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Eriksson, Margaretha
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Publications (10 of 35) Show all publications
Torstensson, T., Butler, S., Lindgren, A., Peterson, M., Nilsson-Wikmar, L., Eriksson, M. & Kristiansson, P. (2018). Anatomical landmarks of the intra-pelvic side-wall as sources of pain in women with and without pregnancy-related chronic pelvic pain after childbirth: a descriptive study. BMC Women's Health, 18, Article ID 54.
Open this publication in new window or tab >>Anatomical landmarks of the intra-pelvic side-wall as sources of pain in women with and without pregnancy-related chronic pelvic pain after childbirth: a descriptive study
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2018 (English)In: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 18, article id 54Article in journal (Refereed) Published
Abstract [en]

Background: Chronic pelvic pain (CPP) affects 15-24% of women and can have a devastating impact on quality of life. Laparoscopy is often used in the investigation, although in one third of the examinations there is no visible pathology and the women may be dismissed without further investigation. Also, the contribution of skeletal, muscular, periosteal and ligamentous tissues to CPP remains to be further elucidated. The objective of the present study was to compare pain intensity provoked from anatomical landmarks of the intra-pelvic side-wall in women with pregnancy-related CPP after childbirth and women without such pain. Methods: This is a descriptive study of 36 non-randomly selected parous women with CPP after childbirth and 29 likewise selected parous women after childbirth without CPP. Pain was determined by questionnaire and clinical examination. The primary outcome measure was reported pain intensity provoked on 13 anatomical landmarks of the intra-pelvic side-wall. All women reported their perceived pain intensity for each anatomical landmark on Likert scales and an individual sum score was calculated. Results: Women with chronic pelvic pain were older than women without CPP. At several intra-pelvic landmarks high intensity pain was provoked in women with CPP compared with less intense pain provoked at fewer landmarks in women without low back or pelvic pain (p < 0.0001). The average sum of pain intensity scores was about 4 times higher in women with CPP (1.3) as compared with those without low back or pelvic pain (0.3), p < 0. 0001. This association remained when adjusting for the age difference between the pain groups in linear regression analysis. In addition, reported pain intensity at worst past week was independently associated with sum of pain intensity scores. The maximum individual sum of pain intensity scores among women without CPP was exceeded by that of 85% of the women with CPP. Conclusions: Parous women with CPP after childbirth had a heightened pain intensity over 13 anatomical landmarks during pelvic examination compared with parous women without CPP. These results need to be confirmed in a larger cohort with different types of CPP.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Anatomical landmarks, Intra-pelvic side-wall, Chronic pelvic pain, Pregnancy-related
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-354347 (URN)10.1186/s12905-018-0542-z (DOI)000428659500002 ()29587728 (PubMedID)
Available from: 2018-06-27 Created: 2018-06-27 Last updated: 2018-06-27Bibliographically approved
Torstensson, T., Butler, S., Lindgren, A., Peterson, M., Eriksson, M. & Kristiansson, P. (2015). Referred pain patterns provoked on intra-pelvic structures among women with and without chronic pelvic pain: a descriptive study. PLoS ONE, 10(3), Article ID e0119542.
Open this publication in new window or tab >>Referred pain patterns provoked on intra-pelvic structures among women with and without chronic pelvic pain: a descriptive study
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2015 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 3, article id e0119542Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES:

To describe referred pain patterns provoked from intra-pelvic structures in women with chronic pelvic pain (CPP) persisting after childbirth with the purpose to improve diagnostics and give implications for treatment.

MATERIALS AND METHODS:

In this descriptive and comparative study 36 parous women with CPP were recruited from a physiotherapy department waiting list and by advertisements in newspapers. A control group of 29 parous women without CPP was consecutively assessed for eligibility from a midwifery surgery. Inclusion criterion for CPP was: moderate pain in the sacral region persisting at least six months after childbirth confirmed by pelvic pain provocation tests. Exclusion criteria in groups with and without CPP were: persistent back or pelvic pain with onset prior to pregnancy, previous back surgery and positive neurological signs. Pain was provoked by palpation of 13 predetermined intra-pelvic anatomical landmarks. The referred pain distribution was expressed in pain drawings and described in pain maps and calculated referred pain areas.

