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  • 401.
    Wilkinson, Tom
    et al.
    Southampton Univ, Fac Med, Southampton, Hants, England.
    Schembri, Stuart
    Univ Dundee, Scottish Ctr Resp Res, Dundee, Scotland.
    Brightling, Christopher
    Univ Leicester, Inst Lung Hlth, Leicester, Leics, England.
    Bakerly, Nawar Diar
    Salford Royal NHS Fdn Trust, Salford, Lancs, England.
    Macnee, William
    Univ Edinburgh, Edinburgh, Midlothian, Scotland.
    Rombo, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Hedner, Jan
    Sahlgrens Univ Hosp, Gothenburg, Sweden.
    Allen, Martin
    Univ Hosp North Midlands NHS Trust, Stoke On Trent, Staffs, England.
    Walker, Paul
    Aintree Univ Hosp NHS Fdn Trust, Liverpool, Merseyside, England.
    De Ryck, Iris
    GSK, Siena, Italy.
    Tasciotti, Annaelisa
    GSK, Siena, Italy.
    Casula, Daniela
    GSK, Siena, Italy.
    Testa, Marco
    GSK, Siena, Italy.
    Arora, Ashwani Kumar
    GSK, Siena, Italy.
    Late Breaking Abstract - Safety and immunogenicity of non-typeable H. influenzae (NTHi) adjuvanted vaccine in older adults with chronic obstructive pulmonary disease (COPD)2018In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52Article in journal (Other academic)
  • 402.
    Wleklik, Marta
    et al.
    Wroclaw Med Univ, Dept Clin Nursing, Wroclaw, Poland.
    Lisiak, Magdalena
    Wroclaw Med Univ, Dept Clin Nursing, Wroclaw, Poland.
    Andreae, Christina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Uchmanowicz, Izabella
    Wroclaw Med Univ, Dept Clin Nursing, Wroclaw, Poland.
    Psychometric Evaluation Of Appetite Questionnaires In Elderly Polish Patients With Heart Failure2019In: Patient Preference and Adherence, ISSN 1177-889X, E-ISSN 1177-889X, Vol. 13, p. 1751-1759Article in journal (Refereed)
    Abstract [en]

    Purpose: Loss of appetite is caused by multifaceted disorders and affects an average of 40% of patients with heart failure (HF). The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ) are designed to assess appetite among older adults. We aimed to assess the psychometric properties of both CNAQ and SNAQ questionnaires in elderly Polish patients with HF. Methods: The study sample involved 103 patients aged >= 65 years with HF diagnosed according to the New York Heart Association (NYHA) functional classes II-IV. The study was conducted among hospitalized patients with HF. In the study, the Mini Nutritional Assessment (MNA) questionnaire was used to assess the validity of the questionnaire. The evaluation of the following psychometric values was taken into account: data quality and homogeneity, factor structure, construct validity and internal consistency. Results: Parallel analysis confirmed the unidimensional structure of both CNAQ and SNAQ. The adjusted eigenvalues for CNAQ were 3.50 for the first factor and 0.62 for the second factor, and for SNAQ they were 2.2 and 0.31, respectively. For CNAQ, the desired CFA values were obtained after modification (RMSEA <0.06, CFI, TLI> 0.95), for SNAQ without modification (RMSEA <0.06, CFI, TLI> 0.95). The correlation between CNAQ and SNAQ and MNA was strong (rs = 0.8 and rs = 0.81, p <0.001, respectively). The internal consistency of the CNAQ and SNAQ tools was 0.88 and 0.86, respectively. Conclusion: The CNAQ and SNAQ questionnaires have positive psychometric properties and can be used to evaluate appetite among elderly Polish patients with HF.

