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Fedder J, Fagerberg C, Jørgensen MW, Gravholt CH, Berglund A, Knudsen UB, Skakkebæk A. Correction: Complete or partial loss of the Y chromosome in an unselected cohort of 865 non-vasectomized, azoospermic men. Basic Clin Androl 2024; 34:1. [PMID: 38182976 PMCID: PMC10768135 DOI: 10.1186/s12610-023-00218-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024] Open
Affiliation(s)
- J Fedder
- Centre of Andrology & Fertility Clinic, Odense University Hospital, Kløvervænget 23, 5000, Odense, Denmark.
- Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark.
- Fertility Clinic, Horsens Hospital, Horsens, Denmark.
| | - C Fagerberg
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - M W Jørgensen
- Department of Clinical Genetics, Lillebaelt Hospital, Vejle, Denmark
| | - C H Gravholt
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Endocrinology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - A Berglund
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - U B Knudsen
- Fertility Clinic, Horsens Hospital, Horsens, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - A Skakkebæk
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
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Fedder J, Fagerberg C, Jørgensen MW, Gravholt CH, Berglund A, Knudsen UB, Skakkebæk A. Complete or partial loss of the Y chromosome in an unselected cohort of 865 non-vasectomized, azoospermic men. Basic Clin Androl 2023; 33:37. [PMID: 38093178 PMCID: PMC10720143 DOI: 10.1186/s12610-023-00212-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/26/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Structural abnormalities as well as minor variations of the Y chromosome may cause disorders of sex differentiation or, more frequently, azoospermia. This study aimed to determine the prevalence of loss of Y chromosome material within the spectrum ranging from small microdeletions in the azoospermia factor region (AZF) to complete loss of the Y chromosome in azoospermic men. RESULTS Eleven of 865 azoospermic men (1.3%) collected from 1997 to 2022 were found to have a karyotype including a 45,X cell line. Two had a pure 45,X karyotype and nine had a 45,X/46,XY mosaic karyotype. The AZF region, or part of it, was deleted in eight of the nine men with a structural abnormal Y-chromosome. Seven men had a karyotype with a structural abnormal Y chromosome in a non-mosaic form. In addition, Y chromosome microdeletions were found in 34 men with a structural normal Y chromosome. No congenital malformations were detected by echocardiography and ultrasonography of the kidneys of the 11 men with a 45,X mosaic or non-mosaic cell line. CONCLUSIONS In men with azoospermia, Y chromosome loss ranging from small microdeletions to complete loss of the Y chromosome was found in 6.1% (53/865). Partial AZFb microdeletions may give a milder testicular phenotype compared to complete AZFb microdeletions.
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Affiliation(s)
- J Fedder
- Centre of Andrology & Fertility Clinic, Odense University Hospital, Kløvervænget 23, DK-5000, Odense, Denmark.
- Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark.
- Fertility Clinic, Horsens Hospital, Horsens, Denmark.
| | - C Fagerberg
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - M W Jørgensen
- Department of Clinical Genetics, Lillebaelt Hospital, Vejle, Denmark
| | - C H Gravholt
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Endocrinology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - A Berglund
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - U B Knudsen
- Fertility Clinic, Horsens Hospital, Horsens, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - A Skakkebæk
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
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Wagenius G, Vikström A, Berglund A, Salomonsson S, Bencina G, Hu X, Chirovsky D, Brunnström H. 51P Real-word outcomes of immunotherapy in non-small cell lung cancer: A population-based cohort study in Sweden. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00305-2] [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: 04/03/2023]
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Liposits G, Ryg J, Skuladottir H, Winther S, Möller S, Hofsli E, Shah CH, Poulsen Oestergaard L, Berglund A, Qvortrup C, Osterlund P, Glimelius B, Sorbye H, Pfeiffer P. 410P Prognostic value of baseline ECOG performance status, frailty phenotype, and geriatric screening tools (G8 and VES-13) in vulnerable older patients with metastatic colorectal cancer: The randomized NORDIC9-study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Klompstra L, Stromberg A, Berglund A, Berglund E, Fallstrom J, Oradd H, Jaarsma T. Development of a mobile exergame for increasing physical activity in patients with heart failure. Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.102] [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]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Vetenskapsrådet
Background
A 10-minute increase a day in physical activity (PA) in patients with heart failure (HF) can have beneficial effects on symptoms, mortality, and hospitalisation risk. Many patients are physically inactive and find it challenging to leave home to participate in physical activity programs, due to symptoms, lack of easily accessible facilities or fear for being exposed to infection (during the pandemic or during flu season).
Developing PA interventions that are tailored to the needs and preferences is challenging, as it needs an interdisciplinary approach and active collaboration with patients. A new approach to increase PA is the use of exergames. An exergame is defined as games that requires participants to be physically active or exercise where player’s body motion controls the game.
Objective
To develop a mobile exergame (called Heart Farming), test the usability of the exergame, and investigate the feasibility for increasing PA in patients with HF.
Methods
The study included three phases: (1) Development of a prototype of the exergame; (2) Usability testing and developing, and (3) Assess feasibility of using the exergame in a PA intervention for patients with HF.
Results
A prototype of an exergame was developed which has as main goal to walk 10 minutes more a day. Game elements such as goal setting, providing feedback, and social connectivity are included to motivate patients. The patients can play the exergame according to their needs and wishes, e.g., competition, strategic playing, and social interaction. The exergame was created (Figure), tested and refined through an iterative developmental process and by multidisciplinary team with game designers, HF specialists, user representatives and researchers.
During usability testing, eight patients within the heart and lung patient organization were invited to test the exergame. Most patients found the game easy to play and enjoyable and thought the game could be helpful to increase their daily walking. The researchers observed that the patients needed support to be able to play the exergame. Proper familiarization and coaching are needed when introducing the game to patients with HF and this was included as an important part in the exergame intervention. The exergame is further developed iteratively by the multidisciplinary team with increased number of user representatives testing the game and giving feedback.
In a feasibility study we will test how feasible the exergame is for a PA intervention in patients with HF. Ten patients will receive the game with structured familiarisation and telephone follow-up including coaching for one month. The results of this feasibility testing will be presented during the conference.
Conclusion
The exergame Heart Farming seems to be easy and enjoyable to play but needs proper familiarisation and coaching. The results of the feasibility study will show if this exergame can be used in a PA intervention for patients with HF.
