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Werther L, Thorén E, Brännström J, Andersson G, Öberg M. Hearing impaired persons' experiences with the online Swedish Individualized Active Communication Education (I-ACE) program: A feasibility study. Internet Interv 2024; 36:100734. [PMID: 38524894 PMCID: PMC10958056 DOI: 10.1016/j.invent.2024.100734] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/29/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024] Open
Abstract
Even with optimally fitted hearing aids, many individuals with hearing impairment struggle to hear in situations with difficult listening conditions. Active Communication Education (ACE) is an interactive group rehabilitation program aimed at helping people with hearing loss communicate more effectively using communication strategies to better cope with everyday life. To increase accessibility and allow more people to benefit from the ACE program, a modified individualized version was created. The purpose of this study was to examine the feasibility of providing the Swedish Individualized Active Communication Education (I-ACE) program via an online platform and to explore hearing impaired persons' experiences with the program. For five weeks, ten participants completed the Swedish I-ACE through an online platform. The participants were assigned a new chapter to complete each week and later received individual feedback on their work via the platform. The participants were asked to complete an evaluation form regarding the content and their experiences during and after completing the I-ACE. They were later interviewed to provide more detailed information on their experiences with the program. The program completion rate was 80 %. Participants found the I-ACE program to be informative and relevant but somewhat repetitive. However, only a few participants thought of the repetitiveness as negative. Few participants reported difficulties using the platform. This study indicated that it is feasible to provide the I-ACE program via an online platform and that the content of the program is informative, relevant, and comprehensible. Further research evaluating the effects of the I-ACE is warranted.
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Affiliation(s)
- Louise Werther
- Department of Otorhinolaryngology in Östergötland, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Elisabet Thorén
- Department of Otorhinolaryngology, Head and Neck Surgery, Audiology Clinic, Skåne University Hospital, Lund, Sweden
- Department of Clinical Science, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Jonas Brännström
- Department of Clinical Science, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Gerhard Andersson
- Department of Otorhinolaryngology in Östergötland, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Marie Öberg
- Department of Otorhinolaryngology in Östergötland, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Sahlén B, Ibertsson T, Asker-Árnason L, Brännström J, Hansson K. Best ear hearing level, time factors and language outcome in Swedish children with mild and moderate hearing loss with hearing aids. LOGOP PHONIATR VOCO 2021; 47:239-248. [PMID: 34287105 DOI: 10.1080/14015439.2021.1951347] [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] [Indexed: 10/20/2022]
Abstract
AIM The risk for language disorder is high in children with all levels of hearing loss (HL). Early identification and intervention should be as important for children with mild HL as for those with more severe HL. Despite new-born hearing screening, a recent survey of speech language therapist services in southern Sweden indicates that children with mild and moderate HL are severely neglected when it comes to language assessment and language intervention. In this study we explore associations between Best Ear Hearing Level (BEHL), time factors and language skills in Swedish children with HL with hearing aids (HA). METHOD Participants were 19 children with mild HL (BEHL 23-39) and 22 children with moderate HL (BEHL 40-70) aged 5-15 years. Information on age at diagnosis and at HA fitting were collected. The children performed a nonword repetition and a sentence comprehension task. RESULTS The time elapsed between diagnosis and fitting with HA was longer for the children with mild HL.Participants with mild HL received their HA significantly later than children with moderate HL. No association between BEHL and the two language measures was found, and language skills were not better in children with mild than moderate HL. 17% of participants performed below cut-off for language disorder on both language measures. CONCLUSION Given the risk for long-term academic and social consequences of even mild HL delayed HA intervention for children with HLleads to serious concerns by families, clinicians, and pedagogues.
