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Nyman V, Svensson A, Hansson M, Johnsson A. Women's experiences of remote video calls with a labour ward midwife during early labour. Women Birth 2024; 37:101620. [PMID: 38704959 DOI: 10.1016/j.wombi.2024.101620] [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: 02/15/2024] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND In an increasingly strained maternity care system with a shortage of midwives and great demands for service, pregnant women in their early labour are at risk of receiving insufficient support. Women make calls and visit the labour ward on multiple occasions before being admitted. A video call with a labour ward midwife during early labour is an unknown practice but could support pregnant women and their partners during this uncertain period. AIM The study aimed to describe women's experiences of remote video calls with a labour ward midwife during early labour. METHODS A qualitative study comprising nine semi-structured interviews followed by an inductive thematic analysis was conducted. RESULTS The results revealed that video calls prepared women and their partners by means of practical support. They received an assessment of early labour and the interaction with labour ward midwives prepared them for the impending birth. The participants reported feeling secure and strengthened by being met at their current stage of labour. Furthermore, they found the service accessible, easy to use and emphasised the need for increased availability and continuity. CONCLUSION This study highlights the positive impact of video calls in early labour when conducted by competent labour ward midwives. The perceived accessibility and ease of use e-health system underscore a demand for extended availability. These findings indicate the potential benefits of integrating video calls in labour care to enhance support, security, accessibility and overall satisfaction for pregnant women and their partners.
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Affiliation(s)
- Viola Nyman
- Department of Health Sciences, University West, Trollhättan, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Department of Research and Development, NU-Hospital Group, Trollhättan, Sweden.
| | - Ann Svensson
- School of Business, Economics and IT, University West, Trollhättan, Sweden.
| | - Malin Hansson
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Region Västra Götaland, Research and Development Primary Healthcare, Sweden.
| | - Anette Johnsson
- Department of Health Sciences, University West, Trollhättan, Sweden.
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2
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Kylén E, Stenholm J, Johansson M, Aggestam L, Svensson A. The Development and Evaluation of an Animated Video for Pre- and Postoperative Instructions for Patients with Osteoarthritis-A Design Science Research Approach. Geriatrics (Basel) 2024; 9:19. [PMID: 38392106 PMCID: PMC10887600 DOI: 10.3390/geriatrics9010019] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/03/2024] [Accepted: 02/04/2024] [Indexed: 02/24/2024] Open
Abstract
Osteoarthritis (OA) is a condition in the hip or knee joints that develops during a long period of time and sometimes needs hip or knee joint replacement surgery when pain gets too intense for the patient. This paper describes how an animated video for pre- and postoperative instructions for patients with osteoarthritis was designed. The design science research (DSR) approach was followed by creating a web-based animated video. The web-based animated video is used to support surgical departments with education for patients suffering from OA. In the web-based animated video, information about OA surgical treatment and its pre- and post-arrangements was included. The relevance, the rigor, and the design cycles were focused on, with some iterations of and improvements in the animations. Even after implementation, there was a feedback-loop with comments from the surgeons and their patients. Moreover, as more departments will use the web-based animated video, they want to make their special mark on it, so that further changes will be made. This paper presents the design and successful implementation of an animated video for pre- and postoperative instructions for patients with osteoarthritis, tightly linked to the patient journey and the workflow of healthcare professionals. The animated video serves not only as a tool to improve care but also as a basis for further scientific research studies.
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Affiliation(s)
- Erik Kylén
- MedFilm AB, Staveredsgatan 20, 461 31 Trollghättan, Sweden
| | - Joel Stenholm
- MedFilm AB, Staveredsgatan 20, 461 31 Trollghättan, Sweden
| | - Madeleine Johansson
- Department of Adult Psychiatry, NU-Care Hospital, Lärketorpsvägen, 461 73 Trollhättan, Sweden
| | - Lena Aggestam
- Department of Engineering Science, University West, Gustava Melins Gata 2, 461 32 Trollhättan, Sweden
| | - Ann Svensson
- School of Business Economics and IT, University West, Gustava Melins Gata 2, 461 32 Trollhättan, Sweden
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3
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Chernyshov PV, Finlay AY, Tomas-Aragones L, Tognetti L, Moscarella E, Pasquali P, Manolache L, Pustisek N, Svensson A, Marron SE, Bewley A, Salavastru C, Suru A, Koumaki D, Linder D, Abeni D, Augustin M, Blome C, Salek SS, Evers AWM, Poot F, Sampogna F, Szepietowski JС. Quality of life measurement in teledermatology. Position statement of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Teledermatology. J Eur Acad Dermatol Venereol 2024; 38:254-264. [PMID: 37877648 DOI: 10.1111/jdv.19570] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/29/2023] [Indexed: 10/26/2023]
Abstract
Many events, including the COVID-19 pandemic, have accelerated the implementation of teledermatology pathways within dermatology departments and across healthcare organizations. Quality of Life (QoL) assessment in dermatology is also a rapidly developing field with a gradual shift from theory to practice. The purpose of this paper organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on QoL and patient-oriented outcomes and the EADV TF on teledermatology is to present current knowledge about QoL assessment during the use of teledermatology approaches, including data on health-related (HR) QoL instruments used in teledermatology, comparison of influence of different treatment methods on HRQoL after face-to-face and teledermatology consultations and to make practical recommendations concerning the assessment of QoL in teledermatology. The EADV TFs made the following position statements: HRQoL assessment may be an important part in most of teledermatology activities; HRQoL assessment may be easily and effectively performed during teledermatology consultations. It is especially important to monitor HRQoL of patients with chronic skin diseases during lockdowns or in areas where it is difficult to reach a hospital for face-to-face consultation; regular assessment of HRQoL of patients with skin diseases during teledermatology consultations may help to monitor therapy efficacy and visualize individual patient's needs; we recommend the use of the DLQI in teledermatology, including the use of the DLQI app which is available in seven languages; it is important to develop apps for dermatology-specific HRQoL instruments for use in children (for example the CDLQI and InToDermQoL) and for disease-specific instruments.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - L Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - E Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - P Pasquali
- Dermatology Department, Pius Hospital de Valls, Tarragona, Spain
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - N Pustisek
- Children's Hospital Zagreb, Zagreb, Croatia
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - S E Marron
- Department of Dermatology, University Hospital Miguel Servet, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - A Bewley
- Whipps Cross University Hospital, London, UK
- The Royal London Hospital, London, UK
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - A Suru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - D Koumaki
- Department of Dermatology and Venereology, University Hospital of Heraklion, Crete, Greece
| | - D Linder
- University Clinic for Medical Psychology and Psychotherapy, Medical University of Graz, Austria
| | - D Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - A W M Evers
- Institute of Psychology, Health, Medical, and Neuropsychology unit, Leiden University, Leiden, The Netherlands
| | - F Poot
- Department of Dermatology, University Hospital Erasme, Brussels, Belgium
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
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Emilsson M, Karlsson C, Svensson A. Experiences of using surveillance cameras as a monitoring solution at nursing homes: The eldercare personnel's perspectives. BMC Health Serv Res 2023; 23:144. [PMID: 36765321 PMCID: PMC9912642 DOI: 10.1186/s12913-023-09130-2] [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: 08/02/2022] [Accepted: 01/31/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND As the number of older people increases, so does the need for care. However, the workforce in eldercare cannot increase at the rate required to match the needs. Welfare technologies, such as surveillance cameras, can replace physical visits and be used at night to monitor older people in order to keep them safe, while not disturbing their sleep. The aim of the paper is to analyze obstacles and opportunities associated with implementation and use of surveillance cameras at nursing homes from the perspectives of the practitioners who use the technology, their working environment and the conditions of the older people with cognitive impairment who live in nursing homes. METHODS Individual semi-structured interviews were conducted with the eldercare personnel at nursing homes to understand their experiences of implementation and use of surveillance cameras. The transcribed interviews were analyzed using qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) was used as a guidance tool. RESULTS The results show that the eldercare personnel experienced lack of adequate information, education and support related to using surveillance cameras. Several benefits are highlighted, such as better working environment and that the residents were not unnecessarily disturbed at night. However, the results also show that it is important to clarify that surveillance cameras cannot replace the human presence. CONCLUSIONS The conclusions from this study are the importance of prerequisites for implementation, and that using surveillance cameras contributed to improvements in the working environment at night and created possibilities to maintain security and integrity for older people living in nursing homes.
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Affiliation(s)
- Maria Emilsson
- grid.412716.70000 0000 8970 3706Department of Health sciences, Section of Nursing Graduate Level, University West, SE-461 86 Trollhättan, Sweden
| | - Christina Karlsson
- grid.412716.70000 0000 8970 3706Department of Health sciences, Section of Nursing Undergraduate Level, University West, SE-461 86 Trollhättan, Sweden
| | - Ann Svensson
- School of Business, Economics and IT, Division of Informatics, University West, SE-461 86, Trollhättan, Sweden.
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5
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Chernyshov PV, Finlay AY, Tomas-Aragones L, Steinhoff M, Manolache L, Pustisek N, Dessinioti C, Svensson A, Marron SE, Bewley A, Salavastru C, Dréno B, Suru A, Koumaki D, Linder D, Evers AWM, Abeni D, Augustin M, Salek SS, Nassif A, Bettoli V, Szepietowski JС, Zouboulis CC. Quality of life measurement in rosacea. Position statement of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa. J Eur Acad Dermatol Venereol 2023; 37:954-964. [PMID: 36744752 DOI: 10.1111/jdv.18918] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/16/2023] [Indexed: 02/07/2023]
Abstract
The European Academy of Dermatology and Venereology (EADV) Task Forces (TFs) on Quality of Life (QoL) and Patient-Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa (ARHS) do not recommend the use of any generic instrument as a single method of Health Related (HR) QoL assessment in rosacea, except when comparing quimp (quality of life impairment) in rosacea patients with that in other non-dermatologic skin diseases and/or healthy controls. The EADV TFs on QoL and Patient-Oriented Outcomes and ARHS recommend the use of the dermatology-specific HRQoL instrument the Dermatology Life Quality Index (DLQI) and the rosacea-specific HRQoL instrument RosaQoL in rosacea patients. The DLQI minimal clinically important difference may be used as a marker of clinical efficacy of the treatment and DLQI score banding of 0 or 1 corresponding to no effect on patients' HRQoL could be an important treatment goal. This information may be added to consensuses and guidelines for rosacea.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - M Steinhoff
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar.,Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar.,Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar.,Weill Cornell Medicine-Qatar, Doha, Qatar.,Medical School, Qatar University, Doha, Qatar.,School of Medicine, Weill Cornell University, New York, New York, USA
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - N Pustisek
- Children's Hospital Zagreb, Zagreb, Croatia
| | - C Dessinioti
- Department of Dermatology, Andreas Syggros Hospital, University of Athens, Athens, Greece
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - S E Marron
- Department of Dermatology, Royo Villanova Hospital, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,The Royal London Hospital, London, UK
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - B Dréno
- INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, Nantes Université, Univ Angers, Nantes, France
| | - A Suru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - D Koumaki
- Department of Dermatology and Venereology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - D Linder
- University Clinic for Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - A W M Evers
- Institute of Psychology, Health, Medical, and Neuropsychology Unit, Leiden University, Leiden, The Netherlands
| | - D Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | | | - V Bettoli
- Department of Medical Sciences, Section of Dermatology, University of Ferrara, Ferrara, Italy
| | - J С Szepietowski
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
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Hedqvist A, Svensson A, Larsson LG. Nurses' experiences of person-centred care planning using video-conferencing. Nurs Open 2022; 10:1879-1888. [PMID: 36326034 PMCID: PMC9912454 DOI: 10.1002/nop2.1452] [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: 10/17/2021] [Revised: 05/05/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
AIM The aim was to illuminate how nurses experience person-centred care planning using video conferencing upon hospital discharge of frail older persons. DESIGN Care planning via video conferencing requires collaboration, communication and information transfer between involved parties, both with regard to preparing and conducting meetings. Participation of involved parties is required to achieve a collaborative effort, but the responsibilities and roles of the involved professions are unclear, despite the existence of regulations. METHOD A qualitative content analysis was conducted based on 11 individual semi-structured interviews with nurses from hospitals, municipalities and primary care in Sweden. RESULTS This study provides valuable insights into challenges associated with care planning via video conferencing. The meeting format, that is video conferencing, is perceived as a barrier that makes the interaction challenging. Shortcomings in video technology make a person-centred approach difficult. The person-centred approach is also difficult for nurses to maintain when the older person or relatives are not involved in the planning.
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Affiliation(s)
| | - Ann Svensson
- School of Business, Economics and ITUniversity WestTrollhättanSweden
| | - Lena G. Larsson
- Department of Health SciencesUniversity WestTrollhättanSweden,Research, Education, Development and Innovation, Primary Health CareRegion Västra GötalandGothenburgSweden
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de Graaf M, Janmohamed S, Schuttelaar M, Agner T, Alfonso J, De Schepper S, Deleuran M, Despontin K, Elenius V, Ghislain P, Huilaja L, Johansson E, Kvenshagen B, Mandelin J, Olset H, Svensson A, van Tuyll van Serooskerken A, Thyssen J, Vestergaard C. Systemic treatment of children and adolescents with atopic dermatitis aged ≥2 years: a Delphi consensus project mapping expert opinion in Northern Europe. J Eur Acad Dermatol Venereol 2022; 36:2153-2165. [PMID: 35793471 PMCID: PMC9796032 DOI: 10.1111/jdv.18410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/14/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Paediatric atopic dermatitis (AD) can be burdensome, affecting mental health and impairing quality of life for children and caregivers. Comprehensive guidelines exist for managing paediatric AD, but practical guidance on using systemic therapy is limited, particularly for new therapies including biologics and Janus kinase (JAK) inhibitors, recently approved for various ages in this indication. OBJECTIVES This expert consensus aimed to provide practical recommendations within this advancing field to enhance clinical decision-making on the use of these and other systemics for children and adolescents aged ≥2 years with moderate-to-severe AD. METHODS Nineteen physicians from Northern Europe were selected for their expertise in managing childhood AD. Using a two-round Delphi process, they reached full or partial consensus on 37 statements. RESULTS Systemic therapy is recommended for children aged ≥2 years with a clear clinical diagnosis of severe AD and persistent disease uncontrolled after optimizing non-systemic therapy. Systemic therapy should achieve long-term disease control and reduce short-term interventions. Recommended are cyclosporine A for short-term use (all ages) and dupilumab or methotrexate for long-term use (ages ≥6 years). Consensus was not reached on the best long-term systemics for children aged 2-6 years, although new systemic therapies will likely become favourable: New biologics and JAK inhibitors will soon be approved for this age group, and more trial and real-world data will become available. CONCLUSIONS This article makes practical recommendations on the use of systemic AD treatments for children and adolescents, to supplement international and regional guidelines. It considers the systemic medication that was available for children and adolescents with moderate-to-severe AD at the time this consensus project was done: azathioprine, cyclosporine A, dupilumab, methotrexate, mycophenolate mofetil and oral glucocorticosteroids. We focus on the geographically similar Northern European countries, whose healthcare systems, local preferences for AD management and reimbursement structures nonetheless differ significantly.