  • 403.
    Wood, William A.
    et al.
    Univ N Carolina, Div Hematol Oncol, Dept Med, Chapel Hill, NC 27515 USA.
    Brazauskas, Ruta
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA.
    Hu, Zhen-Huan
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.
    Abdel-Azim, Hisham
    Univ Southern Calif, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Keck Sch Med, Los Angeles, CA USA.
    Ahmed, Ibrahim A.
    Childrens Mercy Hosp & Clin, Dept Hematol Oncol & Bone Marrow Transplantat, Kansas City, MO USA.
    Aljurf, Mahmoud
    King Faisal Specialist Hosp & Res Ctr, Dept Oncol, Riyadh, Saudi Arabia.
    Badawy, Sherif
    Ann & Robert H Lurie Childrens Hosp Chicago, Div Hematol Oncol & Stem Cell Transplantat, Chicago, IL 60611 USA.
    Beitinjaneh, Amer
    Univ Miami, Dept Hematol Oncol, Miami, FL USA.
    George, Biju
    Christian Med Coll & Hosp, Vellore, Tamil Nadu, India.
    Buchbinder, David
    Childrens Hosp Orange Cty, Div Pediat Hematol, Orange, CA 92668 USA.
    Cerny, Jan
    UMass Mem Med Ctr, Div Hematol Oncol, Worcester, MA USA.
    Dedeken, Laurence
    Hop Univ Enfants Reine Fabiola, Dept Hematol Oncol, Brussels, Belgium.
    Angel Diaz, Miguel
    Hosp Infantil Univ Nino Jesus, Dept Hematol Oncol, Madrid, Spain.
    Freytes, Cesar O.
    Texas Transplant Inst, San Antonio, TX USA.
    Ganguly, Siddhartha
    Univ Kansas, Med Ctr, Blood & Marrow Transplantat, Div Hematol & Oncol, Kansas City, KS 66103 USA.
    Gergis, Usama
    Presbyterian Hosp, Hematolg Malignancies & Bone Marrow Transplant, Dept Med Oncol, Weill Cornell Med Ctr, New York, NY USA.
    Gomez Almaguer, David
    Hosp Univ Autonoma Nuevo Leon, Monterrey, Mexico.
    Gupta, Ashish
    Univ Hosp Cleveland, Seidman Canc Ctr, Med Ctr, Cleveland, OH 44106 USA.
    Hale, Gregory
    Johns Hopkins All Childrens Hosp, Dept Hematol Oncol, St Petersburg, FL USA.
    Hashmi, Shahrukh K.
    Mayo Clin, Dept Internal Med, Rochester, MN USA;King Faisal Specialist Hosp & Res Ctr, Oncol Ctr, Riyadh, Saudi Arabia.
    Inamoto, Yoshihiro
    Natl Canc Ctr, Div Hematopoiet Stem Cell Transplantat, Tokyo, Japan.
    Kamble, Rammurti T.
    Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX 77030 USA.
    Adekola, Kehinde
    Northwestern Univ, Div Hematol Oncol, Dept Med, Chicago, IL 60611 USA;Northwestern Univ, Robert H Lurie Comprehens Canc Ctr, Feinberg Sch Med, Chicago, IL 60611 USA.
    Kindwall-Keller, Tamila
    Univ Virginia Hlth Syst, Div Hematol Oncol, Charlottesville, VA USA.
    Knight, Jennifer
    Med Coll Wisconsin, Dept Psychol, Milwaukee, WI 53226 USA.
    Kumar, Lalit
    All India Inst Med Sci, Inst Rotary Canc Hosp, Dept Med Oncol, New Delhi, India.
    Kuwatsuka, Yachiyo
    Nagoya Univ, Ctr Adv Med & Clin Res, Grad Sch Med, Nagoya, Aichi, Japan.
    Law, Jason
    Floating Hosp Children, Tufts Med Ctr, Dept Pediat, Boston, MA USA.
    Lazarus, Hillard M.
    Univ Hosp Cleveland, Seidman Canc Ctr, Med Ctr, Cleveland, OH 44106 USA.
    LeMaistre, Charles
    Sarah Cannon, Hematol & Bone Marrow Transplant, Nashville, TN USA.
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.
    Pulsipher, Michael A.
    Univ Southern Calif, Childrens Hosp Los Angeles, Div Hematol & Blood & Marrow Transplantat, Keck Sch Med, Los Angeles, CA USA.
    Savani, Bipin N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA.
    Schultz, Kirk R.
    Univ British Columbia, British Columbias Childrens Hosp, Dept Pediat Hematol Oncol & Bone Marrow Transplan, Vancouver, BC, Canada.
    Saad, Ayman A.
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA.
    Seftel, Matthew
    CancerCare Manitoba, Dept Med Oncol & Hematol, Winnipeg, MB, Canada.
    Seo, Sachiko
    Natl Canc Res Ctr East, Dept Hematol & Oncol, Chiba, Japan.
    Shea, Thomas C.
    Univ N Carolina, Div Hematol Oncol, Dept Med, Chapel Hill, NC 27515 USA.
    Steinberg, Amir
    Mt Sinai Hosp, Dept Hematol Oncol, New York, NY 10029 USA.
    Sullivan, Keith
    Duke Univ, Med Ctr, Durham, NC USA.
    Szwajcer, David
    CancerCare Manitoba, Dept Med Oncol & Hematol, Winnipeg, MB, Canada.
    Wirk, Baldeep
    Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA.
    Yared, Jean
    Univ Maryland, Dept Med, Greenebaum Canc Ctr, Blood & Marrow Transplantat Program,Div Hematol O, Baltimore, MD 21201 USA.
    Yong, Agnes
    Univ Adelaide, Royal Adelaide Hosp, SA Pathol, Adelaide, SA, Australia;Univ Adelaide, Sch Med, Adelaide, SA, Australia.
    Dalal, Jignesh
    Univ Hosp Cleveland, Seidman Canc Ctr, Med Ctr, Cleveland, OH 44106 USA.
    Hahn, Theresa
    Roswell Pk Canc Inst, Dept Med, Buffalo, NY 14263 USA.
    Khera, Nandita
    Mayo Clin, Dept Hematol Oncol, Phoenix, AZ USA.
    Bonfim, Carmem
    Hosp Clin Fed Univ Parana, Curitiba, Parana, Brazil.
    Atsuta, Yoshiko
    Nagoya Univ, Ctr Adv Med & Clin Res, Grad Sch Med, Nagoya, Aichi, Japan.
    Saber, Wael
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.
    Country-Level Macroeconomic Indicators Predict Early Post-Allogeneic Hematopoietic Cell Transplantation Survival in Acute Lymphoblastic Leukemia: A CIBMTR Analysis2018In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 24, no 9, p. 1928-1935Article in journal (Refereed)
    Abstract [en]