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Affiliation(s)
- L Klompstra
- Linkoping University, Department of Social and Welfare studies , Linkoping , Sweden
| | - A Stromberg
- Linkoping University, Department of Social and Welfare studies , Linkoping , Sweden
| | - A Berglund
- Linkoping University, Department of Computer and Information Science , Linkoping , Sweden
| | - E Berglund
- Linkoping University, Department of Computer and Information Science , Linkoping , Sweden
| | - J Fallstrom
- Linkoping University, Department of Computer and Information Science , Linkoping , Sweden
| | - H Oradd
- Linkoping University, Department of Computer and Information Science , Linkoping , Sweden
| | - T Jaarsma
- Linkoping University, Department of Social and Welfare studies , Linkoping , Sweden
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Isaksson J, Berglund A, Louie K, Hamidian A, Edsjö A, Johansson M, Hallqvist A, Wagenius G, Willén L, Botling J. 139P KRAS-G12C NSCLC linked to female sex and high risk of CNS metastasis: Real-world data from the National Swedish Lung Cancer Registry 2016-2019. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.169] [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: 11/25/2022] Open
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7
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Extermann M, Walko C, Mishra A, Thomas K, Cao B, Chon H, Critea M, Berglund A, Chem J, Cubitt C, Gomes A, Hoffman M, Kim J, Marchion D, Petersson F, Sansil S, Sehovic M, Shahzad M, Welsh E, Zhang Y. Worsening of ovarian cancer prognosis with age: an exploration of pharmacokinetics, body composition, and biology. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00338-6] [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: 10/19/2022]
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8
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Embring A, Onjukka E, Mercke C, Lax I, Berglund A, Bornedal S, Wennberg B, Dalqvist E, Friesland S. PO-1010 Re-irradiation for head and neck cancer: Cumulative dose and the correlation to carotid blowout. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07461-2] [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: 10/20/2022]
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9
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Embring A, Onjukka E, Bornedal S, Mercke C, Lax I, Wennberg B, Berglund A, Friesland S. PO-0839: Doses and Overlapping Volumes in Reirradiation for Head and Neck Cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00856-2] [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: 11/15/2022]
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Rowland A, Levine G, Schnabel L, Berglund A, Antczak D, Miller D, AE W. Allorecognition of Mesenchymal Stem Cells is Dependent on Major Histocompatibility Complex Haplotype. Vet Comp Orthop Traumatol 2020. [DOI: 10.1055/s-0040-1712896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- A Rowland
- Texas A&M University, College Station, Texas, United States
| | - G Levine
- Texas A&M, College Station, Texas, United States
| | - L Schnabel
- NCSU, Raleigh, North Carolina, United States
| | - A Berglund
- NCSU, Raleigh, North Carolina, United States
| | - D Antczak
- Cornell University, Ithaca, New York, United States
| | - D Miller
- Cornell University, Ithaca, New York, United States
| | - Watts AE
- Texas A&M University, College Station, Texas, United States
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Berglund A, Cleemann L, Oftedal BE, Holm K, Husebye ES, Gravholt CH. 21-hydroxylase autoantibodies are more prevalent in Turner syndrome but without an association to the autoimmune polyendocrine syndrome type I. Clin Exp Immunol 2018; 195:364-368. [PMID: 30372540 DOI: 10.1111/cei.13231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 10/17/2018] [Indexed: 12/22/2022] Open
Abstract
Turner syndrome (TS) is associated with an increased frequency of autoimmunity. Frequently observed autoimmune diseases in TS are also seen in the autoimmune polyendocrine syndrome type I (APS I), of which Addison disease is a key component. An overlapping antibody profile between TS and APS I could be considered. The aim of this work was to study women with TS regarding 21-hydroxylase (21-OH) antibodies and interferon omega (IFN-ω) antibodies, a highly specific marker for APS I, to determine if there are immunological overlaps between TS and APS I. Blood samples from 141 TS were assayed for 21-OH antibodies and IFN-ω antibodies using in-vitro-transcribed and translated autoantigen. Indices with a cut-off point of 57 and 200 for 21-OH antibody and IFN-ω antibody were used as reference. The median age of TS was 31·6 years (range = 11·2-62·2). Positive indices of 21-OH antibodies were present in six TS (4%), with a mean of 144·8 (range = 60-535). None had apparent adrenal insufficiency. There was no age difference comparing 21-OH antibody-positive TS (median age = 33·9 years, range = 17·7-44·7) and 21-OH antibody-negative TS (median age = 31·6 years, range = 11·2-62·2) (P = 0·8). No TS was positive for IFN-ω antibodies (mean = 42·4, range = -435-191). No overlapping autoimmune profile between TS and APS I was found. Autoimmunity against 21-OH among TS patients was more prevalent than previously identified, suggesting an increased risk of adrenal failure in TS. However, whether adrenal impairment will develop remains unknown.
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Affiliation(s)
- A Berglund
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark.,Department of Molecular Medicine, Aarhus University Hospital, Denmark
| | - L Cleemann
- Department of Pediatrics, North Sealand Hospital, Hillerød, Denmark
| | - B E Oftedal
- Department of Clinical Science, University of Bergen, Norway.,K.G. Jebsen Center for Autoimmune Disorders, University of Bergen, Norway
| | - K Holm
- Department of Pediatrics, North Sealand Hospital, Hillerød, Denmark
| | - E S Husebye
- Department of Clinical Science, University of Bergen, Norway.,K.G. Jebsen Center for Autoimmune Disorders, University of Bergen, Norway.,Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - C H Gravholt
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark.,Department of Molecular Medicine, Aarhus University Hospital, Denmark
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Cunha M, Berglund A, Mendes S, Monteiro N. The 'Woman in Red' effect: pipefish males curb pregnancies at the sight of an attractive female. Proc Biol Sci 2018; 285:rspb.2018.1335. [PMID: 30135166 DOI: 10.1098/rspb.2018.1335] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 06/15/2018] [Accepted: 07/26/2018] [Indexed: 11/12/2022] Open
Abstract
In an old Gene Wilder movie, an attractive woman dressed in red devastated a man's current relationship. We have found a similar 'Woman in Red' effect in pipefish, a group of fish where pregnancy occurs in males. We tested for the existence of pregnancy blocks in pregnant male black-striped pipefish (Syngnathus abaster). We allowed pregnant males to see females that were larger and even more attractive than their original high-quality mates and monitored the survival and growth of developing offspring. After exposure to these extremely attractive females, males produced smaller offspring in more heterogeneous broods and showed a higher rate of spontaneous offspring abortion. Although we did not observe a full pregnancy block, our results show that males are able to reduce investment in current broods when faced with prospects of a more successful future reproduction with a potentially better mate. This 'Woman in Red' life-history trade-off between present and future reproduction has similarities to the Bruce effect, and our study represents, to our knowledge, the first documentation of such a phenomenon outside mammals.
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Affiliation(s)
- M Cunha
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, rua Padre Armando Quintas, 4485-661 Vairão, Portugal
| | - A Berglund
- Department of Ecology and Genetics/Animal Ecology, Uppsala University, Uppsala, Sweden
| | - S Mendes
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, rua Padre Armando Quintas, 4485-661 Vairão, Portugal
| | - N Monteiro
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, rua Padre Armando Quintas, 4485-661 Vairão, Portugal .,CEBIMED, Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, rua Carlos da Maia 296, 4200-150 Porto, Portugal
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13
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Zenlander R, von Euler M, Antovic J, Berglund A. Point-of-care versus central laboratory testing of INR in acute stroke. Acta Neurol Scand 2018; 137:252-255. [PMID: 29068041 DOI: 10.1111/ane.12860] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Effective anticoagulant therapy is a contraindication to thrombolysis, which is an effective treatment of ischemic stroke if given within 4.5 hours of symptom onset. INR above 1.7 is generally considered a contraindication for thrombolysis. Rapid measurement of INR in warfarin-treated patients is therefore of major importance in order to be able to decide on thrombolysis or not. We asked whether INR measured on a point-of-care instrument would be as good as a central laboratory instrument. MATERIAL AND METHODS A total of 529 consecutive patients who arrived at the emergency department at a large urban teaching hospital with stroke symptoms were enrolled in the study. INR was measured with a CoaguChek and a Sysmex instrument. Basic clinical information such as age, sex, and diagnosis (if available) was recorded. INR from the instruments was compared using linear regression and Bland-Altman plot. RESULTS Of 529 patients, 459 had INR results from both instruments. Among these, 3 patients were excluded as outliers. The rest (n = 456) showed good correlation between the methods (R2 = 0.97). In the current setting, CoaguChek was in median 63 minutes faster than Sysmex. CONCLUSION Our results indicate that point-of-care testing is a safe mean to rapidly acquire a patient's INR value in acute clinical situations.