RESULTS:

Pain provoked by palpation of the posterior intra-pelvic landmarks was mostly referred to the sacral region and pain provoked by palpation of the ischial and pubic bones was mostly referred to the groin and pubic regions, with or without pain referred down the ipsilateral leg. The average pain distribution area provoked by palpation of all 13 anatomical landmarks was 30.3 mm² (19.2 to 53.7) in women with CPP as compared to 3.2 mm² (1.0 to 5.1) in women without CPP, p< 0.0001.

CONCLUSIONS:

Referred pain patterns provoked from intra-pelvic landmarks in women with CPP are consistent with sclerotomal sensory innervation. Magnification of referred pain patterns indicates allodynia and central sensitization. The results suggest that pain mapping can be used to evaluate and confirm the pain experience among women with CPP and contribute to diagnosis.

National Category
Clinical Medicine
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-211840 (URN)10.1371/journal.pone.0119542 (DOI)000352084200093 ()25793999 (PubMedID)
Available from: 2013-12-02 Created: 2013-12-02 Last updated: 2018-01-19Bibliographically approved
Peterson, M., Butler, S., Eriksson, M. & Svärdsudd, K. (2014). A randomized controlled trial of eccentric vs. concentric graded exercise in chronic tennis elbow (lateral elbow tendinopathy). Clinical Rehabilitation, 28(9), 862-872
Open this publication in new window or tab >>A randomized controlled trial of eccentric vs. concentric graded exercise in chronic tennis elbow (lateral elbow tendinopathy)
2014 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, no 9, p. 862-872Article in journal (Refereed) Published
Abstract [en]

Objective:To analyse treatment effects of eccentric vs. concentric graded exercise in chronic tennis elbow.

Design:Randomized controlled trial.

Setting:Primary care in Uppsala County, Sweden.

Subjects:A total of 120 subjects with tennis elbow lasting more than three months were recruited from primary care and by advertisement.

Intervention:Eccentric (n = 60) or concentric exercise (n = 60), by lowering or lifting a weight, at home daily, for three months with gradually increasing load.

Main measures:Pain during muscle contraction and muscle elongation, as well as strength, was assessed at baseline and after one, two, three, six, and 12 months. Function and quality of life was assessed at baseline and after three, six and 12 months.

Results:The eccentric exercise group had faster regression of pain, with an average of 10% higher responder rate at all levels of pain reduction, both during muscle contraction and elongation, (p < 0.0001 and p = 0.006, respectively). Significant differences were found in Cox's analysis from two months onwards (HR 0.78, 95% confidence interval (CI) 0.63-0.96, p < 0.02). This represents an absolute pain reduction of 10% in the eccentric vs. the concentric group and a number-needed-to-treat of 10. The eccentric group also had a greater increase of muscle strength than the concentric (p < 0.02). The differences persisted throughout the follow-up period. There were no significant differences between the groups regarding function or quality of life measures.

Conclusion:Eccentric graded exercise reduced pain and increased muscle strength in chronic tennis elbow more effectively than concentric graded exercise.

National Category
General Practice
Identifiers
urn:nbn:se:uu:diva-220713 (URN)10.1177/0269215514527595 (DOI)000340950800004 ()24634444 (PubMedID)
Available from: 2014-03-19 Created: 2014-03-19 Last updated: 2018-01-11Bibliographically approved
Bröms, K., Norbäck, D., Eriksson, M., Sundelin, C. & Svärdsudd, K. (2013). Prevalence and co-occurrence of parentally reported possible asthma and allergic manifestations in pre-school children. BMC Public Health, 13, 764
Open this publication in new window or tab >>Prevalence and co-occurrence of parentally reported possible asthma and allergic manifestations in pre-school children
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2013 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, p. 764-Article in journal (Refereed) Published
Abstract [en]