    For patients with acute lymphoblastic leukemia (ALL), allogeneic hematopoietic cell transplantation (alloHCT) offers a potential cure. Life-threatening complications can arise from alloHCT that require the application of sophisticated health care delivery. The impact of country-level economic conditions on post-transplantation outcomes is not known. Our objective was to assess whether these variables were associated with outcomes for patients transplanted for ALL. Using data from the Center for Blood and Marrow Transplant Research, we included 11,261 patients who received a first alloHCT for ALL from 303 centers across 38 countries between the years of 2005 and 2013. Cox regression models were constructed using the following macroeconomic indicators as main effects: Gross national income per capita, health expenditure per capita, and Human Development Index (HDI). The outcome was overall survival at 100 days following transplantation. In each model, transplants performed within lower resourced environments were associated with inferior overall survival. In the model with the HDI as the main effect, transplants performed in the lowest HDI quartile (n = 697) were associated with increased hazard for mortality (hazard ratio, 2.42; 95% confidence interval, 1.64 to 3.57; P < .001) in comparison with transplants performed in the countries with the highest HDI quartile. This translated into an 11% survival difference at 100 days (77% for lowest HDI quartile versus 88% for all other quartiles). Country-level macroeconomic indices were associated with lower survival at 100 days after alloHCT for ALL. The reasons for this disparity require further investigation.

  • 404. Xu, Weiping
    et al.
    Morris, Ulrika
    Aydin-Schmidt, Berit
    Msellem, Mwinyi I.
    Shakely, Deler
    Petzold, Max
    Bjorkman, Anders
    Mårtensson, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    SYBR Green Real-Time PCR-RFLP Assay Targeting the Plasmodium Cytochrome B Gene - A Highly Sensitive Molecular Tool for Malaria Parasite Detection and Species Determination2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 3, article id e0120210Article in journal (Refereed)
    Abstract [en]

    A prerequisite for reliable detection of low-density Plasmodium infections in malaria pre-elimination settings is the availability of ultra-sensitive and high-throughput molecular tools. We developed a SYBR Green real-time PCR restriction fragment length polymorphism assay (cytb-qPCR) targeting the cytochrome b gene of the four major human Plasmodium species (P. falciparum, P. vivax, P. malariae, and P. ovale) for parasite detection and species determination with DNA extracted from dried blood spots collected on filter paper. The performance of cytb-qPCR was first compared against four reference PCR methods using serially diluted Plasmodium samples. The detection limit of the cytb-qPCR was 1 parasite/mu l (p/mu l) for P. falciparum and P. ovale, and 2 p/mu l for P. vivax and P. malariae, while the reference PCRs had detection limits of 0.5-10 p/mu l. The ability of the PCR methods to detect low-density Plasmodium infections was then assessed using 2977 filter paper samples collected during a cross-sectional survey in Zanzibar, a malaria pre-elimination setting in sub-Saharan Africa. Field samples were defined as 'final positive' if positive in at least two of the five PCR methods. Cytb-qPCR preformed equal to or better than the reference PCRs with a sensitivity of 100% (65/65; 95% CI 94.5-100%) and a specificity of 99.9%(2910/2912; 95% CI 99.7-100%) when compared against 'final positive' samples. The results indicate that the cytb-qPCR may represent an opportunity for improved molecular surveillance of low-density Plasmodium infections in malaria pre-elimination settings.

