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  • 1. Aavik, Einari
    et al.
    Lumivuori, Henri
    Leppänen, Olli
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Wirth, Thomas
    Hakkinen, Sanna-Kaisa
    Braesen, Jan-Hinrich
    Beschorner, Ulrich
    Zeller, Thomas
    Braspenning, Maarten
    van Criekinge, Wim
    Makinen, Kimmo
    Yla-Herttuala, Seppo
    Global DNA methylation analysis of human atherosclerotic plaques reveals extensive genomic hypomethylation and reactivation at imprinted locus 14q32 involving induction of a miRNA cluster2015Ingår i: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 36, nr 16, s. 993-U23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims Genetics can explain just above 10% of the observed heritability in cardiovascular diseases. Epigenetics is about to provide some further explanations, but the information needed for that is in the accumulation phase. Genome-wide DNA methylation analysis has revealed thousands of genes, which are epigenetically differentially regulated in atherosclerotic plaques. Our results point to an additional level of complexity that needs to be integrated into the aetiology of atherogenesis.We conducted a genome-wide analysis to identify differentially methylated genes in atherosclerotic lesions. Methods DNA methylation at promoters, exons and introns was identified by massive parallel sequencing. Gene expression was analysed by microarrays, qPCR, immunohistochemistry and western blots. Results Globally, hypomethylation of chromosomal DNA predominates in atherosclerotic plaques and two-thirds of genes showing over 2.5-fold differential in DNA methylation are up-regulated in comparison to healthy mammary arteries. The imprinted chromatin locus 14q32 was identified for the first time as an extensively hypomethylated area in atherosclerosis with highly induced expression of miR127, -136, -410, -431, -432, -433 and capillary formation-associated gene RTL1. The top 100 list of hypomethylated promoters exhibited over 1000-fold enrichment for miRNAs, many of which mapped to locus 14q32. Unexpectedly, also gene body hypermethylation was found to correlate with stimulated mRNA expression. Conclusion Significant changes in genomic methylation were identified in atherosclerotic lesions. The most prominent gene cluster activated via hypomethylation was detected at imprinted chromosomal locus 14q32 with several clustered miRNAs that were up-regulated. These results suggest that epigenetic changes are involved in atherogenesis and may offer new potential therapeutic targets for vascular diseases.

  • 2.
    Abu Hamdeh, Sami
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Neurokirurgi.
    Marklund, Niklas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Neurokirurgi.
    Lannsjö, Marianne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Howells, Tim
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Neurokirurgi.
    Raininko, Raili
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Wikström, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Enblad, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Neurokirurgi.
    Extended anatomical grading in diffuse axonal injury using MRI: Hemorrhagic lesions in the substantia nigra and mesencephalic tegmentum indicate poor long-term outcome2017Ingår i: Journal of Neurotrauma, ISSN 0897-7151, E-ISSN 1557-9042, Vol. 5, nr 34, s. 341-352Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Clinical outcome after traumatic diffuse axonal injury (DAI) is difficult to predict. In this study, three magnetic resonance imaging (MRI) sequences were used to quantify the anatomical distribution of lesions, to grade DAI according to the Adams grading system, and to evaluate the value of lesion localization in combination with clinical prognostic factors to improve outcome prediction. Thirty patients (mean 31.2 years ±14.3 standard deviation) with severe DAI (Glasgow Motor Score [GMS] <6) examined with MRI within 1 week post-injury were included. Diffusion-weighted (DW), T2*-weighted gradient echo and susceptibility-weighted (SWI) sequences were used. Extended Glasgow outcome score was assessed after 6 months. Number of DW lesions in the thalamus, basal ganglia, and internal capsule and number of SWI lesions in the mesencephalon correlated significantly with outcome in univariate analysis. Age, GMS at admission, GMS at discharge, and low proportion of good monitoring time with cerebral perfusion pressure <60 mm Hg correlated significantly with outcome in univariate analysis. Multivariate analysis revealed an independent relation with poor outcome for age (p = 0.005) and lesions in the mesencephalic region corresponding to substantia nigra and tegmentum on SWI (p  = 0.008). We conclude that higher age and lesions in substantia nigra and mesencephalic tegmentum indicate poor long-term outcome in DAI. We propose an extended MRI classification system based on four stages (stage I—hemispheric lesions, stage II—corpus callosum lesions, stage III—brainstem lesions, and stage IV—substantia nigra or mesencephalic tegmentum lesions); all are subdivided by age (≥/<30 years).

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  • 3.
    Abu Sabaa, Amal
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Cancerimmunterapi.
    Clinical and Molecular Studies of Diffuse Large B-cell Lymphoma2023Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The general aim of this thesis was to study the prognostic clinical and biological markers of Diffuse Large B-cell Lymphoma (DLBCL).

    Paper I: Utilizing population-based data for patients with DLBCL in Sweden, the study aimed to establish whether event free survival at 24 months (EFS24) was a reproducible milestone. The disease-free survival for lymphoma patients was compared with that of age and sex matched Swedish general population. We demonstrated that overall survival was similar to age and sex matched general population only for younger patients (<60 years of age) achieving ES24. Patients older than that had worse prognosis. Death was mainly linked to cardiovascular disease and secondary malignancies.

    Paper II: Plasma samples collected via the bio bank U-CAN were analyzed using multiplex extension assay (PEA) utilizing preselected protein panels to examine the possibility of distinguishing lymphomas, leukemias and controls. The study confirmed that  PEA technology could be used not only to effectively screen for large number of plasma protein biomarkers in low plasma sample volumes (1 µL), but even to discriminate between controls and different haematological malignancies. 

    Paper III: Plasma protein pattern evolution in DLBCL patients was highlighted by PEA analysis of plasma proteins at different time points under treatment with Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Significant distinctions in protein patterns at diagnosis compared to controls and striking differences in protein levels before and after treatment in patient who responded to treatment were evident. The three top proteins were TCL1A, CXCL13 and IL2RA. 

    Paper IV: An interesting protein that emerged from the above studies was TCL1A. This plasma protein was analyzed in plasma samples by PEA. Validation by plasma enzyme immunosorbent assay (ELISA) was attempted. The cytoplasm and nucleus bound form of TCL1A were analyzed with the help of immunohistochemistry in tissue microarray samples. The study included 178 patients of which 125 received R-CHOP. Clinical risk factor analysis showed no significant correlation with tissue IHC. Significantly higher levels of plasma TCL1A were seen in male patients (measured by ELISA and PEA) and in patients with Ann Arbor stages II-IV (measured by PEA). Survival analysis showed no statistical significance. 

    Delarbeten
    1. Age is the most important predictor of survival in diffuse large B-cell lymphoma patients achieving EFS24 - a Swedish population-based study.
    Öppna denna publikation i ny flik eller fönster >>Age is the most important predictor of survival in diffuse large B-cell lymphoma patients achieving EFS24 - a Swedish population-based study.
    Visa övriga...
    (Engelska)Ingår i: Artikel i tidskrift (Refereegranskat) Submitted
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-420612 (URN)
    Tillgänglig från: 2020-09-29 Skapad: 2020-09-29 Senast uppdaterad: 2023-08-18
    2. Plasma protein biomarker profiling reveals major differences between acute leukaemia, lymphoma patients and controls
    Öppna denna publikation i ny flik eller fönster >>Plasma protein biomarker profiling reveals major differences between acute leukaemia, lymphoma patients and controls
    Visa övriga...
    2022 (Engelska)Ingår i: New Biotechnology, ISSN 1871-6784, E-ISSN 1876-4347, Vol. 71, s. 21-29Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Aiming to accommodate the unmet need for easily accessible biomarkers with a focus on biological differences between haematological diseases, the diagnostic value of plasma proteins in acute leukaemias and lymphomas was investigated. A multiplex proximity extension assay (PEA) was used to analyze 183 proteins in diagnostic plasma samples from 251 acute leukaemia and lymphoma patients and compared with samples from 60 healthy controls. Multivariate modelling using partial least square discriminant analysis revealed highly significant differences between distinct disease subgroups and controls. The model allowed explicit distinction between leukaemia and lymphoma, with few patients misclassified. Acute leukaemia samples had higher levels of proteins associated with haemostasis, inflammation, cell differentiation and cell-matrix integration, whereas lymphoma samples demonstrated higher levels of proteins known to be associated with tumour microenvironment and lymphoma dissemination. PEA technology can be used to screen for large number of plasma protein biomarkers in low mu L sample volumes, enabling the distinction between controls, acute leukaemias and lymphomas. Plasma protein profiling could help gain insights into the pathophysiology of acute leukaemia and lymphoma and the technique may be a valuable tool in the diagnosis of these diseases.

    Ort, förlag, år, upplaga, sidor
    ElsevierElsevier BV, 2022
    Nyckelord
    Acute leukaemia, Lymphoma, Plasma protein biomarker, Tumor microenvironment, Proximity extension assay
    Nationell ämneskategori
    Hematologi
    Identifikatorer
    urn:nbn:se:uu:diva-481929 (URN)10.1016/j.nbt.2022.06.005 (DOI)000830815200001 ()35779858 (PubMedID)
    Forskningsfinansiär
    CancerfondenVetenskapsrådet
    Tillgänglig från: 2022-08-19 Skapad: 2022-08-19 Senast uppdaterad: 2024-01-15Bibliografiskt granskad
    3. Plasma Protein Profiling using Multiplex Extension Assay in Diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP: A descriptive study
    Öppna denna publikation i ny flik eller fönster >>Plasma Protein Profiling using Multiplex Extension Assay in Diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP: A descriptive study
    Visa övriga...
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Nationell ämneskategori
    Cancer och onkologi
    Identifikatorer
    urn:nbn:se:uu:diva-509416 (URN)
    Tillgänglig från: 2023-08-18 Skapad: 2023-08-18 Senast uppdaterad: 2023-08-18Bibliografiskt granskad
    4. T-cell Leukaemia/Lymphoma Protein 1A (TCL1A) In Diffuse Large B-cell lymphoma (DLBCL)
    Öppna denna publikation i ny flik eller fönster >>T-cell Leukaemia/Lymphoma Protein 1A (TCL1A) In Diffuse Large B-cell lymphoma (DLBCL)
    Visa övriga...
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Nationell ämneskategori
    Cancer och onkologi
    Identifikatorer
    urn:nbn:se:uu:diva-509418 (URN)
    Tillgänglig från: 2023-08-18 Skapad: 2023-08-18 Senast uppdaterad: 2023-08-18Bibliografiskt granskad
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    UUThesis_A-Abu-Sabaa-2023
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  • 4.
    Abu Sabaa, Amal
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Cancerimmunterapi.
    Mörth, Charlott
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Cancerimmunterapi.
    Berglund, Mattias
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Cancerimmunterapi.
    Hashemi, Jamileh
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Cancerimmunterapi.
    Amini, Rose-Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Cancerimmunterapi.
    Freyhult, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Cancerfarmakologi och beräkningsmedicin. Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Biologiska sektionen, Institutionen för cell- och molekylärbiologi.
    Kamali-Moghaddam, Masood
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Molekylära verktyg och funktionsgenomik.
    Robelius, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Hematologi.
    Enblad, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Cancerimmunterapi.
    T-cell Leukaemia/Lymphoma Protein 1A (TCL1A) In Diffuse Large B-cell lymphoma (DLBCL)Manuskript (preprint) (Övrigt vetenskapligt)
  • 5.
    Abu Sabaa, Amal
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Cancerimmunterapi.
    Mörth, Charlott
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Cancerimmunterapi.
    Molin, Daniel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Cancerimmunterapi.
    Freyhult, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Cancerfarmakologi och beräkningsmedicin. Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Biologiska sektionen, Institutionen för cell- och molekylärbiologi.
    Kamali-Moghaddam, Masood
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Molekylära verktyg och funktionsgenomik.
    Robelius, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Hematologi.
    Enblad, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Cancerimmunterapi.
    Plasma Protein Profiling using Multiplex Extension Assay in Diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP: A descriptive studyManuskript (preprint) (Övrigt vetenskapligt)
  • 6.
    Ahmed, Hytham
    et al.
    Menoufia Univ, Dept Pharmaceut Anal, Menofia Governorate, Al Minufiyah, Egypt..
    Wahbi, Abdel-Aziz
    Univ Alexandria, Dept Pharmaceut Analyt Chem, Alexandria 21521, Egypt..
    Elmongy, Hatem
    Univ Alexandria, Dept Pharmaceut Analyt Chem, Alexandria 21521, Egypt..
    Amini, Ahmad
    Swedish Drug Agcy, Uppsala, Sweden..
    Koyi, Hirsh
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Cty Council Gävleborg, Med Gävle Hosp, Dept Resp Med, Gävle, Sweden.
    Brandén, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Cty Council Gävleborg, Med Gävle Hosp, Dept Resp Med, Gävle, Sweden.
    Abdel-Rehim, Mohamed
    Karolinska Inst, SE-17176 Solna, Sweden..
    Determination and Pharmacokinetics of Omeprazole Enantiomers in Human Plasma and Oral Fluid Utilizing Microextraction by Packed Sorbent and Liquid Chromatography-Tandem Mass Spectrometry2021Ingår i: International Journal of Analytical Chemistry, ISSN 1687-8760, E-ISSN 1687-8779, Vol. 2021, artikel-id 8845139Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In the present work, the determination of omeprazole (OME) enantiomers in oral fluid and plasma samples was carried out utilizing microextraction by packed sorbent (MEPS) and liquid chromatography-tandem mass spectrometry. A chiral column with cellulose-SB phase was used for the first time for enantiomeric separation of OME with an isocratic elution system using 0.2% ammonium hydroxide in hexane-ethanol mixture (70 : 30, v/v) as the mobile phase. OME enantiomers were determined utilizing a triple quadrupole tandem mass spectrometer in positive ion mode (ESI+) monitoring mass transitions: m/z 346.3 -> 198.0 for OME and m/z 369.98 -> 252.0 for internal standard. The limits of detection and quantification of the present method for both enantiomers were 0.1 and 0.4 ng/mL, respectively. The method validation provided good accuracy and precision. The matrix effect factor was less than 5%, and no interfering peaks were observed. The interday precision values ranged from 2.2 to 7.5 (%RSD), and the accuracy of determinations varied from -9.9% to 8.3%. In addition, the pharmacokinetics (PK) of omeprazole enantiomers in healthy subjects after a single oral dose was investigated. (S)-Enantiomers showed higher levels than (R)-enantiomers throughout 24 h. It was found that the mean maximum concentrations of (R)- and (S)-omeprazole in plasma samples were about two times higher than in oral fluid.

