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  • 351.
    Rönnberg, AnnKristin
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Obstetrics & Gynaecology, Örebro University Hospital, Örebro, Sweden.
    Östlund, Ingrid
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Obstetrics and Gynaecology, Örebro University Hospital, Örebro, Sweden .
    Fadl, Helena
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Obstetrics & Gynaecology, Örebro University Hospital, Örebro, Sweden.
    Gottvall, T.
    Department of Obstetrics and Gynaecology, Linköping University Hospital, Linköping, Sweden .
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning. Department of Obstetrics & Gynaecology, Örebro University Hospital, Örebro, Sweden.
    Intervention during pregnancy to reduce excessive gestational weight gain: a randomised controlled trial2015Ingår i: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 122, nr 4, s. 537-544Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate if a feasible, low-cost intervention could decrease the percentage of women gaining weight above the Institute of Medicine (IOM) recommendations on gestational weight gain (GWG) compared with standard maternity care.

    Design: A randomised controlled interventional design.

    Setting: Antenatal clinics (n=14) in orebro county, Sweden, participated.

    Population: Healthy women with a body mass index (BMI) 19kg/m(2), age 18years and adequate knowledge of Swedish language who signed in for maternity care at 16weeks of gestation.

    Methods: Standard care was compared with a composite intervention consisting of education on recommended GWG according to IOM, application of personalised weight graph, formalised prescription of exercise and regular monitoring of GWG at every antenatal visit.

    Outcome: The proportion of women gaining weight above IOM guidelines (1990) and mean GWG (kg) was compared between groups.

    Results: In all, 445 women were randomised and 374 women remained for analysis after delivery. A majority of the women analysed were normal weight (72%). The intervention reduced the proportion of women who exceeded the IOM guidelines (41.1% versus 50.0%). The reduction was, however, not statistically significant (P=0.086). Mean GWG was significantly lower among women receiving the intervention, 14.2kg (SD 4.4) versus 15.3kg (SD 5.4) in the standard care group (P=0.029).

    Conclusions: The low-cost intervention programme tested did significantly reduce the mean GWG but the proportion of women who exceeded the IOM recommendations for GWG was not significantly lower. ClinicalTrials.gov Id NCT00451425

  • 352.
    Saeedi, Maryam
    Örebro universitet, Institutionen för läkarutbildning.
    The frequency of operations and reoperations in patients with chronic subduralhaematoma in Örebro county council during 2010-20122014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 353.
    Sahdo, Berolla
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    DeLeo, Frank R.
    Rocky Mountins Laboratories, National Institute an Infectious Deseases, National Institute of Health, 903 South 4th St, Hamilton, Mt 59840 USA.
    Söderqvist, Bo
    Örebro universitet, Institutionen för läkarutbildning.
    Särndahl, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Staphylococcus aureus-mediated caspase-1 activation in human neutrophils: a role for Panton-Valentine Leukocidin?Manuskript (preprint) (Övrigt vetenskapligt)
  • 354.
    Sahdo, Berolla
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Clinical Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Evans, Alina L.
    Department of Forestry and Wildlife Management, Hedmark University College, Evenstad, Norway; Section of Arctic Veterinary Medicine, Norwegian School of Veterinary Science, Tromsø, Norway.
    Arnemo, Jon M.
    Department of Forestry and Wildlife Management, Hedmark University College, Evenstad, Norway; Department of Wildlife, Fish and Environmental Studies, Swedish University of Agricultural Sciences, Umeå, Sweden.
    Fröbert, Ole
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Cardiology, Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Särndahl, Eva
    Örebro universitet, Institutionen för läkarutbildning. Department of Clinical Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden; Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
    Blanc, Stephane
    Institut Pluridisciplinaire Hubert CURIEN (IPHC), Université de Strasbourg, Strasbourg, France; CNRS, Strasbourg, France.
    Body temperature during hibernation is highly correlated with a decrease in circulating innate immune cells in the brown bear (Ursus arctos): a common feature among hibernators?2013Ingår i: International Journal of Medical Sciences, ISSN 1449-1907, E-ISSN 1449-1907, Vol. 10, nr 5, s. 508-514Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Hibernation involves periods of severely depressed metabolism (torpor) and decreases in body temperature (Tb). Small arctic mammals (<5kg), in which Tb generally drop drastically, display leukopenia during hibernation. This raised the question of whether the decreased leukocyte counts in mammalian hibernators is due to torpor per se or is secondary to low Tb. The present study examined immune cell counts in brown bears (Ursus arctos), where torpor is only associated with shallow decreases in Tb. The results were compared across hibernator species for which immune and Tb data were available.

    Methods and Results: The white blood cell counts were determined by flow cytometry in 13 bears captured in the field both during summer and winter over 2 years time. Tb dropped from 39.6+/-0.8 to 33.5+/-1.1 degrees C during hibernation. Blood neutrophils and monocytes were lower during hibernation than during the active period (47%, p=0.001; 43%, p=0.039, respectively), whereas no change in lymphocyte counts was detected (p=0.599). Further, combining our data and those from 10 studies on 9 hibernating species suggested that the decline in Tb explained the decrease in innate immune cells (R-2=0.83, p<0.0001).

    Conclusions: Bears have fewer innate immune cells in circulation during hibernation, which may represent a suppressed innate immune system. Across species comparison suggests that, both in small and large hibernators, Tb is the main driver of immune function regulation during winter dormancy. The lack of a difference in lymphocyte counts in this context requires further investigations.

  • 355.
    Sahdo, Berolla
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Fransén, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Asfaw Idosa, Berhane
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Eriksson, Per
    Division of Rheumatology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Söderquist, Bo
    Örebro universitet, Institutionen för läkarutbildning. Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Kelly, Anne
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Särndahl, Eva
    Örebro universitet, Institutionen för läkarutbildning.
    Cytokine profile in a cohort of healthy blood donors carrying polymorphisms in genes encoding the NLRP3 inflammasome2013Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, nr 10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The NLRP3 inflammasome has been recognized as one of the key components of the innate immunity by sensing a diversity of insults. Inflammasome activation results in the maturation of the pro-inflammatory cytokines interleukin (IL)-1 beta and IL-18. Increased production of IL-1 beta is found in patients with gain-of-function polymorphisms in genes encoding the NLRP3 inflammasome. Since approximately 5% of the Swedish population are heterozygote carriers of these combined gene variants, their impact on inflammasome status and a relationship on disease development is therefore highly relevant to study. The present study investigates levels of inflammasome-produced cytokines as a measure of inflammasome activation in healthy individuals carrying Q705K polymorphism in the NLRP3 gene combined with C10X in the CARD8 gene.

    Materials and Methods: Genotyping of 1006 healthy blood donors was performed for the polymorphisms Q705K in the NLRP3 and C10X in the CARD8 genes. IL-1 beta, IL-18, IL-33, as well as a number of other pro-inflammatory cytokines, were analyzed by Luminex or ELISA in plasma from individuals carrying the polymorphisms and in age and gender matched non-carrier controls.

    Results & Discussion: The prevalence of the polymorphisms was in line with previous studies. Plasma levels of IL-1 beta and IL-33 were elevated among carriers of combined Q705K+C10X polymorphisms compared to controls, whereas no difference was found for IL-18 and the other cytokines measured. Moreover, carriers of C10X or Q705K per se had similar plasma levels of IL-1 beta as non-carriers. These data suggest that the combined polymorphisms create inflammasomes with increased basal activation state, which might provide a more favourable innate immune response. In spite of this, it could also represent the mechanisms by which the inflammatory loop is triggered into a long-term inflammatory phenotype.

