oru.sePublikasjoner
Endre søk
Begrens søket
1234567 1 - 50 of 2797
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Treff pr side
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
Merk
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 1.
    A. Proko, Romina
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Deskriptiv studie av Multimodal Rehabilitering 1-deltagare i västra Region Örebro Län: - förändring i självskattning av ångest/depression och basal kroppskännedom efter åtta veckors intervention2019Independent thesis Basic level (degree of Bachelor of Fine Arts), 10 poäng / 15 hpOppgave
  • 2.
    Aaro, Martina
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Polypharmacy and Inappropriate Drug Use among Elderly Patients admitted to a Short-Term Nursing Home in Örebro2017Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 3.
    Abawi, Akram
    Örebro universitet, Institutionen för medicinska vetenskaper.
    The effect of TGF-B1 and Fetal Bovine Serum on Sema 7A. Expression: An in Vitro study on Bone Marrow derived MSC from patients vith BCR-ABL negative Myeloproliferative neoplasms2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 4.
    Abdulla, Lana
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Recurrent or non-recurrent tamoxifen treated breast cancer2016Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 5.
    Abou El Khair, Ahmad
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Jämförelse mellan prognostiska markörer vid intensivvårdskrävandesepsis på universitetssjukhuset Örebro2019Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Sepsis är ett allvarligt tillstånd som är vanligt förekommande och medför en hög riskför mortalitet. Trots den vanliga förekomsten råder en stor okunnighet om tillståndet. I många århar olika markörer på akutmottagningen studerats, för att ta reda på vilka markörer som äreffektivast på att förutsäga en patients sjukdomsutveckling och utfall. Det finns än idag en storoenighet bland forskare om vilka markörer som är bäst. Laktat, andningsfrekvens (RR;respiratory rate) och base excess (BE) har använts som prognostiska markörer tidigare, menvilken av dem som är bäst är okänt. För behandling av sepsis finns det riktlinjer som säger attantibiotika bör administreras inom en timme efter ankomst till akutmottagningen. Det har visatsig vara avgörande för prognosen hur snabbt antibiotika sätts in.

    Syfte: Att jämföra det prognostiska värdet hos laktat med respirationsfrekvens (RR) med Baseexcess(BE) i blodet, samt att undersöka hur väl de nationella riktlinjerna för initial behandling avsepsis har följts och vilken inverkan på patientutfall detta har.

    Metod: En retrospektiv journalgranskningsstudie gjordes på alla patienter som har vårdats försepsis på IVA på Universitetssjukhuset Örebro under perioden juli 2017 – juli 2018. Utav totalt 62patienter som selekterades ur ett sepsisregister kunde 50 stycken inkluderas i undersökningen.Studiepopulationen indelades i två grupper: mortalitet inom 30 dagar eller ej.

    Resultat: Av de inkluderade 50 patienterna avled 12 stycken (24%) och 38 stycken (76%)utvecklade septisk chock, 42 stycken (88 %) fick vätska administrerat inom 1 h och 26 stycken (52%) fick antibiotika inom 1 h. Mann Whitney U-test visade att fördelningen av laktatvärden (p =0,166), andningsfrekvensvärden (p = 0,059) och base excess-nivåer (p = 0,077) hos gruppen meddödsfall inom 30 dagar jämfört med gruppen utan dödsfall inom 30 dagar inte var statistisktsignifikanta. Log rank test visade: laktat > 4 mmol/l (p = 0,136), RR ≥ 30/min (p = 0,037), BE < -3mmol/l (p = 0,802), antibiotika administrerat inom 1 h (p = 0,636).

    Slutsats: Andningsfrekvens var en bättre prognostisk markör på akutmottagningen än laktat ochbase excess. En otillfredsställande låg andel av patienterna fick antibiotika inom en timme efterankomst till akutmottagningen. Administrering av antibiotika inom en timme efter ankomst tillakutmottagning visade sig inte vara avgörande för prognosen.

  • 6.
    Acevedo, Reinaldo
    et al.
    Biologic Evaluation Department, Finlay Institute of Vaccines, Havana, Cuba.
    Bai, Xilian
    Meningococcal Reference Unit, Public Health England, Manchester, UK.
    Borrow, Ray
    Meningococcal Reference Unit, Public Health England, Manchester, UK.
    Caugant, Dominique A.
    Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.
    Carlos, Josefina
    Department of Pediatrics, College of Medicine, University of the East – Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines.
    Ceyhan, Mehmet
    Faculty of Medicine, Department of Pediatric Infectious Diseases, Hacettepe University, Ankara, Turkey.
    Christensen, Hannah
    Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
    Climent, Yanet
    Biologic Evaluation Department, Finlay Institute of Vaccines, Havana, Cuba.
    De Wals, Philippe
    Department of Social and Preventive Medicine, Laval University, Quebec City QC, Canada.
    Dinleyici, Ener Cagri
    Department of Paediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
    Echaniz-Aviles, Gabriela
    Center for Research on Infectious Diseases, Instituto Nacional de Salud Pública, Cuernavaca, México.
    Hakawi, Ahmed
    Infectious Diseases Control, Ministry of Health, Riyadh, Saudi Arabia.
    Kamiya, Hajime
    Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan.
    Karachaliou, Andromachi
    Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
    Lucidarme, Jay
    Meningococcal Reference Unit, Public Health England, Manchester, UK.
    Meiring, Susan
    Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa.
    Mironov, Konstantin
    Central Research Institute of Epidemiology, Moscow, Russian Federation.
    Safadi, Marco A. P.
    Department of Pediatrics, FCM Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil.
    Shao, Zhujun
    National Institute for Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China.
    Smith, Vinny
    Meningitis Research Foundation, Bristol, UK.
    Steffen, Robert
    Department of Epidemiology and Prevention of Infectious Diseases, WHO Collaborating Centre for Travellers’ Health, University of Zurich, Zurich, Switzerland.
    Stenmark, Bianca
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Laboratory Medicine.
    Taha, Muhamed-Kheir
    Institut Pasteur, National Reference Centre for Meningococci, Paris, France.
    Trotter, Caroline
    Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
    Vazquez, Julio A.
    National Centre of Microbiology, Institute of Health Carlos III, Madrid, Spain.
    Zhu, Bingqing
    National Institute for Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China.
    The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations2019Inngår i: Expert Review of Vaccines, ISSN 1476-0584, E-ISSN 1744-8395, Vol. 18, nr 1, s. 15-30Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Introduction: The 2018 Global Meningococcal Initiative (GMI) meeting focused on evolving invasive meningococcal disease (IMD) epidemiology, surveillance, and protection strategies worldwide, with emphasis on emerging antibiotic resistance and protection of high-risk populations. The GMI is comprised of a multidisciplinary group of scientists and clinicians representing institutions from several continents.

    Areas covered: Given that the incidence and prevalence of IMD continually varies both geographically and temporally, and surveillance systems differ worldwide, the true burden of IMD remains unknown. Genomic alterations may increase the epidemic potential of meningococcal strains. Vaccination and (to a lesser extent) antimicrobial prophylaxis are the mainstays of IMD prevention. Experiences from across the globe advocate the use of conjugate vaccines, with promising evidence growing for protein vaccines. Multivalent vaccines can broaden protection against IMD. Application of protection strategies to high-risk groups, including individuals with asplenia, complement deficiencies and human immunodeficiency virus, laboratory workers, persons receiving eculizumab, and men who have sex with men, as well as attendees at mass gatherings, may prevent outbreaks. There was, however, evidence that reduced susceptibility to antibiotics was increasing worldwide.

    Expert commentary: The current GMI global recommendations were reinforced, with several other global initiatives underway to support IMD protection and prevention.

  • 7.
    Adams, A.
    et al.
    Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom.
    Kalla, R.
    Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom.
    Vatn, S.
    Institute of Clinical Medicine, EpiGen, University of Oslo, Oslo, Norway.
    Bonfiglio, F.
    BioCruces Health Research Institue, Bilbao, Spain.
    Nimmo, E.
    Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom.
    Kennedy, N.
    Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom.
    Ventham, N.
    Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom.
    Vatn, M.
    Institute of Clinical Medicine, EpiGen, University of Oslo, Oslo, Norway.
    Ricanek, P.
    Department of Gastroenterology, Akershus University, Akershus, Norway.
    Bergemalm, Daniel
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Gastroenterology, Örebro University Hospital, Örebro, Sweden.
    Söderholm, J.
    Department of Surgery, Linköping University Hospital, Linköping, Sweden;.
    Pierik, M.
    Department of Gastroenterology and Hepatology, Maastricht University Medical Center (MUMC), Maastricht, Netherlands.
    Törkvist, L.
    Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
    Gomollon, F.
    University Hospital Clinic Lozano Blesa, Zaragoza, Spain.
    Gut, I.
    CNAG-CRG Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain.
    Jahnsen, J.
    Institute of Clinical Medicine, EpiGen, University of Oslo, Oslo, Norway.
    Satsangi, J.
    Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom.
    Epigenetic alterations at diagnosis predict susceptibility, prognosis and treatment escalation in inflammatory bowel disease - IBD Character2017Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 11, nr Suppl. 1, s. S108-S108Artikkel i tidsskrift (Fagfellevurdert)
  • 8.
    af Edholm, Karolina
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Lidman, Christer
    Karolinska University Hospital, Solna, Sweden.
    Andersson, Sören
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Solders, Göran
    Karolinska Institutet, Stockholm, Sweden.
    Paucar, Martin
    Karolinska University Hospital, Solna, Sweden.
    Clinical Reasoning: Leg weakness and stiffness at the emergency room2019Inngår i: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 92, nr 6, s. E622-E625Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    A 48-year-old woman from the Maghreb came to the emergency department with insidious gait difficulties, urgency, and constipation starting 6 months prior to the visit. The patient's complaints consisted of weakness, stiffness, and pain in her legs. Her medical history consisted of Hashimoto thyroiditis and breast cancer, with the latter having motivated surgery 4 months prior to admission. Histopathologic examination had demonstrated ductal cancer sensitive to estrogen and mapping with sentinel node biopsy ruled out metastasis. For that reason, the patient was treated with local radiation given weekly over 1 month and treatment with tamoxifen was started. Physical examination upon admission demonstrated weakness and spasticity in both legs. Reflexes were brisk; bilateral nonsustained foot clonus and Babinski sign were also present. Bilateral dorsal flexion was reduced, but vibration and sensation to touch and pinprick were normal. Sphincter tonus was reduced; systemic manifestations such as myalgias, fever, skin rashes, uveitis, sicca, and arthritic joints were absent.

