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  • 401.
    Thorstenson, Andreas
    et al.
    Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden; Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institute, Stockholm, Sweden; Surgical Intervention Trials Unit, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
    Harmenberg, Ulrika
    Department of Oncology, Karolinska University Hospital, Solna, Stockholm, Sweden.
    Lindblad, Per
    Örebro universitet, Institutionen för läkarutbildning. Dept Urol, Örebro University Hospital, Örebro, Sweden.
    Holmström, Benny
    Department of Urology, Akademiska University Hospital, Uppsala, Sweden.
    Lundstam, Sven
    Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Ljungberg, Börje
    Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.
    Cancer Characteristics and Current Treatments of Patients with Renal Cell Carcinoma in Sweden2015Ingår i: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, artikel-id 456040Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Methodology: Since the start in 2005 virtually all patients with newly diagnosed renal cell carcinoma (RCC) in Sweden are reported to the National Swedish Kidney Cancer Register (NSKCR). The register contains information on histopathology, nuclear grade, clinical stage, preoperative work-up, treatment, recurrence, and survival.

    Results: A total of 8556 patients with newly diagnosed RCC were registered in the NSKCR from 2005 to 2013 resulting in a coverage of 99% as compared to the Swedish Cancer Registry. The mean tumor size at detection decreased from 70 mm in 2005 to 64 mm in 2010. The proportion of patients who were incidentally detected increased. The proportion of patients with tumor stage T1a who underwent partial nephrectomy increased from 22% in 2005 to 56% in 2012. Similarly, the proportion of laparoscopically performed radical nephrectomies increased from 6% in 2005 to 17% in 2010. During the five years of follow-up 20% of the patients had a recurrence.

    Conclusion: Over the last decade there has been a trend of earlier detection and less advanced tumors at detection in patients with RCC. An increasing proportion of the patients undergo laparoscopic and nephron-sparing procedures.

  • 402.
    Thorstenson, Andreas
    et al.
    Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden; Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institute, Stockholm, Sweden; Surgical Intervention Trials Unit, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
    Harmenberg, Ulrika
    Department of Oncology, Karolinska University Hospital Solna, Stockholm, Sweden.
    Lindblad, Per
    Örebro universitet, Institutionen för läkarutbildning. Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Urology.
    Ljungberg, Börje
    Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.
    Lundstam, Sven
    Department of Urology, Sahlgrenska University, Hospital, Göteborg, Sweden.
    Impact of quality indicators on adherence to National and European guidelines for renal cell carcinoma2016Ingår i: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 50, nr 1, s. 2-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim of this population-based study was to evaluate the impact of quality indicators on the adherence to guidelines for renal cell carcinoma (RCC).

    Material and methods: Since 2005, virtually all patients with newly diagnosed RCC in Sweden have been registered in the National Swedish Kidney Cancer Register (NSKCR). The register contains information on histopathology, nuclear grade, clinical stage, preoperative work-up, treatment, recurrence and survival. In addition, a number of quality indicators have been measured in the register aiming to increase the quality of care. The quality indicators are: the coverage of the register, histology reports, preoperative chest computed tomography (CT), partial nephrectomy, laparoscopic surgery, centralization to high-volume hospitals and waiting times.

    Results: A total of 8556 patients with diagnosed RCC were registered from 2005 to 2013 (99% coverage). In 2013, 99% of the histopathology reports were standardized. The number of patients with preoperatively chest CT increased from 59% in 2005 to 89% in 2013. The proportion of patients with RCC T1aN0M0 who underwent partial nephrectomy increased from 22% in 2005 to 56% in 2013. Similarly, laparoscopic radical nephrectomies increased from 6% in 2005 to 24% in 2013. The median tumour size at detection decreased from 60 mm in 2005 to 55 mm in 2013. The proportion of patients who were incidentally detected increased from 43% in 2005 to 55% in 2013.

    Conclusions: The data show an improved adherence to the guidelines for RCC as measured by quality indicators and a steady process of earlier detection of patients with RCC.

  • 403.
    Thunberg, Ulrica
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Oto-rhino-laryngology, Örebro University Hospital, Örebro, Sweden.
    Engström, K.
    Department of Oto-rhino-laryngology, Örebro University Hospital, Örebro, Sweden.
    Olaison, S.
    Department of Oto-rhino-laryngology, Örebro University Hospital, Örebro, Sweden.
    Hugosson, Svante
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. Department of Oto-rhino-laryngology.
    Anterior rhinoscopy and middle meatal culture in acute rhinosinusitis2013Ingår i: Journal of Laryngology and Otology, ISSN 0022-2151, E-ISSN 1748-5460, Vol. 127, nr 11, s. 1088-1092Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To assess the use of bacterial culture findings for middle meatal samples obtained via anterior rhinoscopy, in the diagnosis of adults with acute rhinosinusitis.

    Materials and methods: Microbial cultures were prepared for 30 adult patients with acute rhinosinusitis and suspected bacterial involvement, using samples from the nasopharynx, and from the nasal middle meatus obtained via anterior rhinoscopy. Findings for the ipsilateral maxillary antrum were used as a reference.

    Results: Seventeen patients had a bacterial infection as verified by a positive culture from the maxillary antrum. Middle meatal samples had a similar sensitivity but a better specificity, positive predictive value and negative predictive value, compared with nasopharyngeal samples, although predictive values were not statistically significant at a 95 per cent confidence level.

    Conclusion: Anterior rhinoscopy with culture of middle meatal samples can be recommended as a diagnostic procedure for acute rhinosinusitis. The results can also guide the decision on antibiotic treatment.

  • 404.
    Thunberg, Ulrica
    et al.
    Department of Otorhinolaryngology, Örebro University Hospital, Örebro, Sweden; Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Hugosson, Svante
    Region Örebro län. Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Otorhinolaryngology, Örebro University Hospital, Örebro, Sweden.
    Monecke, Stefan
    Alere Technologies GmbH, Jena, Germany; Institute for Medical Microbiology and Hygiene, Technical University of Dresden, Dresden, Germany.
    Ehricht, Ralf
    Alere Technologies GmbH, Jena, Germany.
    Söderquist, Bo
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Molecular characteristics of Staphylococcus aureus associated with chronic rhinosinusitis2014Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 123, nr 1, s. 37-44Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The anterior nares have been regarded as the major carriage site of Staphylococcus aureus. From here, the organism can spread to other parts of the body where it might act as harmless commensal or cause mild to severe infections. Nasal sinuses are normally sterile, but in patients with chronic rhinosinusitis (CRS), the finding of S. aureus in maxillary sinus cultures is common. Isolates were obtained from the nares and maxillary sinus of patients with CRS and the nares of healthy controls. A significantly higher frequency of S. aureus was found in nares samples from patients (24/42) compared to controls (16/57) (p = 0.004). There is no consensus regarding whether S. aureus is a relevant pathogen in CRS. A DNA microarray was used to investigate the prevalence of S. aureus virulence genes with focus on staphylococcal enterotoxins, toxic shock syndrome toxin-1, agr types, and cell wall-associated proteins. The genotyping of S. aureus isolates revealed only small and non-significant differences in gene prevalence between isolates collected from patients with CRS and those collected from healthy nasal carriers. This study provides an increased knowledge of the genetic pattern of virulence genes among S. aureus collected in CRS.

  • 405.
    Tikkala, Jessica
    Örebro universitet, Institutionen för läkarutbildning.
    Adverse ecological effects on the individual as a consequence of previous antibiotic exposure – a systematic review2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 406.
    Timmerman, Alexandra
    Örebro universitet, Institutionen för läkarutbildning.
    Bacteraemia during tonsillectomy and septoplasty2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 407.
    Tivenius, Johanna
    Örebro universitet, Institutionen för läkarutbildning.
    Penicillinprovokation - gör vi någon nytta?2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 408.
    Tuveson, Viktoria
    Örebro universitet, Institutionen för läkarutbildning.
    THE PREVALENCE OF POPLITEAL ARTERY ANEURYSMS IN PATIENTS WITH ABDOMINAL AORTIC ANEURYSMS Author:2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 409.
    Tärnmark, Karolina
    Örebro universitet, Institutionen för läkarutbildning.
    Prevalence of diagnosed dementia in subjects with schizophrenia as compared to the general population.2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 410.
    Udén, Anna
    Örebro universitet, Institutionen för läkarutbildning.
    Drug therapy in renal impairment: Focus on metformin treatment2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 411.
    Uggla, Bertil
    et al.
    Örebro universitet, Institutionen för läkarutbildning.
    Nilsson, Torbjörn
    Department of Medical Biosciences/Clinical Chemistry, Umeå University, Umeå, Sweden.
    Whole blood viscosity in plasma cell dyscrasias2015Ingår i: Clinical Biochemistry, ISSN 0009-9120, E-ISSN 1873-2933, Vol. 48, nr 3, s. 122-124Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Plasma or serum hyperviscosity in plasma cell dyscrasias (PCD) has been described as a risk factor for circulatory disturbances. Whole blood viscosity (WBV) would theoretically be a better biomarker but has not been studied in PCD.

