milk, atopic heredity, and the development of atopic disease.

    METHODS:

    IgG subclass antibodies to beta-lactoglobulin were analyzed by ELISA at birth, at 6 and 18 months, and at 8 years in 96 children followed prospectively.

    RESULTS:

    The levels of IgG subclass antibodies to beta-lactoglobulin peaked in early childhood and then declined up to 8 years of age. Exposure to cow's milk during the first 3 months of life was associated with high IgG subclass antibody levels to beta-lactoglobulin up to 8 years, particularly in children with maternal atopy. Children with atopic symptoms and sensitivity to allergens often had high levels of IgG4 antibodies to beta-lactoglobulin at 8 years of age, even if they were not exposed to cow's milk during the first 3 months of life. Furthermore, atopic dermatitis was associated with high levels of IgG subclass antibodies to beta-lactoglobulin in early childhood.

    CONCLUSIONS:

    IgG subclass antibody levels to milk peak during early infancy, with particularly high levels in children with atopic dermatitis, and decline thereafter. Exposure to cow's milk during early infancy has long-lasting effects on the humoral antigen-specific responses, indicating less effective tolerance-inducing mechanisms in the intestinal mucosa during the first months of life.

  • 63.
    Jones, A Wayne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry.
    Hylén, L
    Svensson, E
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Helander, A
    Storage of specimens at 4°C or addition of sodium fluoride (1%) prevents formation of ethanol in urine inoculated with Candida albicans1999In: Journal of Analytical Toxicology, ISSN 0146-4760, E-ISSN 1945-2403, Vol. 23, p. 333-336Article in journal (Refereed)
  • 64. Kaminskas, A
    et al.
    Ziedén, Bo
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Elving, B
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Kristenson, Margareta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Abaravicius, A
    Bergdahl, Björn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Olsson, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Kucinskiene, Z
    Adipose tissue fatty acids in men from two populations with different cardiovascular risk - the LiVicordia study.1999In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 59, p. 227-232Article in journal (Refereed)
  • 65. Karpati, F
    et al.
    Giedraitis, V
    Thore, M
    Lindman, R
    Monstein, Hans-Jurg
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Hjelte, L
    Jonasson, Jon
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Arbitrarily primed PCR and sequencing of 16S rDNA for epidemiological typing and species identification of Burkholderia cepacia isolates from Swedish patients with cystic fibrosis reveal genetic heterogeneity2001In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 109, no 5, p. 389-400Article in journal (Refereed)
    Abstract [en]

    To investigate whether arbitrarily primed (AP)-PCR and/or 16S rDNA sequencing could be used as rapid methods for epidemiological typing and species identification of clinical Burkholderia isolates from patients with cystic fibrosis (CF), a total of 39 clinical B. cepacia isolates, including 33 isolates from 14 CF patients, were fingerprinted. ERIC-2 primer was used for AP-PCR. The AP-PCR clustering analysis resulted in 14 different clusters at a 70% similarity level. The AP-PRC patterns were individual despite considerable similarities. To sequence rDNA, a broad-range PCR was applied. The PCR product included four variable loops (V8, V3, V4 and V9) of the 16S ribosomal small subunit RNA gene. The multiple sequence alignment produced 12 different patterns, 5 of them including more than one isolate. Heterogeneity of the bases in the V3 region, indicating the simultaneous presence of at least two different types of 16S rRNA genes in the same cell, was revealed in 10 isolates. Most of the CF patients were adults who had advanced disease at follow-up. Both the sequencing and the AP-PCR patterns revealed genetic heterogeneity of isolates between patients. According to the results obtained, AP-PCR could advantageously be used for epidemiological typing of Burkholderia, whereas partial species identification could effectively be obtained by sequencing of the V3 region of the 16S RNA gene.

  • 66.
    Kjellman, Görel
    et al.
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Öberg, Birgitta
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Hensing, Gunnel
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    A 12-year follow-up of subjects initially sicklisted with neck/shoulder or low back diagnoses2001In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 6, no 1, p. 52-63Article in journal (Refereed)
    Abstract [en]

    Background and Purpose Neck/shoulder and low back pain are common in the Western world and can cause great personal and economic consequences, but so far there are few long term follow-up studies of the consequences of back pain, especially studies that separate the location of back pain. More knowledge is needed about different patterns of risk factors and prognoses for neck/shoulder and low back pain, respectively, and they should not be treated as similar conditions. The aim of the present study was to investigate possible long-term differences in neck/shoulder and low back symptoms, experienced over a 12-year period, with regard to work status, present health, discomfort and influence on daily activities.

    Method A retrospective cohort study of individuals sicklisted with neck/shoulder or low back diagnoses 12 years ago was undertaken. Included were all 213 people who, in 1985, lived in the municipality of Linköping, Sweden, were aged 25–34 years and who had taken at least one new period of sickleave lasting >28 days with a neck/shoulder or low back diagnosis. In 1996, a questionnaire was mailed to the 204 people who were still resident in Sweden (response rate 73%).

    Results Those initially absent with neck/shoulder diagnoses rated their present state of discomfort as worse than those sicklisted with low back diagnoses. Only 4% of the neck/shoulder group reported no present discomfort compared with 25% of the low back group. Notably, both groups reported the same duration of low back discomfort during the last year, which may indicate a higher risk for symptoms in more than one location for subjects with neck/shoulder problems.

    Conclusions Individuals with sickness absence of more than 28 days with neck/shoulder or low back diagnoses appear to be at high risk of developing long-standing symptoms, significantly more so for those initially having neck/shoulder diagnoses.

  • 67.
    Kohli, S
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Noorling Brage, H
    Löfman, O
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Childhood leukaemia in areas with different radon levels: A spatial and temporal analysis using GIS2000In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 54, no 11, p. 822-826Article in journal (Refereed)
    Abstract [en]

    Objectives-To evaluate the relation between exposure to ground radon levels and leukaemia among children using existing population and disease registers. Design-Ecological correlation study. Setting-The county of Ostergotland in Sweden. Methods-Every child born in the county between 1979 and 1992 was mapped to the property centroid coordinates by linking addresses in the population and property registers. Population maps were overlaid with radon maps and exposure at birth and each subsequent year was quantified as high, normal, low or unknown. This was analysed with data from the tumour registry. Standardised mortality ratios (SMRs) were calculated using the age and sex specific rates for Sweden for the year 1995. Results-90 malignancies occurred among 53 146 children (498 887 person years) who formed the study population. SMRs for acute lymphatic leukemia (ALL) among children born in high, normal and low risk areas were 1.43, 1.17 and 0.25 respectively. The relative risk for the normal risk group and high risk group as compared with the low risk group was 4.64 (95% CI 1.29, 28.26) and 5.67 (95% CI 1.06, 42.27). The association between ALL and continued residence at normal or high risk areas showed a similar trend. No association between radon risk levels and any other malignancy was seen. Conclusion-Children born in and staying at areas where the risk from ground radon has been classified as low are less likely to develop ALL than those born in areas classified as normal and high risk.