  • 9.
    Affas, Fatin
    et al.
    Karolinska Inst, Solna, Sweden.
    Nygårds, Eva-Britt
    Karolinska Inst, Solna, Sweden.
    Stiller, Carl-Olav
    Karolinska Univ Hosp, Solna, Sweden.
    Wretenberg, Per
    Örebro universitet, Institutionen för medicinska vetenskaper. Karolinska Inst, Solna, Sweden.
    Olofsson, Christina
    Karolinska Inst, Solna, Sweden.
    Pain control after total knee arthroplasty: a randomized trial comparing local infiltration anesthesia and continuous femoral block2011Inngår i: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 82, nr 4, s. 441-447Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND PURPOSE: Pain after total knee arthroplasty (TKA) is usually severe, and epidural analgesia or femoral nerve block has been considered to be an effective pain treatment. Recently, local infiltration analgesia (LIA) has become increasingly popular but the outcome of this method regarding the analgesic effect has not been fully evaluated. We compared local infiltration analgesia and femoral block with regard to analgesia and morphine demand during the first 24 h after TKA.

    METHODS: 40 patients undergoing TKA under spinal anesthesia were randomized to receive femoral nerve block (group F) or peri- and intraarticular infiltration analgesia (group LIA) with a mixture containing ropivacaine, ketorolac, and epinephrine. All patients had access to intravenous patient-controlled analgesia (PCA) with morphine postoperatively. Pain intensity at rest and upon movement was assessed on a numeric rating scale (0-10) on an hourly basis over 24 h if the patients were awake.

    RESULTS: The average pain at rest was marginally lower with LIA (1.6) than with femoral block (2.2). Total morphine consumption per kg was similar between the 2 groups. Ancillary analysis revealed that 1 of 20 patients in the LIA group reported a pain intensity of > 7 upon movement, as compared to 7 out of 19 in the femoral block group (p = 0.04).

    INTERPRETATION: Both LIA and femoral block provide good analgesia after TKA. LIA may be considered to be superior to femoral block since it is cheaper and easier to perform.

  • 10.
    Agardh, Carl-David
    et al.
    Lund University, Lund, Sweden.
    Ahrén, Bo
    Lund University, Lund, Sweden.
    Hanås, Ragnar
    Jansson, Stefan
    Region Örebro län. Örebro universitet, Institutionen för medicinska vetenskaper. Uppsala University, Uppsala, Sweden.
    Smith, Ulf
    Gothenburg University, Gothenburg, Sweden.
    Toft, Eva
    Karolinska Institutet, Stockholm, Sweden.
    Östenson, Claes-Göran
    Karolinska Institutet, Stockholm, Sweden.
    Varning för okritisk användning av överviktskirurgi vid typ 2-diabetes2012Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 109, nr 25, s. 1208-1209Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [sv]

    Överviktskirurgi diskuteras nu som ett behandlingsalternativ även för patienter med typ 2-diabetes där BMI inte överstiger nuvarande indikationsgräns 35 kg/m2. Artikelförfattarna vill varna för en sådan utveckling i avvaktan på kritisk värdering av denna typ av kirurgi.

  • 11.
    Ahl, Rebecka
    Örebro universitet, Institutionen för medicinska vetenskaper.
    The Association Between Beta-Blockade and Clinical Outcomes in the Context of Surgical and Traumatic Stress2019Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Traumatic injury and major abdominal surgery are areas in general surgery associated with high rates of morbidity and mortality. The overall colorectal cancer surgery mortality rate is around 4%, with that for emergency surgery more than twice as high as for planned. Surgical morbidity varies between 25% and 45%. Around half of trauma patients develop low mood. In one quarter of patients this becomes permanent. Depression is known to impede physical rehabilitation and recovery. The onset of physiological stress, driven by adrenergic hyperactivity following traumatic and surgical injury is hypothesized to contribute to these adverse outcomes. Interest has therefore been sparked into blocking adrenergic receptor activation.

    Papers I and II investigated the role of beta-blocker therapy in preventing post-traumatic depression following severe traumatic brain injury (Paper I) and severe extracranial injury (Paper II). The Karolinska University Hospital Trauma Registry was used to identify patients admitted between 2007 and 2011. In Paper I (n = 545), patients on pre-injury beta-blocker therapy were matched to beta-blocker naïve patients with equivalent injury burden. Results revealed that beta-blocked patients exhibited a 60% reduced risk of needing antidepressant therapy within one year of trauma. In Paper II (n = 596), the lack of beta-blocker use before extracranial trauma was linked to a three-fold increase in the risk of antidepressant initiation.

    Papers III-V explored the role of pre-operative beta-blocker therapy in patients undergoing surgery for colorectal cancer between 2007 and 2016, identified using the nationwide Swedish Colorectal Cancer Registry. Paper III (n = 3,187) identified a 69% reduction in the risk of 30-day mortality in beta-blocked patients. Paper IV (n = 22,337) outlined long-term survival benefits for patients on beta-blocker therapy prior to undergoing elective surgery for colon cancer. Beta-blocked patients showed a risk reduction of 42% for 1-year all-cause mortality and 18% for 5-year cancerspecific mortality. Similarly, patients on beta-blocker therapy who underwent surgery for rectal cancer demonstrated improved survival up to one year after surgery with a risk reduction of 57% and a reduction in anastomotic failure and infectious complications in Paper V (n = 11,966).

    Delarbeid
    1. Does early beta-blockade in isolated severe traumatic brain injury reduce the risk of post traumatic depression?
    Åpne denne publikasjonen i ny fane eller vindu >>Does early beta-blockade in isolated severe traumatic brain injury reduce the risk of post traumatic depression?
    2017 (engelsk)Inngår i: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 48, nr 1, s. 101-105Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Introduction: Depressive symptoms occur in approximately half of trauma patients, negatively impacting on functional outcome and quality of life following severe head injury. Pontine noradrenaline has been shown to increase upon trauma and associated beta-adrenergic receptor activation appears to consolidate memory formation of traumatic events. Blocking adrenergic activity reduces physiological stress responses during recall of traumatic memories and impairs memory, implying a potential therapeutic role of beta-blockers. This study examines the effect of pre-admission beta-blockade on post-traumatic depression.

    Methods: All adult trauma patients (>= 18 years) with severe, isolated traumatic brain injury (intracranial Abbreviated Injury Scale score (AIS) >= 3 and extracranial AIS <3) were recruited from the trauma registry of an urban university hospital between 2007 and 2011. Exclusion criteria were in-hospital deaths and prescription of antidepressants up to one year prior to admission. Pre- and post-admission beta-blocker and antidepressant therapy data was requested from the national drugs registry. Post-traumatic depression was defined as the prescription of antidepressants within one year of trauma. Patients with and without pre-admission beta-blockers were matched 1: 1 by age, gender, Glasgow Coma Scale, Injury Severity Score and head AIS. Analysis was carried out using McNemar's and Student's t-test for categorical and continuous data, respectively.

    Results: A total of 545 patients met the study criteria. Of these, 15% (n = 80) were prescribed beta-blockers. After propensity matching, 80 matched pairs were analyzed. 33% (n = 26) of non beta-blocked patients developed post-traumatic depression, compared to only 18% (n = 14) in the beta-blocked group (p = 0.04). There were no significant differences in ICU (mean days: 5.8 (SD 10.5) vs. 5.6 (SD 7.2), p = 0.85) or hospital length of stay (mean days: 21 (SD 21) vs. 21 (SD 20), p = 0.94) between cohorts.

    Conclusion: beta-blockade appears to act prophylactically and significantly reduces the risk of posttraumatic depression in patients suffering from isolated severe traumatic brain injuries. Further prospective randomized studies are warranted to validate this finding.

    sted, utgiver, år, opplag, sider
    Elsevier, 2017
    Emneord
    Traumatic brain injury, Beta-blockade, Depression
    HSV kategori
    Identifikatorer
    urn:nbn:se:oru:diva-54816 (URN)10.1016/j.injury.2016.10.041 (DOI)000390544600018 ()2-s2.0-85005893752 (Scopus ID)
    Tilgjengelig fra: 2017-01-19 Laget: 2017-01-19 Sist oppdatert: 2019-05-15bibliografisk kontrollert
    2. Corrigendum to "Does early beta-blockade in isolated severe traumatic brain injury reduce the risk of post traumatic depression?": [Injury 48 (2017) 101–105]
    Åpne denne publikasjonen i ny fane eller vindu >>Corrigendum to "Does early beta-blockade in isolated severe traumatic brain injury reduce the risk of post traumatic depression?": [Injury 48 (2017) 101–105]
    2017 (engelsk)Inngår i: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 48, nr 11, s. 2612-2612Artikkel i tidsskrift (Fagfellevurdert) Published
    sted, utgiver, år, opplag, sider
    Elsevier, 2017
    HSV kategori
    Identifikatorer
    urn:nbn:se:oru:diva-62779 (URN)10.1016/j.injury.2017.09.017 (DOI)000414228200042 ()28965685 (PubMedID)2-s2.0-85030663249 (Scopus ID)
    Tilgjengelig fra: 2017-11-24 Laget: 2017-11-24 Sist oppdatert: 2019-05-13bibliografisk kontrollert
    3. Does beta-blockade reduce the risk of depression in patients with isolated severe extracranial injuries?
    Åpne denne publikasjonen i ny fane eller vindu >>Does beta-blockade reduce the risk of depression in patients with isolated severe extracranial injuries?
    Vise andre…
    2017 (engelsk)Inngår i: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 41, nr 7, s. 1801-1806Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    BACKGROUND: Approximately half of trauma patients develop post-traumatic depression. It is suggested that beta-blockade impairs trauma memory recollection, reducing depressive symptoms. This study investigates the effect of early beta-blockade on depression following severe traumatic injuries in patients without significant brain injury.

    METHODS: Patients were identified by retrospectively reviewing the trauma registry at an urban university hospital between 2007 and 2011. Severe extracranial injuries were defined as extracranial injuries with Abbreviated Injury Scale score ≥3, intracranial Abbreviated Injury Scale score <3 and an Injury Severity Score ≥16. In-hospital deaths and patients prescribed antidepressant therapy ≤1 year prior to admission were excluded. Patients were stratified into groups based on pre-admission beta-blocker status. The primary outcome was post-traumatic depression, defined as receiving antidepressants ≤1 year following trauma.

