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Bornefalk Hermansson, AnnaORCID iD iconorcid.org/0000-0001-9934-8485
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Publications (10 of 32) Show all publications
Sundh, J., Bornefalk, H., Skold, C. M., Jansson, C., Blomberg, A., Sandberg, J., . . . Ekstrom, M. (2019). Clinical validation of the Swedish version of Dyspnoea-12 instrument in outpatients with cardiorespiratory disease. BMJ OPEN RESPIRATORY RESEARCH, 6(1), Article ID UNSP e000418.
Open this publication in new window or tab >>Clinical validation of the Swedish version of Dyspnoea-12 instrument in outpatients with cardiorespiratory disease
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2019 (English)In: BMJ OPEN RESPIRATORY RESEARCH, ISSN 2052-4439, Vol. 6, no 1, article id UNSP e000418Article in journal (Refereed) Published
Abstract [en]

Introduction Breathlessness is the cardinal symptom in both cardiac and respiratory diseases, and includes multiple dimensions. The multidimensional instrument Dyspnoea-12 has been developed to assess both physical and affective components of breathlessness. This study aimed to perform a clinical validation of the Swedish version of Dyspnoea-12 in outpatients with cardiorespiratory disease. Methods Stable outpatients with cardiorespiratory disease and self-reported breathlessness in daily life were recruited from five Swedish centres. Assessments of Dyspnoea-12 were performed at baseline, after 30-90 min and after 2 weeks. Factor structure was tested using confirmatory factor analysis and internal consistency using Cronbach's alpha. Test-retest reliability was analysed using intraclass correlation coefficients (ICCs). Concurrent validity at baseline was evaluated by examining correlations with lung function and several instruments for the assessment of symptoms and health status. Results In total, 182 patients were included: with the mean age of 69 years and 53% women. The main causes of breathlessness were chronic obstructive pulmonary disease (COPD; 25%), asthma (21%), heart failure (19%) and idiopathic pulmonary fibrosis (19%). Factor analysis confirmed the expected underlying two-component structure with two subdomains. The Dyspnoea-12 total score, physical subdomain score and affective subdomain scores showed high internal consistency (Cronbach's alpha 0.94, 0.84 and 0.80, respectively) and acceptable reliability after 2 weeks (ICC total scores 0.81, 0.79 and 0.73). Dyspnoea-12 showed concurrent validity with the instruments modified Medical Research Council scale, COPD Assessment Test, European Quality of Life-Five Dimensions-Five levels, the Functional Assessment of Chronic Illness Therapy-Fatigue, the Hospital Anxiety and Depression Scale, and with forced expiratory volume in 1 s in percentage of predicted value. The results were consistent across different cardiorespiratory conditions. Conclusion The Dyspnoea-12 is a valid instrument for multidimensional assessment of breathlessness in Swedish patients with cardiorespiratory diseases.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-400009 (URN)10.1136/bmjresp-2019-000418 (DOI)000500491400007 ()31673362 (PubMedID)
Funder
Swedish Heart Lung Foundation
Available from: 2019-12-18 Created: 2019-12-18 Last updated: 2019-12-18Bibliographically approved
Sundh, J., Bornefalk-Hermansson, A., Ahmadi, Z., Blomberg, A., Janson, C., Currow, D. C., . . . Ekstrom, M. (2019). REgistry-based randomized controlled trial of treatment and Duration and mortality in long-term OXygen therapy (REDOX) study protocol. BMC Pulmonary Medicine, 19, Article ID 50.
Open this publication in new window or tab >>REgistry-based randomized controlled trial of treatment and Duration and mortality in long-term OXygen therapy (REDOX) study protocol
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2019 (English)In: BMC Pulmonary Medicine, ISSN 1471-2466, E-ISSN 1471-2466, Vol. 19, article id 50Article in journal (Refereed) Published
Abstract [en]

Objective:Long-term oxygen therapy (LTOT) during 15 h/day or more prolongs survival in patients with chronicobstructive pulmonary disease (COPD) and severe hypoxemia. No randomized controlled trial has evaluated the neteffects (benefits or harms) from LTOT 24 h/day compared with 15 h/day or the effect in conditions other than COPD.We describe a multicenter, national, phase IV, non-superiority, registry-based, randomized controlled trial (R-RCT) ofLTOT prescribed 24 h/day compared with 15 h/day. The primary endpoint is all-cause-mortality at 1 year. Secondaryendpoints include cause-specific mortality, hospitalizations, health-related quality of life, symptoms, and outcomes ininterstitial lung disease.