  • 68. Kragsbjerg, P
    et al.
    Fredlund, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    The effects of live Streptococcus pneumoniae and tumor necrosis factor-alpha on neutrophil oxidative burst and beta2-integrin expression.2001In: Clinical Microbiology and Infection, ISSN 1198-743X, E-ISSN 1469-0691, Vol. 7, p. 125-129Article in journal (Refereed)
  • 69.
    Kristenson, Margareta
    Linköping University, Department of health and environment. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med. Linköping University, Faculty of Health Sciences.
    The LiVcordia Study: Possible causes for the differences in coronary heart disease mortality between Lithuania and Sweden1998Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: In recent decades coronary heart disease (CHD) mortality has declined in Western Europe and increased in Central and Eastern Europe. A large difference in CHD mortality has developed and the causes are not known. Lithuania and Sweden had similar CHD mortality rates for middle-aged men twenty years ago but in 1994 this mortality was four times higher in Lithuania than in Sweden. Also within countries CHD mortality is higher in low socioeconomic groups.

    Aim of the study: The LiVicordia (Linköping-Vilnius-coronary-artery-disease-risk-assessment) study aimed at identifying possible explanations for the different CHD mortality rates in the two countries.

    Method: This cross-sectional study concomitantly compared 150 randomly sampled 50-year-old men in each of the cities Vilnius, Lithuania and Linköping, Sweden from October 1993 nntil March 1995 using identical, standardised methodology. Investigations included a broad range of traditional and psychosocial risk factors for CHD, measures of oxidative stress, a standardised laboratory stress test and ultrasound measures of Peripheral atherosclerosis.

    Results: The differences found in traditional risk factors for CHD were small. Systolic blood pressure (SBP) was higher in Vilnius men, smoking was similar and plasma LDL cholesterol levels higher in Linköping men. Lower serum levels of the lipid soluble antioxidant vitamins carotene, lycopene and ytocopherol were found in Vilnius men, and also a higher susceptibility of LDL to oxidation in vitro. An unfavourable pattern of psychosocial risk factors for CHD: job strain, social isolation, depression and vital exhaustion characterised Vilnins men, who also showed an attenuated cortisol response to the laboratory stress test. This stress response has earlier been shown in states of chronic stress; loss of dynamic capacity to respond to new demands may be a predisposing factor for disease. Vilnius men had more peripheral atherosclerosis; thicker intima media, more and larger plaques and greater stiffness. Measures of atherosclerosis related to SBP, smoking, LDL cholesterol arrl P-carotene. The same unfavourable profile of risk factors for CHD, which characterised Vilnius men, was also found in underprivileged groups withip the cities. There were few differences in traditional risk factors.

    Conclusions: Thus, based on our survey on risk factors for CHD, it can be stated that traditional risk factors seem not to explain the different CHD mortality rates between Lithuania and Sweden. Possible alternative explanations are psychosocial strain and oxidative stress. These factors were also found among men in underprivileged groups within the cities. Therfore the influence of the risk factors studied may be relevant also for socioeconomic inequalities in CHD mortality within countries.

  • 70.
    Kristenson, Margareta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Jarkman, Kristina
    Wingren, Gun
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine.
    Göransson, Anne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Wärnberg Gerdin, E
    Vang, Johannes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Häggström, Anita
    Problembaserad inlärning som modell för utbildning i folkhälsovetenskap.2000In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 2, p. 154-159Article in journal (Other academic)
  • 71.
    Kristenson, Margareta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Kucinskiene, Z
    Bergdahl, Björn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Tagesson, C
    Orth-Gomer, K
    Olsson, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Self-rated health and biological mechanisms: experiences from the LiVicordia study.2000In: Self-rated health in a European perspective / [ed] Peter Nilsson and Kristina Orth-Gomér, Linköping: Linköpings universitet , 2000, p. 167-175Chapter in book (Other academic)
  • 72.
    Kristenson, Margareta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Kucinskiene, Zita
    Vilnius, Lithuania.
    Bergdahl, Björn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Orth-Gomér, Kristina
    Karoliska inst Stockholm.
    Risk factors for coronary heart disease in different socioeconomic groups of Lithuania and Sweden - The LiVicordia study2001In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 29, no 2, p. 140-150Article in journal (Refereed)
    Abstract [en]

    Aims: Lithuanian middle-aged men have a fourfold higher risk for coronary heart disease (CHD) mortality compared with Swedish men. In Sweden, CHD mortality is twice as high in blue- compared with white-collar workers. Whether the same risk factors that characterized Lithuanian men, compared with Swedish men, could be found in low socioeconomic groups within the cities was investigated. Methods: The LiVicordia study compared both traditional and new possible risk factors for CHD among 150 50-year-old men in Link÷ping, Sweden and Vilnius, Lithuania. A comparison was made of the prevalence of these risk factors in high and low socioeconomic groups within the cities and, after controlling for the city, variations across socioeconomic groups in the total sample. Results: Small differences were found in traditional risk factors between cities. However, Vilnius men were shorter, had lower serum levels of antioxidant vitamins, more psychosocial strain, and lower cortisol response to a standardized laboratory stress test. These characteristics were also found among men in low social classes in both cities. In linear regression models, short stature, low serum ▀-carotene, low social integration, coping and self-esteem, high vital exhaustion, high baseline and low cortisol response to stress were related to low social class. Conclusions: The same set of risk factors, mainly relating to oxidative and psychosocial stress, that characterized Vilnius men was also found in men in low social classes within the cities. The results suggest that a common set of risk factors may help to explain health differences both between and within countries. ⌐ Taylor & Francis 2001.

