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Vikhareva O, Nedopekina E, Sjöström K. Anxiety reduction through obstetric consultation combined with Ultrasound Examination in women after Cesarean section. Journal of Affective Disorders Reports 2022. [DOI: 10.1016/j.jadr.2022.100342] [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: 11/16/2022] Open
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Fernlund A, Jokubkiene L, Sladkevicius P, Valentin L, Sjöström K. Psychological impact of early miscarriage and client satisfaction with treatment: comparison between expectant management and misoprostol treatment in a randomized controlled trial. Ultrasound Obstet Gynecol 2021; 58:757-765. [PMID: 33798287 DOI: 10.1002/uog.23641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/14/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To compare the short- and long-term emotional distress (grief, anxiety and depressive symptoms) after early miscarriage and satisfaction with treatment between women randomized to expectant management vs vaginal misoprostol treatment. METHODS This was a preplanned analysis of data collected during a randomized controlled trial comparing expectant management with misoprostol treatment in women with early anembryonic or embryonic miscarriage and vaginal bleeding. If the miscarriage was not complete on day 31 after inclusion, surgical evacuation was recommended. The main outcomes were levels of anxiety and grief, depressive symptoms and client satisfaction with the treatment, which were assessed using the following validated psychometric self-assessment instruments: Spielberger State-Trait Anxiety Inventory (STAI, Form Y), Perinatal Grief Scale (PGS), Montgomery-Åsberg Depression Rating Scale (MADRS-S; self-reported version) and Client Satisfaction Questionnaire (CSQ-8). All women were assessed at four timepoints: on the day of randomization, on the day when the miscarriage was judged to be complete, and at 3 months and 14 months after complete miscarriage. The psychometric and client satisfaction scores were compared between the misoprostol group and the expectant-management group at each assessment. Analysis was performed by the intention-to-treat principle. RESULTS Ninety women were randomized to expectant management and 94 to misoprostol treatment. The psychometric and client satisfaction scores were similar in the two treatment groups at all assessment timepoints. At inclusion, 41% (35/86) of the women managed expectantly and 37% (34/92) of those treated with misoprostol had a STAI-state score of > 46 ('high level of anxiety'), and 9% (8/86) and 10% (9/91), respectively, had symptoms of moderate or severe depression (MADRS-S score ≥ 20). In both treatment groups, symptom scores for anxiety and depression were significantly higher at inclusion than after treatment and remained low until 14 months after complete miscarriage. Grief reactions were mild in both groups, with a median PGS score of 40.0 at 3 months and 37.0 at 14 months after complete miscarriage in both treatment groups. Four women treated with misoprostol and two women managed expectantly had a PGS score of > 90 (indicating deep grief) 3 months after complete miscarriage, while one woman managed expectantly had a PGS score of > 90 14 months after complete miscarriage. Women in both treatment groups were satisfied with their management, as indicated by a median CSQ-8 score of > 25 at each assessment. More than 85% of participants in each of the two groups reported that they would recommend the treatment they received to a friend. CONCLUSIONS The psychological response to and recovery after early miscarriage did not differ between women treated with misoprostol and those managed expectantly. Satisfaction with treatment was high in both treatment groups. Our findings support patient involvement when deciding on the management of early miscarriage. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- A Fernlund
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - L Jokubkiene
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - P Sladkevicius
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - L Valentin
- Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - K Sjöström
- Department of Care Sciences, Malmö University, Malmö, Sweden
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Duval J, Fourichon C, Madouasse A, Sjöström K, Emanuelson U, Bareille N. A participatory approach to design monitoring indicators of production diseases in organic dairy farms. Prev Vet Med 2016; 128:12-22. [DOI: 10.1016/j.prevetmed.2016.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 03/30/2016] [Accepted: 04/01/2016] [Indexed: 11/27/2022]