    RESULTS: Five hundred and ninety-six patients met the inclusion criteria with 11.4% prescribed pre-admission beta-blockade. Patients receiving beta-blockers were significantly older (57 ± 18 vs. 42 ± 17 years, p < 0.001) with lower Glasgow Coma Scale score (12 ± 3 vs. 14 ± 2, p < 0.001). The beta-blocked cohort spent significantly longer in hospital (21 ± 20 vs. 15 ± 17 days, p < 0.01) and intensive care (4 ± 7 vs. 3 ± 5 days, p = 0.01). A forward logistic regression model was applied and predicted lack of beta-blockade to be associated with increased risk of depression (OR 2.7, 95% CI 1.1-7.2, p = 0.04). After adjusting for group differences, patients lacking beta-blockers demonstrated an increased risk of depression (AOR 3.3, 95% CI 1.2-8.6, p = 0.02).

    CONCLUSIONS: Pre-admission beta-blockade is associated with a significantly reduced risk of depression following severe traumatic injury. Further investigation is needed to determine the beneficial effects of beta-blockade in these instances.

    sted, utgiver, år, opplag, sider
    New York: Springer, 2017
    HSV kategori
    Forskningsprogram
    Kirurgi
    Identifikatorer
    urn:nbn:se:oru:diva-57385 (URN)10.1007/s00268-017-3935-5 (DOI)000403056400020 ()28265730 (PubMedID)2-s2.0-85014574094 (Scopus ID)
    Tilgjengelig fra: 2017-05-08 Laget: 2017-05-08 Sist oppdatert: 2019-05-13bibliografisk kontrollert
    4. Effect of beta-blocker therapy on early mortality after emergency colonic cancer surgery
    Åpne denne publikasjonen i ny fane eller vindu >>Effect of beta-blocker therapy on early mortality after emergency colonic cancer surgery
    Vise andre…
    2019 (engelsk)Inngår i: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 106, nr 4, s. 477-483Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    BACKGROUND: Emergency colorectal cancer surgery is associated with significant mortality. Induced adrenergic hyperactivity is thought to be an important contributor. Downregulating the effects of circulating catecholamines may reduce the risk of adverse outcomes. This study assessed whether regular preoperative beta-blockade reduced mortality after emergency colonic cancer surgery.

    METHODS: This cohort study used the prospectively collected Swedish Colorectal Cancer Registry to recruit all adult patients requiring emergency colonic cancer surgery between 2011 and 2016. Patients were subdivided into those receiving regular beta-blocker therapy before surgery and those who were not (control). Demographics and clinical outcomes were compared. Risk factors for 30-day mortality were evaluated using Poisson regression analysis.

    RESULTS: A total of 3187 patients were included, of whom 685 (21·5 per cent) used regular beta-blocker therapy before surgery. The overall 30-day mortality rate was significantly reduced in the beta-blocker group compared with controls: 3·1 (95 per cent c.i. 1·9 to 4·7) versus 8·6 (7·6 to 9·8) per cent respectively (P < 0·001). Beta-blocker therapy was the only modifiable protective factor identified in multivariable analysis of 30-day all-cause mortality (incidence rate ratio 0·31, 95 per cent c.i. 0·20 to 0·47; P < 0·001) and was associated with a significant reduction in death of cardiovascular, respiratory, sepsis and multiple organ failure origin.

    CONCLUSION: Preoperative beta-blocker therapy may be associated with a reduction in 30-day mortality following emergency colonic cancer surgery.

    sted, utgiver, år, opplag, sider
    John Wiley & Sons, 2019
    HSV kategori
    Identifikatorer
    urn:nbn:se:oru:diva-69119 (URN)10.1002/bjs.10988 (DOI)000459801800023 ()30259967 (PubMedID)
    Tilgjengelig fra: 2018-10-01 Laget: 2018-10-01 Sist oppdatert: 2019-05-13bibliografisk kontrollert
    5. The Effects of Beta-Blocker Therapy on Mortality After Elective Colon Cancer Surgery
    Åpne denne publikasjonen i ny fane eller vindu >>The Effects of Beta-Blocker Therapy on Mortality After Elective Colon Cancer Surgery
    Vise andre…
    (engelsk)Manuskript (preprint) (Annet vitenskapelig)
    HSV kategori
    Identifikatorer
    urn:nbn:se:oru:diva-74247 (URN)
    Tilgjengelig fra: 2019-05-13 Laget: 2019-05-13 Sist oppdatert: 2019-05-13bibliografisk kontrollert
    6. β-Blockade in Rectal Cancer Surgery: A Simple Measure of Improving Outcomes
    Åpne denne publikasjonen i ny fane eller vindu >>β-Blockade in Rectal Cancer Surgery: A Simple Measure of Improving Outcomes
    Vise andre…
    2018 (engelsk)Inngår i: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140Artikkel i tidsskrift (Fagfellevurdert) Epub ahead of print
    Abstract [en]

    OBJECTIVE: To ascertain whether regular β-blocker exposure can improve short- and long-term outcomes after rectal cancer surgery.

    BACKGROUND: Surgery for rectal cancer is associated with substantial morbidity and mortality. There is increasing evidence to suggest that there is a survival benefit in patients exposed to β-blockers undergoing non-cardiac surgery. Studies investigating the effects on outcomes in patients subjected to surgery for rectal cancer are lacking.

    METHODS: All adult patients undergoing elective abdominal resection for rectal cancer over a 10-year period were recruited from the prospectively collected Swedish Colorectal Cancer Registry. Patients were subdivided according to preoperative β-blocker exposure status. Outcomes of interest were 30-day complications, 30-day cause-specific mortality, and 1-year all-cause mortality. The association between β-blocker use and outcomes were analyzed using Poisson regression model with robust standard errors for 30-day complications and cause-specific mortality. One-year survival was assessed using Cox proportional hazards regression model.

    RESULTS: A total of 11,966 patients were included in the current study, of whom 3513 (29.36%) were exposed to regular preoperative β-blockers. A significant decrease in 30-day mortality was detected (incidence rate ratio = 0.06, 95% confidence interval: 0.03-0.13, P < 0.001). Deaths of cardiovascular nature, respiratory origin, sepsis, and multiorgan failure were significantly lower in β-blocker users, as were the incidences in postoperative infection and anastomotic failure. The β-blocker positive group had significantly better survival up to 1 year postoperatively with a risk reduction of 57% (hazard ratio = 0.43, 95% confidence interval: 0.37-0.52, P < 0.001).

    CONCLUSIONS: Preoperative β-blocker use is strongly associated with improved survival and morbidity after abdominal resection for rectal cancer.

    sted, utgiver, år, opplag, sider
    Lippincott Williams & Wilkins, 2018
    HSV kategori
    Identifikatorer
    urn:nbn:se:oru:diva-74248 (URN)10.1097/SLA.0000000000002970 (DOI)30048321 (PubMedID)
    Tilgjengelig fra: 2019-05-13 Laget: 2019-05-13 Sist oppdatert: 2019-05-13bibliografisk kontrollert
  • 12.
    Ahl, Rebecka
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Barmparas, Galinos
    Division of Acute Care Surgery and Surgical Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, USA.
    Riddez, Louis
    Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Ley, Eric J.
    Division of Acute Care Surgery and Surgical Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, USA.
    Wallin, Göran
    Örebro universitet, Institutionen för medicinska vetenskaper. Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Ljungqvist, Olle
    Örebro universitet, Institutionen för medicinska vetenskaper. Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Mohseni, Shahin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden; Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Does beta-blockade reduce the risk of depression in patients with isolated severe extracranial injuries?2017Inngår i: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 41, nr 7, s. 1801-1806Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Approximately half of trauma patients develop post-traumatic depression. It is suggested that beta-blockade impairs trauma memory recollection, reducing depressive symptoms. This study investigates the effect of early beta-blockade on depression following severe traumatic injuries in patients without significant brain injury.

    METHODS: Patients were identified by retrospectively reviewing the trauma registry at an urban university hospital between 2007 and 2011. Severe extracranial injuries were defined as extracranial injuries with Abbreviated Injury Scale score ≥3, intracranial Abbreviated Injury Scale score <3 and an Injury Severity Score ≥16. In-hospital deaths and patients prescribed antidepressant therapy ≤1 year prior to admission were excluded. Patients were stratified into groups based on pre-admission beta-blocker status. The primary outcome was post-traumatic depression, defined as receiving antidepressants ≤1 year following trauma.

    RESULTS: Five hundred and ninety-six patients met the inclusion criteria with 11.4% prescribed pre-admission beta-blockade. Patients receiving beta-blockers were significantly older (57 ± 18 vs. 42 ± 17 years, p < 0.001) with lower Glasgow Coma Scale score (12 ± 3 vs. 14 ± 2, p < 0.001). The beta-blocked cohort spent significantly longer in hospital (21 ± 20 vs. 15 ± 17 days, p < 0.01) and intensive care (4 ± 7 vs. 3 ± 5 days, p = 0.01). A forward logistic regression model was applied and predicted lack of beta-blockade to be associated with increased risk of depression (OR 2.7, 95% CI 1.1-7.2, p = 0.04). After adjusting for group differences, patients lacking beta-blockers demonstrated an increased risk of depression (AOR 3.3, 95% CI 1.2-8.6, p = 0.02).

    CONCLUSIONS: Pre-admission beta-blockade is associated with a significantly reduced risk of depression following severe traumatic injury. Further investigation is needed to determine the beneficial effects of beta-blockade in these instances.

  • 13.
    Ahl, Rebecka
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Lindgren, Rickard
    Region Örebro län. Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Riddez, Louis
    Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Solna, Sweden.
    Mohseni, Shahin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Division of Trauma and Emergency Surgery, Department of Surgery, Orebro University Hospital, Örebro, Sweden; Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Risk factors for depression following traumatic injury: An epidemiological study from a scandinavian trauma center2017Inngår i: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 48, nr 5, s. 1082-1087Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: A significant proportion of patients suffer depression following traumatic injuries. Once manifested, major depression is challenging to overcome and its presence risks impairing the potential for physical rehabilitation and functional recovery. Risk stratification for early detection and intervention in these instances is important. This study aims to investigate patient and injury characteristics associated with an increased risk for depression.

    METHODS: All patients with traumatic injuries were recruited from the trauma registry of an urban university hospital between 2007 and 2012. Patient and injury characteristics as well as outcomes were collected for analysis. Patients under the age of eighteen, prescribed antidepressants within one year of admission, in-hospital deaths and deaths within 30days of trauma were excluded. Pre- and post-admission antidepressant data was requested from the national drugs registry. Post-traumatic depression was defined as the prescription of antidepressants within one year of trauma. To isolate independent risk factors for depression a multivariable forward stepwise logistic regression model was deployed.

    RESULTS: A total of 5981 patients met the inclusion criteria of whom 9.2% (n=551) developed post-traumatic depression. The mean age of the cohort was 42 [standard deviation (SD) 18] years and 27.1% (n=1620) were females. The mean injury severity score was 9 (SD 9) with 18.4% (n=1100) of the patients assigned a score of at least 16. Six variables were identified as independent predictors for post-traumatic depression. Factors relating to the patient were female gender and age. Injury-specific variables were penetrating trauma and GCS score of≤8 on admission. Furthermore, intensive care admission and increasing hospital length of stay were predictors of depression.