  • 356.
    Sahdo, Berolla
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Clinical Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Särndahl, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Clinical Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Elgh, Fredrik
    Department of Clinical Microbiology, Virology, Umeå University, Umeå, Sweden.
    Söderquist, Bo
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län.
    Propionibacterium acnes activates caspase-1 in human neutrophils2013Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 121, nr 7, s. 652-63Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Propionibacterium acnes is a Gram-positive, slow-growing, anaerobic bacillus, predominantly found as a commensal on the skin and mucous membranes of adults. It is, however, also considered an opportunistic pathogen; mostly associated with acne vulgaris, but rarely also with severe infections such as infective endocarditis, prosthetic joint infections, and deep sternal wound infections following cardiothoracic surgery. In addition, P. acnes has recently been found in high frequency in prostate tissue from patients with prostatitis and prostate cancer. The NOD-like receptors (NLR) act as intracellular sensors of microbial components, and a number of various bacteria have been found to induce assembling and activation of NLR-inflammasomes; leading to a pro-inflammatory response. The inflammasome-mediated formation of the pro-inflammatory cytokines interleukin-1β (IL-1β) and IL-18 involves the auto-proteolytic maturation of caspase-1. This study investigated if P. acnes activates inflammasomes. Propionibacterium acnes isolates (n = 29) with diverse origin were used as stimuli for peripheral leukocytes obtained from blood donors (BDs). The activity of inflammasomes was determined by measuring caspase-1 by flow cytometry and cytokine production by ELISA. A significant amount of caspase-1 was found in neutrophils upon P. acnes stimulation, whereas only a modest activation was seen in monocytes. The activation was mainly produced by components of the bacterial cell and no exo-products, because heat-killed and live bacteria caused high activation of caspase-1 as well as cytokine production, whereas the bacterial supernatant elicited minor effect. The response among different BDs varied significantly, almost fivefold. In addition, P. acnes of various origins showed considerable variation, however, the commensal isolates showed a stronger response compared with the invasive. In conclusion, although regarded as a harmless commensal of the skin, P. acnes strongly activates the inflammasome of human peripheral neutrophils.

  • 357.
    Salih, Lavin
    Örebro universitet, Institutionen för läkarutbildning.
    Staphylococcus epidermidis isolated from prosthetic joint infections and nares are mupirocin susceptible2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 358.
    Salén, Ammi
    Örebro universitet, Institutionen för läkarutbildning.
    Characteristics of women who give birth by caesarian section on maternal request2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 359.
    Sandberg, Alexander
    Örebro universitet, Institutionen för läkarutbildning.
    A new medium for selective culturing of Campylobacter to avoid overgrowth by Extended-Spectrum Beta-lactamase producing Enterobacteriaceae2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 360.
    Sandberg, Elin
    Örebro universitet, Institutionen för läkarutbildning.
    Can Medical Yoga be beneficial in the treatment of eating disorder patients?: A brief intervention to evaluate the experience and changes related to self-image2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 361.
    Sandblom, Isabelle
    Örebro universitet, Institutionen för läkarutbildning.
    Vestibular evoked myogenic potentials in patients with Ménière’s Disease2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 362.
    Sandersson Bergqvist, Freja
    Örebro universitet, Institutionen för läkarutbildning.
    Could embolization with Onyx cause adverse effect on the liver?2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 363.
    Santiago Dahlgren, Joakim
    Örebro universitet, Institutionen för läkarutbildning.
    The prevalence of extended-spectrum β-lactamase-producing Enterobacteriaceae in urinary isolates from patients visiting a teaching hospital in northern Kerala, India2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 364.
    Santoro, Aurelia
    et al.
    Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
    Pini, Elisa
    C.I.G. Interdepartmental Centre ‘‘L. Galvani’’, University of Bologna, Bologna, Italy.
    Scurti, Maria
    Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
    Palmas, Giustina
    C.I.G. Interdepartmental Centre ‘‘L. Galvani’’, University of Bologna, Bologna, Italy.
    Berendsen, Agnes
    Department of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
    Brzozowska, Anna
    Division of Human Nutrition, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland.
    Pietruszka, Barbara
    Division of Human Nutrition, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland.
    Szczecinska, Anna
    Division of Human Nutrition, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland.
    Cano, Noël
    Centre de Recherche en Nutrition Humaine d’Auvergne, INRA-Clermont Universite´,Clermont-Ferrand, France.
    Meunier, Nathalie
    Unite´ d’Exploration en Nutrition, Centre Hospitalier Universitaire, Clermont-Ferrand, France.
    de Groot, C. P. G. M.
    Department of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
    Feskens, Edith
    Department of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
    Fairweather-Tait, Susan
    Norwich Medical School, University of East Anglia, Norwich, UK.
    Salvioli, Stefano
    Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
    Capri, Miriam
    Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
    Brigidi, Patrizia
    Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
    Franceschi, Claudio
    Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; C.I.G. Interdepartmental Centre ‘‘L. Galvani’’, University of Bologna, Bologna, Italy.
    Fabbri, Cristina
    Universitá di Bologna, Bologna, Italy.
    Bertarelli, C.
    Universitá di Bologna, Bologna, Italy.
    Izzi, M.
    Universitá di Bologna, Bologna, Italy.
    Mazzocchi, M.
    Universitá di Bologna, Bologna, Italy.
    Cardigny, J. M.
    Institut National de la RechercheAgronomique, Marcenat, France .
    Morio, B.
    Institut National de la RechercheAgronomique, Marcenat, France .
    Rossi, D.
    Spread EuropeanSafetyGeie, Roma, Italy.
    Notarfonso, M.
    Spread EuropeanSafetyGeie, Roma, Italy.
    O'Toole, P. W.
    University College Cork, Cork, Ireland; National University of Ireland, Galway, Ireland.
    Cashman, K.
    University College Cork, Cork, Ireland; National University of Ireland, Galway, Ireland.
    Carding, S. R.
    Institute of Food Research, Norwich, United Kingdom.
    Nicoletti, C.
    Institute of Food Research, Norwich, United Kingdom.
    Jacobs, D.
    FoodDrinkEurope, Bruxelles, Belgium.
    Xipsiti, M.
    FoodDrinkEurope, Bruxelles, Belgium.
    Fernandez, L.
    European Food Information Council AISBL, Bruxelles, Belgium.
    Willis, J.
    European Food Information Council AISBL, Bruxelles, Belgium.
    Irz, X.
    Maa Ja Elintarviketalouden Tutkimuskeskus, Helsinki, Finland.
    Kuosmanen, N.
    Maa Ja Elintarviketalouden Tutkimuskeskus, Helsinki, Finland.
    Gonos, E. S.
    Ethniko Idryma Erevnon, Athens, Greece.
    Voutetakis, K.
    Ethniko Idryma Erevnon, Athens, Greece.
    Salmon, M.
    Straticell Screening Technologies, Les Isnes, Belgium.
    Toussaint, O.
    Straticell Screening Technologies, Les Isnes, Belgium.
    Traill, B. W.
    The University of Reading, Reading, United Kingdom.
    Nocella, G.
    The University of Reading, Reading, United Kingdom.
    Caracciolo, B.
    Karolinska Institutet, Stockholm, Sweden.
    Xu, W.
    Karolinska Institutet, Stockholm, Sweden.
    Mikko, Ikonen
    Valio Oy, Tampere, Finland .
    Tuure, T.
    Valio Oy, Tampere, Finland .
    Brummer, Robert Jan
    Örebro universitet, Institutionen för läkarutbildning.
    Kadi, Fawzi
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Breton, S
    Lesieur SAS, Mayenne, France .
    Triomphe, M.
    Lesieur SAS, Mayenne, France .
    Magario, G
    Villani s.p.a, Rangone MO, Italy.
    Villani, F
    Villani s.p.a, Rangone MO, Italy.
    Pancrazio, A.
    Pancrazio SpA, Cava de' Tirreni SA, Italy .
    Teufner, B.
    WiesbauerGourmet Gastro GmbH, Sitzenberg-Reidling, Austria .
    Stocker, J.
    WiesbauerGourmet Gastro GmbH, Sitzenberg-Reidling, Austria .
    Echevarría, F. J.
    Vidreres Llet, S.L., Girona, Spain .
    Iglesias, J. R.
    Vidreres Llet, S.L., Girona, Spain .
    Smrz, F.
    Zeelandia Spol. s r.o., Malšice, Czech Republic .
    Krejcirova, L
    Zeelandia Spol. s r.o., Malšice, Czech Republic .
    Koytsomitropoulou, E.
    Mevgal SA, Koufalia, Greece .
    Georgakidis, K.
    Mevgal SA, Koufalia, Greece .
    Yornuk, R.
    Yoruk Sut Urunleri Hayvancilik Gida San. Ve Tic. Ltd., Mersin, Turkey.
    Ucar, C.
    Yoruk Sut Urunleri Hayvancilik Gida San. Ve Tic. Ltd., Turkey.
    Van Ommen, B.
    Dutch Organization for Applied Scientific Research (TNO), , ,Netherlands.
    Bouwman, J.
    Dutch Organization for Applied Scientific Research (TNO), , ,Netherlands.
    Collino, S.
    Nestec S.A., Vevey, Switzerland.
    Jankovics, C.
    Mirelite Mirsa Zartkoruen Mukodo Reszvenytarsasag, Albertirsa, Hungary.
    Losó, A.
    Mirelite Mirsa Zartkoruen Mukodo Reszvenytarsasag, Albertirsa, Hungary.
    de Vos, W
    Wageningen Universiteit, Wageningen, Netherlands .
    Fuentes, S
    Wageningen Universiteit, Wageningen, Netherlands .
    Commelin, E
    EC6 Sarl, Paris, France .
    Combating inflammaging through a Mediterranean whole diet approach: The NU-AGE project's conceptual framework and design2014Ingår i: Mechanisms of Ageing and Development, ISSN 0047-6374, E-ISSN 1872-6216, Vol. 136-137, s. 3-13Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The development of a chronic, low grade, inflammatory status named "inflammaging" is a major characteristic of ageing, which plays a critical role in the pathogenesis of age-related diseases. Inflammaging is both local and systemic, and a variety of organs and systems contribute inflammatory stimuli that accumulate lifelong. The NU-AGE rationale is that a one year Mediterranean whole diet (considered by UNESCO a heritage of humanity), newly designed to meet the nutritional needs of the elderly, will reduce inflammaging in fully characterized subjects aged 65-79 years of age, and will have systemic beneficial effects on health status (physical and cognitive). Before and after the dietary intervention a comprehensive set of analyses, including omics (transcriptomics, epigenetics, metabolomics and metagenomics) will be performed to identify the underpinning molecular mechanisms. NU-AGE will set up a comprehensive database as a tool for a systems biology approach to inflammaging and nutrition. NU-AGE is highly interdisciplinary, includes leading research centres in Europe on nutrition and ageing, and is complemented by EU multinational food industries and SMEs, interested in the production of functional and enriched/advanced traditional food tailored for the elderly market, and European Federations targeting policy makers and major stakeholders, from consumers to EU Food & Drink Industries.

