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  • 1.
    Aahlin, Eirik K
    et al.
    Department of GI and HPB Surgery, University Hospital Northern Norway, Breivika, Tromsø, Norway; Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway .
    von Meyenfeldt, Maarten
    Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands; NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands.
    Dejong, Cornelius Hc
    Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands; NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands.
    Ljungqvist, Olle
    Örebro University, School of Medicine, Örebro University, Sweden. Department of Surgery, Örebro University Hospital, Örebro; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Fearon, Kenneth C
    Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK .
    Lobo, Dileep N
    Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research, Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK .
    Demartines, Nicolas
    Hospital of Lausanne (CHUV), Lausanne, Switzerland .
    Revhaug, Arthur
    Department of GI and HPB Surgery, University Hospital Northern Norway, Breivika, Tromsø, Norway; Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway .
    Wigmore, Stephen J
    Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK .
    Lassen, Kristoffer
    Department of GI and HPB Surgery, University Hospital Northern Norway, Breivika, Tromsø, Norway; Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway .
    Functional recovery is considered the most important target: a survey of dedicated professionals2014In: Perioperative medicine, ISSN 2047-0525, Vol. 3, article id 3:5Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to survey the relative importance of postoperative recovery targets and perioperative care items, as perceived by a large group of international dedicated professionals.

    Methods: A questionnaire with eight postoperative recovery targets and 13 perioperative care items was mailed to participants of the first international Enhanced Recovery After Surgery (ERAS) congress and to authors of papers with a clear relevance to ERAS in abdominal surgery. The responders were divided into categories according to profession and region.

    Results: The recovery targets 'To be completely free of nausea', 'To be independently mobile' and 'To be able to eat and drink as soon as possible' received the highest score irrespective of the responder's profession or region of origin. Equally, the care items 'Optimizing fluid balance', 'Preoperative counselling' and 'Promoting early and scheduled mobilisation' received the highest score across all groups.

    Conclusions: Functional recovery, as in tolerance of food without nausea and regained mobility, was considered the most important target of recovery. There was a consistent uniformity in the way international dedicated professionals scored the relative importance of recovery targets and care items. The relative rating of the perioperative care items was not dependent on the strength of evidence supporting the items.

  • 2.
    Aaro, Martina
    Örebro University, School of Medicine, Örebro University, Sweden.
    Antibiotic Prophylaxis in Head and Neck Oncologic Surgeryat Örebro University Hospital (USÖ)2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 3.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Larsson, Per-Göran
    Örebro University, School of Medicine, Örebro University, Sweden.
    Wijma, Barbro
    Institutionen för klinisk och experimentell medicin, Linköpings universitet.
    Berterö, Carina
    Department of Medical and Health Sciences, Linköpings universitet.
    Guilt and emptiness: women's experiences of miscarriage2004In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 25, no 6, p. 543-560Article in journal (Refereed)
    Abstract [en]

    Women who lose an early pregnancy are shocked when they are first given the information that they have miscarried. Later they feel guilt and emptiness. Heideggerian interpretive phenomenology has been used with 13 women from southwest Sweden to uncover their lived experience of miscarriage. Women plan their future with a child during early pregnancy. When miscarriage occurs it is not a gore, an embryo, or a fetus they lose, it is their child. They feel that they are the cause of the miscarriage through something they have done, eaten, or thought. They feel abandonment and they grieve for their profound loss; they are actually in bereavement.

  • 4.
    Ahlbäck, Anton
    Örebro University, School of Medicine, Örebro University, Sweden.
    The effect of prolonged hypoxic bed rest on orthostatic tolerance2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 5.
    Ahlstrand, Erik
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Medicine, Division of Hematology, Örebro University Hospital, Örebro, Sweden.
    Hellmark, Bengt
    Örebro University Hospital. Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Svensson, Karolina
    Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Söderquist, Bo
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital. Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Long-term molecular epidemiology of staphylococcus epidermidis blood culture isolates from patients with hematological malignancies2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 6, article id e99045Article in journal (Refereed)
    Abstract [en]

    Staphylococcus epidermidis is an important cause of bloodstream infections in patients with hematological malignancies. Knowledge of the long-term epidemiology of these infections is limited. We surveyed all S. epidermidis blood culture isolates from patients treated for hematological malignancies at the University Hospital of Orebro, Sweden from 1980 to 2009. A total of 373 S. epidermidis isolates were identified and multilocus sequence typing, staphylococcal chromosome cassette mec (SCCmec) typing and standard antibiotic susceptibility testing were employed to characterize these isolates. The majority of the isolates 361/373 (97%) belonged to clonal complex 2, and the 373 isolates were divided into 45 sequence types (STs); Simpson's Diversity Index was 0.56. The most prevalent STs were ST2 (243/373, 65%) and ST215 (28/373, 8%). Ninety three percent (226/243) of the ST2 isolates displayed either SCCmec type III or IV. ST2 and 215 were isolated during the entire study period, and together these STs caused temporal peaks in the number of positive blood cultures of S. epidermidis. Methicillin resistance was detected in 213/273 (78%) of all isolates. In the two predominating STs, ST2 and ST215, methicillin resistance was detected in 256/271 isolates (95%), compared with 34/100 (34%) in other STs (p<0.001). In conclusion, in this long-term study of patients with hematological malignancies, we demonstrate a predominance of methicillin-resistant ST2 among S. epidermidis blood culture isolates.

  • 6.
    Ahlstrand, Erik
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Division of Hematology, Department of Medicine,Örebro University Hospital, Örebro, Sweden.
    Persson, Lennart
    Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
    Tidefelt, Ulf
    Örebro University, School of Medicine, Örebro University, Sweden. Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
    Söderquist, Bo
    Örebro University, School of Medicine, Örebro University, Sweden. Clinical Microbiology, Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
    Alteration of the colonization pattern of coagulase-negative staphylococci in patients undergoing treatment for hematological malignancy2012In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 31, no 7, p. 1679-1687Article in journal (Refereed)
    Abstract [en]

    The aim was to prospectively describe the colonization pattern of coagulase-negative staphylococci (CoNS) and the relationship between colonizing and invasive CoNS isolates among patients undergoing treatment for hematological malignancy. Fourteen newly diagnosed patients were included with either multiple myeloma or acute leukemia. Patients were repeatedly sampled from nares, throat, axillae, and perineum, and the CoNS isolates obtained were phenotypically characterized together with blood isolates of CoNS using the PhenePlate system (PhP). During the treatment a gradual reduction in the heterogeneity of colonizing CoNS was observed as well as an inter-patient accumulation of phenotypically related and multi-drug-resistant CoNS. These clusters of CoNS persisted for 2–3 months after the end of therapy. Ten positive blood cultures of CoNS were obtained and in the majority of these cases CoNS of the same PhP type were found in superficial cultures collected prior to the blood culture sampling. In conclusion, the study shows that therapy for hematological malignancy is associated with a homogenization of colonizing CoNS isolates and that this acquired flora of CoNS is persistent several months after the end of therapy. Furthermore, the results suggest that the source of bloodstream infections of CoNS in hematological patients is colonizing CoNS of the skin and mucosa.

  • 7.
    Aladagli, Deniz
    Örebro University, School of Medicine, Örebro University, Sweden.
    Lokal utbredning av levermetastaser vid diagnos av kolorektal cancer: En populationsbaserad studie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 8.
    Albertsson, Kenth
    Örebro University, School of Medicine, Örebro University, Sweden.
    Postprandiala nivåer av GLP-1 efter gastrisk bypass av typen Roux-en-Y: En systematisk litteraturöversikt 2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 9.
    Al-Habali, Abdelaziz
    Örebro University, School of Medicine, Örebro University, Sweden.
    Detection of intracellular uropathogenic Escherichia coliduring anin vitroinfection of bladder uroepithelial cells2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 10.
    Allbrand, Marianne
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Dept Obstet & Gynaecol, Örebro Univ Hosp, Örebro, Sweden.
    Björkqvist, Maria
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital. Dept Paediat, Örebro University Hospital, Örebro, Sweden.
    Nilsson, Kerstin
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital. Dept Obstet & Gynaecol, Örebro University Hospital, Örebro, Sweden.
    Östlund, Ingrid
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Dept Obstet & Gynaecol, Örebro University Hospital, Örebro, Sweden.
    Åman, Jan
    Örebro University Hospital. Örebro University. Dept Paediat, Örebro University Hospital, Örebro, Sweden.
    Placental gene expression of inflammatory markers and growth factors: a case control study of obese and normal weight women2015In: Journal of Perinatal Medicine, ISSN 0300-5577, E-ISSN 1619-3997, Vol. 43, no 2, p. 159-164Article in journal (Refereed)
    Abstract [en]

    Objective: To survey the placental gene expression of inflammatory markers and growth factors in non-smoking obese women with an uncomplicated pregnancy without associated morbidity and delivery at term compared with normal weight women.

    Methods: Placental tissue samples from 32 obese women (body mass index, BMI >= 35.0 kg/m(2)) were compared with samples from 94 normal weight women (BMI 18.5-25.0 kg/m(2)) matched for age (+/- 1 year), gestational age (+/- 3 days), parity and mode of delivery. Semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) was used to analyse toll receptor-2 and -4, interleukin-6 and -8, tumour necrosis factor-alpha, leptin, adiponectin, insulin-like growth factor-1 and -2, hepatocyte growth factor, hepatocyte growth factor receptor and insulin receptor.

    Results: There was no significant difference in gene expression in placental tissue samples from obese and normal weight women.

    Conclusion: We found no difference in the occurrence of inflammatory marker and growth factor mRNA levels in placental tissue samples from a large group of obese women without associated morbidity and with healthy infants compared to a closely matched control group of healthy normal weight women. Compared with the previous studies, this anomalous finding may be explained by the absence of associated morbidity in the obese women in our study.