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Affiliation(s)
- M. de Graaf
- Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, Wilhelmina Children's HospitalUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - S.R. Janmohamed
- Department of Dermatology, Unit Pediatric Dermatology, SKIN Research Group, Universitair Ziekenhuis Brussel (UZ Brussel)Vrije Universiteit Brussel (VUB)BrusselsBelgium
| | - M.L.A. Schuttelaar
- Department of Dermatology, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - T. Agner
- Department of Dermatology and VenereologyBispebjerg HospitalCopenhagenDenmark
| | - J.H. Alfonso
- Department of DermatologyOslo University Hospital, RikshospitaletOsloNorway
| | - S. De Schepper
- Department of DermatologyGent University HospitalGentBelgium
| | - M. Deleuran
- Department of DermatologyAarhus University HospitalAarhusDenmark
| | - K. Despontin
- Department of Dermatology and VenereologyCHU UCL NamurNamurBelgium
| | - V. Elenius
- Department of PediatricsTurku University HospitalTurkuFinland
| | - P.‐D. Ghislain
- Department of Dermatology, UCL St‐LucLouvain UniversityBrusselsBelgium
| | - L. Huilaja
- PEDEGO Research UnitUniversity of OuluOuluFinland,Department of Dermatology and Medical Research Center OuluOulu University HospitalOuluFinland
| | - E.K. Johansson
- Dermatology and Venereology Unit, Department of Medicine SolnaKarolinska InstitutetStockholmSweden,Department of DermatologyKarolinska University HospitalStockholmSweden
| | | | - J.M. Mandelin
- Department of DermatologyHelsinki University Central HospitalHelsinkiFinland
| | - H. Olset
- Department of DermatologyHaukeland University HospitalBergenNorway
| | - A. Svensson
- Department of Dermatology and VenereologyMalmö University HospitalMalmöSweden
| | | | - J.P. Thyssen
- Department of Dermatology and VenereologyBispebjerg HospitalCopenhagenDenmark
| | - C. Vestergaard
- Department of DermatologyAarhus University HospitalAarhusDenmark
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8
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Ghaderi A, Zhong W, Okhovat MA, Aschan J, Svensson A, Sander B, Schultz J, Olin T, Österborg A, Hojjat-Farsangi M, Mellstedt H. A ROR1 Small Molecule Inhibitor (KAN0441571C) Induced Significant Apoptosis of Mantle Cell Lymphoma (MCL) Cells. Pharmaceutics 2022; 14:pharmaceutics14102238. [PMID: 36297673 PMCID: PMC9607197 DOI: 10.3390/pharmaceutics14102238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/07/2022] [Accepted: 10/17/2022] [Indexed: 11/18/2022] Open
Abstract
The receptor tyrosine kinase orphan receptor 1 (ROR1) is absent in most normal adult tissues but overexpressed in various malignancies and is of importance for tumor cell survival, proliferation, and metastasis. In this study, we evaluated the apoptotic effects of a novel small molecule inhibitor of ROR1 (KAN0441571C) as well as venetoclax (BCL-2 inhibitor), bendamustine, idelalisib (PI3Kδ inhibitor), everolimus (mTOR inhibitor), and ibrutinib (BTK inhibitor) alone or in combination in human MCL primary cells and cell lines. ROR1 expression was evaluated by flow cytometry and Western blot (WB). Cytotoxicity was analyzed by MTT and apoptosis by Annexin V/PI staining as well as signaling and apoptotic proteins (WB). ROR1 was expressed both in patient-derived MCL cells and human MCL cell lines. KAN0441571C alone induced significant time- and dose-dependent apoptosis of MCL cells. Apoptosis was accompanied by decreased expression of MCL-1 and BCL-2 and cleavage of PARP and caspase 3. ROR1 was dephosphorylated as well as ROR1-associated signaling pathway molecules, including the non-canonical WNT signaling pathway (PI3Kδ/AKT/mTOR). The combination of KAN0441571C and ibrutinib, venetoclax, idelalisib, everolimus, or bendamustine had a synergistic apoptotic effect and significantly prevented phosphorylation of ROR1-associated signaling molecules as compared to KAN0441571C alone. Our results suggest that targeting ROR1 by a small molecule inhibitor, KAN0441571C, should be further evaluated particularly in combination with other targeting drugs as a new therapeutic approach for MCL.
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Affiliation(s)
- Amineh Ghaderi
- Department of Oncology-Pathology, BioClinicum, Karolinska University Hospital Solna and Karolinska Institutet, 171 64 Stockholm, Sweden
| | - Wen Zhong
- Department of Oncology-Pathology, BioClinicum, Karolinska University Hospital Solna and Karolinska Institutet, 171 64 Stockholm, Sweden
| | - Mohammad Ali Okhovat
- Department of Oncology-Pathology, BioClinicum, Karolinska University Hospital Solna and Karolinska Institutet, 171 64 Stockholm, Sweden
| | - Johanna Aschan
- Department of Oncology-Pathology, BioClinicum, Karolinska University Hospital Solna and Karolinska Institutet, 171 64 Stockholm, Sweden
| | - Ann Svensson
- Department of Oncology-Pathology, BioClinicum, Karolinska University Hospital Solna and Karolinska Institutet, 171 64 Stockholm, Sweden
| | - Birgitta Sander
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Johan Schultz
- Kancera AB, Nanna Svartz Väg 4, 171 65 Solna, Sweden
| | - Thomas Olin
- Kancera AB, Nanna Svartz Väg 4, 171 65 Solna, Sweden
| | - Anders Österborg
- Department of Oncology-Pathology, BioClinicum, Karolinska University Hospital Solna and Karolinska Institutet, 171 64 Stockholm, Sweden
- Department of Hematology, Karolinska University Hospital Solna, 171 77 Stockholm, Sweden
| | - Mohammad Hojjat-Farsangi
- Department of Oncology-Pathology, BioClinicum, Karolinska University Hospital Solna and Karolinska Institutet, 171 64 Stockholm, Sweden
- Correspondence: ; Tel.: +46-735-234-706
| | - Håkan Mellstedt
- Department of Oncology-Pathology, BioClinicum, Karolinska University Hospital Solna and Karolinska Institutet, 171 64 Stockholm, Sweden
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9
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Svensson A, Carlson J, Jensen HK, Dahlberg P, Bundgaard H, Christensen AH, Boonstra MJ, Svendsen JH, Cadrin Tourigny J, Te Riele ASJ, Platonov PG. Arrhythmogenic right ventricular cardiomyopathy – evolution of electrocardiographic markers during long-term follow-up prior to ascertainment of diagnosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Depolarization and repolarization abnormalities are part of the diagnostic Task Force Criteria of 2010 (TFC2010) for arrhythmogenic right ventricular cardiomyopathy (ARVC). These abnormalities are thought to be progressive but have also been described as dynamic and sometimes reversible. Evolution of ECG abnormalities prior to clinical ARVC diagnosis is poorly studied.
Objective
To assess the evolution of ECG depolarization and repolarization characteristics in patients with ARVC prior to diagnosis and to identify markers of disease progression at a preclinical stage.
Methods
353 patients with definite ARVC from Sweden, Denmark, the Netherlands and Canada with at least one 12-lead digital ECG (65% males, 67% probands, 56% mutation carriers, median age at diagnosis 42 [IQR 29–53] years and median age at first ECG 44 [30–55] years) were included. Digital ECGs were extracted from regional ECG archives. ECGs with left bundle branch block, ventricular pacing or recorded either prior to 15 years of age or after heart transplantation were excluded. Remaining 6,871 ECGs were digitally processed and automatically analysed using the Glasgow algorithm. Median values for overall QRS duration, terminal activation delay (TAD) in lead V1 as well as amplitudes of QRS-T-components in precordial leads per patient per year were used for analyses and graphically represented using Lowess smoothing with cubic splines (Figure 1). Blue lines indicate smoothed conditional mean with 95% confidence interval (shadow). Time “0” (red line) indicates the time when TFC2010 were fulfilled for definite diagnosis.
A database of 18,564 anonymized digital ECGs (58% males, median age at latest ECG 41 years [IQR 32–52]) who were in contact with health care during 2020–2021 was processed using the same exclusion criteria and signal-processing methodology as in the ARVC group and used as a reference (black line).
Results
TAD in lead V1 and overall QRS duration demonstrated a significant increase years before ARVC diagnosis, and significant reductions were seen in QRS-T voltages measured as R wave amplitude, QRS amplitude (the absolute sum of R wave and S wave), and T wave amplitude (Table 1 and Figure 1). The changes were seen in all precordial leads, not only the right-sided, and visually diverging from the controls.
Conclusion
Development of the ARVC ECG phenotype started several years before diagnosis and continued afterwards. QRS duration and TAD increased, QRS voltages decrease, and T wave amplitude decreased eventually leading to T wave inversion. These changes might be visually assessed but also measured with available ECG software. These findings may be clinically useful in the screening and follow-up of ARVC relatives.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Governmental funding of clinical research (ALF), Region Ostergotland, Sweden.The Swedish Heart-Lung Foundation.
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Affiliation(s)
- A Svensson
- Department of Cardiology, Department of Medical, Health and Caring Sciences, Linkoping University , Linkoping , Sweden
| | - J Carlson
- Department of Cardiology, Clinical Sciences, Lund University , Lund , Sweden
| | - H K Jensen
- Aarhus University Hospital, Department of Clinical Medicine, Aarhus University Hospital , Aarhus , Denmark
| | - P Dahlberg
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg , Gothenburg , Sweden
| | - H Bundgaard
- Rigshospitalet - Copenhagen University Hospital, Department of Clinical Medicine University of Copenhagen , Copenhagen , Denmark
| | - A H Christensen
- Gentofte University Hospital, Department of Clinical Medicine University of Copenhagen , Copenhagen , Denmark
| | - M J Boonstra
- Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University , Utrecht , The Netherlands
| | - J H Svendsen
- Rigshospitalet - Copenhagen University Hospital, Department of Clinical Medicine University of Copenhagen , Copenhagen , Denmark
| | - J Cadrin Tourigny
- Cardiovascular Genetics Center, Montreal Heart Center, Montreal, Quebec, Canada , Montreal , Canada
| | - A S J Te Riele
- Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University , Utrecht , The Netherlands
| | - P G Platonov
- Arrhythmia Clinic, Skane University Hospital Lund and, Department of Cardiology, Clinical Sciences, Lund University , Lund , Sweden
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10
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Újvári G, Klötzli U, Stevens T, Svensson A, Ludwig P, Vennemann T, Gier S, Horschinegg M, Palcsu L, Hippler D, Kovács J, Di Biagio C, Formenti P. Greenland Ice Core Record of Last Glacial Dust Sources and Atmospheric Circulation. J Geophys Res Atmos 2022; 127:e2022JD036597. [PMID: 36245641 PMCID: PMC9542552 DOI: 10.1029/2022jd036597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 06/16/2023]
Abstract
Abrupt and large-scale climate changes have occurred repeatedly and within decades during the last glaciation. These events, where dramatic warming occurs over decades, are well represented in both Greenland ice core mineral dust and temperature records, suggesting a causal link. However, the feedbacks between atmospheric dust and climate change during these Dansgaard-Oeschger events are poorly known and the processes driving changes in atmospheric dust emission and transport remain elusive. Constraining dust provenance is key to resolving these gaps. Here, we present a multi-technique analysis of Greenland dust provenance using novel and established, source diagnostic isotopic tracers as well as results from a regional climate model including dust cycle simulations. We show that the existing dominant model for the provenance of Greenland dust as sourced from combined East Asian dust and Pacific volcanics is not supported. Rather, our clay mineralogical and Hf-Sr-Nd and D/H isotopic analyses from last glacial Greenland dust and an extensive range of Northern Hemisphere potential dust sources reveal three most likely scenarios (in order of probability): direct dust sourcing from the Taklimakan Desert in western China, direct sourcing from European glacial sources, or a mix of dust originating from Europe and North Africa. Furthermore, our regional climate modeling demonstrates the plausibility of European or mixed European/North African sources for the first time. We suggest that the origin of dust to Greenland is potentially more complex than previously recognized, demonstrating more uncertainty in our understanding dust climate feedbacks during abrupt events than previously understood.