  • 365.
    Schoultz, Ida
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Verma, Deepti
    Törkvist, Leif
    Halfvarson, Jonas
    Örebro universitet, Institutionen för läkarutbildning.
    Lerm, Maria
    Söderkvist, Peter
    Söderholm, Johan D.
    M2080 Compound Polymorphisms in CARD8 and CIAS1 Predispose to Crohn's Disease in a Swedish Cohort2008Ingår i: Gastroenterology, ISSN 0016-5085, E-ISSN 1528-0012, Vol. 134, nr 4, s. A464-A465Artikel i tidskrift (Övrigt vetenskapligt)
  • 366.
    Scott, M. J.
    et al.
    Royal Surrey County Hospital, NHS Foundation Trust, University of Surrey, Guildford, United Kingdom.
    Baldini, G.
    Department of Anesthesia, McGill University Health Centre, Montreal General Hospital, Montreal QC, Canada.
    Fearon, K. C. H.
    Royal Infirmary Clinical Surgery, University of Edinburgh, Edinburgh, United Kingdom.
    Feldheiser, A.
    Department of Anesthesiology, Intensive Care Medicine Campus Charite, Mitte and Campus Virchow-Klinikum Charite, University Medicine, Berlin, Germany.
    Feldman, L. S.
    Department of Surgery, McGill University Health Centre, Montreal General Hospital, Montreal QC, Canada.
    Gan, T. J.
    Department of Anesthesiology, Duke University Medical Center, Durham NY, United States; Department of Anesthesiology, Stony Brook University, Stony Brook NY, United States.
    Ljungqvist, Olle
    Örebro universitet, Institutionen för läkarutbildning.
    Lobo, D. N.
    Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research, Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, United Kingdom.
    Rockall, T. A.
    Royal Surrey County Hospital, NHS Foundation Trust, University of Surrey, Guildford, United Kingdom.
    Schricker, T.
    Department of Anesthesia, McGill University Health Centre, Royal Victoria Hospital, Montreal QC, Canada.
    Carli, F.
    Department of Anesthesia, McGill University Health Centre, Montreal General Hospital, Montreal QC, Canada.
    Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations2015Ingår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 59, nr 10, s. 1212-1231Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: The present article has been written to convey concepts of anaesthetic care within the context of an Enhanced Recovery After Surgery (ERAS) programme, thus aligning the practice of anaesthesia with the care delivered by the surgical team before, during and after surgery.

    Methods: The physiological principles supporting the implementation of the ERAS programmes in patients undergoing major abdominal procedures are reviewed using an updated literature search and discussed by a multidisciplinary group composed of anaesthesiologists and surgeons with the aim to improve perioperative care.

    Results: The pathophysiology of some key perioperative elements disturbing the homoeostatic mechanisms such as insulin resistance, ileus and pain is here discussed.

    Conclusions: Evidence-based strategies aimed at controlling the disruption of homoeostasis need to be evaluated in the context of ERAS programmes. Anaesthesiologists could, therefore, play a crucial role in facilitating the recovery process.

  • 367.
    Selden, A. I.
    et al.
    Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden.
    Calo, A.
    Study Consultancy Inc., Örebro, Sweden.
    Molleby, G.
    Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden.
    Hultgren, Olof
    Örebro universitet, Institutionen för läkarutbildning. Department of Clinical Microbiology, Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Chironomid midge sensitization in sewage workers: case study2013Ingår i: Medical and Veterinary Entomology, ISSN 0269-283X, E-ISSN 1365-2915, Vol. 27, nr 3, s. 346-348Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Non-biting chironomid midges (Diptera: Chironomidae) may cause sensitization and allergic reactions in humans and have recently been identified as a potential health problem in Swedish municipal sewage treatment plants. To investigate, on a pilot scale, the allergenic potential of chironomids in sewage workers, all workers (n = 8) at a sewage treatment plant and local controls (n = 16) completed a symptom questionnaire, underwent measurement of the fraction of nitric oxide in exhaled air, spirometry, and provided serum samples for the determination of atopy status and the prevalence of specific immunoglobulin E (IgE) antibodies against Chironomus thummi (Chi t) using a commercial fluorescence enzyme immunoassay (FEIA). Three sewage workers (38%) but no controls (0%) were FEIA positive for C. thummi-specific IgE antibodies (P < 0.05). No other health-related findings were significantly different between the groups. The study suggested that occupational exposure to Chironomids may cause sensitization with circulating IgE-antibodies in sewage workers.