  • 11.
    Alvinzi, Linnea
    Örebro University, School of Medicine, Örebro University, Sweden.
    Kronisk smarta, social angest och uthardandebeteende: -en tvarsnittsstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 12. Amcoff, Karin
    et al.
    Joossens, Marie
    Pierik, Marie J.
    Jonkers, Daisy
    Bohr, Johan
    Joossens, Sofie
    Romberg-Camps, Marielle
    Nyhlin, Nils
    Wickbom, Anna K.
    Rutgeerts, Paul J.
    Tysk, Curt
    Bodin, Lennart
    Colombel, Jean-Frederic
    Vermeire, Severine
    Halfvarson, Jonas
    Örebro University, School of Medicine, Örebro University, Sweden.
    Influence of genetics in the expression of serological markers in twins with IBD2012In: Gastroenterology, ISSN 0016-5085, E-ISSN 1528-0012, Vol. 142, no 5, p. S881-S881Article in journal (Other academic)
  • 13.
    Andersson, Christoffer
    Örebro University, School of Medicine, Örebro University, Sweden.
    Återställning av syra-basbalansen efter intraabdominell hypertension efter intraabdominell hypertension.2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 14.
    Andersson, Erik
    Örebro University, School of Medicine, Örebro University, Sweden.
    Platelet proteome in VHL Arg200Trp positive homozygotes2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 15.
    Arevström, Lilith
    Örebro University, School of Medicine, Örebro University, Sweden.
    BilbErry as A dietaRy SuppleMent After myocaRdial infarcTion (the BEAR SMART trial): Preliminary results of an open-label randomized clinical trial2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 16.
    Ariander, Annaclara
    Örebro University, School of Medicine, Örebro University, Sweden.
    The effect of pressure on capillary refill time time: A clinical study on healthy volunteers 2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 17.
    Asghar, Naveed
    et al.
    School of Natural Science, Technology & Environmental Studies, Södertörn University, Huddinge, Sweden.
    Lindblom, Pontus
    Division of Medical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Melik, Wessam
    School of Natural Science, Technology & Environmental Studies, Södertörn University, Huddinge, Sweden.
    Lindqvist, Richard
    Department of Clinical Microbiology, Virology, Umeå University, Umeå, Sweden.
    Haglund, Mats
    Department of Infectious Diseases, County Hospital, Kalmar, Sweden.
    Forsberg, Pia
    Division of Infectious Diseases, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Clinic of Infectious Diseases, Linköping University Hospital, Linköping, Sweden.
    Överby, Anna K.
    Department of Clinical Microbiology, Virology, Umeå University, Umeå, Sweden.
    Andreassen, Åshild
    Division of Infectious Disease Control, Department of Virology, Norwegian Institute of Public Health, Oslo, Norway.
    Lindgren, Per-Eric
    Division of Medical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Division of Medical Services, Department of Microbiology, County Hospital Ryhov, Jönköping, Sweden.
    Johansson, Magnus
    Örebro University, School of Medicine, Örebro University, Sweden. School of Natural Science, Technology & Environmental Studies, Södertörn University, Huddinge, Sweden; RiSC - Inflammatory Response and Infection Susceptibility Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Tick-Borne Encephalitis Virus Sequenced Directly from Questing and Blood-Feeding Ticks Reveals Quasispecies Variance2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 7, article id e103264Article in journal (Refereed)
    Abstract [en]

    The increased distribution of the tick-borne encephalitis virus (TBEV) in Scandinavia highlights the importance of characterizing novel sequences within the natural foci. In this study, two TBEV strains: the Norwegian Mandal 2009 (questing nymphs pool) and the Swedish Saringe 2009 (blood-fed nymph) were sequenced and phylogenetically characterized. Interestingly, the sequence of Mandal 2009 revealed the shorter form of the TBEV genome, similar to the highly virulent Hypr strain, within the 3' non-coding region (3'NCR). A different genomic structure was found in the 3'NCR of Saringe 2009, as in-depth analysis demonstrated TBEV variants with different lengths within the poly(A) tract. This shows that TBEV quasispecies exists in nature and indicates a putative shift in the quasispecies pool when the virus switches between invertebrate and vertebrate environments. This prompted us to further sequence and analyze the 3'NCRs of additional Scandinavian TBEV strains and control strains, Hypr and Neudoerfl. Toro 2003 and Habo 2011 contained mainly a short (A) 3C(A)6 poly(A) tract. A similar pattern was observed for the human TBEV isolates 1993/783 and 1991/4944; however, one clone of 1991/4944 contained an (A) 3C(A)11 poly(A) sequence, demonstrating that quasispecies with longer poly(A) could be present in human isolates. Neudoerfl has previously been reported to contain a poly(A) region, but to our surprise the resequenced genome contained two major quasispecies variants, both lacking the poly(A) tract. We speculate that the observed differences are important factors for the understanding of virulence, spread, and control of the TBEV.

  • 18.
    Asghar, Naveed
    et al.
    Södertörns Högskola, Huddinge, Sweden.
    Wessam, Melik
    Södertörns Högskola, Huddinge, Sweden.
    Lindblom, Pontus
    Linköpings Universitet, Linköping, Sweden.
    Lindgren, Per-Erik
    Linköpings Universitet, Linköping, Sweden.
    Andreassen, Åshild
    Norska folkhälsoinstitutet, Oslo, Norway.
    Johansson, Magnus
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University, School of Medicine, Örebro University, Sweden.
    Genomic Sequencing of Tick-borne Encephalitis Virus frin Questing and Blood-Feeding Ixodes ricinus2013Conference paper (Other academic)
  • 19.
    Axelsson, Markus
    et al.
    University of Gothenburg, Gothenburg, Sweden .
    Malmeström, Clas
    University of Gothenburg, Gothenburg, Sweden .
    Gunnarsson, Martin
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital.
    Zetterberg, Henrik
    University of Gothenburg, Mölndal, Sweden; Institute of Neurology, The University College London (UCL), London, UK.
    Sundstrom, Peter
    Umeå University, Umeå, Sweden .
    Lycke, Jan
    University of Gothenburg, Gothenburg, Sweden .
    Svenningsson, Anders
    Umeå University, Umeå, Sweden .
    Immunosuppressive therapy reduces axonal damage in progressive multiple sclerosis2014In: Multiple Sclerosis, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 20, no 1, p. 43-50Article in journal (Refereed)
    Abstract [en]

    Background: In progressive multiple sclerosis (PMS), disease-modifying therapies have not been shown to reduce disability progression.

    Objective: The impact from immunosuppressive therapy in PMS was explored by analyzing cerebrospinal fluid (CSF) biomarkers of axonal damage (neurofilament light protein, NFL), astrogliosis (glial fibrillary acidic protein, GFAP), and B-cell regulation (CXCL13).

    Methods: CSF was obtained from 35 patients with PMS before and after 12-24 months of mitoxantrone (n=30) or rituximab (n=5) treatment, and from 14 age-matched healthy control subjects. The levels of NFL, GFAP, and CXCL13 were determined by immunoassays.

    Results: The mean NFL level decreased by 51% (1781 ng/l, SD 2018 vs. 874 ng/l, SD 694, p=0.007), the mean CXCL13 reduction was 55% (9.71 pg/ml, SD 16.08, vs. 4.37 pg/ml, SD 1.94, p=0.008), while GFAP levels remained unaffected. Subgroup analysis showed that the NFL reduction was confined to previously untreated patients (n=20) and patients with Gd-enhancing lesions on magnetic resonance imaging (n=12) prior to study baseline.

    Conclusions: Our data imply that 12-24 months of immunosuppressive therapy reduces axonal damage in PMS, particularly in patients with ongoing disease activity. Determination of NFL levels in CSF is a potential surrogate marker for treatment efficacy and as endpoint in phase II trials of MS.

  • 20.
    Axmon, Oscar
    Örebro University, School of Medicine, Örebro University, Sweden.
    Maxillofacial fractures in a Swedish population–incidence and etiology2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 21.
    Axén, Sofia
    Örebro University, School of Medicine, Örebro University, Sweden.
    Preoperative localization of pathological parathyroid glands in patients with primary hyperparathyroidism using sestamibi--‐SPECT scintigraphy: aretrospective study over 5 years (2009--‐2013)2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 22.
    Baban, Bayar
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Dept of Surgery, Örebro University Hospital, Örebro, Sweden.
    Thorell, Anders
    Department of Clinical Science, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden; Dept of Surgery, Ersta Hospital, Stockholm, Sweden.
    Nygren, Jonas
    Department of Clinical Science, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden; Dept of Surgery, Ersta Hospital, Stockholm, Sweden.
    Bratt, Anette
    Department of Clinical Science, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden; Dept of Surgery, Ersta Hospital, Stockholm, Sweden.
    Ljungqvist, Olle
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital. Dept of Surgery, Örebro University Hospital, Örebro, Sweden; Institution for Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Determination of insulin resistance in surgery: the choice of method is crucial2015In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 34, no 1, p. 123-128Article in journal (Refereed)
    Abstract [en]

    BACKGROUND & AIMS: In elective surgery, postoperative hyperglycaemia and insulin resistance are independent risk factors for complications. Since the simpler HOMA method has been used as an alternative to the hyperinsulinemic normoglycemic clamp in studies of surgery induced insulin resistance, we compared the two methods in patients undergoing elective surgery.

    METHODS: Data from 113 non-diabetic patients undergoing elective surgery were used. Insulin sensitivity, both before and after surgery, was quantified by the clamp and HOMA. Pre- and postoperatively, the results of the clamp were compared to HOMA using regression- and correlation analysis. Degree of agreement between the methods was studied using weighted linear kappa and the Bland-Altman test.

    RESULTS: Both the clamp and HOMA recorded a mean relative reduction in insulin sensitivity of 39 ± 24% and 39 ± 61% respectively after surgery; with significant correlations (p < 0.01) for pre- and post-operative measures as well as for relative changes. However r(2) values were low: 0.04, 0.07 and 0.03 respectively. The degree of agreement for the relative change in insulin sensitivity using the Bland-Altman test gave a mean of difference 0% but "limits of agreement" (±2SD) was ±125%. This poor inter-method agreement was consolidated by a weighted linear kappa value of 0.18.

    CONCLUSION: While the hyperinsulinemic euglycemic clamp measures the postoperative changes in insulin sensitivity, HOMA measures something different. Data using the HOMA method must therefore be interpreted cautiously and is not interchangeable with data obtained from the clamp.

  • 23.
    Bang, Charlotte Sahlberg
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kinnunen, Annica
    IRiSC, Fac Med & Hlth, Univ Örebro, Örebro, Sweden.
    Karlsson, Marie
    IRiSC, Fac Med & Hlth, Univ Örebro, Örebro, Sweden.
    Önnberg, Anna
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Dept Lab Med, Örebro Univ Hosp, Örebro, Sweden.
    Söderquist, Bo
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital. Dept Lab Med, Örebro University Hospital, Örebro, Sweden.
    Persson, Katarina
    Örebro University, School of Medicine, Örebro University, Sweden.
    The antibacterial effect of nitric oxide against ESBL-producing uropathogenic E-coli is improved by combination with miconazole and polymyxin B nonapeptide2014In: BMC Microbiology, ISSN 1471-2180, E-ISSN 1471-2180, Vol. 14, article id 65Article in journal (Refereed)
    Abstract [en]

    Background: Nitric oxide (NO) is produced as part of the host immune response to bacterial infections, including urinary tract infections. The enzyme flavohemoglobin, coded by the hmp gene, is involved in protecting bacterial cells from the toxic effects of NO and represents a potentially interesting target for development of novel treatment concepts against resistant uropathogenic bacteria. The aim of the present study was to investigate if the in vitro antibacterial effects of NO can be enhanced by pharmacological modulation of the enzyme flavohemoglobin.