  • 73.
    Kristenson, Margareta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Lassvik, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Bergdahl, Björn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Kucinskiene, Z
    Aizieniene, L
    Ziedén, Bo
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Schäfer Elinder, Liselott
    Olsson, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Ultrasound determined carotid and femoral atherosclerosis in Lithuanian and Swedish men: The LiVicordia study2000In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 151, no 2, p. 501-508Article in journal (Refereed)
    Abstract [en]

    Coronary heart disease mortality is four times higher in Lithuanian compared to Swedish middle-aged men. Using the same equipment (Acuson XP10 with 5 MHz linear transducer) and staff, we compared the amount of atherosclerosis in carotid and femoral arteries in 100 randomly sampled 50-year-old men in each of the cities Vilnius, Lithuania and Linköping, Sweden. Atherosclerotic plaques were more abundant in Vilnius men compared to Linköping men (53 versus 28% in the common carotid artery, 73 versus 37% in the common femoral artery, P<0.001 for both). Plaques were thicker and more extended in arteries of Vilnius men, and an ultrasound atherosclerosis score was higher in both carotid and femoral arteries (P<0.001 for all). More Vilnius men had a maximal intima-media thickness of the common femoral artery above 1 mm (P<0.005). Stiffness in the common carotid artery was higher in Vilnius men (P<0.001). In a linear regression model of the pooled material, after adjustment for city was made, smoking, systolic blood pressure, low density lipoprotein cholesterol and β-carotene (inversely) significantly contributed to a high total ultrasound score (r2=0.32). These findings show that the higher coronary mortality noted in Lithuanian men goes together with a higher prevalence of early peripheral atherosclerosis.

  • 74.
    Kristjansson, I
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Faresjö, Tomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Lionis, C
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Nosratabadi, Ali Reza
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine.
    Gudmundsson, K
    Halling, A
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Tagesson, Christer
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Pain and Occupational Centre, Occupational and Environmental Medicine Centre.
    Assessment of aluminium in human deciduous teeth2000In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 16, no 3, p. 231-233Article in journal (Refereed)
    Abstract [en]

    The possible role of environmental aluminium exposure in the pathogenesis of various diseases has highlighted the need for methods by which the long-term exposure to aluminium can be assessed. Therefore, we have further developed a method to determine aluminium in human deciduous teeth and applied this method for studying populations in Sweden, Crete and Iceland.

  • 75.
    Kälvegren, Hanna
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Majeed, Meytham
    Linköping University, Department of health and environment.
    Bengtsson, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Pharmacology. Linköping University, Faculty of Health Sciences.
    Chlamydia pneumoniae binds to platelets and triggers P-selectin expression and aggregation: A causal role in cardiovascular disease?2003In: Arteriosclerosis, Thrombosis and Vascular Biology, ISSN 1079-5642, E-ISSN 1524-4636, Vol. 23, no 9, p. 1677-1683Article in journal (Refereed)
    Abstract [en]

    Objective - Evidence linking Chlamydia pneumoniae to atherosclerotic cardiovascular disease is expanding. Platelets are considered to play an essential role in cardiovascular diseases, however, so far platelets have not been associated with an infectious cause of atherosclerosis. This study aims to clarify the interaction between Cpneumoniae and platelets and possibly present a novel mechanism in the pathogenesis of atherosclerosis.

    Methods and Results - The effects of C pneumoniae on platelet aggregation and secretion were assessed with lumiaggregometry, and the ability of C pneumoniae to bind to platelets and stimulate expression of P-selectin was analyzed with flow cytometry. We found that Cpneumoniae, at a chlamydia:platelet ratio of 1:15, adheres to platelets and triggers P-selectin expression after 1 minute and causes an extensive aggregation and ATP secretion after 20 minutes of incubation. Inhibition of glycoprotein IIb/IIIa with Arg-Gly-Asp-Ser or abciximab markedly reduced C pneumoniae-induced platelet aggregation. Exposure of C pneumoniae to polymyxin B, but not elevated temperature, abolished the stimulatory effects on platelet activation, suggesting that chlamydial lipopolysaccharide has an active role. In contrast, other tested bacteria had no or only moderate effects on platelet functions.

    Conclusion - Our findings demonstrate a new concept of how C pneumoniae activates platelets and thereby may cause atherosclerosis and thrombotic vascular occlusion.

     

  • 76. Lalitha, MK
    et al.
    Bäärnhielm, M
    Kihlström, Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Kronvall, G
    Epidemiological typing of Streptococcus pneumoniae from various sources in Sweden and India using Box A PCR fingerprinting.1999In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 107, p. 389-394Article in journal (Refereed)
  • 77.
    Ledent-Semple, Elisabeth
    Linköping University, Department of health and environment. Linköping University, Department of Biomedicine and Surgery. Linköping University, Faculty of Health Sciences.
    A study of factors influencing the quality of blood products during preparation, storage and filtration2001Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The quality of a cell concentrate to be transfused is dependent on the method of preparation and the storage conditions of the blood products. The aim of this study was to determine, compare and evaluate factors influencing the quality of platelet and erythrocyte concentrates. The influence of the method of preparation on platelet concentrates from whole blood and on leukocyte depletion by filtration of erythrocyte concentrates was studied. In addition, the influence of storage on leukocyte depletion by filtration of platelet and erythrocyte concentrates was investigated.

    The method of preparation of platelet concentrates from whole blood influenced the release from the platelet α-granules. A significant increase in the release was found in the concentrates prepared from platelet-rich plasma compared with buffy coat. If the buffy coat was allowed to rest for <4 hours before centrifugation, this difference was significant until day 3 of storage. The ability of platelets to stimulate the growth of fibroblasts followed a similar course and decreased during preparation and storage.

    The method of preparation of erythrocyte concentrates was shown to influence the outcome of leukocyte depletion by filtration. When hard spun, buffy coat depleted, concentrates were used, the number of leukocytes found in the filtrate was significantly higher compared with units that had been supplemented with an additional 5 or 10 ml of plasma. The flow rate during filtration and temperature of the unit was also shown to have an influence on the outcome on the number of leukocytes post filtration.

    The storage time of both erythrocyte and platelet concentrates resulted in significant differences in the number ofleukocytes found after leukocyte depletion by filtration. A short storage time of erythrocyte concentrates was found to give a higher number of leukocytes after filtration compared with a longer storage time. This was in contrast to platelet concentrates where a filtration just after preparation, i.e. no storage time, gave better leukocyte depletion compared with 5 days of storage.

    The distribution ofleukocyte subsets was also changed significantly by filtration. Comparing the pre- and post-filtration percentages of subsets in platelet concentrates, we found a lower percentage of T-lymphocytes and a higher percentage of B-lymphocytes and monocytes post filtration. In conclusion, the method of preparation of cell concentrates and the storage time have a substantial impact on the properties of the final product. Standardized and controlled procedures are of great importance in making optimal blood products.