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Affiliation(s)
- Birgitta Sahlén
- Department of Clinical Sciences, Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Tina Ibertsson
- Department of Clinical Sciences, Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Lena Asker-Árnason
- Department of Clinical Sciences, Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Jonas Brännström
- Department of Clinical Sciences, Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Kristina Hansson
- Department of Clinical Sciences, Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
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3
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Heggdal POL, Larsen KS, Brännström J, Aarstad HJ, Specht K. Reduced grey- and white matter volumes due to unilateral hearing loss following treatment for vestibular schwannoma. Heliyon 2020; 6:e05658. [PMID: 33364477 PMCID: PMC7754525 DOI: 10.1016/j.heliyon.2020.e05658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/14/2019] [Revised: 12/10/2019] [Accepted: 11/30/2020] [Indexed: 12/21/2022] Open
Abstract
Objective Previous studies of the consequences of unilateral hearing loss (UHL) on the functional-structural organization of the brain has included subjects with various degrees of UHL. We suggest that the consequences of a total loss of hearing in one ear might differ from those seen in subjects with residual hearing in the affected ear. Thus, the main aim of the present study was to compare the structural properties of auditory and non-auditory brain regions in persons with complete UHL to those of normal hearing controls. We hypothesize that the consequences of complete UHL following treatment for vestibular schwannoma will differ between ipsi- and contralateral structures, as well as between right- and left side deafness. Design A 3T Siemens Prisma MR-scanner was used. Anatomical images were acquired using a high-resolution T1-weighted sequence. Grey- and white matter volumes were assessed using voxel-based morphometry. Study sample Twenty-two patients with left- or right-side unilateral hearing loss. Fifty normal hearing controls. Results Reductions in grey- and white matter volumes were seen in cortical and sub-cortical regions, mainly in the right hemisphere including the auditory cortex, lingual gyrus, cuneus, middle temporal gyrus, occipital fusiform gyrus, middle cingulate gyrus and the superior temporal gyrus. Patients displayed reduced grey- and white matter volumes in cerebellar exterior structures ipsilateral to the tumor side. Conclusion When compared to controls, right side hearing loss yields more widespread reduction of grey matter volume than left side hearing loss. The findings of reduced grey- and white matter volumes in auditory and non-auditory brain regions could be related to problems with speech perception in adverse listening conditions, increased listening effort and reduced quality of life reported by persons with unilateral hearing loss despite normal hearing in the unaffected ear.
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Affiliation(s)
- Peder O. Laugen Heggdal
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Jonas Lies vei 87, 5021 Bergen, Norway
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, PB 1400, 5021 Bergen, Norway
- Corresponding author.
| | - Kristina S. Larsen
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, PB 1400, 5021 Bergen, Norway
| | - Jonas Brännström
- Department of Clinical Science, Section of Logopedics, Phoniatrics and Audiology, Lund University, Box 117, 221 00 Lund, Sweden
| | - Hans Jørgen Aarstad
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Jonas Lies vei 87, 5021 Bergen, Norway
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, PB 1400, 5021 Bergen, Norway
| | - Karsten Specht
- Department of Biological and Medical Psychology, University of Bergen, PB 7807, 5020 Bergen, Norway
- Department of Education, UiT/The Arctic University of Norway, Tromsø, Norway
- Mohn Medical Imaging and Visualization Center, Haukeland University Hospital, Bergen, Norway
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George-Svahn L, Eriksson LE, Wiklander M, Björling G, Svedhem V, Brännström J. Barriers to HIV testing as reported by individuals newly diagnosed with HIV infection in Sweden. AIDS Care 2020; 33:1286-1295. [PMID: 33233939 DOI: 10.1080/09540121.2020.1844862] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 10/22/2022]
Abstract
Despite the availability of free and anonymous HIV testing almost 60% of Swedish patients are diagnosed late. Identifying predictors of different types of barriers could inform policy makers and health care of interventions to increase testing where needed. This cross-sectional study aimed to describe and analyze barriers to HIV testing as reported by Swedish patients newly diagnosed with HIV infection. N = 285 patients completed the 18-item Barriers to HIV Testing Scale - Karolinska Version. Descriptive analysis and logistic regressions were performed to assess the prevalence of barriers and to identify predictors for the different investigated barriers. Barriers to testing were reported by 60%. Approximately 67% of patients originating from Sweden, 50% from Sub-Saharan Africa and 75% from Eastern European/East Asian countries reported barriers. Patients who were younger and patients who self-initiated HIV testing, had greater odds of reporting a barrier than older individuals and those who were offered a test through screening or by a healthcare professional. To counteract barriers that still exist on an individual level, healthcare-initiated HIV testing could be offered more broadly and information about risks for transmission and effectiveness of HIV treatment still needs to be disseminated among both people born in Sweden and different migrant groups.