  • 405.
    Zander, Viktoria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Univ Hosp Solna, Dept Womens & Childrens Hlth, Karolinska Inst, S-17176 Stockholm, Sweden..
    Eriksson, Henrik
    Swedish Red Cross Univ Coll, Dept Nursing & Care, S-11428 Stockholm, Sweden..
    Christensson, Kyllike
    Karolinska Univ Hosp Solna, Dept Womens & Childrens Hlth, Karolinska Inst, S-17176 Stockholm, Sweden..
    Mullersdorf, Maria
    Malardalen Univ, Sch Hlth Care & Social Welf, S-63105 Eskilstuna, Sweden..
    Development of an Interview Guide Identifying the Rehabilitation Needs of Women from the Middle East Living with Chronic Pain2015In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 12, no 10, p. 12043-12056Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to develop an interview guide for use by primary healthcare professionals to support them in identifying the rehabilitation needs of forced resettled women from the Middle East living with chronic pain. Previous findings together with the existing literature were used as the basis for developing the interview guide in three steps: item generation, cognitive interviews, and a pilot study. The study resulted in a 16-item interview guide focusing on patients' concerns and expectations, with consideration of pre-migration, migration, and post-migration factors that might affect their health. With the help of the guide, patients were also invited to identify difficulties in their daily activities and to take part in setting goals and planning their rehabilitation. The current interview guide provides professional guidance to caretakers, taking a person-centered participative point of departure when meeting and planning care, for and together, with representatives from dispersed ethnic populations in Sweden. It can be used together with the patient by all staff members working in primary healthcare, with the aim of contributing to continuity of care and multi-professional collaboration.

  • 406.
    Zander, Viktoria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Womens & Childrens Hlth, SE-17177 Stockholm, Sweden.
    Eriksson, Henrik
    Swedish Red Cross Univ Coll, Dept Nursing & Care, Stockholm, Sweden.
    Christensson, Kyllike
    Karolinska Inst, Dept Womens & Childrens Hlth, SE-17177 Stockholm, Sweden.
    Müllersdorf, Maria
    Sch Hlth Care & Social Welf, Eskilstuna, Vasteras, Sweden.
    Rehabilitation of Women From the Middle East Living With Chronic Pain-Perceptions From Health Care Professionals.2014In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 11, p. 1194-1207Article in journal (Refereed)
    Abstract [en]

    Meeting patients from other countries constitutes a challenge for health care. The purpose of this study was to increase knowledge about tacit understandings of treatment in practice by determining the perceptions of chronic pain and rehabilitation directed to resettled women from the Middle East, from a variety of health care professionals within primary care. Based on the results, we find a need to support and increase knowledge among health care professionals to involve the patient and consider her beliefs, expectations, background, current life situation, and spirituality, and to involve family in rehabilitation.

  • 407.
    Zavos, A.
    et al.
    Senol Hellen Soc, Athens, Greece..
    Valachis, Antonis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology. Malarsjukhuset, Dept Oncol, S-63188 Eskilstuna, Sweden..
    Risk of chemotherapy-induced amenorrhea in patients with breast cancer: a systematic review and meta-analysis2016In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 55, no 6, p. 664-670Article, review/survey (Refereed)
    Abstract [en]

