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  • 1.
    Abalo, Ernesto
    et al.
    Department of Communication and Behavioural Sciences, Jönköping University, Jönköping, Sweden.
    Olausson, Ulrika
    Jönköping University, School of Education and Communication, HLK, Media and Communication Studies, Jönköping, Sweden.
    An environmental problem in the making: how media logic molds scientific uncertainty in the production of news about artificial turf in Sweden2023Ingår i: Journal of Science Communication, E-ISSN 1824-2049, Vol. 22, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aims to contribute knowledge about how an environmental issue is discursively forged notwithstanding the prevalence of significant scientific uncertainty. This is done by studying the production of news about artificial turf as a microplastic pollutant in Sweden. Semi-structured interviews were conducted with 15 journalists and editors, public officials, politicians, industry representatives and experts, all involved in the issue of artificial turf. The study shows how media logic, among other factors, informs the interpretations of the uncertainties surrounding artificial turf as an environmental problem and concludes that the power of media logic needs to be considered also in the construction of other scientifically charged issues.

  • 2.
    Addjin-Tettey, Theodora Dame
    et al.
    Rhodes University, Makhanda, South Africa.
    Garman, Anthea
    Rhodes University, Makhanda, South Africa.
    Kruger, Franz
    Wits University, Johannesburg, South Africa.
    Olausson, Ulrika
    Jönköping University, School of Education and Communication, HLK, Media and Communication Studies, Jönköping, Sweden.
    Berglez, Peter
    Jönköping University, Jönköping, Sweden.
    Tallert, Lars
    Fojo Media Institute, Linnaeus University, Växjö, Sweden.
    Fritzon, Wilhelm
    Folke Bernadotte Academy, Stockholm, Sweden.
    Towards Sustainable Journalism in Sub-Saharan Africa2021Ingår i: Annual conference 2021 Bergen: Book of Abstract, 2021, s. 103-103Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Sustainable Journalism has been developed and advocated by Peter Berglez, Ulrika Olausson and Mart Ots to respond to present and future global sustainability challenges as well as future sustainability of journalism. The relevance and contribution of Sustainable Journalism as a concept and practice is twofold. First, the concept refers to a journalism that integrates the three sustainability dimensions and does not isolate environmental issues from social and economic conditions. Second, Sustainable Journalism also addresses two intertwined challenges of our time: the sustainability crisis of society and the sustainability crisis of journalism itself. Having been developed in the north and still in its epistemological infancy, we found a need to explore its various dimensions and applications further in the south. Consequently, we critically explored how sustainable journalisms hould be defined and practised in sub-Saharan Africa. Stakeholder discussions were held with journalists, news editors and representatives of media development organisations in Nigeria, Ghana, Liberia, and Kenya to ascertain what they made of Sustainable Journalism and its application in SSA. With the trend of political actors dominating media ownership, resulting in limited editorial independence and polarized media; and insufficient financial sustainability connected to poor quality reporting, among others, we propose that sustainable Journalism should be context driven. Consequently, all media environments should be encouraged to tailor their own way of practicing Sustainable Journalism based on their unique social, environmental and economic circumstances. We also suggest the establishment of a Sustainable Journalism Partnership in sub-Saharan Africa to enhance the development and implementation of the concept.

  • 3.
    Addjin-Tettey, Theodora Dame
    et al.
    School of Journalism and Media Studies, Rhodes University, South Africa.
    Garman, Anthea
    School of Journalism and Media Studies, Rhodes University, South Africa.
    Krüger, Franz
    Wits Radio Academy, University of the Witwatersrand, South Africa.
    Olausson, Ulrika
    Jönköping University, School of Education and Communication, HLK, Media and Communication Studies, Jönköping, Sweden.
    Berglez, Peter
    Jönköping University, School of Education and Communication, HLK, Media and Communication Studies, Jönköping, Sweden.
    Tallert, Lars
    Fojo Media Institute, Linnaeus University, Kalmar, Sweden.
    Berger, Guy
    UNESCO.
    Fritzon, Vilhelm
    Folke Bernadotte Academy (FBA), Swedish agency for peace, security and development, Stockholm, Sweden.
    Towards sustainable journalism in sub-Saharan Africa: Policy brief2021Rapport (Övrigt vetenskapligt)
    Abstract [en]

    In sub-Saharan Africa, Fojo Media Institute, Wits Journalism and four other organisations are jointly promoting independent journalism and protecting the space for civil society organisations and human rights defenders in the CHARM programme. Bringing together academics, media practitioners and researchers from four universities in South Africa and Sweden, the main objective of this policy brief is to introduce the concept of sustainable journalism, defining what the concept could entail in sub-Saharan Africa and investigating the implications for media development in this context. Stakeholder discussions on the subject matter were held with relevant media actors in four countries within sub-Saharan Africa. The findings, which provide clear policy recommendations, are shared in this report.  

    Ladda ner fulltext (pdf)
    Towards sustainable journalism in sub-Saharan Africa: Policy brief
  • 4.
    Al Dabbagh, Z.
    et al.
    Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
    Jansson, K. Å.
    Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
    Stiller, C. O.
    Department of Medicine, Clinical Pharmacology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Weiss, R. J.
    Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
    Long-term pattern of opioid prescriptions after femoral shaft fractures2016Ingår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 60, nr 5, s. 634-641Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The use of opioids in non-cancer-related pain following skeletal trauma is controversial due to the presumed risk of dose escalation and dependence. We therefore examined the pattern of opioid prescriptions, that is, those actually dispensed, in patients with femoral shaft fractures.

    Methods: We analysed data from the Swedish National Hospital Discharge Register and the Swedish Prescribed Drug Register between 2005 and 2008.

    Results: We identified 1471 patients with isolated femoral shaft fractures. The median age was 75 (16-102) years and 56% were female. In this cohort, 891 patients (61%) received dispensed opioid prescriptions during a median follow-up of 20 months (interquartile range 11-32). In the age- and sex-matched comparison cohort (7339 individuals) without fracture, 25% had opioid prescriptions dispensed during the same period. The proportions of patients receiving opioid analgesics at 6 and 12 months after the fracture were 45% (95% CI 42-49) and 36% (32-39), respectively. The median daily morphine equivalent dose (MED) was between 15 and 17 mg 1-12 months post-fracture. After 3 months, less than 5% used prescription doses higher than 20 mg MED per day. Older age (≥ 70 compared with < 70 years) was a significant predictor of earlier discontinuation of opioid use (Hazard ratio [HR] 1.9).

    Conclusion: A notable proportion of patients continued to receive dispensed prescriptions for opioids for over 6 months (45%) and more than a third of them (36%) continued treatment for at least 12 months. However, the risk of dose escalation seems to be small in opioid-naïve patients.

  • 5.
    Al Dabbagh, Zewar
    et al.
    Dept Mol Med & Surg, Sect Orthopaed & Sports Med, Karolinska Univ Hosp, Karolinska Inst, Stockholm, Sweden.
    Jansson, Karl-Åke
    Dept Mol Med & Surg, Sect Orthopaed & Sports Med, Karolinska Univ Hosp, Karolinska Inst, Stockholm, Sweden.
    Stiller, Carl-Olav
    Dept Med, Clin Pharmacol Unit, Karolinska Univ Hosp, Karolinska Inst, Stockholm, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Dept Med, Clin Epidemiol Unit, Karolinska Univ Hosp, Karolinska Inst, Stockholm, Sweden; Dept Epidemiol & Publ Hlth, University College London (UCL), London, England .
    Weiss, Rudiger J.
    Dept Mol Med & Surg, Sect Orthopaed & Sports Med, Karolinska Univ Hosp, Karolinska Inst, Stockholm, Sweden.
    No signs of dose escalations of potent opioids prescribed after tibial shaft fractures: a study of Swedish National Registries2014Ingår i: BMC Anesthesiology, ISSN 1471-2253, E-ISSN 1471-2253, Vol. 14, s. 4-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The pattern of opioid use after skeletal trauma is a neglected topic in pain medicine. The purpose of this study was to analyse the long-term prescriptions of potent opioids among patients with tibial shaft fractures.

    Methods: Data were extracted from the Swedish National Hospital Discharge Register, the National Pharmacy Register, and the Total Population Register, and analysed accordingly. The study period was 2005-2008.

    Results: We identified 2,571 patients with isolated tibial shaft fractures. Of these, 639 (25%) collected a prescription for opioids after the fracture. The median follow-up time was 17 (interquartile range [IQR] 7-27) months. Most patients with opioid prescriptions after fracture were male (61%) and the median age was 45 (16-97) years. The leading mechanism of injury was fall on the same level (41%). At 6 and 12 months after fracture, 21% (95% CI 17-24) and 14% (11-17) were still being treated with opioids. Multiple Cox regression-analysis (adjusted for age, sex, type of treatment, and mechanism of injury) revealed that older patients (age >50 years) were more likely to end opioid prescriptions (Hazard ratio 1.5 [95% CI 1.3-1.9]). During follow-up, the frequency of patients on moderate and high doses declined. Comparison of the daily morphine equivalent dose among individuals who both had prescriptions during the first 3 months and the 6th month indicated that the majority of these patients (11/14) did not have dose escalations.