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Remröd C, Sjöström K, Svensson A. Psychological differences between early- and late-onset psoriasis: a study of personality traits, anxiety and depression in psoriasis. Br J Dermatol 2014; 169:344-50. [PMID: 23565588 DOI: 10.1111/bjd.12371] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [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: 04/01/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND Onset of psoriasis may occur at any age. Early negative experiences often influence personality development, and may lead to physical disease, anxiety and depression in adulthood. Knowledge about onset of psoriasis and psychopathology is limited. OBJECTIVES To examine whether patients with early-onset psoriasis differ psychologically from patients with late-onset psoriasis, regarding personality traits, anxiety and depression. METHODS A descriptive cross-sectional study was conducted among 101 consecutively recruited outpatients with psoriasis. A psychosocial interview was performed followed by self-assessment of validated questionnaires: Swedish Universities Scales of Personality (SSP), Spielberger State-Trait Anxiety Inventory and Beck Depression Inventory. Psoriasis severity was assessed by the Psoriasis Area and Severity Index. RESULTS Patients with early-onset psoriasis (age < 20 years) were significantly more anxious and depressed than patients with late-onset psoriasis. In multiple linear regression models, younger age at onset of psoriasis was a significant determinant of higher scores of four personality traits: SSP-embitterment, -trait irritability, -mistrust and -verbal trait aggression. CONCLUSIONS Our results indicate that early detection of psychological vulnerability when treating children and adolescents with psoriasis seems to be of great importance. Traits of psychological vulnerability and pessimistic personality traits were found to be significantly associated with the early onset of psoriasis, but not with disease duration in this study. These traits may be seen as a consequence of psoriasis, and/or as individual traits modulating and impairing clinical course and efforts to cope with psoriasis.
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Affiliation(s)
- C Remröd
- Department of Dermatology, University of Lund, Malmö, Sweden.
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Hellsten C, Sjöström K, Lindqvist P. A longitudinal 2-year follow-up of quality of life in women referred for colposcopy after an abnormal cervical smear. Eur J Obstet Gynecol Reprod Biol 2009; 147:221-5. [DOI: 10.1016/j.ejogrb.2009.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Revised: 06/20/2009] [Accepted: 09/07/2009] [Indexed: 11/25/2022]
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Hellsten C, Sjöström K, Lindqvist PG. A 2-year follow-up study of anxiety and depression in women referred for colposcopy after an abnormal cervical smear. BJOG 2008; 115:212-8. [PMID: 18081601 DOI: 10.1111/j.1471-0528.2007.01609.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to determine if there were any long-lasting elevated anxiety levels in women attending colposcopy after an abnormal cervical smear. DESIGN Prospective study. SETTING Department of Obstetrics and Gynaecology, Malmö University Hospital, Sweden. POPULATION One hundred consecutive women were invited to participate when referred for colposcopy. METHODS Women in the study group completed the State-Trait Anxiety Inventory, the Montgomery-Asberg Depression Rating Scale-self-rate (MADRS-S) and had a psychosocial interview prior to colposcopy at their two follow-up visits. MAIN OUTCOME MEASURES State anxiety levels and depression scores at first visit, 6 months and 2 years. RESULTS At follow up, levels of state anxiety and the depression scores of the women studied had decreased and were comparable to those of Swedish normative data. Two variables from the MADRS-S, 'ability to focus on different activities' and 'emotional involvement with others and in activities' were the most prominent for women with moderate to severe depression. At the 2-year visit, 30% of the women still had a fear of cancer. CONCLUSIONS Referral for colposcopy after an abnormal cervical smear does not seem to result in long-lasting anxiety and depression. However, a subgroup of women, with the initially highest depression scores, still had at 2-year state anxiety levels and depression scores significantly higher than normal. Almost one-third of the women still had a fear of cancer in spite of lower 2-year state anxiety levels.
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Affiliation(s)
- C Hellsten
- Department of Obstetrics and Gynaecology, Malmö University Hospital, Lund University, Malmö, Sweden.