Background: The aim of this study was to make an in-depth analysis of the prevalence and co-occurrence in pre-school children of possible asthma and atopic manifestations. Methods: In Sweden 74%-84% of preschool children, depending on age, attend municipality organised day-care centres. Parents of 5,886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded to a postal questionnaire regarding symptoms indicating prevalent possible asthma, allergic rhinitis, eczema, and food, furred pet and pollen allergy and other data in their children. Possible asthma was defined as any of the four criteria wheezing four times or more during the last year, physician diagnosis and current wheezing, ever had asthma and current wheezing, and current use of inhalation steroids, all based on questionnaire responses. Results: The overall prevalence of possible asthma was 8.9%, of eczema 21.7%, of rhinitis 8.1%, and of food allergy 6.6%. There was a highly significant co-occurrence between possible asthma and all atopic manifestations, 35.7% having any of the manifestations. Presence of pet allergy was the manifestation showing the closest co-occurrence with presence of possible asthma, presence of pollen allergy with presence of rhinitis, and presence of food allergy with presence of eczema. Assessed from plots of age-specific prevalence of possible asthma, rhinitis, eczema and food allergy, the prevalence of all manifestations increased from one to three years of age and then decreased, except for rhinitis where the prevalence increased until six years of age, indicating no specific ordered sequence. Conclusions: Parentally reported possible asthma, eczema and food allergy had a curvilinear prevalence course across age with a maximum at age 3, while rhinitis prevalence increased consistently with age. Co-occurrence between possible asthma and atopic manifestations was common, and some combinations were more common than others, but there was no evidence of a specific ordered onset sequence.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-208084 (URN)10.1186/1471-2458-13-764 (DOI)000323753900001 ()
Available from: 2013-09-23 Created: 2013-09-23 Last updated: 2017-12-06Bibliographically approved
Bröms, K., Norbäck, D., Sundelin, C., Eriksson, M. & Svärdsudd, K. (2012). A nationwide study of asthma incidence rate and its determinants in Swedish pre-school children. European Journal of Epidemiology, 27(9), 695-703
Open this publication in new window or tab >>A nationwide study of asthma incidence rate and its determinants in Swedish pre-school children
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2012 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 27, no 9, p. 695-703Article in journal (Refereed) Published
Abstract [en]

While many studies on asthma prevalence have been published, the number of studies on asthma incidence in pre-school children is limited. In this project, a nationwide sample of pre-school children was followed with the aim of estimating cumulative 5-year asthma incidence and its determinants. Parents of 5,886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded in 2002 to a baseline postal questionnaire with questions regarding symptoms indicating possible asthma or atopic conditions, and a number of other variables. In 2007, parents of 4,255 children responded to an almost identical follow-up questionnaire. Of these, the 3,715 children who were free from asthma at baseline constitute the study population for this report. A large number of potential baseline determinants for cumulative 5-year asthma incidence were identified. Of these, food allergy, rhinitis, incomplete asthma diagnosis criteria (wheezing last 12 months, and ever had asthma but no current symptoms), parental rhinitis, parental asthma, age, and eczema, in ranking order of importance, remained significant in multivariate logistic regression analysis. The asthma incidence rate was highly dependent on presence or absence of these variables, the average annual rate ranging from 2/1,000/year in 6-year-olds with no determinants to154/1,000/year in 1-year-olds with all determinants, corresponding to 11/1,000/year based on the whole study population.

National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:uu:diva-185282 (URN)10.1007/s10654-012-9725-3 (DOI)000310589700004 ()22911025 (PubMedID)
Available from: 2012-11-21 Created: 2012-11-21 Last updated: 2017-12-07Bibliographically approved
von Celsing, A.-S., Svärdsudd, K., Eriksson, H.-G., Björkegren, K., Eriksson, M. & Wallman, T. (2012). Determinants for return to work among sickness certified patients in general practice. BMC Public Health, 12(1), 1077
Open this publication in new window or tab >>Determinants for return to work among sickness certified patients in general practice
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2012 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, no 1, p. 1077-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Long-term sickness absence is one of the main risk factors for permanent exit out of the labour market. Early identification of the condition is essential to facilitate return to work. The aim of this study was to analyse possible determinants of return to work and their relative impact.

METHODS:

All 943 subjects aged 18 to 63 years, sickness certified at a Primary Health Care Centre in Sweden from 1 January until 31 August 2004, were followed up for three years. Baseline information on sex, age, sick leave diagnosis, employment status, extent of sick leave, and sickness absence during the year before baseline was obtained, as was information on all compensated days of sick leave, disability pension and death during follow-up.

RESULTS:

Slightly more than half the subjects were women, mean age was 39 years. Half of the study population returned to work within 14 days after baseline, and after three years only 15 subjects were still on sick leave. In multivariate proportional hazards regression analysis the extent of previous sick leave, age, being on part-time sick leave, and having a psychiatric, musculoskeletal, cardiovascular, nervous disease, digestive system, or injury or poisoning diagnosis decreased the return to work rate, while being employed increased it. Marital status, sex, being born in Sweden, citizenship, and annual salary had no influence. In logistic regression analyses across follow-up time these variables altogether explained 88-90% of return to work variation.