    Ladda ner fulltext (pdf)
    FULLTEXT01
  • 7.
    Alehagen, Urban
    et al.
    Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden..
    Aaseth, Jan
    Research Department, Innlandet Hospital Trust, N-2381 Brumunddal, Norway..
    Lindahl, Tomas L
    Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85 Linköping, Sweden..
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk nutrition och metabolism.
    Alexander, Jan
    Norwegian Institute of Public Health, N-0403 Oslo, Norway..
    Dietary supplementation with selenium and coenzyme Q10 prevents increase in plasma D-dimer while lowering cardiovascular mortality in an elderly Swedish population.2022Ingår i: Nutrition, Exercise, and End-of-LifeDiscussion in the Cardiovascular Field / [ed] Fukumoto Y, Basel: MDPI, 2022, s. 43-56Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    A low intake of selenium is associated with increased cardiovascular mortality. This could be reduced by supplementation with selenium and coenzyme Q10. D-dimer, a fragment of fibrin mirroring fibrinolysis, is a biomarker of thromboembolism, increased inflammation, endothelial dysfunction and is associated with cardiovascular mortality in ischemic heart disease. The objective was to examine the impact of selenium and coenzyme Q10 on the level of D-dimer, and its relationship to cardiovascular mortality. D-dimer was measured in 213 individuals at the start and after 48 months of a randomised double-blind placebo-controlled trial with selenium yeast (200 µg/day) and coenzyme Q10 (200 mg/day) (n = 106) or placebo (n = 107). The follow-up time was 4.9 years. All included individuals were low in selenium (mean 67 μg/L, SD 16.8). The differences in D-dimer concentration were evaluated by the use of T-tests, repeated measures of variance and ANCOVA analyses. At the end, a significantly lower D-dimer concentration was observed in the active treatment group in comparison with those on placebo (p = 0.006). Although D-dimer values at baseline were weakly associated with high-sensitive CRP, while being more strongly associated with soluble tumour necrosis factor receptor 1 and sP-selectin, controlling for these in the analysis there was an independent effect on D-dimer. In participants with a D-dimer level above median at baseline, the supplementation resulted in significantly lower cardiovascular mortality compared to those on placebo (p = 0.014). All results were validated with a persisting significant difference between the two groups. Therefore, supplementation with selenium and coenzyme Q10 in a group of elderly low in selenium and coenzyme Q10 prevented an increase in D-dimer and reduced the risk of cardiovascular mortality in comparison with the placebo group. The obtained results also illustrate important associations between inflammation, endothelial function and cardiovascular risk.

  • 8.
    Alex, A.
    et al.
    Danderyd Hosp, Dept Rehabil Med, Entrevagen8, SE-18288 Stockholm, Sweden..
    Gonzalez Lindh, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Logopedi.
    Palmcrantz, S.
    Danderyd Hosp, Dept Rehabil Med, Entrevagen8, SE-18288 Stockholm, Sweden.;Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden..
    Assessing eating and swallowing in adults born with intellectual and motor disabilities: Face and content validity of a Swedish translation of the Dysphagia Assessment Package2023Ingår i: Journal of Intellectual Disability Research, ISSN 0964-2633, E-ISSN 1365-2788, Vol. 67, nr 11, s. 1174-1189Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Adults born with intellectual disabilities (ID) and motor disabilities (MD) have higher risk of dysphagia and should be assessed to decrease risk of severe complications. However, standardised assessment tools in Swedish are lacking.

    Methods: The Dysphagia Assessment Package (DAP) was cross-culturally translated from English to Swedish (DAP-SE) and tested for content validity by an expert group. Face validity was assessed by five speech and language therapist (SLT) during meal observations (n = 10), and the clinical relevance was reported in a study-specific questionnaire.

    Results: The DAP-SE was culturally adapted within the process of translation and was found to contain clinically relevant aspects to assess and suggest further interventions for adults with ID and MD. Face and content validity was confirmed by the expert group.

    Conclusion: This study, in which the DAP-SE was tested in a small sample size, provides the first indications of the instrument's validity with respect to evaluating mealtimes, swallowing function and swallowing safety in adults born with ID and MD. The study adds to the knowledge on how to translate and culturally adapt an assessment tool to clinically assess dysphagia on a complex and vulnerable patient group.

    Ladda ner fulltext (pdf)
    fulltext
  • 9.
    Al-Saadi, Jonathan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Stockholm, Sweden.
    Mattsson, Gustav
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Kader, Rozh
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Med Univ Gdansk, Gdansk, Poland.
    Magnusson, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Dept Med, Cardiol Res Unit, Stockholm, Sweden.
    Apical hypertrophic cardiomyopathy with preexcitation presenting as a myocardial infarction and ischemic stroke with a history of recurrent syncope: A case report2019Ingår i: Clinical Case Reports, E-ISSN 2050-0904, Vol. 7, nr 4, s. 816-820Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Key Clinical Message Contrast-enhanced echocardiography or cardiac magnetic resonance imaging is of value in the diagnosis of apical hypertrophic cardiomyopathy. Apical hypertrophic cardiomyopathy is rare in Caucasians, and gene negativity does not rule out the diagnosis. Risk stratification for sudden cardiac death and decisions about anticoagulation in cases with atrial fibrillation should be based on guidelines.

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  • 10.
    Aludden, Hanna
    et al.
    Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, Aalborg, Denmark..
    Dahlin, Anna
    Univ Gothenburg, BIOMATCELL VINN Excellence Ctr, Inst Surg Sci, Dept Biomat,Sahlgrenska Acad, Gothenburg, Sweden..
    Starch-Jensen, Thomas
    Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, Aalborg, Denmark..
    Dahlin, Christer
    Univ Gothenburg, BIOMATCELL VINN Excellence Ctr, Inst Surg Sci, Dept Biomat,Sahlgrenska Acad, Gothenburg, Sweden.;NU Hosp Org, Dept Oral & Maxillofacial Surg, Trollhattan, Sweden..
    Mordenfeld, Arne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Käkkirurgi. Publ Hlth Serv, Dept Oral & Maxillofacial Surg, Gavle, Sweden.
    Histomorphometric analyses of area fraction of different ratios of Bio-Oss((R)) and bone prior to grafting procedures - An in vitro study to demonstrate a baseline2018Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 29, nr 2, s. 185-191Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The objective of this study was to estimate the area fraction of different ratios of Bio-Oss((R)) and bone, prior to grafting in an in vitro model to demonstrate a histomorphometric baseline.

    Methods: Bio-Oss((R)) particles were mixed with autogenous bone from pig jaw in three different ratios (50:50, 80:20 and 100:0) and packed in rice paper in a standardized procedure. Histomorphometric analyses were performed in 25 specimens and 74 regions of interest. The area percentage of Bio-Oss((R)), bone, and non-mineralized tissue (NMT) were calculated. Results were reported as mean values and 95% confidence interval (CI).

    Results: The mean area fraction of Bio-Oss((R)) was 20.6% (CI: 18.2-23) in the 50:50 mixture, 33.6% (CI: 29.7-37.6) in the 80:20 mixture, and 43.4% (CI: 40.5-46.3) in the 100:0 mixture. The mean area fraction of NMT was 60.5% (CI: 57.9-63.1) in the 50:50 mixture, 59.6% (CI: 56.4-62.7) in the 80:20 mixture, and 56.6% (CI: 53.7-59.5) in the 100:0 mixture. The mean area fraction of bone was 18.9% (CI: 16.9-20.9) in the 50:50 mixture and 6.8% (CI: 5-8.6) in the 80:20 mixture.

    Conclusion: There is a great difference in the clinically estimated percentage and the histomorphometrically evaluated percentage of Bio-Oss((R)) at baseline, prior to grafting. The area fraction of different tissues presented in this study may be beneficial as guidance for histomorphometrical baseline calculations when different mixtures of Bio-Oss((R)) and autogenous bone are used as grafting materials.

  • 11.
    Aludden, Hanna
    et al.
    Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, 18-22 Hobrovej, DK-9000 Aalborg, Denmark.
    Mordenfeld, Arne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Käkkirurgi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Publ Hlth Serv, Dept Oral & Maxillofacial Surg, Gavle, Sweden.
    Hallman, Mats
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Publ Hlth Serv, Dept Oral & Maxillofacial Surg, Gavle, Sweden.
    Christensen, Ann-Eva
    Aalborg Univ Hosp, Unit Epidemiol & Biostatist, Aalborg, Denmark.
    Starch-Jensen, Thomas
    Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, 18-22 Hobrovej, DK-9000 Aalborg, Denmark.
    Osteotome-Mediated Sinus Floor Elevation With or Without a Grafting Material: A Systematic Review and Meta-analysis of Long-term Studies (>= 5-Years)2018Ingår i: Implant Dentistry, ISSN 1056-6163, E-ISSN 1538-2982, Vol. 27, nr 4, s. 488-497Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Objective: To test the hypothesis of no difference in the long-term treatment outcome after osteotome-mediated sinus floor elevation with or without a grafting material. Materials and Methods: A MEDLINE/PubMed, Cochrane Library, and EMBASE search in combination with a hand-search of relevant journals was conducted, including human studies published in English from January 1, 1986 to December 1, 2017. Results: One comparative and 7 noncomparative studies fulfilled the inclusion criteria. Survival of suprastructures had never been compared within the same study. Meta-analysis demonstrated an overall estimated patient-based implant survival of 94%. Gain in vertical alveolar bone height was similar with the 2 treatment modalities. Noncomparative studies demonstrated high long-term survival rate of suprastructures and implants with the 2 treatment modalities, as well as limited periimplant marginal bone loss. Conclusion: High long-term implant survival was demonstrated after osteotome-mediated sinus floor elevation with or without a grafting material. However, long-term randomized controlled trials comparing the 2 treatment modalities are sparse. Hence, conclusions drawn from this systematic review should be interpreted with caution.

  • 12. Alwin, J
    et al.
    Krevers, B
    Johansson, Ulla I.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Josephsson, S
    Haraldsson, U
    Boström, C
    Rosshagen, A
    Persson, J
    Health economic and process evaluation of AT interventions for persons with dementia and their relatives: A suggested assessment model2007Ingår i: Technology and Disability, ISSN 1055-4181, Vol. 19, nr 2-3, s. 61-71Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There is growing interest in assistive technology (AT) as a means of enabling participation in everyday activities for persons with dementia and their relatives. Health economic assessment of AT in dementia is of importance due to the consequences of the disease for both patients and relatives and to the high societal costs for dementia care. The aim of this article is to outline a model for assessment of AT interventions for persons with dementia. The model expands existing assessment models as it also includes evaluation of the intervention process. Methodological challenges and possibilities in making health economic assessments, including outcomes and costs, as well as process evaluation, are discussed in the article.