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Affiliation(s)
- G. Újvári
- Centre for Astronomy and Earth SciencesInstitute for Geological and Geochemical ResearchEötvös Loránd Research NetworkBudapestHungary
- CSFKMTA Centre of ExcellenceBudapestHungary
- Department of Lithospheric ResearchUniversity of ViennaViennaAustria
| | - U. Klötzli
- Department of Lithospheric ResearchUniversity of ViennaViennaAustria
| | - T. Stevens
- Department of Earth SciencesUppsala UniversityUppsalaSweden
| | - A. Svensson
- Physics of Ice, Climate and EarthNiels Bohr InstituteUniversity of CopenhagenCopenhagenDenmark
| | - P. Ludwig
- Institute for Meteorology and Climate ResearchKarlsruhe Institute of TechnologyKarlsruheGermany
| | - T. Vennemann
- Institute of Earth Surface DynamicsUniversity of LausanneLausanneSwitzerland
| | - S. Gier
- Department of GeologyUniversity of ViennaViennaAustria
| | - M. Horschinegg
- Department of Lithospheric ResearchUniversity of ViennaViennaAustria
| | - L. Palcsu
- Isotope Climatology and Environmental Research CentreInstitute for Nuclear ResearchDebrecenHungary
| | - D. Hippler
- Institute of Applied GeosciencesGraz University of TechnologyGrazAustria
| | - J. Kovács
- Environmental Analytical and Geoanalytical Research GroupSzentágothai Research CentreUniversity of PécsPécsHungary
- Institute of Geography and Earth SciencesUniversity of PécsPécsHungary
| | - C. Di Biagio
- Université de Paris Cité and University Paris Est CreteilCNRSLISAParisFrance
| | - P. Formenti
- Université de Paris Cité and University Paris Est CreteilCNRSLISAParisFrance
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11
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Poder MT, Colding GM, Frödin K, Pedersen MBT, Andersen MS, Timm LS, Vibe A, Sørensen KN, Lindgren L, Svensson A, Pfeiffer-Jensen M, Fana V, Lykkegaard JJ, Thamsborg G. AB1560-HPR NURSE-DRIVEN DIAGNOSTIC PROCESS OF PATIENTS WITH SJÖGREN’S SYNDROME (SS) A CLINICAL DEVELOPMENT PROJECT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2655] [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: 11/03/2022]
Abstract
BackgroundSjögren’s Syndrome (SS) is a chronic autoimmune disease that affects the body’s glandular functions, especially the lacrimal and salivary glands, causing the mucous membranes to dry out (1). There are no diagnostic criteria, and classification criteria are often used to support the diagnosis (2).We identified a need to unify and consolidate the diagnostic process of patients with SS in the Capital Region of Denmark. A medical working group supervised the nurse-driven diagnostic process at Rigshospitalet, Glostrup. Here an interdisciplinary working group with physicians, nurses, and secretaries developed a diagnostic process and logistic based on the American-European Consensus Group Classification Criteria 2002 (3). The nurse’s took medical history and performed sicca tests and made sure that the patient received adequate guidance.With input from three patients, the nurses at the outpatient clinic developed - written material on eye and mouth dryness. We developed a “smart phrase” for our documentation platform in the interdisciplinary working group. The purpose of the ‘smart phrase”, was to unify the documentation and ensure continuity in the conversation with the patient. The Rheumatologists task was to disprove or confirm the diagnosis and perform a risk stratification especially in relation to the development of lymphoma, but also interstitial lung disease.ObjectivesThe aim of this project was to examine and evaluate the patients’ experience of nurse-driven diagnostic process.MethodsTo evaluate the new patient course, we performed a survey. The questions selected for the survey were primarily based on the patients experience of meaning and coherence in the diagnostic process. The questions were developed by the nurses in the Outpatient Clinic; “Do you feel safe going home after the consultation today?” “Did you get answers to the questions you asked while you were in the consultation?” “Did the staff take the time to listen to you?”. Also, the patients could add comments.ResultsA total of 34 consecutives responded to the questionnaire. 88% felt safe when returning home from the Outpatient Clinic, 85% received answers to their questions during the consultation. Altogether, 94% answered that the health care professionals were present and listened to them.The patients had the following comments: “The diagnostic process contained a lot of unresolved waiting time “ and “There has been some confusion about the division of tasks in the different hospital wards”.ConclusionWe found that the patients were satisfied with the nurse-driven diagnostic process. The diagnostic process created a feeling of safety in the patients and the patients found that they were listened to and allowed to ask questions. In addition, by evaluating the process investigation, we could change practice and further unify the diagnostic process. The result of the questionnaire supports the justification of the nurse competencies, by preforming a high level of information and guidance as well as the need for recognition of the patient’s symptoms.Therefore, the working group chose to meet again and evaluate. We decided that the nurse and rheumatologist consultation should be performed on the same day. Such consultation made it possible for the nurse to ensure continuity in the process, as the same nurse could follow the patient throughout the day. This optimized the opportunity for the nurse to guide the patient in the symptomatic treatment of eye and mouth dryness. Also, the nurse had the opportunity to guide in oral hygiene, fatigue, and lifestyle factors.The next step in our development project is to evaluate our revised nurse-led diagnostic process. In addition, the working group is currently working on material for a course in SS, where 4-6 patients and relatives can have the opportunity to participate.References[1]A.Voss et al. Reumatologi. FADL’s Forlag 2018. 238-251[2]Troldborg, A et al. National behandlingsvejledning, Sjögrens syndrom. 2020.[3]Troldborg, A et al. Sjögrens Syndrom, Dansk Reumatologisk Selskab 2010.AcknowledgementsI would like to thank the patients for the contribution to this project.Disclosure of InterestsNone declared
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Cedervall J, Herre M, Dragomir A, Rabelo-Melo F, Svensson A, Thâlin C, Rosell A, Hjalmar V, Wallén H, Lindman H, Pejler G, Hagstrom E, Hultstrom M, Larsson A, Olsson A. OC-04: Neutrophil extracellular traps promote cancer-associated inflammation and myocardial stress. Thromb Res 2022. [DOI: 10.1016/s0049-3848(22)00176-1] [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: 10/18/2022]
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13
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Cedervall J, Herre M, Dragomir A, Rabelo-Melo F, Svensson A, Thålin C, Rosell A, Hjalmar V, Wallén H, Lindman H, Pejler G, Hagström E, Hultström M, Larsson A, Olsson AK. Neutrophil extracellular traps promote cancer-associated inflammation and myocardial stress. Oncoimmunology 2022; 11:2049487. [PMID: 35309730 PMCID: PMC8928831 DOI: 10.1080/2162402x.2022.2049487] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Cancer is associated with systemic pathologies that contribute to mortality, such as thrombosis and distant organ failure. The aim of this study was to investigate the potential role of neutrophil extracellular traps (NETs) in myocardial inflammation and tissue damage in treatment-naïve individuals with cancer. Mice with mammary carcinoma (MMTV-PyMT) had increased plasma levels of NETs measured as H3Cit-DNA complexes, paralleled with elevated coagulation, compared to healthy littermates. MMTV-PyMT mice displayed upregulation of pro-inflammatory markers in the heart, myocardial hypertrophy and elevated cardiac disease biomarkers in the blood, but not echocardiographic heart failure. Moreover, increased endothelial proliferation was observed in hearts from tumor-bearing mice. Removal of NETs by DNase I treatment suppressed the myocardial inflammation, expression of cardiac disease biomarkers and endothelial proliferation. Compared to a healthy control group, treatment-naïve cancer patients with different malignant disorders had increased NET formation, which correlated to plasma levels of the inflammatory marker CRP and the cardiac disease biomarkers NT-proBNP and sTNFR1, in agreement with the mouse data. Altogether, our data indicate that NETs contribute to inflammation and myocardial stress during malignancy. These findings suggest NETs as potential therapeutic targets to prevent cardiac inflammation and dysfunction in cancer patients.
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Affiliation(s)
- J. Cedervall
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Biomedical Center, Uppsala, Sweden
| | - M. Herre
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Biomedical Center, Uppsala, Sweden
| | - A. Dragomir
- Department of Immunology, Genetics and Pathology, Uppsala University, Rudbeck Laboratory, Uppsala, Sweden
| | - F. Rabelo-Melo
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Biomedical Center, Uppsala, Sweden
| | - A. Svensson
- Department of Medical Cell Biology, Integrative Physiology, Uppsala University, Uppsala, Sweden
- Department of Surgical Sciences, Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
| | - C. Thålin
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - A. Rosell
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - V. Hjalmar
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
- Diagnostic Centre, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden
| | - H. Wallén
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - H. Lindman
- Department of Immunology, Genetics and Pathology, Uppsala University, Rudbeck Laboratory, Uppsala, Sweden
| | - G. Pejler
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Biomedical Center, Uppsala, Sweden
| | - E. Hagström
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - M. Hultström
- Department of Medical Cell Biology, Integrative Physiology, Uppsala University, Uppsala, Sweden
- Department of Surgical Sciences, Anaesthesiology and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
| | - A. Larsson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - AK. Olsson
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Biomedical Center, Uppsala, Sweden
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14
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Persson J, Svensson A, Lindén IG, Kylén S, Hägglin C. Aspects of Expansive Learning in the Context of Healthy Ageing—A Formative Intervention between Dental Care and Municipal Healthcare. IJERPH 2022; 19:ijerph19031089. [PMID: 35162112 PMCID: PMC8834131 DOI: 10.3390/ijerph19031089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/06/2022] [Accepted: 01/14/2022] [Indexed: 02/04/2023]
Abstract
There are great risks of diseases in the ageing population, and oral diseases are no exception. Poor oral health has profound negative impacts on the quality of life. It is therefore crucial to include the oral health perspective in the care for older adults. To meet the challenges associated with oral health in the ageing population, a formative intervention was launched. The intervention, called the TAIK project (=“Dental hygienist in a municipality organization”, in Swedish: Tandhygienist i kommunal verksamhet), meant that six dental hygienists served non-clinically as oral health consultants in five Swedish municipal organizations. The intervention formed an infrastructure and platform for work that benefits the ageing population and created a new basis for decisions regarding oral health in homecare. The aim of this paper is to explore how aspects of collaboration in an interprofessional and interorganizational intervention may lead to expansive learning. Expansive learning forms the theoretical framework of this study. The dental hygienists and the local head nurses were interviewed individually in-depth. Reflection documents from the dental hygienists were also part of the analyzed data. The conclusion is that the formative intervention was reliant of change which created a foundation for reciprocal understanding that led to expansive learning between dental care and municipal healthcare, with resilience and empowerment as crucial factors.
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Affiliation(s)
- Jessica Persson
- Department of Health Sciences, University West, 461 86 Trollhättan, Sweden
- Centre for Gerodontology, Public Dental Service, Region Västra Götaland, 402 33 Gothenburg, Sweden; (I.G.L.); (C.H.)
- Correspondence:
| | - Ann Svensson
- School of Business, Economics and IT, University West, 461 86 Trollhättan, Sweden;
| | - Ingela Grönbeck Lindén
- Centre for Gerodontology, Public Dental Service, Region Västra Götaland, 402 33 Gothenburg, Sweden; (I.G.L.); (C.H.)
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Sven Kylén
- R&D Department, Primary Health Care, Regionhälsan, Region Västra Götaland, 462 35 Vänersborg, Sweden;
| | - Catharina Hägglin
- Centre for Gerodontology, Public Dental Service, Region Västra Götaland, 402 33 Gothenburg, Sweden; (I.G.L.); (C.H.)
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
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15
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Schoultz K, Svensson A, Emilsson M. Nurses' experiences of using AsthmaTuner - an eHealth self-management system for healthcare of patients with asthma. Digit Health 2022; 8:20552076221092542. [PMID: 35433019 PMCID: PMC9008850 DOI: 10.1177/20552076221092542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
Objective This study describes nurses' experiences of using eHealth for assessment in the healthcare of patients with asthma. Methods Five nurses with experience of using AsthmaTuner in the healthcare of patients with asthma participated in the study. Individual semi-structured interviews were conducted with the nurses to understand their experiences of using the eHealth system. The transcribed interviews were analyzed using qualitative content analysis. Results The results show that nurses as well as patients find the tool useful and easy-to-handle. AsthmaTuner gives the nurses access to more and better information about the patients, which facilitates assessments and makes their work more efficient. The patients become more involved in their care, gain increased control and take more responsibility for their illness and treatment. Conclusions The nurses appreciate eHealth in asthma care. Using AsthmaTuner makes the nurses' work more efficient and the patients become more involved in their care.
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Affiliation(s)
| | - Ann Svensson
- School of Business, Economics and IT, University West, Trollhättan, Sweden
| | - Maria Emilsson
- Department of Health Sciences, University West, Trollhättan, Sweden
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16
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Ghaderi A, Okhovat M, Wikanthi LSS, Svensson A, Palma M, Schultz J, Olin T, Österborg A, Mellstedt H, Hojjat‐Farsangi M. A ROR1 small molecule inhibitor (KAN0441571C) induced significant apoptosis of ibrutinib‐resistant ROR1
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CLL cells. eJHaem 2021; 2:498-502. [PMID: 35844694 PMCID: PMC9176142 DOI: 10.1002/jha2.232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 01/21/2023]
Abstract
ROR1 – a receptor tyrosine kinase – is overexpressed in CLL. Ibrutinib, a Bruton's tyrosine kinase inhibitor, is clinically effective in CLL but patients may develop resistance. We evaluated the effect of an ROR1 inhibitor, KAN0441571C, in CLL cells from six patients obtained before and after developing resistance to ibrutinib. The ROR1 inhibitor induced apoptosis in ibrutinib‐resistant CLL cells to the same degree as in ibrutinib‐sensitive cells and dephosphorylated ROR1. This was also noted in one patient who became resistant to both ibrutinib and the Bcl‐2 inhibitor venetoclax. The combination of ROR1 inhibitor and venetoclax had a synergistic apoptotic effect on ibrutinib‐resistant cells.
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Affiliation(s)
- Amineh Ghaderi
- Department of Oncology‐PathologyBioClinicum, Karolinska InstitutetStockholmSweden
| | - Mohammad‐Ali Okhovat
- Department of Oncology‐PathologyBioClinicum, Karolinska InstitutetStockholmSweden
| | | | - Ann Svensson
- Department of Oncology‐PathologyBioClinicum, Karolinska InstitutetStockholmSweden
| | - Marzia Palma
- Department of Oncology‐PathologyBioClinicum, Karolinska InstitutetStockholmSweden
- Department of HematologyKarolinska University Hospital SolnaStockholmSweden
| | - Johan Schultz
- Kancera AB, Karolinska Institute Science ParkSolnaSweden
| | - Thomas Olin
- Kancera AB, Karolinska Institute Science ParkSolnaSweden
| | - Anders Österborg
- Department of Oncology‐PathologyBioClinicum, Karolinska InstitutetStockholmSweden
- Department of HematologyKarolinska University Hospital SolnaStockholmSweden
| | - Håkan Mellstedt
- Department of Oncology‐PathologyBioClinicum, Karolinska InstitutetStockholmSweden
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17
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Chernyshov PV, Tomas-Aragones L, Finlay AY, Manolache L, Marron SE, Sampogna F, Spillekom-van Koulil S, Pustisek N, Suru A, Evers AWM, Salavastru C, Svensson A, Abeni D, Blome C, Poot F, Jemec GBE, Linder D, Augustin M, Bewley A, Salek SS, Szepietowski JC. Quality of life measurement in alopecia areata. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes. J Eur Acad Dermatol Venereol 2021; 35:1614-1621. [PMID: 34107093 DOI: 10.1111/jdv.17370] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/28/2021] [Indexed: 12/13/2022]
Abstract
New treatment options may lead to an increased interest in using reliable and sensitive instruments to assess health-related quality of life in people with alopecia areata (AA). The purpose of this paper is to present current knowledge about quality of life assessment in AA. The dermatology-specific Dermatology Life Quality Index (DLQI) was the most widely reported health-related quality of life instrument used in AA. Three AA-specific (Alopecia Areata Symptom Impact Scale, Alopecia Areata Quality of Life Index and Alopecia Areata Patients' Quality of Life) and three hair disease-specific instruments (Hairdex, Scalpdex and 'hair-specific Skindex-29') were identified with a range of content and validation characteristics: there is little evidence yet of the actual use of these measures in AA. Scalpdex is the best-validated hair disease-specific instrument. Further extensive validation is needed for all of the AA-specific instruments. The European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes recommends the use of the dermatology-specific DLQI questionnaire, hair disease-specific Scalpdex and the alopecia areata-specific instruments the Alopecia Areata Symptom Impact Scale or Alopecia Areata Quality of Life Index, despite the limited experience of their use. We hope that new treatment methods will be able to improve both clinical signs and health-related quality of life in patients with AA. In order to assess the outcomes of trials on these new treatment methods, it would be helpful when further development and validation of AA-specific instruments is being encouraged and also conducted.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - S E Marron
- Department of Dermatology, Aragon Psychodermatology Research Group (GAI+PD), University Hospital Miguel Servet, Zaragoza, Spain
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - S Spillekom-van Koulil
- Radboud Institute for Health Sciences, Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - N Pustisek
- Children's Hospital Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - A Suru
- Paediatric Dermatology Discipline, 'Carol Davila' University of Medicine and Pharmacy, Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
| | - A W M Evers
- Health, Medical, and Neuropsychology unit, Leiden University, Leiden, The Netherlands
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - D Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - C Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Poot
- Department of Dermatology, University Hospital Erasme, Brussels, Belgium
| | - G B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health and Medical Sciences Faulty, University of Copenhagen, Copenhagen, Denmark
| | - D Linder
- Unit of Dermatology, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,The Royal London Hospital, London, UK
| | - S S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
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18
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Ring J, Worm M, Wollenberg A, Thyssen JP, Jakob T, Klimek L, Bangert C, Barbarot S, Bieber T, de Bruin-Weller MS, Chernyshov PV, Christen-Zaech S, Cork M, Darsow U, Flohr C, Fölster-Holst R, Gelmetti C, Gieler U, Gutermuth J, Heratizadeh A, Hijnen DJ, von Kobyletzki LB, Kunz B, Paul C, De Raeve L, Seneschal J, Simon D, Spuls PI, Stalder JF, Svensson A, Szalai Z, Taieb A, Torrelo A, Trzeciak M, Vestergaard C, Werfel T, Weidinger S, Deleuran M. Risk of severe allergic reactions to COVID-19 vaccines among patients with allergic skin diseases - practical recommendations. A position statement of ETFAD with external experts. J Eur Acad Dermatol Venereol 2021; 35:e362-e365. [PMID: 33752263 PMCID: PMC8250791 DOI: 10.1111/jdv.17237] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/23/2021] [Accepted: 03/15/2021] [Indexed: 12/15/2022]
Affiliation(s)
- J Ring
- Department Dermatology Allergy Biederstein, Technical University Munich, Munich, Germany
| | - M Worm
- Divison Allergy and Immunology, Department of Dermatology and Allergology, Charité University Hospital, Berlin, Germany
| | - A Wollenberg
- Department of Dermatology and Allergology, Ludwig Maximilian University Munich, Munich, Germany
| | - J P Thyssen
- Department of Dermatology and Venereology, Bispebjerg Hospital, Copenhagen, Denmark
| | - T Jakob
- Department of Dermatology, University Hospital Giessen-Marburg, Marburg, Germany
| | - L Klimek
- Allergy Center Wiesbaden, Wiesbaden, Germany
| | - C Bangert
- Department of Dermatology University, Vienna, Austria
| | - S Barbarot
- Department of Dermatology, Nantes Université, CHU Nantes UMR 1280 PhAN, INRAE, Nantes, France
| | - T Bieber
- Department of Dermatology and Allergy, University of Bonn, Bonn, Germany
| | - M S de Bruin-Weller
- National Expertise Center of Atopic Dermatitis, Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - S Christen-Zaech
- Pediatric Dermatology Unit, Departments of Dermatology and Pediatrics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - M Cork
- Sheffield Dermatology Research. Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
| | - U Darsow
- Department Dermatology Allergy Biederstein, Technical University Munich, Munich, Germany
| | - C Flohr
- St John's Institute of Dermatology, King's College London and Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - R Fölster-Holst
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Venereology and Allergology, Kiel, Germany
| | - C Gelmetti
- Unit of Pediatric Dermatology, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - U Gieler
- Department of Dermatology, University Hospital Giessen-Marburg, Marburg, Germany
| | - J Gutermuth
- Department of Dermatology, Universitair Ziekenhuis Brussel (UZB), Free University of Brussels (VUB), Brussels, Belgium
| | - A Heratizadeh
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - D J Hijnen
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - L B von Kobyletzki
- Faculty of Medicine, University Healthcare Research Center, Lund University, Lund, Sweden.,Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - B Kunz
- Dermatologikum Hamburg, Hamburg, Germany
| | - C Paul
- Department of Dermatology, Toulouse University, Toulouse, France
| | - L De Raeve
- Department of Dermatology, Universitair Ziekenhuis Brussel (UZB), Free University of Brussels (VUB), Brussels, Belgium
| | - J Seneschal
- Department of Adult and Pediatric Dermatology, CHU Bordeaux, University of Bordeaux, Bordeaux, France
| | - D Simon
- Department of Dermatology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - P I Spuls
- Department of Dermatology. Amsterdam Public Health/Infection and Immunology, Location AMC, Amsterdam, The Netherlands
| | - J F Stalder
- Department of Dermatology, Nantes Université, CHU Nantes UMR 1280 PhAN, INRAE, Nantes, France
| | - A Svensson
- Department of Dermatology, Skane University Hospital, Malmö, Sweden
| | - Z Szalai
- Department of Dermatology of Heim, Pál National Children's Institute Budapest, Budapest, Hungary
| | - A Taieb
- Department of Adult and Pediatric Dermatology, CHU Bordeaux, University of Bordeaux, Bordeaux, France
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Niño Jesús, Madrid, Spain
| | - M Trzeciak
- Department of Dermatology, Venereology and Allergology Medical, University of Gdansk, Gdansk, Poland
| | - C Vestergaard
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - T Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - S Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Venereology and Allergology, Kiel, Germany
| | - M Deleuran
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
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19
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Svensson A, Carlson J, Sherina V, Bundgaard H, Svendsen J, Platonov P. Progressive ECG changes over time in arrhythmogenic right ventricular cardiomyopathy precede diagnosis and continue – indices of disease substrate development? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Depolarization and repolarization abnormalities are common in arrhythmogenic right ventricular cardiomyopathy (ARVC), and are included in the diagnostic 2010 Task Force criteria (TFC2010). However, first ARVC symptoms commonly occur before ECG abnormalities reach the diagnostic thresholds and the time course of ECG abnormalities during initial phase of the disease remains obscure. Regional digital ECG archives allow computerized signal-processing and assessment of ECG phenotype during different disease phases, including the time prior to ascertainment of ARVC diagnosis.