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Affiliation(s)
- L George-Svahn
- Rinkeby Primary Health Care Center, Stockholm, Sweden.,Dept. of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden
| | - L E Eriksson
- Dept. of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.,Dept. of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,School of Health Sciences, City, University of London, London, UK
| | - M Wiklander
- Dept. of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - G Björling
- Dept. of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden.,Dept. of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Faculty of Nursing, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - V Svedhem
- Dept. of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.,Div. of Infectious Disease, Dept. of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - J Brännström
- Div. of Infectious Disease, Dept. of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.,Dept. of Infectious Diseases/Venhälsan, Stockholm South General Hospital, Stockholm, Sweden
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Heggdal POL, Nordvik Ø, Brännström J, Vassbotn F, Aarstad AK, Aarstad HJ. Clinical Application and Psychometric Properties of a Norwegian Questionnaire for the Self-Assessment of Communication in Quiet and Adverse Conditions Using Two Revised APHAB Subscales. J Am Acad Audiol 2020; 29:25-34. [DOI: 10.3766/jaaa.16102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AbstractDifficulty in following and understanding conversation in different daily life situations is a common complaint among persons with hearing loss. To the best of our knowledge, there is currently no published validated Norwegian questionnaire available that allows for a self-assessment of unaided communication ability in a population with hearing loss.The aims of the present study were to investigate a questionnaire for the self-assessment of communication ability, examine the psychometric properties of this questionnaire, and explore how demographic variables such as degree of hearing loss, age, and sex influence response patterns.A questionnaire based on the subscales of the Norwegian translation of the Abbreviated Profile of Hearing Aid Benefit was applied to a group of hearing aid users and normal-hearing controls.A total of 108 patients with bilateral hearing loss, and 101 controls with self-reported normal hearing.The psychometric properties were evaluated. Associations and differences between outcome scores and descriptive variables were examined. A regression analysis was performed to investigate whether descriptive variables could predict outcome.The measures of reliability suggest that the questionnaire has satisfactory psychometric properties, with the outcome of the questionnaire correlating to hearing loss severity, thus indicating that the concurrent validity of the questionnaire is good.The findings indicate that the proposed questionnaire is a valid measure of self-assessed communication ability in both quiet and adverse listening conditions in participants with and without hearing loss.
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Affiliation(s)
- Peder O. Laugen Heggdal
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Øyvind Nordvik
- Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway
| | - Jonas Brännström
- Department of Clinical Science, Section of Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Flemming Vassbotn
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Anne Kari Aarstad
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
| | - Hans Jørgen Aarstad
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Heggdal POL, Aarstad HJ, Brännström J, Vassbotn FS, Specht K. An fMRI-study on single-sided deafness: Spectral-temporal properties and side of stimulation modulates hemispheric dominance. Neuroimage Clin 2019; 24:101969. [PMID: 31419767 PMCID: PMC6706639 DOI: 10.1016/j.nicl.2019.101969] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/21/2019] [Accepted: 08/03/2019] [Indexed: 11/18/2022]
Abstract
Objective Our main aim was to investigate the blood oxygenation level dependent (BOLD) response to monaural and binaural speech- and non-speech stimuli as measured with fMRI in subjects with single-sided deafness and in normal hearing controls. We hypothesised that the response to monaural stimulation in both normal hearing subjects and persons with single-sided deafness would vary with the complexity and nature of the stimuli and the side of stimulation. Design Patients with left- and right single-sided deafness and controls with normal hearing receiving either binaural or monaural stimuli were tested using speech and non-speech auditory stimuli in an event-related fMRI experiment. Study sample Twenty-two patients with single-sided deafness after treatment for vestibular schwannoma and 50 normal hearing controls. Results Normal hearing persons receiving right side monaural stimuli activate bilateral temporal regions. Activation following left side monaural stimulation is more right lateralized. Persons with single-sided deafness respond similarly to controls to monaural stimulation. Persons with right side single-sided deafness show activation of frontal cortical regions not seen in persons with left side single-sided deafness following speech stimuli. This is possibly related to increased effort and more frequently reported problems with communication. Right side single-sided deafness is related to increased activation of areas usually related to processing of degraded input, including the thalamus. Conclusion Hemispheric dominance following monaural auditory stimulation is modulated by the spectral-temporal properties of the stimuli and by which ear is stimulated. Differences between patients with right- and left side deafness suggests that right side deafness is related to increased activation of areas involved in processing of degraded input. Hemispheric dominance following monaural stimulation is modulated by stimuli properties and by which ear is stimulated Results suggests that right side deafness is related to increased activation of eares involved in processing degraded input Self-assessed communication ability and the BOLD-response to phonetic stimuli correlate in several brain regions.
