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Svensson, Malin
Publications (9 of 9) Show all publications
Coelho, R., Ekberg, T., Svensson, M., Mani, M. & Rodriguez-Lorenzo, A. (2017). Reconstruction of late esophagus perforation after anterior cervical spine fusion with an adipofascial anterolateral thigh free flap: A case report.. Microsurgery, 37(6), 684-688
Open this publication in new window or tab >>Reconstruction of late esophagus perforation after anterior cervical spine fusion with an adipofascial anterolateral thigh free flap: A case report.
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2017 (English)In: Microsurgery, ISSN 0738-1085, E-ISSN 1098-2752, Vol. 37, no 6, p. 684-688Article in journal (Refereed) Published
Abstract [en]

Reconstruction of late esophageal perforation usually requires flap surgery to achieve wound healing. However, restoring the continuity between the digestive tract and retropharyngeal space to allow for normal swallowing remains a technical challenge. In this report, we describe the use of a thin and pliable free adipofascial anterolateral thigh (ALT) flap in a 47-year-old tetraplegic man with a history of C5-C6 fracture presented with a large posterior esophagus wall perforation allowing an easier flap insetting for a successful wound closure. The postoperative course was uneventful and mucosalization of the flap was confirmed by esophagoscopy 4 weeks postsurgery. The patient tolerated normal diet and maintained normal swallowing during a follow-up of 3 years postoperatively. The adipofascial ALT flap may provide easier insetting due to the thin and pliable layer of adipofascial tissue for reconstructing large defects of the posterior wall of the esophagus by filling the retroesophageal space.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-335300 (URN)10.1002/micr.30170 (DOI)000411186900030 ()28397296 (PubMedID)
Available from: 2017-12-04 Created: 2017-12-04 Last updated: 2018-01-19Bibliographically approved
Sidibeh, C. O., Pereira, M. J., Börjesson, J. L., Kamble, P. G., Skrtic, S., Katsogianos, P., . . . Eriksson, J. W. (2016). Role of cannabinoid receptor type 1 in glucocorticoid-induced insulin resistance (IR) and lipolysis regulation in human adipose tissue (AT). Paper presented at 52nd Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), SEP 12-16, 2016, Munich, GERMANY. Diabetologia, 59, S244-S245
Open this publication in new window or tab >>Role of cannabinoid receptor type 1 in glucocorticoid-induced insulin resistance (IR) and lipolysis regulation in human adipose tissue (AT)
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2016 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 59, p. S244-S245Article in journal (Refereed) Published
Place, publisher, year, edition, pages
SPRINGER, 2016
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-322053 (URN)000398373701313 ()
Conference
52nd Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), SEP 12-16, 2016, Munich, GERMANY
Available from: 2017-05-16 Created: 2017-05-16 Last updated: 2017-05-16Bibliographically approved
Bengtsson, C., Jonsson, L., Holmström, M., Svensson, M., Theorell-Haglöw, J. & Lindberg, E. (2015). Impact of nasal obstruction on sleep quality: a community-based study of women. European Archives of Oto-Rhino-Laryngology, 272(1), 97-103
Open this publication in new window or tab >>Impact of nasal obstruction on sleep quality: a community-based study of women
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2015 (English)In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 272, no 1, p. 97-103Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to analyse the impact of self-reported nasal obstruction on sleep quality in women. A community-based sample of 400 women underwent a full night of polysomnography. Airway diseases, allergies and sleep-related symptoms were assessed by questionnaires. Women with subjective nasal obstruction were subdivided into three groups: persistent nasal obstruction (PNO, n = 46), hay fever (n = 88) and nasal obstruction at night (NON, n = 30). Sleep problems and related daytime symptoms were most prevalent among women with NON. After adjusting for age, BMI, smoking and asthma, NON was an independent predictor of 'Difficulties inducing sleep due to nasal obstruction' [adjusted odds ratio (95 % CI): 89.5 (27.0-296.7)], 'Snoring' [4.2 (1.7-10.2)], 'Sweating at night' [2.6 (1.1-6.1)], 'Difficulties maintaining sleep' [2.7 (1.2-6.2)], and 'Waking up hastily gasping for breath' [32.2 (8.7-119.1)]. 'Dry mouth on awakening' [7.7 (3.2-18.4)], 'Waking up unrefreshed' [2.7 (1.2-6.0)], 'Excessive daytime sleepiness' [2.6 (1.1-6.0)], and 'Daytime nasal obstruction' [12.2 (4.8-31.2)] were also associated with NON. Persistent nasal obstruction and hay fever were both associated with some reported sleep problems due to an overlap with NON. When women with NON were excluded, only 'Daytime nasal obstruction' was still significantly associated with PNO, while hay fever was associated with 'Daytime nasal obstruction' and 'Waking up hastily gasping for breath'. There were no significant differences in objectively measured sleep variables between any of the three subgroups and the study cohort. Self-reported nasal obstruction at night in women has a significant effect on several subjective day- and nighttime symptoms, but it does not appear to affect objectively measured sleep quality.