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Affiliation(s)
- R. Zenlander
- Department of Clinical Chemistry Karolinska University Hospital Stockholm Sweden
| | - M. von Euler
- Department of Clinical Pharmacology Karolinska University Hospital Stockholm Sweden
- Department of Clinical Science and Education Karolinska Institutet Stockholm Sweden
- Department of Medicine Solna Karolinska Institutet Stockholm Sweden
| | - J. Antovic
- Department of Clinical Chemistry Karolinska University Hospital Stockholm Sweden
- Department of Coagulation Research Institute for Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden
| | - A. Berglund
- Department of Clinical Science and Education Karolinska Institutet Stockholm Sweden
- Department of Internal Medicine Section of Neurology Södersjukhuset Stockholm Sweden
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14
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Nilsson J, Berglund A, Bergström S, Bergqvist M, Lambe M. P1.06-002 The Role of Comorbidity in the Management and Prognosis in Nonsmall Cell Lung Cancer: A Population-Based Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.896] [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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15
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La Fleur L, Boura V, Berglund A, Mattsson J, Djureinovic D, Persson J, Brunnström H, Isaksson J, Branden E, Koyi H, Micke P, Karlsson M, Botling J. MA 05.13 Scavenger Receptor MARCO Defines a Targetable Tumor-Associated Macrophage Subset in Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.488] [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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16
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Stewart P, Slebos R, Welsh E, Cen L, Zhang Y, Chen Z, Cheng CH, Pettersson F, Berglund A, Zhang G, Fang B, Izumi V, Yoder S, Fellows K, Chen Y, Teer J, Eschrich S, Koomen J, Haura E. Proteogenomic Landscape of Squamous Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Salih Joelsson L, Tydén T, Wanggren K, Georgakis MK, Stern J, Berglund A, Skalkidou A. Anxiety and depression symptoms among sub-fertile women, women pregnant after infertility treatment, and naturally pregnant women. Eur Psychiatry 2017; 45:212-219. [PMID: 28957789 DOI: 10.1016/j.eurpsy.2017.07.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 06/27/2017] [Accepted: 07/08/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Infertility has been associated with psychological distress, but whether these symptoms persist after achieving pregnancy via assisted reproductive technology (ART) remains unclear. We compared the prevalence of anxiety and depressive symptoms between women seeking for infertility treatment and women who conceived after ART or naturally. METHODS Four hundred and sixty-eight sub-fertile non-pregnant women, 2972 naturally pregnant women and 143 women pregnant after ART completed a questionnaire in this cross-sectional study. The Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A≥8) and Edinburgh Postnatal Depression Scale (EPDS≥12) were used for assessing anxiety and depressive symptoms, respectively. Multivariate Poisson regression models with robust variance were applied to explore associations with anxiety and depressive symptoms. RESULTS The prevalence of anxiety and depressive symptoms among sub-fertile, non-pregnant women (57.6% and 15.7%, respectively) were significantly higher compared to women pregnant after ART (21.1% and 8.5%, respectively) and naturally pregnant women (18.8% and 10.3%, respectively). History of psychiatric diagnosis was identified as an independent risk factor for both anxiety and depressive symptoms. The presence of at least one unhealthy lifestyle behavior (daily tobacco smoking, weekly alcohol consumption, BMI≥25, and regular physical exercise<2h/week) was also associated with anxiety (Prevalence Ratio, PR: 1.24; 95%CI: 1.09-1.40) and depressive symptoms (PR: 1.25; 95%CI: 1.04-1.49). CONCLUSIONS Women pregnant after ART showed no difference in anxiety and depressive symptoms compared to naturally pregnant women. However, early psychological counseling and management of unhealthy lifestyle behaviors for sub-fertile women may be advisable, particularly for women with a previous history of psychiatric diagnosis.
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Affiliation(s)
- L Salih Joelsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - T Tydén
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - K Wanggren
- Department of Clinical Science, Intervention and Technology, Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden
| | - M K Georgakis
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Sweden
| | - J Stern
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Health Promotion, Sophiahemmet University, Stockholm, Sweden
| | - A Berglund
- The National Centre for Knowledge of Men's Violence against Women, Uppsala University, Uppsala, Sweden
| | - A Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Berglund A, Johannsen T, Stochholm K, Aksglaede L, Fedder J, Viuff M, Main K, Gravholt C. Incidence, prevalence, diagnostic delay, morbidity, mortality and socioeconomic status in males with 46,XX disorders of sex development: a nationwide study. Hum Reprod 2017; 32:1751-1760. [DOI: 10.1093/humrep/dex210] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 05/17/2017] [Indexed: 01/03/2023] Open
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Abstract
Stroke affects both men and women of all ages, although the condition is more common among the elderly. Stroke occurs at an older age among women than among men; although the incidence is lower among women than among men, as women have a longer life expectancy their lifetime risk is slightly higher. Ischemic stroke is the most common type of stroke; and reperfusion treatment is possible if the patient reaches hospital early enough. Thrombolysis and thrombectomy are time-sensitive treatments - the earlier they are initiated the better is the chance of a positive outcome. It is therefore important to identify a stroke as soon as possible. Medical personnel can readily identify typical stroke symptoms but the presentation of non-traditional stroke symptoms, such as impaired consciousness and altered mental status, is often associated with a significant delay in the identification of stroke and thus delay in or inability to provide treatment. Non-traditional stroke symptoms are reported to be more common in women, who are thereby at risk of delayed recognition of stroke and treatment delay.