  • 368.
    Sigra, Sofia
    Örebro universitet, Institutionen för läkarutbildning.
    Short-term effects of watermelon consumption on endothelial function after a high-fat meal in healthy individuals2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 369.
    Skyttestrand, Hanna
    Örebro universitet, Institutionen för läkarutbildning.
    Sköra äldres vårdtid – önskemål och utfall: En intervjustudie på akutmottagningen2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 370.
    Smedberg, Oscar
    Örebro universitet, Institutionen för läkarutbildning.
    Short-term effect of watermelon consumption on arterial stiffness in healthy adults2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 371.
    Smith, Kathleen
    Örebro universitet, Institutionen för läkarutbildning.
    Competition and exercise habits in adolescentswith Type 1 Diabetes Mellitus-effect on glycemic control2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 372.
    Stallberg, Bjorn
    et al.
    Dept Publ Hlth & Caring Sci Family Med & Prevent, Uppsala University, Uppsala, Sweden.
    Janson, Christer
    Dept Med Sci Resp Med & Allergol, Uppsala University, Uppsala, Sweden.
    Sundh, Josefin
    Örebro universitet, Institutionen för läkarutbildning.
    Montgomery, Scott
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Kampe, Mary
    Dept Med Sci Resp Med & Allergol, Uppsala University, Uppsala, Sweden.
    Efraimsson, Eva Osterlund
    Sch Hlth & Social Studies, Dalarna University, Falun, Sweden.
    Ericson, Anna
    Dept Publ Hlth & Caring Sci Family Med & Prevent, Uppsala University, Uppsala, Sweden.
    Lisspers, Karin
    Dept Publ Hlth & Caring Sci Family Med & Prevent, Uppsala University, Uppsala, Sweden.
    New GOLD recommendations in a seven years follow up - changes in symptoms and risk categories2013Ingår i: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 42, nr 57, artikel-id 2742Artikel i tidskrift (Övrigt vetenskapligt)
  • 373.
    Stegberg, Marcus
    Örebro universitet, Institutionen för läkarutbildning.
    Atrial fibrillation and the Cryo Maze procedure2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 374.
    Stenzelius, Karin
    et al.
    Faculty of Health and Society, Malmö University, Skåne University Hospital, Malmö, Sweden.
    Molander, Ulla
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Odeberg, Jenny
    SBU-The Swedish Council on Health Technology Assessment, Stockholm, Sweden.
    Hammarström, Margareta
    Department of Gynecology and Obstetrics, Childrens and Youth Hospital of Queen Silvia, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Franzen, Karin M.
    Örebro universitet, Institutionen för läkarutbildning. Department of Gynecology and Obstetrics, Örebro University Hospital, Örebro, Sweden.
    Midlöv, Patrik
    Clinical Research Centre (CRC), Skåne University Hospital, Malmö, Sweden.
    Samuelsson, Eva
    Family Medicine, Department of Public Health and Clinical medicine, Umeå University, Umeå, Sweden.
    Andersson, Gunnel
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    The effect of conservative treatment of urinary incontinence among older and frail older people: a systematic review2015Ingår i: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 44, nr 5, s. 736-744Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: urinary incontinence (UI) is a common symptom among older people, with a higher prevalence among frail older persons living in nursing homes. Despite consequences such as reduced health and quality of life, many older people do not seek help for their symptoms, resulting in missed opportunity for treatment.

    Objective: the aim of this study was to investigate the evidence and the effect of conservative treatment of UI and the quality of life among older and frail older persons.

    Methods: a systematic review of randomised controlled studies and prospective, non-randomised studies was conducted, evaluating interventions of conservative treatment of UI in an older population (65 years or older). A total of 23 studies fulfilled the inclusion criteria and 9 were of high or moderate quality. Fourteen studies were of low quality and were therefore excluded from the analysis.

    Results: documented and effective conservative treatments are available even for older persons with UI. Pelvic muscle exercise, physical training in combination with ADL, prompted voiding and attention training, and help to toilet are important treatments. In some studies, however, the evidence of effectiveness is limited.

    Conclusions: this systematic review concludes that there are conservative treatments for UI for older and frail older persons that reduce leakage and increase quality of life. There is however a need for further high-quality studies.

  • 375.
    Stevens, Craig
    et al.
    University of Edinburgh, Edinburgh, UK .
    Henderson, Paul
    University of Edinburgh, Edinburgh, UK .
    Nimmo, Elaine R
    University of Edinburgh, Edinburgh, UK .
    Soares, Dinesh S.
    University of Edinburgh, Edinburgh, UK .
    Dogan, Belgin
    Cornell University, Ithaca NY, USA .
    Simpson, Kenneth W.
    Cornell University, Ithaca NY, USA .
    Barrett, Jefferey C.
    Wellcome Trust Sanger Institute, Cambridge, UK .
    Wilson, David C.
    University of Edinburgh, Edinburgh, UK .
    Satsangi, Jack
    University of Edinburgh, Edinburgh, UK .
    The intermediate filament protein vimentin is a regulator of NOD2 activity2013Ingår i: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 62, nr 5, s. 695-707Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective Mutations in the nucleotide-binding oligomerisation domain-containing protein 2 (NOD2) gene remain the strongest genetic determinants for Crohn's disease (CD). Having previously identified vimentin as a novel NOD2-interacting protein, the authors aimed to investigate the regulatory effects of vimentin on NOD2 function and the association of variants in Vim with CD susceptibility.

    Design Coimmunoprecipitation, fluorescent microscopy and fractionation were used to confirm the interaction between NOD2 and vimentin. HEK293 cells stably expressing wild-type NOD2 or a NOD2 frameshift variant (L1007fs) and SW480 colonic epithelial cells were used alongside the vimentin inhibitor, withaferin A (WFA), to assess effects on NOD2 function using the nuclear factor-kappaB (NF-κB) reporter gene, green fluorescent protein-LC3-based autophagy, and bacterial gentamicin protection assays. International genome-wide association meta-analysis data were used to test for associations of single-nucleotide polymorphisms in Vim with CD susceptibility.

    Results The leucine-rich repeat domain of NOD2 contained the elements required for vimentin binding; CD-associated polymorphisms disrupted this interaction. NOD2 and vimentin colocalised at the cell plasma membrane, and cytosolic mislocalisation of the L1007fs and R702W variants correlated with an inability to interact with vimentin. Use of WFA demonstrated that vimentin was required for NOD2-dependent NF-κB activation and muramyl dipeptide-induced autophagy induction, and that NOD2 and vimentin regulated the invasion and survival properties of a CD-associated adherent-invasive Escherichia coli strain. Genetic analysis revealed an association signal across the haplotype block containing Vim.

    Conclusion Vimentin is an important regulator of NOD2 function and a potential novel therapeutic target in the treatment of CD. In addition, Vim is a candidate susceptibility gene for CD, supporting the functional data.

  • 376. Strid, Hilja
    et al.
    Kumawat, Ashok
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Tysk, Curt
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Hultgren Hörnquist, Elisabet
    Örebro universitet, Institutionen för läkarutbildning.
    Bohr, Johan
    Genuttrycket för Renin och IL-6 i kolonmucosan är förändrad vid kollagen kolit2012Konferensbidrag (Övrigt vetenskapligt)
  • 377.
    Strålberg, Towe
    Örebro universitet, Institutionen för läkarutbildning.
    Effects of renal denervation on plasma vasopressin concentration2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 378.
    Støen, Ole-Gunnar
    et al.
    Department of Ecology and Natural Resource Management, Norwegian University of Life Sciences, Ås, Norway; Department of Wildlife, Fish and Environmental Studies, Swedish University of Agricultural Sciences, Umeå, Sweden.
    Ordiz, Andres
    Department of Ecology and Natural Resource Management, Norwegian University of Life Sciences, Ås, Norway; Grimsö Wildlife Research Station, Department of Ecology, Swedish University of Agricultural Sciences, Riddarhyttan, Sweden.
    Evans, Alina L.
    Department of Forestry and Wildlife Management, Hedmark University College, Campus Evenstad, Elverum, Norway.
    Laske, Timothy G.
    Medtronic Inc., Mounds View MN, USA; Department of Surgery, University of Minnesota, Minneapolis MN, USA.
    Kindberg, Jonas
    Department of Wildlife, Fish and Environmental Studies, Swedish University of Agricultural Sciences, Umeå, Sweden.
    Fröbert, Ole
    Örebro universitet, Institutionen för läkarutbildning. Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
    Swenson, Jon E.
    Department of Ecology and Natural Resource Management, Norwegian University of Life Sciences, Ås, Norway; Norwegian Institute for Nature Research, Trondheim, Norway.
    Arnemo, Jon M.
    Department of Wildlife, Fish and Environmental Studies, Swedish University of Agricultural Sciences, Umeå, Sweden; Department of Forestry and Wildlife Management, Hedmark University College Evenstad, Elverum, Norway.
    Physiological evidence for a human-induced landscape of fear in brown bears (Ursus arctos)2015Ingår i: Physiology and Behavior, ISSN 0031-9384, E-ISSN 1873-507X, Vol. 152, nr A, s. 244-248Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Human persecution is a major cause of mortality for large carnivores. Consequently, large carnivores avoid humans, but may use human-dominated landscapes by being nocturnal and elusive. Behavioral studies indicate that certain ecological systems are "landscapes of fear", driven by antipredator behavior. Because behavior and physiology are closely interrelated, physiological assessments may provide insight into the behavioral response of large carnivores to human activity. To elucidate changes in brown bears' (Ursus arctos) behavior associated with human activity, we evaluated stress as changes in heart rate (HR) and heart rate variability (HRV) in 12 GPS-collared, free-ranging bears, 7 males and 5 females, 3-11 years old, using cardiac-monitoring devices. We applied generalized linear regression models with HR and HRV as response variables and chest activity, time of day, season, distance traveled, and distance to human settlements from GPS positions recorded every 30 mm as potential explanatory variables. Bears exhibited lower HRV, an indication of stress, when they were close to human settlements and especially during the berry season, when humans were more often in the forest, picking berries and hunting. Our findings provide evidence of a human-induced landscape of fear in this hunted population of brown bears. (C) 2015 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