National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:uu:diva-231393 (URN)10.1007/s00405-014-3067-6 (DOI)000347292000014 ()24792065 (PubMedID)
Available from: 2014-09-08 Created: 2014-09-08 Last updated: 2019-10-12Bibliographically approved
Bengtsson, C., Jonsson, L., Holmstrom, M., Svensson, M., Theorell-Haglöw, J. & Lindberg, E. (2014). Impact of nasal obstruction on sleep quality - a community based study of women. Paper presented at 22nd Congress of the European-Sleep-Research-Society, SEP 16-20, 2014, Tallinn, ESTONIA. Journal of Sleep Research, 23, 149-149
Open this publication in new window or tab >>Impact of nasal obstruction on sleep quality - a community based study of women
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2014 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 23, p. 149-149Article in journal, Meeting abstract (Other academic) Published
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-249087 (URN)000349960600390 ()
Conference
22nd Congress of the European-Sleep-Research-Society, SEP 16-20, 2014, Tallinn, ESTONIA
Available from: 2015-04-10 Created: 2015-04-10 Last updated: 2017-12-04Bibliographically approved
Spörndly-Nees, S., Åsenlöf, P., Theorell-Haglöw, J., Svensson, M., Igelström, H. & Lindberg, E. (2014). Leisure-time physical activity predicts complaints of snoring in women: a prospective cohort study over 10 years. Sleep Medicine, 15(4), 415-421
Open this publication in new window or tab >>Leisure-time physical activity predicts complaints of snoring in women: a prospective cohort study over 10 years
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2014 (English)In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 15, no 4, p. 415-421Article in journal (Refereed) Published
Abstract [en]

Objective

We aimed to assess the impact of self-reported physical activity on incidence and remission of snoring complaints in women.

Methods

A population-based sample of 4851 women aged >20 years responded to questionnaires in years 2000 and 2010. Based on the responses, the women were categorized into low, medium, or high level of physical activity at baseline and at follow-up.

Results

The prevalence of habitual snoring complaints increased from 7.6% at baseline to 9.2% in 2010 (P<.0001). After adjusting for age, body mass index (BMI), waist and neck circumference, weight gain, smoking status, alcohol dependence, and snoring status at baseline, reported physical activity level at baseline had a protective effect on habitual snoring complaints at follow-up. The adjusted odds ratio (OR) (95% confidence intervals]) for complaints of habitual snoring was 0.7 (0.5–0.9) for the reported medium physical activity level and 0.5 (0.4–0.8) for the high activity level. When subdividing the population by changes in reported physical activity level over the follow-up period, an increase in physical activity was followed by a decrease in the complaint of snoring. Similarly a high level of reported physical activity only had a protective effect on snoring in participants who remained at a high or medium level.

Conclusions

A low level of self-reported physical activity is a risk factor for future habitual snoring complaints in women, independent of weight, weight gain, alcohol dependence, and smoking. Increased physical activity can modify the risk.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-212697 (URN)10.1016/j.sleep.2013.09.020 (DOI)000333762500007 ()
Available from: 2013-12-13 Created: 2013-12-13 Last updated: 2017-12-06Bibliographically approved
Svensson, M., Venge, P., Janson, C. & Lindberg, E. (2012). Relationship Between Sleep-Disordered Breathing and Markers of Systemic Inflammation in Women From the General Population. Journal of Sleep Research, 21(2), 147-154
Open this publication in new window or tab >>Relationship Between Sleep-Disordered Breathing and Markers of Systemic Inflammation in Women From the General Population
2012 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 21, no 2, p. 147-154Article in journal (Refereed) Published
Abstract [sv]