    Results: Four clinical isolates of multidrug-resistant extended-spectrum beta-lactamase (ESBL)-producing uropathogenic E. coli were included in the study. It was shown that the NO-donor substance DETA/NO, but not inactivated DETA/NO, caused an initial growth inhibition with regrowth noted after 8 h of exposure. An hmp-deficient strain showed a prolonged growth inhibition in response to DETA/NO compared to the wild type. The imidazole antibiotic miconazole, that has been shown to inhibit bacterial flavohemoglobin activity, prolonged the DETA/NO-evoked growth inhibition. When miconazole was combined with polymyxin B nonapeptide (PMBN), in order to increase the bacterial wall permeability, DETA/NO caused a prolonged bacteriostatic response that lasted for up to 24 h.

    Conclusion: An NO-donor in combination with miconazole and PMBN showed enhanced antimicrobial effects and proved effective against multidrug-resistant ESBL-producing uropathogenic E. coli.

  • 24.
    Bang, Charlotte Sahlberg
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kruse, Robert
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
    Demirel, Isak
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Önnberg, Anna
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Dept Lab Med, Örebro University Hospital, Örebro, Sweden.
    Söderquist, Bo
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital. Dept Lab Med, Örebro University Hospital, Örebro, Sweden.
    Persson, Katarina
    Örebro University, School of Medicine, Örebro University, Sweden.
    Multiresistant uropathogenic extended-spectrum β-lactamase (ESBL)-producing Escherichia coli are susceptible to the carbon monoxide releasing molecule-2 (CORM-2).2014In: Microbial Pathogenesis, ISSN 0882-4010, E-ISSN 1096-1208, Vol. 66, p. 29-35Article in journal (Refereed)
    Abstract [en]

    Carbon monoxide (CO) releasing molecules (CO-RMs) have been shown to inhibit growth of commensal Escherichia coli (E. coli). In the present study we examined the effect of CORM-2 on uropathogenic E. coli (UPEC) that produces extended-spectrum β-lactamase (ESBL). Viability experiments showed that CORM-2 inhibited the growth of several different ESBL-producing UPEC isolates and that 500 μM CORM-2 had a bactericidal effect within 4 h. The bactericidal effect of CORM-2 was significantly more pronounced than the effect of the antibiotic nitrofurantoin. CORM-2 demonstrated a low level of cytotoxicity in eukaryotic cells (human bladder epithelial cell line 5637) at the concentrations and time-points where the antibacterial effect was obtained. Real-time RT-PCR studies of different virulence genes showed that the expression of capsule group II kpsMT II and serum resistance traT was reduced and that some genes encoding iron acquisition systems were altered by CORM-2. Our results demonstrate that CORM-2 has a fast bactericidal effect against multiresistant ESBL-producing UPEC isolates, and also identify some putative UPEC virulence factors as targets for CORM-2. CO-RMs may be candidate drugs for further studies in the field of finding new therapeutic approaches for treatment of uropathogenic ESBLproducing E. coli.

  • 25.
    Bark, Ida
    Örebro University, School of Medicine, Örebro University, Sweden.
    Intrathoracic tularemia mimicking tumor2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 26.
    Barsk, Martin
    Örebro University, School of Medicine, Örebro University, Sweden.
    A cohort study of insulin-like growth factor-1 and body weight change among hemodialysis patients.2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 27.
    Barth, Henrik
    et al.
    Department of Ophthalmology, Lund University, Lund, Sweden .
    Crafoord, Sven
    Örebro University, School of Medicine, Örebro University, Sweden. Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden.
    O'Shea, Timothy M.
    Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, USA .
    Pritchard, Christopher D.
    Harvard-Massachusetts Institute of Technology, Division of Health Sciences and Technology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, USA .
    Langer, Robert
    Harvard-Massachusetts Institute of Technology, Division of Health Sciences and Technology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, USA .
    Ghosh, Fredrik
    Department of Ophthalmology, Lund University, Lund, Sweden .
    A new model for in vitro testing of vitreous substitute candidates2014In: Graefe's Archives for Clinical and Experimental Ophthalmology, ISSN 0721-832X, E-ISSN 1435-702X, Vol. 252, no 10, p. 1581-1592Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe a new model for in vitro assessment of novel vitreous substitute candidates.

    Methods: The biological impact of three vitreous substitute candidates was explored in a retinal explant culture model; a polyalkylimide hydrogel (Bio-Alcamid (R)), a two component hydrogel of 20 wt.% poly (ethylene glycol) in phosphate buffered saline (PEG) and a cross-linked sodium hyaluronic acid hydrogel (Healaflow (R)). The gels where applied to explanted adult rat retinas and then kept in culture for 2, 5 and 10 days. Gel-exposed explants were compared with explants incubated under standard tissue culture conditions. Cryosections of the specimens were stained with hematoxylin and eosin, immunohistochemical markers (GFAP, Vimentin, Neurofilament 160, PKC, Rhodopsin) and TUNEL.

    Results: Explants kept under standard conditions as well as PEG-exposed explants displayed disruption of retinal layers with moderate pyknosis of all neurons. They also displayed moderate labeling of apoptotic cells. Bio-Alcamid (R)-exposed explants displayed severe thinning and disruption of retinal layers with massive cell death. Healaflow (R)-treated explants displayed normal retinal lamination with significantly better preservation of retinal neurons compared with control specimens, and almost no signs of apoptosis. Retinas exposed to Healaflow (R) and retinas kept under standard conditions showed variable labeling of GFAP with generally low expression and some areas of upregulation. PEG-exposed retinas showed increased GFAP labeling and Bio-Alcamid (R)-exposed retinas showed sparse labeling of GFAP.

    Conclusions: Research into novel vitreous substitutes has important implications for both medical and surgical vitreoretinal disease. The in vitro model presented here provides a method of biocompatibility testing prior to more costly and cumbersome in vivo experiments. The explant culture system imposes reactions within the retina including disruption of layers, cell death and gliosis, and the progression of these reactions can be used for comparison of vitreous substitute candidates. Bio-Alcamid (R) had strong adverse effects on the retina which is consistent with results of prior in vivo trials. PEG gel elicits reactions similar to the control retinas whereas Healaflow (R) shows protection from culture-induced trauma indicating favorable biocompatibility.

  • 28.
    Baumgart, Juliane
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Obstetrics and Gynecology.
    Nilsson, Kerstin
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital. Department of Obstetrics and Gynecology, Örebro University Hospital, Örebro, Sweden.
    Evers, A. Stavreus
    Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden .
    Kallak, T. Kunovac
    Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden.
    Kushnir, M. M.
    ARUP Institute for Clinical and Experimental Pathology, Salt Lake City UT, USA; Department of Pathology, University of Utah School of Medicine, Salt Lake City, USA; Analytical Chemistry/Department of Chemistry, Biomedical Center and SciLife Laboratory, Uppsala University, Uppsala, Sweden.
    Bergquist, J.
    Department of Pathology, University of Utah School of Medicine, Salt Lake City UT, USA; Analytical Chemistry/Department of Chemistry, Biomedical Center and SciLife Laboratory, Uppsala University, Uppsala, Sweden.
    Poromaa, I. Sundström
    Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden .
    Androgen levels during adjuvant endocrine therapy in postmenopausal breast cancer patients2014In: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 17, no 1, p. 48-54Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate plasma steroid hormone levels in postmenopausal breast cancer patients with and without adjuvant endocrine therapy and in healthy postmenopausal women.

    Methods: Steroid hormone levels in postmenopausal breast cancer patients treated with aromatase inhibitors (n = 32) were compared with breast cancer patients treated with tamoxifen (n = 34), breast cancer patients without adjuvant endocrine therapy (n = 15), and healthy postmenopausal women (n = 56). Pregnenolone, 17-hydroxypregnenolone, 17-hydroxyprogesterone, 11-deoxycortisol, cortisol, cortisone, dehydroepiandrosterone (DHEA), androstenedione, total testosterone, dihydrotestosterone, estrone and estradiol were measured using liquid chromatography-tandem mass spectrometry. Sex hormone binding globulin was measured by solid-phase chemiluminescent immunometric assays, and the free androgen index was calculated.

    Results: Aromatase inhibitor users did not differ in dihydrotestosterone, total testosterone, androstenedione, DHEA, or free androgen index levels from healthy controls or untreated breast cancer patients. The highest total testosterone levels were found in tamoxifen-treated women, who had significantly higher plasma concentrations than both women treated with aromatase inhibitors and breast cancer patients without adjuvant treatment. Concentrations of cortisol and cortisone were significantly greater in aromatase inhibitor users as well as tamoxifen users, in comparison with healthy controls and untreated breast cancer patients. Aromatase inhibitor users had lower estrone and estradiol plasma concentrations than all other groups.

    Conclusion: Adjuvant treatment with aromatase inhibitors or tamoxifen was associated with increased cortisol and cortisone plasma concentrations as well as decreased estradiol concentrations. Androgen levels were elevated in tamoxifen-treated women but not in aromatase inhibitor users.