CONCLUSIONS:

Return to work was positively or negatively associated by a number of variables easily accessible in the GP's office. Track record data in the form of previous sick leave was the most influential variable.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-189477 (URN)10.1186/1471-2458-12-1077 (DOI)000313444400002 ()23241229 (PubMedID)
Available from: 2013-01-02 Created: 2013-01-02 Last updated: 2017-12-06Bibliographically approved
Peterson, M., Butler, S., Eriksson, M. & Svardsudd, K. (2011). A randomized controlled trial of eccentric versus concentric exercise in chornic tennis elbow (lateral epicondylosis). European Journal of Pain
Open this publication in new window or tab >>A randomized controlled trial of eccentric versus concentric exercise in chornic tennis elbow (lateral epicondylosis)
2011 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149Article in journal (Refereed) Submitted
Abstract [en]

Chronic tennis elbow was used in this paper as a model for chronic soft tissue pain, which is a common problem, often difficult to treat. Exercise has been shown to have positive effects in chronic pain, but whether eccentric or concentric exercise should be used is controversial. The aim of this study was to test the effects of eccentric versus concentric exercise on pain, strength, function and quality of life in chronic tennis elbow. One hundred and twenty subjects with tennis elbow lasting for more than three months were randomly allocated to eccentric exercise (n=60) or to concentric exercise (n=60), performed at home daily for three months with increasing load. The subjects were seen at baseline and after one, two, three, six, and twelve months of follow up, where the outcome measures pain during maximum voluntary muscle contraction (Cozen’s test), pain during maximum muscle elongation (modified Empty can test), and muscle strength were measured. Function was measured with the Disability of the Arm, Shoulder and Hand questionnaire (DASH) and quality of life with the Gothenburg Quality of Life questionnaire at baseline and after three, six, and twelve months. The eccentric exercise group had faster regression of pain, both during muscle contraction and elongation, as well as greater increase of muscle strength than the concentric group (p<0.0001, p=0.006, and p<0.02, respectively). The differences persisted throughout the follow-up period. There were no significant differences between the groups regarding DASH scores or quality of life measures.

Keywords
eccentric, exercise, concentric, RCT, tennis elbow, epicondylosis, tendinosis, tendinitis, chronic, pain
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-160038 (URN)
Available from: 2011-10-13 Created: 2011-10-13 Last updated: 2017-12-08Bibliographically approved
Peterson, M., Butler, S., Eriksson, M. & Svärdsudd, K. (2011). A randomized controlled trial of exercise versus wait list in chronic tennis elbow (lateral epicondylosis). Upsala Journal of Medical Sciences, 116(4), 269-279
Open this publication in new window or tab >>A randomized controlled trial of exercise versus wait list in chronic tennis elbow (lateral epicondylosis)
2011 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 116, no 4, p. 269-279Article in journal (Refereed) Published
Abstract [en]

Background.

Chronic tennis elbow (lateral epicondylosis) is a common disorder. Like other chronic soft tissue pain conditions it is often difficult to treat successfully. The effects of exercise have been discussed but no convincing evidence has been put forward so far, and a simple protocol for exercise is lacking.

Aims of the study.

This study is a randomized, controlled, clinical trial of the effect of exercise versus expectation (wait-list) on pain, muscle strength, function, and quality of life in patients with longstanding lateral epicondylosis.

Methods.

Eighty-one subjects with tennis elbow lasting for more than three months were randomly allocated to an exercise group (n=40) or a reference group (n=41). The exercise group performed daily exercise, with weekly load increase, for three months. The reference group was wait listed, but otherwise followed in the same way. Outcome measures were pain during maximum voluntary muscle contraction (Cozen´s test) and pain during maximum muscle elongation with a load (modified Empty-can-test), muscle strength measured with a Chatillon MSE 100 hand-held dynamometer, and the Disability of the Arm, Shoulder and Hand (DASH) and the Gothenburg Quality of Life questionnaires.

Results

.The exercise group had greater and faster regression of pain, both during muscle contraction and muscle elongation, than the reference group (p=0.0005 and p=0.0016, respectively). There was a non-significant muscle strength difference between the groups, but no differences regarding DASH scores or quality of life measures.

Conclusions

.Exercise appears to be superior to expectation in reducing pain in chronic lateral epicondylosis.

