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Bergqvist, David
Alternative names
Publications (10 of 191) Show all publications
Kragsterman, B., Bergqvist, D., Siegbahn, A. & Pärsson, H. (2017). Carotid Endarterectomy Induces the Release of Inflammatory Markers and the Activation of Coagulation as Measured in the Jugular Bulb. Journal of Stroke & Cerebrovascular Diseases, 26(10), 2320-2328
Open this publication in new window or tab >>Carotid Endarterectomy Induces the Release of Inflammatory Markers and the Activation of Coagulation as Measured in the Jugular Bulb
2017 (English)In: Journal of Stroke & Cerebrovascular Diseases, ISSN 1052-3057, E-ISSN 1532-8511, Vol. 26, no 10, p. 2320-2328Article in journal (Refereed) Published
Abstract [en]

Background and Purpose: Transient cerebral hypoxia may induce neuronal injury through an ischemia-reperfusion (I/R) response, with a subsequent activation of inflammation and coagulation-fibrinolysis. During carotid endarterectomy (CEA), the artery is clamped, which might impair the regional cerebral perfusion and initiate a local I/R response. Data suggest that the CD40-CD40 ligand dyad acts as a modulator in the induced activation. The aim of this study was to locally measure soluble CD40 ligand (sCD40L), in conjunction with inflammation and coagulation activation markers, during CEA.

Subjects and Methods: This is a prospective study of 18 patients undergoing CEA. Blood samples from the venous jugular bulb (JB) and the radial artery (RA) were drawn at baseline and during the procedure. Measurements of sCD40L, interleukin-6 (IL-6), fragment 1 + 2 (F1 + 2), plasminogen activator inhibitor-1 (PAI-1), and D-dimer were analyzed. Comparisons during CEA were made between levels: baselines versus JB, JB versus RA, and sequential JB measurements. Fifty cardiovascular healthy patients were the reference group for the sCD40L baseline comparison.

Results: Increased cerebral IL-6 levels were demonstrated throughout the procedure, as well as the temporal influence in F1 + 2, PAI-1, and D-dimer values. sCD40L remained unchanged throughout the procedure. This indicates a local cerebral inflammatory reaction together with an activation of coagulation-fibrinolysis, but it does not appear to primarily involve the CD40-CD40 ligand dyad.

Conclusions: Signs of a local inflammatory reaction and activation of coagulation were observed during CEA, but levels of sCD40L remained stable, unaffected by carotid artery clamping and reperfusion.

Keywords
Carotid endarterectomy, carotid clamping, cerebral perfusion, cerebral ischemia
National Category
Cardiac and Cardiovascular Systems Neurology
Identifiers
urn:nbn:se:uu:diva-341672 (URN)10.1016/j.jstrokecerebrovasdis.2017.05.020 (DOI)000414535300041 ()28652057 (PubMedID)
Available from: 2018-02-13 Created: 2018-02-13 Last updated: 2018-02-13Bibliographically approved
Kakkos, S. K., Bicknell, C. D., Tsolakis, I. A. & Bergqvist, D. (2016). Editor's Choice - Management of Secondary Aorto-enteric and Other Abdominal Arterio-enteric Fistulas: A Review and Pooled Data Analysis. European Journal of Vascular and Endovascular Surgery, 52(6), 770-786
Open this publication in new window or tab >>Editor's Choice - Management of Secondary Aorto-enteric and Other Abdominal Arterio-enteric Fistulas: A Review and Pooled Data Analysis
2016 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 52, no 6, p. 770-786Article, review/survey (Refereed) Published
Abstract [en]

Objectives: To compare management strategies for secondary abdominal arterio-enteric fistulas (AEFs). Methods: This study is a review and pooled data analysis. Medline and Scopus databases were searched for studies published between 1999 and 2015. Particular emphasis was given to short- and long-term outcomes in relation to AEF repair type. Results: Two hundred and sixteen publications were retrieved, reporting on 823 patients. In-hospital mortality was 30.7%. Open surgery had higher in-hospital mortality (246/725, 33.9%), than endovascular methods (7/98, 7.1%, p<.001, OR 6.7, 95% CI 3-14.7, including staged endovascular to open surgery, 0/13, 0%). In-hospital mortality after graft removal/extra-anatomical bypass grafting was 31.2% (66/226), graft removal/in situ repair 34% (137/403), primary closure of the arterial defect 62.5% (10/16), and for miscellaneous open procedures 41.3% (33/80), p=.019. Among the subgroups of in situ repair, homografts were associated with a higher mortality than impregnated prosthetic grafts (p=.047). There was no difference in recurrent AEF-free rates between open and endovascular procedures. Extra-anatomical bypass/graft removal and in situ repair had a lower AEF recurrence rate than primary closure and homografts. Late sepsis occurred more often after endovascular surgery (2-year rates 42% vs. 19% for open, p=.001). The early survival benefit of endovascular surgery was blunted during follow-up, although it remained significant (p<.001). Within the in situ repair group, impregnated prosthetic grafts were associated with the worst overall and AEF related mortality free rates and vein grafts with the best. No recurrence, sepsis, or mortality was reported following staged endograft placement to open repair after a mean follow-up of 16.8 months (p=.18, p=.22, and p=.006, respectively, compared with patients in other groups). Conclusions: Endovascular surgery, where appropriate, is associated with better early survival than open surgery for secondary AEFs. Most of this benefit is lost during long-term follow-up, implying that a staged approach with early conversion to in situ vein grafting may achieve the best results in selected patients.