    Conclusions: We did not see any signs in registry-data of major dose escalations over time in patients on potent opioids after tibial shaft fractures.

  • 6. Ali, Magdi M. M.
    et al.
    ElGhazali, Gehad
    Montgomery, Scott M.
    Örebro universitet, Hälsoakademin.
    Farouk, Salah E.
    Nasr, Amre
    Noori, Suzan I. A.
    Shamad, Mahdi M.
    Fadlelseed, Omar E.
    Berzins, Klavs
    Fc gamma RIIa (CD32) polymorphism and onchocercal skin disease: implications for the development of severe reactive onchodermatitis (ROD)2007Ingår i: American Journal of Tropical Medicine and Hygiene, ISSN 0002-9637, E-ISSN 1476-1645, Vol. 77, nr 6, s. 1074-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The pathologic manifestations of Onchocerca volvulus infection depend on the interplay between the host and the parasite. A genetic single nucleotide polymorphism in the Fc gamma RIIa gene, resulting in arginine (R) or histidine (H) at position 131, affects the binding to the different IgG subclasses and may influence the clinical variations seen in onchocerciasis. This study investigated the relationship between this polymorphism and disease outcome. Fc gamma RIIa genotyping was performed on clinically characterized onchocerciasis patients (N = 100) and healthy controls (N = 74). Fc gamma RIIa genotype R/R131 frequencies were significantly higher among patients with severe dermatopathology (P < 0.001). Increased risk of developing this form was mostly associated with one tribe (Masalit) (OR = 3.2, 95% CI 1-9.9, P = 0.042). The H131 allele was found to be significantly associated with a reduced risk of having the severe form of the disease (adjusted OR = 0.26, 95% CI = 0.13-0.46, P < 0.001). Our findings suggest that the polymorphism influences the clinical outcome of onchocerciasis.

  • 7. Amoudruz, Petra
    et al.
    Holmlund, Ulrika
    Schollin, Jens
    Örebro universitet, Hälsoakademin.
    Sverremark-Ekström, Eva
    Montgomery, Scott M.
    Örebro universitet, Hälsoakademin.
    Maternal country of birth and previous pregnancies are associated with breast milk characteristics2009Ingår i: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 20, nr 1, s. 19-29Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Populations in high infectious exposure countries are at low risk of some immune-mediated diseases such as Crohn's disease and allergy. This low risk is maintained upon immigration to an industrialized country, but the offspring of such immigrants have a higher immune-mediated disease risk than the indigenous population. We hypothesize that early life exposures in a developing country shape the maternal immune system, which could have implications for the offspring born in a developed country with a low infectious load. The aim of this study was to investigate if exposures in childhood (indicated by country of origin) and subsequent exposures influence immunologic characteristics relevant to stimulation of offspring. Breast milk components among 64 mothers resident in Sweden, 32 of whom immigrated from a developing country, were examined using the ELISA and Cytometric Bead Array methods. Immigrants from a developing country had statistically significantly higher levels of breast milk interleukin-6 (IL-6), IL-8 and transforming growth factor-beta1. A larger number of previous pregnancies were associated with down-regulation of several substances, statistically significant for soluble CD14 and IL-8. The results suggest that maternal country of birth may influence adult immune characteristics, potentially relevant to disease risk in offspring. Such a mechanism may explain the higher immune-mediated disease risk among children of migrants from a developing to developed country. Older siblings may influence disease risk through the action of previous pregnancies on maternal immune characteristics.

  • 8.
    Arribas, Christina
    et al.
    Department of Pediatrics, Neonatal Intensive Care Unit, Clínica Universidad de Navarra, Madrid, Spain.
    Cavallaro, Giacomo
    Neonatal Intensive Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy.
    Gonzalez, Juan-Luis
    Department of Statistics and Operations Research, Faculty of Medicine, University of Cadiz, Cádiz, Spain.
    Lagares, Carolina
    Department of Statistics and Operations Research, Faculty of Medicine, University of Cadiz, Cádiz, Spain.
    Raffaeli, Genny
    Neonatal Intensive Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy .
    Smits, Anne
    Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.
    Simons, Sinno H. P.
    Department of Pediatrics, Division of Neonatology, Erasmus University Medical Center—Sophia Children’s Hospital, Rotterdam, The Netherlands.
    Villamor, Eduardo
    MosaKids Children’s Hospital, Maastricht University Medical Center (MUMC + ), School for Oncology and Reproduction (GROW), Maastricht University, Maastricht, The Netherlands.
    Allegaert, Karel
    Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Department of Hospital Pharmacy, Erasmus MC, Rotterdam, The Netherlands; Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium .
    Garrido, Felipe
    Department of Pediatrics, Neonatal Intensive Care Unit, Clínica Universidad de Navarra, Madrid, Spain.
    Ullsten, Alexandra (Medarbetare/bidragsgivare)
    Örebro universitet, Institutionen för hälsovetenskaper.
    Olsson, Emma (Medarbetare/bidragsgivare)
    Örebro universitet, Institutionen för hälsovetenskaper.
    Gradin, Maria (Medarbetare/bidragsgivare)
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län.
    Carlsen Misic, Martina (Medarbetare/bidragsgivare)
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län.
    Montgomery, Scott (Medarbetare/bidragsgivare)
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Global cross-sectional survey on neonatal pharmacologic sedation and analgesia practices and pain assessment tools: impact of the sociodemographic index (SDI)2024Ingår i: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There is variability in the use of sedatives and analgesics in neonatal intensive care units (NICUs). We aimed to investigate the use of analgesics and sedatives and the management of neonatal pain and distress.

    Methods: This was a global, prospective, cross-sectional study. A survey was distributed May–November 2022. The primary outcome of this research was to compare results between countries depending on their socio-sanitary level using the sociodemographic index (SDI). We organized results based on geographical location.

    Results: The survey collected 1304 responses, but we analyzed 924 responses after database cleaning. Responses from 98 different countries were analyzed. More than 60% of NICUs reported having an analgosedation guideline, and one-third of respondents used neonatal pain scales in more than 80% of neonates. We found differences in the management of sedation and analgesia between NICUs on different continents, but especially between countries with different SDIs. Countries with a higher SDI had greater availability of and adherence to analgosedation guidelines, as well as higher rates of analgosedation for painful or distressing procedures. Countries with different SDIs reported differences in analgosedation for neonatal intubation, invasive ventilation, and therapeutic hypothermia, among others.

    Conclusions: Socio-economic status of countries impacts on neonatal analgosedation management.

  • 9.
    Athlin, Åsa
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Giezeman, Maaike
    Örebro universitet, Institutionen för medicinska vetenskaper. Centre foClinical Research, Region Värmland, Karlstad, Sweden.
    Hasselgren, Mikael
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College, London, UK.
    Lisspers, Karin
    Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
    Ställberg, Björn
    Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
    Janson, Christer
    Department of Medical Sciences, Respiratory, Allergy & Sleep Research, Uppsala University, Uppsala, Sweden.
    Sundh, Josefin
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Respiratory Medicine.
    Prediction of Mortality Using Different COPD Risk Assessments: A 12-Year Follow-Up2021Ingår i: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 16, s. 665-675Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: A multidimensional approach in the risk assessment of chronic obstructive pulmonary disease (COPD) is preferable. The aim of this study is to compare the prognostic ability for mortality by different COPD assessment systems; spirometric staging, classification by GOLD 2011, GOLD 2017, the age, dyspnea, obstruction (ADO) and the dyspnea, obstruction, smoking, exacerbation (DOSE) indices.

    Patients and Methods: A total of 490 patients diagnosed with COPD were recruited from primary and secondary care in central Sweden in 2005. The cohort was followed until 2017. Data for categorization using the different assessment systems were obtained through questionnaire data from 2005 and medical record reviews between 2000 and 2003. Kaplan-Meier survival analyses and Cox proportional hazard models were used to assess mortality risk. Receiver operating characteristic curves estimated areas under the curve (AUC) to evaluate each assessment systems´ ability to predict mortality.

    Results: By the end of follow-up, 49% of the patients were deceased. The mortality rate was higher for patients categorized as stage 3-4, GOLD D in both GOLD classifications and those with a DOSE score above 4 and ADO score above 8. The ADO index was most accurate for predicting mortality, AUC 0.79 (95% CI 0.75-0.83) for all-cause mortality and 0.80 (95% CI 0.75-0.85) for respiratory mortality. The AUC values for stages 1-4, GOLD 2011, GOLD 2017 and DOSE index were 0.73, 0.66, 0.63 and 0.69, respectively, for all-cause mortality.