  • 13.
    Andrae, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Ingen ska behöva "lida av cellförändringar". Screeningsprogrammen bör ses över län för län: [No one should suffer because of "cervical cytology". Screening programs should be revised in each county]2001Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 98, nr 23, s. 2792-2794Artikel i tidskrift (Övrigt vetenskapligt)
  • 14.
    Andrae, Bengt
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Andersson, Therese M-L
    Lambert, Paul C
    Kemetli, Levent
    Silfverdal, Lena
    Strander, Björn
    Ryd, Walter
    Dillner, Joakim
    Törnberg, Sven
    Sparén, Pär
    Screening and cervical cancer cure: population based cohort study2012Ingår i: The BMJ, E-ISSN 1756-1833, Vol. 344, s. e900-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To determine whether detection of invasive cervical cancer by screening results in better prognosis or merely increases the lead time until death.

    DESIGN: Nationwide population based cohort study.

    SETTING: Sweden.

    PARTICIPANTS: All 1230 women with cervical cancer diagnosed during 1999-2001 in Sweden prospectively followed up for an average of 8.5 years.

    MAIN OUTCOME MEASURES: Cure proportions and five year relative survival ratios, stratified by screening history, mode of detection, age, histopathological type, and FIGO (International Federation of Gynecology and Obstetrics) stage.

    RESULTS: In the screening ages, the cure proportion for women with screen detected invasive cancer was 92% (95% confidence interval 75% to 98%) and for symptomatic women was 66% (62% to 70%), a statistically significant difference in cure of 26% (16% to 36%). Among symptomatic women, the cure proportion was significantly higher for those who had been screened according to recommendations (interval cancers) than among those overdue for screening: difference in cure 14% (95% confidence interval 6% to 23%). Cure proportions were similar for all histopathological types except small cell carcinomas and were closely related to FIGO stage. A significantly higher cure proportion for screen detected cancers remained after adjustment for stage at diagnosis (difference 15%, 7% to 22%).

    CONCLUSIONS: Screening is associated with improved cure of cervical cancer. Confounding cannot be ruled out, but the effect was not attributable to lead time bias and was larger than what is reflected by down-staging. Evaluations of screening programmes should consider the assessment of cure proportions.

  • 15.
    Andrae, Bengt
    et al.
    Uppsala universitet, Fakultetsövergripande enheter, Centrum för klinisk forskning, Gävleborg.
    Kemetli, Levent
    Sparén, Pär
    Silfverdal, Lena
    Strander, Björn
    Ryd, Walter
    Dillner, Joakim
    Törnberg, Sven
    Screening-preventable cervical cancer risks: evidence from a nationwide audit in Sweden.2008Ingår i: J Natl Cancer Inst, ISSN 1460-2105, Vol. 100, nr 9, s. 622-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The effectiveness of cervical cancer screening programs differs widely in different populations. The reasons for these differences are unclear. Routine and comprehensive audits have been proposed as an ethically required component of screening. We performed a nationwide audit of the effectiveness of the Swedish cervical cancer screening program.

    Methods: We identified all invasive cervical cancer cases that were diagnosed in Sweden from January 1, 1999, through December 31, 2001, and had been reported to the Swedish Cancer Registry (n = 1230 cases). We verified the diagnoses by histopathologic rereview and matched each case subject to five (population-based) age-matched control subjects who were identified from the National Population Register. The Pap smear screening histories for case and control subjects were reviewed for a 6-year period using the National Cervical Cancer Screening Register, which contains data on essentially all relevant cytological and histological diagnoses in Sweden. Odds ratios (ORs), and their 95% confidence intervals (CIs), of cervical cancer according to screening history were calculated in conditional logistic regression models. All statistical tests were two-sided.

    Results: Women who had not had a Pap smear within the recommended screening interval had higher risk of cervical cancer than women who had been screened (OR = 2.52, 95% CI = 2.19 to 2.91). This risk was similarly increased for all age groups (Phomogeneity = .96). The risk for nonsquamous cell cervical cancers (OR = 1.59, 95% CI = 1.20 to 2.11) was also increased. Women who had not had a Pap smear within the recommended screening interval had a particularly high risk of advanced cancers (OR = 4.82, 95% CI = 3.61 to 6.44). Among women who had been screened within the recommended interval, those with abnormal Pap smears had a higher risk of cervical cancer than those with normal smears (OR = 7.55, 95% CI = 5.88 to 9.69) and constituted 11.5% of all women with cervical cancer.

    Conclusions: Nonadherence to screening intervals was the major reason for cervical cancer morbidity. The screening program was equally effective for women of all ages and was also effective against nonsquamous cancers.

  • 16. Arbyn, Marc
    et al.
    Rebolj, Matejka
    De Kok, Inge M C M
    Fender, Murielle
    Becker, Nikolaus
    O'Reilly, Marian
    Andrae, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    The challenges of organising cervical screening programmes in the 15 old member states of the European Union2009Ingår i: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 45, nr 15, s. 2671-2678Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Cervical cancer incidence and mortality can be reduced substantially by organised cytological screening at 3 to 5 year intervals, as was demonstrated in the Nordic countries, the United Kingdom, the Netherlands and parts of Italy. Opportunistic screening, often proposed at yearly schedules, has also reduced the burden of cervical cancer in some, but not all, of the other old member states (belonging to the European Union since 1995) but at a cost that is several times greater. Well organised screening programmes have the potential to achieve greater participation of the target population at regular intervals, equity of access and high quality. Despite the consistent evidence that organised screening is more efficient than non-organised screening, and in spite of the Cancer Screening Recommendations of the European Council, health authorities of eight old member states (Austria, Belgium, France, Germany, Greece, Luxembourg, Portugal and Spain) have not yet started national organised implementation of screening for cervical cancer. A decision was made by the Irish government to extend their pilot programme nationally while new regional programmes commenced in Portugal and Spain. Introduction of new methods of prevention, such as HPV screening and prophylactic HPV vaccination, can reduce the burden further, but this will require a high level of organisation with particular attention needed for the maximisation of population coverage, compliance with evidence-based guidelines, monitoring of data enabling continued evaluation and improvement of the preventive programmes.

  • 17. Armuand, Gabriela M.
    et al.
    Rodriguez-Wallberg, Kenny A.
    Wettergren, Lena
    Ahlgren, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Enblad, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för onkologi.
    Höglund, Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Hematologi.
    Lampic, Claudia
    Sex Differences in Fertility-Related Information Received by Young Adult Cancer Survivors2012Ingår i: Journal of Clinical Oncology, ISSN 0732-183X, E-ISSN 1527-7755, Vol. 30, nr 17, s. 2147-2153Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose The aim was to investigate male and female cancer survivors' perception of fertility-related information and use of fertility preservation (FP) in connection with cancer treatment during reproductive age.

    Methods The study sample consisted of cancer survivors diagnosed from 2003 to 2007 identified in population-based registers in Sweden. Inclusion criteria included survivors who were age 18 to 45 years at diagnosis and had lymphoma, acute leukemia, testicular cancer, ovarian cancer, or female breast cancer treated with chemotherapy. Of 810 eligible participants, 484 survivors (60% response rate) completed a postal questionnaire.

    Results The majority of male participants reported having received information about treatment impact on fertility (80%) and FP (68%), and more than half of the men banked frozen sperm (54%). Among women, less than half (48%) reported that they received information about treatment impact on fertility, and 14% reported that they received information about FP. Only seven women (2%) underwent FP. Predictors for receiving information about treatment impact on fertility were a pretreatment desire to have children (odds ratio [OR], 3.5), male sex (OR, 3.2), and being <= 35 years of age at diagnosis (OR, 2.0). Predictors for receiving information about FP included male sex (OR, 14.4), age <= 35 at diagnosis (OR, 5.1), and having no children at diagnosis (OR, 2.5).

    Conclusion Our results show marked sex differences regarding the receipt of fertility-related information and use of FP. There is an urgent need to develop fertility-related information adapted to female patients with cancer to improve their opportunities to participate in informed decisions regarding their treatment and future reproductive ability.

  • 18.
    Arvidsson, Lisa
    et al.
    Univ Gävle, Dept Caring Sci, Fac Hlth & Occupat Studies, Gävle, Sweden..
    Lindberg, Magnus
    Univ Gävle, Dept Caring Sci, Fac Hlth & Occupat Studies, Gävle, Sweden..
    Skytt, Bernice
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Univ Gävle, Dept Caring Sci, Fac Hlth & Occupat Studies, Gävle, Sweden..
    Lindberg, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Univ Gävle, Dept Caring Sci, Fac Hlth & Occupat Studies, Gävle, Sweden..
    Healthcare personnel's working conditions in relation to risk behaviours for organism transmission: A mixed-methods study2022Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 31, nr 7-8, s. 878-894Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives To investigate healthcare personnel's working conditions in relation to risk behaviours for organism transmission. Background Healthcare personnel's behaviour is often influenced by working conditions that in turn can impact the development of healthcare-associated infections. Observational studies are scarce, and further understanding of working conditions in relation to behaviour is essential for the benefit of the healthcare personnel and the safety of the patients. Design A mixed-methods convergent design. Methods Data were collected during 104 h of observation at eight hospital units. All 79 observed healthcare personnel were interviewed. Structured interviews covering aspects of working conditions were performed with the respective first-line manager. The qualitative and quantitative data were collected concurrently and given equal priority. Data were analysed separately and then merged. The study follows the GRAMMS guidelines for reporting mixed-methods research. Results Regardless of measurable and perceived working conditions, risk behaviours frequently occurred especially missed hand disinfection. Healthcare personnel described staffing levels, patient-level workload, physical factors and interruptions as important conditions that influence infection prevention behaviours. The statistical analyses confirmed that interruptions increase the frequency of risk behaviours. Significantly higher frequencies of risk behaviours also occurred in activities where healthcare personnel worked together, which in the interviews was described as a consequence of caring for high-need patients. Conclusions These mixed-methods findings illustrate that healthcare personnel's perceptions do not always correspond to the observed results since risk behaviours frequently occurred regardless of the observed and perceived working conditions. Facilitating the possibility for healthcare personnel to work undisturbed when needed is essential for their benefit and for patient safety. Relevance for Clinical Practice The results can be used to enlighten healthcare personnel and managers and when designing future infection prevention work.

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  • 19.
    Arvidsson, Lisa
    et al.
    Univ Gävle, Fac Hlth & Occupat Studies, Dept Caring Sci, Gävle, Sweden..
    Skytt, Bernice
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Univ Gävle, Fac Hlth & Occupat Studies, Dept Caring Sci, Gävle, Sweden..
    Lindberg, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Univ Gävle, Fac Hlth & Occupat Studies, Dept Caring Sci, Gävle, Sweden..
    Lindberg, Magnus
    Univ Gävle, Fac Hlth & Occupat Studies, Dept Caring Sci, Gävle, Sweden..
    Nurses' assessed self-efficacy levels to medical asepsis and their relation to structural empowerment, work engagement and work-related stress2023Ingår i: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 74, nr 2, s. 501-513Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Nurses' working conditions are important for their well-being at work and for their ability to provide patients with safe care. Self-efficacy can influence employees' behaviour atwork. Therefore, it is valuable to study self-efficacy levels to medical asepsis in relation to working conditions.

    OBJECTIVE: To investigate the relationship between nurses' assessed self-efficacy levels to medical asepsis in care situations and structural empowerment, work engagement and work-related stress.

    METHODS: A cross-sectional study with a correlational design was conducted. A total of 417 registered nurses and licensed practical nurses at surgical and orthopaedic units responded to a questionnaire containing: the Infection Prevention Appraisal Scale, the Conditions ofWork Effectiveness Questionnaire-II, the UtrechtWork Engagement Scale-9 and the Health& Safety Executive Management Standards Indicator Tool. Correlational analyses and group comparisons were performed.

    RESULTS: The nurses rated high levels of self-efficacy to medical asepsis in care situations. The correlational analyses revealed that correlation coefficients between structural empowerment, work engagement, work-related stress and selfefficacy to medical asepsis were 0.254-0.268. Significant differences in self-efficacy were found in the grouped working conditions.

    CONCLUSIONS: This study revealed that nurses rated high self-efficacy levels to medical asepsis and, to some extent, this seemed related to structural empowerment, work engagement and work-related stress. This valuable knowledge could enable improvements at the managerial and organisational levels, benefiting both nurses and patients in the long run.