Methods/design:Patients qualifying for LTOT are randomized to LTOT 24 h/day versus 15 h/day during 12 monthsusing the Swedish Register for Respiratory Failure (Swedevox). Planned sample size in this pragmatic study is 2126randomized patients. Clinical follow-up and concurrent treatments are according to routine clinical practice. Mortality,hospitalizations, and incident diseases are assessed using national Swedish registries with expected complete follow-up. Patient-reported outcomes are assessed using postal questionnaire at 3 and 12 months.

Discussion:The R-RCT approach combines the advantages of a prospective randomized trial and large clinical nationalregistries for enrollment, allocation, and data collection, with the aim of improving the evidence-based use of LTOT.

Trial registration:Clinical Trial registered withwww.clinicaltrials.gov, Title: REgistry-based Treatment Duration andMortality in Long-term OXygen Therapy (REDOX); ID: NCT03441204.

Keywords
Register-based randomized controlled trial, Hypoxaemia, Long-term oxygen therapy, Oxygen duration, Chronic obstructive pulmonary disease, Interstitial lung disease, Mortality, Hospitalizations, Health-related quality of life, Symptoms
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-379585 (URN)10.1186/s12890-019-0809-7 (DOI)000459873800001 ()30808321 (PubMedID)
Available from: 2019-03-25 Created: 2019-03-25 Last updated: 2019-05-17Bibliographically approved
Berling Holm, K., Bornefalk Hermansson, A., Knutsson, J. & von Unge, M. (2019). Surgery for Chronic Otitis Media Causes Greater Taste Disturbance Than Surgery for Otosclerosis.. Otology and Neurotology, 40(1), e32-e39
Open this publication in new window or tab >>Surgery for Chronic Otitis Media Causes Greater Taste Disturbance Than Surgery for Otosclerosis.
2019 (English)In: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 40, no 1, p. e32-e39Article in journal (Refereed) Published
Abstract [en]

Objectives: Patients with otosclerosis more often complain about postoperative taste disturbance than patients with chronic otitis media, which seems paradoxical. We aim to investigate if and potentially why this seems to be the case, since the chorda tympani nerve (CTN) is thought to be severely traumatized less frequently during surgery in the former than in the latter.

Study Design: Prospective cohort study.

Setting: Department of Otorhinolaryngology at Hospital of Vastmanland, Vasteras, Sweden.

Patients: Sixty-five adults undergoing primary middle ear surgery were included. Thirty-seven were operated on for chronic suppurative otitis media with or without cholesteatoma (CSOM) and 28 for otosclerosis.

Interventions: Middle ear surgery due to otosclerosis or CSOM. Subjective and objective taste measurements and quality of life (QoL) questionnaire.

Main Outcome Measures: Taste was assessed using electrogustometry (EGM) and the filter paper disc (FPD) method before and up to 1 year after surgery. Questionnaires on taste disturbance, including a visual analogue scale (VAS), and QoL were completed before and up to 1 year after surgery.

Results: Subjective taste disturbance anytime during the 1-year follow-up were reported by 62 and 46%, respectively. The difference in EGM 1 week after surgery compared with preoperative EGM was significantly greater among CSOM patients than otosclerosis. One year postoperatively, the difference is non-significant.

Conclusion: Surgery for CSOM causes greater initial and more long-lasting taste disturbances as compared with surgery for otosclerosis. One-year postoperative taste normalizes for both CSOM and otosclerosis patients according to VAS and EGM measurements. No real change in QoL was seen 1-year postoperatively.

Level of evidence: Level 2 evidence is prospective observational research with an experimental design.