    Conclusion: All of the risk assessment systems predict mortality. The ADO index was in this study the best predictor and could be a helpful tool in COPD risk assessment.

  • 10.
    Athlin, Åsa
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Lisspers, Karin
    Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
    Hasselgren, Mikael
    Örebro universitet, Institutionen för medicinska vetenskaper. Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden.
    Ställberg, Björn
    Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
    Janson, Christer
    Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Giezeman, Maaike
    Örebro universitet, Institutionen för medicinska vetenskaper. Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden.
    Kisiel, Marta
    Department of Medical Sciences, Occupational and Environment Medicine, Uppsala University, Uppsala, Sweden.
    Nager, Anna
    Division of Family Medicine and Primary Care, Inst NVS, Karolinska Institutet, Stockholm, Sweden.
    Sandelowsky, Hanna
    Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Division of Family Medicine and Primary Care, Inst NVS, Karolinska Institutet, Stockholm, Sweden; Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden.
    Arne, Mats
    Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden; Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
    Sundh, Josefin
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Respiratory Medicine.
    Diagnostic spirometry in COPD is increasing, a comparison of two Swedish cohorts2023Ingår i: npj Primary Care Respiratory Medicine, E-ISSN 2055-1010, Vol. 33, nr 1, artikel-id 23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Spirometry should be used to confirm a diagnosis of chronic obstructive pulmonary disease (COPD). This test is not always performed, leading to possible misdiagnosis. We investigated whether the proportion of patients with diagnostic spirometry has increased over time as well as factors associated with omitted or incorrectly interpreted spirometry. Data from medical reviews and a questionnaire from primary and secondary care patients with a doctors' diagnosis of COPD between 2004 and 2010 were collected. Data were compared with a COPD cohort diagnosed between 2000 and 2003. Among 703 patients with a first diagnosis of COPD between 2004 and 2010, 88% had a diagnostic spirometry, compared with 59% (p < 0.001) in the previous cohort. Factors associated with not having diagnostic spirometry were current smoking (OR 2.21; 95% CI 1.36-3.60), low educational level (OR 1.81; 1.09-3.02) and management in primary care (OR 2.28; 1.02-5.14). The correct interpretation of spirometry results increased (75% vs 82%; p = 0.010). Among patients with a repeated spirometry, 94% had a persistent FEV1/FVC or FEV1/VC ratio <0.70.

  • 11. Bahmanyar, S.
    et al.
    Montgomery, Scott M.
    Örebro universitet, Hälsoakademin.
    Hillert, J.
    Ekbom, A.
    Olsson, T.
    Cancer risk among patients with multiple sclerosis and their parents2009Ingår i: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 72, nr 13, s. 1170-1177Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: We investigated cancer risk among patients with multiple sclerosis (MS) and whether variation by age at MS diagnosis helps to elucidate mechanisms underlying the previously reported reduced cancer risk. We also studied cancer risk among parents to ascertain if MS susceptibility genes may confer protection against cancer in relatives. METHODS: Cox proportional hazards regression, adjusted for age, sex, area, and socioeconomic index, estimated cancer risk among 20,276 patients with MS and 203,951 individuals without MS, using Swedish general population register data. Similar analyses were conducted among 11,284 fathers and 12,006 mothers of patients with MS, compared with 123,158 fathers and 129,409 mothers of controls. RESULTS: With an average of 35 years of follow-up, there was a decreased overall cancer risk among patients with MS (hazard ratio = 0.91, 0.87-0.95). Increased risks were observed for brain tumors (1.44, 1.21-1.72) and urinary organ cancer (1.27, 1.05-1.53). Parents of patients with MS did not have a notably increased or decreased overall cancer risk. CONCLUSIONS: The reduction in cancer risk in patients with multiple sclerosis (MS) may result from behavioral change, treatment, or we speculate that some immunologic characteristics of MS disease activity improve antitumor surveillance. The lack of association among parents indicates that a simple inherited characteristic is unlikely to explain the reduced cancer risk among patients with MS. MS is associated with increased risk for some cancers, such as of urinary organs and brain tumors (although surveillance bias may be responsible).

  • 12.
    Bahmanyar, Shahram
    et al.
    Clinical Epidemiology Unit, Department of Medicine, Karolinska Hospital, Stockholm, Sweden; Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
    Ekbom, Anders
    Clinical Epidemiology Unit, Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
    Askling, Johan
    Clinical Epidemiology Unit, Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
    Johannesson, Marie
    Department, Paediatrics and Child Health, University of Otago, Wellington, New Zealand.
    Montgomery, Scott M.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Clinical Epidemiology Unit, Department of Medicine, Karolinska Hospital, Stockholm, Sweden; Department of Primary Care and Social Medicine, Charing Cross Hospital, Imperial College, London, United Kingdom.
    Cystic fibrosis gene mutations and gastrointestinal diseases2010Ingår i: Journal of Cystic Fibrosis, ISSN 1569-1993, E-ISSN 1873-5010, Vol. 9, nr 4, s. 288-291Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: This study examined if CF mutation heterozygosity is associated with diseases of gastrointestinal epithelial barrier function. Design and methods: Swedish registers identified 865 patients with a diagnosis of CF between 1968 and 2003 and matched with 8101 individuals without CF. Gastrointestinal disease risk was examined among 1534 biological parents and 1396 siblings of CF patients, compared with 15,526 parents and 15,542 siblings of individuals without CF. Results: First-degree relatives of CF patients were not at lower risk of the gastrointestinal diseases, in contrast with a raised risk among CF patients. Conclusion: Heterozygosity for CF gene mutations does not protect against gastrointestinal diseases where impaired barrier function may be relevant. (C) 2010 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  • 13. Bahmanyar, Shahram
    et al.
    Montgomery, Scott M.
    Örebro universitet, Hälsoakademin.
    Weiss, Rüdiger J.
    Ekbom, Anders
    Maternal smoking during pregnancy, other prenatal and perinatal factors, and the risk of Legg-Calvé-Perthes disease2008Ingår i: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 122, nr 2, s. e459-e464Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The causes of Legg-Calvé-Perthes disease are largely unknown, but this pediatric disease seems to result from interruption of the blood supply to the proximal femur and is considered a vascular disease. Because maternal smoking during pregnancy influences fetal development and is associated with cardiovascular diseases in offspring, we hypothesized that this exposure is a risk for Legg-Calvé-Perthes disease and also investigated other markers of impaired fetal development and early-life exposures.

    MATERIALS AND METHODS: The Swedish Inpatient Register identified 852 individuals with a diagnosis of Legg-Calvé-Perthes disease from 1983 to 2005, individually matched by year of birth, age, sex, and region of residence with 4432 randomly selected control subjects. Linkage with the Swedish Medical Birth Register provided information on prenatal factors, including maternal smoking. Conditional logistic regression examined associations of maternal smoking during pregnancy and the other measures with the risk of Legg-Calvé-Perthes disease in offspring, adjusted for socioeconomic index and other potential confounding factors.

    RESULTS: Maternal smoking during pregnancy was associated with an increased Legg-Calvé-Perthes disease risk, and heavy smoking was associated with a risk increase of almost 100%. Very low birth weight and cesarean section were independently associated with approximately 240% and 36% increases in the risk of Legg-Calvé-Perthes disease, respectively.

    CONCLUSION: Maternal smoking during pregnancy and other factors indicated by impaired fetal development may be associated with an increased risk of Legg-Calvé-Perthes disease. 

  • 14.
    Batyrbekova, Nurgul
    et al.
    Department of Biostatistics, Scandinavian Development Services AB.
    Aleman, Soo
    Karolinska Institute, Stockholm, Sweden.
    Lybeck, Charlotte
    Örebro universitet, Institutionen för medicinska vetenskaper. Infectious Diseases.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Duberg, Ann-Sofi
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Hepatitis C virus infection and the temporal trends in the risk of liver cancer: a national register-based cohort study in Sweden2020Ingår i: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 29, nr 1, s. 63-70Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: In many countries, including Sweden, the birth cohorts with the highest prevalence of hepatitis C virus (HCV) infection have now reached the ages with high risk of primary liver cancer (PLC). The aims were to investigate the temporal trends in PLC incidence and the relative risks of PLC among people diagnosed with HCV-infection between 1990 and 2015.

    METHODS: The HCV-cohort (n: 52,853) was compared with a matched non-HCV comparison-cohort (n: 523,649). Both the Cancer (CR) and Death registers (DR) were used for follow-up. The crude and age-standardised PLC incidence rates were calculated. The relative risk was estimated as standardized incidence ratios (SIR) and as hazard ratios (HR) using stratified Cox hazards regression.