    CONCLUSION: Several risk factors associated with the development of post-traumatic depression were identified. A better targeted in-hospital screening and patient-centered follow up can be offered taking these risk factors into consideration.

  • 14.
    Ahl, Rebecka
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Karolinska University Hospital, Stockholm, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden.
    Matthiessen, P.
    School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Fang, X.
    Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; .
    Sjölin, Gabriel
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery.
    Lindgren, R.
    Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Ljungqvist, Olle
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Mohseni, Shahin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Surgery.
    Effect of beta-blocker therapy on early mortality after emergency colonic cancer surgery2019Inngår i: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 106, nr 4, s. 477-483Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Emergency colorectal cancer surgery is associated with significant mortality. Induced adrenergic hyperactivity is thought to be an important contributor. Downregulating the effects of circulating catecholamines may reduce the risk of adverse outcomes. This study assessed whether regular preoperative beta-blockade reduced mortality after emergency colonic cancer surgery.

    METHODS: This cohort study used the prospectively collected Swedish Colorectal Cancer Registry to recruit all adult patients requiring emergency colonic cancer surgery between 2011 and 2016. Patients were subdivided into those receiving regular beta-blocker therapy before surgery and those who were not (control). Demographics and clinical outcomes were compared. Risk factors for 30-day mortality were evaluated using Poisson regression analysis.

    RESULTS: A total of 3187 patients were included, of whom 685 (21·5 per cent) used regular beta-blocker therapy before surgery. The overall 30-day mortality rate was significantly reduced in the beta-blocker group compared with controls: 3·1 (95 per cent c.i. 1·9 to 4·7) versus 8·6 (7·6 to 9·8) per cent respectively (P < 0·001). Beta-blocker therapy was the only modifiable protective factor identified in multivariable analysis of 30-day all-cause mortality (incidence rate ratio 0·31, 95 per cent c.i. 0·20 to 0·47; P < 0·001) and was associated with a significant reduction in death of cardiovascular, respiratory, sepsis and multiple organ failure origin.

    CONCLUSION: Preoperative beta-blocker therapy may be associated with a reduction in 30-day mortality following emergency colonic cancer surgery.

  • 15.
    Ahl, Rebecka
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Matthiessen, Peter
    School of Medical Sciences, Örebro University, Örebro, Sweden; Division of Colorectal Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Sjölin, Gabriel
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Ljungqvist, Olle
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
    Mohseni, Shahin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    The Relationship Between Severe Complications, Beta-Blocker Therapy and Long-Term Survival Following Emergency Surgery for Colon Cancer2019Inngår i: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 43, nr 10, s. 2527-2535Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Emergency surgery for colon cancer carries significant morbidity, and studies show more than doubled mortality when comparing elective to emergency surgery. The relationship between postoperative complications and survival has been outlined. Beta-blocker therapy has been linked to improved postoperative outcomes. This study aims to assess the impact of postoperative complications on long-term survival following emergency surgery for colon cancer and to determine whether beta-blockade can reduce complications.

    STUDY DESIGN: This cohort study utilized the prospective Swedish Colorectal Cancer Registry to identify adults undergoing emergency colon cancer surgery between 2011 and 2016. Prescription data for preoperative beta-blocker therapy were collected from the national drug registry. Cox regression was used to evaluate the effect of beta-blocker exposure and complications on 1-year mortality, and Poisson regression was used to evaluate beta-blocker exposure in patients with major complications.

    RESULTS: A total of 3139 patients were included with a mean age of 73.1 [12.4] of which 671 (21.4%) were prescribed beta-blockers prior to surgery. Major complications occurred in 375 (11.9%) patients. Those suffering major complications showed a threefold increase in 1-year mortality (adjusted HR = 3.29; 95% CI 2.75-3.94; p < 0.001). Beta-blocker use was linked to a 60% risk reduction in 1-year mortality (adjusted HR = 0.40; 95% CI 0.26-0.62; p < 0.001) but did not show a statistically significant association with reductions in major complications (adjusted IRR = 0.77; 95% CI 0.59-1.00; p = 0.055).

    CONCLUSION: The development of major complications after emergency colon cancer surgery is associated with increased mortality during one year after surgery. Beta-blocker therapy may protect against postoperative complications.

  • 16.
    Ahl, Rebecka
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Matthiessen, Peter
    School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Fang, Xin
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Sjölin, Gabriel
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Lindgren, Rickard
    Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Ljungqvist, Olle
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Mohseni, Shahin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Surgery.
    β-Blockade in Rectal Cancer Surgery: A Simple Measure of Improving Outcomes2018Inngår i: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To ascertain whether regular β-blocker exposure can improve short- and long-term outcomes after rectal cancer surgery.

    BACKGROUND: Surgery for rectal cancer is associated with substantial morbidity and mortality. There is increasing evidence to suggest that there is a survival benefit in patients exposed to β-blockers undergoing non-cardiac surgery. Studies investigating the effects on outcomes in patients subjected to surgery for rectal cancer are lacking.

    METHODS: All adult patients undergoing elective abdominal resection for rectal cancer over a 10-year period were recruited from the prospectively collected Swedish Colorectal Cancer Registry. Patients were subdivided according to preoperative β-blocker exposure status. Outcomes of interest were 30-day complications, 30-day cause-specific mortality, and 1-year all-cause mortality. The association between β-blocker use and outcomes were analyzed using Poisson regression model with robust standard errors for 30-day complications and cause-specific mortality. One-year survival was assessed using Cox proportional hazards regression model.

    RESULTS: A total of 11,966 patients were included in the current study, of whom 3513 (29.36%) were exposed to regular preoperative β-blockers. A significant decrease in 30-day mortality was detected (incidence rate ratio = 0.06, 95% confidence interval: 0.03-0.13, P < 0.001). Deaths of cardiovascular nature, respiratory origin, sepsis, and multiorgan failure were significantly lower in β-blocker users, as were the incidences in postoperative infection and anastomotic failure. The β-blocker positive group had significantly better survival up to 1 year postoperatively with a risk reduction of 57% (hazard ratio = 0.43, 95% confidence interval: 0.37-0.52, P < 0.001).

    CONCLUSIONS: Preoperative β-blocker use is strongly associated with improved survival and morbidity after abdominal resection for rectal cancer.

  • 17.
    Ahl, Rebecka
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Matthiessen, Peter
    School of Medical Science, Örebro University, Örebro, sweden; Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Sjölin, Gabriel
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Wallin, Göran
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Ljungqvist, Olle
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Örebro University Hospital, Örebro, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Mohseni, Shahin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Surgery.
    The Effects of Beta-Blocker Therapy on Mortality After Elective Colon Cancer SurgeryManuskript (preprint) (Annet vitenskapelig)
  • 18.
    Ahl, Rebecka
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Division of Trauma and Emergency Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Phelan, Herb A
    Univ of Texas Southwestern Medical Center, Parkland Memorial Hospital, Dallas, USA.
    Dogan, Sinan
    Department of Surgery, Division of Trauma and Emergency Surgery, Örebro University Hospital, Örebro, Sweden.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Cook, Allyson C.
    UT-Southwestern Medical Center. Parkland Memorial Hospital, Dallas, USA.
    Mohseni, Shahin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Surgery, Division of Trauma and Emergency Surgery, Örebro University Hospital, Örebro, Sweden; Department of Surgery, Division of Trauma and Emergency Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Predicting In-Hospital and 1-Year Mortality in Geriatric Trauma Patients Using Geriatric Trauma Outcome Score2017Inngår i: Journal of the American College of Surgeons, ISSN 1072-7515, E-ISSN 1879-1190, Vol. 224, nr 3, s. 264-269Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The Geriatric Trauma Outcome Score, GTOS (= [age] + [Injury Severity Score (ISS)x2.5] + 22 [if packed red blood cells (PRBC) transfused ≤24hrs of admission]), was developed and validated as a prognostic indicator for in-hospital mortality in elderly trauma patients. However, GTOS neither provides information regarding post-discharge outcomes, nor discriminates between patients dying with and without care restrictions. Isolating the latter, GTOS prediction performance was examined during admission and 1-year post-discharge in a mature European trauma registry.

    Study Design: All trauma admissions ≥65years in a university hospital during 2007-2011 were considered. Data regarding age, ISS, PRBC transfusion ≤24hrs, therapy restrictions, discharge disposition and mortality were collected. In-hospital deaths with therapy restrictions and patients discharged to hospice were excluded. GTOS was the sole predictor in a logistic regression model estimating mortality probabilities. Performance of the model was assessed by misclassification rate, Brier score and area under the curve (AUC).

    Results: The study population was 1080 subjects with a median age of 75 years, mean ISS of 10 and PRBC transfused in 8.2%). In-hospital mortality was 14.9% and 7.7% after exclusions. Misclassification rate fell from 14% to 6.5%, Brier score from 0.09 to 0.05. AUC increased from 0.87 to 0.88. Equivalent values for the original GTOS sample were 9.8%, 0.07, and 0.87. One-year mortality follow-up showed a misclassification rate of 17.6%, and Brier score of 0.13.

    Conclusion: Excluding patients with care restrictions and discharged to hospice improved GTOS performance for in-hospital mortality prediction. GTOS is not adept at predicting 1-year mortality.

  • 19.
    Ahl, Rebecka
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Division of Trauma and Acute Care Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Riddez, Louis
    Department of Surgery, Division of Trauma and Acute Care Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Mohseni, Shahin
    Department of Surgery, Division of Trauma and Acute Care Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Surgery, Division of Trauma and Acute Care Surgery, Örebro University Hospital, Örebro, Sweden; Örebro University, Örebro, Sweden.
    Digital rectal examination for initial assessment of the multi-injured patient: Can we depend on it?2016Inngår i: Annals of Medicine and Surgery, ISSN 2049-0801, Vol. 9, s. 77-81Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Digital rectal examination (DRE) is part of the assessment of trauma patients as recommended by ATLS (R). The theory behind is to aid early diagnosis of potential lower intestinal, urethral and spinal cord injuries. Previous studies suggest that test characteristics of DRE are far from reliable. This study examines the correlation between DRE findings and diagnosis and whether DRE findings affect subsequent management.

    Materials and methods: Patients with ICD-10 codes for spinal cord, urethral and lower intestinal injuries were identified from the trauma registry at an urban university hospital between 2007 and 2011. A retrospective review of electronic medical records was carried out to analyse DRE findings and subsequent management.