Sleep-disordered breathing (SDB) is a risk factor for cardiovascular disease (CVD). The underlying pathogenesis is not clear. In patients with obstructive sleep apnoea syndrome (OSAS) elevated levels of inflammatory markers, such as C-reactive protein (CRP), interleukin-6 (IL-6) and tumour necrosis factor a (TNFa) have been found. These markers have also been shown as independent markers of CVD in other populations. The aim of the study was to investigate the association between SDB and systemic inflammation in a population-based cohort of women. From 6817 women who previously answered a questionnaire concerning snoring habits, 230 habitually snoring women and 170 women regardless of snoring status went through polysomnography, anthropometric measurements and blood sampling. Analyses were made for CRP, TNFa, IL-6, myeloperoxidase (MPO) and lysozyme. The levels of CRP, IL-6 and lysozyme were significantly higher in subjects with apnoeahypopnoea index (AHI) =15 compared with women with lower AHI. All inflammatory markers except MPO correlated to AHI and oxygen desaturation measures, and to waist circumference. In multiple linear regressions adjusting for age, waist circumference and smoking, independent correlations between oxygen desaturation indices (ODI) and inflammation were found for IL-6 (P = 0.03 for % sleep time with saturation <90%) and TNFa (P = 0.03 for ODI 3%). No significant correlations were found between AHI and inflammation. Also, for women from the general population there is an independent correlation between SDB and inflammation, even after adjusting for obesity. The results indicate that intermittent hypoxia, and not the AHI, is related to systemic inflammation seen in OSAS.

Keywords
sleep apnea, inflammation, women
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-97948 (URN)10.1111/j.1365-2869.2011.00946.x (DOI)000301931500004 ()
Available from: 2009-01-23 Created: 2009-01-23 Last updated: 2017-12-14Bibliographically approved
Lindberg, E., Theorell-Haglöw, J., Svensson, M., Gislason, T., Berne, C. & Janson, C. (2012). Sleep apnea and glucose metabolism: a long-term follow-up in a community-based sample. Chest, 142(4), 935-942
Open this publication in new window or tab >>Sleep apnea and glucose metabolism: a long-term follow-up in a community-based sample
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2012 (English)In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 142, no 4, p. 935-942Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

It has been suggested that sleep-disordered breathing (SDB) is a risk factor for diabetes, but long-term follow-ups are lacking. The aim of this community-based study was to analyze the influence of SDB on glucose metabolism after more than 10 years.

METHODS:

Men without diabetes (n=141, mean age 57.5 years) were investigated at baseline, including whole-night respiratory monitoring. After a mean period of 11 years and 4 months, they were followed up with an interview, anthropometric measurements and blood sampling. Insulin resistance was quantified using the homeostasis model assessment (HOMA). ΔHOMA-IR was calculated as (HOMA-IR(follow-up) - HOMA-IR(baseline)). An oral glucose tolerance test was performed in 113 men to calculate the insulin sensitivity index (ISI).

RESULTS:

The mean apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) at baseline were 4.7 and 3.3, respectively. At the follow-up, 23 men had diabetes. An oxygen desaturation index (ODI) of >5 was a predictor of developing diabetes (adj. OR 4.4, 95% CI 1.1-18.1 after adjusting for age, BMI(baseline,) ΔBMI, hypertension and years with CPAP during the period). The ODI was inversely related to the ISI at the follow-up (r= -0.27, p=0.003). A deterioration in HOMA-IR was significantly related to all variables of sleep-disordered breathing (AHI, AHI>5, ODI, ODI>5 and MinSaO2) even when adjusting for confounders. When excluding the variable "years on CPAP" from the multivariate model, all associations weakened.