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Affiliation(s)
- A Berglund
- Karolinska Institutet Stroke Research Network at Södersjukhuset, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Department of Internal Medicine, Section of Neurology, Södersjukhuset, Stockholm, Sweden.
| | - K Schenck-Gustafsson
- Department of Medicine, Cardiac Unit, Karolinska University Hospital, Stockholm, Sweden; Center for Gender Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - M von Euler
- Karolinska Institutet Stroke Research Network at Södersjukhuset, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Karolinska Institutet, Department of Medicine, Solna, Stockholm, Sweden; Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
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Affiliation(s)
- A. Berglund
- Dept. of Dental Materials and Technology Faculty of Odontology University of Umea S-90187 Umea Sweden
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Berglund A, Lindmark G. Preconception health and care (PHC)-a strategy for improved maternal and child health. Ups J Med Sci 2016; 121:216-221. [PMID: 27320774 PMCID: PMC5098484 DOI: 10.1080/03009734.2016.1191564] [Citation(s) in RCA: 8] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/11/2016] [Accepted: 05/16/2016] [Indexed: 11/06/2022] Open
Abstract
Maternal health status before pregnancy is a decisive factor for pregnancy outcomes and for risk for maternal and infant complications. Still, maternity care does not start until the pregnancy is established and in most low-income settings not until more than half of the pregnancy has passed, which often is too late to impact outcomes. In Western societies preconception care (PCC) is widely recognized as a way to optimize women's health through biomedical and behavioural changes prior to conception with the aim of improving pregnancy outcomes. But the content of PCC is inconsistent and limited to single interventions or preconception counselling to women with chronic illnesses. It has been suggested that PCC should be extended to preconception health and care (PHC), including interventions prior to pregnancy in order to optimize women's health in general, and thereby subsequent pregnancy outcomes, the well-being of the family, and the health of the future child. With this definition, almost every activity that can improve the health of girls and women can be included in the concept. In the World Health Report of 2005 a longitudinal approach to women's wellness and reproductive health was highlighted, and the World Health Organization has proposed a more comprehensive maternal and child health care, also including psychosocial issues and intimate partner violence. The present article gives an overview of the recent literature and discusses contents and delivery of PCC/PHC in Western as well as low-income countries. The article puts special emphasis on why violence against women is an issue for PHC.
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Affiliation(s)
- Anna Berglund
- National Centre for Knowledge on Men’s Violence against Women, Uppsala University, Uppsala, Sweden
| | - Gunilla Lindmark
- International Maternal and Child Health, Uppsala University, Uppsala, Sweden
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Joelsson L, Berglund A, Wanggren K, Tyden T. Symptoms of anxiety and depression among infertile women, women pregnant after infertility treatment and spontaneously pregnant women. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Joelsson LS, Berglund A, Wånggren K, Lood M, Rosenblad A, Tydén T. Do subfertile women adjust their habits when trying to conceive? Ups J Med Sci 2016; 121:184-91. [PMID: 27216564 PMCID: PMC4967265 DOI: 10.1080/03009734.2016.1176094] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/03/2016] [Accepted: 04/04/2016] [Indexed: 01/07/2023] Open
Abstract
AIM The aim of this study was to investigate lifestyle habits and lifestyle adjustments among subfertile women trying to conceive. MATERIALS AND METHODS Women (n = 747) were recruited consecutively at their first visit to fertility clinics in mid-Sweden. Participants completed a questionnaire. Data were analyzed using logistic regression, t tests, and chi-square tests. RESULTS The response rate was 62% (n = 466). Mean duration of infertility was 1.9 years. During this time 13.2% used tobacco daily, 13.6% drank more than three cups of coffee per day, and 11.6% consumed more than two glasses of alcohol weekly. In this sample, 23.9% of the women were overweight (body mass index, BMI 25-29.9 kg/m(2)), and 12.5% were obese (BMI ≥30 kg/m(2)). Obese women exercised more and changed to healthy diets more frequently than normal-weight women (odds ratio 7.43; 95% confidence interval 3.7-14.9). Six out of ten women (n = 266) took folic acid when they started trying to conceive, but 11% stopped taking folic acid after some time. Taking folic acid was associated with a higher level of education (p < 0.001). CONCLUSIONS Among subfertile women, one-third were overweight or obese, and some had other lifestyle factors with known adverse effects on fertility such as use of tobacco. Overweight and obese women adjusted their habits but did not reduce their body mass index. Women of fertile age would benefit from preconception counseling, and the treatment of infertility should routinely offer interventions for lifestyle changes.
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Affiliation(s)
- Lana Salih Joelsson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research, Uppsala University, County Council of Västmanland, Västmanland County Hospital, Västerås, Sweden
| | - Anna Berglund
- The National Centre for Knowledge of Men’s Violence against Women, Uppsala University, Uppsala, Sweden
| | - Kjell Wånggren
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Lood
- Department of Women’s Health, Fertility Unit, Örebro University Hospital, Örebro, Sweden
| | - Andreas Rosenblad
- Centre for Clinical Research, Uppsala University, County Council of Västmanland, Västmanland County Hospital, Västerås, Sweden
| | - Tanja Tydén
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Berglund A, Heimer G. [Having been exposed to violence increases the risk of health problems later in life]. Lakartidningen 2016; 113:DYMD. [PMID: 27299328] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Violence is a common problem in society worldwide, and recent research has shown links to various signs of ill-health among victims. In a Swedish population based study, 46 per cent of women and 38 per cent of men had, at some point, been subjected to severe sexual, physical or emotional violence. The respondents were also asked about their present health. The study showed a significant over-representation of respondents subjected to serious violence in all ill-health indicators (PTSD, depression, psychosomatic symptoms, self-harm behaviour, risky alcohol intake, low self-rated physical health and heart attacks in the older age group). Several other Swedish studies have addressed abuse and future health. In a study among young people attending youth clinics the last year prevalence of sexual, physical and emotional violence was high, as expected. Young women were to a higher extent than young men exposed to sexual (14 and 4 per cent, respectively) and emotional violence (33 and 18 per cent respectively) and young men more to physical violence than young women (27 and 18 per cent respectively). Those who had been exposed to more than two types of violence were significantly more likely to resort to self-harm behaviour and suicide ideation and rated their psychological wellbeing lower than others. In one study the violence victimization and self-reported physical and mental ill-health among young women belonging to a sexual minority and heterosexual young women was assessed. Being subjected to two or more types of violence was significantly more frequent among the minority women compared to heterosexual women. However all victimized women had significantly higher risk for ill-health in all outcomes (PTSD, sleeping difficulties, and recurrent bowel problems). The impact of being subjected to more than one type of violence has been shown to be even more strongly linked to mental ill-health also in adult patients. Hence, research supports that violence victimisation is associated with various symptoms and conditions for which people seek medical care. Therefore questions about violence victimization should routinely be included in the medical history.
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Affiliation(s)
- Anna Berglund
- Nationellt centrum för kvinnofrid, Uppsala universitet - Uppsala, Sweden National centre for knowledge on men's violence against women, Upsala University - Uppsala, Sweden
| | - Gun Heimer
- Nationellt centrum för kvinnofrid, Uppsala universitet - Uppsala, Sweden Nationellt centrum för kvinnofrid, Uppsala universitet - Uppsala, Sweden
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McClung C, Berglund A, Welsh E, Xiong Y, Bush S, Robertson S, Chon H, Magliocco A, Marchion D, Apte S. Gene expression profiling of 389 endometrioid endometrial carcinomas reveals 4 distinct molecular subtypes. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.498] [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: 10/21/2022]
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Abstract
Cannibalism provides energetic benefits but is also potentially costly, especially when directed towards kin. Since fitness costs increase with time and energy invested in offspring, cannibalism should be infrequent when parental investment is high. Thus, filial cannibalism in male syngnathids, a group known for the occurrence of male pregnancy, should be rare. Using the pipefish (Syngnathus abaster) we aimed to investigate whether cannibalism does occur in both sexes and how it is affected by reproductive and nutritional states. Although rare, we witnessed cannibalism both in the wild and in the laboratory. Unlike non-pregnant males and females, pregnant and post-partum males largely refrained from cannibalising juveniles. Reproducing males decreased their feeding activity, thus rendering cannibalism, towards kin or non-kin, less likely to occur. However, if not continuously fed, all pipefish adopted a cannibal strategy, revealing that sex and life history stages influenced the ratio between the benefits and costs of cannibalism.