National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:uu:diva-377869 (URN)10.1097/MAO.0000000000002048 (DOI)000457643500011 ()30540698 (PubMedID)
Available from: 2019-02-27 Created: 2019-02-27 Last updated: 2019-03-08Bibliographically approved
Isacsson, G., Nohlert, E., Fransson, A. M., Bornefalk Hermansson, A., Wiman Eriksson, E., Ortlieb, E., . . . Tegelberg, Å. (2019). Use of bibloc and monobloc oral appliances in obstructive sleep apnoea: a multicentre, randomized, blinded, parallel-group equivalence trial. European Journal of Orthodontics, 41(1), 80-88
Open this publication in new window or tab >>Use of bibloc and monobloc oral appliances in obstructive sleep apnoea: a multicentre, randomized, blinded, parallel-group equivalence trial
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2019 (English)In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 41, no 1, p. 80-88Article in journal (Refereed) Published
Abstract [en]

Background: The clinical benefit of bibloc over monobloc appliances in treating obstructive sleep apnoea (OSA) has not been evaluated in randomized trials. We hypothesized that the two types of appliances are equally effective in treating OSA.

Objective: To compare the efficacy of monobloc versus bibloc appliances in a short-term perspective.

Patients and methods: In this multicentre, randomized, blinded, controlled, parallel-group equivalence trial, patients with OSA were randomly assigned to use either a bibloc or a monobloc appliance. One-night respiratory polygraphy without respiratory support was performed at baseline, and participants were re-examined with the appliance in place at short-term follow-up. The primary outcome was the change in the apnoea–hypopnea index (AHI). An independent person prepared a randomization list and sealed envelopes. Evaluating dentist and the biomedical analysts who evaluated the polygraphy were blinded to the choice of therapy.

Results: Of 302 patients, 146 were randomly assigned to use the bibloc and 156 the monobloc device; 123 and 139 patients, respectively, were analysed as per protocol. The mean changes in AHI were −13.8 (95% confidence interval −16.1 to −11.5) in the bibloc group and −12.5 (−14.8 to −10.3) in the monobloc group. The difference of −1.3 (−4.5 to 1.9) was significant within the equivalence interval (P = 0.011; the greater of the two P values) and was confirmed by the intention-to-treat analysis (P = 0.001). The adverse events were of mild character and were experienced by similar percentages of patients in both groups (39 and 40 per cent for the bibloc and monobloc group, respectively).

Limitations: The study shows short-term results with a median time from commencing treatment to the evaluation visit of 56 days and long-term data on efficacy and harm are needed to be fully conclusive.

Conclusion: In a short-term perspective, both appliances were equivalent in terms of their positive effects for treating OSA and caused adverse events of similar magnitude.

Trial registration: Registered with ClinicalTrials.gov (#NCT02148510).

National Category
Dentistry
Identifiers
urn:nbn:se:uu:diva-351365 (URN)10.1093/ejo/cjy030 (DOI)000460616900010 ()29771314 (PubMedID)
Available from: 2018-05-25 Created: 2018-05-25 Last updated: 2019-03-25Bibliographically approved
Ekström, M., Bornefalk, H., Sköld, M., Jansson, C., Blomberg, A., Sandberg, J., . . . Sundh, J. (2019). Validation of the Swedish Multidimensional Dyspnea Profile (MDP) in outpatients with cardiorespiratory disease. BMJ OPEN RESPIRATORY RESEARCH, 6(1), Article ID UNSP e000381.
Open this publication in new window or tab >>Validation of the Swedish Multidimensional Dyspnea Profile (MDP) in outpatients with cardiorespiratory disease
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2019 (English)In: BMJ OPEN RESPIRATORY RESEARCH, ISSN 2052-4439, Vol. 6, no 1, article id UNSP e000381Article in journal (Refereed) Published
Abstract [en]