  • 78.
    Levin, Lars-Åke
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Bergqvist, D
    Cost effectiveness of desirudin compared with a low molecular weight heparin in the prevention of deep vein thrombosis after total hip replacement surgery2001In: PharmacoEconomics (Auckland), ISSN 1170-7690, E-ISSN 1179-2027, Vol. 19, no 5 II, p. 589-597Article in journal (Refereed)
    Abstract [en]

    Objectives: This prospective pharmacoeconomic study analyses and discusses the cost effectiveness (expressed as cost per life-year gained) of desirudin in comparison with a low molecular weight heparin (LMWH), enoxaparin, as prophylaxis against deep vein thrombosis (DVT) in total hip replacement. Methods: The cost effectiveness was analysed on the basis of results from a clinical trial that compared the recombinant hirudin, desirudin, with the LMWH, enoxaparin. The trial results regarding the incidence of DVT are included together with epidemiological data in a decision tree, simulating long term cost effectiveness of patients undergoing elective hip replacement. The model includes Markov processes simulating patients up to the age of 85 years, including the costs of DVT-related long term complications. Results: The average total thrombosis-related cost per patient under prophylactic therapy with enoxaparin is 7022 Swedish kronor (SEK) compared with SEK7497 when using desirudin (1998 values). The total costs with desirudin are 7% higher. Prophylaxis with desirudin in those patients undergoing elective hip replacement surgery adds, on average, 7 days of life per patient when compared with treatment using enoxaparin. This is equivalent to 1.91 additional years of life per 100 patients treated. The incremental cost-effectiveness ratio of prophylaxis with desirudin in patients undergoing elective hip replacement surgery is SEK24 864 per life-year gained in comparison with enoxaparin. Conclusion: The present study demonstrates that prophylactic therapy with desirudin is a cost-effective approach for the prevention of DVT in patients undergoing total hip replacement.

  • 79.
    Lindell, Charlotta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Svedin, CG
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, CPS - Centrum för psykiatri och samhällsmedicin, BUP - Barn- och ungdomspsykiatri.
    Physical child abuse in Sweden: A study of police reports between 1986 and 19962001In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 36, no 3, p. 150-157Article in journal (Refereed)
    Abstract [en]

    Background: This study aims at investigating physical child abuse in Sweden during 1986-1996, a period when alarm was being raised about an increased number of police reports on physical child abuse. The study focuses on abuse committed by a parent or carer and aims at analyzing the victim and the perpetrator, family environment, injuries and judicial consequences of physical abuse. Method: All police reports on physical child abuse (0-14 years old) in a designated police district in Sweden during 1986-1996 were examined, as well as any judicial proceedings that followed. Results: Our research yielded three major findings. Firstly, a large part of the increased number of police reports had to do with violence outside the family: 145 children (0.5 per 1000 children) were found abused within the families, by a parent or a carer. Secondly, there was a tendency toward males abusing boys and females abusing girls, and the biological father was the most frequent suspected perpetrator. Thirdly, 20% of the police reports led to prosecutions, and the investigations were time consuming. Known risk factors for physical abuse, such as unemployment, violent spouse relations, substance and drug abuse and poor mental health were found in several families, often among the prosecuted perpetrators. When examining incidence of physical abuse, Sweden was comparable to the other Scandinavian countries, where legislation and social context are similar. Conclusions: The numbers of physically abused children that have been reported to the police in Sweden has increased during the investigated period. Familiar risk factors are present in our study, accompanied by new findings, such as, for instance, a gender preference towards the abuse victim.

  • 80.
    Lindqvist, Kent
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Towards community-based injury prevention: the Motala model1993Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In the Swedish County of Östergötland a comprehensive health policyprogramme including accidents was decided by the health authorities in 1988. An accident prevention programme (the "Motala Accident Prevention Study") had already started with an epidemiological analysis of accidents in the community. The Motala study is based on Bracht and Kingsbury's five-stage model of community development: community analysis, design and initiation,  implementation, maintenance, and reassessment.

    The scientific reporting of the Motala study in this thesis is based on selected parts of the five-stage model and is grouped into reports from the community analysis (the main study) and an intervention study. The aim was to describe the panorama of accidents, their causes and effects in a defined community, and to account for the economic consequences of these accidents. A secondary aim was to provide an epidemiological basis for a sports accident prevention programme and out of that design such a programme, and to evaluate the effects of loan programmes on infant car restraints. In forthcoming papers other parts of the different stages of the model will be presented.

    Total population injury surveillance was performed in an area with apopulation of over 41,000. All accidents (N= 4,926) occurring within a 12-month period and requiring medical care were noted, giving a ratio of 118.9 per 1,000. They consisted of accidents in the home (35.0%), sports accidents (18.9%), accidents at work (13.7%), traffic accidents (12.8%), and "other" accidents (19.5%). Half of the victims covered by health insurance were put on sick leave in connection with the accident, and 12.6% of these were admitted to hospital. The age-group 13-19 years, and men between 20-29 years of age, showed the highest accident rate. The total cost to society for people in the labour force, including treatment cost and production loss, was 103.4 million SEK (15.7 million USD). The cost to society of uninsured people for time lost from "normal activities" because of an accident was estimated at 43.1 million SEK (6.5 million USD). There are three important conclusions with regard to the economic consequences of accidents. Firstly, it appears important to assess not only the productive working time of the injured people, but also other time, in which normal activities are restricted. Secondly, the findings reveal the conflict between the utilitarian and the dutybased ethical basis of health care activities. Thirdly, the results show the need for well-controlled studies with alternatives to show the effects of different actions.