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Affiliation(s)
- M. Cunha
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Rua Padre Armando Quintas, 4485-661 Vairão, Portugal
- Faculdade de Ciências da Universidade do Porto, rua do Campo Alegre, 4169-007 Porto, Portugal
| | - A. Berglund
- Department of Animal Ecology, Evolutionary Biology Centre (EBC), Uppsala University, Norbyvägen 14, 752 36, Uppsala, Sweden
| | - T. Alves
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Rua Padre Armando Quintas, 4485-661 Vairão, Portugal
| | - N.M. Monteiro
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Rua Padre Armando Quintas, 4485-661 Vairão, Portugal
- Faculdade de Ciências da Universidade do Porto, rua do Campo Alegre, 4169-007 Porto, Portugal
- CEBIMED, Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Rua Carlos da Maia 296, 4200-150 Porto, Portugal
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Stern J, Salih Joelsson L, Tydén T, Berglund A, Ekstrand M, Hegaard H, Aarts C, Rosenblad A, Larsson M, Kristiansson P. Is pregnancy planning associated with background characteristics and pregnancy-planning behavior? Acta Obstet Gynecol Scand 2015; 95:182-9. [PMID: 26566076 PMCID: PMC4737297 DOI: 10.1111/aogs.12816] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 10/28/2015] [Indexed: 11/28/2022]
Abstract
Introduction Prevalence of planned pregnancies varies between countries but is often measured in a dichotomous manner. The aim of this study was to investigate to what level pregnant women had planned their pregnancies and whether pregnancy planning was associated with background characteristics and pregnancy‐planning behavior. Material and methods A cross‐sectional study that utilized the baseline measurements from the Swedish Pregnancy Planning study. Pregnant women (n = 3390) recruited at antenatal clinics answered a questionnaire. Data were analyzed with multinomial logistic regression, Kruskal–Wallis H and chi‐squared tests. Results Three of four pregnancies were very or fairly planned and 12% fairly or very unplanned. Of women with very unplanned pregnancies, 32% had considered an induced abortion. Women with planned pregnancies were more likely to have a higher level of education, higher household income, to be currently working (≥50%) and to have longer relationships than women with unplanned pregnancies. The level of pregnancy planning was associated with planning behavior, such as information‐seeking and intake of folic acid, but without a reduction in alcohol consumption. One‐third of all women took folic acid 1 month prior to conception, 17% used tobacco daily and 11% used alcohol weekly 3 months before conception. Conclusions A majority rated their pregnancy as very or fairly planned, with socio‐economic factors as explanatory variables. The level of pregnancy planning should be queried routinely to enable individualized counseling, especially for women with unplanned pregnancies. Preconception recommendations need to be established and communicated to the public to increase health promoting planning behavior.
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Affiliation(s)
- Jenny Stern
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Lana Salih Joelsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Center for Clinical Research, Uppsala University, County Council of Västmanland, Västmanland County Hospital, Västerås, Sweden
| | - Tanja Tydén
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anna Berglund
- The National Center for Knowledge on Men's Violence against Women, Uppsala University, Uppsala, Sweden
| | - Maria Ekstrand
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,Department of Care Science, Malmö University, Malmö, Sweden
| | - Hanne Hegaard
- The Research Unit Women's and Children's Health, The Juliane Marie Center for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,The Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Clara Aarts
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Andreas Rosenblad
- Center for Clinical Research, Uppsala University, County Council of Västmanland, Västmanland County Hospital, Västerås, Sweden
| | - Margareta Larsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Per Kristiansson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Gröndahl G, Berglund A, Skidell J, Bondesson U, Salomonsson M. Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015. Equine Vet J 2015; 47 Suppl 48:22. [PMID: 26375998 DOI: 10.1111/evj.12486_49] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
REASONS FOR PERFORMING STUDY Hypoglycin A (HG) appears to cause atypical myopathy (AM), but to our knowledge, detection of HG in affected and unaffected horses and concurrently in plants that they were exposed to has not previously been reported. OBJECTIVES To investigate HG in samples from horses exposed to Acer pseudoplatanus (European sycamore maple) and in such plant material, at the time of clinical cases of AM in the herd. STUDY DESIGN Cross-sectional study. METHODS Blood was collected from 2 horses with AM and 22 clinically healthy co-grazing horses in 2 Swedish farms within one week of onset of signs (May 2014) and one month later, after horses were moved to other pastures. Ten healthy control horses from unaffected farms were sampled once. Samaras, seedlings, flowers and leaves from Acer pseudoplatanus and from Acer platanoides L (Norway maple) were collected from affected pastures. Hypoglycin A was analysed using chemical derivatisation with dansyl chloride (DNS) and ultra high performance liquid chromatography-tandem mass spectrometry. Hypoglycin A was detected as derivatised compound HG-DNS [M+H]+ with selected reaction monitoring. RESULTS Hypoglycin A was detected in the horses affected with AM, and also in 20 out of 22 co-grazing horses. One month later, a surviving case horse and 9/20 co-grazing horses were still positive for HG. Controls from other farms were negative for HG. Hypoglycin A was detected in plant material from Acer pseudoplatanus, but not from Acer platanoides L. CONCLUSIONS Horses grazing in pastures with HG-containing Acer pseudoplatanus were positive for HG in blood, and some showed severe signs of myopathy. Ethical animal research: Ethical consent for blood sampling was granted (C113/11) and horse owners gave their informed consent to inclusion of horses in the study. SOURCE OF FUNDING National Veterinary Institute, Sweden. Competing interests: None declared.
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Affiliation(s)
- G Gröndahl
- National Veterinary Institute, Uppsala, Sweden
| | | | - J Skidell
- Evidensia Specialist Horse Hospital, Helsingborg, Sweden
| | - U Bondesson
- National Veterinary Institute, Uppsala, Sweden
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Joelsson L, Berglund A, Rosenblad A, Tyden T. Preconception lifestyles and lifestyle modification among women seeking for infertility. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.566] [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: 10/23/2022]
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Drevin J, Stern J, Annerbäck EM, Peterson M, Butler S, Tydén T, Berglund A, Larsson M, Kristiansson P. Adverse childhood experiences influence development of pain during pregnancy. Acta Obstet Gynecol Scand 2015; 94:840-6. [PMID: 25965273 PMCID: PMC5032994 DOI: 10.1111/aogs.12674] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 05/06/2015] [Indexed: 11/30/2022]
Abstract
Objective To investigate the association between adverse childhood experiences (ACE) and pain with onset during pregnancy. Design Cross‐sectional study. Setting Eighteen antenatal clinics in southern Mid‐Sweden. Sample Of 293 women invited to participate, 232 (79%) women agreed to participate in early pregnancy and were assessed in late pregnancy. Methods Questionnaires were distributed in early and late pregnancy. The questionnaires sought information on socio‐demography, ACE, pain location by pain drawing and pain intensity by visual analogue scales. Distribution of pain was coded in 41 predetermined areas. Main outcome measures Pain in third trimester with onset during present pregnancy: intensity, location and number of pain locations. Results In late pregnancy, 62% of the women reported any ACE and 72% reported any pain location with onset during the present pregnancy. Among women reporting any ACE the median pain intensity was higher compared with women without such an experience (p = 0.01). The accumulated ACE displayed a positive association with the number of reported pain locations in late pregnancy (rs = 0.19, p = 0.02). This association remained significant after adjusting for background factors in multiple regression analysis (p = 0.01). When ACE was dichotomized the prevalence of pain did not differ between women with and without ACE. The subgroup of women reporting physical abuse as a child reported a higher prevalence of sacral and pelvic pain (p = 0.0003 and p = 0.02, respectively). Conclusions Adverse childhood experiences were associated with higher pain intensities and larger pain distributions in late pregnancy, which are risk factors for transition to chronic pain postpartum.