    Results: 253 patients met the inclusion criteria with a mean age of 44 +/- 20 years and mean ISS of 26 +/- 16. 160 patients had detailed DRE documentation with abnormal findings in 48%. Sensitivity rate was 0.47. Correlational analysis between examination findings and diagnosis gave a kappa of 0.12. Subsequent management was not altered in any case due to DRE findings.

    Conclusion: DRE in trauma settings has low sensitivity and does not change subsequent management. Excluding or postponing this examination should therefore be considered. (C) 2016 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

  • 20.
    Ahl, Rebecka
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Sarani, Babak
    Department of Surgery, Center for Trauma and Critical Care, George Washington University, Washington, USA.
    Sjölin, Gabriel
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Division of Trauma and Emergency Surgery, Örebro University Hospital, Örebro, Sweden.
    Mohseni, Shahin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Surgery.
    The Association of Intracranial Pressure Monitoring and Mortality: A Propensity Score-Matched Cohort of Isolated Severe Blunt Traumatic Brain Injury2019Inngår i: Journal of Emergencies, Trauma and Shock, ISSN 0974-2700, E-ISSN 0974-519X, Vol. 12, nr 1, s. 18-22Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Intracranial pressure (ICP) monitoring in traumatic brain injury (TBI) is common. Yet, its efficacy varies between studies, and the actual effect on the outcome is debated. This study investigates the association of ICP monitoring and clinical outcome in patients with an isolated severe blunt TBI.

    Patients and Methods: Patients were recruited from the American College of Surgeons-Trauma Quality Improvement Program database during 2014. Inclusion criteria were limited to adult patients (>= 18 years) who had a sustained isolated severe intracranial injury (Abbreviated Injury Scale [AIS] head of >= 3 and Glasgow Coma Scale [GCS] of <= 8) following blunt trauma to the head. Patients with AIS score >0 for any extracranial body area were excluded. Patients' demographics, injury characteristics, interventions, and outcomes were collected for analysis. Patients receiving ICP monitoring were matched in a 1:1 ratio with controls who were not ICP monitored using propensity score matching.

    Results: A total of 3289 patients met inclusion criteria. Of these, 601 (18.3%) were ICP monitored. After propensity score matching, 557 pairs were available for analysis with a mean age of 44 (standard deviation 18) years and 80.2% of them were male. Median GCS on admission was 4[3,7], and a third of patients required neurosurgical intervention. There were no statistical differences in any variables included in the analysis between the ICP-monitored group and their matched counterparts. ICP-monitored patients required significantly longer intensive care unit and hospital length of stay and had an increased mortality risk with odds ratio of 1.6 (95% confidence interval: 1.1-2.5, P = 0.038).

    Conclusion: ICP monitoring is associated with increased in-hospital mortality in patients with an isolated severe TBI. Further investigation into which patients may benefit from this intervention is required.

  • 21.
    Ahl, Rebecka
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Division of Trauma and Emergency Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Sjölin, Gabriel
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Surgery, Division of Trauma and Emergency Surgery, Örebro University Hospital, Örebro, Sweden.
    Mohseni, Shahin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Surgery, Division of Trauma and Emergency Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Surgery, Division of Trauma and Emergency Surgery, Örebro University Hospital, Örebro, Sweden.
    Corrigendum to "Does early beta-blockade in isolated severe traumatic brain injury reduce the risk of post traumatic depression?": [Injury 48 (2017) 101–105]2017Inngår i: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 48, nr 11, s. 2612-2612Artikkel i tidsskrift (Fagfellevurdert)
  • 22.
    Ahl, Rebecka
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Sjölin, Gabriel
    Örebro universitet, Institutionen för medicinska vetenskaper. Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Mohseni, Shahin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden; Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Does early beta-blockade in isolated severe traumatic brain injury reduce the risk of post traumatic depression?2017Inngår i: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 48, nr 1, s. 101-105Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Depressive symptoms occur in approximately half of trauma patients, negatively impacting on functional outcome and quality of life following severe head injury. Pontine noradrenaline has been shown to increase upon trauma and associated beta-adrenergic receptor activation appears to consolidate memory formation of traumatic events. Blocking adrenergic activity reduces physiological stress responses during recall of traumatic memories and impairs memory, implying a potential therapeutic role of beta-blockers. This study examines the effect of pre-admission beta-blockade on post-traumatic depression.

    Methods: All adult trauma patients (>= 18 years) with severe, isolated traumatic brain injury (intracranial Abbreviated Injury Scale score (AIS) >= 3 and extracranial AIS <3) were recruited from the trauma registry of an urban university hospital between 2007 and 2011. Exclusion criteria were in-hospital deaths and prescription of antidepressants up to one year prior to admission. Pre- and post-admission beta-blocker and antidepressant therapy data was requested from the national drugs registry. Post-traumatic depression was defined as the prescription of antidepressants within one year of trauma. Patients with and without pre-admission beta-blockers were matched 1: 1 by age, gender, Glasgow Coma Scale, Injury Severity Score and head AIS. Analysis was carried out using McNemar's and Student's t-test for categorical and continuous data, respectively.

    Results: A total of 545 patients met the study criteria. Of these, 15% (n = 80) were prescribed beta-blockers. After propensity matching, 80 matched pairs were analyzed. 33% (n = 26) of non beta-blocked patients developed post-traumatic depression, compared to only 18% (n = 14) in the beta-blocked group (p = 0.04). There were no significant differences in ICU (mean days: 5.8 (SD 10.5) vs. 5.6 (SD 7.2), p = 0.85) or hospital length of stay (mean days: 21 (SD 21) vs. 21 (SD 20), p = 0.94) between cohorts.

    Conclusion: beta-blockade appears to act prophylactically and significantly reduces the risk of posttraumatic depression in patients suffering from isolated severe traumatic brain injuries. Further prospective randomized studies are warranted to validate this finding.

  • 23.
    Ahl, Rebecka
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden ; .
    Thelin, Eric Peter
    Department of Clinical Neuroscience, Karolinska Institutet Solna, Stockholm, Sweden.
    Sjölin, Gabriel
    Örebro universitet, Institutionen för medicinska vetenskaper. Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Bellander, Bo Michael
    Department of Clinical Neuroscience, Karolinska Institutet Solna, Stockholm, Sweden.
    Riddez, Louis
    Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Talving, Peep
    Department of Surgery, Tartu University Hospital, Tartu, Estonia.
    Mohseni, Shahin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden; Division of Trauma and Emergency Surgery, Department of Surgery, Orebro University Hospital, Orebro, Sweden.
    β-Blocker after severe traumatic brain injury is associated with better long-term functional outcome: a matched case control study2017Inngår i: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941, Vol. 43, nr 6, s. 783-789Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: Severe traumatic brain injury (TBI) is the predominant cause of death and disability following trauma. Several studies have observed improved survival in TBI patients exposed to β-blockers, however, the effect on functional outcome is poorly documented.

    METHODS: Adult patients with severe TBI (head AIS ≥ 3) were identified from a prospectively collected TBI database over a 5-year period. Patients with neurosurgical ICU length of stay <48 h and those dying within 48 h of admission were excluded. Patients exposed to β-blockers ≤ 48 h after admission and who continued with treatment until discharge constituted β-blocked cases and were matched to non β-blocked controls using propensity score matching. The outcome of interest was Glasgow Outcome Scores (GOS), as a measure of functional outcome up to 12 months after injury. GOS ≤ 3 was considered a poor outcome. Bivariate analysis was deployed to determine differences between groups. Odds ratio and 95% CI were used to assess the effect of β-blockers on GOS.

    RESULTS: 362 patients met the inclusion criteria with 21% receiving β-blockers during admission. After propensity matching, 76 matched pairs were available for analysis. There were no statistical differences in any variables included in the analysis. Mean hospital length of stay was shorter in the β-blocked cases (18.0 vs. 26.8 days, p < 0.01). The risk of poor long-term functional outcome was more than doubled in non-β-blocked controls (OR 2.44, 95% CI 1.01-6.03, p = 0.03).

    CONCLUSION: Exposure to β-blockers in patients with severe TBI appears to improve functional outcome. Further prospective randomized trials are warranted.

  • 24.
    Ahlberg, Rickard
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Skårberg, Kurt
    Örebro universitet, Institutionen för medicinska vetenskaper. Addiction Center.
    Brus, Ole
    Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Kjellin, Lars
    Örebro universitet, Institutionen för hälsovetenskaper.
    Auricular acupuncture for substance use: a randomized controlled trial of effects on anxiety, sleep, drug use and use of addiction treatment services2016Inngår i: Substance Abuse Treatment, Prevention, and Policy, ISSN 1747-597X, E-ISSN 1747-597X, Vol. 11, nr 1, artikkel-id 24Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: A common alternative treatment for substance abuse is auricular acupuncture. The aim of the study was to evaluate the short and long-term effect of auricular acupuncture on anxiety, sleep, drug use and addiction treatment utilization in adults with substance abuse.

    Method: Of the patients included, 280 adults with substance abuse and psychiatric comorbidity, 80 were randomly assigned to auricular acupuncture according to the NADA protocol, 80 to auricular acupuncture according to a local protocol (LP), and 120 to relaxation (controls). The primary outcomes anxiety (Beck Anxiety Inventory; BAI) and insomnia (Insomnia Severity Index; ISI) were measured at baseline and at follow-ups 5 weeks and 3 months after the baseline assessment. Secondary outcomes were drug use and addiction service utilization. Complete datasets regarding BAI/ISI were obtained from 37/34 subjects in the NADA group, 28/28 in the LP group and 36/35 controls. Data were analyzed using Chi-square, Analysis of Variance, Kruskal Wallis, Repeated Measures Analysis of Variance, Eta square (η(2)), and Wilcoxon Signed Ranks tests.

    Results: Participants in NADA, LP and control group improved significantly on the ISI and BAI. There was no significant difference in change over time between the three groups in any of the primary (effect size: BAI, η(2) = 0.03, ISI, η(2) = 0.05) or secondary outcomes. Neither of the two acupuncture treatments resulted in differences in sleep, anxiety or drug use from the control group at 5 weeks or 3 months.

    Conclusion: No evidence was found that acupuncture as delivered in this study is more effective than relaxation for problems with anxiety, sleep or substance use or in reducing the need for further addiction treatment in patients with substance use problems and comorbid psychiatric disorders. The substantial attrition at follow-up is a main limitation of the study.

    Trial registration: Clinical Trials NCT02604706 (retrospectively registered).