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Affiliation(s)
- Peder O Laugen Heggdal
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Jonas Lies vei 87, 5021 Bergen, Norway; Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, PB 1400, 5021 Bergen, Norway.
| | - Hans Jørgen Aarstad
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Jonas Lies vei 87, 5021 Bergen, Norway; Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, PB 1400, 5021 Bergen, Norway.
| | - Jonas Brännström
- Department of Clinical Science, Section of logopedics, Phoniatrics and Audiology, Lund University, Box 117, 22100 Lund, Sweden.
| | - Flemming S Vassbotn
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, PB 1400, 5021 Bergen, Norway.
| | - Karsten Specht
- Department of Biological and Medical Psychology, University of Bergen, PB 7807, 5020 Bergen, Norway; Department of Education, UiT/The Arctic University of Norway, Tromsø, Norway.
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Karjalainen S, Sahlén B, Falck A, Brännström J, Lyberg-Åhlander V. Implementation and evaluation of a teacher intervention program on classroom communication. LOGOP PHONIATR VOCO 2019; 45:110-122. [DOI: 10.1080/14015439.2019.1595131] [Citation(s) in RCA: 4] [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] [Indexed: 10/26/2022]
Affiliation(s)
- Suvi Karjalainen
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Birgitta Sahlén
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Andreas Falck
- Department of Psychology, Lund University, Lund, Sweden
- Institut Jean Nicod, Département d’études cognitives, ENS, EHESS, PSL University, CNRS, Paris, France
| | - Jonas Brännström
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Viveka Lyberg-Åhlander
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
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Rudner M, Lyberg-Åhlander V, Brännström J, Nirme J, Pichora-Fuller MK, Sahlén B. Listening Comprehension and Listening Effort in the Primary School Classroom. Front Psychol 2018; 9:1193. [PMID: 30050489 PMCID: PMC6052349 DOI: 10.3389/fpsyg.2018.01193] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 02/05/2018] [Accepted: 06/20/2018] [Indexed: 11/13/2022] Open
Abstract
In the primary school classroom, children are exposed to multiple factors that combine to create adverse conditions for listening to and understanding what the teacher is saying. Despite the ubiquity of these conditions, there is little knowledge concerning the way in which various factors combine to influence listening comprehension and the effortfulness of listening. The aim of the present study was to investigate the combined effects of background noise, voice quality, and visual cues on children's listening comprehension and effort. To achieve this aim, we performed a set of four well-controlled, yet ecologically valid, experiments with 245 eight-year-old participants. Classroom listening conditions were simulated using a digitally animated talker with a dysphonic (hoarse) voice and background babble noise composed of several children talking. Results show that even low levels of babble noise interfere with listening comprehension, and there was some evidence that this effect was reduced by seeing the talker's face. Dysphonia did not significantly reduce listening comprehension scores, but it was considered unpleasant and made listening seem difficult, probably by reducing motivation to listen. We found some evidence that listening comprehension performance under adverse conditions is positively associated with individual differences in executive function. Overall, these results suggest that multiple factors combine to influence listening comprehension and effort for child listeners in the primary school classroom. The constellation of these room, talker, modality, and listener factors should be taken into account in the planning and design of educational and learning activities.
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Affiliation(s)
- Mary Rudner
- Linnaeus Centre HEAD, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Viveka Lyberg-Åhlander
- Department of Clinical Sciences, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Jonas Brännström
- Department of Clinical Sciences, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Jens Nirme
- Lund University Cognitive Science (LUCS), Lund University, Lund, Sweden
| | | | - Birgitta Sahlén
- Department of Clinical Sciences, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
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Nirme J, Haake M, Lyberg Åhlander V, Brännström J, Sahlén B. A virtual speaker in noisy classroom conditions: supporting or disrupting children's listening comprehension? LOGOP PHONIATR VOCO 2018; 44:79-86. [PMID: 29619859 DOI: 10.1080/14015439.2018.1455894] [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] [Indexed: 10/17/2022]
Abstract
AIM Seeing a speaker's face facilitates speech recognition, particularly under noisy conditions. Evidence for how it might affect comprehension of the content of the speech is more sparse. We investigated how children's listening comprehension is affected by multi-talker babble noise, with or without presentation of a digitally animated virtual speaker, and whether successful comprehension is related to performance on a test of executive functioning. MATERIALS AND METHODS We performed a mixed-design experiment with 55 (34 female) participants (8- to 9-year-olds), recruited from Swedish elementary schools. The children were presented with four different narratives, each in one of four conditions: audio-only presentation in a quiet setting, audio-only presentation in noisy setting, audio-visual presentation in a quiet setting, and audio-visual presentation in a noisy setting. After each narrative, the children answered questions on the content and rated their perceived listening effort. Finally, they performed a test of executive functioning. RESULTS We found significantly fewer correct answers to explicit content questions after listening in noise. This negative effect was only mitigated to a marginally significant degree by audio-visual presentation. Strong executive function only predicted more correct answers in quiet settings. CONCLUSIONS Altogether, our results are inconclusive regarding how seeing a virtual speaker affects listening comprehension. We discuss how methodological adjustments, including modifications to our virtual speaker, can be used to discriminate between possible explanations to our results and contribute to understanding the listening conditions children face in a typical classroom.