Purpose
We aimed to assess the natural course of ECG characteristics associated with ARVC, hypothesizing that ARVC is a progressive disease and that ECG parameters progress over time due to disease substrate development.
Methods
Definite ARVC patients with at least one digital ECG recruited in three tertiary care hospitals in Sweden and Denmark were included (n=102, 66% males, 68% probands, 52% carrying a pathogenic genetic variant, 74% ICD carriers and 25% physically active >4 hours/week). Median age at diagnosis was 41 years (IQR 30–55). 12-lead digital ECGs were extracted from the regional ECG archives, containing all recordings in the hospital catchment areas since 1988. After excluding ECGs with heart rate <40 or >100/min, left bundle branch block or ventricular pacing, and those recorded prior to 14 years of age, the remaining 2067 ECGs were digitally processed and automatically analyzed using the Glasgow algorithm (median 3 [IQR 0–9] ECGs prior to diagnosis and 6 [IQR 2–14] ECGs during follow-up). Overall QRS duration as well as the right precordial lead indices exemplified by the lead V2 (terminal activation delay [TAD], area under the T-wave [T-wave area] and R-prime amplitude) were calculated and graphically represented using generalized additive model (GAM) with cubic splines (Figure 1). A median value for each measurement per patient per year was used for analysis. Blue line indicates smoothed conditional mean with 95% confidence interval (shadow). Time “0” (red line) indicates the time when TFC2010 criteria were fulfilled.
Results
Marked and consistent changes are seen in all studied depolarization and repolarization parameters over 10 years preceding ARVC diagnosis and continue afterwards. TAD demonstrates gradual increase, while T-wave area demonstrates consistent decrease over time before and after diagnosis indicating amplitude reduction and transition to T-wave inversion. The R-prime curve indicates that the terminal part of QRS complex demonstrate abnormalities first late in the course of the disease (Figure 1).
Conclusion
Electrocardiographic ARVC phenotype appears to become detectable long before the time of ARVC diagnosis indicating the progressive nature of ARVC and may explain arrhythmic events that may occur during the subclinical phase before ECG criteria are fulfilled.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Svensson
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - J Carlson
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden
| | - V Sherina
- Research Statistics, Biostatistics, GSK, Upper Providence, PA, United States of America
| | - H Bundgaard
- Unit for Inherited Cardiac Diseases, the Heart Center, National University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J.H Svendsen
- Department of Cardiology, Rigshospitalet, University of Copenhagen and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - P.G Platonov
- Department of Cardiology, Clinical Sciences, Lund University, Arrhythmia Clinic, Skane University Hospital, Lund, Sweden
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20
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Finlay AY, Chernyshov PV, Tomas Aragones L, Bewley A, Svensson A, Manolache L, Marron S, Suru A, Sampogna F, Salek MS, Poot F. Methods to improve quality of life, beyond medicines. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes. J Eur Acad Dermatol Venereol 2020; 35:318-328. [PMID: 33094518 DOI: 10.1111/jdv.16914] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 08/21/2020] [Indexed: 12/21/2022]
Abstract
The pharmaceutical approach to skin disease has been hugely successful, but despite effective drugs being available and used, there are still vast numbers of people who continue to have some level of persisting skin disease and continue to experience quality of life (QoL) impairment. So the question that needs to be answered, while we await further advances in our drug-based armamentarium, is how can we improve patients' QoL, beyond drugs? A working group was formed from members of the EADV Task Force on QoL and Patient Oriented Outcomes. Participants were asked to suggest all the ways in which they considered patients' QoL may be improved beyond medicines. Four groups of management approaches that may improve QoL in dermatology were identified: interventions within the dermatology service (hospitalization, multidisciplinary teams, patch testing and establishing relevant allergens and education), external services (corrective make-up, climatotherapy and balneotherapy), psychological (psychological intervention, cognitive therapy, hypnosis), lifestyle (lifestyle behavioural changes, religion and spirituality and music). The ultimate aim of therapy is to eradicate a disease in an individual and return the person's life to normal. But until the day comes when this has been achieved for every skin disease and for every patient there will be a need to support and assist many patients in additional non-pharmaceutical ways. These 'adjuvant' approaches receive too little attention while dermatologists and researchers strive for better pharmacological therapy. The different ways in which patients may benefit have been reviewed in our paper, but the reality is that most have a very poor evidence base. The research challenges that we have to meet are to identify those approaches that might be of value and to provide evidence for their optimal use. In the meantime, clinicians should consider the use of these approaches where QoL remains impaired despite optimal use of standard therapy.
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Affiliation(s)
- A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - L Tomas Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,Queen Mary University Medical School, London, UK
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - S Marron
- Department of Dermatology, Aragon Psychodermatology Research Group (GAI+PD), University Hospital Miguel Servet, Zaragoza, Spain
| | - A Suru
- Dermatology Research Unit, Paediatric Dermatology Discipline, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - F Poot
- Department of Dermatology, University Hospital Erasme, Brussels, Belgium
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21
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Chernyshov PV, Tomas Aragones L, Salavastru CM, Sampogna F, Boffa MJ, Poot F, Bettoli V, Pustišek N, Evers AWM, Bewley A, Marron SE, Abeni D, Svensson A, Szepietowski JS. Selection process of measures for core outcome set should utilize the highest methodology level and should be maximally free of bias. Comment on 'IDQoL, CDLQI and the 45-item CADIS received a sufficient content validity rating during the HOME VII meeting in Japan: a group discussion study'. J Eur Acad Dermatol Venereol 2020; 35:e208-e209. [PMID: 32885856 DOI: 10.1111/jdv.16921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 08/26/2020] [Indexed: 12/15/2022]
Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - L Tomas Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - C M Salavastru
- Paediatric Dermatology Discipline, "Carol Davila" University of Medicine and Pharmacy & Colentina Clinical Hospital, Bucharest, Romania
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - M J Boffa
- Department of Dermatology, Sir Paul Boffa Hospital, Floriana, Malta
| | - F Poot
- Department of Dermatology, University Hospital Erasme, Brussels, Belgium
| | - V Bettoli
- Department of Medical Sciences, Section of Dermatology, University of Ferrara, Ferrara, Italy
| | - N Pustišek
- Medical School, Children's Hospital Zagreb, University of Zagreb, Zagreb, Croatia
| | - A W M Evers
- Health, Medical, and Neuropsychology unit, Leiden University, Leiden, The Netherlands
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,Queen Mary University Medical School, London, UK
| | - S E Marron
- Department of Dermatology, Aragon Psychodermatology Research Group (GAI+PD), University, Hospital Miguel Servet, Zaragoza, Spain
| | - D Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - J S Szepietowski
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
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22
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Chernyshov PV, John SM, Tomas-Aragones L, Gonçalo M, Svensson A, Bewley A, Evers AWM, Szepietowski JC, Marron SE, Manolache L, Pustisek N, Suru A, Salavastru CM, Tiplica GS, Salek MS, Finlay AY. Quality of life measurement in occupational skin diseases. Position paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Occupational Skin Disease. J Eur Acad Dermatol Venereol 2020; 34:1924-1931. [PMID: 32662100 DOI: 10.1111/jdv.16742] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/03/2020] [Indexed: 12/19/2022]
Abstract
The European Academy of Dermatology and Venereology (EADV) has started the 'Healthy Skin @ Work' campaign aimed to raise awareness among the public and EU authorities on the frequency and impact of occupational skin diseases (OSDs). The EADV Task Forces (TFs) on Quality of Life and Patient Oriented Outcomes (QoL/PO) and on OSD present their mutual position statement on QoL assessment in OSDs. The EADV TFs recommend the use of the DLQI as a dermatology-specific instrument and SF-36 as a generic instrument in health-related (HR) QoL studies on OSDs. The OSD-specific questionnaire, LIOD, is not recommended for general use in its present form because of its three months recall period. The EADV TFs discourage the use of non-validated and of non-validated modifications of previously validated HRQoL instruments. The EADV TFs wish to encourage research into: the HRQoL impact of OSDs other than occupational contact dermatitis and hand eczema; comparisons between the effects of different treatments and other interventions on HRQoL in OSDs; and into the HRQoL impairment of patients with OSDs from different countries, and with different provoking factors, to predict if the results of successful therapeutic and educational interventions may be generalized across countries and between occupations.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - S M John
- Department of Dermatology, Environmental Medicine, Health Theory, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrueck, Osnabrueck, Germany
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - M Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,Queen Mary University Medical School, London, UK
| | - A W M Evers
- Health, Medical, and Neuropsychology unit, Leiden University, Leiden, The Netherlands
| | - J C Szepietowski
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - S E Marron
- Department of Dermatology, Aragon Psychodermatology Research Group (GAI+PD), University, Hospital Miguel Servet, Zaragoza, Spain
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - N Pustisek
- Children's Hospital Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - A Suru
- Paediatric Dermatology Discipline, "Carol Davila" University of Medicine and Pharmacy, Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
| | - C M Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - G S Tiplica
- Department of Dermatology II, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - A Y Finlay
- Department of Dermatology and Wound Healing, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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23
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Chernyshov PV, Tomas-Aragones L, Augustin M, Svensson A, Bewley A, Poot F, Szepietowski JC, Marron SE, Manolache L, Pustisek N, Suru A, Salavastru CM, Blome C, Salek MS, Abeni D, Sampogna F, Dalgard F, Linder D, Evers AWM, Finlay AY. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes on quality of life issues in dermatologic patients during the COVID-19 pandemic. J Eur Acad Dermatol Venereol 2020; 34:1666-1671. [PMID: 32498128 PMCID: PMC7301033 DOI: 10.1111/jdv.16720] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/27/2020] [Indexed: 12/11/2022]
Abstract
The pandemic of COVID‐19 is a global challenge for health care, and dermatologists are not standing apart from trying to meet this challenge. The European Academy of Dermatology and Venereology (EADV) has collected recommendations from its Task Forces (TFs) related to COVID‐19. The Journal of the EADV has established a COVID‐19 Special Forum giving free access to related articles. The psychosocial effects of the pandemic, an increase in contact dermatitis and several other skin diseases because of stress, disinfectants and protective equipment use, especially in healthcare workers, the temporary limited access to dermatologic care, the dilemma whether or not to pause immunosuppressive therapy, and, finally, the occurrence of skin lesions in patients infected by COVID‐19 all contribute to significant quality of life (QoL) impairment. Here, we present detailed recommendations of the EADV TF on QoL and patient‐oriented outcomes on how to improve QoL in dermatologic patients during the COVID‐19 pandemic for several different groups of patients and for the general population.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing, German Center for Health Services Research in Dermatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,Queen Mary University Medical School, London, UK
| | - F Poot
- Department of Dermatology, University Hospital Erasme, Brussels, Belgium
| | - J C Szepietowski
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - S E Marron
- Department of Dermatology, University, Hospital Miguel Servet, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - N Pustisek
- Children's Hospital Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - A Suru
- Paediatric Dermatology Discipline, Dermatology Research Unit, "Carol Davila" University of Medicine and Pharmacy, Colentina Clinical Hospital, Bucharest, Romania
| | - C M Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - C Blome
- Institute for Health Services Research in Dermatology and Nursing, German Center for Health Services Research in Dermatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - D Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - F Dalgard
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - D Linder
- Department of Dermatology, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - A W M Evers
- Health, Medical, and Neuropsychology unit, Leiden University, Leiden, The Netherlands
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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24
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Holst BS, Panzani D, Camillo F, Svensson A, Rota A. Anti-Müllerian hormone (AMH) concentrations are maximal at puberty in male donkeys and secretion is redirected from the blood stream to seminal plasma. Anim Reprod Sci 2020; 218:106484. [PMID: 32507264 DOI: 10.1016/j.anireprosci.2020.106484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 10/10/2019] [Revised: 05/01/2020] [Accepted: 05/02/2020] [Indexed: 10/24/2022]
Abstract
Sertoli cells produce anti-Müllerian hormone (AMH) and number of these cells is associated with numbers of sperm produced. The study aim was to quantify AMH concentrations in serum and seminal plasma of donkeys during puberty, and to correlate the values with those for testicular width and semen quality of sexually mature males. Blood was collected from five donkeys every second month from 4 to 24 months of age, and then once at 40 months of age. Semen was collected once monthly, from 13 to 19 and 23-25 months of age. There was quantification of AMH concentrations in serum and seminal plasma. During puberty, there was a redirection of AMH secretion from the blood stream into seminal plasma. In serum, AMH concentrations increased during puberty with a maximal concentration at 16 months and the changes were similar for seminal plasma with a maximal concentration at 18 months of age. Serum AMH concentrations from 14-20 were greater than at 12 or 22 months of age. Maximal serum AMH concentrations were associated with testicular width at 24 months (r = 0.97, P = 0.005), but not with sperm count, sperm motility or percentage of sperm with normal morphology at 42 months of age. There were no significant correlations among values for AMH concentrations in seminal plasma during puberty and values for any of the seminal variables.