    Design and methods: Plasma viscosity (PV) and WBV were measured in 89 subjects with PCD and in 60 healthy blood donors by free oscillation rheometry. A complete blood count was obtained using an automated hematology analyzer. Plasma proteins were quantitated by immunoturbidimetry.

    Results: The reference intervals for men & women were 1.16-1.36 & 1.16-1.38. mPa for PV, and 4.9-6.3 & 4.4-6.2. mPa for WBV, respectively. Of the PCD patients, 71% had PV above the reference limit and 40% were above the WBV limit. Multivariate analysis showed that WBV was independently related to hematocrit, PV, concentration of the monoclonal protein (M-protein), plasma fibrinogen concentration and albumin concentration. This model accounted for 76% of the variance in WBV. When the same model was applied to PV, only the concentration of the M-protein was significantly related and the model accounted only for 20% of the variance in PV.

    Conclusion: PV cannot be used as a surrogate marker for WBV in PCD patients. Whole blood viscosity should replace plasma viscosity in patients with PCD.

  • 412.
    Van den Nieuwboer, M.
    et al.
    Athena Institute, Vrije University, Amsterdam, Netherlands .
    Brummer, Robert J.
    Örebro universitet, Institutionen för läkarutbildning.
    Guarner, F.
    Food Microbiology and Biotechnology Digestive System Research Unit, CIBERehd, University Hospital Vall d'Hebron, Barcelona, Spain.
    Morelli, L.
    Istituto di Microbiologia Università Cattolica S.C., Piacenza, Italy .
    Cabana, M.
    Departments of Pediatrics, Epidemiology and Biostatistics, University of California San Francisco (UCSF), San Francisco CA, United States .
    Claassen, E.
    Athena Institute, Vrije University, Amsterdam, Netherlands; Erasmus Medical Center, Department of Viroscience, Rotterdam, Netherlands.
    The administration of probiotics and synbiotics in immune compromised adults: is it safe?2015Ingår i: Beneficial Microbes, ISSN 1876-2883, E-ISSN 1876-2891, Vol. 6, nr 1, s. 3-17Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to systematically evaluate safety of probiotics and synbiotics in immune compromised adults (>= 18 years). Safety was analysed using the Common Terminology Clinical Adverse Events (CTCAE version 4.0) classification, thereby providing an update on previous reports using the most recent available clinical data (2008-2013). Safety aspects are represented and related to number of participants per probiotic strain/culture, study duration, dosage, clinical condition and selected afflictions. Analysis of 57 clinical studies indicates that probiotic and/or synbiotic administration in immune compromised adults is safe with regard to the current evaluated probiotic strains, dosages and duration. Individuals were considered immune compromised if HIV-infected, critically ill, underwent surgery or had an organ- or an autoimmune disease. There were no major safety concerns in the study, as none of the serious adverse events (AE)s were related, or suspected to be related, to the probiotic or synbiotic product and the study products were well tolerated. Overall, AEs occurred less frequent in immune compromised subjects receiving probiotics and/or synbiotics compared to the control group. In addition, the results demonstrated a flaw in precise reporting and classification of AE in most studies. Furthermore, generalisability of conclusions are greatly limited by the inconsistent, imprecise and potentially incomplete reporting as well as the variation in probiotic strains, dosages, administration regimes, study populations and reported outcomes. We argue that standardised reporting on adverse events (CTCAE) in 'food' studies should be obligatory, thereby improving reliability of data and re-enforcing the safety profile of probiotics.

  • 413.
    van den Nieuwboer, M.
    et al.
    Athena Institute, Vrije University, Amsterdam, the Netherlands.
    Brummer, Robert Jan
    Örebro universitet, Institutionen för läkarutbildning.
    Guarner, F.
    Digestive System Research Unit, CIBERehd, University Hospital Vall d’Hebron, Barcelona, Spain.
    Morelli, L.
    Istituto di Microbiologia, Università Cattolica S.C., Piacenza, Italy.
    Cabana, M.
    Departments of Pediatrics, Epidemiology and Biostatistics, University of California (UCSF), San Francisco, USA.
    Claassen, E.
    Athena Institute, Vrije University, Amsterdam, the Netherlands; Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands.
    Safety of probiotics and synbiotics in children under 18 years of age2015Ingår i: Beneficial Microbes, ISSN 1876-2883, E-ISSN 1876-2891, Vol. 6, nr 5, s. 615-630Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to systematically evaluate safety of probiotics and synbiotics in children ageing 0-18 years. This study is the third and final part in a safety trilogy and an update is provided using the most recent available clinical data (2008-2013) by means of the Common Terminology Clinical Adverse Events (CTCAE version 4.0) classification. Safety aspects are represented and related to number of participants per probiotic strain/culture, study duration, dosage, clinical condition and selected afflictions. Analysis of 74 clinical studies indicated that probiotic and/or synbiotic administration in children is safe with regard to the specific evaluated strains, dosages and duration. The population of children include healthy, immune compromised and obese subjects, as well as subjects with intestinal disorders, infections and inflammatory disorders. This study revealed no major safety concerns, as the adverse events (AEs) were unrelated, or not suspected to be related, to the probiotic or synbiotic product. In general the study products were well tolerated. Overall, AEs occurred more frequent in the control arm compared to children receiving probiotics and/or synbiotics. Furthermore, the results indicate inadequate reporting and classification of AEs in the majority of the studies. In addition, generalizability of conclusions are greatly limited by the inconsistent, imprecise and potentially incomplete reporting as well as the variation in probiotic strains, dosages, administration regimes, study populations and reported outcomes.

  • 414.
    van den Nieuwboer, M
    et al.
    Athena Inst, Vrije Univ Amsterdam, Amsterdam, Netherlands; Swammerdam Inst Life Sci, Univ Amsterdam, Amsterdam, Netherlands.
    Claassen, E
    Athena Inst, Vrije Univ Amsterdam, Amsterdam, Netherlands; Dept Virosci, Erasmus MC, Rotterdam, Netherlands .
    Morelli, L
    Ist Microbiol, Univ Cattolica SC, Piacenza, Italy.
    Guarner, F
    CIBERehd, Digest Syst Res Unit, Univ Hosp Vall dHebron, Barcelona, Spain.
    Brummer, Robert J
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län.
    Probiotic and synbiotic safety in infants under two years of age2014Ingår i: Beneficial Microbes, ISSN 1876-2883, E-ISSN 1876-2891, Vol. 5, nr 1, s. 45-60Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In this study, we systematically evaluated safety aspects in clinical trials with probiotics and synbiotics in young infants (0-2 years of age). This study is an update of earlier reports and covers the recent literature from 2008-2013. The safety evaluation is performed along the Common Terminology Clinical Adverse Events (CTCAE) version 4.0 scale, hereby also providing guidance for future studies. Safety aspects are represented and related to number of participants per probiotic strain/culture, study duration, dosage, clinical condition and selected afflictions. The results show a deficiency in the precise reporting and classification of adverse events in most studies. Analysis of 57 clinical trials with probiotics and synbiotics in combination with eight follow-up studies indicate that probiotic administration to infants between 0 and 24 months is safe with regard to the evaluated strains in infants with a particular health status or susceptibility. Most adverse events and serious adverse events were considered unrelated to the study product, and there were no major safety concerns. Almost all studies concluded that none of the adverse effects were related to the study product; the study products are generally well tolerated. Finally, inconsistent, imprecise and potentially incomplete reporting as well as the variation in probiotic strains, dosages, administration regimes, study populations and reported outcomes, greatly limit the generalizability of conclusions and argue convincingly for obligatory and standardised behaviour on adverse events (CTCAE) reporting in 'food' studies.