  • 379.
    Su, Chi
    Örebro universitet, Institutionen för läkarutbildning.
    Uterine Myoma: A quality assurance of the care provided at The Department of Obstetrics & Gynecology at Örebro University Hospital during the years 2008 and 20092014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 380.
    Sundh, Josefin
    et al.
    Örebro universitet, Institutionen för läkarutbildning. Department of Respiratory Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Johansson, Gunnar
    Department of Public Health and Caring Science, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
    Larsson, Kjell
    Unit for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Linden, Anders
    Unit for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Löfdahl, Claes-Göran
    Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden.
    Janson, Christer
    Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden.
    Sandström, Thomas
    Department of Public Health and Clinical Medicine, Division of Medicine/Respiratory Medicine, Umeå University, Umeå, Sweden.
    Comorbidity and health-related quality of life in patients with severe chronic obstructive pulmonary disease attending Swedish secondary care units2015Ingår i: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 10, s. 173-183Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Our understanding of how comorbid diseases influence health-related quality of life (HRQL) in patients with chronic obstructive pulmonary disease (COPD) is limited and in need of improvement. The aim of this study was to examine the associations between comorbidities and HRQL as measured by the instruments EuroQol-5 dimension (EQ-5D) and the COPD Assessment Test (CAT).

    Methods: Information on patient characteristics, chronic bronchitis, cardiovascular disease, diabetes, renal impairment, musculoskeletal symptoms, osteoporosis, depression, and EQ-5D and CAT questionnaire results was collected from 373 patients with Forced Expiratory Volume in one second (FEV1) <50% of predicted value from 27 secondary care respiratory units in Sweden. Correlation analyses and multiple linear regression models were performed using EQ-5D index, EQ-5D visual analog scale (VAS), and CAT scores as response variables.

    Results: Having more comorbid conditions was associated with a worse HRQL as assessed by all instruments. Chronic bronchitis was significantly associated with a worse HRQL as assessed by EQ-5D index (adjusted regression coefficient [95% confidence interval] -0.07 [-0.13 to -0.02]), EQ-5D VAS (-5.17 [-9.42 to -0.92]), and CAT (3.78 [2.35 to 5.20]). Musculoskeletal symptoms were significantly associated with worse EQ-5D index (-0.08 [-0.14 to -0.02]), osteoporosis with worse EQ-5D VAS (-4.65 [-9.27 to -0.03]), and depression with worse EQ-5D index (-0.10 [-0.17 to -0.04]). In stratification analyses, the associations of musculoskeletal symptoms, osteoporosis, and depression with HRQL were limited to female patients.

    Conclusion: The instruments EQ-5D and CAT complement each other and emerge as useful for assessing HRQL in patients with COPD. Chronic bronchitis, musculoskeletal symptoms, osteoporosis, and depression were associated with worse HRQL. We conclude that comorbid conditions, in particular chronic bronchitis, depression, osteoporosis, and musculoskeletal symptoms, should be taken into account in the clinical management of patients with severe COPD.

  • 381.
    Sundh, Josefin
    et al.
    Örebro universitet, Institutionen för läkarutbildning. Dept Resp Med.
    Johansson, Gunnar
    Department of Public Health and Caring Science, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
    Larsson, Kjell
    Unit for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Linden, Anders
    Unit for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Löfdahl, Claes-Göran
    Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden.
    Sandström, Thomas
    Department of Public Health and Clinical Medicine, Division of Medicine/Respiratory Medicine, Umeå University, Umeå, Sweden.
    Janson, Christer
    Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
    The phenotype of concurrent chronic bronchitis and frequent exacerbations in patients with severe COPD attending Swedish secondary care units2015Ingår i: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 10, s. 2327-2334Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Chronic bronchitis and previous exacerbations are both well-known risk factors for new exacerbations, impaired health-related quality of life, and increased mortality in COPD. The aim of the study was to characterize the phenotype of concurrent chronic bronchitis and frequent exacerbation in severe COPD.

    Methods: Information on patient characteristics, comorbidity, and exacerbations from the previous year (total number and number requiring hospitalization) was collected from 373 patients with stage III and IV COPD attending 27 secondary care respiratory units in Sweden. Logistic regression used chronic bronchitis and frequent exacerbations (. 2 exacerbations or. 1 hospitalized exacerbations in the previous year) as response variables. Stratification and interaction analyses examined effect modification by sex.

    Results: Chronic bronchitis was associated with current smoking (adjusted odds ratio [OR] [95% CI], 2.75 [1.54-4.91]; P=0.001), frequent exacerbations (OR [95% CI], 1.93 [1.24-3.01]; P=0.004), and musculoskeletal symptoms (OR [95% CI], 1.74 [1.05-2.86]; P=0.031), while frequent exacerbations were associated with lung function (forced expiratory volume in 1 second as a percentage of predicted value [FEV1% pred]) (OR [95% CI] 0.96 [0.94-0.98]; P=0.001) and chronic bronchitis (OR [95% CI] 1.73 [1.11-2.68]; P=0.015). The phenotype with both chronic bronchitis and frequent exacerbations was associated with FEV1% pred (OR [95% CI] 0.95 [0.92-0.98]; P=0.002) and musculoskeletal symptoms (OR [95% CI] 2.55 [1.31-4.99]; P=0.006). The association of smoking with the phenotype of chronic bronchitis and exacerbations was stronger in women than in men (interaction, P=0.040).

    Conclusion: Musculoskeletal symptoms and low lung function are associated with the phenotype of combined chronic bronchitis and frequent exacerbations in severe COPD. In women, current smoking is of specific importance for this phenotype. This should be considered in clinical COPD care.

  • 382.
    Sundin, Johanna
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Brummer, Robert
    Örebro universitet, Institutionen för läkarutbildning.
    Hultgren Hörnquist, Elisabet
    Örebro universitet, Institutionen för läkarutbildning.
    Rangel, Ignacio
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Increased number of double positive CD3+ CD8+ CD4+ lamina propria T lymphocyte in gut mucosa of post infectious IBS patients compared to healthy controls2012Ingår i: Neurogastroenterology and Motility, ISSN 1350-1925, E-ISSN 1365-2982, Vol. 24, nr Suppl. 2, s. 104-105Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Objective: Irritable bowel syndrome (IBS) developed after a gastroenteritis is denoted post infectious IBS (PI-IBS) and is thought to represent a specific patho-physiological entity. Naive CD8+CD45RA+cytotoxic T lymphocytes recognize antigen derived from intracellular bacteria and viruses. Naive CD4+CD45RA+helper T lymphocytes are activated by the antigen from extracellular microorganisms with the help of antigen-presenting cells. Activated CD4+CD45RO+helper T lymphocytes help phagocytes to kill microbes and activate naive B lymphocytes.

    Aim: To characterize subsets of mucosal lymphocytes in PI-IBS with flow cytometry analysis as a lead in identifying new therapeutic methods.

    Methods: 5 PI-IBS patients and 6 healthy individuals were recruited. We performed a distal colonoscopy without bowel cleansing or other preparation. Lamina propria lymphocytes (LPL) and intra-epithelial lymphocytes (IEL) were isolated from sigmodal biopsies and sub classified by CD3, CD4, CD8, CD45RO and CD45RA with flow cytometry.