CONCLUSIONS:

SDB is independently related to the development of insulin resistance and thereby the risk of manifest diabetes mellitus.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-191208 (URN)10.1378/chest.11-1844 (DOI)000317153200019 ()22499826 (PubMedID)
Available from: 2013-01-09 Created: 2013-01-09 Last updated: 2018-06-29Bibliographically approved
Lindberg, E., Berne, C., Franklin, K. A., Svensson, M. & Janson, C. (2007). Snoring and daytime sleepiness as risk factors for hypertension and diabetes in women--a population-based study. Respiratory Medicine, 101(6), 1283-1290
Open this publication in new window or tab >>Snoring and daytime sleepiness as risk factors for hypertension and diabetes in women--a population-based study
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2007 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 101, no 6, p. 1283-1290Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to analyze whether snoring and excessive daytime sleepiness (EDS), the main symptoms of obstructive sleep apnea syndrome (OSAS), are associated with hypertension and diabetes in women. A random sample of 6779 women aged 20–99 years answered questionnaires on sleep disturbances, daytime symptoms and somatic diseases. The women were categorized into four groups: “no EDS or snoring” (reference group), “snoring but no EDS”, “EDS but no snoring” and “snoring and EDS”. Prevalences of hypertension and diabetes were lowest in the reference group (8.7% and 1.6%, respectively) and highest among women with both snoring and EDS (hypertension: 26.3%, diabetes: 5.8%). In a multivariate model adjusting for age, body mass index, smoking, physical activity and alcohol dependency, “snoring and EDS” was a risk factor for hypertension (adjusted OR 1.82 (95% CI 1.30–2.55)) while isolated snoring or EDS was not. “Snoring and EDS” was more closely related to hypertension among women aged <50 years (adj. OR 3.41 (1.78–6.54) vs. 1.50 (1.02–2.19), P=0.01). For diabetes, both “EDS but no snoring” and “snoring and EDS” were risk factors and the associations were most pronounced in women aged >50 years (adj. OR 2.33 (1.28–4.26) for “EDS but no snoring” and 2.00 (1.05–3.84) for “snoring and EDS”). We conclude that the combination of snoring and EDS is a risk factor for hypertension and diabetes in women. For hypertension, the risk is partly age dependent and, for diabetes, EDS without snoring is a risk factor of similar magnitude. These differences might indicate differences in pathophysiologic mechanisms underlying the association between sleep-disordered breathing and hypertension and diabetes respectively.

Keywords
Diabetes, Epidemiology, Hypertension, Sleepiness, Snoring, Women
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-11742 (URN)10.1016/j.rmed.2006.10.015 (DOI)000247313000031 ()17127049 (PubMedID)
Available from: 2008-01-22 Created: 2008-01-22 Last updated: 2017-12-11Bibliographically approved
Svensson, M., Holmström, M., Broman, J.-E. & Lindberg, E. (2006). Can anatomical and functional features in the upper airways predict sleep apnea? A population-based study in females. Acta Oto-Laryngologica, 126(6), 613-620
Open this publication in new window or tab >>Can anatomical and functional features in the upper airways predict sleep apnea? A population-based study in females
2006 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 126, no 6, p. 613-620Article in journal (Refereed) Published
Abstract [en]

CONCLUSION: The importance of clinical findings in the nose and throat, including fiberoptic endoscopy during the Muller maneuver, in predicting sleep apnea is greater in normal-weight than in overweight women. OBJECTIVES: The aim of this study was to identify clinical features that could predict sleep apnea in women. METHOD: From 6817 women who previously answered a questionnaire concerning snoring habits, 230 women who reported habitual snoring and 170 women from the whole cohort went through a full-night polysomnography. A nose and throat examination including fiber endoscopic evaluation of the upper airways during the Muller maneuver was performed in a random selection of 132 women aged 20-70 years. RESULTS: Sleep apnea was defined as an apnea-hypopnea index of > or = 10. The influence of clinical features on the prevalence of sleep apnea varied between normal-weight and overweight women. A low soft palate, retrognathia, the uvula touching the posterior pharyngeal wall in the supine position, and a 75% or more collapse at the soft palate during the Muller maneuver were all significant predictors of sleep apnea in women with a body mass index (BMI) < 25 kg/m2 but not in overweight women.

Keywords
women, nose and throat, sleep apnea
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-97946 (URN)10.1080/00016480500468984 (DOI)16720446 (PubMedID)
Available from: 2009-01-23 Created: 2009-01-23 Last updated: 2017-12-14Bibliographically approved
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