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Affiliation(s)
- Jennifer Drevin
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Jenny Stern
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Eva-Maria Annerbäck
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Magnus Peterson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Stephen Butler
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Tanja Tydén
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anna Berglund
- National Centre for Knowledge on Men's Violence against Women, Uppsala University, Akademiska Hospital, Uppsala, Sweden
| | - Margareta Larsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Per Kristiansson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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31
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Franklin O, Ohlund D, Berglund A, Hellman U, Sund M. 351. Stromal hyaluronan in pancreatic cancer. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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32
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Estes JD, Reilly C, Trubey CM, Fletcher CV, Cory TJ, Piatak M, Russ S, Anderson J, Reimann TG, Star R, Smith A, Tracy RP, Berglund A, Schmidt T, Coalter V, Chertova E, Smedley J, Haase AT, Lifson JD, Schacker TW. Antifibrotic therapy in simian immunodeficiency virus infection preserves CD4+ T-cell populations and improves immune reconstitution with antiretroviral therapy. J Infect Dis 2014; 211:744-54. [PMID: 25246534 DOI: 10.1093/infdis/jiu519] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [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: 11/14/2022] Open
Abstract
Even with prolonged antiretroviral therapy (ART), many human immunodeficiency virus-infected individuals have <500 CD4(+) T cells/µL, and CD4(+) T cells in lymphoid tissues remain severely depleted, due in part to fibrosis of the paracortical T-cell zone (TZ) that impairs homeostatic mechanisms required for T-cell survival. We therefore used antifibrotic therapy in simian immunodeficiency virus-infected rhesus macaques to determine whether decreased TZ fibrosis would improve reconstitution of peripheral and lymphoid CD4(+) T cells. Treatment with the antifibrotic drug pirfenidone preserved TZ architecture and was associated with significantly larger populations of CD4(+) T cells in peripheral blood and lymphoid tissues. Combining pirfenidone with an ART regimen was associated with greater preservation of CD4(+) T cells than ART alone and was also associated with higher pirfenidone concentrations. These data support a potential role for antifibrotic drug treatment as adjunctive therapy with ART to improve immune reconstitution.
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Affiliation(s)
- Jacob D Estes
- Frederick National Laboratory, Leidos Biomedical Research
| | - Cavan Reilly
- Department of Biostatistics, University of Minnesota, Minneapolis
| | | | | | - Theodore J Cory
- College of Pharmacy, University of Nebraska Medical Center, Omaha
| | - Michael Piatak
- Frederick National Laboratory, Leidos Biomedical Research
| | | | | | | | - Robert Star
- National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of Health, Bethesda, Maryland
| | | | - Russell P Tracy
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington
| | | | | | - Vicky Coalter
- Frederick National Laboratory, Leidos Biomedical Research
| | - Elena Chertova
- Frederick National Laboratory, Leidos Biomedical Research
| | - Jeremy Smedley
- Frederick National Laboratory, Leidos Biomedical Research
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Torres-Roca J, Berglund A, Welsh E, Mule J, Dalton W, Eschrich S. Correlation Between Tumor Intrinsic Radiosensitivity and Immune Activation in Solid Tumors. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2369] [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: 10/24/2022]
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Roth O, Sundin J, Berglund A, Rosenqvist G, Wegner KM. Male mate choice relies on major histocompatibility complex class I in a sex-role-reversed pipefish. J Evol Biol 2014; 27:929-38. [DOI: 10.1111/jeb.12365] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 03/05/2014] [Accepted: 03/06/2014] [Indexed: 11/29/2022]
Affiliation(s)
- O. Roth
- Evolutionary Ecology of Marine Fishes; GEOMAR Helmholtz Centre for Ocean Research Kiel; Kiel Germany
| | - J. Sundin
- Department of Animal Ecology; Evolutionary Biology Centre (EBC); Uppsala University; Uppsala Sweden
| | - A. Berglund
- Department of Animal Ecology; Evolutionary Biology Centre (EBC); Uppsala University; Uppsala Sweden
| | - G. Rosenqvist
- Department of Biology; Norwegian University of Science and Technology; Trondheim Norway
| | - K. M. Wegner
- Coastal Ecology; Alfred Wegener Institute-Helmholtz Centre for Polar and Marine Research; List Germany
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Mårell L, Tillberg A, Widman L, Bergdahl J, Berglund A. Regression of oral lichenoid lesions after replacement of dental restorations. J Oral Rehabil 2014; 41:381-91. [DOI: 10.1111/joor.12151] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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)
- L. Mårell
- Department of Odontology; Faculty of Medicine; Umeå University; Umeå Sweden
| | - A. Tillberg
- Institute of Clinical Dentistry; Faculty of Medicine; University of Tromsø and Public Dental Competence Centre for Northern Norway; Tromsø Norway
| | - L. Widman
- Department of Occupational and Environmental Health; Faculty of Medicine; Umeå University; Umeå Sweden
| | - J. Bergdahl
- Department of Psychology; Umeå University; Umeå Sweden
- Institute of Clinical Dentistry; Faculty of Medicine; University of Tromsø; Tromsø Norway
| | - A. Berglund
- Department of Odontology; Faculty of Medicine; Umeå University; Umeå Sweden
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36
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Moreno Velasquez I, Frumento P, Berglund A, Johansson K, De Faire U, Leander K, Gigante B. Interleukin 8 serum levels and the risk of myocardial infarction. Results from the Stockholm Heart Epidemiology program. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1564] [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: 11/13/2022] Open
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Granfors M, Åkerud H, Berglund A, Skogö J, Sundström-Poromaa I, Wikström AK. Thyroid testing and management of hypothyroidism during pregnancy: a population-based study. J Clin Endocrinol Metab 2013; 98:2687-92. [PMID: 23690313 DOI: 10.1210/jc.2013-1302] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT There are international guidelines on thyroid function testing and management of hypothyroidism during pregnancy. Few studies have evaluated how they are implemented into clinical practice. OBJECTIVE In this descriptive study, we assessed the implementation of international guidelines in this field into local guidelines and also into clinical practice. DESIGN AND PARTICIPANTS In a nationwide survey, all guidelines in Sweden were collected (n = 29), and the adherence of the local guidelines to The Endocrine Society Guidelines 2007 was evaluated. In a follow-up in 1 district, 5254 pregnant women with an estimated date of delivery between January 1, 2009, and December 31, 2011, were included for subsequent review of their medical reports. RESULTS All but 1 district had guidelines on the subject. All local guidelines included fewer than the 10 listed reasons for thyroid testing recommended by The Endocrine Society Guidelines. Furthermore, most guidelines recommended additional types of thyroid function tests to TSH sampling and lower trimester-specific TSH upper reference limits for women on levothyroxine treatment (P < .001). In the follow-up, the thyroid testing rate was 20%, with an overall frequency of women with trimester-specific elevated TSH of 18.5%. More than half of the women (50.9%) who were on levothyroxine treatment at conception had an elevated TSH level at thyroid testing according to The Endocrine Society Guidelines. CONCLUSIONS The local guidelines are variable and poorly compliant with international guidelines. Performance of thyroid testing is not optimal, and rates of elevated TSH at testing are extremely high in subgroups.