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  • 20.
    Arvidsson, Patrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Jönköping Univ, Sch Hlth & Welf, Swedish Inst Disabil Res, Jönköping, Sweden..
    Dada, Shakila
    Univ Pretoria, Ctr Augmentat & Alternat Commun, Pretoria, South Africa..
    Granlund, Mats
    Jönköping Univ, Sch Hlth & Welf, Swedish Inst Disabil Res, Jönköping, Sweden..
    Imms, Christine
    Australian Catholic Univ, Ctr Disabil & Dev Res, Melbourne, Vic, Australia..
    Bornman, Juan
    Univ Pretoria, Ctr Augmentat & Alternat Commun, Pretoria, South Africa..
    Elliott, Catherine
    Curtin Univ, Sch Occupat Therapy Speech Pathol & Social Work, Perth, WA, Australia..
    Huus, Karina
    Jönköping Univ, Sch Hlth & Welf, Swedish Inst Disabil Res, Jönköping, Sweden..
    Content validity and usefulness of Picture My Participation for measuring participation in children with and without intellectual disability in South Africa and Sweden2020Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 27, nr 5, s. 336-348Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Participation comprises attendance and involvement in everyday situations. Picture My Participation (PmP) is an instrument intended to measure participation in children with disabilities, particularly in low and middle income countries. Aim: To investigate content validity and usefulness of PmP for measuring participation in children with intellectual disability (ID) in South Africa and Sweden. Methods: A picture supported interview with 149 children, 6-18 years, with and without ID. Twenty everyday activities were provided. The three most important activities were selected by the child. Attendance was rated on all activities. Involvement was rated on the most important. Results: All activities were selected as important by at least one child with ID in both countries. There were similarities in perceived importance between the children with and without ID from South Africa. The children from South Africa with ID were the only subgroup that used all scale points for rating attendance and involvement. Conclusion: The 20 selected activities of PmP were especially relevant for children with ID in South Africa. The usefulness of the scales was higher for the children with ID in both countries. PmP is promising for assessing participation across different settings but psychometrical properties and clinical utility need further exploration.

  • 21.
    Arvidsson, Patrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Jönköping Univ, Children Hlth Intervent Learning & Dev CHILD, Fac Hlth Sci, Jönköping, Sweden.;Jönköping Univ, Fac Hlth & Welf, Sch Hlth & Welf, Swedish Inst Disabil Res, Jönköping, Sweden.
    Dade, Shakila
    Univ Pretoria, Fac Humanities, Ctr Augmentat & Alternat Commun, Pretoria, South Africa..
    Granlund, Mats
    Jönköping Univ, Children Hlth Intervent Learning & Dev CHILD, Fac Hlth Sci, Jönköping, Sweden.;Jönköping Univ, Fac Hlth & Welf, Sch Hlth & Welf, Swedish Inst Disabil Res, Jönköping, Sweden..
    Imms, Christine
    Univ Melbourne, Fac Med Dent & Hlth Sci, Dept Paediat, Melbourne, Vic, Australia..
    Shi, Lin Jun
    Jönköping Univ, Children Hlth Intervent Learning & Dev CHILD, Fac Hlth Sci, Jönköping, Sweden.;Jönköping Univ, Fac Hlth & Welf, Sch Hlth & Welf, Swedish Inst Disabil Res, Jönköping, Sweden.;Tianjin Med Univ, Sch Nursing, Tianjin, Peoples R China..
    Kang, Lin Ju
    Chang Gung Univ, Grad Inst Early Intervent, Taoyuan, Taiwan.;Chang Gung Mem Hosp, Dept Phys Med & Rehabil, Linkou, Taiwan..
    Hwang, Ai-Wen
    Chang Gung Univ, Grad Inst Early Intervent, Taoyuan, Taiwan.;Chang Gung Mem Hosp, Dept Phys Med & Rehabil, Linkou, Taiwan..
    Huus, Karina
    Jönköping Univ, Children Hlth Intervent Learning & Dev CHILD, Fac Hlth Sci, Jönköping, Sweden.;Jönköping Univ, Fac Hlth & Welf, Sch Hlth & Welf, Swedish Inst Disabil Res, Jönköping, Sweden..
    Structural validity and internal consistency of Picture My Participation: A measure for children with disability2021Ingår i: African Journal of Disability, ISSN 2226-7220, Vol. 10, artikel-id a763Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Picture My Participation (PMP) intended to measure participation, defined as attendance and involvement in everyday situations, of children with disabilities, particularly in low- and middle-income settings. Objectives: To explore structural validity of PMP by identifying possible subcomponents in the attendance scale and examining internal consistency of the total score and each subcomponent. Method: A picture-supported interview was conducted with 182 children, 7-18 years, with and without intellectual disability (ID). Frequency of attendance in 20 activities was rated on a four-point Likert scale (never, seldom, sometimes and always). Results: An exploratory principal component analysis extracted four subcomponents: (1) organised activities, (2) social activities and taking care of others, (3) family life activities and 4) personal care and development activities. Internal consistency for the total scale (alpha = 0.85) and the first two subcomponents (alpha = 0.72 and 0.75) was acceptable. The two last subcomponents alpha values were 0.57 and 0.49. Conclusion: The four possible subcomponents of PMP can be used to provide information about possible domains in which participation and participation restrictions exist. This study provided further psychometric evidence about PMP as a measure of participation. The stability and the utility of these subcomponents needed further exploration.

  • 22.
    Arvidsson, Patrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Granlund, Mats
    The Relationship Between Intelligence Quotient and Aspects of Everyday Functioning and Participation for People Who Have Mild and Borderline Intellectual Disabilities.2018Ingår i: JARID: Journal of applied research in intellectual disabilities, ISSN 1360-2322, E-ISSN 1468-3148, Vol. 31, nr 1, s. e68-e78Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: This study explored the relationship between intelligence quotient (IQ) and aspects of everyday functioning/participation in individuals (age 16-40) who have a mild/borderline intellectual disability (IQ 55-85).

    METHOD: Correlations were examined between IQ and (i) self-rated (n = 72) ability, participation as performance (how often an activity is performed), important participation restriction (not/seldom performing an activity perceived as important) and general well-being and (ii) proxy-rated (n = 41) ability and participation as performance.

    RESULTS: No significant correlations between IQ and any of the explored measures were found. However, the effect sizes of the correlations between IQ and ability were considered as small but not negligible.

    CONCLUSIONS: The results support the notion that IQ is a poor predictor of general aspects of everyday functioning in persons with mild/borderline intellectual disability. The result indicates that self-ratings partly generate other information than proxy ratings which may be important for assessments of supportive requirements and diagnosis.

  • 23.
    Arvidsson, Patrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Granlund, Mats
    Thyberg, Ingrid
    Thyberg, Mikael
    Important aspects of participation and participation restrictions in people with a mild intellectual disability2014Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 15, s. 1264-1272Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: This study explored a possibility to assess the concepts of participation and participation restrictions in the International Classification of Functioning, Disability and Health (ICF) by combining self-ratings of the perceived importance with the actual performance of different everyday activities in people with a mild intellectual disability. Method: Structured interviews regarding 68 items from the ICF activity/participation domain were conducted (n = 69). The items were ranked by perceived importance, performance and by combined measures. Furthermore, the measures were related to a single question about subjective general well-being. Results: Rankings of performance highlighted about the same items as "important participation", while rankings of low performance addressed quite different items compared with "important participation restriction". Significant correlations were found between subjective general well-being and high performance (r = 0.56), high performance/high importance (important participation) (r = 0.56), low performance (r = -0.56) and low performance/high importance (important participation restriction; r -0.55). Conclusions: The results support the clinical relevance of the ICF and the studied selection of 68 items. Although performance only may sometimes be a relevant aspect, knowledge about the relationship between the perceived importance and the actual performance is essential for clinical interventions and for research aiming to understand specific needs regarding participation.

  • 24.
    Arvidsson, Patrik
    et al.
    Uppsala universitet, Fakultetsövergripande enheter, Centrum för klinisk forskning, Gävleborg.
    Granlund, Mats
    Thyberg, Mikael
    Factors Related to Self-Rated Participation in Adolescents and Adults with Mild Intellectual Disability – A Systematic Literature Review2008Ingår i: Journal of Applied Research in Intellectual Disabilities, Vol. 21, s. 277-291Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Self-rated participation is a clinically relevant

    intervention outcome for people with mild intellectual

    disability. The aim of this systematic review was to

    analyse empirical studies that explored relationships

    between either environmental factors or individual characteristics

    and aspects of participation in young adults

    with mild intellectual disability.

    Method Four databases were used, 756 abstracts examined

    and 24 studies were evaluated in-depth.

    Results Four aspects of participation were found:

    involvement, perceptions of self, self-determination and

    psychological well-being. Reported environmental factors

    were: social support, choice opportunity, living conditions,

    school, work and leisure, attitudes, physical

    availability and society. Reported individual characteristics

    were adaptive and social skills.

    Conclusions There is a relative lack of studies of factors

    influencing self-rated participation and existing studies

    are difficult to compare because of disparity regarding

    approaches, conceptual frameworks, etc. For adequate

    interventions, it seems important to study how profiles

    of participation are influenced by different patterns of

    environmental factors and individual characteristics.

    Keywords: adaptive behaviour, environmental factors,

    ICF, self rating

  • 25.
    Arvidsson, Patrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Granlund, Mats
    Thyberg, Mikael
    How are the activity and participation aspects of the ICF used?: Examples from studies of people with intellectual disability2015Ingår i: NeuroRehabilitation (Reading, MA), ISSN 1053-8135, E-ISSN 1878-6448, Vol. 36, nr 1, s. 45-49Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Interdisciplinary differences regarding understanding the International Classification of Functioning, Disability and Health (ICF) concepts activity/participation may hinder its unifying purpose. In the ICF model, functioning (and disability) is described as a tripartite concept: 1) Body structures/functions, 2) Activities, and 3) Participation. Activities refer to an individual perspective on disability that does not tally with the basic structure of social models. OBJECTIVE: To review how activity and participation are actually used in studies of intellectual disability (ID). CONCLUSION: Based on 16 papers, four different usages of activity/participation were found. 1) Theoretical reference to tripartite ICF concept with attempts to use it. 2) Theoretical reference to tripartite ICF concept without actual use of activities. 3) "Atheoretical" approach with implicit focus on participation. 4) Theoretical reference to bipartite concept with corresponding use of terms. The highlighted studies have in common a focus on participation. However, the usage of the term "activity" differs both within and between studies. Such terminology will probably confuse interdisciplinary communication rather than facilitating it. Also, the use of an explicit underlying theory differs, from references to a tripartite to references to a bipartite concept of disability. This paper is focused on ID, but the discussed principles regarding the ICF and interdisciplinary disability theory are applicable to other diagnostic groups within rehabilitation practices.

  • 26.
    Arvidsson, Patrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Centre for Research & Development, Region Gävleborg, Gävle, Sweden;School of Health and Welfare, Disability Research, Jönköping University, Jönköping, Sweden.
    Janeslätt, Gunnel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning Dalarna. Centrum för Klinisk Forskning i Dalarna.
    Wennberg, Birgitta
    Lidström-Holmqvist, Kajsa
    Holmefur, Marie
    Roshanai, Afsaneh
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicinsk epidemiologi. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Evaluation of the group intervention “Let’s Get Organized” for improving time management, organisational, and planning skills in people with mild intellectual disability2023Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, ISSN ISSN 1103-8128, s. 1257-1266Artikel i tidskrift (Refereegranskat)
  • 27. Astrand, Per
    et al.
    Engquist, Bo
    Anzén, Bengt
    Bergendal, Tom
    Hallman, Mats
    Uppsala universitet, Fakultetsövergripande enheter, Centrum för klinisk forskning, Gävleborg.
    Karlsson, Ulf
    Kvint, Sven
    Lysell, Leif
    Rundcranz, Torgil
    A three-year follow-up report of a comparative study of ITI Dental Implants and Bråemark System implants in the treatment of the partially edentulous maxilla.2004Ingår i: Clin Implant Dent Relat Res, ISSN 1523-0899, Vol. 6, nr 3, s. 130-41Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Many longitudinal studies of different implant systems have been published but few controlled randomized investigations have been reported. A 1-year report of a comparative study of ITI Dental Implant System implants (Straumann AG, Waldenburg, Switzerland) and Branemark System implants (Nobel Biocare AB, Gothenburg, Sweden) has been published by the present authors. This paper is a 3-year follow-up of that randomized study. PURPOSE: The aim of the study was to compare the outcome of fixed partial prostheses supported by ITI or Branemark implants. The outcome was evaluated primarily in terms of survival rates and changes in marginal bone level. MATERIAL AND METHODS: The study group comprised 28 patients with anterior residual dentition in the maxilla. The patients were provided with two to four implants on each side of the dentition and were randomly allocated to Branemark implants or ITI implants; 77 ITI implants and 73 Branemark implants were inserted. After 6 months abutment connections were made to both ITI and Branemark implants. All patients were provided with fixed partial prostheses of gold-ceramic. The patients were followed up annually with clinical and radiographic examinations for 3 years RESULTS: Two Branemark implants and two ITI implants were lost. The Branemark implants were lost before loading whereas the ITI implants were lost because of periimplantitis. The survival rate for both groups was 97.3%. The mean marginal bone level of the Branemark implants was situated 1.8 mm from the reference point at both the baseline and the 3-year examinations. The corresponding values for the ITI implants were 1.4 mm at baseline and 1.3 mm after 3 years. There was no significant difference between the implant systems with regard to bone level or bone level change. A steady state of the marginal bone level was calculated to have been reached after 3 years for 95.5% of the Branemark implants and 87.1% of the ITI implants. Periimplantitis (infection including pus and bone loss) was observed with seven ITI implants but with none of the Branemark implants. This difference was statistically significant. CONCLUSIONS: No statistically significant differences were found between the implants studied, except for the frequency of periimplantitis, which was higher for the ITI implants. The survival rates were high, and the marginal bone loss was small for both systems.