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Affiliation(s)
- Jens Nirme
- a Division of Cognitive Science , Lund University , Lund , Sweden
| | - Magnus Haake
- a Division of Cognitive Science , Lund University , Lund , Sweden
| | - Viveka Lyberg Åhlander
- b Division of Logopedics, Phoniatrics and Vocology, Department of Clinical Sciences , Lund University , Lund , Sweden
| | - Jonas Brännström
- b Division of Logopedics, Phoniatrics and Vocology, Department of Clinical Sciences , Lund University , Lund , Sweden
| | - Birgitta Sahlén
- b Division of Logopedics, Phoniatrics and Vocology, Department of Clinical Sciences , Lund University , Lund , Sweden
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Nordvik Ø, Laugen Heggdal PO, Brännström J, Vassbotn F, Aarstad AK, Aarstad HJ. Generic quality of life in persons with hearing loss: a systematic literature review. BMC Ear Nose Throat Disord 2018; 18:1. [PMID: 29386982 PMCID: PMC5778781 DOI: 10.1186/s12901-018-0051-6] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 01/02/2018] [Indexed: 12/11/2022]
Abstract
Background To the best of our knowledge, no empirically based consensus has been reached as to if, and to what extent, persons with hearing loss (HL) have reduced generic Quality of life (QoL). There seems to be limited knowledge regarding to what extent a hearing aid (HA) would improve QoL. The main aim of the present study was to review studies about the relationship between HL and QoL. A supporting aim was to study the association between distress and HL. Methods Literature databases (Cinahl, Pub Med and Web of Science) were searched to identify relevant journal articles published in the period from January 2000 to March 17, 2016. We performed a primary search pertaining to the relationship between HL, HA and QoL (search number one) followed by a supporting search pertaining to the relationship between distress/mood/anxiety and HL (search number two). After checking for duplications and screening the titles of the papers, we read the abstracts of the remaining papers. The most relevant papers were read thoroughly, leaving us with the journal articles that met the inclusion criteria. Results Twenty journal articles were included in the present review: 13 were found in the primary search (HL and QoL), and seven in the supporting search (HL and distress). The literature yields equivocal findings regarding the association between generic QoL and HL. A strong association between distress and HL was shown, where distressed persons tend to have a lowered generic QoL. It is suggested that QoL is lowered among HL patients. Some studies suggest an increased generic QoL following the use of HA, especially during the first few months after initiation of treatment. Other studies suggest that HA use is one of several possible factors that contribute to improve generic QoL. Conclusions The majority of the studies suggest that HL is associated with reduced generic QoL. Using hearing aids seem to improve general QoL at follow-up within the first year. HL is a risk factor for distress. Further research is needed to explore the relationship between HL and generic QoL, in addition to the importance of influencing variables on this relationship.