    RESULTS: There were 1,609 with PLC-diagnosis in the HCV-cohort, the annual number increased continuously with the crude incidence rate reaching 4.56 per 1,000 person-years in 2013, while remaining low and stable in the comparison-cohort. In the HCV-cohort, the age-standardised PLC incidence rates per 1,000 person-years remained relatively constant at 2.64 (95% CI: 1.54, 3.75) in 2000 and 3.31 (2.51, 4.12) in 2014. The highest SIR was 73 (65.9, 79.5) among those infected for 35-40 years; and the highest HR was 65.9 (55.9, 77.6) for men and 62.2 (31.9, 121.1) for women.

    CONCLUSIONS: There was a considerable increase in PLC-incidence over time and an extremely high relative risk in the population with HCV-infection for more than 35 years.

    IMPACT: The national HCV-associated PLC-incidence should be monitored in future studies to evaluate the effect of DAA-treatment.

  • 15.
    Bejerot, Susanne
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Faculty of Health and Medical Sciences, University Health Care Research Centre, Örebro University, Örebro, Sweden.
    Eklund, Daniel
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Hesser, Hugo
    Örebro universitet, Institutionen för beteende-, social- och rättsvetenskap.
    Hietala, Max Albert
    Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
    Kariis, Tarmo
    Karlstad Central Hospital, Region Värmland, Karlstad, Sweden.
    Lange, Niclas
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Lebedev, Alexander
    Center for Psychiatry Research (CPF), Center for Cognitive and Computational Neuropsychiatry (CCNP), Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Nordenskjöld, Axel
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Petrovic, Predrag
    Center for Psychiatry Research (CPF), Center for Cognitive and Computational Neuropsychiatry (CCNP), Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Söderbergh, Annika
    Department of Rheumatology, Örebro University Hospital, Örebro, Sweden.
    Thunberg, Per
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Radiology and Medical Physics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Center for Experimental and Biomedical Imaging in Örebro (CEBIO), Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Wikström, Sverre
    Örebro universitet, Institutionen för medicinska vetenskaper. Centre for Clinical Research, County Council of Värmland, Karlstad, Sweden.
    Humble, Mats B.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Study protocol for a randomized controlled trial with rituximab for psychotic disorder in adults (RCT-Rits)2023Ingår i: BMC Psychiatry, E-ISSN 1471-244X, Vol. 23, nr 1, artikel-id 771Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The role of inflammation in the aetiology of schizophrenia has gained wide attention and research on the association shows an exponential growth in the last 15 years. Autoimmune diseases and severe infections are risk factors for the later development of schizophrenia, elevated inflammatory markers in childhood or adolescence are associated with a greater risk of schizophrenia in adulthood, individuals with schizophrenia have increased levels of pro-inflammatory cytokines compared to healthy controls, and autoimmune diseases are overrepresented in schizophrenia. However, treatments with anti-inflammatory agents are so far of doubtful clinical relevance. The primary objective of this study is to test whether the monoclonal antibody rituximab, directed against the B-cell antigen CD20 ameliorates psychotic symptoms in adults with schizophrenia or schizoaffective disorder and to examine potential mechanisms. A secondary objective is to examine characteristics of inflammation-associated psychosis and to identify pre-treatment biochemical characteristics of rituximab responders. A third objective is to interview a subset of patients and informants on their experiences of the trial to obtain insights that rating scales may not capture.

    METHODS: A proof-of-concept study employing a randomised, parallel-group, double-blind, placebo-controlled design testing the effect of B-cell depletion in patients with psychosis. 120 participants with a diagnosis of schizophrenia spectrum disorders (SSD) (ICD-10 codes F20, F25) will receive either one intravenous infusion of rituximab (1000 mg) or saline. Psychiatric measures and blood samples will be collected at baseline, week 12, and week 24 post-infusion. Brief assessments will also be made in weeks 2 and 7. Neuroimaging and lumbar puncture, both optional, will be performed at baseline and endpoints. Approximately 40 of the patients and their informants will be interviewed for qualitative analyses on the perceived changes in well-being and emotional qualities, in addition to their views on the research.

    DISCUSSION: This is the first RCT investigating add-on treatment with rituximab in unselected SSD patients. If the treatment is helpful, it may transform the treatment of patients with psychotic disorders. It may also heighten the awareness of immune-psychiatric disorders and reduce stigma.

    TRIAL REGISTRATION: NCT05622201, EudraCT-nr 2022-000220-37 version 2.1. registered 14th of October 2022.

  • 16. Bereczky, S.
    et al.
    Dolo, A.
    Maiga, B.
    Hayano, M.
    Granath, F.
    Montgomery, Scott M.
    Örebro universitet, Hälsoakademin.
    Daou, M.
    Arama, C.
    Troye-Blomberg, M.
    Doumbo, O. K.
    Färnert, A.
    Spleen enlargement and genetic diversity of Plasmodium falciparum infection in two ethnic groups with different malaria susceptibility in Mali, West Africa2006Ingår i: Transactions of the Royal Society of Tropical Medicine and Hygiene, ISSN 0035-9203, E-ISSN 1878-3503, Vol. 100, nr 3, s. 248-257Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The high resistance to malaria in the nomadic Fulani population needs further understanding. The ability to cope with multiclonal Plasmodium falciparum infections was assessed in a cross-sectional survey in the Fulani and the Dogon, their sympatric ethnic group in Mali. The Fulani had lower parasite prevalence and densities and more prominent spleen enlargement. Spleen rates in children aged 2–9 years were 75% in the Fulani and 44% in the Dogon (P < 0.001). There was no difference in number of P. falciparum genotypes, defined by merozoite surface protein 2 polymorphism, with mean values of 2.25 and 2.11 (P = 0.503) in the Dogon and Fulani, respectively. Spleen rate increased with parasite prevalence, density and number of co-infecting clones in asymptomatic Dogon. Moreover, splenomegaly was increased in individuals with clinical malaria in the Dogon, odds ratio 3.67 (95% CI 1.65–8.15, P = 0.003), but not found in the Fulani, 1.36 (95% CI 0.53–3.48, P = 0.633). The more susceptible Dogon population thus appear to respond with pronounced spleen enlargement to asymptomatic multiclonal infections and acute disease whereas the Fulani have generally enlarged spleens already functional for protection. The results emphasize the importance of spleen function in protective immunity to the polymorphic malaria parasite.

  • 17. Bereczky, Sándor
    et al.
    Liljander, Anne
    Rooth, Ingegerd
    Faraja, Lea
    Granath, Fredrik
    Montgomery, Scott M.
    Örebro universitet, Hälsoakademin.
    Färnert, Anna
    Multiclonal asymptomatic Plasmodium falciparum infections predict a reduced risk of malaria disease in a Tanzanian population2007Ingår i: Microbes and infection, ISSN 1286-4579, E-ISSN 1769-714X, Vol. 9, nr 1, s. 103-110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Protective immunity to malaria is acquired after repeated exposure to the polymorphic Plasmodium falciparum parasite. Whether the number of concurrent antigenically diverse clones in asymptomatic infections predicts the risk of subsequent clinical malaria needs further understanding. We assessed the diversity of P. falciparum infections by merozoite surface protein 2 genotyping in a longitudinal population based study in Tanzania. The number of clones was highest in children 6–10 years and in individuals with long time to previous anti-malarial treatment. Individual exposure, analysed by circumsporozoite protein antibody levels, was associated with parasite prevalence but not with the number of clones. The risk of subsequent clinical malaria in children free of acute disease or recent treatment was, compared to one clone, reduced in individuals with multiclonal infections or without detectable parasites, with the lowest hazard ratio 0.28 (95% confidence interval 0.10–0.78 Cox regression) for 2–3 clones. The number of clones was not associated with haemoglobin levels. A reduced risk of malaria in asymptomatic individuals with multiclonal persistent P. falciparum infections suggests that controlled maintenance of diverse infections is important for clinical protection in continuously exposed individuals, and needs to be considered in the design and evaluation of new malaria control strategies.

  • 18.
    Bergh, Cecilia
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    Fall, Katja
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Udumyan, Ruzan
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Sjöqvist, Hugo
    Örebro universitet, Handelshögskolan vid Örebro Universitet.
    Fröbert, Ole
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Cardiology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Severe infections and subsequent delayed cardiovascular disease2017Ingår i: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 24, nr 18, s. 1958-1966Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Severe infections in adulthood are associated with subsequent short-term cardiovascular disease. Whether hospital admission for sepsis or pneumonia is associated with persistent increased risk (over a year after infection) is less well established.

    Design: The design of this study was as a register-based cohort study.