  • 81. Lindskog, S
    et al.
    Zetterström, Olle
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Medicine, Allergy Centre UHL.
    Kamkar, A
    Bergman, E
    Forsgardh, A
    Blomlöf, L
    Skin-prick test for severe marginal periodontitis.1999In: The international journal of periodontics & restorative dentistry, ISSN 0198-7569, E-ISSN 1945-3388, Vol. 19, p. 373-377Article in journal (Refereed)
  • 82.
    Locht, H
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Rheumatology.
    Skogh, Thomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Rheumatology. Östergötlands Läns Landsting, Centre for Medicine, Department of Rheumatology in Östergötland.
    Kihlström, Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Anti-lactoferrin antibodies and other types of anti-neutrophil cytoplasmic antibodies (ANCA) in reactive arthritis and ankylosing spondylitis. 1999In: Clinical and Experimental Immunology, ISSN 0009-9104, E-ISSN 1365-2249, Vol. 117, p. 568-573Article in journal (Refereed)
  • 83.
    Lundin, Björn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, CPS - Centrum för psykiatri och samhällsmedicin, BUP - Barn- och ungdomspsykiatri.
    Croner, Stefan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Barn.
    Barnmisshandel genom förfalskning av symtom.2001In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 98, p. 2302-2311Article in journal (Other academic)
  • 84.
    Lundqvist, G
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Öjehagen, A
    Childhood sexual abuse. An evaluation of a two-year group therapy in adult women.2001In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 16, p. 64-67Article in journal (Refereed)
  • 85.
    Majeed, Meytham
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Medical Microbiology.
    Krause, K-H
    Clark, RA
    Kihlström, Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Stendahl, Olle
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Medical Microbiology.
    Localization of intracellular Ca2+ stores in HeLa cells during infection with Chlamydia trachomatis. 1999In: Journal of Cell Science, ISSN 0021-9533, E-ISSN 1477-9137, Vol. 112, p. 35-44Article in journal (Refereed)
  • 86.
    Marcusson, Agneta
    et al.
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL. Östergötlands Läns Landsting, Sinnescentrum.
    List, Thomas
    Östergötlands Läns Landsting.
    Paulin, Gunnar
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL. Östergötlands Läns Landsting, Sinnescentrum.
    Åkerlind, Ingemar
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Reliability of a multidimensional questionnaire for adults with treated complete cleft lip and palate2001In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 35, no 3, p. 271-278Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to evaluate the reliability of a multidimensional questionnaire for Swedish adults with treated complete unilateral or bilateral cleft lip and palate (CLP). The questionnaire was designed to be used in the evaluation of adults with treated CLP after treatment. Before any conclusions were drawn from the results of the study we assessed the test-retest reliability of the questionnaire. The questionnaire included 168 questions and assessed the following domains: aesthetics, functions associated with CLP, satisfaction with treatment and perceived need for treatment, quality of life, depression and non-specific physical symptoms, body image, and jaw function. The subjects answered the questionnaire twice at a 2-3-week interval. Sixty-one adults (38 men, 23 women) mean age 24 years (range 20-29) participated in the study. The response rate for the questionnaire was acceptable at 75%. The test-retest reliability varied among the different domains. The reliability of questions regarding aesthetics, functions associated with CLP, and treatment satisfaction was good to excellent (intraclass correlation coefficient (ICC) = 0.51 to 0.89). Good to excellent (ICC = 0.61 to 1.0) reliability was also found for the quality of life in various life domains and the wellbeing scales. The reliability of the body image scale was moderate (kappa = 0.43-0.60) for most items and lower than that of other scales used in this study. The reliability of the mean depression symptom score (ICC = 0.93) and the mean non-specific physical symptoms score (ICC = 0.85) were excellent. The reliability of the mandibular function impairment was good (ICC = 0.67). The conclusion of the study is that an overall reliability was good for the multidimensional questionnaire.

  • 87. Moisander, P.A.
    et al.
    Edston, Erik
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of health and environment.
    Torture and its sequel - A comparison between victims from six countries2003In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 137, no 2-3, p. 133-140Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to compare torture victims from six different nations and analyse differences and similarities. From the files of the Centre for Trauma Victims in Stockholm (KTC), 160 patients were selected: 53 patients from Bangladesh, 21 from Iran, 16 from Peru, 24 from Syria, 25 from Turkey, and 21 from Uganda. The data was classified into: (i) information about social conditions and circumstances pertaining to alleged torture, (ii) type of trauma and torture methods, and (iii) acute and late sequel to torture. Descriptive and non-parametric statistics were used in the analyses. There was a strong male dominance in all but the Ugandan group where 43% were women. The majority in all but the Turkish group had college exams and/or university studies. Over 84% were members of a political organisation except in the Iranian and Syrian groups, where more than 40% had no political affiliation. The majority in all groups had travelled to Sweden alone to apply for asylum, but most refugees from Turkey, Iran, and Syria had close relatives already living in Sweden. The stories of circumstances and torture methods were similar within each group but differed a great deal between groups. Typically, in Bangladesh, Peru, and Turkey, the periods under arrest were short: from a few hours to 3 days. In Iran, Uganda, and Syria, the time in custody varied from several months to several years. A prison sentence preceded by trial was common only in Iran. Many patients, especially from Bangladesh and Turkey, had been arrested several times. Sensory deprivation by isolation and blindfolding was common in all countries except Uganda and Peru. Beating with fists, sticks, truncheons, etc. were reported in 100% in every group. In Bangladesh, police batons (lathi) were used more commonly than in any other group. Whipping with electric cords occurred frequently only in Iran and Syria. Rape was most often reported among the Ugandans. Genital torture was frequently alleged by patients from Bangladesh and Turkey. Suspension was common in all countries except for Uganda. Falaka, i.e. beating of the soles, and electric torture were common (>60%) in Bangladesh, Iran, Syria, and Turkey. Sharp injuries inflicted with knives and bayonets were often seen among the Bangladeshi and Ugandans. Burning injuries due to cigarettes were commonly seen only in patients from Bangladesh. Some methods were found to be almost exclusive for each country: "water treatment" (Bangladesh), the "tyre" (Syria), " telephono" and "submarino" (Peru). The sequel of torture differed in some respects between groups. Fractures were more common among Iranians. Patients from Uganda and Bangladesh had numerous scars. Subjectively reported symptoms were most frequent among Bangladeshi, especially joint pain and ear, nose, and throat symptoms and least frequent among Ugandans. PTSD diagnosed on the basis of a psychiatric interview and psychological tests was found in 69-92% of patients in all groups. The study shows significant differences between countries regarding circumstances, torture methods, and sequel to torture. This knowledge is of value to forensic specialists documenting alleged torture and essential for fair and valid forensic statements. © 2003 Elsevier Ireland Ltd. All rights reserved.

  • 88.
    Monstein, Hans-Jurg
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Ahrne, A
    Molin, G
    Nikpour-Badr, S
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Jonasson, Jon
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Identification of enterococcal isolates by temperature gradient gel electrophoresis and partial sequence analysis of PCR-amplified 16S rDNA variable V6 regions2001In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 109, no 3, p. 209-216Article in journal (Refereed)
    Abstract [en]

    Based on partial sequence analysis of PCR-amplified 16S rDNA variable V6 regions of 14 enterococcal type strains, Enterococcus faecalis, Enterococcus mundtii, Enterococcus gallinarum, Enterococcus avium, Enterococcus raffinosus and Enterococcus saccharolyticus showed characteristic sequence motifs which made it possible to separate them into six individual species lines. Furthermore, two species cluster groups could be identified, including (i) Enterococcus faecium, Enterococcus durans, Enterococcus hirae, Enterococcus malodoratus, and (ii) Enterococcus casseliflavus/Enterococcus flavescens, Enterococcus pseudoavium, Enterococcus dispar and Enterococcus sulfureus. There were identical DNA sequences in the V6 region within each group. Temporal temperature gradient gel electrophoresis (TTGE) of the PCR products from 16 type strains, 12 enterococcal reference strains and 8 clinical isolates revealed that a single nucleotide divergence in DNA sequences was sufficient for separation, identification and division of the studied enterococcal strains into corresponding TTGE profiles. It was concluded that partial DNA sequence analysis and TTGE profiling of PCR-amplified 16S rDNA variable V6 regions provide useful tools for the identification of clinically important Enterococcus spp.