    Results: We observed a significant deference (P < 0.01, two-tailed Mann–Whitney test) in double positive CD3+CD8+CD4+LPL between PI-IBS patient and healthy controls. We also observed a trend towards increased frequency of CD3+CD4+LPL in PI-IBS patients. Additionally, PI-IBS patients showed an increased frequency of CD3+CD8+LPL and IEL. The proportion of memory / activated CD45RO+CD4+LPL was higher in PI-IBS patients, and its proportion of the CD8+population was lower compared with the healthy controls. On the contrary the proportion of naive CD45RA+CD4+LPL was lower in PI-IBS patients compared with healthy controls. However, we found no differences in the distribution naı¨ve / activated CD4+ and CD8+IEL between PI-IBS patients and healthy controls.

    Conclusion: The difference in double positive (DP) CD3+CD8+CD4+LPL seen between PI-IBS patient and healthy controls is consistent with findings of increased number DP T cells in target organs in immuno-inflammatory conditions. Our analysis revealed that the normal gut has a greater variation in the prevalence of CD3+CD4+and CD4+CD45RO+LPL than that of PI-IBS patients. These findings confirm aberrant mucosal subsets of lymphocytes. However, more subjects need to be included in the study in order to draw firm conclusions.

  • 383. Sundin, Johanna
    et al.
    Kumawat, Ashok Kumar
    Rangel, I.
    Brummer, Robert
    Hultgren Hörnquist, Elisabet
    Örebro universitet, Institutionen för läkarutbildning.
    Karakterisering av T-lymfocyter från tarmmukosan hos patienter med postinfektiös IBS2012Konferensbidrag (Övrigt vetenskapligt)
  • 384.
    Sundin, Johanna
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Rangel, Ignacio
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Örebro universitet, Institutionen för läkarutbildning.
    Kumawat, Ashok K
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Hultgren-Hörnquist, Elisabeth
    Örebro universitet, Institutionen för läkarutbildning.
    Brummer, Robert J
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län.
    Aberrant mucosal lymphocyte number and subsets in the colon of post-infectious irritable bowel syndrome patients2014Ingår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 49, nr 9, s. 1068-1075Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Irritable bowel syndrome (IBS) is characterized by chronic abdominal symptoms such as pain, discomfort, and altered bowel habits. A subset of IBS patients, denoted as post-infectious IBS (PI-IBS) patients, develop symptoms after an enteric infection. Distinct abnormalities in the gut mucosa, including mucosal inflammation, have been proposed to contribute to or be the cause of PI-IBS. This study investigated lymphocyte subsets in PI-IBS patients compared to healthy controls.

    Materials and methods: Ten PI-IBS patients and nine healthy controls participated. All PI-IBS patients met the Rome III diagnostic criteria for IBS and reported sustained symptoms at least 1 year after an episode of acute gastroenteritis. Intraepithelial lymphocytes and lamina propria lymphocytes (LPLs), isolated from mucosal tissue samples, were stained and analyzed for a comprehensive set of cell markers using flow cytometry.

    Results: The number of LPLs in PI-IBS was significantly increased compared to those in healthy controls (p < 0.05). PI-IBS patients showed significantly increased proportions of CD45RO(+) CD4(+) activated/memory T cells (p < 0.05) and double-positive CD4(+) CD8(+) cells (p < 0.05), respectively, in the lamina propria. The number of CD19(+) LPLs was decreased in PI-IBS patients compared to healthy controls (p < 0.001).

    Conclusion: This study presents new evidence that PI-IBS is associated with a sustained aberrant mucosal immune response and support future studies of anti-inflammatory or immune-modulating treatments in these patients.

  • 385.
    Sundin, Johanna
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Rangel, Ignacio
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Repsilber, Dirk
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Brummer, Robert J.
    Örebro universitet, Institutionen för läkarutbildning.
    Cytokine response after stimulation with key commensal bacteria differ in post-­infectious irritable bowel syndrome (PI-­IBS) patients compared to healthy subjectsManuskript (preprint) (Övrigt vetenskapligt)
  • 386.
    Sundin, Johanna
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Rangel, Ignacio
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Repsilber, Dirk
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Brummer, Robert-Jan
    Örebro universitet, Institutionen för läkarutbildning.
    Cytokine Response after Stimulation with Key Commensal Bacteria Differ in Post-Infectious Irritable Bowel Syndrome (PI-IBS) Patients Compared to Healthy Controls2015Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 9, artikel-id e0134836Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Microbial dysbiosis and prolonged immune activation resulting in low-grade inflammation and intestinal barrier dysfunction have been suggested to be underlying causes of post-infectious irritable bowel syndrome (PI-IBS). The aim of this study was to evaluate the difference in cytokine response between mucosal specimens of PI-IBS patients and healthy controls (HC) after ex vivo stimulation with key anaerobic bacteria.

    Methods: Colonic biopsies from 11 PI-IBS patients and 10 HC were stimulated ex vivo with the commensal bacteria Bacteroides ovatus, Ruminococcus gnavus, Akkermansia muciniphila, Subdoligranulum variabile and Eubacterium limosum, respectively. The cytokine release (IL-1 beta, IL-2, IL-8, IL-10, IL-13, IL-17, TNF-alpha and IFN-gamma) in stimulation supernatants was analyzed using the LUMINEX assay. Comparison of cytokine release between PI-IBS patients and healthy controls was performed taking both unstimulated and bacterially stimulated mucosal specimens into account.

    Key Results: IL-13 release from mucosal specimens without bacterial stimulation was significantly lower in PI-IBS patients compared to HC (p < 0.05). After stimulation with Subdoligranulum variabile, IL-1 beta release from PI-IBS patients was significantly increased compared to HC (p < 0.05). Stimulation with Eubacterium limosum resulted in a significantly decreased IL-10 release in HC compared to PI-IBS patients (p < 0.05) and a tendency to decreased IL-13 release in HC compared to PI-IBS patients (p = 0.07).

    Conclusions & Inferences: PI-IBS patients differ from HC with regard to cytokine release ex vivo after stimulation with selected commensal bacteria. Hence, our results support that the pathogenesis of PI-IBS comprises an altered immune response against commensal gut microbes.

  • 387.
    Svensson, Maria A.
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Perner, S.
    Dept. of Prostate Cancer Research, Institute of Pathology, University Hospital of Bonn, Bonn, Germany.
    Ohlson, A-L.
    Dept. of Urology, University Hospital of Örebro, Sweden; Dept. of Laboratory Medicine, University Hospital of Örebro, Sweden.
    Day, J. R.
    Hologic Gen-Probe, San Diego, USA.
    Kirsten, R.
    Dept. of Prostate Cancer Research, Institute of Pathology, University Hospital of Bonn, Bonn, Germany.
    Groskopf, J.
    Hologic Gen-Probe, San Diego, USA.
    Sollie, T.
    Dept. of Laboratory Medicine, University Hospital of Örebro, Sweden.
    Helenius, Gisela
    Örebro universitet, Institutionen för läkarutbildning.
    Andersson, Swen-Olof
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Demichelis, F.
    Centre for Integrative Biology, University of Trento, Trento, Italy; Institute for Computational Biomedicine, Weill Cornell Medical College, New York, USA.
    Andrén, Ove
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Rubin, M. A.
    Dept. of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, USA.
    A comparative study of ERG status assessment on DNA-, mRNA-, and proteinlevels using unique samples from a Swedish biopsy cohortManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    The ERG rearrangement is identified in approximately 50% of prostate cancer (PCa) screened cohorts and is known to be highly specific. This genetic aberration, most commonly leading to the TMPRSS2-ERG fusion, but also SLC45A3-ERG or NDRG1- ERG fusions, all leading to an over expression of a truncated ERG protein. Most studies have applied in situ hybridization (FISH) methods or mRNA based assays to investigate the ERG status. Recently, studies showed that ERG protein levels assessed by ERG antibodies can be used as a surrogate marker for ERG rearrangement. In the current study we investigate ERG status on a series of diagnostic biopsies using DNA-, mRNA- and protein based assays. We formally compare three assay results (i.e. FISH, fusion mRNA and immunohistochemistry) to identify which method could be most appropriate to use when having limited amount of tissue. ERG rearrangement was found in 56% of the cases. Comparing ERG rearrangement status by FISH with ERG over expression and TMPRSS2-ERG fusion transcript we found 95.1% (154/162, Fisher’s exact test 9.50E-36) and 85.2% (138/162, Fisher’s exact test 7.26E-22) concordance, respectively. We show that the ERG antibody highly correlates with the ERG rearrangement with high sensitivity and specificity. We also identified the most common TMPRSS2-ERG isoform in the majority of ERG rearranged cases. These results provide compelling evidence that the ERG antibody can be used to further investigate the role of ERG in PCa.