    Methods: Some 236,739 men born between 1952-1956 were followed from conscription assessments in adolescence to 2010. All-cause cardiovascular disease ( n = 46,754), including coronary heart disease ( n = 10,279) and stroke ( n = 3438), was identified through national registers 1970-2010 (at ages 18-58 years).

    Results: Sepsis or pneumonia in adulthood (resulting in hospital admission) are associated with increased risk of cardiovascular disease in the years following infection. The risk is highest during the first year after the infection, with an adjusted hazard ratio (and 95% confidence intervals) of 6.33 (5.65-7.09) and a notably increased risk persisted with hazard ratios of 2.47 (2.04-3.00) for the second and 2.12 (1.71-2.62) for the third year after infection. The risk attenuated with time, but remained raised for at least five years after infection; 1.87 (1.47-2.38). The results are adjusted for characteristics in childhood, cardiovascular risk factors and medical history in adolescence. Similar statistically significant associations were found for coronary heart disease and stroke.

    Conclusions: Raised risks of cardiovascular disease following hospital admission for sepsis or pneumonia were increased for more than five years after the infection, but with the highest magnitude during the first three years following infection, suggesting a period of vulnerability when health professionals and patients should be aware of the heightened risk for cardiovascular disease.

  • 19.
    Bergh, Cecilia
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Fall, Katja
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Udumyan, Ruzan
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Sjöqvist, Hugo
    School of Medical Sciences, Örebro University, Örebro, sweden.
    Fröbert, Ole
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Cardiology.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, UK .
    Severe infections and subsequent delayed cardiovascular disease: national cohort studyManuskript (preprint) (Övrigt vetenskapligt)
  • 20.
    Bergh, Cecilia
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Hiyoshi, Ayako
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
    Eriksson, Mats
    Örebro universitet, Institutionen för hälsovetenskaper.
    Fall, Katja
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Division, Department of Medicine, Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, UK.
    Shared unmeasured characteristics among siblings confound the association of Apgar score with stress resilience in adolescence2019Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, nr 11, s. 2001-2007Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: We investigated the association between low Apgar score, other perinatal characteristics and low stress resilience in adolescence. A within-siblings analysis was used to tackle unmeasured shared familial confounding.

    METHODS: We used a national cohort of 527,763 males born in Sweden between 1973 and 1992 who undertook military conscription assessments at mean age 18 years (17-20). Conscription examinations included a measure of stress resilience. Information on Apgar score and other perinatal characteristics was obtained through linkage with the Medical Birth Register. Analyses were conducted using ordinary least squares and fixed-effects linear regression models adjusted for potential confounding factors.

    RESULTS: Infants with a prolonged low Apgar score at five minutes had an increased risk of low stress resilience in adolescence compared to those with highest scores at one minute, with an adjusted coefficient and 95% confidence interval of -0.26 (-0.39, -0.13). The associations were no longer statistically significant when using within-siblings models. However, the associations with stress resilience and birthweight remained statistically significant in all analyses.

    CONCLUSION: The association with low Apgar score seems to be explained by confounding due to shared childhood circumstances among siblings from the same family, while low birthweight is independently associated with low stress resilience.

  • 21.
    Bergh, Cecilia
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Oasti, Zahra
    Örebro University, Örebro, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Non-psychotic mental disorders in adolescent men and risk of myocardial infarction: A national cohort study2020Ingår i: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 41, nr Suppl. 2, s. 2812-2812Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Background/Purpose: Recent studies show that early life stress is associated with later risk of cardiovascular disease (CVD) and stress may also increase the risk of psychiatric disease. We investigated the association between non-psychotic mental disorders in adolescence and subsequent myocardial infarction, and the role of stress resilience and physical fitness in this association.

    Method: This is a register-based cohort study with 238 013 males born between 1952 and 1956 followed from 1987 to 2010 using information from Swedish registers. Stress resilience was measured at a compulsory military conscription examination using a semi-structured interview with a psychologist. Physical fitness was measured at conscription examination with a cycle ergometer test. A total of 34 503 men were diagnosed with a non-psychotic mental disorder at conscription. Using Cox regression, we estimated the association of mental disorders with myocardial infarction after adjustment for other established CVD risk factors in adolescence. Stress resilience and physical fitness were included in the adjusted model in a second set of analyses.

    Results: A total of 5891 diagnoses of first myocardial infarction were identified. Non-psychotic mental disorders were associated with an increased risk of myocardial infarction, with a hazard ratio (HR) and confidence interval (CI) of 1.51 (1.41–1.62). The association remained statistically significant after adjustment for other important potential confounders in adolescence such as systolic and diastolic blood pressure, body mass index, inflammation, cognitive function, parental socioeconomic index and a summary disease score (HR 1.24 (CI 1.13–1.35)). The association was further explained by stress resilience and lifestyle factors assessed with a cardiovascular fitness test in adolescence, as the association attenuated but remained statistically significant when further adjusting for stress resilience and physical fitness (HR 1.18 (CI 1.08–1.29)).

    Conclusion: A non-psychotic mental disorder in adolescences may increase the risk of developing myocardial infarction later in life. This association was partly but not completely explained by poorer stress resilience and physical fitness. Effective prevention might focus on behaviour/lifestyle and psychosocial stress in early life.

  • 22.
    Bergh, Cecilia
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Udumyan, Ruzan
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Appelros, Peter
    Department of Neurology, School of Medical Sciences, Örebro University, Örebro, Sweden.
    Fall, Katja
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Determinants in adolescence of stroke-related hospital stay duration in men: a national cohort study2016Ingår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 47, nr 9, s. 2416-2418Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and purpose: Physical and psychological characteristics in adolescence are associated with subsequent stroke risk. Our aim is to investigate their relevance to length of hospital stay and risk of second stroke.

    Methods: Swedish men born between 1952 and 1956 (n=237 879) were followed from 1987 to 2010 using information from population-based national registers. Stress resilience, body mass index, cognitive function, physical fitness, and blood pressure were measured at compulsory military conscription examinations in late adolescence. Joint Cox proportional hazards models estimated the associations of these characteristics with long compared with short duration of stroke-related hospital stay and with second stroke compared with first.

    Results: Some 3000 men were diagnosed with nonfatal stroke between ages 31 and 58 years. Low stress resilience, underweight, and higher systolic blood pressure (per 1-mm Hg increase) during adolescence were associated with longer hospital stay (compared with shorter) in ischemic stroke, with adjusted relative hazard ratios (and 95% confidence intervals) of 1.46 (1.08-1.89), 1.41 (1.04-1.91), and 1.01 (1.00-1.02), respectively. Elevated systolic and diastolic blood pressures during adolescence were associated with longer hospital stay in men with intracerebral hemorrhage: 1.01 (1.00-1.03) and 1.02 (1.00-1.04), respectively. Among both stroke types, obesity in adolescence conferred an increased risk of second stroke: 2.06 (1.21-3.45).

    Conclusions: Some characteristics relevant to length of stroke-related hospital stay and risk of second stroke are already present in adolescence. Early lifestyle influences are of importance not only to stroke risk by middle age but also to recurrence and use of healthcare resources among stroke survivors.

  • 23.
    Bergh, Cecilia
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Udumyan, Ruzan
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Fall, Katja
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Almroth, Henrik
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Montgomery, Scott
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Stress resilience and physical fitness in adolescence and risk of coronary heart disease in middle age2015Ingår i: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 101, nr 8, s. 623-629Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Psychosocial stress is a suggested risk for coronary heart disease (CHD). The relationship of stress resilience in adolescence with subsequent CHD risk is underinvestigated, so our objective was to assess this and investigate the possible mediating role of physical fitness.

    METHODS: In this register-based study, 237 980 men born between 1952 and 1956 were followed from 1987 to 2010 using information from Swedish registers. Stress resilience was measured at a compulsory military conscription examination using a semistructured interview with a psychologist. Some 10 581 diagnoses of CHD were identified. Cox regression estimated the association of stress resilience with CHD, with adjustment for established cardiovascular risk factors.

    RESULTS: Low-stress resilience was associated with increased CHD risk. The association remained after adjustment for physical fitness and other potential confounding and mediating factors, with adjusted HRs (and 95% CIs) of 1.17 (1.10 to 1.25), with some evidence of mediation by physical fitness. CHD incidence rates per 1000 person-years (and 95% CIs) for low-stress, medium-stress and high-stress resilience were 2.61 (2.52 to 2.70), 1.97 (1.92 to 2.03) and 1.59 (1.53 to 1.67) respectively. Higher physical fitness was inversely associated with CHD risk; however, this was attenuated by low-stress resilience, shown by interaction testing (p<0.001).

    CONCLUSIONS: Low-stress resilience in adolescence was associated with increased risk of CHD in middle age and may diminish the benefit of physical fitness. This represents new evidence of the role of stress resilience in determining risk of CHD and its interrelationship with physical fitness.