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Affiliation(s)
- B S Holst
- Department of Clinical Sciences, Box 7054, Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden.
| | - D Panzani
- Dipartimento Di Scienze Veterinarie, Università Di Pisa, via Livornese Lato Monte, 56122 San Piero a Grado (PI), Italy
| | - F Camillo
- Dipartimento Di Scienze Veterinarie, Università Di Pisa, via Livornese Lato Monte, 56122 San Piero a Grado (PI), Italy
| | - A Svensson
- Department of Clinical Sciences, Box 7054, Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden
| | - A Rota
- Dipartimento Di Scienze Veterinarie, Università Di Pisa, via Livornese Lato Monte, 56122 San Piero a Grado (PI), Italy
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25
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Seegräber M, Worm M, Werfel T, Svensson A, Novak N, Simon D, Darsow U, Augustin M, Wollenberg A. Recurrent eczema herpeticum – a retrospective European multicenter study evaluating the clinical characteristics of eczema herpeticum cases in atopic dermatitis patients. J Eur Acad Dermatol Venereol 2020; 34:1074-1079. [DOI: 10.1111/jdv.16090] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 10/24/2019] [Indexed: 12/12/2022]
Affiliation(s)
- M. Seegräber
- Department of Dermatology and Allergy Ludwig‐Maximilian‐University Munich Germany
| | - M. Worm
- Department of Dermatology and Allergy Charité Universitätsmedizin Berlin Berlin Germany
| | - T. Werfel
- Department of Dermatology and Allergy Hannover Medical School Hannover Germany
- Cluster of Excellence RESIST (EXC 2155) Hannover Medical School Hannover Germany
| | - A. Svensson
- Department of Dermatology and Venerology Skane University Hospital Malmö Sweden
| | - N. Novak
- Department of Dermatology and Allergy University Clinic of Bonn Bonn Germany
| | - D. Simon
- Department of Dermatology and Allergy University of Berne Berne Switzerland
| | - U. Darsow
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - M. Augustin
- Department of Dermatology and Allergy University of Hamburg Hamburg Germany
| | - A. Wollenberg
- Department of Dermatology and Allergy Ludwig‐Maximilian‐University Munich Germany
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Baturova MA, Svensson A, Svendsen JH, Bundgaard H, Carlson J, Meurling C, Astrom Aneq M, Platonov PG. P5653Atrial fibrillation in arrhythmogenic right ventricular cardiomyopathy and its association with left atrial volume index. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recent studies in arrhythmogenic right ventricular cardiomyopathy (ARVC) support atrial involvement in the disease progression and consider atrial fibrillation (AF) as one of the primary manifestations of ARVC. We aimed to assess clinical factors, components of 2010 Task Force criteria (TFC2010) and echocardiographic characteristics of atria associated with AF in the Scandinavian cohort of ARVC patients.
Methods
Study sample comprised of 106 definite ARVC patients by TFC2010 from three tertiary care centers participating in the Nordic ARVC Registry (33% females, median age at ARVC diagnosis 41 years [IQR 30–54 years]). No concomitant diseases were observed in 90 patients (85%) while 16 patients had one or more comorbidities: hypertension (n=6), diabetes mellitus (n=5), coronary artery disease (n=5) or congestive heart failure (n=9). AF was included in the registry protocol as a pre-specified clinical event and verified by processing of the electronic ECG databases which contains all ECG recordings from the involved hospitals catchment areas (earliest ECG from 1988). Left (LA) and right atrial (RA) dimensions were obtained by revisiting cardiac ultrasound examinations performed at the time of ARVC diagnosis. Association between AF and clinical characteristics was assessed using multivariable logistic regression analysis adjusted for age and gender.
Results
AF was diagnosed in 29 patients (27%) at a median age of 53 (IQR 38–63) years, 7 females (24%). Median time from ARVC diagnosis to AF onset was 8 (IQR 2–12) years. AF was univariately associated with right ventricular structural abnormalities meeting the definition of major imaging criterion by 2010TFC, ventricular tachycardia (VT) with superior axis (major criterion) and LA volume index. Significantly associated variables were included in a multivariate model, in which LA volume index (OR=1.07, 95% CI 1.01–1.14, p=0.021) and superior axis VT (OR=7.45, 95% CI 1.82–30.55, p=0.005) remained independently associated with AF. In receiver operating characteristic (ROC) curve analysis, LA volume index was significantly associated with AF (AUC=0.703, p=0.005) and with superior axis VT (AUC=0.703, p=0.021). AF was not associated with either RA volume index (univariate OR=1.03, 95% CI 0.99–1.06, p=0.203) or left ventricular ejection fraction (OR=0.97, 95% CI 0.92–1.03, p=0.299).
Conclusion
In patients with ARVC,AF is primarily associated with LA structural abnormalities without indication of RA involvement and is strongly associated with ventricular arrhythmias thus indicating parallel development of atrial and ventricular arrhythmic substrate.
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Affiliation(s)
- M A Baturova
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden, Research Park, St.Petersburg State University, St.Petersburg, Russian Federation
| | - A Svensson
- Linkoping University, Department of Cardiology and Department of Medical and Health Sciences, Linkoping, Sweden
| | - J H Svendsen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
| | - H Bundgaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - C Meurling
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - M Astrom Aneq
- Linkoping University, Department of Clinical Physiology and Department of Medical and Health Sciences, Linkoping, Sweden
| | - P G Platonov
- Lund University, Department of cardiology, Clinical Sciences, Arrhythmia Clinic, Skåne University Hospital, Lund, Sweden
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Platonov PG, Carlson J, Castrini I, Svensson A, Christiansen MK, Gilljam T, Madsen T, Hansen J, Astrom MA, Haagua K, Jensen HK, Edvardsen T, Svendsen JH. P2247Pregnancies and childbirth in women with arrhythmogenic right ventricular cardiomyopathy are associated with low risk of ventricular arrhythmias. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with a risk of ventricular arrhythmias (VA) and sudden cardiac death (SCD). Even though female patients with ARVC are considered to be at lower risk of VA, the impact of pregnancy and child birth on the arrhythmic risk and development of arrhythmic substrate in the context of ARVC remains insufficiently studied.
Objective
To assess the risk of VA in relation to childbirth in women with ARVC and the impact of multiple pregnancies on progression of arrhythmic manifestations of the disease.
Methods
The study included 186 females with definite ARVC (n=107, 70 probands) or unaffected mutation-carriers (n=79) with median age at the end of follow up of 48 (IQR 34–60) years. Seventeen women had 1, 59 had 2 and 29 had ≥3 child births by the age of 40 years. VA was defined as ventricular tachycardia, appropriate ICD therapy, aborted cardiac arrest or SCD. Proportions of patients who experienced VA by the age of 40 years were compared between nulliparous women (n=81) and those with reported child births (n=105). VA-free survival after accomplished pregnancies was assessed for women ≥40 years of age (n=119). Cumulative probability of VA for each pregnancy (n=230) was assessed from conception through 2 years after child birth and compared between those that occurred before ARVC diagnosis (Pre-Ds, n=164), after it (Post-Ds, n=11) and in unaffected mutation carriers (No-Ds, n=55).
Results
The nulliparous women had lower age at ARVC diagnosis (37 vs 44, p=0.023) and more often had VA before the age of 40 (31% vs 13%, p=0.003) while the number of child births was not related to the prevalence of VA (18% among women with 1 childbirth, 12% in those with 2 and 14% in those with 3 or more, ns). Three women suffered SCD before the age of 40. VA-free survival after 40 years did not differ between nulliparous and those who gave birth (Figure A). Only four pregnancy-related events were documented (Figure B): 1 in the Post-Ds group and three in the Pre-Ds group. No pregnancy-related events were reported in the unaffected mutation carriers.
Conclusion
In this Scandinavian cohort of women with ARVC we observed no indication of an increased VA risk either associated with pregnancies or during long-term follow up after the last child birth.
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Affiliation(s)
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | | | | | | | - T Gilljam
- Sahlgrenska Academy, Gothenburg, Sweden
| | - T Madsen
- Aalborg University Hospital, Aalborg, Denmark
| | - J Hansen
- Gentofte University Hospital, Gentofte, Denmark
| | | | - K Haagua
- University of Oslo, Oslo, Norway
| | - H K Jensen
- Aarhus University Hospital, Aarhus, Denmark
| | | | - J H Svendsen
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
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28
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Christiansen MK, Haugaa K, Svensson A, Gilljam T, Madsen T, Hansen J, Holst A, Bundgaard H, Edvardsen T, Svendsen JH, Platonov P, Jensen HK. P992Incidence, predictors, and success of ventricular tachycardia catheter ablation in arrhythmogenic right ventricular cardiomyopathy (ARVC): A long-term cohort study from the Nordic ARVC registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Catheter ablation may reduce ventricular tachycardia (VT) burden in arrhythmogenic right ventricular cardiomyopathy (ARVC) patients. However, little is known about factors predicting need for ablation and various outcomes have been reported.
Purpose
We sought to investigate predictors and use of VT ablation and to evaluate the post-procedural outcome in ARVC patients.
Methods
We studied 435 patients from the Nordic ARVC registry including 220 probands with definite ARVC according to the 2010 task force criteria and 215 mutation-carrying relatives identified through cascade screening. Patients were followed until first-time VT ablation, death, heart transplantation, or January 1st 2018. Additionally, patients undergoing VT ablation were further followed from the time of ablation for recurrent ventricular arrhythmias.
Results
Cumulative use of VT ablation was 4% (95% CI 3%-6%) and 11% (95% CI 8%-15%) after 1 and 10 years. All procedures were performed in probands in whom the cumulative use was 8% (95% CI 5%-12%) and 20% (95% CI 15%-26%). In adjusted analyses restricted to probands, only young age predicted need for ablation. In patients undergoing ablation, risk of recurrent arrhythmias was 59% (95% CI 44%-71%) and 74% (95% CI 59%-84%) 1 and 5 years after the procedure. Despite high recurrence rates, the burden of ventricular arrhythmias was reduced after ablation (p=0.0042). Young age, use of several antiarrhythmic drugs and inducibility to VT immediately after ablation were associated with an unfavorable outcome.
Conclusions
Twenty percent of ARVC probands developed a clinical indication for VT ablation within 10 years after diagnosis whereas mutation-carrying relatives were without such need. Although the burden of ventricular arrhythmias decreased after ablation, risk of recurrence was substantial.
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Affiliation(s)
- M K Christiansen
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - K Haugaa
- Oslo University Hospital, Department of cardiology, Oslo, Norway
| | - A Svensson
- Linkoping University, Department of Cardiology, Linkoping, Sweden
| | - T Gilljam
- Sahlgrenska Academy, Department of Cardiology, Gothenburg, Sweden
| | - T Madsen
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - J Hansen
- Gentofte University Hospital, Department of Cardiology, Gentofte, Denmark
| | - A Holst
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - H Bundgaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - T Edvardsen
- Oslo University Hospital, Department of cardiology, Oslo, Norway
| | - J H Svendsen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - P Platonov
- Lund University, Department of Cardiology, Lund, Sweden
| | - H K Jensen
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
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Chankeaw W, Guo YZ, Båge R, Svensson A, Andersson G, Humblot P. Elevated non-esterified fatty acids impair survival and promote lipid accumulation and pro-inflammatory cytokine production in bovine endometrial epithelial cells. Reprod Fertil Dev 2019; 30:1770-1784. [PMID: 30086824 DOI: 10.1071/rd17537] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 06/11/2018] [Indexed: 12/11/2022] Open
Abstract
Elevated non-esterified fatty acids (NEFAs) are associated with negative effects on bovine theca, granulosa and oviductal cells but the effects of NEFAs on bovine endometrial epithelial cells (bEECs) are not as well documented. The objective of this study was to define the effects of NEFAs on bEECs. Postprimary bEECs were treated with 150, 300 or 500µM of either palmitic acid (PA), stearic acid (SA) or oleic acid (OA) or a mixture of NEFAs (150µM of each FA) or 0.5% final concentration of vehicle ethanol (control). Viability and proliferation of bEECs exposed to 150µM of each NEFA or a mixture of NEFAs were unaffected. Increased lipid accumulation was found in all treated groups (P<0.01). In cells exposed to 500µM of each NEFA and 300µM PA decreased cell viability (P<0.001), proliferation (P<0.05) and increased apoptosis (P<0.05) were observed. Treatment with 500µM OA, PA and SA had the strongest effects on cell viability, proliferation and apoptosis (P<0.05). Treatment with PA and OA increased interleukin-6 (IL-6) concentrations (P<0.05), whereas only the highest concentration of PA, OA and SA stimulated IL-8 production (P<0.05). These results suggest that high concentrations of NEFAs may impair endometrial function with more or less pronounced effects depending on the type of NEFA and time of exposure.