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Affiliation(s)
- Øyvind Nordvik
- 3Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway
| | - Peder O Laugen Heggdal
- 1Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.,2Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Jonas Brännström
- 4Department of Clinical Science, Section of Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Flemming Vassbotn
- 1Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.,2Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Anne Kari Aarstad
- 1Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.,5Department of Health Science, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Hans Jørgen Aarstad
- 1Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.,2Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Boström G, Brännström J, Rosendahl E, Nordström P, Littrand H, Lövheim H, Gustafson Y. GENDER, PSYCHOTROPIC DRUG USE AND MORTALITY IN OLDER PEOPLE WITH DEMENTIA. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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12
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Brännström J, Sönnerborg A, Svedhem V, Neogi U, Marrone G. A high rate of HIV-1 acquisition post immigration among migrants in Sweden determined by a CD4 T-cell decline trajectory model. HIV Med 2017; 18:677-684. [PMID: 28444865 DOI: 10.1111/hiv.12509] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 02/12/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES There is a lack of knowledge about the extent to which migrants become HIV-1 infected after arrival in European countries. The objective of this study was to assess the extent to which migrants to Sweden become HIV-1 infected post immigration using a CD4 T-cell decline trajectory model. METHODS All migrants (n = 2268) who were ≥ 15 years old, were diagnosed with HIV-1 infection in the period 1983-2013, had a known year of arrival in Sweden, did not have primary HIV infection and were not infected via mother-to-child transmission were included in the study. The CD4 T-cell decline trajectory model was applied and estimates of HIV acquisition were compared to the clinical reports. Phylogenetic analysis was performed in a subset of patients to explore whether this would favour the model or the doctor's estimate. RESULTS The model estimated 19% of individuals to have been infected after arrival in Sweden, whereas the physician's estimate was 12%. In 79% of cases the estimates agreed. Discordance was predominantly seen when the doctor estimated HIV acquisition to have occurred before arrival in Sweden, while the model estimated it to have occurred after arrival in Sweden, and this type of discordance was seen in 10% of all patients. The probability of a discordance was greater for older patients, those with a high first CD4 T-cell count and those infected via heterosexual transmission. The phylogenetic analysis showed a higher concordance with the CD4 model than with the clinical reports (36 vs. 13%, respectively). CONCLUSIONS The model indicated that a substantially higher proportion of migrants are infected after arrival in Sweden than estimated using clinical routine reports. It is therefore important to further emphasize primary preventive measures among migrants who have established themselves in their new country.
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Affiliation(s)
- J Brännström
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - A Sönnerborg
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.,Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - V Svedhem
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - U Neogi
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - G Marrone
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
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Carlander C, Marrone G, Brännström J, Yilmaz A, Elfgren K, Sparén P, Sönnerborg A. Assessing cervical intraepithelial neoplasia as an indicator disease for HIV in a low endemic setting: a population-based register study. BJOG 2017; 124:1680-1687. [PMID: 28235246 DOI: 10.1111/1471-0528.14614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 02/20/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To analyse whether the prevalence of undiagnosed HIV among (1) all women in Sweden and (2) migrant women, diagnosed with cervical intraepithelial neoplasia grade 2 or worse CIN2+ reaches the threshold of 0.1%, which has been suggested to be cost-effective for HIV testing. DESIGN Population-based register study. SETTING Counties of Stockholm and Gothenburg, Sweden, 1990-2014. POPULATION All women, born between 1940 and 1990, with at least one cervical cytology or histology registered in the Swedish National Cervical Screening Register (NKCx). METHODS Data were collected from the NKCx and the Swedish National HIV register. The proportion of women with undiagnosed HIV among women with CIN2+ compared with women with a normal/mildly abnormal cytology/histology was assessed. MAIN OUTCOME MEASURES Proportion of women with undiagnosed HIV. RESULTS The proportion of undiagnosed HIV was higher among all women with CIN2+ than among those without CIN2+ : 0.06% (95% CI 0.04-0.08) versus 0.04% (95% CI 0.04-0.04); P = 0.017). Among migrant women, the proportion of undiagnosed HIV was higher among those with CIN2+ than among those without [0.30% (95% CI 0.20-0.43) versus 0.08% (95% CI 0.07-0.10); P < 0.001] and exceeded 0.1%, suggesting the cost-effectiveness of HIV testing. Women with undiagnosed HIV at the time of CIN2+ had a significantly lower nadir CD4+ T-cell count, as a measure of immunosuppression, compared with women without CIN2+ before HIV diagnosis (median nadir CD4, 95 cells/mm3 versus 210 cells/mm3 ; P < 0.01). CONCLUSIONS HIV testing should be performed in migrant women with unknown HIV status diagnosed with CIN2+ . TWEETABLE ABSTRACT HIV testing should be performed in migrant women with unknown HIV status diagnosed with CIN2+ .