  • 29.
    Bedrosian, Nareg
    Örebro University, School of Medicine, Örebro University, Sweden.
    Nikotinstopp och dess inverkan på sömnen2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 30.
    Bengtsson, Torbjörn
    et al.
    Örebro University, School of Medicine, Örebro University, Sweden.
    Khalaf, Atika
    The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden.
    Khalaf, Hazem
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Secreted gingipains from Porphyromonas gingivalis colonies exert potent immunomodulatory effects on human gingival fibroblasts2015In: Microbiology Research, ISSN 0944-5013, E-ISSN 1618-0623, Vol. 178, p. 18-26Article in journal (Refereed)
    Abstract [en]

    Periodontal pathogens, including Polphyromonas gingivalis, can form biofilms in dental pockets and cause inflammation, which is one of the underlying mechanisms involved in the development of periodontal disease, ultimately leading to tooth loss. Although P. gingivalis is protected in the biofilm, it can still cause damage and modulate inflammatory responses from the host, through secretion of microvesicles containing proteinases. The aim of this study was to evaluate the role of cysteine proteinases in P. gingivalis colony growth and development, and subsequent immunomodulatory effects on human gingival fibroblast. By comparing the wild type W50 with its gingipain deficient strains we show that cysteine proteinases are required by P. gingivalis to form morphologically normal colonies. The lysine-specific proteinase (Kgp), but not arginine-specific proteinases (Rgps), was associated with immunomodulation. P. gingivalis with Kgp affected the viability of gingival fibroblasts and modulated host inflammatory responses, including induction of TGF-beta 1 and suppression of CXCL8 and IL-6 accumulation. These results suggest that secreted products from P. gingivalis, including proteinases, are able to cause damage and significantly modulate the levels of inflammatory mediators, independent of a physical host-bacterial interaction. This study provides new insight of the pathogenesis of P. gingivalis and suggests gingipains as targets for diagnosis and treatment of periodontitis.

  • 31. Beraki, Åsa
    et al.
    Magnuson, Anders
    Samuelsson, Ulf
    Åman, Jan
    Särnblad, Stefan
    Örebro University, School of Medicine, Örebro University, Sweden.
    Ökad fysisk aktivitet är relaterat till lägre HbA1c -nivåer hos barn och ungdomar med typ 1-diabetes: Resultat från en studie baserad på det Svenska pediatriska kvalitets registret för barn och ungdomar med diabetes (SWEDIABKIDS)2014In: BestPractice ApS, ISSN 1902-7583, no 12Article in journal (Other academic)
  • 32.
    Beraki, Åsa
    et al.
    Linköping University, Linköping, Sweden.
    Magnusson, Anders
    Clinical Epidemiology and Biostatistic Unit, Örebro University Hospital, Örebro, Sweden.
    Särnblad, Stefan
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital. Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
    Åman, Jan
    Örebro University Hospital. Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
    Samuelsson, Ulf
    Department of Clinical and Experimental Medicine, Division of Pediatrics and Diabetes Research Centre, Linköping University, Linköping, Sweden.
    Increase in physical activity is associated with lower HbA1c levels in children and adolescents with type 1 diabetes: results from a cross-sectional study based on the Swedish pediatric diabetes quality registry (SWEDIABKIDS)2014In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 105, no 1, p. 119-125Article in journal (Refereed)
    Abstract [en]

    Aims: To evaluate the associations between physical activity (PA) and metabolic control, measured by glycated hemoglobin (HbA1c), in a large group of children and adolescents with type 1 diabetes.

    Methods: Cross-sectional analysis of data from 4655 patients, comparing HbA1c values with levels of physical activity. The data for the children and adolescents were obtained from the Swedish pediatric diabetes quality registry, SWEDIABKIDS. The patients were 7-18 years of age, had type 1 diabetes and were not in remission. Patients were grouped into five groups by frequency of PA.

    Results: Mean HbA1c level was higher in the least physically active groups (PA0: 8.8% +/- 1.5 (72 +/- 16 mmol/mol)) than in the most physically active groups (PA4: 7.7% +/- 1.0 (60 +/- 11 mmol/mol)) (p < 0.001). An inverse dose-response association was found between PA and HbA1c (beta: -0.30, 95%CI: -0.34 to -0.26, p < 0.001). This association was found in both sexes and all age groups, apart from girls aged 7-10 years. Multiple regression analysis revealed that the relationship remained significant (beta: -0.21, 95% CI: -0.25 to -0.18, p < 0.001) when adjusted for possible confounding factors.

    Conclusions: Physical activity seems to influence HbA1c levels in children and adolescents with type 1 diabetes. In clinical practice these patients should be recommended daily physical activity as a part of their treatment.

  • 33.
    Berg von Linde, Maria
    Örebro University, School of Medicine, Örebro University, Sweden.
    Insights from the den: How hibernating bears may help us understand and treat human disease2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 34.
    Berglund, Charlotte
    Örebro University, School of Medicine, Örebro University, Sweden.
    The impact of BMI on response to controlled ovarian hyperstimulation in in vitro fertilization/intracytoplasmic sperm injection cycles, aretrospective cohort study.2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 35.
    Bergman, Fanny
    Örebro University, School of Medicine, Örebro University, Sweden.
    Early outcome of orchiopexy - a retrospective review of patients treated for cryptorchidism at Örebro University Hospital2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 36.
    Bergsten, Helena
    Örebro University, School of Medicine, Örebro University, Sweden.
    Clinical severity of lung infection corresponds to its invasiveness in community S. aureus strains2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 37.
    Bielak, Wojciech
    Örebro University, School of Medicine, Örebro University, Sweden.
    Äldre patienter på akutmottagningen - återbesök inom 30 dagar.2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 38.
    Bignert, Vidar
    Örebro University, School of Medicine, Örebro University, Sweden.
    Possible factors influencing perceived symptoms in the indoor environment of office buildings2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 39.
    Bitar, Saher
    Örebro University, School of Medicine, Örebro University, Sweden.
    Malignt melanom vid Hudkliniken på Örebro universitetssjukhus2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 40.
    Björksten, Markus
    Örebro University, School of Medicine, Örebro University, Sweden.
    Prescriptions of Folic Acid, Beta Blockers and Antipsychotics: differences between patients with and without dementia.2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 41. Blixt, Christina
    et al.
    Ahlstedt, Christian
    Ljungqvist, Olle
    Örebro University, School of Medicine, Örebro University, Sweden. Dept of Surgery, Örebro University Hospital, Örebro, Sweden.
    Isaksson, Bengt
    Kalman, Sigridur
    Rooyackers, Olav
    The effect of perioperative glucose control on postoperative insulin resistance2012In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 31, no 5, p. 676-681Article in journal (Refereed)
    Abstract [en]

    BACKGROUND & AIMS: Postoperative insulin resistance and the consequent hyperglycemia affects clinical outcome. Insulin sensitivity may be modulated by preoperative nutrition, adequate pain management and minimal invasive surgery. This study aims to disclose the impact of perioperative glucose control on postoperative insulin resistance.

    METHODS: Twenty patients scheduled for elective open hepatectomy were enrolled in this prospective, randomized study. In the treatment group (n = 9) insulin was administered intravenously to keep blood glucose between 6 and 8 mmol/l during surgery. The control group (n = 8) received insulin if blood glucose >14 mmol/l. Insulin sensitivity was measured by a hyperinsulinemic normoglycemic clamp (0.8 mU/kg/min), performed on all patients both on the day before surgery and immediately postoperatively. Plasma cortisol, insulin and C-peptide were measured.

    RESULTS: There was a significant difference in mean glucose value during surgery. In the control group 8.8 mmol/l (SD 1.5) vs. 6.9 mmol/l (SD 0.4) in the treated group, p = 0.003. In the control group insulin sensitivity decreased to 21.9% ± 16.2% of the preoperative value and in the insulin treated group to 46.8 ± 15.5%, p < 0.005. Insulin levels were significantly higher in the treatment group as well as consequently lower C-peptide levels.

    CONCLUSIONS: This trial revealed a significant difference in postoperative insulin resistance in the group treated with insulin during surgery.

  • 42.
    Blomqvist, My
    et al.
    Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    Bejerot, Susanne
    Örebro University, School of Medicine, Örebro University, Sweden. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Dahllöf, Göran
    Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
    A cross-sectional study on oral health and dental care in intellectually able adults with autism spectrum disorder2015In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 15, article id 81Article in journal (Refereed)
    Abstract [en]

    Background: Autism spectrum disorder (ASD) is characterized by impairments in social interaction and communication, restricted patterns of behaviour, and unusual sensory sensitivities. The hypotheses to be tested were that adult patients with ASD have a higher caries prevalence, have more risk factors for caries development, and utilize dental health care to a lesser extent than people recruited from the normal population.

    Methods: Forty-seven adults with ASD, (25 men, 22 women, mean age 33 years) and of normal intelligence and 69 age-and sex-matched typical controls completed a dental examination and questionnaires on oral health, dental hygiene, dietary habits and previous contacts with dental care.

    Results: Except for increased number of buccal gingival recessions, the oral health was comparable in adults with ASD and the control group. The group with ASD had less snacking, but also less frequent brushing of teeth in the mornings. The stimulated saliva secretion was lower in the ASD group, regardless of medication. Frequencies of dental care contacts were equal in both groups. The most common reason for missing a dental appointment was forgetfulness in the ASD group.

    Conclusions: Adults with ASD exhibited more gingival recessions and considerably lower saliva flow compared to healthy controls. Despite equal caries prevalence, the risk for reduced oral health due to decreased salivary flow should be taken into consideration when planning dental care for patients with ASD. Written reminders of dental appointments and written and verbal report on oral health status and oral hygiene instructions are recommended.

  • 43.
    Borén, Tora
    Örebro University, School of Medicine, Örebro University, Sweden.
    Utvärdering av specialistläkarleddteamtriagering på akutmottagningenur ett patientsäkerhetsperspektiv2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 44.
    Brenner, P.
    et al.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Burkill, S.
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Jokinen, J.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Sciences, Umeå University, Umeå, Sweden.
    Moore, A.
    Quantitative Safety & Epidemiology, Novartis Pharma AG, Basel, Switzerland.
    Geissbuehler, Y.
    Quantitative Safety & Epidemiology, Novartis Pharma AG, Basel, Switzerland.
    Hillert, J.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Bahmanyar, S.
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Montgomery, Scott
    Örebro University, School of Medicine, Örebro University, Sweden. DepDepartment of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Multiple sclerosis and risk of completed and attempted suicide - a national cohort study2015In: Multiple Sclerosis, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 21, no Suppl. 11, p. 23-24Article in journal (Other academic)
    Abstract [en]

    Introduction: Patients with multiple sclerosis (MS) are known to have an elevated suicide risk, but attempted suicide is incompletely investigated.

    Objectives: To estimate attempted suicide and completed suicide risks among MS patients using national registers and to assess if the inverse association of higher-level education with completed suicide is affected by MS.

    Methods: A total of 29,617 Swedish MS patients were identified through the Swedish Patient Register and matched (by birth year, sex, vital status at diagnosis and region) with 296,164 people without MS from the general population. Cox regression estimated hazard ratios (HR) (with 95% confidence intervals) for the association of MS with attempted and completed suicide, with adjustment for age, sex, education level, decade of study entry, and previous suicide attempts.