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Affiliation(s)
- W Chankeaw
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences, SLU, P.O. Box 7054, 750 07 Uppsala, Sweden
| | - Y Z Guo
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences, SLU, P.O. Box 7054, 750 07 Uppsala, Sweden
| | - R Båge
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences, SLU, P.O. Box 7054, 750 07 Uppsala, Sweden
| | - A Svensson
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences, SLU, P.O. Box 7054, 750 07 Uppsala, Sweden
| | - G Andersson
- Department of Animal Breeding and Genetics, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences, SLU, P.O. Box 7023, 750 07 Uppsala, Sweden
| | - P Humblot
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences, SLU, P.O. Box 7054, 750 07 Uppsala, Sweden
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30
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Forsman B, Svensson A. Frail Older Persons' Experiences of Information and Participation in Hospital Care. Int J Environ Res Public Health 2019; 16:E2829. [PMID: 31398821 PMCID: PMC6720347 DOI: 10.3390/ijerph16162829] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 07/30/2019] [Accepted: 08/07/2019] [Indexed: 01/06/2023]
Abstract
The aim of this paper is to describe frail older persons' experiences of hospital care of information and participation when being an inpatient at a hospital. A qualitative method was used. Data were collected at the hospital from 20 interviews with frail older patients, together with observations in the environment at the hospital ward. A content analysis was performed. Patients experienced not receiving information about their care and rehabilitation, or receiving such information in noisy surroundings. They experienced situations of misunderstanding related to their medication, which indicates the need for appropriate discharge calls for frail older patients. They expressed feelings of distress concerning the future, caused by hasty admissions or relatives' problems to handle the situation. The results highlight the need to receive appropriate information and to participate in decision-making. The level of health literacy should be taken notice of when giving information, using peaceful and quiet environments when informing frail older persons. Person-centered care should be recognized to a greater extent in order for healthcare professionals to give information to frail older people in a health literacy-friendly way. This might make it easier for frail older persons to participate in a partnership in care.
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Affiliation(s)
- Berit Forsman
- Department of Health Sciences, University West, 461 86 Trollhättan, Sweden
| | - Ann Svensson
- School of Business, Economics and IT, University West, 461 86 Trollhättan, Sweden.
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31
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Uddh Söderberg T, Berggren Kleja D, Åström M, Jarsjö J, Fröberg M, Svensson A, Augustsson A. Metal solubility and transport at a contaminated landfill site - From the source zone into the groundwater. Sci Total Environ 2019; 668:1064-1076. [PMID: 31018448 DOI: 10.1016/j.scitotenv.2019.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/25/2019] [Accepted: 03/01/2019] [Indexed: 06/09/2023]
Abstract
Risks associated with metal contaminated sites are tightly linked to material leachability and contaminant mobility. In this study, metal solubility and transport were characterized within a glass waste landfill through i) lysimeter-collection of pore water and standardized batch leaching tests, ii) soil profiles extending from the landfill surface, through unsaturated soil underneath, and into the groundwater zone, and iii) groundwater samples upstream, at, and downstream of the landfill. The soil analyzes targeted both pseudo-total and geochemically active concentrations of contaminant metals (As, Cd, Pb, Sb) and basic soil geochemistry (pH, org. C, Fe, Mn). Water samples were analyzed for dissolved, colloid-bound and particulate metals, and speciation modelling of the aqueous phase was conducted. The results revealed a highly contaminated system, with mean metal concentrations in the waste zone between 90 and 250 times the regional background levels. Despite severe contamination of the waste zone and high geochemically active fractions (80-100%) of all contaminant metals as well as elevated concentrations in landfill pore water, the concentrations of Cd and Pb decrease abruptly at the transition between landfill and underlying natural soil and no indication of groundwater contamination was found. The efficient cation retention is likely due to the high pH. However, the sorption of As and Sb is weaker at such high pH, which explains their higher mobility from the pore water zone into groundwater. The field soil:solution partitioning (Kd) displayed a high spatial variability within the waste zone (the highest Kd variability was seen for Pb, ranging from 140 to 2,900,000 l kg-1), despite little variability in basic geochemical variables, which we suggest is due to waste material heterogeneity.
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Affiliation(s)
- T Uddh Söderberg
- Department of Biology and Environmental Science, Linnaeus University, Kalmar, Sweden.
| | - D Berggren Kleja
- Swedish Geotechnical Institute, Olaus Magnus väg 35, Linköping, Sweden; Department of Soil and Environment, Swedish University of Agricultural Sciences, Box 7014, Uppsala, Sweden
| | - M Åström
- Department of Biology and Environmental Science, Linnaeus University, Kalmar, Sweden
| | - J Jarsjö
- Department of Physical Geography, Stockholm University, Stockholm, Sweden
| | - M Fröberg
- Swedish Geotechnical Institute, Olaus Magnus väg 35, Linköping, Sweden
| | - A Svensson
- Department of Biology and Environmental Science, Linnaeus University, Kalmar, Sweden
| | - A Augustsson
- Department of Biology and Environmental Science, Linnaeus University, Kalmar, Sweden
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32
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Chernyshov PV, Zouboulis CC, Tomas-Aragones L, Jemec GB, Svensson A, Manolache L, Tzellos T, Sampogna F, Pustisek N, van der Zee HH, Marron SE, Spillekom-van Koulil S, Bewley A, Linder D, Abeni D, Szepietowski JC, Augustin M, Finlay AY. Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient-Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa. J Eur Acad Dermatol Venereol 2019; 33:1633-1643. [PMID: 31037773 DOI: 10.1111/jdv.15519] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 02/04/2019] [Indexed: 02/06/2023]
Abstract
This paper is organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on Quality of Life (QoL) and Patient-Oriented Outcomes and the EADV TF on acne, rosacea and hidradenitis suppurativa (ARHS). The purpose of this paper was to present current knowledge about QoL assessment in HS, including data on HS-specific health-related (HR) QoL instruments and HRQoL changes in clinical trials, and to make practical recommendations concerning the assessment of QoL in people with HS. HS results in significant quimp that is higher than in most other chronic skin diseases. HS impact in published studies was assessed predominantly (84% of studies) by the Dermatology Life Quality Index (DLQI). There is a lack of high-quality clinical trials in HS patients where HRQoL instruments have been used as outcome measures. One double-blind randomized placebo-controlled trial on infliximab with low number of participants reported significantly better HRQoL improvement in the treatment group than in the placebo group. Well-designed clinical studies in HS patients to compare different treatment methods, including surgical methods and assessing long-term effects, are needed. Because of lack of sufficient validation, the Task Forces are not at present able to recommend existing HS-specific HRQoL instruments for use in clinical studies. The EADV TFs recommend the dermatology-specific DLQI questionnaire for use in HS patients. The EADV TFs encourage the further development, validation and use of other HS-specific, dermatology-specific and generic instruments but such use should be based on the principles presented in the previous publications of the EADV TF on QoL and Patient-Oriented Outcomes.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - G B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - T Tzellos
- Department of Dermatology, Faculty of Health Sciences, University Hospital of North Norway, Troms, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - N Pustisek
- Children's Hospital Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - H H van der Zee
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - S E Marron
- Department of Dermatology, Royo Villanova Hospital, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - S Spillekom-van Koulil
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,The Royal London Hospital, London, UK
| | - D Linder
- Unit of Dermatology, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - D Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - J C Szepietowski
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Y Finlay
- Department of Dermatology and Wound Healing, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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Chernyshov PV, Lallas A, Tomas-Aragones L, Arenbergerova M, Samimi M, Manolache L, Svensson A, Marron SE, Sampogna F, Spillekom-vanKoulil S, Bewley A, Forsea AM, Jemec GB, Szepietowski JC, Augustin M, Finlay AY. Quality of life measurement in skin cancer patients: literature review and position paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes, Melanoma and Non-Melanoma Skin Cancer. J Eur Acad Dermatol Venereol 2019; 33:816-827. [PMID: 30963614 DOI: 10.1111/jdv.15487] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 01/18/2019] [Indexed: 12/13/2022]
Abstract
The European Academy of Dermatology and Venereology (EADV) Task Forces (TFs) on Quality of Life (QoL) and Patient Oriented Outcomes, Melanoma and Non-Melanoma Skin Cancer (NMSC) present a review of the literature and position statement on health-related (HR) QoL assessment in skin cancer patients. A literature search was carried out to identify publications since 1980 that included information about the impact of SC on QoL. Generic, dermatology-specific, cancer-specific, SC-specific, facial SC-specific, NMSC-specific, basal cell carcinoma-specific and melanoma-specific QoL questionnaires have been used to assess HRQoL in SC patients. HRQoL was assessed in the context of creation and validation of the HRQoL instruments, clinical trials, comparison of QoL in SC and other cancers, other diseases or controls, HRQoL assessment after treatment, comorbidities, behaviour modification, predictors of QoL and survival, supportive care needs, coping strategies and fear of cancer recurrence. The most widely used instruments for HRQoL assessment in SC patients are the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-C30), the Functional Assessment of Cancer Therapy-Melanoma (FACT-M), Skin Cancer Index (SCI), Short Form 36 Item Health Survey (SF-36) and the Dermatology Life Quality Index (DLQI). The TFs recommend the use of the cancer-specific EORTC QLQ-C30, especially in late stages of disease, and the melanoma-specific FACT-M and SC-specific SCI questionnaires. These instruments have been well validated and used in several studies. Other HRQoL instruments, also with good basic validation, are not currently recommended because the experience of their use is too limited. Dermatology-specific HRQoL instruments can be used to assess the impact of skin-related problems in SC. The TFs encourage further studies to validate HRQoL instruments for use in different stages of SC, in order to allow more detailed practical recommendations on HRQoL assessment in SC.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - M Arenbergerova
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - M Samimi
- Dermatology Department, University of Tours, Tours, France
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - S E Marron
- Department of Dermatology, Royo Villanova Hospital, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - F Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS FLMM, Rome, Italy
| | - S Spillekom-vanKoulil
- Radboud Institute for Health Sciences, Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,The Royal London Hospital, London, UK
| | - A M Forsea
- Department of Oncologic Dermatology and Allergology, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - G B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Y Finlay
- Department of Dermatology and Wound Healing, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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34
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Svensson A, Haugaa KH, Zareba W, Jensen HK, Bundgaard H, Gilljam T, Madsen T, Hansen J, Karlsson L, Green A, Polonsky B, Edvardsen T, Svendsen JH, Gunnarsson C, Platonov PG. P688Genetic variant score predicts cardiac events in arrhythmogenic right ventricular cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p688] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Svensson
- Department of Cardiology and Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden
| | - K H Haugaa
- Department of Cardiology, Centre for Cardiological Innovation, Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway and University of Oslo, Oslo, Norway
| | - W Zareba
- University of Rochester Medical Center, Rochester, NY, Rochester, United States of America
| | - H K Jensen
- Department of Cardiology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - H Bundgaard
- Unit for Inherited Cardiac Diseases, the Heart Center, National University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - T Gilljam
- Department of Cardiology, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - T Madsen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - J Hansen
- Department of Cardiology, Herlev-Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - L Karlsson
- Department of Cardiology and Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden
| | - A Green
- Department of Clinical Genetics, Department of Clinical Experimental Medicine, Linköping University, Linkoping, Sweden
| | - B Polonsky
- University of Rochester Medical Center, Rochester, NY, Rochester, United States of America
| | - T Edvardsen
- Department of Cardiology, Centre for Cardiological Innovation, Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway and University of Oslo, Oslo, Norway
| | - J H Svendsen
- Department of Cardiology, the Heart Centre, Rigshospitalet, University of Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - C Gunnarsson
- Department of Clinical Genetics, Department of Clinical Experimental Medicine, Linköping University, Centre for Rare Diseases in South East Region of Sweden, Linköping University, Linkoping, Sweden
| | - P G Platonov
- Department of Cardiology, Clinical Sciences, Lund University, and Arrhythmia Clinic, Skåne University Hospital, Lund, Sweden
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Baturova MA, Svensson A, Svendsen JH, Bundgaard H, Sherina V, Carlson J, Platonov PG. P2506Long-term evolution of P wave indices in arrhythmogenic right ventricular cardiomyopathy indicates atrial involvement. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2506] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M A Baturova
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - A Svensson
- Linkoping University, Department of Cardiology and Department of Medical and Health Sciences, Linkoping, Sweden
| | - J H Svendsen
- University of Copenhagen, Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen, Denmark
| | - H Bundgaard
- University of Copenhagen, Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen, Denmark
| | - V Sherina
- University of Rochester, Department of Biostatistics and computational biology, Rochester, United States of America
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - P G Platonov
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
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Chernyshov P, Tomas-Aragones L, Manolache L, Svensson A, Marron S, Evers A, Bettoli V, Jemec G, Szepietowski J. Which acne treatment has the best influence on health-related quality of life? Literature review by the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes. J Eur Acad Dermatol Venereol 2018; 32:1410-1419. [DOI: 10.1111/jdv.15048] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 04/13/2018] [Indexed: 12/14/2022]
Affiliation(s)
- P.V. Chernyshov
- Department of Dermatology and Venereology; National Medical University; Kiev Ukraine
| | - L. Tomas-Aragones
- Department of Psychology; Aragon Health Sciences Institute (IACS); University of Zaragoza; Zaragoza Spain
| | | | - A. Svensson
- Department of Dermatology and Venereology; Skane University Hospital; Malmö Sweden
| | - S.E. Marron
- Department of Dermatology; Royo Villanova Hospital; Aragon Health Sciences Institute (IACS); Zaragoza Spain
| | - A.W.M. Evers
- Health, Medical, and Neuropsychology unit; Leiden University; Leiden The Netherlands
| | - V. Bettoli
- Department of Medical Sciences; Section of Dermatology; University of Ferrara; Ferrara Italy
| | - G.B. Jemec
- Department of Dermatology; Zealand University Hospital; Roskilde Denmark
| | - J.C. Szepietowski
- Department of Dermatology, Venereology and Allergology; Wrocław Medical University; Wrocław Poland
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Palma M, Hansson L, Mulder TA, Adamson L, Näsman-Glaser B, Eriksson I, Heimersson K, Ryblom H, Mozaffari F, Svensson A, Gentilcore G, Österborg A, Mellstedt H. Lenalidomide as immune adjuvant to a dendritic cell vaccine in chronic lymphocytic leukemia patients. Eur J Haematol 2018; 101:68-77. [PMID: 29569742 DOI: 10.1111/ejh.13065] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES We previously showed that immunization with ex vivo- generated autologous dendritic cells loaded with apoptotic tumor cells (Apo-DC) potentiated tumor-specific immunity in chronic lymphocytic leukemia (CLL) patients. Here, we evaluated safety and immunogenicity of Apo-DC in combination with lenalidomide, granulocyte-macrophage colony-stimulating factor (GM-CSF), and low-dose cyclophosphamide (CTX). METHODS Ten previously untreated patients with slowly progressing CLL received 5 Apo-DC vaccinations and lenalidomide orally for 24 weeks either alone (cohort I, n = 5) or together with subcutaneous GM-CSF and intravenous CTX (cohort II, n = 5). Tumor-specific T-cell responses were measured by proliferation and IFN-γ ELISPOT assays. Immune monitoring was performed by flow cytometry. RESULTS Dose-limiting toxicity was observed in 3/10 patients, 2 in cohort I and one in cohort II. One patient developed autoimmune hemolytic anemia and another grade 4 thrombocytopenia. Vaccine-induced immune responses were seen in 5/5 and 4/5 patients in cohort I and II, respectively. The expression of immune checkpoints on T cells did not change significantly. CONCLUSIONS Lenalidomide alone or in combination with GM-CSF and low-dose CTX as immune adjuvant to the Apo-DC vaccine elicited tumor-specific T-cell responses in CLL patients. However, unexpected toxicity was observed and caution is suggested in further exploring this drug as immune adjuvant in CLL.