  • 28.
    Balton, Sadna
    et al.
    Univ Pretoria, Ctr Augmentat & Alternat Commun, Pretoria, South Africa..
    Arvidsson, Patrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Jönköping Univ, Sch Hlth & Welf, Swedish Inst Disabil Res, CHILD, Jönköping, Sweden..
    Granlund, Mats
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Huus, Karina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Dada, Shakila
    Univ Pretoria, Ctr Augmentat & Alternat Commun, Pretoria, South Africa..
    Test-retest reliability of Picture My Participation in children with intellectual disability in South Africa2022Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 29, nr 4, s. 315-324Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Picture My Participation (PmP) is a promising instrument for measuring the participation in everyday situations of children with intellectual disability (ID), particularly in low- and middle-income countries. Aim To explore test-retest reliability of PmP by comparing two repeated measurements of children with ID in an urban context in South Africa. Methods A picture-supported interview with 31 children with ID, aged 7-17 years, was conducted twice, two weeks apart. The children rated their participation, operationalised as attendance and involvement, in 20 everyday activities. Analyses were completed for total scores, for the four subcomponents and at item level. Results Test-retest agreement at an item level for both attendance and involvement showed slight/fair agreement for most activities (Kappa = 0.01-0.40), and moderate agreement for some activities (Kappa = 0.41-0.60). Moderate agreement was shown for the total scale and at component level (ICC = 0.5-0.75), except for (firstly) attendance of and involvement in 'Family Activities' (ICC = 0.26 for attendance, 0.33 for involvement), and (secondly) involvement in 'Personal Activities' (ICC = 0.33). Conclusion The result indicates that PmP can reliably be used at component level and as a screening tool for intervention planning to identify participation and participation restrictions in children with ID.

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  • 29.
    Bandert, Anna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Department of Anaesthesiology and Intensive Care, Gävle Hospital, Lasarettvägen 1, 80324, Gävle, Sweden.
    Lipcsey, Miklós
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård, Hedenstiernalaboratoriet.
    Frithiof, Robert
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Smekal, David
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    In an endotoxaemic model, antibiotic clearance can be affected by different central venous catheter positions, during renal replacement therapy2023Ingår i: Intensive Care Medicine Experimental, E-ISSN 2197-425X, Vol. 11, nr 1, artikel-id 32Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: In intensive care, different central venous catheters (CVC) are often used for infusion of drugs. If a patient is treated with continuous renal replacement therapy (CRRT) a second catheter, a central venous dialysis catheter (CVDC), is needed. Placing the catheters close together might pose a risk that a drug infused in a CVC could be directly aspirated into a CRRT machine and cleared from the blood without giving the effect intended. The purpose of this study was to elucidate if drug clearance is affected by different catheter placement, during CRRT. In this endotoxaemic animal model, an infusion of antibiotics was administered in a CVC placed in the external jugular vein (EJV). Antibiotic clearance was compared, whether CRRT was through a CVDC placed in the same EJV, or in a femoral vein (FV). To reach a target mean arterial pressure (MAP), noradrenaline was infused through the CVC and the dose was compared between the CDVDs.

    RESULTS: The main finding in this study was that clearance of antibiotics was higher when both catheter tips were in the EJV, close together, compared to in different vessels, during CRRT. The clearance of gentamicin was 21.0 ± 7.3 vs 15.5 ± 4.2 mL/min (p 0.006) and vancomycin 19.3 ± 4.9 vs 15.8 ± 7.1 mL/min (p 0.021). The noradrenaline dose to maintain a target MAP also showed greater variance with both catheters in the EJV, compared to when catheters were placed in different vessels.

    CONCLUSION: The results in this study indicate that close placement of central venous catheter tips could lead to unreliable drug concentration, due to direct aspiration, during CRRT.

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  • 30.
    Basu, Samar
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Oxidativ stress och inflammation.
    Helmersson, Johanna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Oxidativ stress och inflammation. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Bioaktiva isoprostaner : nya markörer för oxidativ stress och inflammationsrelaterade sjukdomar2009Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, nr 5, s. 274-278Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Oxidativ stress (fria radikaler) tros vara orsaken till åldrande och flera sjukdomar, däri bland arterioskleros, men det har saknats en pålitlig metodik för att påvisa aktiviteten av fria radikaler in vivo. Här presenteras isoprostaner som nya och tillförlitliga markörer för mätning av oxidativ stress in vivo genom indirekt mätning av radikalreaktioner. Isoprostaner kan ses i ökad mängd vid flera sjukdomstillstånd som är associerade med oxidativ stress och inflammation, till exempel kardiovaskulära sjukdomar, sjukdomar som är associerade med en ökad kardiovaskulär risk samt lungsjukdomar. Mätning av isoprostaner kan vidare ge ökad kunskap om fria radikalers fysiologiska roll och antioxidanternas roll vid sjukdomar samt vara ett verktyg vid utveckling av nya läkemedel mot oxidativ stress.

  • 31. Batista, N
    et al.
    Perez-Manga, G
    Constenla, M
    Ruiz, A
    Carabantes, F
    Castellanos, J
    Gonzalez Baron, M
    Villman, K
    Söderberg, M
    Ahlgren, J
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi. Fakultetsövergripande enheter, Centrum för klinisk forskning, Gävleborg.
    Casinello, J
    Regueiro, P
    Murias, A
    Phase II study of capecitabine in combination with paclitaxel in patients with anthracycline-pretreated advanced/metastatic breast cancer.2004Ingår i: Br J Cancer, ISSN 0007-0920, Vol. 90, nr 9, s. 1740-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The addition of oral capecitabine to docetaxel improves response rate, time to progression (TTP) and overall survival in anthracycline-pretreated metastatic breast cancer (MBC). This phase II study evaluates the efficacy and safety of a 21-day cycle of oral capecitabine (1000 mg m(-2) twice daily, days 1-14) plus i.v. paclitaxel (175 mg m(-2), day 1) in anthracycline-pretreated advanced/MBC. In all, 73 patients were enrolled at 13 Swedish and Spanish centres. The objective response rate was 52% (95% confidence interval (CI): 40-63%) in the intent-to-treat population, including complete responses in 11%. Disease was stabilised in a further 29%. The median time to disease progression (TTP) was 8.1 months and the median overall survival was 16.5 months. The combination was generally well tolerated with a predictable safety profile. The most common treatment-related nonhaematological adverse events were hand-foot syndrome (42%), alopecia (30%) and diarrhoea (26%). The only treatment-related Grade 3/4 adverse events occurring in >5% of patients were alopecia (22%) and hand-foot syndrome (11%). Grade 3/4 neutropenia and lymphocytopenia were reported in 12 and 14% of patients, respectively. Capecitabine plus paclitaxel is highly active with a favourable safety profile in anthracycline-pretreated MBC.

  • 32. Bazargani, Farhan
    et al.
    Feldmann, Ingalill
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Bondemark, Lars
    Three-dimensional analysis of effects of rapid maxillary expansion on facial sutures and bones: a systematic review2013Ingår i: Angle orthodontist, ISSN 0003-3219, E-ISSN 1945-7103, Vol. 83, nr 6, s. 1074-1082Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Objective:

    To evaluate the evidence on three-dimensional immediate effects of rapid maxillary expansion (RME) treatment on growing patients as assessed by computed tomography/cone beam computed tomography (CT/CBCT) imaging.

    Materials and Methods:

    The published literature was searched through the PubMed, Embase, and Cochrane Library electronic databases from January 1966 to December 2012. The inclusion criteria consisted of randomized controlled trials, prospective controlled studies, and prospective case-series. Two reviewers extracted the data independently and assessed the quality of the studies.

    Results:

    The search strategy resulted in 73 abstracts or full-text articles, of which 10 met the inclusion criteria. When treating posterior crossbites with a RME device, the existing evidence points out that the midpalatal suture opening is around 20%-50% of the total screw expansion. There seems to be no consistent evidence on whether the midpalatal sutural opening is parallel or triangular. The effect on the nasal cavity dimensions after RME seems to be apparent and indicates an enlargement between 17% and 33% of the total screw expansion. Circummaxillary sutures, particularly the zygomaticomaxillary and frontomaxillary sutures and also spheno-occipital synchondrosis, appear to be affected by the maxillary expansion. Overall, however, the changes were small and the evidence not conclusive.

    Conclusions:

    CT imaging proved to be a useful tool for assessment of treatment effects in all three dimensions. The majority of the articles were judged to be of low quality, and therefore, no evidence-based conclusions could to be drawn from these studies.