    Results: The adjusted HR for attempted suicide among MS patients is 2.18 (1.97-2.43) compared with the general population cohort. For completed suicide the HR is 1.87 (1.53-2.30). Overall, men were at higher risk of completing suicide, while women were at higher risk of attempting suicide. Higher education is inversely associated with completed suicide among the non-MS cohort with an HR of 0.68, (0.51-0.91), but not among MS patients, where the HR is 1.10, (0.60-2.04). MS patients were less likely to use a violent method than the non-MS cohort.

    Conclusion: MS patients are at higher risk of both attempted and completed suicide, and the risk increase is present in both men and women. Possibly the stress and perceived prognosis associated with an MS diagnosis increases the risk of suicide. MS appears to eliminate the protective association of higher education with completed suicide.

  • 45.
    Brosche, Linn
    Örebro University, School of Medicine, Örebro University, Sweden.
    Etiska dilemman vid HLR-beslut2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 46.
    Bruggmann, P.
    et al.
    Arud Ctr Addict Med, Zurich, Switzerland.
    Berg, T.
    Univ Leipzig, Leipzig, Germany.
    Ovrehus, A. L. H.
    Dept Infect Dis, Odense Univ Hosp, Odense, Denmark.
    Moreno, C.
    Erasme Univ Hosp, Univ Libre Brussels, Brussels, Belgium.
    Brandao Mello, C. E.
    Dept Gastroenterol, Univ Fed Rio de Janeiro, Rio De Janeiro, Brazil.
    Roudot-Thoraval, F.
    Dept Sante Publ, Hop Henri Mondor, Creteil, France.
    Marinho, R. T.
    Ctr Hosp Lisboa Norte, Dept Gastroenterol, Hosp Santa Maria,Lisbon, Portugal.
    Sherman, M.
    Toronto Gen Hosp, Univ Hlth Network, Univ Toronto, Toronto, Canada.
    Ryder, S. D.
    Nottingham Univ Hosp NHS Trust, Nottingham, England; Biomed Res Unit, Nottingham, England.
    Sperl, J.
    Dept Hepatogastroenterol, Inst Clin & Expt Med, Prague, Czech Republic.
    Akarca, U.
    Ege Univ, Izmir, Turkey.
    Balik, I.
    Ankara Univ, Ankara, Turkey.
    Bihl, F.
    Dept Gastroenterol, Osped Cantonale, Bellinzona, Switzerland.
    Bilodeau, M.
    Dept Med, Liver Unit, Univ Montreal, Montreal, Canada.
    Blasco, A. J.
    Adv Tech Hlth Serv Res TAISS, Madrid, Spain.
    Buti, M.
    Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBEREHD), Hosp Valle De Hebron, Barcelona, Spain.
    Calinas, F.
    Dept Gastroenterol, Ctr Hosp Lisboa Cent, Hosp Santo Antonio Capuchos, Lisbon, Portugal.
    Calleja, J. L.
    Hosp Puerta Hierro, Madrid, Spain.
    Cheinquer, H.
    Hosp Clin, Univ Fed Rio Grande do Sul, Porto Alegre RS, Brazil.
    Christensen, P. B.
    Dept Infect Dis, Odense Univ Hosp, Odense, Denmark.
    Clausen, M.
    Region Hosp Hovedstaden, Region Hovedstaden, Hillerød, Denmark.
    Coelho, H. S. M.
    Dept Clin Med, Univ Fed Rio de Janeiro, Rio De Janeiro, Brazil.
    Cornberg, M.
    Dept Gastroenterol Hepatol & Endocrinol,Hannover Med Sch, Hannover, Germany; German Liver Fdn, Hannover, Germany.
    Cramp, M. E.
    Peninsula Schools Med & Dent, Univ Plymouth, Plymouth, England.
    Dore, G. J.
    Kirby Inst, Univ New S Wales, Sydney NSW, Australia.
    Doss, W.
    Cairo Univ, Cairo, Egypt.
    Duberg, Ann-Sofi
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital. Dept Infect Dis, Örebro University Hospital, Örebro, Sweden.
    El-Sayed, M. H.
    Ain Shams Univ, Cairo, Egypt.
    Ergor, G.
    Dokuz Eylul Univ, Izmir, Turkey.
    Esmat, G.
    Cairo Univ, Cairo, Egypt.
    Estes, C.
    Ctr Dis Anal CDA, Louisville CO, USA.
    Falconer, K.
    Infect Dis Unit, Dept Med Huddinge, Karolinska Inst, Stockholm, Sweden.
    Felix, J.
    Exigo Consultores, Alhos Vedros, Portugal.
    Ferraz, M. L. G.
    Div Gastroenterol, Univ Fed Sao Paulo, Sao Paulo, Brazil.
    Ferreira, P. R.
    Div Infect Dis, Univ Fed Sao Paulo, Sao Paulo, Brazil.
    Frankova, S.
    Dept Hepatogastroenterol, Inst Clin & Expt Med, Prague, Czech Republic.
    Garcia-Samaniego, J.
    Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBEREHD), Hosp Carlos III, Madrid, Spain.
    Gerstoft, J.
    Univ Copenhagen, Copenhagen, Denmark.
    Giria, J. A.
    Direccao Geral Saude, Lisbon, Portugal.
    Goncales, F. L., Jr.
    Fac Ciencias Med, UNICAMP,Dept Clin Med, Grp Estudo Hepatites,Disciplina Doencas Infeccios, Univ Estadual Campinas, Sao Paulo, Brazil.
    Gower, E.
    Ctr Dis Anal CDA, Louisville CO, USA.
    Gschwantler, M.
    Dept Internal Med 4, Wilhelminenspital Stadt Wien, Vienna, Austria.
    Guimaraes Pessoa, M.
    Sch Med, Div Gastroenterol & Hepatol, Univ Sao Paulo, Sao Paulo, Brazil.
    Hezode, C.
    Serv Hepatogastroenterol, Hop Henri Mondor, Creteil, France.
    Hofer, H.
    Dept Internal Med 3, Div Gastroenterol & Hepatol, Med Univ Vienna, Vienna, Austria.
    Husa, P.
    Clin Infect Dis, Univ Hosp Brno, Masaryk Univ, Brno, Czech Republic.
    Idilman, R.
    Dept Gastroenterol, Sch Med, Ankara Univ, Ankara, Turkey.
    Kåberg, M.
    Infect Dis Unit, Dept Med Huddinge, Karolinska Inst, Stockholm, Sweden.
    Kaita, K. D. E.
    Dept Internal Med, Sect Hepatol, Univ Manitoba, Winnipeg MB, Canada; Viral Hepatitis Invest Unit, Hlth Sci Ctr, Winnipeg MB, Canada.
    Kautz, A.
    European Liver Patients Assoc, St Truiden, Belgium.
    Kaymakoglu, S.
    Istanbul Univ, Istanbul, Turkey.
    Krajden, M.
    British Columbia Ctr Dis Control, Univ British Columbia, Vancouver, Canada.
    Krarup, H.
    Dept Med Gastroenterol, Aalborg Univ Hosp, Aalborg, Denmark; Sect Mol Diagnost, Aalborg Univ Hosp, Aalborg, Denmark.
    Laleman, W.
    Univ Hosp Leuven, Katholieke Univ Leuven, Louvain, Belgium.
    Lavanchy, D.
    Lazaro, P.
    Adv Tech Hlth Serv Res TAISS, Madrid, Spain.
    Marotta, P.
    Div Gastroenterol, Univ Western Ontario, London ON, Canada.
    Mauss, S.
    Univ Dusseldorf, Dusseldorf, Germany.
    Mendes Correa, M. C.
    Sch Med, Univ Sao Paulo, Sao Paulo, Brazil.
    Muellhaupt, B.
    Swiss HPB Hepatopancreatobiliary Ctr, Univ Zurich Hosp, Zurich, Switzerland; Dept Gastroenterol & Hepatol, Univ Zurich Hosp, Zurich, Switzerland.
    Myers, R. P.
    Liver Unit, Div Gastroenterol & Hepatol, Univ Calgary, Calgary AB, Canada.
    Negro, F.
    Div Gastroenterol & Hepatol, Univ Hosp, Geneva, Switzerland; Div Clin Pathol,Univ Hosp, Geneva, Switzerland.
    Nemecek, V.
    Natl Reference Lab Hepatitis, Natl Inst Publ Hlth, Prague, Czech Republic.
    Ormeci, N.
    Ankara Univ, Ankara, Turkey.
    Parkes, J.
    Univ Southhampton, Southampton, England.
    Peltekian, K. M.
    Dept Med, Halifax, NS, Canada; Dept Surg, Dalhousie Univ, Halifax, Canada; Serv Hepatol, Queen Elizabeth II Hlth Sci Ctr, Capital Dist Hlth Author, Halifax NS, Canada.
    Ramji, A.
    Dept Gastroenterol, Univ British Columbia, Vancouver, Canada.
    Razavi, H.
    Ctr Dis Anal CDA, Louisville CO, USA.
    Reis, N.
    Assembleia Republ, Lisbon, Portugal.
    Roberts, S. K.
    Alfred Hosp, Melbourne Vic, Australia; Monash Univ, Melbourne, Australia.
    Rosenberg, W. M.
    Inst Liver & Digest Hlth, Div Med, University College London (UCL), London, England.
    Sarmento-Castro, R.
    Dept Infect Dis, Ctr Hosp Porto, Oporto, Portugal.
    Sarrazin, C.
    JW Goethe Univ Hosp, Frankfurt, Germany.
    Semela, D.
    Div Gastroenterol & Hepatol, Cantonal Hosp St Gallen, St Gallen, Switzerland.
    Shiha, G. E.
    Egyptian Liver Res Inst & Hosp ELRIAH, Dakahliah, Egypt.
    Sievert, W.
    Monash Univ, Melbourne, Australia; Monash Hlth, Melbourne Vic, Australia.
    Starkel, P.
    Clin Univ St Luc, Catholic Univ Louvain, Brussels, Belgium.
    Stauber, R. E.
    Dept Internal Med, Div Gastroenterol & Hepatol, Med Univ Graz, Graz, Austria.
    Thompson, A. J.
    Dept Gastroenterol, St Vincents Hosp, Melbourne Vic, Australia; Univ Melbourne, Melbourne Vic, Australia.
    Urbanek, P.
    Dept Internal Med, Fac Med 1, Charles Univ Prague, Prague, Czech Republic; Cent Mil Hosp, Prague, Czech Republic.
    van Thiel, I.
    St Truiden, Belgium; Deutsch Leberhilfe eV, European Liver Patients Assoc, Cologne, Germany.
    Van Vlierberghe, H.
    Ghent Univ Hosp, Ghent, Belgium.
    Vandijck, D.
    Ghent Univ Hosp, Ghent, Belgium; Univ Ghent, Ghent, Belgium; Dept Hlth Econ & Patient Safety, Hasselt Univ, Diepenbeek, Belgium.
    Vogel, W.
    Med Univ Innsbruck, Innsbruck, Austria.
    Waked, I.
    Natl Liver Inst, Menoufia, Egypt.
    Wedemeyer, H.
    Dept Gastroenterol Hepatol & Endocrinol, Hannover Med Sch, Hannover, Germany; German Liver Fdn, Hannover, Germany.
    Weis, N.
    Copenhagen Univ Hosp, Hvidovre, Denmark.
    Wiegand, J.
    Univ Leipzig, Leipzig, Germany.
    Yosry, A.
    Cairo Univ, Cairo, Egypt.
    Zekry, A.
    St George Hosp Clin Sch Med, Univ New S Wales, Sydney NSW, Australia; Sch Med Sci, Univ New S Wales, Sydney NSW, Australia.
    Van Damme, P.
    Univ Antwerp, Antwerp, Belgium.
    Aleman, S.
    Dept Med Huddinge, Karolinska Inst, Stockholm, Sweden; Dept Gastroenterol & Hepatol Infect Dis, Karolinska Univ Hosp, Stockholm, Sweden.
    Hindman, S. J.
    Ctr Dis Anal CDA, Louisville CO, USA.
    Historical epidemiology of hepatitis C virus (HCV) in selected countries2014In: Journal of Viral Hepatitis, ISSN 1352-0504, E-ISSN 1365-2893, Vol. 21, p. 5-33Article in journal (Refereed)
    Abstract [en]