  • 415.
    Viitala, Emmi
    Örebro universitet, Institutionen för läkarutbildning.
    Long-term care needs after a severe traumatic brain injury2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 416.
    Visuri, Isabella
    Örebro universitet, Institutionen för läkarutbildning.
    Korrelation mellan utfallet i triagesystemet RETTS och skillnader i medicinskallvarlighetsgrad, ledtider på akutmottagningen samt patientkaraktäristika2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 417.
    von Kobyletzki, L. B.
    et al.
    Department of Dermatology, Skåne University Hospital, Lund University, Malmö , Sweden; Department of Public Health Sciences, Karlstad University, Karlstad, Sweden.
    Berner, A.
    Primary Care Research Unit, County Council of Värmland, Karlstad, Sweden.
    Carlstedt, F.
    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.
    Bornehag, C. G.
    Department of Public Health Sciences, Karlstad University, Karlstad, Sweden; SP Technical Research Institute of Sweden, Borås , Sweden.
    Svensson, A.
    Department of Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden.
    Validation of a parental questionnaire to identify atopic dermatitis in a population-based sample of children up to 2 years of age2013Ingår i: Dermatology, ISSN 1018-8665, E-ISSN 1421-9832, Vol. 226, nr 3, s. 222-226Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Validated eczema questionnaires have been available for schoolchildren only, but the incidence of atopic dermatitis (AD) is highest during infancy. Objective: To validate a parental questionnaire to identify AD in children up to 2 years of age.

    Methods: Parents of 476 children answered a written questionnaire prior to an examination by a physician. Sensitivity, specificity, predictive values and test-retest reliability of the questionnaire were assessed.

    Results: A total of 245 (51%) girls and 231 (49%) boys, aged 1-24 months, with and without physician-diagnosed AD participated. Seventy-one children (15%) had physician-diagnosed AD. Validation of the questionnaire by comparisons with physicians' diagnoses showed a sensitivity of 0.87 (95% confidence interval, CI, 0.77-0.94) and a specificity of 0.98 (95% CI, 0.96-0.99). The positive predictive value was 0.90 (95% CI, 0.80-0.96) and the negative predictive value was 0.98 (95% CI, 0.96-0.99). Conclusion: The questionnaire identified AD in children aged 0-2 years with high accuracy.

  • 418.
    Västgård, Rebecka
    Örebro universitet, Institutionen för läkarutbildning.
    Endovascular treatment of abdominal aortic aneurysm- can use of Onyx cause hepatic damage or is co-morbidity the main factor?2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 419.
    Wadelius, M.
    et al.
    Department of Medical Sciences, Clinical Pharmacology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
    Marshall, S. E.
    Medical Research Institute, College of Medicine, Dentistry and Nursing, Ninewells Hospital, University of Dundee, Dundee, UK.
    Islander, G.
    Department of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden.
    Nordang, L.
    Department of Surgical Sciences, Otorhinolaryngology, and Head & Neck Surgery, Uppsala University, Uppsala, Sweden.
    Karawajczyk, M.
    Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden.
    Yue, Q-Y
    Medical Products Agency, Uppsala, Sweden.
    Terreehorst, I.
    Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands.
    Baranova, E. V.
    Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands.
    Hugosson, Svante
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. Department of Otorhinolaryngology, Örebro University Hospital, Örebro, Sweden.
    Sköldefors, K.
    Department of Otorhinolaryngology, Hudiksvall Hospital, Hudiksvall, Sweden.
    Pirmohamed, M.
    Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK.
    Maitland-van der Zee, A-H
    Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands.
    Alfirevic, A.
    Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK.
    Hallberg, P.
    Department of Medical Sciences, Clinical Pharmacology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
    Palmer, C. N. A.
    Medical Research Institute, College of Medicine, Dentistry and Nursing, University of Dundee, Dundee, UK.
    Phenotype Standardization of Angioedema in the Head and Neck Region Caused by Agents Acting on the Angiotensin System2014Ingår i: Clinical Pharmacology and Therapeutics, ISSN 0009-9236, E-ISSN 1532-6535, Vol. 96, nr 4, s. 477-481Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Angioedema is a potentially life-threatening adverse reaction to angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. To study the genetic etiology of this rare adverse event, international consortia and multicenter recruitment of patients are needed. To reduce patient heterogeneity, we have standardized the phenotype. In brief, it comprises swelling in the head and neck region that first occurs during treatment. It should not coincide with urticaria or have another likely cause such as hereditary angioedema.

  • 420.
    Waldau, Markus
    Örebro universitet, Institutionen för läkarutbildning.
    Does BMI and muscle strength in adolescents affect the risk of type 2 diabetes later in life?2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 421.
    Waldemar, Axdorph
    Örebro universitet, Institutionen för läkarutbildning.
    Staphyscope – Microbiological occurrence on stethoscopes within the inpatient care2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 422.
    Wang, Chao-Jie
    et al.
    Dept Oncolgy, Henan Province Peoples Hospital, Zhengzhou University, Zhengzhou, Peoples R China.; Fac Hlth Sci, Div Oncol, Dept Clin & Experimental Medicine, Linköping University, Linköping, Sweden.
    Frayennbergh-Karlson, Hanna
    Fac Health Science, Div Oncology, Dept Clin & Experimental Med, Linköping University, Linköping, Sweden..
    Wang, Da-Wei
    Dept Stomatol, Hosp 1, Hebei Medical University, Shijiazhuang, Peoples R China.
    Arbman, Gunnar
    Dept Surg, Vrinnevi Hospital, Linköping University, Norrköping, Sweden.
    Zhang, Hong
    Örebro universitet, Institutionen för läkarutbildning.
    Sun, Xiao-Feng
    Fac Health Science, Div Oncology, Dept Clin & Experimental Medicine , City Council Östergötland, Linköping University, Linköping, Sweden.
    Clinicopathological significance of BTF3 expression in colorectal cancer2013Ingår i: Tumor Biology, ISSN 1010-4283, E-ISSN 1423-0380, Vol. 34, nr 4, s. 2141-2146Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Basic transcription factor 3 (BTF3) is a general RNA polymerase II transcription factor and is also involved in apoptosis regulation. Increasing evidence shows that BTF3 is aberrantly expressed in several kinds of malignancies, but there is no study to analyze BTF3 expression in colorectal cancer (CRC) patients. Applying immunohistochemistry, we detected BTF3 in CRCs (n = 156), the corresponding distant (n = 42), adjacent normal mucosa (n = 96), lymph node metastases (n = 35), and analyzed its relationships with clinicopathological and biological variables. Our results showed that BTF3 staining significantly increased from distant or adjacent normal mucosa to primary CRCs (p < 0.0001) or metastases (p = 0.002 and p < 0.0001). BTF3 was higher in distal cancers than in proximal cancers (57 % vs. 39 %, p = 0.041). It also showed stronger staining in primary CRCs stage I and II than that in stage III and IV (64 % vs. 35 %, p = 0.0004), or metastases (64 % vs. 29 %, p = 0.004). Cancers with better differentiation had a higher expression than those with worse differentiation (56 % vs. 37 %, p = 0.031). There were positive correlations of BTF3 expression with nuclear factor kappa B (NF-kappa B), RAD50, MRE11, NBS1, and AEG-1 (p < 0.05). In conclusion, BTF3 overexpression may be an early event in CRC development and could be useful biomarker for the early stage of CRCs. BTF3 has positive correlations with NF-kappa B, RAD50, MRE11, NBS1 and AEG-1, and might influence complex signal pathways in CRC.