Keywords
Aortoenteric fistula, Arterioenteric fistula, Endovascular, Graft removal, Secondary
National Category
Cardiac and Cardiovascular Systems Surgery
Identifiers
urn:nbn:se:uu:diva-315006 (URN)10.1016/j.ejvs.2016.09.014 (DOI)000390738800012 ()27838156 (PubMedID)
Available from: 2017-02-08 Created: 2017-02-08 Last updated: 2017-11-29Bibliographically approved
Bergqvist, D. & Wanhainen, A. (2015). Konsten att skriva ett vetenskapligt manus. Svensk Kirurgi, 73(1), 10-12
Open this publication in new window or tab >>Konsten att skriva ett vetenskapligt manus
2015 (Swedish)In: Svensk Kirurgi, ISSN 0346-847X, Vol. 73, no 1, p. 10-12Article in journal (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-276841 (URN)
Available from: 2016-02-16 Created: 2016-02-16 Last updated: 2017-11-30Bibliographically approved
Bergqvist, D. (2015). Kultur på tentamen: i kärlkirurgi. Läkartidningen, 112(6), 226-227, Article ID DAXM.
Open this publication in new window or tab >>Kultur på tentamen: i kärlkirurgi
2015 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, no 6, p. 226-227, article id DAXMArticle in journal (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-276840 (URN)
Note

Läkartidningen. 2015;112:DAXM

Available from: 2016-02-16 Created: 2016-02-16 Last updated: 2017-11-30Bibliographically approved
Bergqvist, D. (2015). Mästerkirurgen Acrel: och behandling av kärlskador på 1700-talet. Läkartidningen, 112(50), 2300-2301, Article ID DRXL.
Open this publication in new window or tab >>Mästerkirurgen Acrel: och behandling av kärlskador på 1700-talet
2015 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, no 50, p. 2300-2301, article id DRXLArticle in journal (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-276849 (URN)
Note

Available from: 2016-02-16 Created: 2016-02-16 Last updated: 2017-11-30Bibliographically approved
Mitchell, D., Venermo, M., Mani, K., Björck, M., Troëng, T., Debus, S., . . . Lees, T. (2015). Quality Improvement in Vascular Surgery: The Role of Comparative Audit and Vascunet.. European Journal of Vascular and Endovascular Surgery, 49(1)
Open this publication in new window or tab >>Quality Improvement in Vascular Surgery: The Role of Comparative Audit and Vascunet.
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2015 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 49, no 1Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-267236 (URN)26347910 (PubMedID)
Available from: 2015-11-19 Created: 2015-11-19 Last updated: 2017-12-01
Bergqvist, D. (2015). Screening av bukaortaaneurysm fortfarande indicerad. Läkartidningen, 112
Open this publication in new window or tab >>Screening av bukaortaaneurysm fortfarande indicerad
2015 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112Article in journal (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-276847 (URN)
Note

Debattartikel

Available from: 2016-02-16 Created: 2016-02-16 Last updated: 2017-11-30Bibliographically approved
Bergqvist, D. (2015). Spännande läkekonsthistorik. Paper presented at 2015;73:224-226. Svensk Kirurgi, 73(4), 224-226
Open this publication in new window or tab >>Spännande läkekonsthistorik
2015 (Swedish)In: Svensk Kirurgi, ISSN 0346-847X, Vol. 73, no 4, p. 224-226Article in journal (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-276848 (URN)
Conference
2015;73:224-226
Note

Bokrecension

Available from: 2016-02-16 Created: 2016-02-16 Last updated: 2017-11-30Bibliographically approved
Francis, C. W., Kessler, C. M., Goldhaber, S. Z., Kovacs, M. J., Monreal, M., Huisman, M. V., . . . Kakkar, A. K. (2015). Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12months: the DALTECAN Study. Journal of Thrombosis and Haemostasis, 13(6), 1028-1035
Open this publication in new window or tab >>Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12months: the DALTECAN Study
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2015 (English)In: Journal of Thrombosis and Haemostasis, ISSN 1538-7933, E-ISSN 1538-7836, Vol. 13, no 6, p. 1028-1035Article in journal (Refereed) Published
Abstract [en]