  • 388.
    Szigeti, Victor
    Örebro universitet, Institutionen för läkarutbildning.
    Syra-basbalans vid intraabdominell hypertension såsom vid koldioxidinducerad pneumoperitoneum och abdominellt kompartmentsyndrom2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 389.
    Säll, Olof
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Faculty of Medicine and Health, Department of Infectious Diseases, Örebro University, Örebro, Sweden.
    Johansson, Karin
    Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden; , Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Norén, Torbjörn
    Örebro universitet, Institutionen för läkarutbildning. Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden; , Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Low colonization rates of Clostridium difficile among patients and healthcare workers at Örebro University Hospital in Sweden2015Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 123, nr 3, s. 240-244Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to investigate the rate of asymptomatic colonization rate of Clostridium difficile among both healthcare workers (HCWs) and patients in a hospital ward in Sweden. In a prospective observational study, asymptomatic HCWs (n=22) (22/60; 37%) attending patients in an infectious disease ward in Sweden participated and were screened once for C. difficile. At the same time, 58 consecutive patients (58/227; 26%) admitted to the same ward were screened for C. difficile, first at admission and thereafter two times weekly. Fecal samples were obtained by rectal swabs and cultured anaerobically using both cycloserine-cefoxitin-fructose agar and enrichment (Cooked Meat broth). All samples were also tested by loop-mediated isothermal amplification and isolates were tested for the presence of toxin A or B by enzyme immunoassay. None of the analyzed fecal samples from HCWs contained C. difficile. Among the patients during a 2-month observational period, three of the 58 patients (5.2%) were culture positive regarding C. difficile on admission and one additional patient became asymptomatically colonized with C. difficile during the hospital stay. Thus, the colonization rates were 0% (0/22) (95% confidence interval (CI): 0-15.4%) among HCWs and 5.2% (3/58) (95% CI: 1.1-14.4%) among patients at admission. As the HCWs were screened only once, we have not studied transient colonization. In conclusion, with observed low colonization rates, we find no support that HCWs would be an important source for C. difficile transmission.

  • 390.
    Särnblad, Stefan
    Örebro universitet, Institutionen för läkarutbildning.
    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).2013Konferensbidrag (Refereegranskat)
    Abstract [en]

    Objectives: Physical activity is an important part of diabetes management. However, studies concerning the relation between physical activity and metabolic control have shown conflicting results. In this study we wanted to evaluate the effect of physical activity (PA) on metabolic control, measured by glycosylated hemoglobin (HbA1c) in a large cohort of children and adolescents with type 1 diabetes. 

    Methods: Cross-sectional analysis of data from 4,655 patients in 2010-2011, comparing HbA1c values with levels of physical activity. Data were obtained from the Swedish pediatric diabetes quality registry, SWEDIABKIDS. The patients were 7–18 years of age, had type 1 diabetes and were out of remission. The patients were grouped by frequency of physical activity lasting at least 30 minutes each week as follows: PA0, none, PA1, less than once a week, PA2, 1-2 times per week, PA3, 3-5 times per week, and PA4, every day.

    Results: The frequency of physical activity was lower for older children and adolescents (p < 0.001), mean age varying from 13.5 years in PA4 to 15.9 years in PA0.

    Mean HbA1c level was higher in the least active group (PA0: 70 ± 15  mmol/mol (8.5% ± 1.4)) than in the most active group (PA4: 61 ± 13 mmol/mol (7.8% ± 1.2)) (p<0.001). Linear regression showed an inverse dose-response association between physical activity and HbA1c (β: -2.7, 95% CI: -3.0 to -2.3, p<0.001). This effect was found in both sexes and all age groups, apart from girls aged 7-10 years (p=0.252). Multiple regression analysis revealed that the association remained significant (β: -2.0, 95% CI: -2.4 to -1.7, p<0.001) when adjusted for disease duration, insulin dose, insulin methods, and hypoglycemia.

    Conclusions: This study indicates that a higher level of physical activity results in better metabolic control. More studies with objective methods in large populations are required to confirm the inverse dose-response relationship between physical activity and HbA1c.

  • 391.
    Särnblad, Stefan
    Örebro universitet, Institutionen för läkarutbildning.
    Metabola effekter av träning hos ungdomar med typ 1 diabetes2014Ingår i: Sticket, ISSN 1400-8505, nr 2, s. 4-4Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 392.
    Särnblad, Stefan
    et al.
    Örebro universitet, Institutionen för läkarutbildning.
    Adolfsson, Sten
    Forsander, Gun
    Diabetes Mellitus in children with Down's syndrome2007Konferensbidrag (Refereegranskat)
    Abstract [en]

    Objectives: Children with Down’s syndrome have an increased risk of type 1 diabetes. However, the reports regarding the prevalence of Down’s syndrome in children with diabetes are few. The aim oft his study was to describe the prevalence of Down’s syndrome among children with diabetes in Sweden. Another aim was to describe the insulin treatment regimens and metabolic control in children and adolescents with diabetes and Down’s syndrome.

    Methods: Data were collected by a questionnaire that was distributed to all paediatric diabetes centres in Sweden. Data on Down’s syndrome in the background population was obtained from the Swedish birth defect registry.

    Result: 41 out of 43 clinics answered the questionnaire representing 7083 subjects with diabetes. In April 2007, 15 subjects with Down’s syndrome were identified. Median age was 15.6 (range 4.5 –20.0) years, with a median duration of diabetes of 5.0 years. All children were treated with insulin, mainly with multiple insulin injections (10/15). Three children used insulin pump and two children were treated with twice daily insulin injections. One child was also treated with metformin. The median daily insulin dosage was 0.76 U/kg/d (range 0.05 – 1.7 U/kg/d) and HbA1c (Mono-S, upper reference limit 5.3% ) was 6.3 % (range 4.1 – 7.9%). Coeliac disease was reported in 5 and thyroid disease in 8 children. Simultaneous hypothyroidism, diabetes and celiac disease were noted in two children with Down’s syndrome. We identified a prevalence of Down’s syndrome in patients with diabetes of 0.21%,whereas the prevalence of Down’s syndrome in new-born children in the background population is estimated to 0.13%.

    Conclusion: The prevalence of Down’s syndrome in children with diabetes seems to be increased in Sweden. Intensive insulin therapy is possible in children and adolescence with Down’s syndrome and the metabolic control is often satisfactory. Registry validated studies are needed to confirm our findings

  • 393.
    Särnblad, Stefan
    et al.
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
    Berg, Lars
    Department of Medicine, Södra Älvsborg Hospital, Borås, Sweden.
    Detlofsson, Ingalill
    Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
    Jönsson, Åsa
    Swedish Diabetes Association, Stockholm, Sweden.
    Forsander, Gun
    Department of Pediatrics, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Diabetes management in Swedish schools: a national survey of attitudes of parents, children, and diabetes teams2014Ingår i: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 15, nr 8, s. 550-556Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Parents of children with type 1 diabetes often raise complaints about self-care support during school time. The aim of this study was to investigate attitudes to diabetes care in school reported by children with type 1 diabetes, their parents, and their diabetes teams.

    Method: Children who had completed preschool class or at least one grade in the nine-year compulsory school system were invited to participate. Data were collected using separate questionnaires for the children and their parents. In addition, the members of the diabetes team answered a separate questionnaire. All pediatric diabetes centers in Sweden were invited to participate in the study.

    Results: All Swedish children and adolescents with diabetes are treated at pediatric diabetes centers. Out of 44 eligible centers, 41 were able to participate. The questionnaires were completed by 317 children and adolescents and 323 parents. The mean age was 11.4 ± 2.7 years and HbA1c was 61.8 ± 12.4 mmol/mol (7.8 ± 1.1%). For 57% of the children, there was no member of staff at the school with principal responsibility to support diabetes self-care. A written action plan for hypoglycemia existed for 60% of the children. Twenty-one percent of the parents regularly gave less insulin than they calculated would be needed at breakfast because of fear of hypoglycemia during school time.