Keywords
exercise, chronic, pain, tennis elbow, epicondylitis, RCT, epicondylosis, tendinosis, tendinitis
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:uu:diva-159954 (URN)10.3109/03009734.2011.600476 (DOI)000296794100008 ()
Available from: 2011-10-13 Created: 2011-10-12 Last updated: 2017-12-08Bibliographically approved
Bröms, K., Norbäck, D., Eriksson, M., Sundelin, C. & Svärdsudd, K. F. (2009). Effect of degree of urbanisation on age and sex-specific asthmaprevalence in Swedish preschool children. BMC Public Health, 9, 303
Open this publication in new window or tab >>Effect of degree of urbanisation on age and sex-specific asthmaprevalence in Swedish preschool children
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2009 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 9, p. 303-Article in journal (Refereed) Published
Abstract [en]

Background: There are few studies on age and sex-specific asthma   prevalence in the age range 1-6 years. The purpose of this report was   to estimate age and sex specific asthma prevalence in preschool   children and to analyse the influence of possible demographic and   geographic determinants.   Methods: All 70 allergen avoidance day-care centres and 140 matched   ordinary day-care centres across Sweden were sampled. The parents of   all 8,757 children attending these day-care centres received the   International Study of Asthma and Allergies in Childhood (ISAAC)   written questionnaire, supplemented with questions on medical   treatment, physician assessed asthma diagnosis, and other asthma   related questions. The response rate was 68%.   Results: The age specific asthma prevalence, adjusted for the   underlying municipality population size, was among boys 9.7% at age 1,   11.1% at age 2, 11.4 at age 3, 10.5 at age 4, 8.7 at age 5, and 6.4 at   age 6. The corresponding proportions among girls were 8.9%, 9.9%, 9.8%,   8.8%, 7.0%, and 5.0%, on average 9.6% for boys and 8.2% for girls,   altogether 8.9%. In addition to age and sex the prevalence increased by   municipality population density, a proxy for degree of urbanisation.   Moreover, there was a remaining weak geographical gradient with   increasing prevalence towards the north and the west.   Conclusion: The age-specific asthma prevalence was curvilinear with a   peak around age 3 and somewhat higher for boys than for girls. The   asthma prevalence increased in a slowly accelerating pace by   municipality population density as a proxy for degree of urbanisation.

National Category
Medical and Health Sciences
Research subject
Family Medicine
Identifiers
urn:nbn:se:uu:diva-120578 (URN)10.1186/1471-2458-9-303 (DOI)000270673700001 ()19695101 (PubMedID)
Available from: 2010-03-15 Created: 2010-03-15 Last updated: 2017-12-12Bibliographically approved
Eriksson, M., Wedel, H., Wallander, M.-A., Krakau, I., Hugosson, J., Carlsson, S. & Svärdsudd, K. (2007). The impact of birth weight on prostate cancer incidence and mortality in a population-based study of men born in 1913 and followed up from 50 to 85 years of age. The Prostate, 67(11), 1247-1254
Open this publication in new window or tab >>The impact of birth weight on prostate cancer incidence and mortality in a population-based study of men born in 1913 and followed up from 50 to 85 years of age
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2007 (English)In: The Prostate, ISSN 0270-4137, E-ISSN 1097-0045, Vol. 67, no 11, p. 1247-1254Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Insulin-like growth factor-I (IGF-I) hormone is directly associated with birth weight (BW), and high IGF-I measured in adults is associated with increased risk of prostate cancer (PCA). Whether BW and PCA are related is inconclusive to date. METHODS: BW and PCA incidence and mortality data for a population-based cohort of 1,436 singleton Swedish men born in 1913 and followed until 85 years of age were obtained. RESULTS: BW > or = 4,250 g was associated with significantly higher PCA incidence [62% (CI: 4%-151%)] and PCA mortality [82% (CI: 3%-221%)] than BW 3,001-4,249 g, even when other potential effect modifiers were taken into account. The hazards ratio for PCA incidence fell from approximately 3 at age 50 to unity at age 85. Approximately one out of every six PCA incident cases between 50 and 70 years of age could be attributed to BW > or = 4,250 g. CONCLUSIONS: In the current study PCA incidence and mortality rate appears to increase with BW.

Keywords
Birth weight, Cohort studies, Follow-up studies, Prostate cancer
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-13899 (URN)10.1002/pros.20428 (DOI)000248537500012 ()17570499 (PubMedID)
Available from: 2008-01-28 Created: 2008-01-28 Last updated: 2017-12-11Bibliographically approved
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