  • 25.
    Ahlbäck, Anton
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Formalized triage systems and outcomes of adult trauma patients: a systematic review2017Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 26.
    Ahlsson, Anders
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
    Friberg, Örjan
    Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Källman, Jan
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
    An angry cat causing Pasteurella multocida endocarditis and aortic valve replacement: A case report2016Inngår i: International journal of surgery case reports, ISSN 2210-2612, E-ISSN 2210-2612, Vol. 24, s. 91-93Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: Cat bite infections usually involve a mix of anaerobic and aerobic bacteria including species of Pasteurella, Streptococcus, Staphylococcus, Bacteroides, and Fusobacterium. We report a case of Pasteurella multocida infection from cat bites leading to endocarditis and subsequent aortic valve replacement.

    PRESENTATION OF CASE: A 70-year-old male was admitted because of fever, tachycardia, and malaise. He had a history of alcohol abuse and was living alone with a cat in a rural area. A sepsis of unknown origin was suspected, and intravenous treatment with gentamicin and cefotaxime was initiated. Blood cultures yielded Pasteurella multocida, and the patient history revealed repeated cat bites. After four days, the patient was discharged with oral penicillin V treatment. Two weeks later, the patient returned with fever and a new systolic murmur. An aortic valve endocarditis was diagnosed, and it became clear that the patient had not completed the prescribed penicillin V treatment. The patient underwent a biological aortic valve replacement with debridement of an annular abscess, and the postoperative course was uneventful.

    DISCUSSION: Endocarditis due to Pasteurella is extremely rare, and there are only a few reports in the literature. Predisposing factors in the present case were alcohol abuse and reduced compliance to treatment.

    CONCLUSION: Cat bites are often deep, and in rare circumstances can lead to life-threatening endocarditis. Proper surgical revision, antibiotic treatment, and patient compliance are necessary components in patient care to avoid this complication.

  • 27.
    Ahlsson, Anders
    et al.
    Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Wickbom, Anders
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Cardiothoracic and Vascular Surgery.
    Geirsson, Arnar
    Department of Cardiothoracic Surgery, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
    Franco-Cereceda, Anders
    Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Ahmad, Khalil
    Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark.
    Gunn, Jarmo
    Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
    Hansson, Emma C.
    Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hjortdal, Vibeke
    Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark.
    Jarvela, Kati
    Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark.
    Jeppsson, Anders
    Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Mennander, Ari
    Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nozohoor, Shahab
    Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Pan, Emily
    Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
    Zindovic, Igor
    Department of Clinical Sciences, Skane University Hospital, Lund University, Lund, Sweden; Department of Cardiothoracic Surgery, Skane University Hospital, Lund University, Lund, Sweden.
    Gudbjartsson, Tomas
    Department of Cardiothoracic Surgery, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
    Olsson, Christian
    Department of Cardiothoracic Surgery, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
    Is There a Weekend Effect in Surgery for Type A Dissection?: Results From the Nordic Consortium for Acute Type A Aortic Dissection Database2019Inngår i: Annals of Thoracic Surgery, ISSN 0003-4975, E-ISSN 1552-6259, Vol. 108, nr 3, s. 770-776Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Aortic dissection type A requires immediate surgery. In general surgery populations, patients operated on during weekends have higher mortality rates compared with patients whose operations occur on weekdays. The weekend effect in aortic dissection type A has not been studied in detail.

    Methods: The Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) registry includes data for 1,159 patients who underwent type A dissection surgery at 8 Nordic centers during 2005 to 2014. This study is based on data relating to surgery conducted during weekdays versus weekends and starting between 8:00 AM and 8:00 Pm ("daytime") versus from 8:00 Pm to 8:00 AM ("nighttime"), as well as time from symptoms, admittance, and diagnosis to surgery. The influence of timing of surgery on the 30-day mortality rate was assessed using logistic regression analysis.

    Results: The 30-day mortality was 18% (204 of 1,159), with no difference in mortality between surgery performed on weekdays (17% [150 of 889]) and on weekends (20% [54 of 270], p = 0.45), or during nighttime (19% [87 of 467]) versus daytime (17% [117 of 680], p = 0.54). Time from symptoms to surgery (median 7.0 hours vs 6.5 hours, p = 0.31) did not differ between patients who survived and those who died at 30 days. Multivariable regression analysis of risk factors for 30-day mortality showed no weekend effect (odds ratio, 1.04; 95% confidence interval, 60.67 to 1.60; p = 0.875), but nighttime surgery was a risk factor (odds ratio, 2.43; 95% confidence interval, 1.29 to 4.56; p = 0.006).

    Conclusions: The 30-day mortality in surgical repair of aortic dissection type A was not significantly affected by timing of surgery during weekends versus weekdays. Nighttime surgery seems to predict increased 30-day mortality, after correction for other risk factors.

  • 28.
    Ahlstrand, Erik
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Medicine, Hematology, Örebro University Hospital, Örebro, Sweden.
    Bäckman, Anders
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Research Centre, Örebro University Hospital, Örebro, Sweden.
    Persson, Lennart
    Region Örebro län. Department of Infectious diseases, Örebro University Hospital, Örebro, Sweden.
    Mölling, Paula
    Region Örebro län. Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
    Tidefelt, Ulf
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Söderquist, Bo
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Infectious diseases & Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Evaluation of a PCR method to determine the clinical significance of blood cultures with Staphylococcus epidermidis in patients with hematological malignancies2014Inngår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 122, nr 6, s. 539-544Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim was to investigate whether the detection and quantification of Staphylococcus epidermidis DNA in blood could distinguish S. epidermidis blood stream infections (BSIs) from blood culture contaminations in patients with hematological malignancies. The hld gene was chosen to identify S. epidermidis DNA and DNA in blood samples was detected by real-time PCR. Blood samples were obtained simultaneously with blood cultures positive for S. epidermidis (n = 30), during blood culture-negative episodes (n = 10) and episodes of bacteremia with other bacteria than S. epidermidis (n = 4) and from healthy blood donors (n = 10). In addition, DNA from S. epidermidis and a selection of other bacterial species were analyzed. Three different sets of criteria were used to classify episodes with positive blood cultures with S. epidermidis as BSIs or contaminations. All DNA preparations from S. epidermidis (n = 48) were hld-positive, but other bacterial species (n = 13) were negative. Sixteen (53%) of 30 blood samples from patients with blood cultures positive for S. epidermidis were hld-positive, but none of the controls. There was no clear association between a positive hld PCR and episodes interpreted as BSIs. In conclusion, hld PCR failed to distinguish S. epidermidis BSIs from blood culture contaminations in patients with hematological malignancies.

  • 29.
    Ahlund, Veronica
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Development of Clostridium difficile resistance to Piperacillin/Tazobactam over a period of ten years2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 30.
    Ahmadi, Zainab
    et al.
    Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, Sweden.
    Sundh, Josefin
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Respiratory Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Bornefalk-Hermansson, Anna
    Department of Statistics, Uppsala University, Uppsala, Sweden.
    Ekström, Magnus
    Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, Sweden.
    Long-Term Oxygen Therapy 24 vs 15 h/day and Mortality in Chronic Obstructive Pulmonary Disease2016Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, nr 9, artikkel-id e0163293Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Long-term oxygen therapy (LTOT) ≥ 15 h/day improves survival in hypoxemic chronic obstructive pulmonary disease (COPD). LTOT 24 h/day is often recommended but may pose an unnecessary burden with no clear survival benefit compared with LTOT 15 h/day. The aim was to test the hypothesis that LTOT 24 h/day decreases all-cause, respiratory, and cardiovascular mortality compared to LTOT 15 h/day in hypoxemic COPD. This was a prospective, observational, population-based study of COPD patients starting LTOT between October 1, 2005 and June 30, 2009 in Sweden. Overall and cause-specific mortality was analyzed using Cox and Fine-Gray regression, controlling for age, sex, prescribed oxygen dose, PaO2 (air), PaCO2 (air), Forced Expiratory Volume in one second (FEV1), WHO performance status, body mass index, comorbidity, and oral glucocorticoids. A total of 2,249 included patients were included with a median follow-up of 1.1 years (interquartile range, 0.6-2.1). 1,129 (50%) patients died and no patient was lost to follow-up. Higher LTOT duration analyzed as a continuous variable was not associated with any change in mortality rate (hazard ratio [HR] 1.00; (95% confidence interval [CI], 0.98 to 1.02) per 1 h/day increase above 15 h/day. LTOT exactly 24 h/day was prescribed in 539 (24%) patients and LTOT 15-16 h/day in 1,231 (55%) patients. Mortality was similar between the groups for all-cause, respiratory and cardiovascular mortality. In hypoxemic COPD, LTOT 24 h/day was not associated with a survival benefit compared with treatment 15-16 h/day. A design for a registry-based randomized trial (R-RCT) is proposed.

  • 31.
    Ahmadi, Zainab
    et al.
    Lund University, Lund, Sweden.
    Sundh, Josefin
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Hermansson, Anna B.
    Uppsala University Hospital, Uppsala, Sweden.
    Ekström, Magnus
    Lund University, Lund, Sweden.
    Does Long-Term Oxygen Therapy 24 H/day Improve Survival Compared To 15 H/day In Hypoxemic Chronic Obstructive Pulmonary Disease?2016Inngår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 193Artikkel i tidsskrift (Fagfellevurdert)
  • 32.
    Ahmed Abdi, Samed
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Comparison between two different colon cleansing methods prior to colonoscopy2016Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 33.
    Ahola-Erkkilä, Sofia
    et al.
    Research Program of Molecular Neurology, Biomedicum-Helsinki, University of Helsinki, Helsinki, Finland.
    Carroll, Christopher J.
    Research Program of Molecular Neurology, Biomedicum-Helsinki, University of Helsinki, Helsinki, Finland.
    Peltola-Mjösund, Katja
    Research Program of Molecular Neurology, Biomedicum-Helsinki, University of Helsinki, Helsinki, Finland.
    Tulkki, Valtteri
    Research Program of Molecular Neurology, Biomedicum-Helsinki, University of Helsinki, Helsinki, Finland.
    Mattila, Ismo
    VTT Technical Research Centre of Finland, Espoo, Finland.
    Seppänen-Laakso, Tuulikki
    VTT Technical Research Centre of Finland, Espoo, Finland.
    Oresic, Matej
    Örebro universitet, Institutionen för medicinska vetenskaper. VTT Technical Research Centre of Finland, Espoo, Finland.
    Tyynismaa, Henna
    Research Program of Molecular Neurology, Biomedicum-Helsinki, University of Helsinki, Helsinki, Finland.
    Suomalainen, Anu
    Research Program of Molecular Neurology, Biomedicum-Helsinki, University of Helsinki, Helsinki, Finland; Department of Neurology, Helsinki, University Central Hospital, Helsinki, Finland.
    Ketogenic diet slows down mitochondrial myopathy progression in mice2010Inngår i: Human Molecular Genetics, ISSN 0964-6906, E-ISSN 1460-2083, Vol. 19, nr 10, s. 1974-1984Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Mitochondrial dysfunction is a major cause of neurodegenerative and neuromuscular diseases of adult age and of multisystem disorders of childhood. However, no effective treatment exists for these progressive disorders. Cell culture studies suggested that ketogenic diet (KD), with low glucose and high fat content, could select against cells or mitochondria with mutant mitochondrial DNA (mtDNA), but proper patient trials are still lacking. We studied here the transgenic Deletor mouse, a disease model for progressive late-onset mitochondrial myopathy, accumulating mtDNA deletions during aging and manifesting subtle progressive respiratory chain (RC) deficiency. We found that these mice have widespread lipidomic and metabolite changes, including abnormal plasma phospholipid and free amino acid levels and ketone body production. We treated these mice with pre-symptomatic long-term and post-symptomatic shorter term KD. The effects of the diet for disease progression were followed by morphological, metabolomic and lipidomic tools. We show here that the diet decreased the amount of cytochrome c oxidase negative muscle fibers, a key feature in mitochondrial RC deficiencies, and prevented completely the formation of the mitochondrial ultrastructural abnormalities in the muscle. Furthermore, most of the metabolic and lipidomic changes were cured by the diet to wild-type levels. The diet did not, however, significantly affect the mtDNA quality or quantity, but rather induced mitochondrial biogenesis and restored liver lipid levels. Our results show that mitochondrial myopathy induces widespread metabolic changes, and that KD can slow down progression of the disease in mice. These results suggest that KD may be useful for mitochondrial late-onset myopathies.