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Abstract
OBJECTIVE To elucidate psychosexual problems in women referred for colposcopy after an abnormal cervical smear and a 6-month and 2-year follow up. DESIGN Prospective study. SETTING Department of Gynaecology, Malmö University Hospital, Sweden. POPULATION One hundred consecutive women referred for colposcopy for the first time subsequent to receiving notification of an abnormal cervical smear. METHODS The women completed the State-Trait Anxiety Inventory, a psychosexual questionnaire and had one psychosocial interview prior to colposcopy at all three visits. MAIN OUTCOME MEASURES Depending upon the result of the cervical biopsy, women had either a loop electrosurgical excision procedure (LEEP) or not. Psychosexual variables, anxiety measures, and psychosocial variables were used to estimate sexual functioning at the beginning of the study and at follow up. Differences in sexual functioning between LEEP and non-LEEP groups were estimated. RESULTS 'Spontaneous interest in sex', 'frequency of intercourse', and 'sexual arousal' were reported to be statistically significant lower at 6 months compared with the first visit, and at 2 years, 'spontaneous interest in sex' and 'frequency of intercourse' still remained low. There was no difference in sexual functioning between the LEEP and non-LEEP groups at follow up. CONCLUSIONS Two years after referral for colposcopy, women still had an effect on sexual functioning, that is, lesser 'spontaneous interest' and decreased 'frequency of intercourse'. We found no support for a relationship between treatment of cervical intraepithelial neoplasia by LEEP and deterioration in sexual functioning.
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Affiliation(s)
- C Hellsten
- Department of Obstetrics and Gynaecology, Clinical Science, Malmö University Hospital, Lund University, Malmö, Sweden.
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Lindeberg S, Jönsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjöström K, Ahrén B. A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia 2007; 50:1795-1807. [PMID: 17583796 DOI: 10.1007/s00125-007-0716-y] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.8] [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] [Received: 05/01/2007] [Accepted: 05/04/2007] [Indexed: 11/28/2022]
Abstract
AIMS/HYPOTHESIS Most studies of diet in glucose intolerance and type 2 diabetes have focused on intakes of fat, carbohydrate, fibre, fruits and vegetables. Instead, we aimed to compare diets that were available during human evolution with more recently introduced ones. METHODS Twenty-nine patients with ischaemic heart disease plus either glucose intolerance or type 2 diabetes were randomised to receive (1) a Palaeolithic ('Old Stone Age') diet (n = 14), based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts; or (2) a Consensus (Mediterranean-like) diet (n = 15), based on whole grains, low-fat dairy products, vegetables, fruits, fish, oils and margarines. Primary outcome variables were changes in weight, waist circumference and plasma glucose AUC (AUC Glucose(0-120)) and plasma insulin AUC (AUC Insulin(0-120)) in OGTTs. RESULTS Over 12 weeks, there was a 26% decrease of AUC Glucose(0-120) (p = 0.0001) in the Palaeolithic group and a 7% decrease (p = 0.08) in the Consensus group. The larger (p = 0.001) improvement in the Palaeolithic group was independent (p = 0.0008) of change in waist circumference (-5.6 cm in the Palaeolithic group, -2.9 cm in the Consensus group; p = 0.03). In the study population as a whole, there was no relationship between change in AUC Glucose(0-120) and changes in weight (r = -0.06, p = 0.9) or waist circumference (r = 0.01, p = 1.0). There was a tendency for a larger decrease of AUC Insulin(0-120) in the Palaeolithic group, but because of the strong association between change in AUC Insulin(0-120) and change in waist circumference (r = 0.64, p = 0.0003), this did not remain after multivariate analysis. CONCLUSIONS/INTERPRETATION A Palaeolithic diet may improve glucose tolerance independently of decreased waist circumference.