    Background: The aim of the study was to calculate the rate of chemotherapy-induced amenorrhea (CIA) after treatment with different adjuvant therapies in patients with breast cancer and to evaluate the risk factors for CIA based on the quality of evidence.Patient and methods: A search of PubMed and ISI Web of Science was performed. All published trials with female breast cancer patients who received adjuvant chemotherapy and presented data on the rate of CIA were considered eligible. The pooled rates of CIA were calculated by random effects model. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each potential risk factor for CIA by using the generic inverse weighted method.Results: We identified 580 potentially relevant studies, of which 75 were included in the analysis. Among 75 eligible studies, 19 different definitions of CIA have been used. The pooled rate of CIA was 55% (95% CI 50-60%) including 23 673 patients from 74 studies. The rate of CIA was increased by age with an estimate of 26% (95% CI 12-43%), 39% (95% CI 31-58%), and 77% (95% CI 71-83%) for women<35, 35-40, and>40 years old, respectively. Two risk factors were associated with the occurrence of CIA and were supported by strong level of evidence: older age (>40 years old), and the use of tamoxifen.Conclusions: This meta-analysis summarized the updated evidence on the impact of different adjuvant treatment regimens for breast cancer in menstruation and could serve as a helpful guide for oncologists during the discussion with their patients on fertility issues before decision on adjuvant therapy is made. A uniform definition of CIA is essential in future studies to make the interpretation of results more reliable.

  • 408.
    Zewenghiel, Luwam
    et al.
    Orebro Univ, Inst Med Sci, Campus USO, S-70182 Orebro, Sweden.
    Lindman, Henrik
    Akad Univ Hosp, Dept Oncol, Uppsala, Sweden.
    Valachis, Antonis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Malarsjukhuset, Dept Oncol, Eskilstuna, Sweden.
    Impact of body mass index on the efficacy of endocrine therapy in patients with metastatic breast cancer - A retrospective two-center cohort study2018In: Breast, ISSN 0960-9776, E-ISSN 1532-3080, Vol. 40, p. 136-140Article in journal (Refereed)
    Abstract [en]

    Bakground: The aim of this study was to investigate the impact of body mass index (BMI) on the efficacy of endocrine therapy in postmenopausal women with metastatic hormone receptor breast cancer (HR+BC) as well as to identify if the potential difference in efficacy was associated with Fulvestrant only or both aromatase inhibitors (AIs) and Fulvestrant. Methods: A consecutive cohort of postmenopausal women with HR+metastatic breast cancer that have received endocrine therapy including Fulvestrant as a metastatic treatment strategy at the Departments of Oncology in Eskilstuna and Uppsala, Sweden, between 2008 and 2016 were identified. The primary outcome of the study was time to disease progression (TTP) during the treatment with Fulvestrant in overweight and obese women compared to patient with normal BMI. Results: In total, 173 patients were enrolled in the study cohort, amongst these, 141 patients received both Fulvestrant and Als and 32 received only Fulvestrant. No statistical significant association was observed between the three BMI categories and TTP, during Fulvestrant treatment (p = 0.136). The rates of objective response and clinical benefit due to Fulvestrant were similar among patients with normal weight, overweight and obesity, respectively. Conclusions: No difference in treatment efficacy was seen between normal, overweight and obese women with metastatic HR+BC, when treated with Fulvestrant. Until further research with prospective studies is available, there is no evidence to support any modification in how Fulvestrant treatment is used in patients with metastatic breast cancer in regard to BMI.

  • 409.
    Åhman, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Axelsson, Ove
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Maras, Gordan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Lindgren, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Ultrasonographic fetal soft markers in a low-risk population: prevalence, association with trisomies and invasive tests2014In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 93, no 4, p. 367-373Article in journal (Refereed)
    Abstract [en]

    Objective

    To investigate the prevalence of soft markers identified at second trimester ultrasound in a low-risk population and the association of these markers with trisomies and invasive testing.

    Design

    Prospective observational study.

    Setting

    Swedish University Hospital.

    Population

    All women with fetuses examined by ultrasound at 15+0–22+0 weeks gestation between July 2008 and March 2011.

    Methods

    Cases with soft markers were compared with non-cases with regard to trisomies and invasive testing.

    Main outcome measures

    Prevalence of soft markers, likelihood ratio for trisomies and risk ratio for invasive tests after detection of soft markers.

    Results

    Second trimester ultrasound was performed on 10 710 fetuses. Markers were detected in 5.9% of fetuses. 5.1% were isolated, 0.7% were multiple and 0.1% were combined with an anomaly. Presence of markers showed a positive likelihood ratio for Down syndrome, but the association (likelihood ratio = 7.1) was only statistically significant for the combined category of any marker (isolated, multiple or combined with anomaly). The risk ratio for invasive testing after the second trimester ultrasound was 24.0 in pregnancies with isolated soft markers compared with those without markers.