  • 24.
    Bergh, Cecilia
    et al.
    Region Örebro län. Örebro universitet, Institutionen för medicinska vetenskaper.
    Udumyan, Ruzan
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Fall, Katja
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK.
    Pre-stroke characteristics and stroke severity after first stroke in middle-aged men2015Ingår i: Nordic Stroke 2015: 18th Nordic Congress of Cerebrovascular Diseases, 2015Konferensbidrag (Refereegranskat)
  • 25.
    Bergh, Cecilia
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Physiotherapy, Örebro University Hospital, Örebro, Sweden.
    Udumyan, Ruzan
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Fall, Katja
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Appelros, Peter
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Neurology, Örebro University Hospital, Örebro, Sweden.
    Montgomery, Scott
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Departnment of Epidemiology and Public Health, University College London, London, UK; Cinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
    Stress resilience in male adolescents and subsequent stroke risk: cohort study2014Ingår i: Journal of Neurology, Neurosurgery and Psychiatry, ISSN 0022-3050, E-ISSN 1468-330X, Vol. 85, nr 12, s. 1331-1336Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective Exposure to psychosocial stress has been identified as a possible stroke risk, but the role of stress resilience which may be relevant to chronic exposure is uncertain. We investigated the association of stress resilience in adolescence with subsequent stroke risk.

    Methods Register-based cohort study. Some 237 879 males born between 1952 and 1956 were followed from 1987 to 2010 using information from Swedish registers. Cox regression estimated the association of stress resilience with stroke, after adjustment for established stroke risk factors.

    Results Some 3411 diagnoses of first stroke were identified. Lowest stress resilience (21.8%) compared with the highest (23.7%) was associated with increased stroke risk, producing unadjusted HR (with 95% CIs) of 1.54 (1.40 to 1.70). The association attenuated slightly to 1.48 (1.34 to 1.63) after adjustment for markers of socioeconomic circumstances in childhood; and after further adjustment for markers of development and disease in adolescence (blood pressure, cognitive function and pre-existing cardiovascular disease) to 1.30 (1.18 to 1.45). The greatest reduction followed further adjustment for markers of physical fitness (BMI and physical working capacity) in adolescence to 1.16 (1.04 to 1.29). The results were consistent when stroke was subdivided into fatal, ischaemic and haemorrhagic, with higher magnitude associations for fatal rather than non-fatal, and for haemorrhagic rather than ischaemic stroke.

    Conclusions Stress susceptibility and, therefore, psychosocial stress may be implicated in the aetiology of stroke. This association may be explained, in part, by poorer physical fitness. Effective prevention might focus on behaviour/lifestyle and psychosocial stress.

  • 26.
    Berglez, Peter
    et al.
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Eriksson, Göran
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Ekström, Mats
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Moberg, Ulla
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Olausson, Ulrika
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Pressen sviker sin roll2010Övrigt (Övrig (populärvetenskap, debatt, mm))
  • 27.
    Berglez, Peter
    et al.
    Jönköping University, School of Education and Communication, HLK, Media and Communication Studies, Jönköping, Sweden.
    Hedenmo, Otto
    Jönköping University, School of Education and Communication, HLK, Media and Communication Studies, Jönköping, Sweden.
    Olausson, Ulrika
    Jönköping University, School of Education and Communication, HLK, Media and Communication Studies, Jönköping, Sweden.
    A Digital-Multimodal Turn in Cross-Sector Collaboration? The case of climate change2019Konferensbidrag (Övrigt vetenskapligt)
  • 28.
    Berglez, Peter
    et al.
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Höijer, Birgitta
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Olausson, Ulrika
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Individualisation and nationalisation of the climate issue: two ideological horizons in Swedish news media2009Ingår i: Climate change and the media / [ed] Tammy Boyce, Justin Lewis, New York: Peter Lang Publishing Group, 2009, s. 211-223Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 29.
    Berglez, Peter
    et al.
    Jönköping University, School of Education and Communication, Jönköping, Sweden.
    Olausson, Ulrika
    Jönköping University, School of Education and Communication, Jönköping, Sweden.
    Climate irresponsibility on social media: A critical approach to “high-carbon visibility discourse”2021Ingår i: Social Semiotics, ISSN 1035-0330, E-ISSN 1470-1219, s. 1-15Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Human GHG emissions are entering networked everyday relations. On social media, users potentially "reveal" their carbon footprints when they post pictures of a beef-based dinner or intercontinental travel. As the increasing urgency of climate change coincides with people's increasingly online-oriented lifestyles, we suggest that social-media research should devote attention to the ways in which users overlook, hide, limit, or casually articulate their high-carbon oriented lifestyles in digital space. This would contribute important knowledge about the role of social-media communication concerning climate change as an individual responsibility, and requires a concentration on how status updates become loaded with ideological meaning (high-carbon visibility discourse). The purpose is to present a framework for critical analyses of visual disclosure of carbon footprints in social media use. Media theory, semiotics, network theory and critical theory are combined to theorize how users' activities on social media become high-carbon oriented; their promotion of a business-as-usual stance; and how this operates ideologically through reification, legitimation and unification.

  • 30.
    Berglez, Peter
    et al.
    Jönköping University, Jönköping, Sweden.
    Olausson, Ulrika
    Jönköping University, Jönköping, Sweden.
    Global Journalism2019Ingår i: The international encyclopedia of journalism studies / [ed] Tim P. Vos; Folker Hanusch, John Wiley & Sons, 2019Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    Global journalism appears to become increasingly important in the field of journalism studies, however, there is no agreement about how it should be applied in research. This entry presents four perspectives: the global-mapping perspective, which is concerned with mapping and analyzing how journalism works in different parts of the world; the media-technology perspective, which focuses on the potential of cross-border media technology to facilitate the creation of a “global public sphere”; the ethics perspective, which deals with how journalism should approach other cultures in order to reduce the distance between “us” and “them” and minimize stereotypical depictions of the Other; and the discourse perspective, which associates global journalism with reporting that sheds light on the multitude of cross-border interdependencies between people, processes, and events. The entry also discusses the positions of “globalists” and “skeptics” in the media globalization debate and the role of journalism education in the development of global journalism.

  • 31.
    Berglez, Peter
    et al.
    Örebro universitet, Humanistiska institutionen.
    Olausson, Ulrika
    Örebro universitet, Humanistiska institutionen.
    Individualization and nationalization of the climate issue: two ideological horizons in Swedish news media2008Konferensbidrag (Övrigt vetenskapligt)
  • 32.
    Berglez, Peter
    et al.
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Olausson, Ulrika
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Intentional and unintentional transnationalism: two political identities repressed by national identity in the news media2011Ingår i: National Identities, ISSN 1460-8944, E-ISSN 1469-9907, Vol. 13, nr 1, s. 35-49Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This article explores how the powerful mechanisms of nation-state discourse in the news media obscure emerging constructions of transnational political thought and action. With the aid of empirical examples from qualitative media studies on critical events extensively covered by the news media, the article demonstrates how national identity in the news media represses transnational political identities of the intentional as well as the unintentional kind.

  • 33.
    Berglez, Peter
    et al.
    Örebro universitet, Humanistiska institutionen.
    Olausson, Ulrika
    Örebro universitet, Humanistiska institutionen.
    Intentional and unintentional transnationalism: two political identities repressed by national media2007Konferensbidrag (Övrigt vetenskapligt)
  • 34.
    Berglez, Peter
    et al.
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Olausson, Ulrika
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    ‘Klimatfrågans död till stor del mediernas fel’2013Övrigt (Övrig (populärvetenskap, debatt, mm))
  • 35.
    Berglez, Peter
    et al.
    Örebro universitet, Humanistiska institutionen.
    Olausson, Ulrika
    Örebro universitet, Humanistiska institutionen.
    Kritisk diskursanalys2008Ingår i: Mediernas språk / [ed] Mats Ekström, Malmö: Liber , 2008, 1, s. 121-138Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 36.
    Berglez, Peter
    et al.
    Jönköping University, Jönköping, Sweden.
    Olausson, UlrikaJönköping University, Jönköping, Sweden.
    Media research on climate change: where have we been and where are we heading?2017Proceedings (redaktörskap) (Refereegranskat)
    Abstract [en]

    Research on media coverage of climate change, as a particular subfield of environmental communication research, has proliferated over the past decade. This book sets out to consider what conclusions can be drawn in light of the existing body of work, what lessons can be learnt, what are the challenges to be met, and what are the directions to be taken in order to further develop media research on climate change. The mixture of articles in this volume serve well to illustrate the range of empirical, theoretical, and methodological approaches subsumed under the broad heading of "media studies on climate change." Some contributions focus on the past—how the subfield has developed and what we can learn from that—and some look toward the future. Either way, all the authors share the ambition to suggest important avenues of research, be they centered on media, context, applicability of results, or theoretical advancement. As such they make a valuable contribution to identifying important directions for future research on the role of the media in communicating climate change. This book was previously published as a special issue of Environmental Communication.