  • 89.
    Monstein, Hans-Jurg
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    de la Cour, CD
    Jonasson, Jon
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Probing 23S ribosomal RNA cleavage sites in coccoid Helicobater pylori.2001In: Helicobacter, ISSN 1083-4389, E-ISSN 1523-5378, Vol. 6, no 2, p. 100-109Article in journal (Refereed)
    Abstract [en]

    Background. Previous studies have revealed that extensive nonrandom fragmentation of ribosomal RNA occurs during conversion of Helicobacter pylori to the coccoid form. The 16S rRNA fragmentation has been characterised in some detail. The aim of the present study was to define corresponding cleavage-sites in the 3'-half of the 23S rRNA molecule. Materials and Methods. Northern blot analysis using 23S rRNA specific antisense riboprobes and a 5'-end- labelled oligonucleotide probe was used to analyse the 23S rRNA fragmentation pattern in coccoid H. pylori type strain CCUG 17874T and H. pylori 26695, for which the genome has been sequenced. A double- stranded cDNA-dependent (ds-cDNA) primer- extension analysis technique using 23S rRNA ds-cDNA and a primer targeting the vicinity of the peptidyl-transferase centre was used to determine cleavage sites at the nucleotide level. Results. We report here the mapping of putative cleavage sites within domains IV and V, enclosing the peptidyl transferase centre, in the 3'-half of the 23S rRNA molecule. Three cleavage sites were located in domain IV. Two other cleavage sites were located in the peptidyl transferase centre, and one presumptive multiple-break site between helices 77 and 78 in domain V. The DNA motifs were different from the postulated A + U rich single-strand cleavage sites recognised by RNase E, which has been implicated in rRNA degradation in Escherichia coli. Conclusions. The present analysis suggests that a hitherto unknown mechanism is responsible for the nonrandom fragmentation of rRNA in coccoid H. pylori, which may have important consequences for the growth, and survival of the bacterium.

  • 90.
    Monstein, Hans-Jurg
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Johansson, Yvonne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Jonasson, Jon
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Detection of vancomycin resistance genes combined with typing of Enterococci by means of multiplex PCR amplification and multiple primer DNA sequencing2000In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 108, no 1, p. 67-73Article in journal (Refereed)
    Abstract [en]

    A multiplex PCR assay for the detection of vancomycin resistance (van) genes in enterococci was established. Primers targeting the 16S rRNA gene were included in the reaction mixture. Multiple-primer DNA sequencing of the PCR products provided species identification through partial nucleotide sequences of 16S rRNA genes, as well as confirmation of the correct identification of vanA, vanB, vanC-1, and vanC-2/3 genotypes. Thirty-nine enterococcal clinical isolates and type strains were examined for the presence of vancomycin resistance determinants. Twelve other isolates from a clinical reference collection (some of them having vanA, vanB, vanC-1, or vanC-2/3 genotypes) were used as controls. Hybridization and partial DNA sequence analysis of multiplex PCR products revealed that none of the clinical isolates had a vanA genotype and only one had a vanB genotype, vanC- 1 was found in three clinical isolates, and vanC-2/3 in one. Results obtained with the reference and type strains were in agreement with earlier results.

  • 91.
    Monstein, Hans-Jurg
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Jonasson, Jon
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Differential virulence-gene mRNA expression in coccoid forms of Helicobacter pylori2001In: Biochemical and Biophysical Research Communications - BBRC, ISSN 0006-291X, E-ISSN 1090-2104, Vol. 285, no 2, p. 530-536Article in journal (Refereed)
    Abstract [en]

    Controversy exists whether coccoid forms of Helicobacter pylori maintain transcriptional and translational processes. The aim of the present study was to investigate mRNA levels in coccoid H. pylori and, if possible, to establish a correlation with the state of nonrandom fragmentation of rRNA in those cells. For that purpose, UreA, UreI, CagA, VacA, SodB, and Hsp60 mRNA levels in bacillary and coccoid forms of H. pylori CCUG 17874T, H. pylori 26695, and H. pylori J99, respectively, were studied by means of a multiplex reverse-transcription PCR assay and Southern blot analysis of the RT-PCR-amplified products. Nonrandom fragmentation of 23S rRNA was assessed by a recently described assay. Virulence-gene-derived mRNA transcripts were visualized in DNase I-treated RNA preparations. All three strains revealed the presence of different mRNA patterns in bacillary and coccoid forms. Putative promoter sequences similar to the consensus Escherichia coli -10 hexamer TATAAA box were present in all six virulence genes analyzed. Moreover, the decrease seen in mRNA levels during conversion into the coccoid form appeared to correlate with the 23S rRNA nonrandom fragmentation pattern. The present data indicate that modulation of virulence-gene expression is differently regulated in bacillary and coccoid H. pylori.

  • 92.
    Monstein, Hans-Jurg
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Nikpour-Badr, S
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Jonasson, Jon
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Rapid molecular identification and subtyping of Helicobacter pylori by pyrosequencing of the 16S rDNA variable V1 and V3 regions2001In: FEMS Microbiology Letters, ISSN 0378-1097, E-ISSN 1574-6968, Vol. 199, no 1, p. 103-107Article in journal (Refereed)
    Abstract [en]

    We describe here the use of real-time DNA sequence analysis of Helicobacter pylori 16S rRNA gene fragments by pyrosequencingÖ for rapid molecular identification and subtyping of clinical isolates based on DNA sequence heterogeneity within the variable V1 and V3 regions. Six individual 16S rDNA V1 alleles (position 75-100) were identified in 23 clinical isolates obtained from gastric biopsy specimens. Eleven of these revealed sequence identities with H. pylori 26695 and one was identical with the rrn genes in strain J99. The other V1 alleles showing single or double nucleotide mutations or single nucleotide insertions could be divided into four groups with 5, 4, 1, and 1 isolates each. Two out of 25 isolates demonstrated single C to T transitions in the V3 region (position 990-1020). The present findings show that subtle DNA sequence variation occurs sufficiently often in the 16S rDNA variable V1 and V3 regions of H. pylori to provide a consistent system for subtyping.