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Affiliation(s)
- Michaela Granfors
- Department of Women's and Children's Health, University Hospital, Uppsala University, SE 751 85 Uppsala, Sweden.
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Johnsson A, Hagman H, Frödin JE, Berglund A, Keldsen N, Fernebro E, Sundberg J, De Pont Christensen R, Garm Spindler KL, Bergström D, Jakobsen A. A randomized phase III trial on maintenance treatment with bevacizumab alone or in combination with erlotinib after chemotherapy and bevacizumab in metastatic colorectal cancer: the Nordic ACT Trial. Ann Oncol 2013; 24:2335-41. [PMID: 23788755 DOI: 10.1093/annonc/mdt236] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [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: 12/13/2022] Open
Abstract
BACKGROUND The main objective was to study the effect on progression-free survival (PFS) of adding erlotinib to bevacizumab as maintenance treatment following chemotherapy and bevacizumab as first-line treatment of metastatic colorectal cancer (mCRC). PATIENTS AND METHODS Patients with untreated mCRC received doublet chemotherapy + bevacizumab during 18 weeks and those without tumor progression were eligible for randomization to bevacizumab + erlotinib (arm A) or bevacizumab alone (arm B), until progression or unacceptable toxic effect. RESULTS Of the 249 patients enrolled, 80 started maintenance treatment in arm A and 79 in arm B. The rate of any grade 3/4 toxic effect was 53% in arm A and 13% in arm B. Median PFS was 5.7 months in arm A and 4.2 months in arm B (HR = 0.79; 95% confidence interval 0.55-1.12; P = 0.19). Overall survival (OS) from start of induction chemotherapy was 26.7 months in the randomized population, with no difference between the two arms. CONCLUSIONS The addition of erlotinib to bevacizumab as maintenance treatment after first-line chemotherapy in mCRC did not improve PFS significantly. On-going clinical and translational studies focus on identifying subgroups of patients that may benefit from erlotinib in the maintenance setting. CLINICAL TRIALS NUMBER NCT00598156.
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Affiliation(s)
- A Johnsson
- Department of Oncology, Skåne University Hospital, Lund, Sweden.
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Aronsen T, Mobley K, Berglund A, Sundin J, Billing A, Rosenqvist G. The operational sex ratio and density influence spatial relationships between breeding pipefish. Behav Ecol 2013. [DOI: 10.1093/beheco/art019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nystrom H, Naredi P, Berglund A, Tavelin B, Palmqvist R, Sund M. 190. Liver-metastatic potential of colorectal cancer is related to stromal composition of the tumor. European Journal of Surgical Oncology 2012. [DOI: 10.1016/j.ejso.2012.06.187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Granstam Björneklett H, Lindemalm C, Ojutkangas ML, Berglund A, Letocha H, Strang P, Bergkvist L. PD04-06: A Randomised Controlled Trial of Quality of Life and Fatigue after Support Group Intervention in Primary Breast Cancer Patients. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-pd04-06] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: When diagnosed with breast cancer, most women's lives change as well as their perspectives on and appreciation of life. The aim of the present study was to evaluate whether psychosocial support intervention could influence health- related quality of life and fatigue during the first year after diagnosis.
Material and Methods: Of 382 patients with newly diagnosed breast cancer, 191 + 191 patients were randomized to an intervention group or to a routine control group respectively.
The intervention group received support intervention that lasted one week on a residential basis, followed by four days of follow-up two months later. The support intervention included informative-educational parts, relaxation training, mental visualisation and nonverbal communication. Health-related quality of life was measured using the EORTC-QLQ 30 and QLQ-BR23 questionnaires and fatigue with the Norwegian version of the Fatigue scale at baseline, 2, 6 and 12 months after intervention.
Result: There were a time-dependant improvement in both functional and symptom scales between baseline and 12 months as measured by the EORTC QLQ 30 and BR 23 questionnaires and there was a decrease in fatigue between baseline and after 2 months with further improvement up to 12 months in both groups but there were no differences between the intervention and control groups at any point in time.
Conclusion: Health related Quality of Life improves and symptoms of fatigue decreases over time, but we could not see any additional effect from the rehabilitation program in this setting.
Key words: Support intervention, breast cancer, health- related quality of life, fatigue, EORTC-QLQ 30 and BR 23, the Norwegian version of the fatigue scale.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr PD04-06.
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Affiliation(s)
- H Granstam Björneklett
- 1Centre for Clinical Research, Västerås, Sweden; Cancer Centre Karolinska, Solna, Sweden; Centre for Clinical Research, Central Hospital, Västerås, Sweden; Karolinska Institute, SSH, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden
| | - C Lindemalm
- 1Centre for Clinical Research, Västerås, Sweden; Cancer Centre Karolinska, Solna, Sweden; Centre for Clinical Research, Central Hospital, Västerås, Sweden; Karolinska Institute, SSH, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden
| | - M-L Ojutkangas
- 1Centre for Clinical Research, Västerås, Sweden; Cancer Centre Karolinska, Solna, Sweden; Centre for Clinical Research, Central Hospital, Västerås, Sweden; Karolinska Institute, SSH, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden
| | - A Berglund
- 1Centre for Clinical Research, Västerås, Sweden; Cancer Centre Karolinska, Solna, Sweden; Centre for Clinical Research, Central Hospital, Västerås, Sweden; Karolinska Institute, SSH, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden
| | - H Letocha
- 1Centre for Clinical Research, Västerås, Sweden; Cancer Centre Karolinska, Solna, Sweden; Centre for Clinical Research, Central Hospital, Västerås, Sweden; Karolinska Institute, SSH, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden
| | - P Strang
- 1Centre for Clinical Research, Västerås, Sweden; Cancer Centre Karolinska, Solna, Sweden; Centre for Clinical Research, Central Hospital, Västerås, Sweden; Karolinska Institute, SSH, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden
| | - L Bergkvist
- 1Centre for Clinical Research, Västerås, Sweden; Cancer Centre Karolinska, Solna, Sweden; Centre for Clinical Research, Central Hospital, Västerås, Sweden; Karolinska Institute, SSH, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden
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Abstract
BACKGROUND Around 10-15% of women suffer from depressive illness during pregnancy or the first year postpartum. Depression during pregnancy constitutes a risk for prenatal stress and preterm birth. No validated screening instrument for detecting depression during pregnancy was available in Swedish. AIMS We aimed to validate the Edinburgh Postnatal Depression Scale (EPDS) against DSM-IV criteria for depression during pregnancy, establish a reliable cut-off and estimate the correlation between the EPDS and HAD-S (Hospital Anxiety and Depression Scale). METHODS In a population-based community sample of 1175 pregnant women, 918 women (78%) answered questionnaires with the EPDS and HAD-S. In all, 121 were interviewed using the PRIME-MD (Primary Care Evaluation of Mental disorders) for diagnosing depression. Women were interviewed in mean gestational week 13 (range 8-21). For the EPDS, a receiver operating characteristic (ROC) curve was calculated for prediction of depression. Pearson's correlation coefficient was used to investigate the association between EPDS and HAD-S scores. RESULTS The optimal cut-off score on the EPDS scale for detecting depression was ≥13 (standard error coefficient of 1.09 and c-statistics of 0.84) giving a sensitivity of 77% and specificity of 94%. The EPDS scores correlated strongly with the HAD-S, Pearson's correlation was 0.83 (P < 0.0001). CONCLUSIONS This study confirms that the EPDS is a valid screening instrument for detection of depressive symptoms during pregnancy. The EPDS shows persuasive measuring outcomes with an optimal cut-off at ≥13. CLINICAL IMPLICATIONS Healthcare for pregnant women should consider screening procedures and follow-up routines for depressive symptoms.