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Affiliation(s)
- Marzia Palma
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Lotta Hansson
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Tom A Mulder
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Lars Adamson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | | | - Ingrid Eriksson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Kia Heimersson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Harriet Ryblom
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Fariba Mozaffari
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Ann Svensson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Giusy Gentilcore
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Anders Österborg
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Håkan Mellstedt
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
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Svensson A, Ofenloch R, Bruze M, Naldi L, Cazzaniga S, Elsner P, Goncalo M, Schuttelaar ML, Diepgen T. 皮肤病在五个欧洲国家基于人口的成人样本中的流行性. Br J Dermatol 2018. [DOI: 10.1111/bjd.16644] [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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39
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Svensson A, Ofenloch R, Bruze M, Naldi L, Cazzaniga S, Elsner P, Goncalo M, Schuttelaar ML, Diepgen T. Prevalence of skin disease in a population-based sample of adults from five European countries. Br J Dermatol 2018. [DOI: 10.1111/bjd.16625] [Citation(s) in RCA: 1] [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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40
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Augustsson C, Svensson A, Kjaer B, Chao TY, Wenjuan X, Krogh BO, Breinholt J, Clausen JT, Hilden I, Petersen HH, Petersen LC. Factor Xa and VIIa inhibition by tissue factor pathway inhibitor is prevented by a monoclonal antibody to its Kunitz-1 domain. J Thromb Haemost 2018; 16:893-904. [PMID: 29532595 DOI: 10.1111/jth.14000] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 07/16/2017] [Indexed: 12/24/2022]
Abstract
Essentials Activated FVII (FVIIa) and FX (FXa) are inhibited by tissue factor pathway inhibitor (TFPI). A monoclonal antibody, mAb2F22, was raised against the N-terminal fragment of TFPI (1-79). mAb2F22 bound exclusively to the K1 domain of TFPI (KD ∼1 nm) and not to the K2 domain. mAb2F22 interfered with inhibition of both FVIIa and FXa activities and restored clot formation. SUMMARY Background Initiation of coagulation is induced by binding of activated factor VII (FVIIa) to tissue factor (TF) and activation of factor X (FX) in a process regulated by tissue factor pathway inhibitor (TFPI). TFPI contains three Kunitz-type protease inhibitor domains (K1-K3), of which K1 and K2 block the active sites of FVIIa and FXa, respectively. Objective To produce a monoclonal antibody (mAb) directed towards K1, to characterize the binding epitope, and to study its effect on TFPI inhibition. Methods A monoclonal antibody, mAb2F22, was raised against the N-terminal TFPI(1-79) fragment. Binding data were obtained by surface plasmon resonance analysis. The Fab-fragment of mAb2F22, Fab2F22, was expressed and the structure of its complex with TFPI(1-79) determined by X-ray crystallography. Effects of mAb2F22 on TFPI inhibition were measured in buffer- and plasma-based systems. Results mAb2F22 bound exclusively to K1 of TFPI (KD ~1 nm) and not to K2. The crystal structure of Fab2F22/TFPI (1-79) mapped an epitope on K1 including seven residues upstream of the domain. TFPI inhibition of TF/FVIIa amidolytic activity was neutralized by mAb2F22, although the binding epitope on K1 did not include the P1 residue. Binding of mAb2F22 to K1 blocked TFPI inhibition of the FXa amidolytic activity and normalized hemostasis in hemophilia human A-like plasma and whole blood. Conclusion mAb2F22 blocked TFPI inhibition of both FVIIa and FXa activities and mapped a FXa exosite for binding to K1. It reversed TFPI feedback inhibition of TF/FVIIa-induced coagulation and restored clot formation in FVIII-neutralized human plasma and blood.
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Affiliation(s)
- C Augustsson
- Global Research, Novo Nordisk A/S, Måløv, Denmark
| | - A Svensson
- Global Research, Novo Nordisk A/S, Måløv, Denmark
| | - B Kjaer
- Global Research, Novo Nordisk A/S, Måløv, Denmark
| | - T-Y Chao
- Novo Nordisk Research Center China, Beijing, China
| | - X Wenjuan
- Novo Nordisk Research Center China, Beijing, China
| | - B O Krogh
- Global Research, Novo Nordisk A/S, Måløv, Denmark
| | - J Breinholt
- Global Research, Novo Nordisk A/S, Måløv, Denmark
| | - J T Clausen
- Global Research, Novo Nordisk A/S, Måløv, Denmark
| | - I Hilden
- Global Research, Novo Nordisk A/S, Måløv, Denmark
| | - H H Petersen
- Global Research, Novo Nordisk A/S, Måløv, Denmark
| | - L C Petersen
- Global Research, Novo Nordisk A/S, Måløv, Denmark
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Schüpbach S, Fischer H, Bigler M, Erhardt T, Gfeller G, Leuenberger D, Mini O, Mulvaney R, Abram NJ, Fleet L, Frey MM, Thomas E, Svensson A, Dahl-Jensen D, Kettner E, Kjaer H, Seierstad I, Steffensen JP, Rasmussen SO, Vallelonga P, Winstrup M, Wegner A, Twarloh B, Wolff K, Schmidt K, Goto-Azuma K, Kuramoto T, Hirabayashi M, Uetake J, Zheng J, Bourgeois J, Fisher D, Zhiheng D, Xiao C, Legrand M, Spolaor A, Gabrieli J, Barbante C, Kang JH, Hur SD, Hong SB, Hwang HJ, Hong S, Hansson M, Iizuka Y, Oyabu I, Muscheler R, Adolphi F, Maselli O, McConnell J, Wolff EW. Greenland records of aerosol source and atmospheric lifetime changes from the Eemian to the Holocene. Nat Commun 2018; 9:1476. [PMID: 29662058 PMCID: PMC5902614 DOI: 10.1038/s41467-018-03924-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 03/21/2018] [Indexed: 11/16/2022] Open
Abstract
The Northern Hemisphere experienced dramatic changes during the last glacial, featuring vast ice sheets and abrupt climate events, while high northern latitudes during the last interglacial (Eemian) were warmer than today. Here we use high-resolution aerosol records from the Greenland NEEM ice core to reconstruct the environmental alterations in aerosol source regions accompanying these changes. Separating source and transport effects, we find strongly reduced terrestrial biogenic emissions during glacial times reflecting net loss of vegetated area in North America. Rapid climate changes during the glacial have little effect on terrestrial biogenic aerosol emissions. A strong increase in terrestrial dust emissions during the coldest intervals indicates higher aridity and dust storm activity in East Asian deserts. Glacial sea salt aerosol emissions in the North Atlantic region increase only moderately (50%), likely due to sea ice expansion. Lower aerosol concentrations in Eemian ice compared to the Holocene are mainly due to shortened atmospheric residence time, while emissions changed little. Past climate changes in Greenland ice were accompanied by large aerosol concentration changes. Here, the authors show that by correcting for transport effects, reliable source changes for biogenic aerosol from North America, sea salt aerosol from the North Atlantic, and dust from East Asian deserts can be derived.
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Affiliation(s)
- S Schüpbach
- Climate and Environmental Physics, Physics Institute & Oeschger Centre for Climate Change Research, University of Bern, Sidlerstrasse 5, 3012, Bern, Switzerland
| | - H Fischer
- Climate and Environmental Physics, Physics Institute & Oeschger Centre for Climate Change Research, University of Bern, Sidlerstrasse 5, 3012, Bern, Switzerland.
| | - M Bigler
- Climate and Environmental Physics, Physics Institute & Oeschger Centre for Climate Change Research, University of Bern, Sidlerstrasse 5, 3012, Bern, Switzerland
| | - T Erhardt
- Climate and Environmental Physics, Physics Institute & Oeschger Centre for Climate Change Research, University of Bern, Sidlerstrasse 5, 3012, Bern, Switzerland
| | - G Gfeller
- Climate and Environmental Physics, Physics Institute & Oeschger Centre for Climate Change Research, University of Bern, Sidlerstrasse 5, 3012, Bern, Switzerland
| | - D Leuenberger
- Climate and Environmental Physics, Physics Institute & Oeschger Centre for Climate Change Research, University of Bern, Sidlerstrasse 5, 3012, Bern, Switzerland
| | - O Mini
- Climate and Environmental Physics, Physics Institute & Oeschger Centre for Climate Change Research, University of Bern, Sidlerstrasse 5, 3012, Bern, Switzerland
| | - R Mulvaney
- British Antarctic Survey, National Environment Research Council, High Cross Madingley Road, Cambridge, CB3 0ET, UK
| | - N J Abram
- British Antarctic Survey, National Environment Research Council, High Cross Madingley Road, Cambridge, CB3 0ET, UK.,Research School of Earth Sciences, The Australian National University, Canberra, ACT 2602, Australia
| | - L Fleet
- British Antarctic Survey, National Environment Research Council, High Cross Madingley Road, Cambridge, CB3 0ET, UK
| | - M M Frey
- British Antarctic Survey, National Environment Research Council, High Cross Madingley Road, Cambridge, CB3 0ET, UK
| | - E Thomas
- British Antarctic Survey, National Environment Research Council, High Cross Madingley Road, Cambridge, CB3 0ET, UK
| | - A Svensson
- Centre for Ice and Climate, Niels Bohr Institute, University of Copenhagen, Juliane Maries Vej 30, 2100, Copenhagen K, Denmark
| | - D Dahl-Jensen
- Centre for Ice and Climate, Niels Bohr Institute, University of Copenhagen, Juliane Maries Vej 30, 2100, Copenhagen K, Denmark
| | - E Kettner
- Centre for Ice and Climate, Niels Bohr Institute, University of Copenhagen, Juliane Maries Vej 30, 2100, Copenhagen K, Denmark
| | - H Kjaer
- Centre for Ice and Climate, Niels Bohr Institute, University of Copenhagen, Juliane Maries Vej 30, 2100, Copenhagen K, Denmark
| | - I Seierstad
- Centre for Ice and Climate, Niels Bohr Institute, University of Copenhagen, Juliane Maries Vej 30, 2100, Copenhagen K, Denmark
| | - J P Steffensen
- Centre for Ice and Climate, Niels Bohr Institute, University of Copenhagen, Juliane Maries Vej 30, 2100, Copenhagen K, Denmark
| | - S O Rasmussen
- Centre for Ice and Climate, Niels Bohr Institute, University of Copenhagen, Juliane Maries Vej 30, 2100, Copenhagen K, Denmark
| | - P Vallelonga
- Centre for Ice and Climate, Niels Bohr Institute, University of Copenhagen, Juliane Maries Vej 30, 2100, Copenhagen K, Denmark
| | - M Winstrup
- Centre for Ice and Climate, Niels Bohr Institute, University of Copenhagen, Juliane Maries Vej 30, 2100, Copenhagen K, Denmark
| | - A Wegner
- Alfred-Wegener-Institut, Helmholtz-Zentrum für Polar-und Meeresforschung, Am Alten Hafen 26, 27568, Bremerhaven, Germany
| | - B Twarloh
- Alfred-Wegener-Institut, Helmholtz-Zentrum für Polar-und Meeresforschung, Am Alten Hafen 26, 27568, Bremerhaven, Germany
| | - K Wolff
- Alfred-Wegener-Institut, Helmholtz-Zentrum für Polar-und Meeresforschung, Am Alten Hafen 26, 27568, Bremerhaven, Germany
| | - K Schmidt
- Alfred-Wegener-Institut, Helmholtz-Zentrum für Polar-und Meeresforschung, Am Alten Hafen 26, 27568, Bremerhaven, Germany
| | - K Goto-Azuma
- National Institute of Polar Research, 10-3 Midori-cho, Tachikawa, Tokyo, 190-8518, Japan
| | - T Kuramoto
- National Institute of Polar Research, 10-3 Midori-cho, Tachikawa, Tokyo, 190-8518, Japan.,Fukushima Prefectural Centre for Environmental Creation, 10-2 Fukasaku, Miharu Town, Fukushima, 963-7700, Japan
| | - M Hirabayashi
- National Institute of Polar Research, 10-3 Midori-cho, Tachikawa, Tokyo, 190-8518, Japan
| | - J Uetake
- National Institute of Polar Research, 10-3 Midori-cho, Tachikawa, Tokyo, 190-8518, Japan.,Department of Atmospheric Science, Colorado State University, 200 West Lake Street, 1371 Campus Delivery, Fort Collins, CO, 80523-1371, USA
| | - J Zheng
- Natural Resources Canada, Geological Survey of Canada, 601 Booth Street, Ottawa, K1A 0E8, Canada
| | - J Bourgeois
- Natural Resources Canada, Geological Survey of Canada, 601 Booth Street, Ottawa, K1A 0E8, Canada
| | - D Fisher
- Department of Earth Sciences, Environment and Geomatics, University of Ottawa, Ottawa, ON, Canada
| | - D Zhiheng
- State Key Laboratory of Cryospheric Sciences, Cold and Arid Regions Environmental and Engineering Research Institute, Chinese Academy of Sciences, Lanzhou, 730000, China
| | - C Xiao
- State Key Laboratory of Cryospheric Sciences, Cold and Arid Regions Environmental and Engineering Research Institute, Chinese Academy of Sciences, Lanzhou, 730000, China
| | - M Legrand
- Institut des Géosciences de l'Environnement, Université Grenoble Alpes, CS 40 700, 38058, Grenoble Cedex 9, France
| | - A Spolaor
- Institute for the Dynamics of Environmental Processes-CNR, University of Venice, via Torino, 155, 30172, Venice-Mestre, Italy
| | - J Gabrieli
- Institute for the Dynamics of Environmental Processes-CNR, University of Venice, via Torino, 155, 30172, Venice-Mestre, Italy
| | - C Barbante
- Institute for the Dynamics of Environmental Processes-CNR, University of Venice, via Torino, 155, 30172, Venice-Mestre, Italy
| | - J-H Kang
- Korea Polar Research Institute, 26 Songdomirae-ro, Yeonsu-gu, Incheon, 21990, Republic of Korea
| | - S D Hur
- Korea Polar Research Institute, 26 Songdomirae-ro, Yeonsu-gu, Incheon, 21990, Republic of Korea
| | - S B Hong
- Korea Polar Research Institute, 26 Songdomirae-ro, Yeonsu-gu, Incheon, 21990, Republic of Korea
| | - H J Hwang
- Korea Polar Research Institute, 26 Songdomirae-ro, Yeonsu-gu, Incheon, 21990, Republic of Korea
| | - S Hong
- Department of Ocean Sciences, Inha University, 100 Inha-ro, Nam-gu, Incheon, 22212, Republic of Korea
| | - M Hansson
- Department of Physical Geography, Stockholm University, S-106 91, Stockholm, Sweden
| | - Y Iizuka
- Department of Physical Geography, Stockholm University, S-106 91, Stockholm, Sweden
| | - I Oyabu
- Department of Physical Geography, Stockholm University, S-106 91, Stockholm, Sweden
| | - R Muscheler
- Department of Geology, Lund University, Solvegatan 12, SE-22362, Lund, Sweden
| | - F Adolphi
- Climate and Environmental Physics, Physics Institute & Oeschger Centre for Climate Change Research, University of Bern, Sidlerstrasse 5, 3012, Bern, Switzerland.,Department of Geology, Lund University, Solvegatan 12, SE-22362, Lund, Sweden
| | - O Maselli
- Desert Research Institute, Nevada System of Higher Education, Reno, NV, 89512, USA
| | - J McConnell
- Desert Research Institute, Nevada System of Higher Education, Reno, NV, 89512, USA
| | - E W Wolff
- Department of Earth Sciences, University of Cambridge, Downing Street, Cambridge, CB2 3EQ, UK
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Svensson A, Ofenloch R, Bruze M, Naldi L, Cazzaniga S, Elsner P, Goncalo M, Schuttelaar ML, Diepgen T. Prevalence of skin disease in a population-based sample of adults from five European countries. Br J Dermatol 2018; 178:1111-1118. [DOI: 10.1111/bjd.16248] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2017] [Indexed: 11/30/2022]
Affiliation(s)
- A. Svensson
- Department of Dermatology; Lund University; Skåne University Hospital; Malmö Sweden
| | - R.F. Ofenloch
- Department of Clinical Social Medicine; Occupational and Environmental Dermatology; University Hospital Heidelberg; Heidelberg Germany
| | - M. Bruze
- Department of Occupational and Environmental Dermatology; Lund University; Skåne University Hospital; Malmö Sweden
| | - L. Naldi
- Department of Dermatology; Azienda Ospedaliera papa Giovanni XXIII; Bergamo, Centro Studi GISED - FROM Presidio Ospedaliero Matteo Rota; Via Garibaldi 13/15 24122 Bergamo Italy
| | - S. Cazzaniga
- Department of Dermatology; Azienda Ospedaliera papa Giovanni XXIII; Bergamo, Centro Studi GISED - FROM Presidio Ospedaliero Matteo Rota; Via Garibaldi 13/15 24122 Bergamo Italy