  • 423.
    Wang, Mo-Jin
    et al.
    Sichuan University, Chengdu, China; Linköping University, Linköping, Sweden.
    Ping, Jie
    Linköping University, Linköping, Sweden.
    Li, Yuan
    Sichuan University, Chengdu, China.
    Adell, Gunnar
    Linköping University, Linköping, Sweden.
    Arbman, Gunnar
    Linköping University, Linköping, Sweden.
    Nodin, Bjorn
    Lund University, Lund, Sweden.
    Meng, Wen-Jian
    Sichuan University, Chengdu, China; Linköping University, Linköping, Sweden.
    Zhang, Hong
    Örebro universitet, Institutionen för läkarutbildning.
    Yu, Yong-Yang
    Sichuan University, Chengdu, China.
    Wang, Cun
    Sichuan University, Chengdu, China.
    Yang, Lie
    Sichuan University, Chengdu, China.
    Zhou, Zong-Guang
    Sichuan University, Chengdu, China.
    Sun, Xiao-Feng
    Sichuan University, Chengdu, China; Linköping University, Linköping, Sweden.
    The prognostic factors and multiple biomarkers in young patients with colorectal cancer2015Ingår i: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 5, artikel-id 10645Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The incidence of colorectal cancer (CRC) in young patients (<= 50 years of age) appears to be increasing. However, their clinicopathological characteristics and survival are controversial. Likewise, the biomarkers are unclear. We used the West China (2008-2013, China), Surveillance, Epidemiology, and End Results program (1973-2011, United States) and Linkoping Cancer (1972-2009, Sweden) databases to analyse clinicopathological characteristics, survival and multiple biomarkers of young CRC patients. A total of 509,934 CRC patients were included from the three databases. The young CRC patients tended to have more distal location tumours, fewer tumour numbers, later stage, more mucinous carcinoma and poorer differentiation. The cancer-specific survival (CSS) of young patients was significantly better. The PRL (HR = 12.341, 95% CI = 1.615-94.276, P = 0.010), RBM3 (HR = 0.093, 95% CI = 0.012-0.712, P = 0.018), Wrap53 (HR = 1.952, 95% CI = 0.452-6.342, P = 0.031), p53 (HR = 5.549, 95% CI = 1.176-26.178, P = 0.045) and DNA status (HR = 17.602, 95% CI = 2.551-121.448, P = 0.001) were associated with CSS of the young patients. In conclusion, this study suggests that young CRC patients present advanced tumours and more malignant pathological features, while they have a better prognosis. The PRL, RBM3, Wrap53, p53 and DNA status are potential prognostic biomarkers for the young CRC patients.

  • 424.
    Wang, Mo-Jin
    et al.
    Department of Gastrointestinal Surgery, Institute of Digestive Surgery and State key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China; Department of Oncology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Ping, Jie
    Department of Oncology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Li, Yuan
    Department of Paediatric Surgery, Institute of Digestive Surgery and State key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
    Holmqvist, Annica
    Department of Oncology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Adell, Gunnar
    Department of Oncology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Arbman, Gunnar
    Department of Oncology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Zhang, Hong
    Örebro universitet, Institutionen för läkarutbildning.
    Zhou, Zong-Guang
    Department of Gastrointestinal Surgery, Institute of Digestive Surgery and State key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
    Sun, Xiao-Feng
    Department of Gastrointestinal Surgery, Institute of Digestive Surgery and State key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China; Department of Oncology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Prognostic significance and molecular features of colorectal mucinous adenocarcinomas: A strobe-compliant study2015Ingår i: Medicine (Baltimore, Md.), ISSN 0025-7974, E-ISSN 1536-5964, Vol. 94, nr 51, artikel-id e2350Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Mucinous adenocarcinoma (MC) is a special histology subtype of colorectal adenocarcinoma. The survival of MC is controversial and the prognostic biomarkers of MC remain unclear. To analyze prognostic significance and molecular features of colorectal MC. This study included 755,682 and 1001 colorectal cancer (CRC) patients from Surveillance, Epidemiology, and End Results program (SEER, 1973 2011), and Linkoping Cancer (LC, 1972-2009) databases. We investigated independently the clinicopathological characteristics, survival, and variety of molecular features from these 2 databases. MC was found in 9.3% and 9.8% patients in SEER and LC, respectively. MC was more frequently localized in the right colon compared with nonmucinous adenocarcinoma (NMC) in both SEER (57.7% vs 37.2%, P < 0.001) and LC (46.9% vs 27.7%, P < 0.001). Colorectal MC patients had significantly worse cancer-specific survival (CSS) than NMC patients (SEER, P < 0.001; LC, P = 0.026), prominently in stage III (SEER, P < 0.001; P=0.023). The multivariate survival analysis showed that MC was independently related to poor prognosis in rectal cancer patients (SEER, hazard ratios [HR], 1.076; 95% confidence intervals [CI], 1.057-1.096; P < 0.001). In LC, the integrated analysis of genetic and epigenetic features showed that that strong expression of PINCH (HR, 3.954; 95% CI, 1.493-10.47; P = 0.013) and weak expression of RAD50 (HR 0.348, 95% CT, 0.106-1.192; P=0.026) were significantly associated with poor CSS of colorectal MC patients. In conclusion, the colorectal MC patients had significantly worse CSS than NMC patients, prominently in stage III. MC was an independent prognostic factor associated with worse survival in rectal cancer patients. The PINCH and RAD50 were prognostic biomarkers for colorectal MC patients.