    Chronic infection with hepatitis C virus (HCV) is a leading indicator for liver disease. New treatment options are becoming available, and there is a need to characterize the epidemiology and disease burden of HCV. Data for prevalence, viremia, genotype, diagnosis and treatment were obtained through literature searches and expert consensus for 16 countries. For some countries, data from centralized registries were used to estimate diagnosis and treatment rates. Data for the number of liver transplants and the proportion attributable to HCV were obtained from centralized databases. Viremic prevalence estimates varied widely between countries, ranging from 0.3% in Austria, England and Germany to 8.5% in Egypt. The largest viremic populations were in Egypt, with 6358000 cases in 2008 and Brazil with 2106000 cases in 2007. The age distribution of cases differed between countries. In most countries, prevalence rates were higher among males, reflecting higher rates of injection drug use. Diagnosis, treatment and transplant levels also differed considerably between countries. Reliable estimates characterizing HCV-infected populations are critical for addressing HCV-related morbidity and mortality. There is a need to quantify the burden of chronic HCV infection at the national level.

  • 47.
    Burisch, J.
    et al.
    Gastrounit, Medical section, Hvidovre University Hospital, Hvidovre, Denmark.
    Kaimakliotis, I.
    Nicosia Private practice, Nicosia, Cyprus.
    Duricova, D.
    IBD Center ISCARE, Charles University, Prague, Czech Republic.
    Kievit, L.
    Department of medicine, Herning Central Hospital, Herning, Denmark.
    Dahlerup, J. F.
    Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
    Salupere, R.
    Division of Endocrinology and Gastroenterology, Tartu University Hospital, Tartu, Estonia.
    Nielsen, K. R.
    Medical Department, The National Hospital of the Faroe Islands, Thorshavn, Denmark.
    Manninen, P.
    Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
    Tsianos, E. V.
    1st Division of Internal Medicine and Hepato-Gastroenterology Unit, University Hospital, Ioannina, Greece.
    Vegh, Z.
    1st Department of Medicine, Semmelweis University, Budapest, Hungary.
    Odes, S.
    Department of Gastroenterology and Hepatology, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel.
    D'Inca, R.
    EpiCom Northern Italy, Florence, Forlì and Padova, Italy.
    Kupcinskas, L.
    Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Turcan, S.
    Department of Gastroenterology, Chisinau, State University of Medicine and Pharmacy of the Republic of Moldova, Moldova, Republic of Moldova.
    Magro, F.
    Institute for molecular and cell biology, University of Porto, Porto, Portugal; Department of Gastroenterology, Hospital de São João, Porto, Portugal; Institute of Pharmacology and Therapeutics, Oporto Medical School, Porto, Portugal.
    Goldis, A.
    Clinic of Gastroenterology, University of Medicine Victor Babes, Timisoara, Romania.
    Hernandez, V.
    Gastroenterology Department, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
    Halfvarson, Jonas
    Örebro University, School of Medicine, Örebro University, Sweden.
    Arebi, N.
    Gastroenterology, St Mark's Hospital, London, United Kingdom.
    Langholz, E.
    Department of Medical Gastroenterology, Gentofte Hospital, Copenhagen, Denmark.
    Lakatos, P. L.
    1st Department of Medicine, Semmelweis University, Budapest, Hungary.
    Munkholm, P.
    Department of gastroenterology, Herlev University Hospital, Herlev, Denmark.
    EpiCom Northern Italy, Group author
    Unchanged surgery and hospitalization rates in an East-West European inception cohort despite differences in use of biologicals-3-year follow-up of the ECCO-EpiCom cohort2015In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 9, p. S5-S6Article in journal (Other academic)
  • 48.
    Burisch, J.
    et al.
    Med Sect, Ctr Digest Dis, Herlev Univ Hosp, Copenhagen, Denmark.
    Vegh, Z.
    Med Sect, Ctr Digest Dis, Herlev Univ Hosp, Copenhagen, Denmark; Dept Med 1, Semmelweis Univ, Budapest, Hungary.
    Pedersen, N.
    Med Sect, Ctr Digest Dis, Herlev Univ Hosp, Copenhagen, Denmark.
    Cukovic-Cavka, S.
    Univ Hosp Ctr Zagreb, Div Gastroenterol & Hepatol, Univ Zagreb Sch Med, Zagreb, Croatia.
    Turk, N.
    Univ Hosp Ctr Zagreb, Div Gastroenterol & Hepatol, Univ Zagreb Sch Med, Zagreb, Croatia.
    Kaimakliotis, I.
    Duricova, D.
    IBD Ctr ISCARE, Charles Univ, Prague, Czech Republic.
    Bortlik, M.
    IBD Ctr ISCARE, Charles Univ, Prague, Czech Republic.
    Shonova, O.
    Dept Gastroenterol, Hosp Ceske Budejovice, Ceske Budejovice, Czech Republic.
    Thorsgaard, N.
    Dept Med, Cent Hosp, Herning, Denmark.
    Krabbe, S.
    Dept Med, Reg Hosp, Viborg, Denmark.
    Andersen, V.
    Dept Med, Reg Hosp, Viborg, Denmark; Dept Med, Hosp Southern Jutland, Aabenraa, Denmark; Inst Reg Hlth Res, Univ Southern Denmark, Odense, Denmark.
    Dahlerup, J. F.
    Dept Med Hepatol & Gastroenterol 5, Aarhus Univ Hosp, Aarhus, Denmark.
    Kjeldsen, J.
    Dept Med Gastroenterol, Univ Hosp, Odense, Denmark.
    Salupere, R.
    Div Gastroenterol & Endocrinol, Univ Hosp, Tartu, Estonia.
    Olsen, J.
    Dept Med, Natl Hosp Faroe Isl, Torshavn, Denmark.
    Nielsen, K. R.
    Dept Med, Natl Hosp Faroe Isl, Torshavn, Denmark.
    Manninen, P.
    Dept Gastroenterol & Alimentary Tract Surg, Univ Hosp, Tampere, Finland.
    Collin, P.
    Dept Gastroenterol & Alimentary Tract Surg, Univ Hosp, Tampere, Finland.
    Katsanos, K. H.
    Sch Med, Div Internal Med 1, Univ Ioannina, Ioannina, Greece; Sch Med, Div Gastroenterol, Univ Ioannina, Ioannina, Greece.
    Tsianos, E. V.
    Sch Med, Div Internal Med 1, Univ Ioannina, Ioannina, Greece; Sch Med, Div Gastroenterol, Univ Ioannina, Ioannina, Greece.
    Ladefoged, K.
    Dept Med, Dronning Ingrids Hosp, Nuuk, Greenland.
    Ragnarsson, G.
    Sect Gastroenterol & Hepatol, Dept Internal Med, Natl Univ Hosp, Reykjavik, Iceland.
    Björnsson, E.
    Sect Gastroenterol & Hepatol, Dept Internal Med, Natl Univ Hosp, Reykjavik, Iceland.
    Bailey, Y.
    Dept Gastroenterol, Adelaide & Meath Hosp, Trinity College Dublin, Dublin, Ireland.
    O'Morain, C.
    Dept Gastroenterol, Adelaide & Meath Hosp, Trinity College Dublin, Dublin, Ireland.
    Schwartz, D.
    Odes, S.
    Dept Gastroenterol & Hepatol, Soroka Med Ctr, Beer Sheva, Israel; Ben Gurion Univ Negev, Beer Sheva, Israel .
    Politi, S. P.
    UO Med Interna & Gastroenterol, Azienda Osped Istituti Ospitalieri Cremona, Cremona, Italy; EpiCom Northern Italy Ctr, Crema Cremona, Italy; EpiCom Northern Italy Ctr, Florence, Italy; EpiCom Northern Italy Ctr, Forli, Italy; EpiCom Northern Italy Ctr, Padua, Italy; EpiCom Northern Italy Ctr, Reggio Emilia, Italy .
    Santini, A.
    Gastroenterol Unit, Careggi Hosp, Florence, Italy; EpiCom Northern Italy Ctr, Crema Cremona, Italy; EpiCom Northern Italy Ctr, Florence, Italy; EpiCom Northern Italy Ctr, Forli, Italy; EpiCom Northern Italy Ctr, Padua, Italy; EpiCom Northern Italy Ctr, Reggio Emilia, Italy .
    Kiudelis, G.
    Inst Digest Res, Lithuanian Univ Hlth Sci, Kaunas, Lithuania.
    Kupcinskas, L.
    Inst Digest Res, Lithuanian Univ Hlth Sci, Kaunas, Lithuania.
    Turcan, S.
    State Univ Med & Pharm Republ Moldova, Dept Gastroenterol, Kishinev, Moldova.
    Magro, F.
    Hosp Sao Joao, Dept Gastroenterol, Oporto, Portugal; Inst Pharmacol & Therapeut, Oporto Med Sch, Oporto, Portugal; Inst Mol & Cell Biol, Univ Porto, Oporto, Portugal.
    Barros, L.
    Hosp Vale Sousa, Oporto, Portugal.
    Lazar, D.
    Gastroenterol Clin, Univ Med Victor Babes, Timisoara, Romania.
    Goldis, A.
    Gastroenterol Clin, Univ Med Victor Babes, Timisoara, Romania.
    Nikulina, I.
    Dept Gastroenterol, Moscow Reg Res Clin Inst, Moscow, Russia.
    Belousova, E.
    Moscow Reg Res Clin Inst, Dept Gastroenterol, Moscow, Russia.
    Sanroman, L.
    Dept Gastroenterol, Complexo Hosp Univ Vigo, Vigo, Spain.
    Martinez-Ares, D.
    Dept Gastroenterol, Complexo Hosp Univ Vigo, Vigo, Spain.
    Almer, S.
    Dept Med, Div Gastroenterol & Hepatol, Karolinska Inst, Stockholm, Sweden; Dept Gastroenterol UHL, Cty Council Ostergötland, Linköping, Sweden .
    Zhulina, Yaroslava
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Div Gastroenterol, Dept Med, Örebro Univ Hosp, Örebro, Sweden.
    Halfvarson, Jonas
    Örebro University, School of Medicine, Örebro University, Sweden. Div Gastroenterol, Dept Med, Örebro Univ Hosp, Örebro, Sweden.
    Arebi, N.
    St Marks Hosp, Sir Alan Parks Physiol Unit, Univ London Imperial Coll Sci Technol & Med, London, England.
    Houston, Y.
    Hull & East Yorkshire HNS Trust, Dept Gastroenterol, Kingston Upon Hull, N Humberside, England.
    Sebastian, S.
    Hull & East Yorkshire NHS Trust, Hull Royal Infirm, Kingston Upon Hull, England; Hull & York Med Sch, Hull Royal Infirm, Kingston Upon Hull, England.
    Langholz, E.
    Dept Med Gastroenterol, Gentofte Univ Hosp, Copenhagen, Denmark.
    Lakatos, P. L.
    Dept Med 1, Semmelweis Univ, Budapest, Hungary.
    Munkholm, P.
    Med Sect, Ctr Digest Dis, Herlev Univ Hosp, Copenhagen, Denmark.
    Health care and patients' education in a European inflammatory bowel disease inception cohort: an ECCO-EpiCom study2014In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 8, no 8, p. 811-818Article in journal (Refereed)
    Abstract [en]