  • 37.
    Berglez, Peter
    et al.
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Olausson, UlrikaÖrebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Mediesamhället: centrala begrepp2009Samlingsverk (redaktörskap) (Övrigt vetenskapligt)
    Abstract [sv]

    Idag ökar medvetenheten om mediernas viktiga roll i samhället inom olika vetenskapliga discipliner. Denna bok möter det växande kunskapsbehovet genom att på ett pedagogiskt sätt presentera en rad olika perspektiv på mediesamhället, eller närmare bestämt relationen mellan medier och samhälle; hur de förra inverkar på och medskapar det senare. Författarna tar bland annat upp frågan om vilken mediernas roll är för skapandet av maktförhållanden, offentligheter, identiteter, mobilitet, risker och interaktiva processer. Vad finns det för forskning om detta, och hur kan man inkludera medierna i sin egen samhällsforskning?Denna introduktion till studier om mediesamhället riktar sig till studenter, lärare och forskare inom medie- och kommunikationsvetenskap, men också till andra samhällsvetenskapliga discipliner. Boken är skriven av medie- och kommunikationsvetare från sju universitet och högskolor i Sverige.Redaktörer är Peter Berglez och Ulrika Olausson, Örebro universitet. Övriga medverkande är: Ester Appelgren, Ulf Buskqvist, Jesper Falkheimer, Heike Graf, Mats Heide, Birgitta Höijer, André Jansson, Stig-Arne Nohrstedt, Tobias Olsson och Linda Ryan Bengtsson.

  • 38.
    Berglez, Peter
    et al.
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Olausson, Ulrika
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Miljön, forskningen - och så medie- och kommunikationsforskningen2011Ingår i: Nordicom Information, ISSN 0349-5949, Vol. 33, nr 3, s. 83-86Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 39.
    Berglez, Peter
    et al.
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Olausson, Ulrika
    Örebro University, School of Humanities, Education and Social Sciences, Örebro, Sweden.
    “Miljön, forskningen och så MKV”: (The Environment, the Research – and Media and Communications)2011Ingår i: Nordicom Information, ISSN 0349-5949, Vol. 33, nr 3-4, s. 83-86Artikel i tidskrift (Refereegranskat)
  • 40.
    Berglez, Peter
    et al.
    Örebro universitet, Humanistiska institutionen.
    Olausson, Ulrika
    Örebro universitet, Humanistiska institutionen.
    Social representations of climate change in the media and among citizens2007Konferensbidrag (Övrigt vetenskapligt)
  • 41.
    Berglez, Peter
    et al.
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    Olausson, Ulrika
    Örebro universitet, Akademin för humaniora, utbildning och samhällsvetenskap.
    The 'climate threat' as ideology: interrelations between citizen and media discourses2010Konferensbidrag (Refereegranskat)
  • 42.
    Berglez, Peter
    et al.
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Olausson, Ulrika
    School of Education and Communication, Media and CommunicationStudies, Jönköping University, Jönköping, Sweden.
    The Post-political Condition of Climate Change: An Ideology Approach2014Ingår i: Capitalism, Nature, Socialism, ISSN 1045-5752, E-ISSN 1548-3290, Vol. 25, nr 1, s. 54-71Artikel i tidskrift (Refereegranskat)
  • 43.
    Berglez, Peter
    et al.
    Örebro universitet, Humanistiska institutionen.
    Olausson, Ulrika
    Örebro universitet, Humanistiska institutionen.
    The structural repression of the transnational: social representations of the nation-state in the news media2007Konferensbidrag (Övrigt vetenskapligt)
  • 44.
    Berglez, Peter
    et al.
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Olausson, Ulrika
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Towards a renewed Research Agenda for Media Studies on Climate Change2013Konferensbidrag (Refereegranskat)
    Abstract [en]

    This paper aims to outline a renewed research agenda for media studies on climate change. This field is rather young, and so far, researchers have primarily tended to analyse media content and –although to a much lesser extent –citizens’ representations of climate change in relation to media discourse. Thus, the field is still in the phase of mapping out media representations of climate change from various perspectives (scientific, democratic, political, visual, emotional, etc.). Admittedly, this is an essential task for obtaining basic knowledge on climate reporting and its implications, but the timely question now is how media research on climate change might theoretically and empirically evolve, and move into the next phase. In this paper, we identify four important research challenges which we believe should be considered by scholars in the field: 1) the practical challenge, 2) the normative challenge, 3) the discursive challenge, and 4) the interdisciplinary challenge

  • 45.
    Berglez, Peter
    et al.
    Jönköping University, School of Education and Communication, HLK, Media and Communication Studies, Jönköping, Sweden.
    Olausson, Ulrika
    Jönköping University, School of Education and Communication, HLK, Media and Communication Studies, Jönköping, Sweden.
    Towards a Research Agenda for Sustainable Journalism2017Konferensbidrag (Övrigt vetenskapligt)
  • 46.
    Berglez, Peter
    et al.
    Jönköping University, School of Education and Communication, HLK, Media and Communication Studies, Jönköping, Sweden.
    Olausson, UlrikaJönköping University, School of Education and Communication, HLK, Media and Communication Studies, Jönköping, Sweden.Ots, MartJönköping University, Jönköping International Business School, JIBS, Business Administration, Jönköping University, Jönköping; International Business School, JIBS, Media, Management and Transformation Centre (MMTC), Jönköping, Sweden.
    What is sustainable journalism? Integrating the environmental, social, and economic challenges of journalism2017Samlingsverk (redaktörskap) (Refereegranskat)
    Abstract [en]

    This edited volume, which elaborates on the idea and concept of sustainable journalism, is the result of a perceived lack of integral research approaches to journalism and sustainable development. Thirty years ago, in 1987, the Brundtland Report pointed out economic growth, social equality and environmental protection as the three main pillars of a sustainable development. These pillars are intertwined, interdependent, and need to be reconciled. However, usually, scholars interested in the business crisis of the media industry tend to leave the social and environmental dimensions of journalism aside, and vice versa. What Is Sustainable Journalism? is the first book that discusses and examines the economic, social and environmental challenges of professional journalism simultaneously. This unique book and fresh contribution to the discussion of the future of journalism assembles international expertise in all three fields, arguing for the necessity of integral research perspectives and for sustainable journalism as the key to long-term survival of professional journalism. The book is relevant for scholars and master’s students in media economy, media and communication, and environmental communication.

  • 47. Bergquist, Annika
    et al.
    Montgomery, Scott M.
    Örebro universitet, Hälsoakademin.
    Bahmanyar, Shahram
    Olsson, Rolf
    Danielsson, Åke
    Lindgren, Stefan
    Prytz, Hanne
    Hultcrantz, Rolf
    Lööf, Lars
    Sandberg-Gertzén, Hanna
    Almer, Sven
    Askling, Johan
    Ehlin, Anna
    Ekbom, Anders
    Increased risk of primary sclerosing cholangitis and ulcerative colitis in first-degree relatives of patients with primary sclerosing cholangitis2008Ingår i: Clinical Gastroenterology and Hepatology, ISSN 1542-3565, E-ISSN 1542-7714, Vol. 6, nr 8, s. 939-943Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background & Aims: The importance of genetic factors for the development of primary sclerosing cholangitis (PSC) is incompletely understood. This study assessed the risk of PSC and inflammatory bowel disease (IBD) among first-degree relatives of patients with PSC, compared with the first-degree relatives of a cohort without PSC. Methods: Subjects from the national Swedish cohort of PSC patients (n = 678) were matched for date of birth, sex, and region to up to 10 subjects without a diagnosis of PSC (n = 6347). Linkage through general population registers identified first-degree relatives of subjects in both the PSC and comparison cohorts (n = 34,092). Diagnoses among first-degree relatives were identified by using the Inpatient Register. Results: The risk of cholangitis was statistically significantly increased in offspring, siblings, and parents of the PSC patient cohort, compared with relatives of the comparison cohort, with the hazard ratios and 95% confidence intervals, 11.5 (1.6–84.4), 11.1 (3.3–37.8), and 2.3 (0.9–6.1), respectively. The hazard ratios for ulcerative colitis (UC) among first-degree relatives of all PSC patients was 3.3 (2.3–4.9) and for Crohn's disease 1.4 (0.8–2.5). The risk of UC for relatives of PSC patients without IBD was also increased, 7.4 (2.9–18.9). Conclusions: First-degree relatives of patients with PSC run an increased risk of PSC, indicating the importance of genetic factors in the etiology of PSC. First-degree relatives of PSC patients without IBD are also at an increased risk of UC, which might indicate shared genetic susceptibility factors for PSC and UC. 