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Berglund A, Heimer G. [To ask women about violence exposure must become a routine]. Lakartidningen 2011; 108:2082. [PMID: 22165533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Rogell B, Berglund A, Laurila A, Höglund J. Population divergence of life history traits in the endangered green toad: implications for a support release programme. J Zool (1987) 2011. [DOI: 10.1111/j.1469-7998.2011.00843.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Male pregnancy in the family Syngnathidae (pipefishes, seahorses and seadragons) predisposes males to limit female reproductive success; sexual selection may then operate more strongly on females and female sexual signals may evolve (sex-role reversal). A bewildering array of female signals has evolved in Syngnathids, e.g. skin folds, large body size, colouration, markings on the body and elaborate courtship. These female sexual signals do not seem quantitatively or qualitatively different from those that evolve in males in species with conventional sex roles where males provide females or offspring with direct benefits. In several syngnathid species, males also evolve ornaments, females are choosy in addition to being competitive and males compete as well as choosing partners. Thus, sex roles form a continuum, spanning from conventional to reversed within this group of fishes. Cases are presented here suggesting that stronger sexual selection on females may be most extreme in species showing classical polyandry (one male mates with several females, such as many species where males brood their eggs on the trunk), intermediate in polygynandrous species (males and females both mate with more than one partner, as in many species where males brood their eggs on the tail) and least extreme, even exhibiting conventional sex roles, in monogamous species (one male mates solely with one female, as in many seahorses and tropical pipefishes). At the same time caution is needed before unanimously establishing this pattern: first, the connection between mating patterns, strength of sexual selection, sex roles and ornament expression is far from simple and straightforward, and second, knowledge of the actual morphology, ecology and behaviour of most syngnathid species is scanty. Basically only a few Nerophis, Syngnathus and Hippocampus species have been studied in any detail. It is known, however, that this group of fishes exhibits a remarkable variation in sex roles and ornamentation, making them an ideal group for the study of mating patterns, sexual selection and sexually selected signals.
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Affiliation(s)
- G Rosenqvist
- Department of Biology, Centre of Conservation Biology, Norwegian University of Science and Technology, N-7491 Trondheim, Norway.
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Abstract
Broad-nosed pipefish Syngnathus typhle were used to investigate whether males used scent in their search for mates. When the males in an experiment had access to olfactory cues only, they did not locate females better than they located males. Thus, S. typhle, was less successful in mate search when visual cues were absent.
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Affiliation(s)
- C Lindqvist
- Department of Biology, Gotland University, SE-621 67 Visby, Sweden.
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Sundin J, Jacobsson Ö, Berglund A, Rosenqvist G. Straight-nosed pipefish Nerophis ophidion and broad-nosed pipefish Syngnathus typhle avoid eelgrass overgrown with filamentous algae. J Fish Biol 2011; 78:1855-1860. [PMID: 21651533 DOI: 10.1111/j.1095-8649.2011.02982.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In a habitat choice experiment straight-nosed pipefish Nerophis ophidion and broad-nosed pipefish Syngnathus typhle avoided eelgrass Zostera marina covered with filamentous algae. Both juveniles as well as brooding adult males of the two species clearly preferred to position themselves in Z. marina without growth of filamentous algae.
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Affiliation(s)
- J Sundin
- Department of Ecology and Genetics/Animal Ecology, Uppsala University, Norbyvägen 18 D, SE-75236 Uppsala, Sweden.
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Suzuki C, Blomqvist L, Sundin A, Bystrom P, Berglund A, Jacobsson H, Nygren P, Glimelius B. Initial change in tumor size as an imaging surrogate of outcomes in patients with metastatic colorectal cancer (mCRC) treated with first-line irinotecan and 5-FU combination chemotherapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3569] [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: 11/20/2022] Open
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49
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Johnsson A, Frodin J, Berglund A, Hagman H, Sundberg J, Bergstrom D, Christensen RD, Keldsen N, Spindler KG, Jakobsen AKM. A randomized phase III trial on maintenance treatment with bevacizumab (bev) alone or in combination with erlotinib (erlo) after chemotherapy and bev in metastatic colorectal cancer (mCRC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3526] [Citation(s) in RCA: 2] [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: 11/20/2022] Open
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Byström P, Berglund A, Nygren P, Wernroth L, Johansson B, Larsson A, Einarsson R, Glimelius B. An explorative study on the clinical utility of baseline and serial serum tumour marker measurements in advanced upper gastrointestinal cancer. Oncol Rep 2011; 24:1645-52. [PMID: 21042763 DOI: 10.3892/or_00001029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The value of early tumour marker changes during palliative chemotherapy in patients with upper gastrointestinal adenocarcinoma (UGIA) is unclear. Seventy-three patients with advanced UGIA were randomised to receive 45 mg/m2 docetaxel or 180 mg/m2 irinotecan with 5-FU/leucovorin. After every 2nd course the patients were crossed over to the other regimen. Serum was sampled before start of chemotherapy and every 2nd week during 8 weeks for CEA, TPA, TPS, CA72-4, CA19-9 and CA242 measurements. Eighteen patients (25%) had partial response (PR) and 21 patients had stable disease for at least 4 months (SD4). All baseline marker levels, except CA72-4, correlated with time to progression and survival. Patients with normal levels, except CA72-4, also had more clinical responses (PR+SD4) than patients with elevated values. Tumour marker changes early during treatment provided modest predictive information for tumour response and survival. A model combining baseline level, the change and the interaction between them gave the best prediction of outcome, however, insignificantly better than baseline level for all markers except CA242. Baseline tumour marker levels provide prognostic information for patients with UGIA on palliative chemotherapy. Early changes generally failed to provide accurate information for tumour response and survival.
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Affiliation(s)
- P Byström
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
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