  • 33.
    Beeton, Michael L.
    et al.
    Cardiff Metropolitan Univ, Dept Biomed Sci, Cardiff, S Glam, Wales.
    Zhang, Xu-Sheng
    Publ Hlth England, London, England.
    Uldum, Soren A.
    Statens Serum Inst, Dept Bacteria Parasites & Fungi, Copenhagen, Denmark.
    Bebear, Cecile
    Univ Bordeaux, Mycoplasmal & Chlamydia Infect Humans, USC EA 3671, Bordeaux, France.
    Dumke, Roger
    Tech Univ Dresden, Dresden, Germany.
    Gullsby, Karolina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Ieven, Margareta
    Antwerp Univ Hosp Edegem, Edegem, Belgium.
    Loens, Katherine
    Antwerp Univ Hosp Edegem, Edegem, Belgium.
    Nir-Paz, Ran
    Hadassah Hebrew Univ, Med Ctr, Dept Clin Microbiol & Infect Dis, Jerusalem, Israel.
    Pereyre, Sabine
    Univ Bordeaux, Mycoplasmal & Chlamydia Infect Humans, USC EA 3671, Bordeaux, France.
    Spiller, O. Brad
    Cardiff Univ, Sch Med, Dept Med Microbiol, Div Infect & Immun, Cardiff, S Glam, Wales.
    Chalker, Victoria J.
    Publ Hlth England, London, England.
    Bossuyt, Nathalie
    Sciensano, Serv Epidemiol Infect Dis, Brussels, Belgium.
    Lagrou, Katrien
    Univ Hosp Leuven, Natl Reference Ctr Resp Pathogens, Leuven, Belgium.
    Mitis, George
    Nicosia Gen Hosp, Dept Immunol, Nicosia, Cyprus.
    Koliou, Maria
    Archbishop Makarios III Hosp, Dept Paediat, Nicosia, Cyprus.
    Havlickova, Martina
    Natl Inst Publ Hlth, Prague, Czech Republic.
    Kyncl, Jan
    Natl Inst Publ Hlth, Prague, Czech Republic.
    Emborg, Hanne-Dorthe
    Statens Serum Inst, Copenhagen, Denmark.
    Voldstedlund, Marianne
    Statens Serum Inst, Copenhagen, Denmark.
    MacKenzie, Colin Rae
    Heinrich Heine Univ, Inst Med Microbiol & Hosp Hyg, Dusseldorf, Germany.
    Maltezou, Helena C.
    Natl Publ Hlth Org, Athens, Greece.
    Georgakopoulou, Theano
    Natl Publ Hlth Org, Athens, Greece.
    Petridou, Evangelina
    Aghia Sophia Children Hosp, Athens, Greece.
    Banou, Kirkira
    Aghia Sophia Children Hosp, Athens, Greece.
    Balla, Eszter
    Natl Publ Hlth Ctr, Dept Reference Labs, Budapest, Hungary.
    Connell, Jeff
    Univ Coll Dublin, Natl Virus Reference Lab, Dublin, Ireland.
    Yandle, Zoe
    Univ Coll Dublin, Natl Virus Reference Lab, Dublin, Ireland.
    Moran, Joanne
    Univ Coll Dublin, Natl Virus Reference Lab, Dublin, Ireland.
    Burns, Karen
    Hlth Protect Surveillance Ctr, Dublin, Ireland.
    Michael-Gayego, Ayelet
    Hadassah Hebrew Univ, Med Ctr, Dept Clin Microbiol & Infect Dis, Jerusalem, Israel.
    Moses, Allon E.
    Hadassah Hebrew Univ, Med Ctr, Dept Clin Microbiol & Infect Dis, Jerusalem, Israel.
    Fenech, Tanya Melillo
    Minist Hlth, Valletta, Malta.
    Anestad, Gabriel
    Norwegian Inst Publ Hlth, Oslo, Norway.
    Blystad, Hans
    Norwegian Inst Publ Hlth, Oslo, Norway.
    Vestrheim, Didrik F.
    Norwegian Inst Publ Hlth, Oslo, Norway.
    Froes, Filipe
    Hosp Pulido Valente, Lisbon, Portugal;Gen Directorate Hlth Consultant Pneumol, Lisbon, Portugal.
    Kese, Darja
    Univ Ljubljana, Fac Med, Ljubljana, Slovenia;Inst Microbiol & Immunol, Ljubljana, Slovenia.
    Socan, Maja
    Natl Inst Publ Hlth, Ljubljana, Slovenia.
    Cano Portero, Rosa
    Inst Salud Carlos III, CIBERESP, Natl Ctr Epidemiol, Madrid, Spain.
    Santos Sanz, Sara
    Minist Hlth Social Affairs & Equal, Directorate Gen Publ Hlth, Coordinat Alerts & Publ Hlth Emergencies, Madrid, Spain.
    Suarez Rodriguez, Berta
    Minist Hlth Social Affairs & Equal, Directorate Gen Publ Hlth, Coordinat Alerts & Publ Hlth Emergencies, Madrid, Spain.
    Ternhag, Anders
    Karolinska Univ Hosp, Stockholm, Sweden;Publ Hlth Agcy Sweden, Stockholm, Sweden.
    Giske, Christian
    Karolinska Univ Hosp, Stockholm, Sweden.
    Wisell, Karin Tegmark
    Publ Hlth Agcy Sweden, Stockholm, Sweden.
    Marques, Diogo Pereira
    Hlth Protect Scotland, Glasgow, Lanark, Scotland.
    Reynolds, Arlene
    Hlth Protect Scotland, Glasgow, Lanark, Scotland.
    McMenamin, Jim
    Hlth Protect Scotland, Glasgow, Lanark, Scotland.
    Mycoplasma pneumoniae infections, 11 countries in Europe and Israel, 2011 to 20162020Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 25, nr 2, s. 39-51Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Mycoplasma pneumoniae is a leading cause of community-acquired pneumonia, with large epidemics previously described to occur every 4 to 7 years.

    Aim: To better understand the diagnostic methods used to detect M. pneumoniae; to better understand M. pneumoniae testing and surveillance in use; to identify epidemics; to determine detection number per age group, age demographics for positive detections, concurrence of epidemics and annual peaks across geographical areas; and to determine the effect of geographical location on the timing of epidemics.

    Methods: A questionnaire was sent in May 2016 to Mycoplasma experts with national or regional responsibility within the ESCMID Study Group for Mycoplasma and Chlamydia Infections in 17 countries across Europe and Israel, retrospectively requesting details on M. pneumoniae-positive samples from January 2011 to April 2016. The Moving Epidemic Method was used to determine epidemic periods and effect of country latitude across the countries for the five periods under investigation.

    Results: Representatives from 12 countries provided data on M. pneumoniae infections, accounting for 95,666 positive samples. Two laboratories initiated routine macrolide resistance testing since 2013. Between 2011 and 2016, three epidemics were identified: 2011/12, 2014/15 and 2015/16. The distribution of patient ages for M. pneumoniae-positive samples showed three patterns. During epidemic years, an association between country latitude and calendar week when epidemic periods began was noted.

    Conclusions: An association between epidemics and latitude was observed. Differences were noted in the age distribution of positive cases and detection methods used and practice. A lack of macrolide resistance monitoring was noted.

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  • 34.
    Belger, Mark
    et al.
    Eli Lilly & Co Ltd, Lilly Res Ctr, Windlesham, Surrey, England.
    Haro, Josep Maria
    Univ Barcelona, CIBERSAM, Barcelona, Spain.
    Reed, Catherine
    Eli Lilly & Co Ltd, Lilly Res Ctr, Windlesham, Surrey, England.
    Happich, Michael
    Eli Lilly & Co Ltd, Lilly Res Ctr, Windlesham, Surrey, England.
    Argimon, Josep Maria
    Agencia Qualitat & Avaluacio Sanitaries Catalunya, Barcelona, Spain.
    Bruno, Giuseppe
    Sapienza Univ Rome, Clin Memoria, Dept Neurol & Psychiat, Rome, Italy.
    Dodel, Richard
    Essen Univ Hosp, Geriatrie Zentrum Haus Berge, Essen, Germany.
    Jones, Roy W.
    Royal United Hosp, RICE Res Inst Care Older People, Bath, Avon, England.
    Vellas, Bruno
    Toulouse Univ Hosp, Gerontopole, INSERM 1027, Toulouse, France.
    Wimo, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Div Neurogeriatr, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Determinants of time to institutionalisation and related healthcare and societal costs in a community-based cohort of patients with Alzheimer's disease dementia2019Ingår i: European Journal of Health Economics, ISSN 1618-7598, E-ISSN 1618-7601, Vol. 20, nr 3, s. 343-355Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To examine the costs of caring for community-dwelling patients with Alzheimer’s disease (AD) dementia in relation to the time to institutionalisation.

    Methods: GERAS was a prospective, non-interventional cohort study in community-dwelling patients with AD dementia and their caregivers in three European countries. Using identified factors associated with time to institutionalisation, models were developed to estimate the time to institutionalisation for all patients. Estimates of monthly total societal costs, patient healthcare costs and total patient costs (healthcare and social care together) prior to institutionalisation were developed as a function of the time to institutionalisation.

    Results: Of the 1495 patients assessed at baseline, 307 (20.5%) were institutionalised over 36 months. Disease severity at baseline [based on Mini-Mental State Examination (MMSE) scores] was associated with risk of being institutionalised during follow up (p < 0.001). Having a non-spousal informal caregiver was associated with a faster time to institutionalisation (944 fewer days versus having a spousal caregiver), as was each one-point worsening in baseline score of MMSE, instrumental activities of daily living and behavioural disturbance (67, 50 and 30 fewer days, respectively). Total societal costs, total patient costs and, to a lesser extent, patient healthcare-only costs were associated with time to institutionalisation. In the 5 years pre-institutionalisation, monthly total societal costs increased by more than £1000 (€1166 equivalent for 2010) from £1900 to £3160 and monthly total patient costs almost doubled from £770 to £1529.

    Conclusions: Total societal costs and total patient costs rise steeply as community-dwelling patients with AD dementia approach institutionalisation.

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  • 35.
    Bendrik, Regina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin. Reg Gavleborg, Gavle, Sweden..
    Kallings, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin. Swedish Sch Sport & Hlth Sci, Stockholm, Sweden..
    Broms, K.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Reg Gavleborg, Gavle, Sweden..
    Emtner, Morgan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Maximal Step-Up Test A New Functional Test In Hip Or Knee Osteoarthritis2016Ingår i: Osteoarthritis and Cartilage, ISSN 1063-4584, E-ISSN 1522-9653, Vol. 24, s. S471-S471Artikel i tidskrift (Övrigt vetenskapligt)
  • 36.
    Bengtsson, Caroline
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Grote, Ludger
    Sahlgrens Univ Hosp, Sleep Disorders Ctr, Pulm Dept, Gothenburg, Sweden.;Gothenburg Univ, Sahlgrenska Acad, Ctr Sleep & Wake Disorders, Gothenburg, Sweden..
    Ljunggren, Mirjam
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Ekström, Magnus
    Lund Univ, Fac Med, Dept Clin Sci Lund Resp Med & Allergol, Resp Med & Allergol, Lund, Sweden..
    Palm, Andreas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Nasal polyposis is a risk factor for nonadherence to CPAP treatment in sleep apnea: the population-based DISCOVERY study2023Ingår i: Journal of Clinical Sleep Medicine (JCSM), ISSN 1550-9389, E-ISSN 1550-9397, Vol. 19, nr 3, s. 573-579Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study Objectives: The aim was to evaluate nasal polyposis as a risk factor for nonadherence to continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnea (OSA).

    Methods: This was a population-based, longitudinal analysis of patients starting CPAP treatment for OSA in the Swedish quality registry Swedevox between 2010 and 2018. Data were cross-linked with national registries. The impact of nasal polyposis on CPAP adherence was analyzed using uni-and multivariable logistic and linear regression models. Relevant confounders (age, sex, usage of nasal and oral steroids) were identified using a direct acyclic graph.

    Results: Of 20,521 patients with OSA on CPAP treatment (29.5% females), 331 (1.6%) had a diagnosis of nasal polyposis at baseline. At the 1-year follow-up, nasal polyposis was associated with an increased risk of CPAP usage < 4 hours/night (unadjusted odds ratio [OR] 1.21; 95% confidence interval [CI] 0.95-1.55); adjusted OR 1.38; 95% CI 1.08-1.77). In this group, unadjusted nocturnal mean CPAP usage was 15.4 minutes (95% CI-31.62 to 0.83) shorter and was an adjusted 24.1 minutes (95% CI-40.6 to-7.7) shorter compared with patients with OSA without nasal polyposis.

    Conclusions: Nasal polyposis is associated with reduced CPAP usage per night. These results highlight the importance of diagnosing nasal polyposis in patients with OSA before the start of CPAP treatment. Treatment of the condition may improve adherence, efficacy, and patient outcomes.

  • 37.
    Berggard, Cecilia
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Farmakologi.
    Damberg, Mattias
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Oreland, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Farmakologi.
    Brainstem levels of transcription factor AP-2 in rat are changed after treatment with phenelzine, but not with citalopram2005Ingår i: BMC Pharmacology, ISSN 1471-2210, Vol. 5, s. 1-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Before therapeutic effect is obtained after treatment with antidepressant drugs, like serotonin selective reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAO-Is) there is an initial lag-period of a few weeks. Neuronal adaptations on a molecular level are supposed to be involved in the initiation of the antidepressant effect. Transcription factor AP-2 is essential for neuronal development and many genes involved in the brainstem monoaminergic systems have binding sites for AP-2 in their regulatory regions. The genotype of the AP-2beta isoform has been associated with e.g. anxiety-related personality traits and with platelet MAO activity. In addition, previous studies have shown that the levels of AP-2alpha and AP-2beta in rat whole brain were decreased after 10 days of treatment with citalopram (SSRI) and imipramine (TCA), and were increased with phenelzine (MAO-I). RESULTS: In the present study, we report that treatment with citalopram for 1, 7 or 21 days did not have effect on the AP-2 levels in rat brainstem. However, after treatment with phenelzine for 1, 7 or 21 days the levels of AP-2alpha and AP-2beta had increased after 7 days, but had returned to control levels at day 21. CONCLUSION: The decrease in AP-2 levels in rat whole brain previously seen after treatment with citalopram does not seem to be localised to the brainstem, it may rather occur in the monoaminergic terminal projection areas. The present data suggest that the increase in AP-2 levels previously seen in rat whole brain after subchronic treatment with phenelzine is located in the brainstem. It cannot, however, be excluded that other brain regions are involved.