  • 425.
    Wedemeyer, H.
    et al.
    Dept Gastroenterol Hepatol & Endocrinol, Hannover Med Sch, Hannover, Germany; German Liver Fdn, Hannover, Germany.
    Duberg, Ann-Sofi
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. Dept Infect Dis, Örebro University Hospital, Örebro, Sweden.
    Buti, M.
    CIBERehd, Hosp Valle De Hebron, Barcelona, Spain.
    Rosenberg, W. M.
    Div Med, UCL Inst Liver & Digest Hlth, University College, London, London, England.
    Frankova, S.
    Dept Hepatogastroenterol, Inst Clin & Expt Med, Prague, Czech Republic.
    Esmat, G.
    Cairo Univ, Cairo, Egypt.
    Ormeci, N.
    Ankara Univ, Ankara, Turkey.
    Van Vlierberghe, H.
    Ghent Univ Hosp, Ghent, Belgium.
    Gschwantler, M.
    Dept Internal Med 4, Wilhelminenspital Stadt Wien, Vienna, Austria.
    Akarca, U.
    Ege Univ, Izmir, Turkey.
    Aleman, S.
    Dept Med Huddinge, Karolinska Inst, Stockholm, Sweden; Dept Gastroenterol & Hepatol Infect Dis, Karolinska Univ Hosp, Stockholm, Sweden .
    Balik, I.
    Ankara Univ, Ankara, Turkey.
    Berg, T.
    Univ Leipzig, Leipzig, Germany.
    Bihl, F.
    Dept Gastroenterol, Osped Cantonale, Bellinzona, Switzerland.
    Bilodeau, M.
    Dept Med, Liver Unit, Univ Montreal, Montreal, Canada.
    Blasco, A. J.
    Adv Tech Hlth Serv Res TAISS, Madrid, Spain.
    Brandao Mello, C. E.
    Dept Gastroenterol, Fed Univ State Rio de Janeiro, Rio De Janeiro, Brazil.
    Bruggmann, P.
    Arud Ctr Addict Med, Zurich, Switzerland.
    Calinas, F.
    Ctr Hosp Lisboa Cent, Dept Gastroenterol, Hosp Santo Antonio Capuchos, Lisbon, Portugal.
    Calleja, J. L.
    Hosp Puerta Hierro, Madrid, Spain.
    Cheinquer, H.
    Hosp Clin, Univ Fed Rio Grande do Sul, Porto Alegre RS, Brazil.
    Christensen, P. B.
    Dept Infect Dis, Odense Univ Hosp, Odense, Denmark.
    Clausen, M.
    Region Hosp Hovedstaden, Region Hovedstaden, Hillerød, Denmark.
    Coelho, H. S. M.
    Dept Clin Med, Univ Fed Rio de Janeiro, Rio De Janeiro, Brazil.
    Cornberg, M.
    Dept Gastroenterol Hepatol & Endocrinol, Hannover Med Sch, Hannover, Germany; German Liver Fdn, Hannover, Germany.
    Cramp, M. E.
    Peninsula Sch Med & Dent, Univ Plymouth, Plymouth, England.
    Dore, G. J.
    Kirby Inst, Univ New S Wales, Sydney NSW, Australia.
    Doss, W.
    Cairo Univ, Cairo, Egypt.
    El-Sayed, M. H.
    Ain Shams Univ, Cairo, Egypt.
    Ergor, G.
    Dokuz Eylul Univ, Izmir, Turkey.
    Estes, C.
    Ctr Dis Anal CDA, Louisville CO, USA.
    Falconer, K.
    Dept Med, Karolinska Inst, Huddinge, Sweden; Infect Dis Unit, Karolinska Univ Hosp, Stockholm, Sweden.
    Felix, J.
    Exigo Consultores, Alhos Vedros, Portugal.
    Ferraz, M. L. G.
    Div Gastroenterol, Univ Fed Sao Paulo, Sao Paulo, Brazil.
    Ferreira, P. R.
    Div Infect Dis, Univ Fed Sao Paulo, Sao Paulo, Brazil.
    Garcia-Samaniego, J.
    Biomedical Research Networking Center in Hepatic and Digestive Diseases, Hosp Carlos III, Madrid, Spain.
    Gerstoft, J.
    Univ Copenhagen, Copenhagen, Denmark.
    Giria, J. A.
    Direccao Geral Saude, Lisbon, Portugal.
    Goncales, F. L., Jr.
    Fac Ciencias Med, Disciplina Doencas Infecciosas, Grp Estudo Hepatites,Dept Clin Med, Univ Estadual Campinas, Sao Paulo, Brazil.
    Guimaraes Pessoa, M.
    Sch Med, Div Gastroenterol & Hepatol, Univ Sao Paulo, Sao Paulo, Brazil.
    Hezode, C.
    Serv Hepatogastroenterol, Hop Henri Mondor, Creteil, France.
    Hindman, S. J.
    Dept Med Huddinge, Karolinska Inst, Stockholm, Sweden; Infect Dis Unit, Karolinska Univ Hosp, Stockholm, Sweden.
    Hofer, H.
    Div Gastroenterol & Hepatol, Dept Internal Med 3, Med Univ Vienna, Vienna, Austria.
    Husa, P.
    Clin Infect Dis, Univ Hosp Brno, Masaryk Univ, Brno, Czech Republic.
    Idilman, R.
    Dept Gastroenterol, Sch Med, Ankara Univ, Ankara, Turkey.
    Kåberg, M.
    Dept Med Huddinge, Karolinska Inst, Stockholm, Sweden; Infect Dis Unit, Karolinska Univ Hosp, Stockholm, Sweden.
    Kaita, K. D. E.
    Dept Internal Med, Sect Hepatol, Univ Manitoba, Winnipeg MB, Canada; Viral Hepatitis Invest Unit, Hlth Sci Ctr, Winnipeg MB, Canada .
    Kautz, A.
    European Liver Patients Assoc, St Truiden, Belgium.
    Kaymakoglu, S.
    Istanbul Univ, Istanbul, Turkey.
    Krajden, M.
    British Columbia Ctr Dis Control, Univ British Columbia, Vancouver, Canada.
    Krarup, H.
    Dept Med Gastroenterol, Aalborg Univ Hosp, Aalborg, Denmark; Sect Mol Diagnost, Aalborg Univ Hosp, Aalborg, Denmark .
    Laleman, W.
    Univ Hosp Leuven, Katholieke Univ Leuven, Louvain, Belgium.
    Lavanchy, D.
    Lazaro, P.
    Adv Tech Hlth Serv Res TAISS, Madrid, Spain.
    Marinho, R. T.
    Ctr Hosp Lisboa Cent, Dept Gastroenterol, Hosp Santo Antonio Capuchos, Lisbon, Portugal.
    Marotta, P.
    Div Gastroenterol, Univ Western Ontario, London ON, Canada.
    Mauss, S.
    Univ Dusseldorf, Dusseldorf, Germany.
    Mendes Correa, M. C.
    Sch Med, Univ Sao Paulo, Sao Paulo, Brazil.
    Moreno, C.
    Erasme Univ Hosp, Univ Libre Brussels, Brussels, Belgium.
    Muellhaupt, B.
    Swiss HPB Hepatopancreatobiliary Ctr, Univ Zurich Hosp, Zurich, Switzerland; Dept Gastroenterol & Hepatol, Univ Zurich Hosp, Zurich, Switzerland.
    Myers, R. P.
    Div Gastroenterol & Hepatol, Liver Unit, Univ Calgary, Calgary AB, Canada.
    Nemecek, V.
    Natl Reference Lab Hepatitis, Natl Inst Publ Hlth, Prague, Czech Republic.
    Ovrehus, A. L. H.
    Dept Infect Dis, Odense Univ Hosp, Odense, Denmark.
    Parkes, J.
    Univ Southhampton, Southampton, England.
    Peltekian, K. M.
    Queen Elizabeth II Hlth Sci Ctr, Capital Dist Hlth Author, Dept Med, Dalhousie Univ & Hepatol Serv, Halifax NS, Canada; Queen Elizabeth II Hlth Sci Ctr, Capital Dist Hlth Author, Dept Surg, Dalhousie Univ & Hepatol Serv, Halifax NS, Canada .
    Ramji, A.
    Dept Gastroenterol, Univ British Columbia, Vancouver, Canada.
    Razavi, H.
    Ctr Dis Anal CDA, Louisville CO, USA.
    Reis, N.
    Assembleia Republ, Lisbon, Portugal.
    Roberts, S. K.
    Alfred Hosp, Melbourne Vic, Australia; Monash Univ, Melbourne, Australia.
    Roudot-Thoraval, F.
    Dept Sante Publ, Hop Henri Mondor, Creteil, France.
    Ryder, S. D.
    Nottingham Univ Hosp NHS Trust, Nottingham, England; Biomed Res Unit, Nottingham, England .
    Sarmento-Castro, R.
    Dept Infect Dis, Ctr Hosp Porto, Oporto, Portugal.
    Sarrazin, C.
    JW Goethe Univ Hosp, Frankfurt, Germany.
    Semela, D.
    Div Gastroenterol & Hepatol, Cantonal Hosp St Gallen, St Gallen, Switzerland.
    Sherman, M.
    Univ Hlth Network, Univ Toronto, Toronto Gen Hosp, Toronto, Canada.
    Shiha, G. E.
    Egyptian Liver Res Inst & Hosp ELRIAH, Dakahliah, Egypt.
    Sperl, J.
    Dept Hepatogastroenterol, Inst Clin & Expt Med, Prague, Czech Republic.
    Starkel, P.
    Clin Univ St Luc, Catholic Univ Louvain, Brussels, Belgium.
    Stauber, R. E.
    Med Univ Graz, Div Gastroenterol & Hepatol, Dept Internal Med, Graz, Austria.
    Thompson, A. J.
    St Vincents Hosp, Dept Gastroenterol, Melbourne Vic, Australia; Univ Melbourne, Melbourne Vic, Australia.
    Urbanek, P.
    Dept Internal Med, Fac Med 1, Charles Univ, Prague, Czech Republic; Cent Mil Hosp, Prague, Czech Republic.
    Van Damme, P.
    Univ Antwerp, Antwerp, Belgium.
    van Thiel, I.
    European Liver Patients Assoc, St Truiden, Belgium; Deutsch Leberhilfe eV, Cologne, Germany.
    Vandijck, D.
    Univ Ghent, Dept Hlth Econ & Patient Safety, Ghent, Belgium; Hasselt Univ, Diepenbeek, Belgium.
    Vogel, W.
    Med Univ Innsbruck, Innsbruck, Austria.
    Waked, I.
    Natl Liver Inst, Menoufia, Egypt.
    Weis, N.
    Copenhagen Univ Hosp, Hvidovre, Denmark.
    Wiegand, J.
    Univ Leipzig, Leipzig, Germany.
    Yosry, A.
    Cairo Univ, Cairo, Egypt.
    Zekry, A.
    Univ New S Wales, St George Hosp Clin Sch Med, Sydney, NSW, Australia; Univ New S Wales, Sch Med Sci, Sydney, NSW, Australia.
    Negro, F.
    Univ Hosp, Div Gastroenterol & Hepatol, Geneva, Switzerland; Monash Hlth, Melbourne Vic, Australia.
    Sievert, W.
    Monash Hlth, Melbourne Vic, Australia; Monash Univ, Melbourne, Australia.
    Gower, E.
    Ctr Dis Anal CDA, Louisville CO, USA.
    Strategies to manage hepatitis C virus (HCV) disease burden2014Ingår i: Journal of Viral Hepatitis, ISSN 1352-0504, E-ISSN 1365-2893, Vol. 21, s. 60-89Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The number of hepatitis C virus (HCV) infections is projected to decline while those with advanced liver disease will increase. A modeling approach was used to forecast two treatment scenarios: (i) the impact of increased treatment efficacy while keeping the number of treated patients constant and (ii) increasing efficacy and treatment rate. This analysis suggests that successful diagnosis and treatment of a small proportion of patients can contribute significantly to the reduction of disease burden in the countries studied. The largest reduction in HCV-related morbidity and mortality occurs when increased treatment is combined with higher efficacy therapies, generally in combination with increased diagnosis. With a treatment rate of approximately 10%, this analysis suggests it is possible to achieve elimination of HCV (defined as a >90% decline in total infections by 2030). However, for most countries presented, this will require a 3-5 fold increase in diagnosis and/or treatment. Thus, building the public health and clinical provider capacity for improved diagnosis and treatment will be critical.

  • 426.
    Westerdahl, Elisabeth
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Wittrin, Anna
    Faculty of Medicine and Health, Department of Neurology and Neurophysiology, Örebro University, Örebro, Sweden.
    Kånåhols, Margareta
    Faculty of Medicine and Health, Department of Neurology and Neurophysiology, Örebro University, Örebro, Sweden.
    Gunnarsson, Martin
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. Department of Neurology and Neurophysiology, Örebro University Hospital, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län.
    Deep breathing exercises with positive expiratory pressure in patients with multiple sclerosis: a randomized controlled trial2016Ingår i: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 10, nr 6, s. 698-706Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Breathing exercises with positive expiratory pressure are often recommended to patients with advanced neurological deficits, but the potential benefit in multiple sclerosis (MS) patients with mild and moderate symptoms has not yet been investigated in randomized controlled trials.

    Objectives: To study the effects of 2 months of home-based breathing exercises for patients with mild to moderate MS on respiratory muscle strength, lung function, and subjective breathing and health status outcomes.

    Methods: Forty-eight patients with MS according to the revised McDonald criteria were enrolled in a randomized controlled trial. Patients performing breathing exercises (n = 23) were compared with a control group (n = 25) performing no breathing exercises. The breathing exercises were performed with a positive expiratory pressure device (10-15 cmH2 O) and consisted of 30 slow deep breaths performed twice a day for 2 months. Respiratory muscle strength (maximal inspiratory and expiratory pressure at the mouth), spirometry, oxygenation, thoracic excursion, subjective perceptions of breathing and self-reported health status were evaluated before and after the intervention period.

    Results: Following the intervention, there was a significant difference between the breathing group and the control group regarding the relative change in lung function, favoring the breathing group (vital capacity: P < 0.043; forced vital capacity: P < 0.025). There were no other significant differences between the groups.

    Conclusion: Breathing exercises may be beneficial in patients with mild to moderate stages of MS. However, the clinical significance needs to be clarified, and it remains to be seen whether a sustainable effect in delaying the development of respiratory dysfunction in MS can be obtained.

  • 427.
    Westerling Andersson, Kristian
    Örebro universitet, Institutionen för läkarutbildning.
    Coronary atherosclerosis, adiponectin and a vegetarian diet: A SYSTEMATIC LITERATURE STUDY2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 428.
    Wiberg, Carl Johan
    Örebro universitet, Institutionen för läkarutbildning.
    Finns det skillnader mellan de öppna och de laparoskopiskt utförda appendektomierna gällande operationstid, vårdtid och komplikationer i form av ytliga och djupa infektioner? En analys av appendektomier utförda på Universitetssjukhuset i Örebro 2012.2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 429.
    Wijk, Lena
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Dept Obstet & Gynecol, Univ Örebro, Örebro, Sweden.
    Franzén, Karin
    Örebro universitet, Institutionen för läkarutbildning. Dept Obstet & Gynecol, Univ Örebro, Örebro, Sweden; Sch Hlth & Med Sci, Univ Örebro, Örebro, Sweden.
    Ljungqvist, Olle
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. Dept Surg.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning. Dept Obstet & Gynecol, Örebro University Hospital, Örebro, Sweden.
    Implementing a structured Enhanced Recovery After Surgery (ERAS) protocol reduces length of stay after abdominal hysterectomy2014Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 93, nr 8, s. 749-756Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To study the effects of introducing an Enhanced Recovery After Surgery (ERAS) protocol, modified for gynecological surgery, on length of stay and complications following abdominal hysterectomy.

    Design: Observational study.

    Setting: Department of Obstetrics and Gynecology, Orebro University Hospital, Sweden.

    Population: Eighty-five patients undergoing abdominal hysterectomy for benign or malignant indications between January and December 2012, with or without salpingo-oophorectomy. Outcomes were compared with all consecutive patients who had undergone the same surgery from January to December 2011, immediately before establishing the ERAS protocol (n = 120).

    Methods: The ERAS protocol was initiated in January 2012 as part of a targeted implementation program. Data were extracted from patient records and from a specific database.

    Main outcome measures: Length of stay and the proportion of patients achieving target length of stay (2 days).

    Results: Length of stay was significantly reduced in the study population after introducing the ERAS protocol from a mean of 2.6 (SD 1.1) days to a mean of 2.3 (SD 1.2) days (p = 0.011). The proportion of patients discharged at 2 days was significantly increased from 56% pre-ERAS to 73% after ERAS (p = 0.012). No differences were found in complications (5% vs. 3.5% in primary stay, 12% vs. 15% within 30 days after discharge), reoperations (2% vs. 1%) or readmission (4% vs. 4%).

    Conclusions: Introducing the ERAS protocol for abdominal hysterectomy reduced length of stay without increasing complications or readmissions.

  • 430.
    Wistrand, Camilla
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Cardiothoracic surgery and Vascular surgery, Örebro University Hospital, Örebro, Sweden.
    Söderquist, Bo
    Örebro universitet, Institutionen för läkarutbildning.
    Magnusson, Anders
    Nilsson, Ulrica
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    The effect of preheated versus room-temperature skin disinfection on bacterial colonization during pacemaker device implantation: a randomized controlled non-inferiority trial2015Ingår i: Antimicrobial Resistance and Infection Control, ISSN 2047-2994, E-ISSN 2047-2994, Vol. 4, artikel-id 44Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In clinical practice, patients who are awake often comment that cold surgical skin disinfectant is unpleasant. This is not only a problem of patients’ experience; heat loss during the disinfection process is a problem that can result in hypothermia. Evidence for the efficacy of preheated disinfection is scarce. We tested whether preheated skin disinfectant was non-inferior to room-temperature skin disinfectant on reducing bacterial colonization during pacemaker implantation.

    Methods: This randomized, controlled, non-inferiority trial included 220 patients allocated to skin disinfection with preheated (36 °C) or room-temperature (20 °C) chlorhexidine solution in 70 % ethanol. Cultures were obtained by swabbing at 4 time-points; 1) before skin disinfection (skin surface), 2) after skin disinfection (skin surface), 3) after the incision (subcutaneously in the wound), and 4) before suturing (subcutaneously in the wound).

    Results: The absolute difference in growth between patients treated with preheated versus room-temperature skin disinfectant was zero (90 % CI −0.101 to 0.101; preheated: 30 of 105 [28.6 %] vs. room-temperature: 32 of 112 [28.6 %]). The pre-specified margin for statistical non-inferiority in the protocol was set at 10 % for the preheated disinfectant. There were no significant differences between groups regarding SSIs three month postoperatively, which occurred in 0.9 % (1 of 108) treated with preheated and 1.8 % (2 of 112) treated with room-temperature skin disinfectant.

    Conclusion: Preheated skin disinfection is non-inferior to room-temperature disinfection in bacterial reduction. We therefore suggest that preheated skin disinfection become routine in clean surgery.

  • 431.
    Wittrin, A.
    et al.
    Örebro Univ Hosp, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Westerdahl, Elisabeth
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Gunnarsson, Martin
    Örebro universitet, Institutionen för läkarutbildning. Örebro Univ Hosp, Örebro, Sweden.
    Self-assessment of walking ability in patients with multiple sclerosis and its impact on the expanded disability status scale (EDSS) score2013Ingår i: Multiple Sclerosis, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 19, nr 11, s. 118-118Artikel i tidskrift (Övrigt vetenskapligt)
  • 432. Wouters, Mira M.
    et al.
    Lambrechts, Diether
    Cleynen, Isabelle
    Whorwell, Peter J.
    Lambaerts, Kathleen
    Agreus, Lars
    Dlugosz, Aldona
    Schmidt, Peter T.
    Halfvarson, Jonas
    Örebro universitet, Institutionen för läkarutbildning.
    Simren, Magnus
    Ohlsson, Bodil
    Karling, Pontus
    Van Wanrooy, Sander
    Vermeire, Severine
    Lindberg, Greger
    Spiller, Robin C.
    D'Amato, Mauro
    Boeckxstaens, Guy E.
    Association of protective IL13 polymorphism with irritable bowel syndrome2012Ingår i: Gastroenterology, ISSN 0016-5085, E-ISSN 1528-0012, Vol. 142, nr 5, s. S178-S178Artikel i tidskrift (Övrigt vetenskapligt)
  • 433.
    Wouters, Mira M.
    et al.
    Translational Research Center for Gastrointestinal Disorders, Leuven University, Leuven, Belgium.
    Lambrechts, Diether
    Vesalius Research Center, VIB, Leuven University, Leuven, Belgium; Laboratory for Translational Genetics, Department of Oncology, Leuven University, Leuven, Belgium .
    Knapp, Michael
    Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany .
    Cleynen, Isabelle
    Translational Research Center for Gastrointestinal Disorders, Leuven University, Leuven, Belgium .
    Whorwell, Peter
    Department of Medicine, University of Manchester, Manchester, UK .
    Agreus, Lars
    Centre for Family Medicine, Karolinska Institutet, Stockholm, Sweden.
    Dlugosz, Aldona
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden .
    Schmidt, Peter Thelin
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden .
    Halfvarson, Jonas
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. Department of Internal Medicine.
    Simren, Magnus
    Department of Internal Medicine, Gothenburg University, Gothenburg, Sweden .
    Ohlsson, Bodil
    Department of Clinical Sciences, Skånes University Hospital, Malmö, Sweden .
    Karling, Pontus
    Department of Medicine, Umeå University, Umeå, Sweden .
    Van Wanrooy, Sander
    Translational Research Center for Gastrointestinal Disorders, Leuven University, Leuven, Belgium.
    Mondelaers, Stephanie
    Translational Research Center for Gastrointestinal Disorders, Leuven University, Leuven, Belgium.
    Vermeire, Severine
    Translational Research Center for Gastrointestinal Disorders, Leuven University, Leuven, Belgium.
    Lindberg, Greger
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Spiller, Robin
    Queen's Medical Centre, Nottingham, UK .
    Dukes, George
    Academic DPU, GlaxoSmithKline, Research Triangle Park, Durham NC, USA .
    D'Amato, Mauro
    Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
    Boeckxstaens, Guy
    Translational Research Center for Gastrointestinal Disorders, Leuven University, Leuven, Belgium .
    Genetic variants in CDC42 and NXPH1 as susceptibility factors for constipation and diarrhoea predominant irritable bowel syndrome2014Ingår i: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 63, nr 7, s. 1103-1111Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The complex genetic aetiology underlying irritable bowel syndrome (IBS) needs to be assessed in large-scale genetic studies. Two independent IBS cohorts were genotyped to assess whether genetic variability in immune, neuronal and barrier integrity genes is associated with IBS.

    Design: 384 single nucleotide polymorphisms (SNPs) covering 270 genes were genotyped in an exploratory cohort (935 IBS patients, 639 controls). 33 SNPs with P-uncorrected<0.05 were validated in an independent set of 497 patients and 887 controls. Genotype distributions of single SNPs were assessed using an additive genetic model in IBS and clinical subtypes, IBS-C and IBS-D, both in individual and combined cohorts. Trait anxiety (N=614 patients, 533 controls), lifetime depression (N=654 patients, 533 controls) and mRNA expression in rectal biopsies (N=22 patients, 29 controls) were correlated with SNP genotypes.

    Results: Two SNPs associated independently in the exploratory and validation cohort: rs17837965-CDC42 with IBS-C (ORexploratory=1.59 (1.05 to 1.76); ORvalidation=1.76 (1.03 to 3.01)) and rs2349775-NXPH1 with IBS-D (ORexploratory=1.28 (1.06 to 1.56); ORvalidation=1.42 (1.08 to 1.88)). When combining both cohorts, the association of rs2349775 withstood post hoc correction for multiple testing in the IBS-D subgroup. Additionally, three SNPs in immune-related genes (rs1464510-LPP, rs1881457-IL13, rs2104286-IL2RA), one SNP in a neuronal gene (rs2349775-NXPH1) and two SNPs in epithelial genes (rs245051-SLC26A2, rs17837965-CDC42) were weakly associated with total-IBS (P-uncorrected<0.05). At the functional level, rs1881457 increased IL13 mRNA levels, whereas anxiety and depression scores did not correlate with rs2349775-NXPH1.

    Conclusions: Rs2349775 (NXPH1) and rs17837965 (CDC42) were associated with IBS-D and IBS-C, respectively, in two independent cohorts. Further studies are warranted to validate our findings and to determine the mechanisms underlying IBS pathophysiology.

  • 434.
    Wästfelt, Maja
    Örebro universitet, Institutionen för läkarutbildning.
    Lidocaine and ropivacaine affect cell viability in colorectal cancer cells in vitro2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 435.
    Wätterbjörk, Inger
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning.
    Sahlberg Blom, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Gravida kvinnors och deras partners beslut om KUB-test2012Konferensbidrag (Övrigt vetenskapligt)
  • 436.
    Wätterbjörk, Inger
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning.
    Sahlberg Blom, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    To decide about prenatal screening2012Konferensbidrag (Refereegranskat)
  • 437.
    Wätterbjörk, Inger
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning.
    Sahlberg Blom, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Tvåstegssamtal inför beslut om fosterdiagnostik2010Konferensbidrag (Övrigt vetenskapligt)
  • 438.
    Wätterbjörk, Inger
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning.
    Sahlberg Blom, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Tvåstegssamtal inför beslut om fosterdiagnostik2010Konferensbidrag (Övrigt vetenskapligt)
  • 439.
    Wätterbjörk, Inger
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning.
    Sahlberg Blom, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Tvåstegssamtal inför beslut om fosterdiagnostik: en kvalitativ studie2010Konferensbidrag (Övrigt vetenskapligt)
  • 440.
    Wätterbjörk, Inger
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning.
    Sahlberg Blom, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Tvåstegssamtal inför beslut om fosterdiagnostik: resultat från en kvalitativ studie2010Konferensbidrag (Övrigt vetenskapligt)
  • 441.
    Wätterbjörk, Inger
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. Department of Obstetrics & Gynaecology, Örebro University Hospital, Örebro, Sweden.
    Sahlberg-Blom, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Decision-making process of prenatal screening described by pregnant women and their partners2015Ingår i: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 18, nr 5, s. 1582-1592Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Pregnant women are often faced with having to decide about prenatal screening for Down’s syndrome. However,the decision to participate in or refrain from prenatal screening can be seen as an important decision not only for the pregnant woman but also for both the partners.

    Objective: The aim of this study was to explore the couples’ processes of decision making about prenatal screening.

    Methods: A total of 37 semi-structured interviews conducted at two time points were analysed using the interpretive description.

    Setting: The study was carried out in Maternal health-care centres,Örebro County Council, Sweden.

    Participants: Fifteen couples of different ages and with different experiences of pregnancy and childbirth were interviewed.

    Results: Three different patterns of decision making were identified. For the couples in The open and communicative decision-making process’, the process was straightforward and rational, and the couples discussed the decision with each other. ‘The closed and personal decision-making process’ showed an immediate and non-communicative decision making where the couples decided each for themselves. The couples showing ‘The searching and communicative decision-making process’ followed an arduous road in deciding whether to participate or not in prenatal screening and how to cope with the result.

    Conclusions: The decision-making process was for some couples a fairly straightforward decision, while for others it was a more complex process that required a great deal of consideration.