    Background and Aims: The EpiCom study and inception cohort was initiated in 2010 in 31 centers from 14 Western and 8 Eastern European countries, covering a 10.1 million person background population. Our aim was to investigate whether there is a difference between Eastern and Western Europe in health care and education of patients with inflammatory bowel disease (IBD).

    Methods: A quality of care (QoC) questionnaire was developed in the EpiCom group consisting of 16 questions covering 5 items: time interval between the onset of symptoms and diagnosis, information, education, empathy and access to health care providers.

    Results: Of 1,515 patients, 947 (217 east/730 west) answered the QoC questionnaire. Only 23% of all patients had knowledge about IBD before diagnosis. In Eastern Europe, significantly more patients searched out information about IBD themselves (77% vs. 68%, p < 0.05), the main source was the Internet (92% vs. 88% p = 0.23). In Western Europe, significantly more patients were educated by nurses (19% vs. 1%, p < 0.05), while in Eastern Europe, gastroenterologists were easier to contact (80% vs. 68%, p < 0.05).

    Conclusion: Health care differed significantly between Eastern and Western Europe in all items, but satisfaction rates were high in both geographic regions. Because of the low awareness and the rising incidence of IBD, general information should be the focus of patient organizations and medical societies. In Western Europe IBD nurses play a very important role in reducing the burden of patient management. (c) 2014 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  • 49.
    Burisch, Johan
    et al.
    Med Sect, Ctr Digest Dis, Herlev Univ Hosp, Copenhagen, Denmark.
    Pedersen, Natalia
    Med Sect, Ctr Digest Dis, Herlev Univ Hosp, Copenhagen, Denmark.
    Cukovic-Cavka, Silvja
    Univ Hosp Ctr Zagreb, Div Gastroenterol & Hepatol, Univ Zagreb School of Medicine, Zagreb, Croatia.
    Turk, Niksa
    Univ Hosp Ctr Zagreb, Div Gastroenterol & Hepatol, Univ Zagreb School of Medicine, Zagreb, Croatia.
    Kaimakliotis, Ioannis
    Nicosia Private Practice, Nicosia, Cyprus.
    Duricova, Dana
    IBD Ctr ISCARE, Charles Univ Prague, Prague, Czech Republic.
    Shonova, Olga
    Dept Gastroenterol, Hosp Ceske Budejovice, Ceske Budejovice, Czech Republic.
    Vind, Ida
    Dept Med, Amager Hosp, Amager, Denmark.
    Avnstrom, Soren
    Dept Med, Amager Hosp, Amager, Denmark.
    Thorsgaard, Niels
    Dept Med, Herning Cent Hosp, Herning, Denmark.
    Krabbe, Susanne
    Dept Med, Viborg Reg Hosp, Viborg, Denmark.
    Andersen, Vibeke
    Medical Department, Viborg Regional Hospital, Viborg, Denmark; Medical Department, Hospital of Southern Jutland, Aabenraa, Denmark; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.
    Jens, Frederik Dahlerup
    Dept Med Hepatol & Gastroenterol 5, Aarhus Univ Hosp, Aarhus, Denmark.
    Kjeldsen, Jens
    Dept Med Gastroenterol, Odense Univ Hosp, Odense, Denmark.
    Salupere, Riina
    Div Gastroenterol & Endocrinol, Tartu Univ Hosp, Tartu, Estonia.
    Olsen, Jongero
    Dept Med, Natl Hosp Faroe Islands, Torshavn, Denmark.
    Nielsen, Kari Rubek
    Dept Med, Natl Hosp Faroe Islands, Torshavn, Denmark.
    Manninen, Pia
    Dept Gastroenterol & Alimentary Tract Surg, Tampere Univ Hosp, Tampere, Finland.
    Collin, Pekka
    Dept Gastroenterol & Alimentary Tract Surg, Tampere Univ Hosp, Tampere, Finland.
    Katsanos, Konstantinnos H.
    Div Internal Med 1, Univ Hosp, Ioannina, Greece ; Hepatogastroenterol Unit, Univ Hosp, Ioannina, Greece.
    Tsianos, Epameinondas V.
    Div Internal Med 1, Univ Hosp, Ioannina, Greece ; Hepatogastroenterol Unit, Univ Hosp, Ioannina, Greece.
    Ladefoged, Karin
    Dept Med, Dronning Ingrids Hosp, Nuuk, Greenland.
    Lakatos, Laszlo
    Dept Med, Csolnoky F Prov Hosp, Veszprem, Hungary.
    Bailey, Yvonne
    Adelaide & Meath Hosp, Dept Gastroenterol, Trinity Coll Dublin, Dublin, Ireland.
    O'Morain, Colm
    Dept Gastroenterol, Adelaide & Meath Hosp, Dublin, Ireland.
    Schwartz, Doron
    Dept Gastroenterol & Hepatol, Soroka Med Ctr, Beer Sheva, Israel; Ben Gurion Univ of the Negev, Beer Sheva, Israel .
    Odes, Selwyn
    Dept Gastroenterol & Hepatol, Soroka Med Ctr, Beer Sheva, Israel; Ben Gurion Univ of the Negev, Beer Sheva, Israel .
    Martinato, Matteo
    U.O. Gastroenterologia, Azienda Ospedaliera, Università di Padova, Padova, Italy.
    Lombardini, Silvia
    UO Medicina 38 e Gastroenterologia, Azienda Ospedaliera Arcispedale S Maria Nuova, Reggio Emilia, Italy.
    Jonaitis, Laimas
    Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Kupcinskas, Limas
    Department of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Moldova.
    Turcan, Svetlana
    Dept Gastroenterol, State Univ Med & Pharm Republ Moldova, Kishinev, Moldova.
    Barros, Louisa
    Dept Med, Hosp Vale de Sousa, Oporto, Portugal.
    Magro, Fernando
    Dept Gastroenterol, Hosp Sao Joao, Oporto, Portugal ; Inst Pharmacol & Therapeut, Oporto Med Sch, Oporto, Portugal ; Inst Mol & Cell Biol, Univ Porto, Oporto, Portugal .
    Lazar, Daniela
    Gastroenterol Clin, Univ Med 'Victor Babes', Timisoara, Romania.
    Goldis, Adrian
    Gastroenterol Clin, Univ Med 'Victor Babes', Timisoara, Romania.
    Nikulina, Inna
    Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russian Federation.
    Belousova, Elena
    Dept Gastroenterol, Moscow Reg Res Clin Inst, Moscow, Russia.
    Fernandez, Alberto
    Dept Gastroenterol, POVISA Hosp, Vigo, Spain.
    Hernandez, Vicent
    Dept Gastroenterol, Complexo Hospitalario Univ Vigo, Vigo, Spain.
    Almer, Sven
    Div Gastroenterol & Hepatol, Karolinska Instutue, Stockholm, Sweden ; Dept Gastroenterol UHL, Cty Council Östergötland,Linköping, Sweden .
    Zhulina, Yaroslava
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Div Gastroenterol, Dept Med, Örebro University Hospital, Örebro, Sweden.
    Halfvarson, Jonas
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital. Div Gastroenterol, Dept Med, Örebro University Hospital, Örebro, Sweden.
    Tsai, Her-Hsin
    Hull and East Yorkshire NHS Trust, Kingston-Upon-Hull, UK; Hull and York Medical School, Kingston-Upon-Hull, UK; Hull Royal Infirmary, Kingston-Upon-Hull, UK.
    Sebastian, Shaji
    Hull and East Yorkshire NHS Trust, Kingston-Upon-Hull, UK; Hull and York Medical School, Kingston-Upon-Hull, UK; Hull Royal Infirmary, Kingston-Upon-Hull, UK.
    Lakatos, Peter Laszlo
    Dept Med 1, Semmelweis Univ, Budapest, Hungary.
    Langholz, Ebbe
    Dept Med Gastroenterol, Gentofte Univ Hosp, Copenhagen, Denmark.
    Munkholm, Pia
    Med Sect, Ctr Digest Dis, Herlev Univ Hosp, Copenhagen, Denmark.
    EpiCom Northern Italy Centre Based in Crema and Cremona, Padova and Reggio Emilia, Italy (Lombardini & Martinato, on behalf of ), Group author
    Initial Disease Course and Treatment in an Inflammatory Bowel Disease Inception Cohort in Europe: The ECCO-EpiCom Cohort2014In: Inflammatory Bowel Diseases, ISSN 1078-0998, E-ISSN 1536-4844, Vol. 20, no 1, p. 36-46Article in journal (Refereed)
    Abstract [en]

    Background:The EpiCom cohort is a prospective, population-based, inception cohort of inflammatory bowel disease (IBD) patients from 31 European centers covering a background population of 10.1 million. The aim of this study was to assess the 1-year outcome in the EpiCom cohort.