  • 34.
    Ahonen, Linda
    et al.
    Steno Diabetes Center Copenhagen, Gentofte, Denmark.
    Jäntti, Sirkku
    Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland.
    Suvitaival, Tommi
    Steno Diabetes Center Copenhagen, Gentofte, Denmark.
    Theilade, Simone
    Steno Diabetes Center Copenhagen, Gentofte, Denmark.
    Risz, Claudia
    Steno Diabetes Center Copenhagen, Gentofte, Denmark.
    Kostiainen, Risto
    Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland.
    Rossing, Peter
    Steno Diabetes Center Copenhagen, Gentofte, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
    Oresic, Matej
    Örebro universitet, Institutionen för medicinska vetenskaper. Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland.
    Hyötyläinen, Tuulia
    Örebro universitet, Institutionen för naturvetenskap och teknik.
    Targeted Clinical Metabolite Profiling Platform for the Stratification of Diabetic Patients2019Inngår i: Metabolites, ISSN 2218-1989, E-ISSN 2218-1989, Vol. 9, nr 9, artikkel-id E184Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Several small molecule biomarkers have been reported in the literature for prediction and diagnosis of (pre)diabetes, its co-morbidities, and complications. Here, we report the development and validation of a novel, quantitative method for the determination of a selected panel of 34 metabolite biomarkers from human plasma. We selected a panel of metabolites indicative of various clinically-relevant pathogenic stages of diabetes. We combined these candidate biomarkers into a single ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method and optimized it, prioritizing simplicity of sample preparation and time needed for analysis, enabling high-throughput analysis in clinical laboratory settings. We validated the method in terms of limits of detection (LOD) and quantitation (LOQ), linearity (R2), and intra- and inter-day repeatability of each metabolite. The method's performance was demonstrated in the analysis of selected samples from a diabetes cohort study. Metabolite levels were associated with clinical measurements and kidney complications in type 1 diabetes (T1D) patients. Specifically, both amino acids and amino acid-related analytes, as well as specific bile acids, were associated with macro-albuminuria. Additionally, specific bile acids were associated with glycemic control, anti-hypertensive medication, statin medication, and clinical lipid measurements. The developed analytical method is suitable for robust determination of selected plasma metabolites in the diabetes clinic.

  • 35.
    Akram, Abawi
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Transcatheter aortic valve implantation for patients with aorticstenosis and concomitant ischemic heart disease:: A five-yearfollow-up2019Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Introduction: Transcatheter aortic valve implantation (TAVI) is an established procedure to treat severe aortic stenosis (AS). This study investigates the impact of ischemic heart disease (IHD) on survival in patients undergoing TAVI.

    Aim: Five-year all-cause mortality stratified according to the presence or absence of IHD.

    Methods: Retrospective register study including all patients that underwent a TAVI-procedure 2009 to 2018. Patients were stratified according to the presence or absence of IHD. Our primary end-point was five-year all-cause mortality. Survival was analyzed using Kaplan-Meier curve. Data were acquired through the SWENTRY registry and patient files.

    Results: A total of 264 patients were included in the study, with 139 (52.7 %) patients in the IHD group vs 125 (47.3 %) patients in the non-IHD group. Mean follow-up time was 40 ±30 months. At baseline, there was a higher proportion of males, patients with hypertension, peripheral arterial disease, left ventricular ejection fraction <50 % and, a higher EuroSCORE I in the IHD-group. Transfemoral approach was most common in both groups. No differences were noted in respect to peri- and postoperative complications. Five-year all-cause mortality was 17/38 (44.7 %) vs 18/30 (60.0 %), p = 0,232, in the IHD and non-IHD group respectively. Non-adjusted cumulative five-year survival was not significantly different between the groups (Log-Rank, p = 0,056).

    Conclusions: In patients with severe AS undergoing TAVI, the five-year all-cause mortality was not statistically different between patients with or without IHD.

  • 36.
    Al Azawi, Omar
    Örebro universitet, Institutionen för medicinska vetenskaper.
    A Cohort Study of Endothelin-1 levels and Mortality in Haemodialysis2019Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 37.
    Al Azawi, Omar
    Örebro universitet, Institutionen för medicinska vetenskaper.
    A cohort study of the effects of smoking on malnutrition and sruvival in haemodialysis2016Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 38.
    Aladagli Poulsen, Deniz
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Mental health among colorectal cancer survivors – a systematic review2017Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 39.
    Alaedini, Armin
    et al.
    Institute of Human Nutrition, Columbia University Medical Center, New York NY, USA; Department of Medicine, Celiac Disease Center, Columbia University Medical Center, New York NY, USA .
    Lebwohl, Benjamin
    Department of Medicine, Celiac Disease Center, Columbia University Medical Center, New York NY, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Wormser, Gary P.
    Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla NY, United States.
    Green, Peter H.
    Department of Medicine, Celiac Disease Center, Columbia University Medical Center, Columbia University, New York NY, USA.
    Ludvigsson, Jonas F.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; School of Medicine, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom.
    Borrelia infection and risk of celiac disease2017Inngår i: BMC Medicine, ISSN 1741-7015, E-ISSN 1741-7015, Vol. 15, artikkel-id 169Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Environmental factors, including infectious agents, are speculated to play a role in the rising prevalence and the geographic distribution of celiac disease, an autoimmune disorder. In the USA and Sweden where the regional variation in the frequency of celiac disease has been studied, a similarity with the geographic distribution of Lyme disease, an emerging multisystemic infection caused by Borrelia burgdorferi spirochetes, has been found, thus raising the possibility of a link. We aimed to determine if infection with Borrelia contributes to an increased risk of celiac disease.

    Methods: Biopsy reports from all of Sweden's pathology departments were used to identify 15,769 individuals with celiac disease. Through linkage to the nationwide Patient Register, we compared the rate of earlier occurrence of Lyme disease in the patients with celiac disease to that in 78,331 matched controls. To further assess the temporal relationship between Borrelia infection and celiac disease, we also examined the risk of subsequent Lyme disease in patients with a diagnosis of celiac disease.

    Results: Twenty-five individuals (0.16%) with celiac disease had a prior diagnosis of Lyme disease, whereas 79 (0.5%) had a subsequent diagnosis of Lyme disease. A modest association between Lyme disease and celiac disease was seen both before (odds ratio, 1.61; 95% confidence interval (CI), 1.06-2.47) and after the diagnosis of celiac disease (hazard ratio, 1.82; 95% CI, 1.40-2.35), with the risk of disease being highest in the first year of follow-up.

    Conclusions: Only a minor fraction of the celiac disease patient population had a prior diagnosis of Lyme disease. The similar association between Lyme disease and celiac disease both before and after the diagnosis of celiac disease is strongly suggestive of surveillance bias as a likely contributor. Taken together, the data indicate that Borrelia infection is not a substantive risk factor in the development of celiac disease.

  • 40.
    Albertsson, Kenth
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Contraindications for anticoagulation therapy among patients with atrial fibrillation associated stroke2015Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 41.
    Albrecht, Sandra
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Roll av TRUL/MR fusionsbiopsi (KOELIS) i diagnostik av prostatacancer hos män med tidigare negativ TRUL-ledd biopsi och förhöjt PSA: – resultatet från eget material vid Urologiska Kliniken på Universitetssjukhuset Örebro2018Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 42.
    Alder, Susanna
    et al.
    Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institute, Stockholm, Sweden.
    Megyessi, David
    Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institute, Stockholm, Sweden.
    Sundström, Karin
    Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden; Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden.
    Östensson, Ellinor
    Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institute, Stockholm, Sweden.
    Mints, Miriam
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institute, Stockholm, Sweden.
    Belkić, Karen
    Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden; School of Community and Global Health, Claremont Graduate University, California, USA; Keck School of Medicine, University of Southern California, USA.
    Arbyn, Marc
    Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium.
    Andersson, Sonia
    Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institute, Stockholm, Sweden.
    Incomplete Excision of Cervical Intraepithelial Neoplasia as a Predictor of the Risk of Recurrent Disease -: a 16 Year Follow-Up Study2019Inngår i: American Journal of Obstetrics and Gynecology, ISSN 0002-9378, E-ISSN 1097-6868Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Women treated for high-grade cervical intraepithelial neoplasia (CIN, grade 2 or 3) are at elevated risk of developing cervical cancer. Suggested factors identifying women at highest risk for recurrence post-therapeutically include incomplete lesion excision, lesion location, size and severity, older age, treatment modality and presence of high-risk human papilloma virus (hrHPV) after treatment. This question has been intensively investigated over decades, but there is still substantial debate as to which of these factors or combination of factors most accurately predict treatment failure.

    OBJECTIVES: In this study, we examine the long-term risk of residual/recurrent CIN2+ among women previously treated for CIN2 or 3 and how this varies according to margin status (considering also location), as well as comorbidity (conditions assumed to interact with hrHPV acquisition and/or CIN progression), post-treatment presence of hrHPV and other factors.