  • 48. Bergquist, Annika
    et al.
    Montgomery, Scott M.
    Örebro universitet, Institutionen för klinisk medicin.
    Lund, Ulrika
    Ekbom, Anders
    Olsson, Rolf
    Lindgren, Stefan
    Prytz, Hanne
    Hultcrantz, Rolf
    Broomé, Ulrika
    Perinatal events and the risk of developing primary sclerosing cholangitis2006Ingår i: World Journal of Gastroenterology, ISSN 1007-9327, E-ISSN 2219-2840, Vol. 12, nr 37, s. 6037-6040Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To investigate whether perinatal events, intrauterine or postpartum, are associated with the development of primary sclerosing cholangitis (PSC) later in life.

    METHODS: Birth records from 97 patients with adult PSC in Sweden were reviewed. Information on perinatal events including medications and complications during pregnancy, gestation length, birth weight and length were collected. Two control children of the same sex were selected for each subject. Conditional multiple logistic regression was used to assess associations of the perinatal measures with development of PSC.

    RESULTS: No significant associations were found between gestational age, birth length, breastfeeding, and the majority of medical complications including infections or medication during pregnancy for the mothers or postpartum for the children. Vaginal bleeding and peripheral oedema showed associations with PSC, with matched odds ratios of 5.70 (95% CI, 1.13-28.83) and 2.28 (95% CI, 1.04-5.03), respectively.

     

    CONCLUSION: The associations of vaginal bleeding and oedema with subsequent PSC cannot readily be explained, so our findings do not strongly support the hypothesis of a significant role of perinatal events as a risk for the development of PSC later in life.

  • 49.
    Bergsten, Elisabet
    et al.
    Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden; Theme of Children’s and Women’s Health, Karolinska University Hospital, Stockholm, Sweden.
    Horne, AnnaCarin
    Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden; Theme of Children’s and Women’s Health, Karolinska University Hospital, Stockholm, Sweden.
    Aricó, Maurizio
    Direzione Generale, Azienda Sanitaria Provinciale, Ragusa, Italy.
    Astigarraga, Itziar
    Servicio de Pediatria, BioCruces Health Research Institute, Hospital Universitario Cruces, Universidad del Pais Vasco–Euskal Herriko Unibertsitatea (UPV/EHU), Barakaldo, Spain.
    Egeler, R. Maarten
    Division of Hematology & Oncology, The Hospital for Sick Children, Toronto ON, Canada.
    Filipovich, Alexandra H.
    Division of Bone Marrow Transplant and Immune Deficiency, Cincinnati Children’s Hospital Medical Center, Cincinnati OH, USA.
    Ishii, Eiichi
    Department of Pediatrics, Graduate School of Medicine, Ehime University, Ehime, Japan.
    Janka, Gritta
    Pediatric Hematology and Oncology, University Medical Center Hamburg, Hamburg, Germany.
    Ladisch, Stephan
    Center for Cancer and Immunology Research, Children’s Research Institute, Children’s National Medical Center, Washington DC, USA.
    Lehmberg, Kai
    Pediatric Hematology and Oncology, University Medical Center Hamburg, Hamburg, Germany.
    McClain, Kenneth L.
    Texas Children’s Cancer Center, Baylor College of Medicine, Houston TX, USA.
    Minkov, Milen
    University Clinic of Pediatrics, St. Anna Children’s Hospital, Medical University of Vienna, Vienna, Austria.
    Montgomery, Scott
    Örebro universitet, Institutionen för medicinska vetenskaper. Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Nanduri, Vasanta
    Department of Pediatrics, Watford General Hospital, Watford, United Kingdom.
    Rosso, Diego
    Department of Pediatric Hematology and Oncology, Hospital de Niños Dr Pedro De Elizalde, Buenos Aires, Argentina; Department of Pediatrics, Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
    Henter, Jan-Inge
    Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden; Theme of Children’s and Women’s Health, Karolinska University Hospital, Stockholm, Sweden.
    Confirmed efficacy of etoposide and dexamethasone in HLH treatment: long-term results of the cooperative HLH-2004 study2017Ingår i: Blood, ISSN 0006-4971, E-ISSN 1528-0020, Vol. 130, nr 25, s. 2728-2738Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome comprising familial/genetic HLH (FHL) and secondary HLH. In the HLH-94 study, with an estimated 5-year probability of survival (pSu) of 54% (95% confidence interval, 48%-60%), systemic therapy included etoposide, dexamethasone, and, from week 9, cyclosporine A (CSA). Hematopoietic stem cell transplantation (HSCT) was indicated in patients with familial/genetic, relapsing, or severe/persistent disease. In HLH-2004, CSA was instead administered upfront, aiming to reduce pre-HSCT mortality and morbidity. From 2004 to 2011, 369 children aged <18 years fulfilled HLH-2004 inclusion criteria (5 of 8 diagnostic criteria, affected siblings, and/or molecular diagnosis in FHL-causative genes). At median follow-up of 5.2 years, 230 of 369 patients (62%) were alive (5-year pSu, 61%; 56%-67%). Five-year pSu in children with (n = 168) and without (n = 201) family history/genetically verified FHL was 59% (52%-67%) and 64% (57%-71%), respectively (familial occurrence [n = 47], 58% [45%-75%]). Comparing with historical data (HLH-94), using HLH-94 inclusion criteria, pre-HSCT mortality was nonsignificantly reduced from 27% to 19% (P = .064 adjusted for age and sex). Time from start of therapy to HSCT was shorter compared with HLH-94 (P =020 adjusted for age and sex) and reported neurological alterations at HSCT were 22% in HLH-94 and 17% in HLH-2004 (using HLH-94 inclusion criteria). Five-year pSu post-HSCT overall was 66% (verified FHL, 70% [63%-78%]). Additional analyses provided specific suggestions on potential pre-HSCT treatment improvements. HLH-2004 confirms that a majority of patients may be rescued by the etoposide/dexamethasone combination but intensification with CSA upfront, adding corticosteroids to intrathecal therapy, and reduced time to HSCT did not improve outcome significantly.

  • 50. Bhattarai, Achuyt
    et al.
    Ali, Abdullah S.
    Kachur, S. Patrick
    Mårtensson, Andreas
    Abbas, Ali K.
    Khatib, Rashid
    Al-Mafazy, Abdul-Wahiyd
    Ramsan, Mahdi
    Rotllant, Guida
    Gerstenmaier, Jan F.
    Molteni, Fabrizio
    Abdulla, Salim
    Montgomery, Scott M.
    Örebro universitet, Hälsoakademin.
    Kaneko, Akira
    Björkman, Anders
    Impact of artemisinin-based combination therapy and insecticide-treated nets on malaria burden in Zanzibar2007Ingår i: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 4, nr 11, s. e309-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The Roll Back Malaria strategy recommends a combination of interventions for malaria control. Zanzibar implemented artemisinin-based combination therapy (ACT) for uncomplicated malaria in late 2003 and long-lasting insecticidal nets (LLINs) from early 2006. ACT is provided free of charge to all malaria patients, while LLINs are distributed free to children under age 5 y (“under five”) and pregnant women. We investigated temporal trends in Plasmodium falciparum prevalence and malaria-related health parameters following the implementation of these two malaria control interventions in Zanzibar.

    Methods and Findings

    Cross-sectional clinical and parasitological surveys in children under the age of 14 y were conducted in North A District in May 2003, 2005, and 2006. Survey data were analyzed in a logistic regression model and adjusted for complex sampling design and potential confounders. Records from all 13 public health facilities in North A District were analyzed for malaria-related outpatient visits and admissions. Mortality and demographic data were obtained from District Commissioner's Office. P. falciparum prevalence decreased in children under five between 2003 and 2006; using 2003 as the reference year, odds ratios (ORs) and 95% confidence intervals (CIs) were, for 2005, 0.55 (0.28–1.08), and for 2006, 0.03 (0.00–0.27); p for trend < 0.001. Between 2002 and 2005 crude under-five, infant (under age 1 y), and child (aged 1–4 y) mortality decreased by 52%, 33%, and 71%, respectively. Similarly, malaria-related admissions, blood transfusions, and malaria-attributed mortality decreased significantly by 77%, 67% and 75%, respectively, between 2002 and 2005 in children under five. Climatic conditions favorable for malaria transmission persisted throughout the observational period.

    Conclusions

    Following deployment of ACT in Zanzibar 2003, malaria-associated morbidity and mortality decreased dramatically within two years. Additional distribution of LLINs in early 2006 resulted in a 10-fold reduction of malaria parasite prevalence. The results indicate that the Millennium Development Goals of reducing mortality in children under five and alleviating the burden of malaria are achievable in tropical Africa with high coverage of combined malaria control interventions.

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