Introduction Breathlessness is a cardinal symptom in cardiorespiratory disease. An instrument for measuring different aspects of breathlessness was recently developed, the Multidimensional Dyspnea Profile (MDP). This study aimed to validate the MDP in terms of the underlying factor structure, internal consistency, test-retest reliability and concurrent validity in Swedish outpatients with cardiorespiratory disease. Methods Outpatients with stable cardiorespiratory disease and breathlessness in daily life were recruited. Factor structure of MDP was analysed using confirmatory factor analysis; internal consistency was analysed using Cronbach's alpha; and test-retest reliability was analysed using intraclass correlation coefficients (ICCs) for patients with unchanged breathlessness between assessments (baseline, after 30-90 min and 2 weeks). Concurrent validity was evaluated using correlations with validated scales of breathlessness, anxiety, depression and health-related quality of life. Results In total, 182 outpatients with cardiorespiratory disease and breathlessness in daily life were included; 53.3% were women; main diagnoses were chronic obstructive pulmonary disease (24.7%), asthma (21.4%), heart failure (19.2%) and idiopathic pulmonary fibrosis (18.7%). The MDP total, immediate perception and emotional response scores, and individual item scores showed expected factor structure and acceptable measurement properties: internal consistency (Cronbach's alpha, range 0.80-0.93); test-retest reliability at 30-90 min and 2 weeks (ICC, range 0.67-0.91); and concurrent validity. There was no evidence of a learning effect. Findings were similar between diagnoses. Discussion MDP is a valid instrument for multidimensional measurement of breathlessness in Swedish outpatients across cardiorespiratory diseases.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-400011 (URN)10.1136/bmjresp-2018-000381 (DOI)000500491400001 ()31681476 (PubMedID)
Funder
Swedish Heart Lung Foundation
Available from: 2019-12-19 Created: 2019-12-19 Last updated: 2019-12-19Bibliographically approved
Ekström, M., Bornefalk Hermansson, A., Wysham, N., Currow, D. C. & MacIntyre, N. (2018). Spirometric Volumes and Breathlessness Across Levels of Airflow Limitation: The COPDGene Study.. American Journal of Respiratory and Critical Care Medicine, 198(5), 678-681
Open this publication in new window or tab >>Spirometric Volumes and Breathlessness Across Levels of Airflow Limitation: The COPDGene Study.
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2018 (English)In: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 198, no 5, p. 678-681Article in journal, Editorial material (Refereed) Published
Keywords
COPD, Dyspnea, Gender, Lung function
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-351364 (URN)10.1164/rccm.201803-0594LE (DOI)000443435800024 ()29702011 (PubMedID)
Funder
AstraZenecaGlaxoSmithKline (GSK)Swedish Society of MedicineSwedish Heart Lung FoundationSwedish Society for Medical Research (SSMF)
Available from: 2018-05-25 Created: 2018-05-25 Last updated: 2018-11-05Bibliographically approved
Isacsson, G., Nohlert, E., Fransson, A., WimanEriksson, E., Ortlieb, E., Fodor, C., . . . Bornefalk Hermansson, A. (2017). Bibloc and monobloc oral appliances in the treatment of obstructive sleep apnoea: a multicenter, randomized, blinded, parallel-group trial. Paper presented at The 2017 joint congress of World Association of Sleep Medicine (WASM) and World Sleep Federation (WSF), October 7-11, 2017, Prague, Czech Republic.. Sleep Medicine, 40(Supplement 1), E142-E143
Open this publication in new window or tab >>Bibloc and monobloc oral appliances in the treatment of obstructive sleep apnoea: a multicenter, randomized, blinded, parallel-group trial
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2017 (English)In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 40, no Supplement 1, p. E142-E143Article in journal (Refereed) Published
National Category
Dentistry
Identifiers
urn:nbn:se:uu:diva-339868 (URN)10.1016/j.sleep.2017.11.416 (DOI)000444558902416 ()
Conference
The 2017 joint congress of World Association of Sleep Medicine (WASM) and World Sleep Federation (WSF), October 7-11, 2017, Prague, Czech Republic.
Available from: 2018-01-23 Created: 2018-01-23 Last updated: 2019-03-25Bibliographically approved
Ekström, M., Ahmadi, Z., Bornefalk Hermansson, A. & Currow, D. (2017). Oxygen For Breathlessness In Patients With COPD Who Do Not Qualify For Home Oxygen Therapy: An Updated Cochrane Analysis. Paper presented at International Conference of the American-Thoracic-Society (ATS), MAY 19-24, 2017, Washington, AFGHANISTAN. American Journal of Respiratory and Critical Care Medicine, 195, Article ID A5450.
Open this publication in new window or tab >>Oxygen For Breathlessness In Patients With COPD Who Do Not Qualify For Home Oxygen Therapy: An Updated Cochrane Analysis
2017 (English)In: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 195, article id A5450Article in journal, Meeting abstract (Other academic) Published
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-332905 (URN)000400372505252 ()
Conference
International Conference of the American-Thoracic-Society (ATS), MAY 19-24, 2017, Washington, AFGHANISTAN
Available from: 2017-11-06 Created: 2017-11-06 Last updated: 2017-11-06Bibliographically approved
Ekström, M. & Bornefalk-Hermansson, A. (2016). Cardiovascular and antacid treatment and mortality in oxygen-dependent pulmonary fibrosis: A population-based longitudinal study. Respirology (Carlton South. Print), 21(4), 705-711
Open this publication in new window or tab >>Cardiovascular and antacid treatment and mortality in oxygen-dependent pulmonary fibrosis: A population-based longitudinal study
2016 (English)In: Respirology (Carlton South. Print), ISSN 1323-7799, E-ISSN 1440-1843, Vol. 21, no 4, p. 705-711Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND OBJECTIVE: Severe idiopathic pulmonary fibrosis is associated with an increased risk of cardiovascular disease and gastro-oesophageal reflux, which may influence prognosis. We evaluated associations between cardiovascular and antacid medications, and mortality, in oxygen-dependent pulmonary fibrosis (PF) of unknown cause.