    Methods:Patients were followed-up every third month during the first 12 (3) months, and clinical data, demographics, disease activity, medical therapy, surgery, cancers, and deaths were collected and entered in a Web-based database (www.epicom-ecco.eu).

    Results:In total, 1367 patients were included in the 1-year follow-up. In western Europe, 65 Crohn's disease (CD) (16%), 20 ulcerative colitis (UC) (4%), and 4 IBD unclassified (4%) patients underwent surgery, and in eastern Europe, 12 CD (12%) and 2 UC (1%) patients underwent surgery. Eighty-one CD (20%), 80 UC (14%), and 13 (9%) IBD unclassified patients were hospitalized in western Europe compared with 17 CD (16%) and 12 UC (8%) patients in eastern Europe. The cumulative probability of receiving immunomodulators was 57% for CD in western (median time to treatment 2 months) and 44% (1 month) in eastern Europe, and 21% (5 months) and 5% (6 months) for biological therapy, respectively. For UC patients, the cumulative probability was 22% (4 months) and 15% (3 months) for immunomodulators and 6% (3 months) and 1% (12 months) for biological therapy, respectively in the western and eastern Europe.

    Discussion:In this cohort, immunological therapy was initiated within the first months of disease. Surgery and hospitalization rates did not differ between patients from eastern and western Europe, although more western European patients received biological agents and were comparable to previous population-based inception cohorts.

  • 50.
    Burisch, Johan
    et al.
    Digestive Disease Centre, Medical Section, Herlev University Hospital, Copenhagen, Denmark.
    Vardi, Hillel
    Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
    Pedersen, Natalia
    Digestive Disease Centre, Medical Section, Herlev University Hospital, Copenhagen, Denmark.
    Brinar, Marko
    Division of Gastroenterology and Hepatology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
    Cukovic-Cavka, Silvja
    Division of Gastroenterology and Hepatology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
    Kaimakliotis, Ioannis
    Private Practice, Nicosia, Cyprus.
    Duricova, Dana
    IBD Center ISCARE, Charles University, Prague, Czech Republic.
    Bortlik, Martin
    IBD Center ISCARE, Charles University, Prague, Czech Republic.
    Shonová, Olga
    Department of Gastroenterology, Hospital Ceske Budejovice, Ceske Budejovice, Czech Republic.
    Vind, Ida
    Department of Medicine, Amager Hospital, Amager, Denmark.
    Avnstrøm, Søren
    Department of Medicine, Amager Hospital, Amager, Denmark.
    Thorsgaard, Niels
    Department of Medicine, Herning Central Hospital, Herning, Denmark.
    Krabbe, Susanne
    Medical Department, Viborg Regional Hospital, Viborg, Denmark.
    Andersen, Vibeke
    Medical Department, Viborg Regional Hospital, Viborg, Denmark; Organ Center, Hospital of Southern Jutland, Aabenraa, Denmark; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.
    Dahlerup, Jens F
    Department of Medicine V (Hepatology and Gastroenterology), Aarhus University Hospital, Arhus, Denmark.
    Kjeldsen, Jens
    Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark.
    Salupere, Riina
    Division of Endocrinology and Gastroenterology, Tartu University Hospital, Tartu, Estonia.
    Olsen, Jónger
    Medical Department, The National Hospital of the Faroe Islands, Torshavn, Faroe Islands.
    Nielsen, Kári R
    Medical Department, The National Hospital of the Faroe Islands, Torshavn, Faroe Islands.
    Manninen, Pia
    Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
    Collin, Pekka
    Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
    Katsanos, Konstantinnos H
    First Division of Internal Medicine and Hepato-Gastroenterology Unit, University Hospital, Ioannina, Greece.
    Tsianos, Epameinondas V
    First Division of Internal Medicine and Hepato-Gastroenterology Unit, University Hospital, Ioannina, Greece.
    Ladefoged, Karin
    Medical Department, Dronning Ingrids Hospital, Nuuk, Greenland.
    Lakatos, Laszlo
    First Department of Medicine, Semmelweis University, Budapest, Hungary.
    Bailey, Yvonne
    Department of Gastroenterology, Adelaide and Meath Hospital, TCD, Dublin, Ireland.
    OʼMorain, Colm
    Department of Gastroenterology, Adelaide and Meath Hospital, TCD, Dublin, Ireland.
    Schwartz, Doron
    Department of Gastroenterology and Hepatology, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel.
    Lupinacci, Guido
    U.O. di Gastroenterologia e Endoscopia Digestiva, Az.Ospedaliera Ospedale Maggiore di Crema, Crema, Italy; EpiCom Northern Italy centre based in Crema and Cremona, Firenze, Forli, Padova and Reggio Emilia, Italy.
    De Padova, Angelo
    EpiCom Northern Italy centre based in Crema and Cremona, Firenze, Forli, Padova and Reggio Emilia, Italy; U.O. Gastroenterologia ed Endoscopia Digestiva, Ospedale Morgagni, Pierantoni, Forli, Italy.
    Jonaitis, Laimas
    Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Kupcinskas, Limas
    Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Turcan, Svetlana
    Department of Gastroenterology, State University of Medicine and Pharmacy of the Republic of Moldova, Chisinau, Republic of Moldova.
    Barros, Louisa
    Department of Medicine, Hospital de Vale de Sousa, Porto, Portugal.
    Magro, Fernando
    Department of Gastroenterology, Hospital de Sao Joao, Porto, Portugal; Institute of Pharmacology and Therapeutics, Oporto Medical School, Porto, Portugal; Institute for molecular and cell biology, University of Porto, Porto, Portugal.
    Lazar, Daniela
    Clinic of Gastroenterology, University of Medicine "Victor Babes," Timisoara, Romania.
    Goldis, Adrian
    Clinic of Gastroenterology, University of Medicine "Victor Babes," Timisoara, Romania.
    Nikulina, Inna
    Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russia.
    Belousova, Elena
    Department of Gastroenterology, Moscow Regional Research Clinical Institute, Moscow, Russia.
    Fernandez, Alberto
    Gastroenterology Department, POVISA Hospital, Vigo, Spain.
    Pineda, Juan R
    Gastroenterology Department, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
    Almer, Sven
    GastroCentrum, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Solna, Karolinska University Hospital, Stockholm, Sweden.
    Halfvarson, Jonas
    Örebro University, School of Medicine, Örebro University, Sweden. Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Tsai, Her-Hsin
    Hull and East Yorkshire NHS Trust and Hull and York Medical School, Hull Royal Infirmary, Hull, United Kingdom.
    Sebastian, Shaji
    Hull and East Yorkshire NHS Trust and Hull and York Medical School, Hull Royal Infirmary, Hull, United Kingdom.
    Friger, Michael
    Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
    Greenberg, Dan
    Department of Health Systems Management, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel; Guilford Glazer Faculty of Business and Management, Ben Gurion University of the Negev, Beer Sheva, Israel.
    Lakatos, Peter L
    First Department of Medicine, Semmelweis University, Budapest, Hungary.
    Langholz, Ebbe
    Department of Medical Gastroenterology, Gentofte Hospital, Copenhagen, Denmark.
    Odes, Selwyn
    Department of Gastroenterology and Hepatology, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel.
    Munkholm, Pia
    Digestive Disease Centre, Medical Section, Herlev University Hospital, Copenhagen, Denmark.
    Costs and resource utilization for diagnosis and treatment during the initial year in a European inflammatory bowel disease inception cohort: an ECCO-EpiCom Study2015In: Inflammatory Bowel Diseases, ISSN 1078-0998, E-ISSN 1536-4844, Vol. 21, no 1, p. 121-131Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: No direct comparison of health care cost in patients with inflammatory bowel disease across the European continent exists. The aim of this study was to assess the costs of investigations and treatment for diagnostics and during the first year after diagnosis in Europe.

    METHODS: The EpiCom cohort is a prospective population-based inception cohort of unselected inflammatory bowel disease patients from 31 Western and Eastern European centers. Patients were followed every third month from diagnosis, and clinical data regarding treatment and investigations were collected. Costs were calculated in euros (&OV0556;) using the Danish Health Costs Register.

    RESULTS: One thousand three hundred sixty-seven patients were followed, 710 with ulcerative colitis, 509 with Crohn's disease, and 148 with inflammatory bowel disease unclassified. Total expenditure for the cohort was &OV0556;5,408,174 (investigations: &OV0556;2,042,990 [38%], surgery: &OV0556;1,427,648 [26%], biologicals: &OV0556;781,089 [14%], and standard treatment: &OV0556;1,156,520 [22%)]). Mean crude expenditure per patient in Western Europe (Eastern Europe) with Crohn's disease: investigations &OV0556;1803 (&OV0556;2160) (P = 0.44), surgery &OV0556;11,489 (&OV0556;13,973) (P = 0.14), standard treatment &OV0556;1027 (&OV0556;824) (P = 0.51), and biologicals &OV0556;7376 (&OV0556;8307) (P = 0.31). Mean crude expenditure per patient in Western Europe (Eastern Europe) with ulcerative colitis: investigations &OV0556;1189 (&OV0556;1518) (P < 0.01), surgery &OV0556;18,414 (&OV0556;12,395) (P = 0.18), standard treatment &OV0556;896 (&OV0556;798) (P < 0.05), and biologicals &OV0556;5681 (&OV0556;72) (P = 0.51).

    CONCLUSIONS: In this population-based unselected cohort, costs during the first year of disease were mainly incurred by investigative procedures and surgeries. However, biologicals accounted for >15% of costs. Long-term follow-up of the cohort is needed to assess the cost-effectiveness of biological agents.

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