    STUDY DESIGN: This prospective study included 991 women with histopathologically-confirmed CIN2/3 who underwent conization in 2000-2007. Information on the primary histopathologic finding, treatment modality, comorbidity, age and hrHPV status during follow-up and residual/recurrent CIN2+ was obtained from the Swedish National Cervical Screening Registry and medical records. Cumulative incidence of residual/recurrent CIN2+ was plotted on Kaplan-Meier curves, with determinants assessed by Cox regression.

    RESULTS: During a median of 10 years and maximum of 16 years follow-up, 111 patients were diagnosed with residual/recurrent CIN2+. Women with positive/uncertain margins had a higher risk of residual/recurrent CIN2+ than women with negative margins, adjusting for potential confounders (hazard ratio (HR)=2.67; 95% confidence interval (CI): 1.81-3.93). The risk of residual/recurrent CIN2+ varied by anatomical localization of the margins (endocervical: HR=2.72; 95%CI: 1.67-4.41) and both endo- and ectocervical (HR=4.98; 95%CI: 2.85-8.71). The risk did not increase significantly when only ectocervical margins were positive/uncertain. The presence of comorbidity (autoimmune disease, human immunodeficiency viral infection, hepatitis B and/or C, malignancy, diabetes, genetic disorder and/or organ transplant) was also a significant independent predictor of residual/recurrent CIN2+. In women with positive hrHPV findings during follow-up, the HR of positive/uncertain margins for recurrent/residual CIN2+ increased significantly compared to women with hrHPV positive findings but negative margins.

    CONCLUSIONS: Patients with incompletely excised CIN2/3 are at increased risk of residual/recurrent CIN2+. Margin status combined with hrHPV results and consideration of comorbidity may increase the accuracy for predicting treatment failure.

  • 43.
    Alexopoulou, Sofia
    et al.
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Fart, Frida
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Jonsson, Ann-Sofie
    Örebro universitet, Restaurang- och hotellhögskolan.
    Karni, Liran
    Örebro universitet, Handelshögskolan vid Örebro Universitet.
    Kenalemang, Lame Maatla
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Krishna, Sai
    Örebro universitet, Institutionen för naturvetenskap och teknik.
    Lindblad, Katarina
    Örebro universitet, Musikhögskolan.
    Loutfi, Amy
    Örebro universitet, Institutionen för naturvetenskap och teknik.
    Lundin, Elin
    Örebro universitet, Institutionen för hälsovetenskaper.
    Samzelius, Hanna
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Schoultz, Magnus
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Spang, Lisa
    Örebro universitet, Institutionen för hälsovetenskaper.
    Söderman, Annika
    Örebro universitet, Institutionen för hälsovetenskaper.
    Tarum, Janelle
    Örebro universitet, Institutionen för hälsovetenskaper.
    Tsertsidis, Antonios
    Örebro universitet, Handelshögskolan vid Örebro Universitet.
    Widell, Bettina
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Nilsson, Kerstin ()
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Successful ageing in an interdisciplinary context: popular science presentations2018Bok (Annet (populærvitenskap, debatt, mm))
  • 44.
    Algilani, Samal
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Östlund-Lagerström, Lina
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Kihlgren, Annica
    Örebro universitet, Institutionen för hälsovetenskaper.
    Schoultz, Ida
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Schröder, Agneta
    Örebro universitet, Institutionen för hälsovetenskaper.
    Mental health as a prerequisite for functioning as optimally as possible in old age: a phenomenological approachManuskript (preprint) (Annet vitenskapelig)
  • 45.
    Algilani, Samal
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Östlund-Lagerström, Lina
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Schoultz, Ida
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Brummer, Robert J.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Kihlgren, Annica
    Örebro universitet, Institutionen för hälsovetenskaper.
    Increasing the qualitative understanding of optimal functionality in older adults: a focus group based study2016Inngår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, nr 1, artikkel-id 70Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Decreased independence and loss of functional ability are issues regarded as inevitably connected to old age. This ageism may have negative influences on older adults' beliefs about aging, making it difficult for them to focus on their current ability to maintain a good health. It is therefore important to change focus towards promoting Optimal Functionality (OF). OF is a concept putting the older adult's perspective on health and function in focus, however, the concept is still under development. Hence, the aim was to extend the concept of optimal functionality in various groups of older adults.

    Methods: A qualitative study was conducted based on focus group discussions (FGD). In total 6 FGDs were performed, including 37 older adults from three different groups: group 1) senior athletes, group 2) free living older adults, group 3) older adults living in senior living homes. All data was transcribed verbatim and analyzed following the process of deductive content analysis.

    Results: The principal outcome of the analysis was "to function as optimally as you possibly can", which was perceived as the core of the concept. Further, the concept of OF was described as multifactorial and several new factors could be added to the original model of OF. Additionally the findings of the study support that all three cornerstones comprising OF have to occur simultaneously in order for the older adult to function as optimal as possible.

    Conclusions: OF is a multifaceted and subjective concept, which should be individually defined by the older adult. This study further makes evident that older adults as a group are heterogeneous in terms of their preferences and views on health and should thus be approached as such in the health care setting. Therefore it is important to promote an individualized approach as a base when caring for older adults.

  • 46.
    Al-Habali, Abdelaziz
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Atrial Fibrillation After CABG and PCI: A pilot study of the AFAF-study2017Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 47.
    Alhamdow, Ayman
    et al.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Lindh, Christian
    Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
    Hagberg, Jessika
    Örebro universitet, Institutionen för naturvetenskap och teknik. Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Graff, Pål
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; National Institute of Occupational Health, Oslo, Norway.
    Westberg, Håkan
    Örebro universitet, Institutionen för naturvetenskap och teknik. Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Krais, Annette M.
    Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
    Albin, Maria
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden; Centre for Occupational and Environmental Medicine (CAMM), Stockholm County Council, Stockholm, Sweden.
    Gustavsson, Per
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine (CAMM), Stockholm County Council, Stockholm, Sweden.
    Tinnerberg, Håkan
    Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
    Broberg, Karin
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
    DNA-methylation of the cancer-related genes F2RL3 and AHRR is associated with occupational exposure to polycyclic aromatic hydrocarbons2018Inngår i: Carcinogenesis, ISSN 0143-3334, E-ISSN 1460-2180, Vol. 39, nr 7, s. 869-878Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Some polycyclic aromatic hydrocarbons (PAH) are known carcinogens and workplace PAH exposure may increase the risk of cancer. Monitoring early cancer-related changes can indicate whether the exposure is carcinogenic. Here, we enrolled 151 chimney sweeps, 152 controls, and 19 creosote-exposed male workers from Sweden. We measured urinary PAH metabolites using LC/MS/MS, the cancer-related markers telomere length (TL) and mitochondrial DNA copy number (mtDNAcn) using qPCR, and DNA methylation of lung cancer-related genes F2RL3 and AHRR using pyrosequencing. The median 1-hydroxypyrene (PAH metabolite) concentrations were highest in creosote-exposed workers (8.0 μg/g creatinine) followed by chimney sweeps (0.34 μg/g creatinine) and controls (0.05 μg/g creatinine). TL and mtDNAcn did not differ between study groups. Chimney sweeps and creosote-exposed workers had significantly lower methylation of AHRR CpG site cg05575921 (88.1% and 84.9%, respectively) than controls (90%). Creosote-exposed workers (73.3%), but not chimney sweeps (76.6%) had lower methylation of F2RL3 cg03636183 than controls (76.7%). Linear regression analyses showed that chimney sweeps had lower AHRR cg05575921 methylation (B=-2.04; P<0.057, adjusted for smoking and age) and lower average AHRR methylation (B=-2.05; P<0.035), and non-smoking chimney sweeps had lower average F2RL3 methylation (B=-0.81; P<0.042, adjusted for age) compared with controls. These cancer-related markers were not associated with urinary concentrations of PAH metabolites. In conclusion, although we found no associations with PAH metabolites in urine (short-term exposure), our results suggest dose-response relationship between PAH exposure and DNA hypomethylation of lung cancer-related loci. These findings indicate that further protective measures should be taken to reduce PAH exposure.

  • 48.
    Ali, Abdi
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Host microRNA affects the growth of Escherichia coli2018Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 49.
    Ali, Imran
    et al.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Julin, Bettina
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Glynn, Anders
    The National Food Agency, Uppsala, Sweden.
    Högberg, Johan
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Berglund, Marika
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Johansson, Jan-Erik
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Department of Urology, Örebro University Hospital, Örebro, Sweden.
    Andersson, Swen-Olof
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Department of Urology, Örebro University Hospital, Örebro, Sweden.
    Andrén, Ove
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Urology, Örebro University Hospital, Örebro, Sweden.
    Giovannucci, Edward
    Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston MA, United States.
    Wolk, Alicja
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Stenius, Ulla
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Åkesson, Agneta
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Exposure to polychlorinated biphenyls and prostate cancer: population-based prospective cohort and experimental studies2016Inngår i: Carcinogenesis, ISSN 0143-3334, E-ISSN 1460-2180, Vol. 37, nr 12, s. 1144-1151Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Polychlorinated biphenyls (PCBs) are highly persistent environmental pollutants and are undesirable components of our daily food. PCBs are classified as human carcinogens, but the evidence for prostate cancer is limited and available data are inconsistent. We explored the link between non-dioxin-like PCB and grade of prostate cancer in a prospective cohort as well as in cell experiments. A population-based cohort of 32496 Swedish men aged 45-79 years was followed prospectively through 1998-2011, to assess the association between validated estimates of dietary PCB exposure and incidence of prostate cancer by grade (2789 cases, whereof 1276 low grade, 756 intermediate grade, 450 high grade) and prostate cancer mortality (357 fatal cases). In addition, we investigated a non-dioxin-like PCB153-induced cell invasion and related markers in normal prostate stem cells (WPE-stem) and in three different prostate cancer cell lines (PC3, DU145 and 22RV1) at exposure levels relevant to humans. After multivariable-adjustment, dietary PCB exposure was positively associated with high-grade prostate cancer, relative risk (RR) 1.35 [95% confidence interval (CI): 1.03-1.76] and with fatal prostate cancer, RR 1.43 (95% CI: 1.05-1.95), comparing the highest tertile with the lowest. We observed no association with low or intermediate grade of prostate cancer. Cell invasion and related markers, including MMP9, MMP2, Slug and Snail, were significantly increased in human prostate cancer cells as well as in prostate stem cells after exposure to PCB153. Our findings both from the observational and experimental studies suggest a role of non-dioxin-like PCB153 in the development of high-grade and fatal prostate cancer.

  • 50.
    Alić, Hasan
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Proliferative Effect ofNon-Neuronal Acetylcholinein Ovarian Cell Cancer2019Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
1234567 1 - 50 of 2797
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf