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Deas J, Shah ND, Konijeti GG, Lundin A, Lanser O, Magavi P, Ali S. Dietary therapies for adult and pediatric inflammatory bowel disease. Nutr Clin Pract 2024. [PMID: 38505875 DOI: 10.1002/ncp.11146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/21/2024] Open
Abstract
Diet is an environmental exposure implicated in the development of inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). Dietary therapy is also a tool for management of these conditions. Nutrition therapy for IBD has been shown to reduce intestinal inflammation, promote healing, and alleviate symptoms, as well as improve patients' nutrition status. Although the mechanisms of action of most nutrition therapies for IBD are not well understood, the diets are theorized to eliminate triggers for gut dysbiosis and mucosal immune dysfunction associated with the typical Western diet. Exclusive enteral nutrition and the Crohn's disease exclusion diet are increasingly being used as the primary treatment modality for the induction of remission and/or maintenance therapy in children, and in some adults, with CD. Several other diets, such as the Mediterranean diet, anti-inflammatory diet for IBD, and diets excluding gluten, FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), lactose, or other compounds, may be helpful in symptom management in both CD and UC, though evidence for biochemical efficacy is limited. In this review, we discuss the role of diet components in IBD pathogenesis and examine diets currently used in the management of children and adults with IBD. We also address practical, psychosocial, and cultural considerations for dietary therapy across diverse populations.
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Affiliation(s)
- Jessica Deas
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Neha D Shah
- Colitis and Crohn's Disease Center, University of California San Francisco, San Francisco, California, USA
| | - Gauree G Konijeti
- Division of Gastroenterology & Hepatology, Scripps Clinic, La Jolla, California, USA
| | - Abigail Lundin
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Benioff Children Hospitals, University of California San Francisco, San Francisco, California, USA
| | - Olivia Lanser
- Division of Gastroenterology & Hepatology, Scripps Clinic, La Jolla, California, USA
| | - Pooja Magavi
- Division of Gastroenterology & Hepatology, Scripps Clinic, La Jolla, California, USA
| | - Sabina Ali
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Benioff Children Hospitals, University of California San Francisco, San Francisco, California, USA
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Östh J, Danielsson AK, Lundin A, Wennberg P, Andréasson S, Jirwe M. Keeping Track of My Drinking - Patient Perceptions of Using Smartphone Applications as a Treatment Complement for Alcohol Dependence. Subst Use Misuse 2023; 59:291-299. [PMID: 37876238 DOI: 10.1080/10826084.2023.2269578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
BACKGROUND Alcohol dependence is common, yet highly undertreated. Smartphone applications (apps) have potential to enhance treatment accessibility and effectiveness, however evidence is limited, especially studies focussing on user experiences. The aim was to describe patient perceptions on the usability and acceptability of self-monitoring apps provided as treatment complement for alcohol dependence. METHODS Individual semi-structured interviews were conducted through video or phone calls with 21 participants, recruited from a randomized controlled trial at a dependency clinic in Stockholm. The participants had used two specific apps for self-monitoring consumption ("Glasklart" and "iBAC") during 12 wk prior to the interviews. Data was analyzed using Qualitative Content Analysis. RESULTS Two domains were identified: 1) Smartphone applications as facilitators to treatment, and 2) Barriers to smartphone application use. Using apps within the treatment context was believed to increase the accuracy of the reported consumption. Participants became more aware of their alcohol problem and described the apps as reinforcers that could increase both the motivation to change and the focus on the problem and commitment to treatment. The apps were further described as helpful to control alcohol consumption. However, app usage was constrained by technical problems, unfit app-specific features and procedures, and alcohol-related shame and stigma. DISCUSSION AND CONCLUSIONS Self-monitoring alcohol apps have several beneficial features that can help assess, track, and control alcohol consumption, and improve communication with clinicians. The results indicate they can be useful complements to treatment for patients with alcohol dependence, but their use can be limited by different, foremost technical, issues.
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Affiliation(s)
- J Östh
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - A K Danielsson
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - A Lundin
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - P Wennberg
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - S Andréasson
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - M Jirwe
- Department of Health Sciences, Swedish Red Cross University, Huddinge, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Melin J, Lundin A, Johansson M. An off-target scale limits the utility of Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) as a measure of well-being in public health surveys. Public Health 2021; 202:43-48. [PMID: 34883409 DOI: 10.1016/j.puhe.2021.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/06/2021] [Accepted: 10/19/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To assess the utility and measurement properties for the well-being scale Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) in a Swedish general population survey. STUDY DESIGN A cross-sectional survey study. METHODS Data were retrieved from the 2018 public health survey in Stockholm County, containing a random sample of 22 856 persons stratified to be representative for the municipalities and districts within the region. The data were analyzed according to Rasch Measurement Theory. RESULTS Person attribute values are positively skewed (mean 2.32, SD 1.85), with wide gaps in the item threshold attribute values. Overall item fit statistics were acceptable, and person measurement separation reliability was 0.83, indicating three statistically distinct ranges in the estimated well-being values. CONCLUSION While the SWEMWBS items indicated acceptable fit to the Rasch measurement model, targeting of items to sample is skewed toward lower levels of well-being, and there is a ceiling effect. Thus, we suggest a careful reconsideration of SWEMWBS as a tool for use in general public health surveys, especially for assessing change over time and group differences, as there are large measurement uncertainties for the majority of cases when the population as a whole is sampled. We encourage revisions applying a coherent and comprehensive ordinal construct theory for well-being to fill the gaps in the upper end of the SWEMWBS scales' item thresholds. The addition of more challenging items would improve targeting for population-based surveys, increase reliability, and provide more actionable information that could be useful in improving individuals' well-being.
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Affiliation(s)
- J Melin
- RISE Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology, Sweden; The Gothenburg Centre for Person Centred Care (GPCC), University of Gothenburg, Sahlgrenska Academy, Sweden.
| | - A Lundin
- Global Public Health, Karolinska Institutet, Sweden
| | - M Johansson
- RISE Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology, Sweden
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Lundin A, Waern M, Löve J, Lövestad S, Hensing G, Danielsson AK. Towards ICD-11 for alcohol dependence: Diagnostic agreement with ICD-10, DSM-5, DSM-IV, DSM-III-R and DSM-III diagnoses in a Swedish general population of women. Drug Alcohol Depend 2021; 227:108925. [PMID: 34358771 DOI: 10.1016/j.drugalcdep.2021.108925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/10/2021] [Accepted: 06/17/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND The proposed ICD-11 classification includes major revisions of alcohol dependence. We aimed to evaluate the presence of, and concordance between the proposed ICD-11 dependence and ICD-10, DSM-5, DSM-IV, DSM-III-R and DSM-III in a general population. We also examine as aspects of validity, including longitudinal stability and how meaningful clinical correlates associated across the systems. METHODS Longitudinal population-based study of women in Gothenburg, Sweden. Participants (n = 1,614) were sampled during 1989-2015 through double-phase stratified random sampling. Alcohol use disorders were assessed through structured diagnostic interviews (CIDI-SAM), at baseline and follow-up 5-10 years later (n = 930). Concordance was examined using contingency tables and Cohen's kappa coefficient. RESULTS At baseline, the prevalence of lifetime alcohol dependence was 10.6 % according to ICD-11. Corresponding figures were ICD-10, 4.0 %; DSM-IV, 4.3 %; DSM-III-R, 7.5 %; and DSM-III, 12.3 %.DSM-5 Alcohol Use Disorder was 14.3 %. Concordance between ICD-11 and other diagnoses ranged from almost perfect agreement (with DSM-5 AUD) to substantial (with DSM-III and DSM-III-R) and moderate (with ICD-10 and DSM-IV). The broadening of the "persistent use despite problems" criteria in ICD-11 had little effect on the prevalence. ICD-11 captured a lower proportion of family history of alcohol problems and treatment-seeking compared to ICD-10 and DSM-IV and showed lower stability. CONCLUSIONS The proposed ICD-11 algorithm yields a higher prevalence than either ICD-10 or DSM-III-R /-IV dependence, as well as lower agreement with previous diagnostic systems, lower longitudinal stability and weaker associations with clinical correlates. This is important for knowing how changes in diagnostic criteria impact prevalence estimates and related research.
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Affiliation(s)
- A Lundin
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - M Waern
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Psychosis Clinic, Gothenburg, Sweden
| | - J Löve
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - S Lövestad
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - G Hensing
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - A-K Danielsson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Gémes K, Forsell Y, Janszky I, László KD, Lundin A, Ponce De Leon A, Mukamal KJ, Moller J. Moderate alcohol consumption and depression - a longitudinal population-based study in Sweden. Acta Psychiatr Scand 2019; 139:526-535. [PMID: 30980542 DOI: 10.1111/acps.13034] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/08/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS The interrelationship between alcohol consumption and depression is complex, and the direction of the association is unclear. We investigated whether alcohol consumption influences the risk of depression while accounting for this potential bidirectionality. METHODS A total of 10 441 individuals participated in the PART study in 1998-2000, 8622 in 2001-2003, and 5228 in 2010. Participants answered questions on their alcohol consumption, symptoms of depression, childhood adversity, and sociodemographic, socioeconomic, psychosocial, and lifestyle factors. A total of 5087 participants provided repeated information on alcohol consumption. We used marginal structural models to analyze the association between alcohol consumption and depression while controlling for previous alcohol consumption and depressive symptoms and other time-varying confounders. RESULTS Non-drinkers had a higher depression risk than light drinkers (≤7 drinks/week) (risk ratio: 1.7; 95% confidence interval 1.3-2.1). Consumers of seven-fourteen drinks/week had a depression risk similar to that of light drinkers. Hazardous drinking was associated with a higher risk of depression than non-hazardous alcohol consumption (risk ratio: 1.8, 95% confidence interval: 1.4-2.4). CONCLUSION Light and moderate alcohol consumption and non-hazardous drinking were associated with the lowest risk of subsequent depression after accounting for potential bidirectional effects. Hazardous drinking increased the risk of depression.
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Affiliation(s)
- K Gémes
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Y Forsell
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - I Janszky
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Regional Center for Health Care Improvement St.Olav's Hospital, Trondheim, Norway
| | - K D László
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - A Lundin
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - A Ponce De Leon
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro, Brasil.,Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - K J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - J Moller
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Rabiee R, Lundin A, Agardh E, Danielsson AK. Cannabis use, other illicit drug use and substance use disorders: a 14-year follow-up study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Rabiee
- Karolinska Institute, Stockholm, Sweden
| | - A Lundin
- Karolinska Institute, Stockholm, Sweden
| | - E Agardh
- Karolinska Institute, Stockholm, Sweden
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Åhs J, Kosidou K, Wicks S, Lundin A, Dalman C. Trends in Inpatient Psychiatric Diagnoses in Sweden 1997-2011. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Åhs
- Karolinska Institute, Stockholm, Sweden
| | - K Kosidou
- Karolinska Institute, Stockholm, Sweden
| | - S Wicks
- Stockholm County Council, Stockholm, Sweden
| | - A Lundin
- Karolinska Institute, Stockholm, Sweden
| | - C Dalman
- Karolinska Institute, Stockholm, Sweden
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Lundin A. Pathways to psychiatric outpatient care and patient satisfaction with services in Stockholm, Sweden. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Lundin
- Karolinska Institutet, Stockholm, Sweden
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Hallgren M, Stubbs B, Vancampfort D, Lundin A, Jääkallio P, Forsell Y. Treatment guidelines for depression: Greater emphasis on physical activity is needed. Eur Psychiatry 2016; 40:1-3. [PMID: 27837666 DOI: 10.1016/j.eurpsy.2016.08.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 08/24/2016] [Accepted: 08/26/2016] [Indexed: 12/27/2022] Open
Affiliation(s)
- M Hallgren
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
| | - D Vancampfort
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium
| | - A Lundin
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - P Jääkallio
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Y Forsell
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
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Kehler M, Albrechtsson U, Arnadóttir E, Ebbesen A, Hochbergs P, Lundin A, Lyttkens K, Kheddache K, Månsson LG, Angelhed JE. Digital Luminescence Radiography Using a Chest Phantom. Acta Radiol 2016. [DOI: 10.1177/028418519203300207] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ninety-eight digital radiographs of a chest phantom with simulated tumors in the mediastinum and left lung and a pneumothorax-simulation in the right hemithorax were compared with the corresponding examinations saved on optical disk and viewed on a 1 000-line monitor. The examinations were reviewed by 7 radiologists with different experience, and receiver operating characteristic (ROC) curves were constructed. There was no significant difference between the hard-copy and the monitor results. A significant interobserver difference was seen only with the low attenuating 6 mm “tumor” and then only between the observer with the highest and the one with the lowest scores.
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Kehler M, Albrechtsson U, Andrésdóttir A, Brådvik I, Hochbergs P, Lárusdóttir H, Lundin A. Digital Luminescence Radiography in Interstitial Lung Disease. Acta Radiol 2016. [DOI: 10.1177/028418519103200106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The subtle changes often found in interstitial lung disease can be difficult to evaluate at conventional radiography. In order to define the information obtained with digital radiography, it is particularly important to find out to what extent interstitial lung disease can be observed with this technique. Ninety-one patients, 56 with interstitial lung disease and 35 with normal lungs, were examined both with a digital system and with conventional film-screen technique. The examinations were reviewed independently by 4 radiologists with different experience and receiver operating characteristics (ROC) curves were constructed. The 2 systems were equal in diagnostic performance with no statistic difference between the conventional radiographs, the 2 digital images reviewed together or the 2 digital images reviewed separately. There was a significant difference between the 2 observers with the highest and the one with the lowest score only in the review of digital unsharp mask images, but otherwise no differences statistically. A lower number of false negatives and a higher number of false positives were seen with the digital unsharp mask image, producing a higher sensitivity and lower specificity.
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Kehler M, Albrechtsson U, Andersson B, Lárusdóttir H, Lundin A, Pettersson H. Assessment of Digital Chest Radiography Using Stimulable Phosphor. Acta Radiol 2016. [DOI: 10.1177/028418518903000603] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this pilot study, conventional and digital radiography of the chest was compared in 170 patients. Two digitized radiographs, one frequency modified and one simulating the conventional film-screen combination, and the conventional films were reviewed independently by 5 radiologists with different experience. In spite of the smaller size and lower spatial resolution of the digitized compared with the conventional radiograph, only slight differences were revealed in the observation of different pulmonary and mediastinal changes. Digitized radiography is therefore considered suitable for chest examinations.
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Abstract
Patella height was defined by the distance between the midpoint of the articular surface of the patella and the condylar plane, which was constructed perpendicular to the mechanical axis of the tibia. In two series of normal individuals the measured distances were related to body height and the length of the lower leg and thus expressed as its ratio, which was the same in both sexes. The measurements were performed on lateral radiographs of the knee and lower leg obtained in weight-bearing and 30° to 40° of knee flexion using a simple device to obtain a standardized position of the lower leg during the examination. The standing position is proposed for these measurements since the patellar ligament is shorter in the recumbent position. The method can be used for biomechanical analysis of the femoropatellar joint.
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Kehler M, Albrechtsson U, Andrésdóttir A, Lárusdóttir H, Lundin A. Accuracy of Digital Radiography Using Stimulable Phosphor for Diagnosis of Pneumothorax. Acta Radiol 2016. [DOI: 10.1177/028418519003100109] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To evaluate the efficacy of digitized radiography in diagnosing pneumothorax 78 patients were examined with both the conventional film-screen technique and digital radiography. Of these 78 examinations 40 were normal and in 38 a pneumothorax was found. Four observers with different experience reviewed the films. In an ROC analysis no significant differences were found between the two systems. Between the observers, however, there were slight differences, one of them showing significantly lower specificity.
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Thorvinger B, Lundin A, Albrechtsson U. Increased Rate of Left Predominance Associated with Adult Valvular Aortic Stenosis. Acta Radiol 2016. [DOI: 10.1177/028418519003100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The anatomy of the coronary arteries was outlined angiographically in 2 190 adult patients in order to determine the proportion of left predominance. Of 253 patients with valvular aortic stenosis 14.3 per cent were found to have left predominance, while the frequency of left predominance in the rest of the patients (1 937) was 8.5 per cent. Furthermore, this rate increases with the severity (gradient > 50 mmHg) of the aortic stenosis in the absence of aortic valve incompetence. These findings support the current concept of a relationship between adult aortic stenosis and congenital valvular malformation.
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Kehler M, Albrechtsson U, Andrésdóttir A, Hochbergs P, Lárusdóttir H, Lundin A, Lönntoft M. Efficacy of Inverted Digital Luminescence Radiography in Evaluating Chest Neoplasms. Acta Radiol 2016. [DOI: 10.1177/028418519103200602] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Inverted (positive) digital chest radiographs of patients with lung tumors were compared with commonly used (negative) digital images, consisting of one simulated normal and one contrast enhanced image. The first part of the material consisted of 80 patients of whom 40 had tumors and 40 were normal. Five radiologists with different experience reviewed the examinations. From their answers, ROC curves were constructed. The second part of the material consisted of 100 chest phantom examinations with a simulated tumor in the mediastinum (45 examinations) and/or the left lung (46 examinations). In 31 exposures there was no abnormality. These were reviewed by 3 observers and performed as an ROC study as well. There was no statistical difference between the different types of images or between the observers in the 2 studies.
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Lundin A, Kjellberg K, Leijon O, Punnett L, Hemmingsson T. The Association Between Self-Assessed Future Work Ability and Long-Term Sickness Absence, Disability Pension and Unemployment in a General Working Population: A 7-Year Follow-Up Study. J Occup Rehabil 2016; 26:195-203. [PMID: 26319413 DOI: 10.1007/s10926-015-9603-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Purpose Work ability is commonly measured with self-assessments, in the form of indices or single items. The validity of these assessments lies in their predictive ability. Prospective studies have reported associations between work ability and sickness absence and disability pension, but few examined why these associations exist. Several correlates of work ability have been reported, but their mechanistic role is largely unknown. This study aims to investigate to what extent individual's own prognosis of work ability predicts labor market participation and whether this was due to individual characteristics and/or working conditions. Methods Self-assessed prognosis of work ability, 2 years from "now," in the Stockholm Public Health Questionnaire (2002-2003) was linked to national registers on sickness absence, disability pension and unemployment up to year 2010. Effects were studied with Cox regression models. Results Of a total of 12,064 individuals 1466 reported poor work ability. There were 299 cases of disability pension, 1466 long-term sickness absence cases and 765 long-term unemployed during follow-up. Poor work ability increased the risk of long-term sickness absence (HR 2.25, CI 95 % 1.97-2.56), disability pension (HR 5.19, CI 95 % 4.07-6.62), and long-term unemployment (HR 2.18, CI 95 % 1.83-2.60). These associations were partially explained by baseline health conditions, physical and (less strongly) psychosocial aspects of working conditions. Conclusions Self-assessed poor ability predicted future long-term sickness absence, disability pension and long-term unemployment. Self-assessed poor work ability seems to be an indicator of future labor market exclusion of different kinds, and can be used in public health monitoring.
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Affiliation(s)
- A Lundin
- Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, 113 65, Stockholm, Sweden.
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
| | - K Kjellberg
- Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, 113 65, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - O Leijon
- Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, 113 65, Stockholm, Sweden
- Swedish Social Insurance Inspectorate, Stockholm, Sweden
| | - L Punnett
- Department of Work Environment, University of Massachusetts Lowell, Lowell, MA, USA
| | - T Hemmingsson
- Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, 113 65, Stockholm, Sweden
- Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
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Lundin A, Hallgren M, Theobald H, Hellgren C, Torgén M. Validity of the 12-item version of the General Health Questionnaire in detecting depression in the general population. Public Health 2016; 136:66-74. [PMID: 27040911 DOI: 10.1016/j.puhe.2016.03.005] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 02/18/2016] [Accepted: 03/02/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The 12-item version of the General Health Questionnaire (GHQ-12) is frequently used to measure common mental disorder in public health surveys, but few population-based validations have been made. We validated the GHQ-12 against structured psychiatric interviews of depression using a population-based cohort in Stockholm, Sweden. METHODS We used a population-based cohort of 484 individuals in Stockholm, Sweden (participation rate 62%). All completed the GHQ-12 and a semi-structured psychiatric interview. Last month DSM-III-R symptoms were used to classify major and minor depression. Three scoring methods for GHQ-12 were assessed, the Standard, Likert and Corrected method. Discriminatory ability was assessed with area under the receiver operating characteristic (ROC) curve. RESULTS A total of 9.5% had a major or minor depression. The area under the ROC curve was for the Standard method 0.73 (0.65-0.82), the Likert method 0.80 (0.72-0.87) and the Corrected method 0.80 (0.73-0.87) when using major or minor depression as standard criterion. Adequate sensitivity and specificity for separating those with or without a depressive disorder was reached at ≥12 Likert scored points (80.4 and 69.6%) or ≥6 Corrected GHQ points (78.3 and 73.7%). Sensitivity and specificity was at ≥2 Standard scored points 67.4% and 74.2%. CONCLUSION When scored using the Likert and Corrected methods, the GHQ-12 performed excellently. When scored using the Standard method, performance was acceptable in detecting depressive disorder in the general population. The GHQ-12 appears to be a good proxy for depressive disorder when used in public health surveys.
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Affiliation(s)
- A Lundin
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - M Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - H Theobald
- Academic Primary Health Care Centre, Stockholm County Council and Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - C Hellgren
- Swedish Council for Higher Education, Stockholm, Sweden
| | - M Torgén
- Department of Medical Science, Uppsala University, Uppsala, Sweden
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Danielsson AK, Lundin A, Yaregal A, Östenson CG, Allebeck P, Agardh EE. Cannabis Use as Risk or Protection for Type 2 Diabetes: A Longitudinal Study of 18 000 Swedish Men and Women. J Diabetes Res 2016; 2016:6278709. [PMID: 27843955 PMCID: PMC5098083 DOI: 10.1155/2016/6278709] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 09/22/2016] [Accepted: 10/05/2016] [Indexed: 12/27/2022] Open
Abstract
Aims. Whether or not cannabis use may increase or decrease the risk of type 2 diabetes is not clear. We analyzed the association between cannabis and subsequent type 2 diabetes and if a potential positive or reverse association persisted after controlling for potential confounders. Methods. In this population-based cohort study, 17,967 Swedish men and women (aged 18-84 years), who answered an extensive questionnaire in 2002 (including questions on cannabis use), were followed up for new cases of type 2 diabetes (n = 608) by questionnaire (in 2010) and in health registers during 2003-2011. Odds ratios (ORs) with 95% CIs were estimated in a multiple logistic regression analysis. Potential confounders included age, sex, BMI, physical inactivity, smoking, alcohol use, and occupational position. Results. The crude association showed that cannabis users had a reduced risk of type 2 diabetes OR = 0.68 (95% CIs: 0.47-0.99). However, this inverse association attenuated to OR = 0.94 (95% CIs: 0.63-1.39) after adjusting for age. Conclusions. The present study suggests that there is no association between cannabis use and subsequent type 2 diabetes after controlling for age. To make more robust conclusions prospective studies, with longer periods of follow-up and more detailed information about cannabis use, are needed.
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Affiliation(s)
- A. K. Danielsson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - A. Lundin
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - A. Yaregal
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - C. G. Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - P. Allebeck
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm County, Sweden
| | - E. E. Agardh
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- *E. E. Agardh:
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Falkstedt D, Hemmingsson T, Sorjonen K, Lundin A, Sörberg A, Melin B. Differences in emotional stability among young men and later rates of mortality. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku161.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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22
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Falkstedt D, Backhans M, Lundin A, Allebeck P, Hemmingsson T. Explaining associations between shorter education and future disability retirement among men and women in Sweden. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kuchálik J, Granath B, Ljunggren A, Magnuson A, Lundin A, Gupta A. Postoperative pain relief after total hip arthroplasty: a randomized, double-blind comparison between intrathecal morphine and local infiltration analgesia. Br J Anaesth 2013; 111:793-9. [PMID: 23872462 DOI: 10.1093/bja/aet248] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Postoperative pain after total hip arthroplasty (THA) can delay mobilization. This was assessed after intrathecal morphine (ITM) compared with local infiltration analgesia (LIA) using a non-inferiority design. METHODS Eighty patients were recruited in this randomized, double-blind study. ITM 0.1 mg (Group ITM) or periarticular local anaesthetic (ropivacaine 300 mg)+ketorolac 30 mg+ epinephrine 0.5 mg (total volume 151.5 ml) (Group LIA) were compared. After 24 h, 22 ml of saline (Group ITM) or ropivacaine (150 mg)+ketorolac (30 mg)+epinephrine (0.1 mg) (Group LIA) were injected via a catheter. After operation, rescue analgesic consumption, pain intensity, and home-readiness were measured. RESULTS Morphine consumption was equivalent, median difference 0 mg (95% confidence interval -4 to 4.5) between the groups at 0-24 h. During 24-48 h, it was lower in Group LIA (3 mg, 0-60 mg, median, range) compared with Group ITM (10 mg, 0-81 mg) (P=0.01). Lower pain scores were recorded at rest at 8 h in Group ITM (P<0.01), but in Group LIA on standing and mobilization, at 24-48 h (P<0.01). Paracetamol and tramadol consumption was lower in Group LIA (P=0.05 and 0.05, respectively) as was pruritus, nausea, and vomiting (P<0.05). CONCLUSION Lower pain intensity was recorded early after surgery in ITM group but later, analgesic consumption, pain intensity on mobilization, and side-effects were lower in patients receiving LIA. LIA is a good alternative to ITM in patients undergoing THA.
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MESH Headings
- Aged
- Aged, 80 and over
- Amides/administration & dosage
- Amides/adverse effects
- Amides/therapeutic use
- Analgesics, Opioid/administration & dosage
- Analgesics, Opioid/adverse effects
- Analgesics, Opioid/therapeutic use
- Anesthesia, Local
- Anesthetics, Local/administration & dosage
- Anesthetics, Local/adverse effects
- Anesthetics, Local/therapeutic use
- Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
- Anti-Inflammatory Agents, Non-Steroidal/adverse effects
- Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
- Arthroplasty, Replacement, Hip
- Double-Blind Method
- Early Ambulation
- Epinephrine/administration & dosage
- Epinephrine/adverse effects
- Epinephrine/therapeutic use
- Female
- Humans
- Injections, Spinal
- Ketorolac/administration & dosage
- Ketorolac/adverse effects
- Ketorolac/therapeutic use
- Length of Stay
- Male
- Middle Aged
- Morphine/administration & dosage
- Morphine/adverse effects
- Morphine/therapeutic use
- Pain Management/methods
- Pain Measurement
- Pain, Postoperative/drug therapy
- Ropivacaine
- Vasoconstrictor Agents/administration & dosage
- Vasoconstrictor Agents/adverse effects
- Vasoconstrictor Agents/therapeutic use
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Affiliation(s)
- J Kuchálik
- Department of Anaesthesiology and Intensive Care
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Björn LG, Kopp E, Herrmann U, Eberhardt P, Dickinson PHG, Mackinnon DJ, Arnold F, Witt G, Lundin A, Jenkins DB. Heavy ionospheric ions in the formation process of noctilucent clouds. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/jd090id05p07985] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Oh S, Cho Y, Stewart J, Moseley J, Kelly V, Xie J, Fyles A, Brock K, Lim K, Lundin A, Rehbinder H, Milosevic M, Jaffray D. TH-E-BRA-08: MR Guided Radiotherapy for Cervix Cancer Treatment; Retrospective Feasibility Study. Med Phys 2012. [DOI: 10.1118/1.4736369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
OBJECTIVE To investigate the associations between psychiatric diagnosis in late adolescence in an unselected population and subsequent suicide attempt and suicide during 36-year follow-up. METHOD A total of 49,321 Swedish men conscripted for compulsory military training in 1969/1970, born 1949-1951, were screened for psychiatric disorder and, if detected, diagnosed by a psychiatrist according to ICD-8. Data on suicides and suicide attempts 1971-2006 were collected in national registers. RESULTS At conscription examination, 11.7% of the cohort received a psychiatric diagnosis. Among those, increased risks of suicide 1971-2006 [HR = 2.7 (2.2-3.2), 624 cases] and suicide attempt 1973-2006 [HR = 3.5 (3.1-4.0), 1170 cases] were found. The increased relative risks persisted during the follow-up period 19-36 years after examination [1989-2006 suicide HR = 2.1 (1.6-2.7), 308 cases, and 1989-2006 suicide attempt HR = 2.6 (2.1-3.1), 484 cases]. The dominant diagnostic groups, neurosis and personality disorder, were significantly associated with suicide and suicide attempt in the early as well as the late follow-up period. CONCLUSION Psychiatric diagnoses made in late adolescence predicted subsequent suicide and suicide attempt over a 36-year follow-up period. The increased relative risks were not limited to young adulthood but were also evident 18-36 years after conscription examination.
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Affiliation(s)
- A Lundin
- Division of Occupational and Environmental Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
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Halldórsdóttir AM, Lundin A, Murray F, Mansouri L, Knuutila S, Sundström C, Laurell A, Ehrencrona H, Sander B, Rosenquist R. Impact of TP53 mutation and 17p deletion in mantle cell lymphoma. Leukemia 2011; 25:1904-8. [PMID: 21720382 DOI: 10.1038/leu.2011.162] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Lundin A, Lundberg I, Hallsten L, Ottosson J, Hemmingsson T. Unemployment and mortality--a longitudinal prospective study on selection and causation in 49321 Swedish middle-aged men. J Epidemiol Community Health 2011; 64:22-8. [PMID: 19289388 DOI: 10.1136/jech.2008.079269] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Unemployment is associated with increased risk of mortality. It is, however, not clear to what extent this is causal, or whether other risk factors remain uncontrolled for. The aim of this study was to investigate the association between unemployment and all-cause and cause-specific mortality, adjusting for indicators of mental disorder, behavioural risk factors and social factors over the life course. METHODS This study was based on a cohort of 49321 Swedish males, born 1949/51, tested for compulsory military conscription in 1969/70. Data on employment/unemployment 1990-4 was based on information from the Longitudinal Register of Education and Labour Market Statistics. Information on childhood circumstances was drawn from National Population and Housing Census 1960. Information on psychiatric diagnosis and behavioral risk factors was collected at conscription testing in 1969/70. Data on mortality and hospitalisation 1973-2004 were collected in national registers. RESULTS An increased risk of mortality 1995-2003 was found among individuals who experienced 90 days or more of unemployment during 1992-4 compared with those still employed (all-cause mortality HR 1.91, 95% CI 1.58 to 2.31. Adjustment for risk factors measured along the life course considerably lowered the relative risk (all cause mortality HR 1.30, 95% CI 1.06 to 1.58). Statistically significant increased relative risk was found during the first 4 years of follow up (all-cause mortality, adjusted HR 1.57, 95% CI 1.13 to 2.18, but not the following 4 years (all cause mortality, adjusted HR 1.17, 95% CI 0.91 to 1.50). CONCLUSION The results suggest that a substantial part of the increased relative risk of mortality associated with unemployment may be attributable to confounding by individual risk factors.
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Affiliation(s)
- A Lundin
- Division of Occupational and Environmental Medicine, Department of Public Health Sciences, Karolinska Institutet, Norrbacka plan 5, 171 76 Stockholm, Sweden.
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Månsdotter A, Lundin A, Falkstedt D, Hemmingsson T. The association between masculinity rank and mortality patterns: a prospective study based on the Swedish 1969 conscript cohort. J Epidemiol Community Health 2010; 63:408-13. [PMID: 19366891 DOI: 10.1136/jech.2008.082628] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Being male constitutes a risk factor for early death, and this may be connected to concepts of masculinity. The objective of the present study was to investigate the association between masculinity rank during late adolescence and mortality patterns in a cohort of 49 321 Swedish men tested for compulsory military training in 1969. METHODS The measure of masculinity consisted of a five-grade ranking from the conscription information that comprised leisure interests and occupational preferences. Information on all-cause mortality, alcohol-related mortality, suicide, mortality from other violent causes and mortality from cardiovascular disease was collected from national registers for 1970-2003. The analyses were performed using Cox proportional hazard models with hazard ratios as estimates of relative risk. RESULTS For all-cause mortality, the crude relative risks versus ordinary masculinity were: lowest masculinity 1.98 (95% CI 1.71 to 2.31), low masculinity 1.38 (95% CI 1.24 to 1.53), high masculinity 0.90 (95% CI 0.81 to 1.01) and highest masculinity 0.78 (95% CI 0.62 to 0.97). After adjustments for childhood class, smoking, alcohol drinking, blood pressure, short stature, psychiatric disorder, low intelligence and contact with police or childcare authorities, conscripts who were ranked lowest on masculinity had a remaining increased relative risk of all-cause mortality (1.49; 95% CI 1.28 to 1.75) and suicide (1. 79; 95% CI 1.31 to 2.43). For mortality from violent causes other than suicide, no statistically significant associations were demonstrated. CONCLUSIONS Earlier research has proposed that masculinity may hold both positive and negative aspects regarding lifetime health. The major conclusion here is that being ranked less masculine is associated with higher mortality.
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Affiliation(s)
- A Månsdotter
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
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Klepczyńska Nyström A, Svartengren M, Grunewald J, Pousette C, Rödin I, Lundin A, Sköld CM, Eklund A, Larsson BM. Health effects of a subway environment in healthy volunteers. Eur Respir J 2009; 36:240-8. [PMID: 20032018 DOI: 10.1183/09031936.00099909] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Environmental particle exposure, often estimated as the particulate mass of particles with a diameter <10 microm, <2.5 microm or <1 microm (PM(10), PM(2.5) or PM(1)), is known to have a negative impact on the health of the population. Little is known about how the size and origin of particles influence the effects. We have previously shown that exposure to a road tunnel environment causes a cellular inflammatory response in the airways of healthy individuals. In the present study, our aim was to investigate potential airway health effects from exposure to a subway environment. 20 healthy volunteers were exposed to a subway and a control environment for 2 h, followed by measurements of lung function and the inflammatory response in the lower airways (bronchoscopy) and in the peripheral blood. No cellular response was found in the airways after exposure to the subway environment. In the blood, we found a statistically significant increase in fibrinogen and regulatory T-cells expressing CD4/CD25/FOXP3. Subway and road tunnel environments have similar levels of PM(10) and PM(2.5), whilst the concentrations of ultrafine particles, nitrogen monoxide and dioxide are lower in the subway. Although no cellular response was detected, the findings indicate a biological response to the subway environment. Our studies show that using gravimetric estimates of ambient particulate air pollution alone may have clear limitations in health-risk assessment.
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Affiliation(s)
- A Klepczyńska Nyström
- Dept of Public Health Sciences, Division of Occupational and Environmental Medicine, Karolinska Institutet, Norrbacka, 4th floor, SE-17176 Stockholm, Sweden.
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31
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Stewart J, Lim K, Brock K, Moseley J, Xie J, Lundin A, Rehbinder H, Fyles A, Jaffray D, Milosevic M. Optimized Replanning for IMRT of Cervix Cancer Based on Dosimetric Assessment of Treatment Progress. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Stewart J, Lim K, Kelly V, Xie J, Brock K, Moseley J, Cho YB, Lundin A, Rehbinder H, Fyles A, Jaffray D, Milosevic M. 56 DOSIMETRIC TREATMENT EVALUATION AND OPTIMIZED REPLANNING FOR IMRT OF CERVIX CANCER. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72443-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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McCann C, Purdie TG, Rehbinder H, Lundin A, Hope AJ, Bezjak A, Bissonnette JP. Sci-Thurs PM: Planning-06: A Simple, Robust IMRT Optimization Method for Lung Cancer, Accounting for Tissue Heterogeneity and Intra-Fraction Lung Tumour Motion. Med Phys 2009. [DOI: 10.1118/1.3244177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Cho Y, Xie J, Kelly V, Lim K, Stewart J, Lundin A, Rehbinder H, Jaffray D, Fyles A, Milosevic M. EVALUATION OF ADAPTIVE RADIOTHERAPY DOSE DISTRIBUTIONS FOR CERVIX CANCER USING CONFORMITY ANALYSIS. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72654-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Yenamandra SP, Lundin A, Arulampalam V, Yurchenko M, Pettersson S, Klein G, Kashuba E. Expression profile of nuclear receptors upon Epstein -- Barr virus induced B cell transformation. Exp Oncol 2009; 31:92-96. [PMID: 19550398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Infection of human B cells with Epstein - Barr virus (EBV) induces metabolic activation, morphological transformation, cell proliferation and eventual immortalization. AIM To identify the nuclear receptors, which are the cellular interaction partners of EBNAs, that will help to elucidate the mechanism of B cell transformation. METHODS We have compared the nuclear receptor profile in the naïve and EBV-transformed B-lymphocytes, using TaqMan LDA microfluidic card technology. RESULTS Out of 48 nuclear receptor, 17 showed differential expression at the mRNA level. The expression of 5 genes was elevated in EBV-transformed cells, whereas 12 genes were downregulated in lymphoblastoid cells (LCLs). 7 genes were studied at the protein level; 2 genes were up regulated (Nr2F2 and RARA) and 4 genes were down regulated (ERB, NUR77, PPARG, and VDR) in LCLs. CONCLUSION The nuclear receptor profiling on EBV infected B cells showed alterations of nuclear receptors expression at both mRNA and protein levels compared with non infected peripheral blood cells. Further analysis on a possible role of each nuclear receptor in EBV induced cell transformation should be performed.
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Affiliation(s)
- S P Yenamandra
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institute, Stockholm S17177, Sweden
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Abstract
Mastocytosis gives rise to clinical symptoms such as flushing, itching and diarrhoea. We report a patient with urticaria pigmentosa without evidence of systemic involvement but with recurrent episodes of diarrhoea. The patient had elevated circulating levels of calcitonin, which might have been a mediator of her diarrhoea. We suggest that serum calcitonin level should be checked in patients with mast cell disease and diarrhoea.
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Santos E, Lundin A, Pötting K, Quaino P, Schmickler W. Hydrogen evolution and oxidation—a prototype for an electrocatalytic reaction. J Solid State Electrochem 2008. [DOI: 10.1007/s10008-008-0702-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Stewart J, Lim K, Brock K, Moseley J, Xie J, Lundin A, Rehbinder H, Fyles A, Milosevic M, Jaffray D. Automated Weekly Online Replanning for IMRT of Cervix Cancer. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cho Y, Xie J, Kelly V, Lim K, Stewart J, Fyles A, Brock K, Lundin A, Rehbinder H, Milosevic M. Region of Interest Analysis as a Tool for Exploring Adaptive IMRT Strategy for Cervix Cancer Patients. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lim K, Kelly V, Stewart J, Moseley J, Brock K, Cho Y, Fyles A, Lundin A, Rehbinder H, Milosevic M. Whole Pelvis IMRT for Cervix Cancer: What Gets Missed & Why? Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bissonnette J, Hope A, Lundin A, Rehbinder H, Purdie T. A Simple, Robust IMRT Optimization Method for Lung Cancer, Accounting for Tissue Heterogenity and Intra-fraction Lung Tumor Motion. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Brock K, Moseley J, Stewart J, Lim K, Xie J, Lundin A, Rehbinder H, Fyles A, Milosevic M, Jaffray D. SU-GG-J-102: Image Guided Radiotherapy of the Cervix with Biomechanical Model-Based Deformable Registration. Med Phys 2008. [DOI: 10.1118/1.2961652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Cho Y, Kelly V, Lim K, Stewart J, Fyles A, Brock K, Moseley J, Xie J, Lundin A, Rehbinder H, Milosevic M. SU-GG-T-56: Planning Target Volume Adaptation Using Convex Hull of CTVs for Cervix Cancer Patients. Med Phys 2008. [DOI: 10.1118/1.2961806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Lundin A, Deboussard C, Edman G, Borg J. Predictors for postconcussional disorder after mild traumatic brain injury. Eur Psychiatry 2008. [DOI: 10.1016/j.eurpsy.2008.01.1331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Lim K, Fyles A, Lundin A, Cho Y, Kelly V, Moseley J, Brock K, Stewart J, Rehbinder H, Milosevic M. Adaptive Whole Pelvis Intensity Modulated Radiotherapy for Cervix Cancer. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lim K, Fyles A, Lundin A, Cho Y, Kelly V, Moseley J, Brock K, Stewart J, Rehbinder H, Milosevic M. 5030 POSTER Dose impact of inter-fraction motion on whole pelvis IMRT in cervix cancer. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71202-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Rehbinder H, Lundin A, Cho Y, Lim K, Brock K, Fyles A, Kelly V, Milosevic M, Moseley J, Stewart J, Xie J, Chan P, Jaffray D. TH-E-M100F-01: Impact of Organ Motion On IMRT Dose Distributions for Patients with Cancer of the Cervix. Med Phys 2007. [DOI: 10.1118/1.2761747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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48
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Abstract
OBJECTIVE Examine frequency, character and course of symptoms until 3 months after MTBI and the relation between symptoms and disability. METHODS Prospective cohort study of 122 consecutive patients with MTBI. Symptom assessment after 1, 7 and 14 days and 3 months post-injury by use of Rivermead Post-concussional Questionnaire. Disability assessment by use of Rivermead Head Injury Follow-up Questionnaire. RESULTS Patients reporting one or more symptoms declined from 86% on day 1 to 49% 3 months post-injury, when 25% also reported change in one or more domains of everyday activities. Poor memory, sleep disturbance and fatigue were most commonly reported. Symptom and disability scores were correlated (tau = 0.60; p < 0.001). Early symptom load correlated with late symptom load (tau = 0.38; p < 0.01). CONCLUSIONS Symptoms gradually decline post-injury. Symptoms correlate with disability at 3 months. Patients with early high symptom load are at risk for developing persisting complaints.
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Affiliation(s)
- A Lundin
- Department of Psychiatry, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
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Larsson BM, Sehlstedt M, Grunewald J, Sköld CM, Lundin A, Blomberg A, Sandström T, Eklund A, Svartengren M. Road tunnel air pollution induces bronchoalveolar inflammation in healthy subjects. Eur Respir J 2007; 29:699-705. [PMID: 17251238 DOI: 10.1183/09031936.00035706] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Traffic-related air pollution is associated with adverse respiratory effects. The aim of the present study was to investigate whether exposure to air pollution in a road tunnel causes airway inflammatory and blood coagulation responses. A total of 16 healthy subjects underwent bronchoscopy with bronchial mucosal biopsies and bronchoalveolar lavage (BAL) on two occasions, in random order: once at 14 h after a 2-h exposure to air pollution in a busy road tunnel, and once after a control day with subjects exposed to urban air during normal activities. Peripheral blood was sampled prior to bronchoscopy. The road tunnel exposures included particulate matter with a 50% cut-off aerodynamic diameter of 2.5 microm, particulate matter with a 50% cut-off aerodynamic diameter of 10 mum and nitrogen dioxide which had median concentrations of 64, 176 and 230 microg.m(-3), respectively. Significantly higher numbers of BAL fluid total cell number, lymphocytes and alveolar macrophages were present after road tunnel exposure versus control. Significantly higher nuclear expression of the transcription factor component c-Jun was found in the bronchial epithelium after exposure. No upregulation of adhesion molecules or cellular infiltration was present and blood coagulation factors were unaffected. In conclusion, exposure of healthy subjects to traffic-related air pollution resulted in a lower airway inflammatory response with cell migration, together with signs of an initiated signal transduction in the bronchial epithelium.
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Affiliation(s)
- B-M Larsson
- Dept of Public Health Sciences, Division of Occupational Medicine, Karolinska Institutet, SE-171 76 Stockholm, Sweden.
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Rehbinder H, Andersson J, Ericson S, Eriksson K, Forsgren C, Hårdemark B, Korevaar E, Larsson M, Liander A, Lundin A, Riddersporre J, Rosseau D, Sundgren C, Uhrdin J, Löf J. TH-C-230A-10: A General Software Framework for Investigations in Radiation Therapy Planning. Med Phys 2006. [DOI: 10.1118/1.2241873] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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