    Conclusions: Although Sweden has legislation underlining the specific need for diabetes care in school, this nationwide study demonstrates deficiencies in the support of self-care management. 

  • 394.
    Särnblad, Stefan
    et al.
    Örebro universitet, Institutionen för läkarutbildning. Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden .
    Ekelund, Ulf
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Medical Research Council Epidemiology Unit, Cambridge, U.K. .
    Åman, Jan
    Örebro universitet, Institutionen för klinisk medicin. Department of Pediatrics, University Hospital, Örebro, Sweden; Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden .
    Dietary fat intake predicts 1-year change in body fat in adolescent girls with type 1 diabetes2006Ingår i: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 29, nr 6, s. 1227-1230Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The purpose of this study was to determine whether objectively measured physical activity and dietary macronutrient intake differentially predict body fat in adolescent girls with type 1 diabetes and control girls.

    RESEARCH DESIGN AND METHODS: This study comprised 23 girls (12-19 years) with type 1 diabetes and 19 age-matched healthy control girls. At baseline, physical activity and energy intake were assessed for 7 consecutive days by accelerometry and a structured food diary, respectively. Body composition was measured by dual-energy X-ray absorptiometry at baseline and after 1 year.

    RESULTS: Fat intake was positively related to a 1-year change in percentage body fat (P = 0.006), after adjustment for total energy intake. No significant interaction was observed (case-control group x main exposure), indicating that the association between fat intake and gain in body fat was similar in both groups. Physical activity did not predict gain in body fat; however, total physical activity was positively associated with a gain in lean body mass (P < 0.01). Girls treated with six daily dosages of insulin increased their percentage of body fat significantly more than those treated with four daily injections (P < 0.05).

    CONCLUSIONS: In this prospective case-control study, we found that fat intake predicted gain in percentage of body fat in both adolescent girls with type 1 diabetes and healthy control girls. The number of daily insulin injections seems to influence the accumulation of body fat in girls with type 1 diabetes.

  • 395.
    Särnblad, Stefan
    et al.
    Örebro universitet, Institutionen för läkarutbildning.
    Åkesson, Karin
    Fernström, Lillemor
    Ilvered, Rosita
    Forsander, Gun
    Improved diabetes management in Swedish schools: results from two national surveys2016Konferensbidrag (Refereegranskat)
  • 396.
    Söderlund, Emma
    Örebro universitet, Institutionen för läkarutbildning.
    Outcome of using triage on patients 65 years or older and considered frail at Örebro University Hospital2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 397.
    Söderquist, Bo
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. The Departments of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden; Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
    Prosthetic hip joint infection caused by non-capsulated Haemophilus influenzae2014Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 46, nr 9, s. 665-668Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Haemophilus influenzae is rarely described as a causative agent of prosthetic joint infections. Here, a case of prosthetic hip joint infection caused by H. influenzae is reported. Treatment was successful, resulting in implant salvage, by debridement and antibiotic treatment with ciprofloxacin as monotherapy for 3 months.

  • 398.
    Tevell, Staffan
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Infectious Diseases, Karlstad Hospital, Karlstad, Sweden.
    Claesson, C.
    Division of Clinical Microbiology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden; Department of Clinical Microbiology, County Council of Östergötland, Linköping, Sweden.
    Hellmark, Bengt
    Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Söderquist, Bo
    Örebro universitet, Institutionen för läkarutbildning. Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden; Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
    Nilsdotter-Augustinsson, Å.
    Division of Infectious Diseases, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden; Department of Infectious Diseases, County Council of Östergötland, Linköping, Sweden.
    Heterogeneous glycopeptide intermediate Staphylococcus epidermidis isolated from prosthetic joint infections2014Ingår i: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 33, nr 6, s. 911-917Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Methicillin-resistant Staphylococcus epidermidis (MRSE) poses a major problem in prosthetic joint infections (PJIs). Vancomycin is often considered the drug of choice in the empirical treatment of staphylococcal PJIs. As recent decades have seen reports of heterogeneous glycopeptide intermediate S. aureus (hGISA), our aim was to examine the prevalence of heterogeneous glycopeptide intermediate S. epidermidis (hGISE) in PJIs. S. epidermidis isolates (n = 122) from 119 patients in three Swedish counties between 1993 and 2012 were included. All were isolated from perioperative tissue samples from revision surgery in clinically verified PJIs. Antimicrobial susceptibility testing against staphylococcal antibiotics was performed. The macromethod Etest (MME) and glycopeptide resistance detection (GRD) Etest were used to detect hGISE. Standard minimal inhibitory concentration (MIC) determination revealed no vancomycin-resistant isolates, while teicoplanin resistance was detected in 14 out of 122 isolates (11.5 %). hGISE was found in 95 out of 122 isolates (77.9 %), 64 out of 67 of isolates with teicoplanin MIC > 2 mg/L (95.5 %) and 31 out of 55 of isolates with teicoplanin MIC a parts per thousand currency sign2 mg/L (56.4 %). Thus, the presence of hGISE cannot be ruled out by teicoplanin MIC a parts per thousand currency sign2 mg/L alone. Multidrug resistance was detected in 86 out of 95 hGISE isolates (90.5 %) and in 16 out of 27 isolates (59.3 %), where hGISE could not be detected. In conclusion, hGISE detected by MME or GRD was common in this material. However, hGISE is difficult to detect with standard laboratory diagnostic routines. Glycopeptide treatment may not be sufficient in many of these PJIs, even if standard MIC classifies the isolated S. epidermidis as susceptible.

  • 399.
    Theander, Kersti
    et al.
    Department of Nursing, Faculty of Health Science and Technology, Karlstad University, Karlstad, Sweden; Primary Care Research Unit, County Council of Värmland, Karlstad, Sweden.
    Hasselgren, Mikael
    Örebro universitet, Institutionen för läkarutbildning. Primary Care Research Unit, County Council of Värmland, Karlstad, Sweden.
    Luhr, Kristina
    Family Medicine Research Centre, Örebro County Council, Örebro, Sweden.
    Eckerblad, Jeanette
    Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Unosson, Mitra
    Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Karlsson, Ingela
    Department of Nursing, Faculty of Health Science and Technology, Karlstad University, Karlstad, Sweden.
    Symptoms and impact of symptoms on function and health in patients with chronic obstructive pulmonary disease and chronic heart failure in primary health care2014Ingår i: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 9, s. 785-794Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Patients with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) seem to have several symptoms in common that impact health. However, methodological differences make this difficult to compare.

    Aim: Comparisons of symptoms, impact of symptoms on function and health between patients with COPD and CHF in primary health care (PHC).

    Method: The study is cross sectional, including patients with COPD (n=437) and CHF (n=388), registered in the patient administrative systems of PHC. The patients received specific questionnaires - the Memorial Symptom Assessment Scale, the Medical Research Council dyspnea scale, and the Fatigue Impact Scale - by mail and additional questions about psychological and physical health.

    Results: The mean age was 70 +/- 10 years and 78 +/- 10 years for patients with COPD and CHF respectively (P=0.001). Patients with COPD (n=273) experienced more symptoms (11 +/- 7.5) than the CHF patients (n=211) (10 +/- 7.6). The most prevalent symptoms for patients with COPD were dyspnea, cough, and lack of energy. For patients with CHF, the most prevalent symptoms were dyspnea, lack of energy, and difficulty sleeping. Experience of dyspnea, cough, dry mouth, feeling irritable, worrying, and problems with sexual interest or activity were more common in patients with COPD while the experience of swelling of arms or legs was more common among patients with CHF. When controlling for background characteristics, there were no differences regarding feeling irritable, worrying, and sexual problems. There were no differences in impact of symptoms or health.

    Conclusion: Patients with COPD and CHF seem to experience similar symptoms. There were no differences in how the patients perceived their functioning according to their cardinal symptoms; dyspnea and fatigue, and health. An intervention for both groups of patients to optimize the management of symptoms and improve function is probably more relevant in PHC than focusing on separate diagnosis groups.

  • 400.
    Thorold, Hanna
    Örebro universitet, Institutionen för läkarutbildning.
    Effekten av Lucentisbehandling vid Diabetesmakulaödem i Örebro2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
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