  • 93. Nimeri, G
    et al.
    Majeed, Meytham
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of health and environment.
    Elwing, H
    Öhman, Lena
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Infectious Diseases . Östergötlands Läns Landsting, Centre for Medicine, Department of Infectious Diseases in Östergötland.
    Wetterö, Jonas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Rheumatology .
    Bengtsson, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Pharmacology .
    Oxygen radical production in neutrophils interacting with platelets and surface-immobilized plasma proteins: role of tyrosine phosphorylation2003In: Journal of Biomedical Materials Research, ISSN 0021-9304, E-ISSN 1097-4636, Vol. 67A, no 2, p. 439-447Article in journal (Refereed)
    Abstract [en]

    The interaction between neutrophil granulocytes and platelets is considered to play an important role in the inflammatory process induced by an implanted foreign material. However, the cellular mechanisms involved remain incompletely understood. We used a luminol-dependent chemiluminescence (CL) technique to analyze the generation of reactive oxygen species (ROS) in human neutrophils interacting with different plasma protein-coated surfaces in the presence or absence of unstimulated or stimulated platelets. The role of tyrosine phosphorylation in the regulation of NADPH oxidase activity was evaluated with quantitative fluorescence microscopy and the specific tyrosine kinase inhibitor genistein. We found that the ROS-production is 2 to 3 times higher in neutrophils on immunoglobulin G (IgG)coated surfaces than in cells interacting with albumin- or fibrinogen-coated surfaces. Incubation with superoxide dismutase and catalase revealed that about 45% of the ROS was released extracellularly on IgG surfaces whereas corresponding values were 90% and 85% in neutrophils interacting with albumin and fibrinogen, respectively. The presence of platelets markedly increased the extracellular generation of ROS, mainly in neutrophils. interacting with IgG- or fibrinogen-coated surfaces whereas the intracellular production was only modestly affected. Quantitative fluorescence microscopy of neutrophils stained with FITC-conjugated anti-phosphotyrosine antibodies showed a correlation between tyrosine phosphorylation, cell spreading, and ROS production. Platelets markedly amplified the anti-phosphotyrosine staining on both fibrinogen- and IgG-coated surfaces whereas the low level of tyrosine phosphorylation in neutrophils on albumin-coated surfaces was not further elevated by platelets. Furthermore, the tyrosine kinase inhibitor genistein inhibited both extra- and intracellular ROS production in neutrophils regardless of the presence of platelets. We demonstrate that plasma protein coating and the presence of platelets are crucial for the inflammatory response of adhering neutrophils and that the oxidative response correlates with the extent of tyrosine phosphorylation of proteins in focal contacts. (C) 2003 Wiley Periodicals, Inc.

  • 94.
    Nordqvist, Cecilia
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Barajas, Josefin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Keberg, K
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Rehabilitering inom Samhall - att finna ett annat arbete.2000In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 77, p. 438-444Article in journal (Other (popular science, discussion, etc.))
  • 95.
    Nordqvist, Cecilia
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Cedersund, Elisabet
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Holmqvist, C
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Att komma igen. Om att återgå i arbete efter sjukskrivning för rygg-, nack- eller skulderbesvär, en pilotstudie med fokusgrupper.2000In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 4, p. 347-356Article in journal (Other (popular science, discussion, etc.))
  • 96.
    Olcén, Per
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Fredlund, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Isolation, culture, and identification of meningococci from clinical specimens.2001In: Renal Cancer : Methods and Protocols / [ed] Jack H Mydlo, Linköping: Linköpings universitet , 2001, p. -403Chapter in book (Other academic)
    Abstract [en]

    Because renal cancer can be managed successfully only when localized, there is a great need to develop new treatments for patients with advanced or metastatic disease. In Renal Cancer: Methods and Protocols, Jack H. Mydlo, MD, and a panel of leading clinicians and researchers review every aspect of the latest surgical, medical, and immunological therapies that can be used in the diagnosis and treatment of renal cancer. These broadly experienced investigators also present a practical account of their best basic research methods, including the use of reverse transcriptase PCR combined with genomic hybridization, cadherin, and metalloproteinase expression to reveal important factors in the detection, staging, aggressiveness, and treatment of this disease. Gene therapy, the generation of monoclonal antibodies, and the use of interferon alpha, GM-CSF, and IL-6 are also discussed. In vivo assays are provided for analyzing angiogenesis, anti-angiogenesis, and general renal tumor biology as a prelude to human clinical trials.  Comprehensive and pioneering, Renal Cancer: Methods and Protocols offers urologists, medical oncologists, laboratory investigators, and pathologists a practical collection of  the major cutting-edge techniques and therapies for renal cancer today, together with a view of the highly promising future of gene therapy.

  • 97.
    Olhager, Elisabeth
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Thuomas, Karl-Åke
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences.
    Wigström, Lars
    Linköping University, Department of Medicine and Care, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Forsum, Elisabet
    Linköping University, Department of Biomedicine and Surgery, Nutrition. Linköping University, Faculty of Health Sciences.
    Description and evaluation of a method based on magnetic resonance imaging to estimate adipose tissue volume and total body fat in infants1998In: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 44, no 4, p. 572-577Article in journal (Refereed)
    Abstract [en]

    Information about body fatness is important during nutritional assessment of infants, but current methods to estimate body composition in vivo are often not applicable in infants. Therefore, a new method based on magnetic resonance imaging (MRI) was developed. This method, which can assess the volume and distribution of adipose tissue (AT) as well as total body fat, was applied in 11 healthy full-term infants. Their total body water was also estimated using the isotope dilution technique. Adipose tissue volume (ATV) was calculated from AT area in 16 images of the body taken by an MRI scanner (1.5 tesla). AT area was assessed using a computer program in which AT criteria was defined by the observer. ATV of the infants was therefore evaluated once by three observers and twice by a fourth observer. The different observers estimated total, s.c., and non-s.c. ATV with a precision that varied between 1.9 and 7.2%, 2.0 and 4.8%, and 4.2 and 40.7%, respectively. Variations during AT area calculations accounted for a large part of the imprecision when assessing total and s.c. ATV. The linear relationship between percent total body water and total ATV in relation to body weight was significant in all evaluations. Although average total ATV varied when estimated by the four observers, there was, within each evaluation, a fairly constant order between infants with respect to their ATV. It is concluded that the MRI procedure represents a useful possibility to assess body fatness in infants.

  • 98.
    Palfi, Miodrag
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Antibodies during pregnancy: Aspects on complications during pregnancy and complications related to transfusion1999Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The fetus acquires half of its genetic infonnation from the father and represents a foreign graft in pregnancy. The overall mechanisms contributing to immunologic tolerance and successful pregancy still are an enigma. Accumulating results of immunologic research, however, offer an explanation for many events in pregnancy. The purpose of this study was to investigate immune responses in pregnancy, antibody production, fetomatemal transport of antibodies and their impact on complications during pregnancy and complications related to transfusion.