METHODS: Prospective population-based study of adults starting long-term oxygen therapy (LTOT) for PF in Sweden 2005-2009. PF of unknown cause was defined by excluding patients with known or probable secondary PF. Time-dependent associations between medications and all-cause mortality were analysed using extended Cox regression, adjusting for potential confounders including age, sex, vital capacity, blood gases, body mass index, performance status, comorbidity and concurrent medications.

RESULTS: Of 462 included patients, 329 (71%) died under observation. No patient was lost to follow-up. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARB) were associated with reduced adjusted mortality (HR 0.63; 0.47-0.85) and antiplatelet drugs with increased mortality (HR 1.49; 1.11-2.00), largely driven by higher mortality in women. There were no associations with mortality for antacid treatments, β-blockers, diuretics or statins.

CONCLUSION: In oxygen-dependent PF, treatment with ACEI/ARB was associated with improved survival, antiplatelet drugs with decreased survival, whereas there was no association between antacid, β-blocker, diuretic or statin treatment and survival.

Keywords
cardiovascular disease; clinical epidemiology; clinical respiratory medicine; interstitial lung disease; lung fibrosis
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-282869 (URN)10.1111/resp.12781 (DOI)000374688900018 ()27009834 (PubMedID)
Available from: 2016-04-07 Created: 2016-04-07 Last updated: 2017-11-30Bibliographically approved
Ahmadi, Z., Sundh, J., Bornefalk Hermansson, A. & Ekström, M. (2016). Does Long-Term Oxygen Therapy 24 H/day Improve Survival Compared To 15 H/day In Hypoxemic Chronic Obstructive Pulmonary Disease?. Paper presented at International Conference of the American-Thoracic-Society (ATS), MAY 13-18, 2016, San Francisco, CA. American Journal of Respiratory and Critical Care Medicine, 193
Open this publication in new window or tab >>Does Long-Term Oxygen Therapy 24 H/day Improve Survival Compared To 15 H/day In Hypoxemic Chronic Obstructive Pulmonary Disease?
2016 (English)In: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 193Article in journal (Refereed) Published
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-315138 (URN)000390749606650 ()
Conference
International Conference of the American-Thoracic-Society (ATS), MAY 13-18, 2016, San Francisco, CA
Available from: 2017-02-09 Created: 2017-02-09 Last updated: 2017-11-29Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0001-9934-8485

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