    Conclusion

    In a low-risk population, soft markers were found in 5.9% of fetuses at second trimester ultrasound. The likelihood ratio for Down syndrome was significant only for any marker (isolated, multiple or combined with anomaly). The presence of soft markers increased the incidence of invasive procedures substantially. Soft markers should be noted when information on second trimester ultrasound is formulated, and all units performing fetal ultrasound examinations should have established routines concerning information management when soft markers are identified.

  • 410.
    Ångerud, Katja
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Annerbäck, Eva-Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research.
    Boddeti, Santosh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Kristiansson, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Adverse childhood experiences and depressive symptomatology among pregnant women2018In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 97, no 6, p. 701-708Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Adverse childhood experiences (ACE) result in somatic and mental health disturbances. Its influence on antenatal depression is scarcely studied. This study examined the association between experience of ACE and antenatal depressive symptomatology.

    MATERIAL AND METHODS: 1257 women from 172 antenatal clinics in Sweden were surveyed during pregnancy and one year after delivery. Demographics, previous medical history and Edinburgh Postpartum Depression Scale (EPDS) were collected in pregnancy and postpartum and ACE one year postpartum. ACEs were partitioned into 10 categories. Statistical analyses used linear and logistic regression with EPDS score as main outcome measure.

    RESULTS: 736 (58.6%) women reported at least one ACE category and 88 women (7%) reported five or more ACE categories. An EPDS score of ≥13, which qualifies for a probable depression diagnosis, was reported by 277 (23%) women. In simple regression analyses the EPDS score was positively associated with the number of ACEs, cigarette smoking before pregnancy, body mass index and psychiatric disorders while education level was inversely associated. In a multiple regression analysis ACEs, education level and psychiatric disorder remained associated to the EPDS score. Among women with an ACE score ≥5 the odds ratio of having an EPDS score indicating probable depression was 4.2 (CI; 2.5-7.0).

    CONCLUSIONS: ACE was commonly reported. ACE and depressive symptomatology in late pregnancy were strongly associated in a dose-response manner. Women with several ACEs had high odds of depressive symptomatology in late pregnancy and were more likely to report depressive symptoms both in late pregnancy and postpartum.

  • 411.
    Österberg, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Kvist, Joanna
    Dahlgren, Madeleine Abrandt
    Ways of experiencing participation and factors affecting the activity level after nonreconstructed anterior cruciate ligament injury: a qualitative study2013In: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 43, no 3, p. 172-183Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN:

    Phenomenographic, cross-sectional.

    OBJECTIVES:

    To describe ways of experiencing participation in activities of individuals with a nonreconstructed anterior cruciate ligament injury and to describe the emotional aspects related to participation. Further, the objective was to explore factors affecting the activity level.

    BACKGROUND:

    The importance of assessing different factors (knee status, muscle performance, psychological factors, performance-based tests, and subjective rating of knee function) after an anterior cruciate ligament injury has been emphasized. However, the results of these assessments do not answer the question of how the individuals themselves experience their participation in activities.

    METHODS:

    Semi-structured interviews were conducted with 19 strategically selected informants (age range, 18-43 years) who had sustained an anterior cruciate ligament injury 18 to 67 months previously. A phenomenographic approach, which describes individuals' ways of experiencing a phenomenon, was used.

    RESULTS:

    Five qualitatively different categories were identified: (A) unconditioned participation, (B) participation as conditioned by risk appraisal, (C) participation as conditioned by experienced control of the knee, (D) participation as conditioned by experienced knee impairment, and (E) participation as conditioned by neglecting the knee injury. Within each category, 5 interrelated aspects were discerned: focus, level of performance, activities, strategies, and feelings. Categories A, C, and E reflected experiences of full participation, whereas categories B and D reflected experiences of modified participation. There were mostly positive feelings regarding participation. Negative feelings were expressed in category D. Factors affecting the activity level were grouped according to the framework of the International Classification of Functioning, Disability and Health and described as facilitating or hindering the activity level. Facilitating factors included regaining and maintaining physical function, regaining confidence in knee function, and learning/relearning movement patterns. Hindering factors included fear of injury/reinjury, uncontrollable giving way, and loss of motivation.

    CONCLUSION:

    With different strategies, most of the informants achieved a satisfactory activity level, despite impairments and decreased activity level. Both physical and psychological factors were described to affect the activity level, as well as time since injury.

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