    The human immune system exerts its effects by cellular (T-cell mediated, Thl dominated) and humoral (antibody mediated, Th2-dominated) immunity. Cellular immunity provides protection against foreign and infected cells while humoral immunity protects against extracellular pathogens. According to the Thl/Th2 paradigm successful pregnancy is Th2 dominated. We found elevated numbers of cytokine secreting cells of both Th-1 and Th-2 type in normal pregnancy and recurrent spontaneous abortions. However, the overall immune response may functionally be Th2-dominated and possibly more pronounced locally, at the fetomaternal interface.

    The fetus, despite the fetomaternal barrier, represents a huge antigenic challenge for the mother. As a consequence, the mother produces a variety of antibodies, directed against fetal antigens of paternal origin. In pregnancy, only IgG antibodies are, by an active process, transported from the mother to the fetus. Normal fetal IgG concentrations during pregnancy were established, as reliable published data were rare. The calculated regression line for f/m IgG ratio can be considered an accurate description of the nonnal IgG distribution in the fetus in relation to the mother.

    It has been proposed that lgG transport may be decreased in Rh (D) immunizations. According to this hypothesis, the impaired transport of anti-D should represent a protective mechanism against hemolytic disease of the newborn. Our studies gave controversial results. We could partly confirm the hypotesis as measured by correlation of fetal IgG vs maternal anti-D concentrations and fetal/newborn hemoglobin concentrations. In contrast we did not find significantly lower fetal IgG concentrations in Rh (D) immunizations compared with normal pregnancy.

    The lgG subclass composition of anti-D in Rh (D) immunizations was studied by an established test performed in microtiter plates and our own novel gel-test. Comparison of these two test showed that the same IgG subclasses of anti-D were detected by both methods. However, the gel-test had two major advantages: it was much more rapid and most importantly, interpretation of results was easier than with the microtitre assay.

    Women immunized during pregnancy may later become blood donors. The concentration of antibodies produced during pregnancy may afterwards decrease. However, the antibodoes do not disappear, and may thereby cause post-transfusion reactions. It has been reported that granulocyte- and I-ILA antibodies may cause transfusion-related acute lung injury (TRALI). TRALI is a rare but life-threatening complication of blood transfusion. Data from our study suggest that multiparous donors(≥ 3 pregnancies) should donate only plasma for fractionation or, if cell concentrates must be used, they shouid be washed before transfusion.

  • 99.
    Ragnarsson, Eva Ge
    et al.
    Uppsala University.
    Schoultz, Ida
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery .
    Gullberg, Elisabet
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery .
    Carlsson, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery .
    Tafazoli, Farideh
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Lerm, Maria
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Medical Microbiology .
    Magnusson, Karl-Eric
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Medical Microbiology .
    Söderholm, Johan D
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery . Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Artursson, Per
    Uppsala University.
    Yersinia pseudotuberculosis induces transcytosis of nanoparticles across human intestinal villus epithelium via invasin-dependent macropinocytosis2008In: Laboratory Investigation, ISSN 0023-6837, E-ISSN 1530-0307, Vol. 88, no 11, p. 1215-1226Article in journal (Refereed)
    Abstract [en]

    Crohns disease is characterized by a defect in intestinal barrier function, where bacteria are considered the most important inflammation-driving factor. Enteric bacteria, including E. coli and Yersinia spp, affect tight junctions in enterocytes, but little is known about bacterial effects on the transcellular pathway. Our objective was to study the short-term effects of Y. pseudotuberculosis on uptake of nanoparticles across human villus epithelium. Monolayers of human colon epithelium-derived Caco-2 cells and biopsies of normal human ileum were studied after 2 h exposure to Y. pseudotuberculosis expressing (inv+) or lacking (inv-) the bacterial adhesion molecule, invasin. Transepithelial transport of fluorescent nanoparticles (markers of transcytosis) was quantified by flow cytometry, and mechanisms explored by using inhibitors of endocytosis. Epithelial expressions of beta 1-integrin and particle uptake pathways were studied by confocal microscopy. The paracellular pathway was assessed by electrical resistance (TER), mannitol flux, and expression of tight junction proteins occludin and caludin-4 by confocal microscopy. Inv + Y. pseudotuberculosis adhered to the apical surface of epithelial cells and induced transcytosis of exogenous nanoparticles across Caco-2 monolayers (30-fold increase, P < 0.01) and ileal mucosa (268 +/- 47% of control; P < 0.01), whereas inv-bacteria had no effect on transcytosis. The transcytosis was concentration-, particle size-and temperature-dependent, and possibly mediated via macropinocytosis. Y. pseudotuberculosis also induced apical expression of beta 1-integrin on epithelial cells. A slight drop in TER was seen after exposure to inv+ Y. pseudotuberculosis, whereas mannitol flux and tight junction protein expression was unchanged. In summary, Y. pseudotuberculosis induced apical expression of beta 1-integrin and stimulated uptake of nanoparticles via invasin-dependent transcytosis in human intestinal epithelium. Our findings suggest that bacterial factors may initiate transcytosis of luminal exogenous particles across human ileal mucosa, thus presenting a novel mechanism of intestinal barrier dysfunction.

  • 100.
    Rahmqvist, Mikael
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment.
    Patient satisfaction in relation to age, health status and other background factors: A model for comparisons of care units2001In: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 13, no 5, p. 385-390Article in journal (Refereed)
    Abstract [en]

    Objective. To analyse the relationship between patient satisfaction and background factors such as age, gender, health status and pain. In addition, to use background factors to create less biased ranking in comparisons of patient satisfaction between medical specialities. Design. A questionnaire was sent by post to patients who had recently received inpatient care at a hospital within the County of ╓sterg÷tland, Sweden. The questionnaire contained 33 questions, 21 of which concerned the quality of health care and patient satisfaction. Setting. Inpatient departments at all four hospitals in the County of ╓sterg÷tland, Sweden. Subjects. All patients discharged from the hospital during a period of 6 weeks. Approximately 3400 patients aged 1-94 years responded to the questionnaire, resulting in a response rate of 69%. Main outcome measures. Patient satisfaction index score (PSI). Results. Of the background factors tested, patient age had the greatest explanatory value regarding the PSI, closely followed by experiencing anxiety during admission. With regard to variations in the PSI, about 20% could be explained by the background factors taken as a whole. Gender did not correlate with the PSI, although males were somewhat more satisfied than females. PSI scores differed among medical specialities and, interestingly, when age and other background factors were controlled for, the picture changed regarding the medical speciality that received the best PSI score. Conclusion. The change in ranking among medical specialities after adjustment for background factors emphasizes the importance of including background factors in patient satisfaction analyses in order to obtain less biased comparisons.

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