  • 38.
    Bergkvist, Leif
    et al.
    Uppsala universitet, Fakultetsövergripande enheter, Centrum för klinisk forskning, Västerås.
    Liljegren, Göran
    Ahlgren, Johan
    Centrum för klinisk forskning, Gävleborg.
    Lidin, Annika
    Holmqvist, Marit
    Holmberg, Lars
    Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    [Registries contribute to better breast cancer care]2004Ingår i: Lakartidningen, ISSN 0023-7205, Vol. 101, nr 34, s. 2579-81Artikel i tidskrift (Refereegranskat)
  • 39.
    Berglund, Anders
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Endokrinkirurgi.
    Wigertz, Annette
    Adolfsson, Jan
    Ahlgren, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Fornander, Tommy
    Wärnberg, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Endokrinkirurgi.
    Lambe, Mats
    Impact of comorbidity on management and mortality in women diagnosed with breast cancer2012Ingår i: Breast Cancer Research and Treatment, ISSN 0167-6806, E-ISSN 1573-7217, Vol. 135, nr 1, s. 281-289Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To investigate associations between comorbidity burden, management, and mortality in women with breast cancer. A total of 42,646 women diagnosed with breast cancer between 1992 and 2008 were identified in two Clinical Quality Registers in Central Sweden. Breast cancer-specific, conditional breast cancer, competing-cause and all-cause mortality were estimated in relation to comorbidity burden assessed by the Charlson comorbidity index. All analyses were stratified by stage at diagnosis using competing risk analyses, and all-cause mortality was estimated as a function of follow-up time. Following adjustment for age and calendar period, breast conserving surgery was significantly less likely to be offered to women with severe comorbidity (OR 0.63; 95 % CI 0.58-0.69). Similarly, the proportion treated with radiotherapy, tamoxifen, or chemotherapy was lower in women with severe compared to those with no comorbidity. In women with early stage disease, breast cancer-specific mortality was higher among patients with severe comorbidity (sHR 1.47; 95 % CI 1.11-1.94). In all stages of breast cancer, conditional breast cancer and competing-cause mortality were elevated in women with severe comorbidity. For all stages, the relative risk of all-cause mortality between women with severe versus no comorbidity varied by time since diagnosis, and was most pronounced at early follow-up. Comorbidity affects treatment decisions and mortality. In women with early stage breast cancer, severe comorbidity was associated not only with conditional breast cancer, competing-cause and all-cause mortality, but also breast cancer-specific mortality. The observed differences in breast cancer-specific mortality may be due to less extensive treatment, impaired tumor defense and differences in general health status and lifestyle factors.

  • 40.
    Bergman, Emma Ahlen
    et al.
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Unit Immunol & Allergy, Stockholm, Sweden..
    Hartana, Ciputra Adijaya
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Unit Immunol & Allergy, Stockholm, Sweden..
    Johansson, Markus
    Sundsvall Hosp, Dept Urol, Sundsvall, Sweden.;Umea Univ, Dept Surg & Perioperat Sci, Urol & Androl, Umea, Sweden..
    Linton, Ludvig B.
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Unit Immunol & Allergy, Stockholm, Sweden..
    Berglund, Sofia
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Unit Immunol & Allergy, Stockholm, Sweden..
    Hyllienmark, Martin
    TLA Targeted Immunotherapies AB, Stockholm, Sweden..
    Lundgren, Christian
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Unit Immunol & Allergy, Stockholm, Sweden..
    Holmström, Benny
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Urologkirurgi.
    Palmqvist, Karin
    Umea Univ, Dept Surg & Perioperat Sci, Urol & Androl, Umea, Sweden.;Ostersund Cty Hosp, Urol Sect, Dept Surg, Ostersund, Sweden..
    Hansson, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Alamdari, Farhood
    Vastmanland Hosp, Dept Urol, Vasteras, Sweden..
    Huge, Ylva
    Linkoping Univ, Div Urol, Dept Clin & Expt Med, Linkoping, Sweden..
    Aljabery, Firas
    Linkoping Univ, Div Urol, Dept Clin & Expt Med, Linkoping, Sweden..
    Riklund, Katrine
    Umea Univ, Dept Radiat Sci, Diagnost Radiol, Umea, Sweden..
    Winerdal, Malin E.
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Unit Immunol & Allergy, Stockholm, Sweden..
    Krantz, David
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Unit Immunol & Allergy, Stockholm, Sweden..
    Zirakzadeh, A. Ali
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Unit Immunol & Allergy, Stockholm, Sweden.;Umea Univ, Dept Surg & Perioperat Sci, Urol & Androl, Umea, Sweden..
    Marits, Per
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Unit Immunol & Allergy, Stockholm, Sweden..
    Sjöholm, Louise K.
    Karolinska Inst, Dept Clin Neurosci, Ctr Mol Med, Stockholm, Sweden..
    Sherif, Amir
    Umea Univ, Dept Surg & Perioperat Sci, Urol & Androl, Umea, Sweden.;Umea Univ, Dept Radiat Sci, Diagnost Radiol, Umea, Sweden..
    Winqvist, Ola
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Unit Immunol & Allergy, Stockholm, Sweden..
    Increased CD4(+) T cell lineage commitment determined by CpG methylation correlates with better prognosis in urinary bladder cancer patients2018Ingår i: Clinical Epigenetics, E-ISSN 1868-7083, Vol. 10, artikel-id 102Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Urinary bladder cancer is a common malignancy worldwide. Environmental factors and chronic inflammation are correlated with the disease risk. Diagnosis is performed by transurethral resection of the bladder, and patients with muscle invasive disease preferably proceed to radical cystectomy, with or without neoadjuvant chemotherapy. The anti-tumour immune responses, known to be initiated in the tumour and draining lymph nodes, may play a major role in future treatment strategies. Thus, increasing the knowledge of tumour-associated immunological processes is important. Activated CD4(+) T cells differentiate into four main separate lineages: Th1, Th2, Th17 and Treg, and they are recognized by their effector molecules IFN-gamma, IL-13, IL-17A, and the transcription factor Foxp3, respectively. We have previously demonstrated signature CpG sites predictive for lineage commitment of these four major CD4(+ )T cell lineages. Here, we investigate the lineage commitment specifically in tumour, lymph nodes and blood and relate them to the disease stage and response to neoadjuvant chemotherapy.

    Results: Blood, tumour and regional lymph nodes were obtained from patients at time of transurethral resection of the bladder and at radical cystectomy. Tumour-infiltrating CD4(+ )lymphocytes were significantly hypomethylated in all four investigated lineage loci compared to CD4(+) lymphocytes in lymph nodes and blood (lymph nodes vs rumour-infiltrating lymphocytes: IFNG -4229 bp p < 0.0001, IL13 -11 bp p < 0.05, IL17A -122 bp p < 0.01 and FOXP3 -77 bp p> 0.05). Examination of individual lymph nodes displayed different methylation signatures, suggesting possible correlation with future survival. More advanced post-cystectomy tumour stages correlated significantly with increased methylation at the IFNG -4229 bp locus. Patients with complete response to neoadjuvant chemotherapy displayed significant hypomethylation in CD4(+ )T cells for all four investigated loci, most prominently in IFNG p < 0.0001. Neoadjuvant chemotherapy seemed to result in a relocation of Th1-committed CD4(+) T cells from blood, presumably to the tumour, indicated by shifts in the methylation patterns, whereas no such shifts were seen for lineages corresponding to IL13, IL17A and FOXP3.

    Conclusion: Increased lineage commitment in CD4(+) T cells, as determined by demethylation in predictive CpG sites, is associated with lower post-cystectomy tumour stage, complete response to neoadjuvant chemotherapy and overall better outcome, suggesting epigenetic profiling of CD4(+) T cell lineages as a useful readout for clinical staging.

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  • 41.
    Bergqvist, Michael
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Umeå Univ, Dept Radiat Sci, Umeå, Sweden..
    Christensen, Helene N.
    AstraZeneca Nordic Baltic, Södertälje, Sweden..
    Wiklund, Fredrik
    Statisticon AB, Stockholm, Sweden..
    Bergström, Stefan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Real world utilization of EGFR TKIs and prognostic factors for survival in NSCLC during 2010-2016 in Sweden: A nationwide observational study2020Ingår i: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 146, nr 9, s. 2510-2517Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of our study was to investigate time trends in treatment pattern and prognostic factors for overall survival (OS) in epidermal growth factor receptor (EGFR) targeting tyrosine kinase inhibitors (TKIs) treated nonsmall cell lung cancer (NSCLC) patients. Utilizing Swedish nationwide registers, we identified all Stage IIIB-IV NSCLC patients treated with EGFR TKIs and followed them from diagnosis (2010-2015) until death or end of observation (2016). Multivariable Cox regression analyses were performed to test associations of patient-, tumor-related factors with OS. Of 9,992 Stage IIIB-IV NSCLC patients, the 1,419 (14%) who initiated EGFR TKI treatment during observation were younger (median age 68 vs. 71 years), less >= 1 comorbidities (34% vs. 46%), more often female (59% vs. 47%), Stage IV (89% vs. 85%) and adenocarcinoma (85% vs. 66%) compared to non-TKI treated patients. After TKI initiation, 7% (n = 100) of the patients switched, 4% (n = 62) rechallenged a TKI treatment, 65% (n = 919) discontinued and 24% (n = 338) had died. A more recent diagnosis demonstrated shorter time to EGFR TKI initiation, prolonged treatment length and longer median OS (15.3 months 2010-2011; 14.4 months 2012-2013; 18.6 months 2014-2015). Prognostic factors for longer OS when treated with EGFR TKIs were younger age, adenocarcinoma, less advanced clinical stage and less comorbid disease. In conclusion, during the observation period, survival improved for EGFR TKI treated NSCLC patients, as did the accessibility for targeted therapies for these patients.

  • 42.
    Bergqvist, Michael
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi. Umea Univ, Dept Radiat Sci, Umea, Sweden.
    Holgersson, Georg
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Experimentell och klinisk onkologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Bondarenko, Igor
    Grechanaya, Elena
    Maximovich, Alexey
    Andor, György
    Klockare, Maria
    Thureson, Marcus
    Jerling, Markus
    Harmenberg, Johan
    Phase II randomized study of the IGF-1R pathway modulator AXL1717 compared to docetaxel in patients with previously treated, locally advanced or metastatic non-small cell lung cancer2017Ingår i: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 53, nr 3, s. 441-447Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The primary objective of this study was to compare the progression-free survival (PFS) at 12 weeks between patients treated with IGF-1R pathway modulator AXL1717 (AXL) and patients treated with docetaxel (DCT).

    MATERIAL AND METHODS: The study was conducted at 19 study centers in five countries. A total of 99 patients with previously treated, locally advanced or metastatic non-small cell lung cancer (NSCLC) of the squamous cell carcinoma (SCC) or adenocarcinoma (AC) subtypes in need of additional treatment were randomized and treated with either 300 or 400 mg of AXL as daily BID treatment (58 patients) or DCT given as 75 mg/m(2) in three-week cycles (41 patients) as monotherapy in a 3:2 ratio for each NSCLC subtype. Patients were treated in the primary study treatment period for a maximum of four treatment cycles.

    RESULTS: The 12-week PFS rate, median PFS and overall survival (OS), as well Kaplan-Meier hazard ratio for PFS and OS, did not show any statistically significant differences between the treatment groups. For the primary endpoint, the AXL group had a lower percentage of patients (25.9%) who were progression-free at Week 12 as compared to the DCT group (39.0%), although the difference was not statistically significant. The most notable difference in the incidence of treatment emergent adverse effects (TEAEs) was the lower incidence of treatment-related grade 3/4 neutropenia in patients treated with AXL.

    CONCLUSION: These results suggest neither of the treatments to be superior of the other when treating locally advanced or metastatic NSCLC. Considering the lower incidence of grade 3/4 neutropenia in the AXL group this treatment warrants further research.

  • 43.
    Bergsten, Eva L.
    et al.
    Univ Gävle, Fac Hlth & Occupat Studies, Dept Occupat Hlth Sci & Psychol, S-80176 Gävle, Sweden..
    Wijk, Katarina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin/CHAP. Univ Gävle, Fac Hlth & Occupat Studies, Dept Occupat Hlth Sci & Psychol, S-80176 Gävle, Sweden..
    Hallman, David M.
    Univ Gävle, Fac Hlth & Occupat Studies, Dept Occupat Hlth Sci & Psychol, S-80176 Gävle, Sweden..
    Implementation of Activity-Based Workplaces (ABW)-The Importance of Participation in Process Activities2022Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, nr 21, artikel-id 14338Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Relocation to new office solutions such as activity-based workplaces (ABW) has increased but satisfaction with the ABW among employees varies, and the importance of participation in the relocation process is unclear. This study aimed to examine the association between employees' extent of participation in the implementation process activities and satisfaction with the relocation to ABW. Data were collected from 699 employees in a Swedish governmental agency 3-months prior to, 3-months and 9-months after relocation to the ABW. Questionnaires were used to assess participation in process activities and perceived satisfaction with knowledge about working in ABW, office rules, and information and support during the process. Participation in activities was significantly associated with higher overall satisfaction with knowledge, office rules, information and support, and effects were generally more pronounced as the number of attended activities increased. Satisfaction also increased among non-participants, although without reaching the same levels as participants. Our results show the importance to offer and facilitate a high participation in the relocation process activities to obtain satisfaction with a relocation to ABW.