  • 442.
    Wätterbjörk, Inger
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Sahlberg Blom, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning.
    Barnmorskan informerar om fosterdiagnostik: vad tycker kvinnan och partnern och hur bestämmer de sig?2014Konferensbidrag (Övrigt vetenskapligt)
  • 443.
    Wätterbjörk, Inger
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Sahlberg Blom, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning.
    Information aboutprenatal screening: midwives informs in two steps2013Konferensbidrag (Refereegranskat)
  • 444.
    Wätterbjörk, Inger
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Family Medicine Research Centre.
    Sahlberg-Blom, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning.
    Decision-making about prenatal screening: are pregnant women and partners satisfied with their decision?2013Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Objective The combined test for Down syndrome is offered to pregnant women. Qualitative studies have shown that the decision, whether or not to accept the test,is a rational one for most couples, although for some it may be difficult. Little is known about the couples’ satisfaction with the decision afterwards; the aim of this study was to extend that knowledge

    Method Pregnant women and their partners were invited to fill out a questionnaire at approximately pregnancy week 20. The questionnaire, which covered aspects of their decision on prenatal testing, was based on the Decision Regret Scale, with additional questions

    Results The response rate was 77% (295/359 women and 223/315 partners). The decision whether or not to participate in the combined test was seen as mutual by 95% of the women and 96% of the partners, and was perceived as uncomplicated by 93% of both women and partners. The decision was considered as difficult/very difficult by 6%. With a range of 93% – 99% women and partners were satisfied with their decision afterwards, but 1%–7% were not

    Conclusion The majority of the participants were satisfied wither their decision. However, a small minority were not, which is important to recognize.

  • 445.
    Wätterbjörk, Inger
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Sahlberg-Blom, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Reasons for declining extended information visit on prenatal screening among pregnant women and their partners2015Ingår i: Prenatal Diagnosis, ISSN 0197-3851, E-ISSN 1097-0223, Vol. 35, nr 12, s. 1232-1237Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: A two-step model on information on prenatal screening consists of brief information at the first visit at the Maternal Health Care Centre and an offer of extended information at a separate visit. There is a lack of knowledge why some pregnant women and their partners refrain from the extended information visit. The aim of this study was to explore their reasons

    Method: Eight qualitative interviews were analysed using Interpretive Description.

    Results: In the first theme “From an individual view”, the interviewees saw the invitation from their own points of view. They refrained because they did not want to receive any more information or had taken an individual position against chromosomal testing. In the theme, “From a societal view”, the interviewees perceived the offer as part of a societal view on prenatal screening that they could not support.

    Conclusion: The findings shows that these interviewees' reasons of declining an extended information visit are multidimensional and influenced by different views, from both an individual perspective and a more societal one. Health care professionals should be aware that some persons could have a different view on health care services and could be reluctant to accept offered services.

  • 446.
    Wätterbjörk, Inger
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Sahlberg-Blom, Eva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för läkarutbildning.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Views on prenatal screening among pregnant women and partners declining an extended informationArtikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: A County Council in Sweden has implemented a two-step information model about prenatal screening. In addition to the regular brief information delivered by the midwife at the first routine visit at the maternal health care centre, the two-step model includes an offer of extended information at a separate visit. However, a substantial number of the couples decline and there is a lack of knowledge about their reasons. The aim of this study was to describe views about prenatal screening among couples who had not taken part in an extended information visit, to increase understanding of the perspectives of prenatal screening in this group.

    Method: Qualitative interviews were performed with seven couples not participating in an extended information visit about prenatal screening. Data were analysed using Interpretive Description. Results: The results showed two themes. In the theme “From an individual view”, with the subthemes Declining further information and, Position taken against prenatal screening, the couples saw the invitation and prenatal screening from their own points of view. They refrained because they did not want to receive any more information. In the other theme, “From a societal view”, with the subthemes Society has a hidden agenda and, The health care service’s responsibilities, the couples perceived the offer as part of a societal view on prenatal screening, that they could not support.

    Conclusion: The findings in this group of couples shows that couples’ perceptions of prenatal screening are multidimensional and influenced by different views, from both an individual perspective and a more societal one.

    Practice Implications: Health care professionals should be aware that some persons could be reluctant to accept health care service, and that the challenge is to meet all individuals, without violating their autonomy. Person-centred care could assist with an approach to meeting the person as an individual.

  • 447.
    Yachnin, Kevin
    Örebro universitet, Institutionen för läkarutbildning.
    CpG methylation in HIV-12015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 448.
    Yngvesson, Oskar
    Örebro universitet, Institutionen för läkarutbildning.
    Treatment of Macular Detachment associated with Optic Disc Pit2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 449.
    Zhang, Boxi
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Elmabsout, Ali Ateia
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Khalaf, Hazem
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Basic, Vladimir T.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Jayaprakash, Kartheyaene
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Kruse, Robert
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Bengtsson, Torbjörn
    Örebro universitet, Institutionen för läkarutbildning.
    Sirsjö, Allan
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    The periodontal pathogen Porphyromonas gingivalis changes the gene expression in vascular smooth muscle cells involving the TGFbeta/Notch signalling pathway and increased cell proliferation2013Ingår i: BMC Genomics, ISSN 1471-2164, E-ISSN 1471-2164, Vol. 14, s. 770-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Porphyromonas gingivalis is a gram-negative bacterium that causes destructive chronic periodontitis. In addition, this bacterium is also involved in the development of cardiovascular disease. The aim of this study was to investigate the effects of P. gingivalis infection on gene and protein expression in human aortic smooth muscle cells (AoSMCs) and its relation to cellular function.

    Results: AoSMCs were exposed to viable P. gingivalis for 24 h, whereafter confocal fluorescence microscopy was used to study P. gingivalis invasion of AoSMCs. AoSMCs proliferation was evaluated by neutral red assay. Human genome microarray, western blot and ELISA were used to investigate how P. gingivalis changes the gene and protein expression of AoSMCs. We found that viable P. gingivalis invades AoSMCs, disrupts stress fiber structures and significantly increases cell proliferation. Microarray results showed that, a total of 982 genes were identified as differentially expressed with the threshold log2 fold change >|1| (adjust p-value <0.05). Using bioinformatic data mining, we demonstrated that up-regulated genes are enriched in gene ontology function of positive control of cell proliferation and down-regulated genes are enriched in the function of negative control of cell proliferation. The results from pathway analysis revealed that all the genes belonging to these two categories induced by P. gingivalis were enriched in 25 pathways, including genes of Notch and TGF-beta pathways.

    Conclusions: This study demonstrates that P. gingivalis is able to invade AoSMCs and stimulate their proliferation. The activation of TGF-beta and Notch signaling pathways may be involved in the bacteria-mediated proliferation of AoSMCs. These findings further support the association between periodontitis and cardiovascular diseases.

  • 450.
    Zhang, Boxi
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Khalaf, Hazem
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Sirsjö, Allan
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Bengtsson, Torbjörn
    Örebro universitet, Institutionen för läkarutbildning.
    Gingipains from the Periodontal Pathogen Porphyromonas gingivalis Play a Significant Role in Regulation of Angiopoietin 1 and Angiopoietin 2 in Human Aortic Smooth Muscle Cells2015Ingår i: Infection and Immunity, ISSN 0019-9567, E-ISSN 1098-5522, Vol. 83, nr 11, s. 4256-4265Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Angiopoietin 1 (Angpt1) and angiopoietin 2 (Angpt2) are the ligands of tyrosine kinase (Tie) receptors, and they play important roles in vessel formation and the development of inflammatory diseases, such as atherosclerosis. Porphyromonas gingivalis is a Gram-negative periodontal bacterium that is thought to contribute to the progression of cardiovascular disease. The aim of this study was to investigate the role of P. gingivalis infection in the modulation of Angpt1 and Angpt2 in human aortic smooth muscle cells (AoSMCs). We exposed AoSMCs to wild-type (W50 and 381), gingipain mutant (E8 and K1A), and fimbrial mutant (DPG-3 and KRX-178) P. gingivalis strains and to different concentrations of tumor necrosis factor (TNF). The atherosclerosis risk factor TNF was used as a positive control in this study. We found that P. gingivalis (wild type, K1A, DPG3, and KRX178) and TNF upregulated the expression of Angpt2 and its transcription factor ETS1, respectively, in AoSMCs. In contrast, Angpt1 was inhibited by P. gingivalis and TNF. However, the RgpAB mutant E8 had no effect on the expression of Angpt1, Angpt2, or ETS1 in AoSMCs. The results also showed that ETS1 is critical for P. gingivalis induction of Angpt2. Exposure to Angpt2 protein enhanced the migration of AoSMCs but had no effect on proliferation. This study demonstrates that gingipains are crucial to the ability of P. gingivalis to markedly increase the expressed Angpt2/Angpt1 ratio in AoSMCs, which determines the regulatory role of angiopoietins in angiogenesis and their involvement in the development of atherosclerosis. These findings further support the association between periodontitis and cardiovascular disease.

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