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Affiliation(s)
- C Carlander
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.,Centre for Clinical Research, Västmanland County Hospital, Västerås, Sweden
| | - G Marrone
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - J Brännström
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - A Yilmaz
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - K Elfgren
- CLINTEC, Department of Obstetrics and Gynaecology, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - P Sparén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - A Sönnerborg
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.,Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
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Brännström J, Svedhem Johansson V, Marrone G, Wendahl S, Yilmaz A, Blaxhult A, Sönnerborg A. Deficiencies in the health care system contribute to a high rate of late HIV diagnosis in Sweden. HIV Med 2015; 17:425-35. [PMID: 26559921 DOI: 10.1111/hiv.12321] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the study was to identify factors in HIV-infected patients and the health care system which contribute to late diagnosis. METHODS All patients who were newly diagnosed with HIV infection at 12 clinics in Sweden over a period of 2.5 years (n = 575) were included in the study, corresponding to three-quarters of newly diagnosed HIV infections in the country. The patients were classified as non-late presenters or late presenters (LPs), defined as those with a CD4 count < 350 cells/μL or AIDS. LPs were subdivided into those without and those with advanced HIV disease, which was defined as a CD4 count < 200 cells/μL or AIDS. Demographics, missed AIDS and HIV-associated symptoms in the preceding 3 years, immigration date, and health examination at immigration were recorded. RESULTS Fifty-eight per cent of the patients were LPs, of whom 66% had advanced disease. Age > 30 years, origin in sub-Saharan Africa or Eastern Europe/Asia/the Pacific region, and country of transmission being in sub-Saharan Africa or unknown were associated with late presentation. Half of the patients of non-Swedish origin had lived for more than 1 year in Sweden at diagnosis and 66% had a missed HIV testing opportunity at immigration. Twenty-seven per cent of all patients had presented for health care with AIDS- and/or HIV-associated conditions without having an HIV test. Sixteen per cent had a history of symptoms without seeking care. CONCLUSIONS Deficiencies in the health care system with missed HIV testing opportunities contribute to the high proportion of late presenters in Sweden, especially among migrants. With increased testing at immigration and further incorporation of "indicator-guided" testing in general practice, most patients could be diagnosed earlier.
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Affiliation(s)
- J Brännström
- Unit of Infectious Diseases, Department of Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - V Svedhem Johansson
- Unit of Infectious Diseases, Department of Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - G Marrone
- Unit of Infectious Diseases, Department of Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - S Wendahl
- Department of Infectious Diseases, Sunderbyn Hospital, Luleå, Sweden
| | - A Yilmaz
- Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden
| | - A Blaxhult
- Department of Clinical Science and Education, Venhälsan, South General Hospital, Stockholm, Sweden
| | - A Sönnerborg
- Unit of Infectious Diseases, Department of Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.,Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
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Lyberg-Åhlander V, Haake M, Brännström J, Schötz S, Sahlén B. Does the speaker's voice quality influence children's performance on a language comprehension test? Int J Speech Lang Pathol 2015; 17:63-73. [PMID: 24725074 DOI: 10.3109/17549507.2014.898098] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
PURPOSE A small number of studies have explored children's perception of speakers' voice quality and its possible influence on language comprehension. The aim of this explorative study was to investigate the relationship between the examiner's voice quality, the child's performance on a digital version of a language comprehension test, the Test for Reception of Grammar (TROG-2), and two measures of cognitive functioning. METHOD The participants were (n = 86) mainstreamed 8-year old children with typical language development. Two groups of children (n = 41/45) were presented with the TROG-2 through recordings of one female speaker: one group was presented with a typical voice and the other with a simulated dysphonic voice. RESULT Significant associations were found between executive functioning and language comprehension. The results also showed that children listening to the dysphonic voice achieved significantly lower scores for more difficult sentences ("the man but not the horse jumps") and used more self-corrections on simpler sentences ("the girl is sitting"). CONCLUSION Findings suggest that a dysphonic speaker's voice may force the child to allocate capacity to the processing of the voice signal at the expense of comprehension. The findings have implications for clinical and research settings where standardized language tests are used.