BackgroundTreatment of venous thromboembolism (VTE) in patients with cancer has a high rate of recurrence and bleeding complications. Guidelines recommend low-molecular-weight heparin (LMWH) for at least 3-6months and possibly indefinitely for patients with active malignancy. There are, however, few data supporting treatment with LMWH beyond 6months. The primary aim of the DALTECAN study (NCT00942968) was to determine the safety of dalteparin between 6 and 12months in cancer-associated VTE. MethodsPatients with active cancer and newly diagnosed VTE were enrolled in a prospective, multicenter study and received subcutaneous dalteparin for 12months. The rates of bleeding and recurrent VTE were evaluated at months 1, 2-6 and 7-12. FindingsOf 334 patients enrolled, 185 and 109 completed 6 and 12months of therapy; 49.1% had deep vein thrombosis (DVT); 38.9% had pulmonary embolism (PE); and 12.0% had both on presentation. The overall frequency of major bleeding was 10.2% (34/334). Major bleeding occurred in 3.6% (12/334) in the first month, and 1.1% (14/1237) and 0.7% (8/1086) per patient-month during months 2-6 and 7-12, respectively. Recurrent VTE occurred in 11.1% (37/334); the incidence rate was 5.7% (19/334) for month 1, 3.4% (10/296) during months 2-6, and 4.1% (8/194) during months 7-12. One hundred and sixteen patients died, four due to recurrent VTE and two due to bleeding. ConclusionMajor bleeding was less frequent during dalteparin therapy beyond 6months. The risk of developing major bleeding complications or VTE recurrence was greatest in the first month of therapy and lower over the subsequent 11 months.

Keywords
cancer, dalteparin, deep vein thrombosis, low-molecular-weight heparin, pulmonary embolism, venous thromboembolism
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-258033 (URN)10.1111/jth.12923 (DOI)000355746100017 ()25827941 (PubMedID)
Available from: 2015-07-13 Created: 2015-07-10 Last updated: 2017-12-04Bibliographically approved
Hull, R. D., Liang, J., Bergqvist, D. & Yusen, R. D. (2014). Benefit-to-harm ratio of thromboprophylaxis for patients undergoing major orthopaedic surgery. Thrombosis and Haemostasis, 111(2), 199-212
Open this publication in new window or tab >>Benefit-to-harm ratio of thromboprophylaxis for patients undergoing major orthopaedic surgery
2014 (English)In: Thrombosis and Haemostasis, ISSN 0340-6245, Vol. 111, no 2, p. 199-212Article in journal (Refereed) Published
Abstract [en]

Surgeons consider the benefit-to-harm ratio when making decisions regarding the use of anticoagulant venous thromboembolism (VIE) prophylaxis. We evaluated the benefit-to-harm ratio of the use of newer anticoagulants as thromboprophylaxis in patients undergoing major orthopaedic surgery using the likelihood of being helped or harmed (LHH), and assessed the effects of variation in the definition of major bleeding on the results. A systematic literature search was performed to identify phase II and phase III studies that compared regulatory authority-approved newer anticoagulants to the low-molecular-weight heparin enoxaparin in patients undergoing major orthopaedic surgery. Analysis of outcomes data estimated the clinical benefit (number-needed-to-treat [NNT] to prevent one symptomatic VIE) and clinical harm (number-needed-to-harm [NNH] or the NNT to cause one major bleeding event) of therapies. We estimated each trial's benefit, to-harm ratio from NNT and NNH values, and expressed this as LHH = (1/NNT)/(1/NNH) = NNH/NNT, Based on reporting of efficacy and safety outcomes, most studies favoured enoxaparin over fondaparinux, and rivaroxaban over enoxaparin. However, when using the LHH metric, most trials favoured enoxaparin over both fondaparinux and rivaroxaban when they included surgical-site bleeding that did not require reoperation in the definition of major bleeding. The exclusion of bleeding at surgical site which did not require reoperation shifted the benefit-to-harm ratio in favour of the newer agents. Variations in the definitions of major bleeding may change the benefit-to-harm ratio and subsequently affect its interpretation. Clinical trials should attempt to improve the consistency of major bleeding reporting.

Keywords
Major orthopaedic surgery, thromboprophylaxis, enoxaparin, the likelihood of being helped or harmed, benefit-to-harm ratio
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-220295 (URN)10.1160/TH13-08-0654 (DOI)000330750500002 ()
Available from: 2014-03-17 Created: 2014-03-12 Last updated: 2017-12-05Bibliographically approved
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