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  • 44.
    Bergsten, Eva L.
    et al.
    Univ Gävle, Dept Occupat Hlth Sci & Psychol, Fac Hlth & Occupat Studies, S-80176 Gävle, Sweden..
    Wijk, Katarina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin/CHAP. Univ Gävle, Dept Occupat Hlth Sci & Psychol, Fac Hlth & Occupat Studies, S-80176 Gävle, Sweden..
    Hallman, David M.
    Univ Gävle, Dept Occupat Hlth Sci & Psychol, Fac Hlth & Occupat Studies, S-80176 Gävle, Sweden..
    Relocation to Activity-Based Workplaces (ABW)-Importance of the Implementation Process2021Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, nr 21, artikel-id 11456Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Activity-based workplaces (ABW) have been implemented in many organizations to offer office flexibility and decrease facility costs. Evaluations of the ABW implementation process are rare. The study aimed to examine the ABW relocation process of two offices in a Swedish governmental agency and to explore factors that influence the implementation process and satisfaction with it. Qualitative or quantitative data were collected on process variables (context, recruitment, reach, dose delivered, dose received, satisfaction), barriers and facilitators to the process were explored in focus group interviews, and immediate outcomes (perceived knowledge, understanding office rules, satisfying information and support) were measured by questionnaire before and after the relocation. The evaluation showed that recruitment was unsatisfactory and reach insufficient-and participation in activities was thus low for both offices. However, intended changes improved. Unclear aims of ABW, lack of manager support and, lack of communication were some of the reported barriers to participation, while a well-planned process, work groups, and program activities were facilitators. Thus, to increase satisfaction with the relocation, our results suggest that recruitment should be thoroughly planned, taking these factors into account to increase participation. This knowledge may be useful for planning and designing successful ABW relocations and evaluations.

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  • 45.
    Bergstrom, Charlotta
    et al.
    Karolinska Inst, Dept Womens & Childrens Hlth, SE-17177 Stockholm, Sweden.;Danderyd Hosp, Dept Surg & Urol, Stockholm, Sweden..
    Lampic, Claudia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom. Karolinska Inst, Dept Womens & Childrens Hlth, SE-17177 Stockholm, Sweden.;Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden.;Umea Univ, Dept Psychol, Umea, Sweden..
    Roy, Ricky
    Karolinska Inst, Dept Womens & Childrens Hlth, SE-17177 Stockholm, Sweden.;Karolinska Univ Hosp, Dept Urol, Huddinge, Sweden..
    Hedman, Christel
    Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden.;Stockholms Sjukhem Fdn, R&D Dept, Stockholm, Sweden.;Lund Univ, Dept Clin Sci Lund, Lund, Sweden..
    Ahlgren, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Orebro Univ, Fac Med & Hlth, Dept Oncol, Orebro, Sweden.;Karolinska Inst, Dept Womens & Childrens Hlth, SE-17177 Uppsala, Sweden..
    Stahl, Olof
    Skane Univ Hosp, Dept Oncol, Lund, Sweden..
    Smedby, Karin E.
    Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Hematol, Stockholm, Sweden..
    Hellman, Kristina
    Karolinska Univ Hosp, Dept Gynecol Canc, Theme Canc, Stockholm, Sweden..
    Henriksson, Roger
    Univ Hosp, Dept Radiat Sci & Oncol, Umea, Sweden..
    Eriksson, Lars E.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;City Univ London, Sch Hlth & Psychol Sci, London, England.;Karolinska Univ Hosp, Med Unit Infect Dis, Huddinge, Sweden..
    Wettergren, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom. Karolinska Inst, Dept Womens & Childrens Hlth, SE-17177 Stockholm, Sweden.;Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden..
    Do young adults with cancer receive information about treatment- related impact on sex life?: Results from a population-based study2023Ingår i: Cancer Medicine, E-ISSN 2045-7634, Vol. 12, nr 8, s. 9893-9901Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Sexual dysfunction is common following a cancer diagnosis in young adulthood (18-39 years) and problems related to sex life are ranked among the core concerns in this age group. Yet, few studies have investigated to what extent adults younger than 40, receive information from healthcare providers about the potential impact of cancer and its treatment on their sex life.Methods A population-based cross-sectional survey study was conducted with 1010 young adults 1.5 years after being diagnosed with cancer (response rate 67%). Patients with breast, cervical, ovarian and testicular cancer, lymphoma, and brain tumors were identified in national quality registries. Sociodemographic and clinical factors associated with receiving information were examined using multivariable binary logistic regression.Results Men to a higher extent than women reported having received information about potential cancer-related impact on their sex life (68% vs. 54%, p < 0.001). Receipt of information varied across diagnoses; in separate regression models, using lymphoma as reference, both women and men with brain tumors were less likely to receive information (women: OR 0.10, CI = 0.03-0.30; men: OR 0.37, CI = 0.16-0.85). More intensive treatment was associated with higher odds of receiving information in both women (OR 1.89; CI = 1.28-2.79) and men (OR 2.08; CI = 1.09-3.94). None of the sociodemographic factors were associated with receipt of information.Conclusions To improve sexual health communication to young adults with cancer, we recommend diagnosis-specific routines that clarify when in the disease trajectory to discuss these issues with patients and what to address in these conversations.

  • 46. Bergström, Stefan
    et al.
    Ahlgren, Johan
    Uppsala universitet, Fakultetsövergripande enheter, Centrum för klinisk forskning, Gävleborg.
    Hagberg, Hans
    [Erythropoietin can reduce the effect of radiotherapy]2004Ingår i: Lakartidningen, ISSN 0023-7205, Vol. 101, nr 41, s. 3160-1Artikel i tidskrift (Refereegranskat)
  • 47.
    Bertilsson, Ann-Sofie
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Ekstam, Lisa
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Lund Univ, Dept Hlth Sci, Lund, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden .
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden.
    Andersson, Magnus
    Karolinska Inst, Dept Clin Neurosci, Solna, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke: One year follow-up of caregivers2016Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, nr 8, s. 765-775Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Compare caregiver burden, provision of informal care, participation in everyday occupationsand life satisfaction of caregivers to people with stroke, who either had received a client-centred, activitiesof daily living intervention or usual activities of daily living interventions.

    Design: A multicentre cluster randomized controlled trial in which 16 rehabilitation units were randomlyassigned to deliver a client-centred, activities of daily living intervention or usual activities of daily livinginterventions. Caregiver outcomes were compared cross-sectionally at 12 months and changes inoutcomes between three and 12 months after people with stroke were included in the study.

    Setting: Inpatient and outpatient rehabilitation.

    Participants: Caregivers of people with stroke enrolled in the trial.

    Intervention: A client-centred, activities of daily living intervention aiming to increase agency in dailyactivities and participation in everyday life for people after stroke.

    Main measures: Caregiver Burden Scale, Occupational Gaps Questionnaire, LiSat-11.

    Results: There were no differences in outcomes between caregivers in the client-centred, activities ofdaily living (n = 88) and the usual activities of daily living (n = 95) group at 12 months. The caregiver burdenscore was 42.7 vs. 41.8, p = 0.75, mean occupational gaps were 3.5 vs. 4.0, p = 0.52 and satisfaction with lifewas 53% vs. 50%, p = 0.87. There were no differences in changes between three and 12 months. However,within groups there were significant differences in caregiver burden, factor general strain, for caregivers inthe client-centred, activities of daily living group, and in provision of informal care for the usual activitiesof daily living group.

    Conclusion: The client-centred intervention did not bring about any difference between caregivergroups,but within groups some difference was found for caregiver burden and informal care.

  • 48.
    Bertilsson, Ann-Sofie
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Ekstam, Lisa
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Lund Univ, Dept Hlth Sci, Lund, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden .
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden.
    Andersson, Magnus
    Karolinska Inst, Dept Clin Neurosci, Solna, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke: One year follow-up of caregivers2016Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, nr 8, s. 765-775Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Compare caregiver burden, provision of informal care, participation in everyday occupationsand life satisfaction of caregivers to people with stroke, who either had received a client-centred, activitiesof daily living intervention or usual activities of daily living interventions.

    Design: A multicentre cluster randomized controlled trial in which 16 rehabilitation units were randomlyassigned to deliver a client-centred, activities of daily living intervention or usual activities of daily livinginterventions. Caregiver outcomes were compared cross-sectionally at 12 months and changes inoutcomes between three and 12 months after people with stroke were included in the study.

    Setting: Inpatient and outpatient rehabilitation.

    Participants: Caregivers of people with stroke enrolled in the trial.

    Intervention: A client-centred, activities of daily living intervention aiming to increase agency in dailyactivities and participation in everyday life for people after stroke.

    Main measures: Caregiver Burden Scale, Occupational Gaps Questionnaire, LiSat-11.

    Results: There were no differences in outcomes between caregivers in the client-centred, activities ofdaily living (n = 88) and the usual activities of daily living (n = 95) group at 12 months. The caregiver burdenscore was 42.7 vs. 41.8, p = 0.75, mean occupational gaps were 3.5 vs. 4.0, p = 0.52 and satisfaction with lifewas 53% vs. 50%, p = 0.87. There were no differences in changes between three and 12 months. However,within groups there were significant differences in caregiver burden, factor general strain, for caregivers inthe client-centred, activities of daily living group, and in provision of informal care for the usual activitiesof daily living group.

    Conclusion: The client-centred intervention did not bring about any difference between caregivergroups,but within groups some difference was found for caregiver burden and informal care.

  • 49. Bertilsson, Ann-Sofie
    et al.
    Ranner, Maria
    von Koch, Lena
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Ytterberg, Charlotte
    Guidetti, Susanne
    Tham, Kerstin
    A client-centred ADL intervention: three-month follow-up of a randomized controlled trial2014Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, nr 5, s. 377-391Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim was to study a client-centred activities of daily living (ADL) intervention (CADL) compared with the usual ADL intervention (UADL) in people with stroke regarding: independence in ADL, perceived participation, life satisfaction, use of home-help service, and satisfaction with training and, in their significant others, regarding: caregiver burden, life satisfaction, and informal care. Methods: In this multicentre study, 16 rehabilitation units were randomly assigned to deliver CADL or UADL. The occupational therapists who provided the CADL were specifically trained. Eligible for inclusion were people with stroke treated in a stroke unit 3 months after stroke, dependent in two ADL, not diagnosed with dementia, and able to understand instructions. Data were collected at inclusion and three months thereafter. To detect a significant difference between the groups in the Stroke Impact Scale (SIS) domain "participation", 280 participants were required. Intention-to-treat analysis was applied. Results: At three months, there was no difference in the outcomes between the CADL group (n = 129) and the UADL group (n = 151), or their significant others (n = 87/n = 93) except in the SIS domain "emotion" in favour of CADL (p = 0.04). Conclusion: The CADL does not appear to bring about short-term differences in outcomes and longer follow-ups are required.

  • 50.
    Bertilsson, Ann-Sofie
    et al.
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, S-14183 Stockholm, Sweden..
    Von Koch, Lena
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, S-14183 Stockholm, Sweden.;Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden..
    Tham, Kerstin
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, S-14183 Stockholm, Sweden.;Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden..
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, S-14183 Stockholm, Sweden..
    Client-centred ADL intervention after stroke: Significant others' experiences2015Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, nr 5, s. 377-386Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Client-centredness is a prominent contemporary concept in rehabilitation. However, there is a lack of knowledge on if and how a client-centred rehabilitation approach is incorporated in the everyday life of significant others of people who receive such rehabilitation. Objective: Explore and describe if and how a client-centred ADL intervention (CADL) was integrated in the everyday lives of significant others of people with stroke. Materials and methods: Qualitative longitudinal design, with a grounded theory approach. Seven significant others, who cohabited with persons receiving a CADL intervention, were interviewed during the first year. Findings: One core category was identified: "Taking responsibility and achieving balance with respect to self-esteem in order to get on with everyday life". The integration of the CADL was a process. A key aspect was that as the person with stroke acted upon his/her own desired activity goals the significant others were encouraged to act on their own needs. Conclusions: Enablement is important also for the significant others of people with stroke. One way of enabling significant others to maintain an active lifestyle and find respite in everyday life might be to enable people with stroke to formulate and act upon their desired activity goals.

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