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Affiliation(s)
- Viveka Lyberg-Åhlander
- Logopedics, Phoniatrics and Audiology, Clinical Sciences, Lund University , Lund , Sweden
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Olsen US, Lello E, Nagaraj VS, Reimer Å, Ibertsson T, Brännström J. Factors affecting severity of tinnitus - a follow-up study of tinnitus subjects at an Ear Nose Throat clinic in Sweden. Int Tinnitus J 2013; 18:115-21. [PMID: 25773102 DOI: 10.5935/0946-5448.20130013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of the present study was to examine whether perceived tinnitus severity changes over time, and if so what factors contribute to this change. DESIGN A modified Swedish version of tinnitus severity questionnaire (MS-TSQ) was used to examine changes in tinnitus severity over a period of time. STUDY SAMPLE The MS-TSQ questionnaire was completed by 455 subjects visiting an Ear, Nose and Throat (ENT) clinic in Sweden as part of baseline assessment (Sb). The same questionnaire was completed during follow-up assessment (Sf) by 174 of these subjects to examine changes in tinnitus severity, if any. The difference in scores obtained from the two assessments was calculated and was termed as difference scores (Sd). RESULTS RESULTS of analyses of variance (ANOVA) indicated significant reduction in tinnitus severity from Sb to Sf scores (p < 0.001). Subjects with noise induced hearing loss showed significantly lower Sd scores than subjects with unspecified sensorineural hearing loss (p < 0.01). The group who received psychological treatment for tinnitus obtained significantly higher Sd than those who did not (p < 0.01). CONCLUSIONS RESULTS provide valuable framework for understanding the factors that affect tinnitus severity over a period of time.
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Brännström J, Svedhem V, Yilmaz A, Blaxhult A, Wendahl S, Sönnerborg A. A high occurrence of late presenters and missed HIV diagnosis in clinical care in Sweden. J Int AIDS Soc 2010. [PMCID: PMC3112948 DOI: 10.1186/1758-2652-13-s4-p169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Brännström J, Akerlund B, Arneborn M, Blaxhult A, Giesecke J. Patients unaware of their HIV infection until AIDS diagnosis in Sweden 1996-2002--a remaining problem in the highly active antiretroviral therapy era. Int J STD AIDS 2005; 16:702-6. [PMID: 16212720 DOI: 10.1258/095646205774357262] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Our objective was to analyse the characteristics of patients who were unaware of their HIV infection until they developed AIDS, in the period after introduction of highly active antiretroviral therapy. The complete national register of HIV and AIDS cases reported to the Department of Epidemiology at the Swedish Institute for Infectious Disease Control 1996-2002 was searched for cases diagnosed with HIV less than three months before AIDS diagnosis (so-called "late testers"). Of a total of 487 patients with AIDS, reported during the seven-year period, 219 (45%) were late testers. Their proportion of all AIDS cases increased from 22% in 1996 to 58% in 2002. Heterosexual route of transmission, age greater than 40 years, and foreign origin were all significant risk factors for being a late tester. Intravenous drug users were associated with a highly significant reduced risk. The group without previously known HIV infection represents an increasing part of all cases of AIDS. From a disease control and from a medical perspective, it is important to study this group further and discover what measures are needed for earlier identification and access to medical care.
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Affiliation(s)
- J Brännström
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
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Abstract
BACKGROUND Helicobacter pylori, which causes gastritis and peptic ulcer, seems to be an important factor in the pathogenesis of gastric cancer and MALT lymphoma. Thus our aim was to examine whether H. pylori influences DNA synthesis in epithelial cells in vitro. METHODS Sonicated and water extracts of H. pylori (cytotoxic strains NCTC 11637, 88-23 and A5, and a noncytotoxic isogenic mutant of A5, A5 vac A) were diluted to a final concentration of 1/1,000, 1/100, 1/50 and 1/10. Water extracts of Escherichia coli were used as reference. IEC-6 cells were incubated during 24 h with fragments of H. pylori or extracts of the concentrations described above. The cells were labeled with 3H-methylthymidine for 4 h and processed for autoradiography. DNA synthesis was evaluated by the labeling index (LI). RESULTS The LI% of controls was 15.6 +/- 5.1%. All the water extracts and sonicated strains of H. pylori increased the LI% in a dose-dependent manner (p < 0.001). The highest concentrations of the sonicated strains tended to reduce the LI%, although these values were still higher than those of the control group. The water extracts of E. coli increased the LI% in a dose-dependent manner (p < 0.0001). CONCLUSION H. pylori stimulates DNA synthesis in epithelial cells in vitro, but no association was found with the presence of cytotoxin production. Our results suggest that hitherto unknown components of H. pylori may contribute to the increase in cell proliferation observed in gastritis and to the development of MALT lymphoma and gastric cancer.
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Affiliation(s)
- J Brännström
- Department of Medicine, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden
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