| | - P. Elsner
- Department of Dermatology; University Hospital Jena; Jena Germany
| | - M. Goncalo
- Department of Dermatology; Coimbra University Hospital; Faculty of Medicine; University of Coimbra; Coimbra Portugal
| | - M.-L.A. Schuttelaar
- Department of Dermatology; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| | - T.L Diepgen
- Department of Clinical Social Medicine; Occupational and Environmental Dermatology; University Hospital Heidelberg; Heidelberg Germany
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43
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Chernyshov P, Linder M, Pustišek N, Manolache L, Szepietowski J, Tomas-Aragones L, Marron S, Poot F, Augustin M, Bewley A, van Cranenburgh O, Jemec G, Salek M, Sampogna F, Svensson A. Quimp (quality of life impairment): an addition to the quality of life lexicon. J Eur Acad Dermatol Venereol 2017; 32:e181-e182. [DOI: 10.1111/jdv.14693] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- P.V. Chernyshov
- Department of Dermatology and Venereology; National Medical University; Kiev Ukraine
| | - M.D. Linder
- Oslo Centre for Biostatistics and Epidemiology; University of Oslo; Oslo Norway
| | - N. Pustišek
- Children's Hospital Zagreb; Medical School; University of Zagreb; Zagreb Croatia
| | | | - J.C. Szepietowski
- Department of Dermatology, Venereology and Allergology; Wrocław Medical University; Wrocław Poland
| | | | - S.E. Marron
- Department of Dermatology; Aragon Health Sciences Institute (IACS); Royo Villanova Hospital; Zaragoza Spain
| | - F. Poot
- Department of Dermatology; ULB-Erasme Hospital; Brussels Belgium
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf; Hamburg Gemany
| | - A. Bewley
- Whipps Cross University Hospital; London UK
- The Royal London Hospital; London UK
| | - O.D. van Cranenburgh
- Department of Medical Psychology; Academic Medical Center; Amsterdam The Netherlands
- Dutch Skin Foundation; Nieuwegein The Netherlands
| | - G.B. Jemec
- Department of Dermatology; Zealand University Hospital; Roskilde Denmark
| | - M.S. Salek
- Department of Pharmacy, Pharmacology and Postgraduate Medicine; School of Life & Medical Sciences; University of Hertfordshire; Hatfield UK
| | - F. Sampogna
- Clinical Epidemiology Unit; Istituto Dermopatico dell'Immacolata (IDI)-IRCCS FLMM; Rome Italy
| | - A. Svensson
- Department of Dermatology and Venereology; Skane University Hospital; Malmö Sweden
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Chernyshov PV, Zouboulis CC, Tomas-Aragones L, Jemec GB, Manolache L, Tzellos T, Sampogna F, Evers AWM, Dessinioti C, Marron SE, Bettoli V, van Cranenburgh OD, Svensson A, Liakou AI, Poot F, Szepietowski JC, Salek MS, Finlay AY. Quality of life measurement in acne. Position Paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa. J Eur Acad Dermatol Venereol 2017; 32:194-208. [PMID: 28898474 DOI: 10.1111/jdv.14585] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [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: 06/28/2017] [Accepted: 09/05/2017] [Indexed: 12/13/2022]
Abstract
Acne causes profound negative psychological and social effects on the quality of life (QoL) of patients. The European Dermatology Forum S3-Guideline for the Treatment of Acne recommended adopting a QoL measure as an integral part of acne management. Because of constantly growing interest in health-related QoL assessment in acne and because of the high impact of acne on patients' lives, the European Academy of Dermatology and Venereology Task Force on QoL and Patient Oriented Outcomes and the Task Force on Acne, Rosacea and Hidradenitis Suppurativa have documented the QoL instruments that have been used in acne patients, with information on validation, purposes of their usage, description of common limitations and mistakes in their usage and overall recommendations.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodore Fontane, Dessau, Germany
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Aragon Health Sciences Institute (IACS), Zaragoza, Spain
| | - G B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - T Tzellos
- Department of Dermatology, Faculty of Health Sciences, University Hospital of North Norway, Troms, Norway
| | - F Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS FLMM, Rome, Italy
| | - A W M Evers
- Health, Medical, and Neuropsychology Unit, Leiden University, Leiden, The Netherlands
| | - C Dessinioti
- Department of Dermatology, Andreas Syggros Hospital, Athens, Greece
| | - S E Marron
- Department of Dermatology, Royo Villanova Hospital, Aragon Health Sciences Institute (IACS), Zaragoza, Spain
| | - V Bettoli
- Department of Medical Sciences, Section of Dermatology, University of Ferrara, Ferrara, Italy
| | - O D van Cranenburgh
- Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands.,Dutch Skin Foundation, Nieuwegein, The Netherlands
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - A I Liakou
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" General University Hospital, Athens, Greece
| | - F Poot
- Department of Dermatology, ULB-Erasme Hospital, Brussels, Belgium
| | - J C Szepietowski
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - M S Salek
- Department of Pharmacy, Pharmacology and Postgraduate Medicine, School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - A Y Finlay
- Department of Dermatology and Wound Healing, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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Cortez D, Svensson A, Carlson J, Platonov P. P797In which non-ischemic cardiomyopathies can the VCG identify those at risk for sustained ventricular tachycardia? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p797] [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: 11/12/2022] Open
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Svensson A, Carlson J, Fluur C, Lundin C, Platonov P. P1599Low sensitivity of conventional electrocardiographic criteria for arrhythmogenic right ventricular cardiomyopathy at symptom onset: emerging role of inferior T-wave inversion. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1599] [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: 11/12/2022] Open
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Hansson A, Svensson A, Ahlström BH, Larsson LG, Forsman B, Alsén P. Flawed communications: Health professionals' experience of collaboration in the care of frail elderly patients. Scand J Public Health 2017; 46:680-689. [PMID: 28699383 DOI: 10.1177/1403494817716001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Frail elderly patients who have multiple illnesses do not fare well in modern health care systems, mainly due to a lack of care planning and flawed communication between health professionals in different care organisations. This is especially noticeable when patients are discharged from hospital. The aim of this study was to explore health care professionals' experience of obstacles and opportunities for collaboration. METHODS Health professionals were invited to participate in three focus groups, each consisting of a hospital physician, a primary care physician, a hospital nurse, a primary care nurse, a municipal home care nurse or an assistant officer, a physical or occupational therapist and a patient or a family member representative. These individual people were then asked to discuss the obstacles and opportunities for communication between themselves and with the patients and their relatives when presented with the case report of a fictitious patient. Content analysis was used to identify categories. RESULTS Several obstacles were identified for effective communication and care planning: insufficient communication with patients and relatives; delayed collaboration between care-givers; the lack of an adequate responsible person for care planning; and resources not being distributed according to the actual needs of patients. The absence of an overarching responsibility for the patient, beyond organisational borders, was a recurring theme. These obstacles could also be seen as opportunities. CONCLUSIONS Obstacles for collaboration were found on three levels: societal, organisational and individual. As health care professionals are well aware of the problems and also see solutions, management for health care should support employees' own initiatives for changes that are of benefit in the care of frail elderly patients with multiple illnesses.
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Affiliation(s)
- Anders Hansson
- 1 University Health Care Research Centre, Region Örebro County and School of Medical Sciences, Örebro University, Sweden.,2 Academy of Sahlgrenska, Institute of Medicine, University of Gothenburg, Sweden
| | - Ann Svensson
- 3 School of Business, Economics and IT, University West, Sweden
| | - Britt Hedman Ahlström
- 4 Department of Health Science, Section for Health Promotion and Care Sciences, University West, Sweden
| | - Lena G Larsson
- 2 Academy of Sahlgrenska, Institute of Medicine, University of Gothenburg, Sweden
| | - Berit Forsman
- 5 Department of Health Sciences, Section for Nursing, Graduate Level, University West, Sweden
| | - Pia Alsén
- 5 Department of Health Sciences, Section for Nursing, Graduate Level, University West, Sweden
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Lindgren H, Qvarfordt P, Åkesson M, Bergman S, Gottsäter A, Jansson I, Litterfeldt E, Lindgren H, Qvarfordt P, Fransson T, Öjersjö A, Hilbertson A, Röjlar T, Åkesson M, Gottsäter A, Gruber G, Hörer T, Larzon T, Jonasson T, Strandberg C, Andersson P, Bergman S, Lundell L, Svensson A, Warvsten M. Primary Stenting of the Superficial Femoral Artery in Intermittent Claudication Improves Health Related Quality of Life, ABI and Walking Distance: 12 Month Results of a Controlled Randomised Multicentre Trial. Eur J Vasc Endovasc Surg 2017; 53:686-694. [DOI: 10.1016/j.ejvs.2017.01.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 01/31/2017] [Indexed: 10/19/2022]
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Chanrot M, Guo Y, Dalin AM, Persson E, Båge R, Svensson A, Gustafsson H, Humblot P. Dose related effects of LPS on endometrial epithelial cell populations from dioestrus cows. Anim Reprod Sci 2016; 177:12-24. [PMID: 27939589 DOI: 10.1016/j.anireprosci.2016.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 06/27/2016] [Revised: 11/28/2016] [Accepted: 12/01/2016] [Indexed: 12/22/2022]
Abstract
Lipopolysaccharides (LPS) from Gram negative bacteria are involved in the pathogeny of uterine diseases in cows. This study aimed to investigate LPS effects on the growth of bovine endometrial epithelial cells (bEEC) and relationships between LPS response and tissue characteristics. Uteri from 35 females were characterized for parity and stage of oestrous cycle. Densities of glandular tissue (dGT), CD11b+ cells and Ki67+ cells were measured in the endometrial tissue. Cells from 13 dioestrus cows were exposed to 0, 2, 4, 8, 12, 16 or 24μg/mL LPS. Effects of parity and stage of the oestrous cycle on tissue characteristics and effects of LPS dosage, cow and tissue characteristics on changes in cell numbers were analyzed by ANOVA. The dGT was higher in metoestrus and dioestrus samples than in pro-oestrus ones whereas densities of CD11b+ and Ki67+ cells were higher at pro-oestrus (p<0.05-p<0.01). LPS influenced bEEC populations in a dose related manner. An increase in number of live cells was observed for dosages ranging from 2 to 12μg/mL LPS (p<0.0001 vs controls). No effect was found on numbers and frequencies of dead cells. With higher dosages, the numbers of live cells did not increase but the numbers of dead did increase. No relationships were observed between cow or tissue characteristics and growth patterns or frequencies of viable bEEC in controls nor in the response to LPS. To conclude this model is suitable for further studies on dysregulations induced by LPS in endometrial tissue.
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Affiliation(s)
- M Chanrot
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SLU, PO Box 7054, 750 07 Uppsala, Sweden; Faculty of Veterinary Science, Rajamangala University of Technology Srivijaya, 133, Moo 5, Tambol Thungyai, Thungyai, Nakornsrithammarat 80240, Thailand.
| | - Y Guo
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SLU, PO Box 7054, 750 07 Uppsala, Sweden.
| | - A M Dalin
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SLU, PO Box 7054, 750 07 Uppsala, Sweden.
| | - E Persson
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, SLU, PO Box 7011, 750 07 Uppsala, Sweden.
| | - R Båge
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SLU, PO Box 7054, 750 07 Uppsala, Sweden.
| | - A Svensson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SLU, PO Box 7054, 750 07 Uppsala, Sweden.
| | - H Gustafsson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SLU, PO Box 7054, 750 07 Uppsala, Sweden.
| | - P Humblot
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, SLU, PO Box 7054, 750 07 Uppsala, Sweden.
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50
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Bourne AJ, Abbott PM, Albert PG, Cook E, Pearce NJG, Ponomareva V, Svensson A, Davies SM. Underestimated risks of recurrent long-range ash dispersal from northern Pacific Arc volcanoes. Sci Rep 2016; 6:29837. [PMID: 27445233 PMCID: PMC4956762 DOI: 10.1038/srep29837] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 06/24/2016] [Indexed: 11/23/2022] Open
Abstract
Widespread ash dispersal poses a significant natural hazard to society, particularly in relation to disruption to aviation. Assessing the extent of the threat of far-travelled ash clouds on flight paths is substantially hindered by an incomplete volcanic history and an underestimation of the potential reach of distant eruptive centres. The risk of extensive ash clouds to aviation is thus poorly quantified. New evidence is presented of explosive Late Pleistocene eruptions in the Pacific Arc, currently undocumented in the proximal geological record, which dispersed ash up to 8000 km from source. Twelve microscopic ash deposits or cryptotephra, invisible to the naked eye, discovered within Greenland ice-cores, and ranging in age between 11.1 and 83.7 ka b2k, are compositionally matched to northern Pacific Arc sources including Japan, Kamchatka, Cascades and Alaska. Only two cryptotephra deposits are correlated to known high-magnitude eruptions (Towada-H, Japan, ca 15 ka BP and Mount St Helens Set M, ca 28 ka BP). For the remaining 10 deposits, there is no evidence of age- and compositionally-equivalent eruptive events in regional volcanic stratigraphies. This highlights the inherent problem of under-reporting eruptions and the dangers of underestimating the long-term risk of widespread ash dispersal for trans-Pacific and trans-Atlantic flight routes.
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Affiliation(s)
- A J Bourne
- Department of Geography, College of Science, Swansea University, Swansea, UK
| | - P M Abbott
- Department of Geography, College of Science, Swansea University, Swansea, UK
| | - P G Albert
- Department of Geography, College of Science, Swansea University, Swansea, UK
| | - E Cook
- Department of Geography, College of Science, Swansea University, Swansea, UK.,Centre for Ice and Climate, Niels Bohr Institute, University of Copenhagen, Denmark
| | - N J G Pearce
- Department of Geography and Earth Sciences, Aberystwyth University, Aberystwyth, UK
| | - V Ponomareva
- Inst. of Volcanology and Seismology, Petropavlovsk-Kamchatsky, Russia
| | - A Svensson
- Centre for Ice and Climate, Niels Bohr Institute, University of Copenhagen, Denmark
| | - S M Davies
- Department of Geography, College of Science, Swansea University, Swansea, UK
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