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Affiliation(s)
- S Lindeberg
- Department of Medicine, Hs 32, University of Lund, SE-221 85, Lund, Sweden.
| | - T Jönsson
- Department of Medicine, Hs 32, University of Lund, SE-221 85, Lund, Sweden
| | - Y Granfeldt
- Department of Applied Nutrition and Food Chemistry, University of Lund, Lund, Sweden
| | - E Borgstrand
- Department of Medicine, Hs 32, University of Lund, SE-221 85, Lund, Sweden
| | - J Soffman
- Department of Medicine, Hs 32, University of Lund, SE-221 85, Lund, Sweden
| | - K Sjöström
- Department of Medicine, Hs 32, University of Lund, SE-221 85, Lund, Sweden
| | - B Ahrén
- Department of Medicine, Hs 32, University of Lund, SE-221 85, Lund, Sweden
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Sjöström K, Blomberg C, Fernebro J, Dagerhamn J, Morfeldt E, Barocchi MA, Browall S, Moschioni M, Andersson M, Henriques F, Albiger B, Rappuoli R, Normark S, Henriques-Normark B. Clonal success of piliated penicillin nonsusceptible pneumococci. Proc Natl Acad Sci U S A 2007; 104:12907-12. [PMID: 17644611 PMCID: PMC1929012 DOI: 10.1073/pnas.0705589104] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [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] Open
Abstract
Antibiotic resistance in pneumococci is due to the spread of strains belonging to a limited number of clones. The Spain(9V)-3 clone of sequence type (ST)156 is one of the most successful clones with reduced susceptibility to penicillin [pneumococci nonsusceptible to penicillin (PNSP)]. In Sweden during 2000-2003, a dramatic increase in the number of PNSP isolates was observed. Molecular characterization of these isolates showed that a single clone of sequence type ST156 increased from 40% to 80% of all serotype 14, thus causing the serotype expansion. Additionally, during the same time period, we examined the clonal composition of two serotypes 9V and 19F: all 9V and 20% of 19F isolates belonged to the clonal cluster of ST156, and overall approximately 50% of all PNSP belonged to the ST156 clonal cluster. Moreover, microarray and PCR analysis showed that all ST156 isolates, irrespective of capsular type, carried the rlrA pilus islet. This islet was also found to be present in the penicillin-sensitive ST162 clone, which is believed to be the drug-susceptible ancestor of ST156. Competitive experiments between related ST156 serotype 19F strains confirmed that those containing the rlrA pilus islet were more successful in an animal model of carriage. We conclude that the pilus island is an important biological factor common to ST156 isolates and other successful PNSP clones. In Sweden, a country where the low antibiotic usage does not explain the spread of resistant strains, at least 70% of all PNSP isolates collected during year 2003 carried the pilus islet.
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Affiliation(s)
- K. Sjöström
- *Department of Bacteriology, Swedish Institute for Infectious Disease Control, SE-171 82 Solna, Sweden
- Department of Microbiology, Tumor Biology, and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - C. Blomberg
- *Department of Bacteriology, Swedish Institute for Infectious Disease Control, SE-171 82 Solna, Sweden
- Department of Microbiology, Tumor Biology, and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - J. Fernebro
- *Department of Bacteriology, Swedish Institute for Infectious Disease Control, SE-171 82 Solna, Sweden
- Department of Microbiology, Tumor Biology, and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - J. Dagerhamn
- *Department of Bacteriology, Swedish Institute for Infectious Disease Control, SE-171 82 Solna, Sweden
- Department of Microbiology, Tumor Biology, and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - E. Morfeldt
- *Department of Bacteriology, Swedish Institute for Infectious Disease Control, SE-171 82 Solna, Sweden
| | | | - S. Browall
- *Department of Bacteriology, Swedish Institute for Infectious Disease Control, SE-171 82 Solna, Sweden
| | | | - M. Andersson
- *Department of Bacteriology, Swedish Institute for Infectious Disease Control, SE-171 82 Solna, Sweden
| | - F. Henriques
- *Department of Bacteriology, Swedish Institute for Infectious Disease Control, SE-171 82 Solna, Sweden
| | - B. Albiger
- Department of Microbiology, Tumor Biology, and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
- Department of Clinical Microbiology, Lund University, SE-221 00 Malmö, Sweden
| | - Rino Rappuoli
- Novartis Vaccines, 53100 Siena, Italy; and
- To whom correspondence may be addressed. E-mail: or
| | - S. Normark
- *Department of Bacteriology, Swedish Institute for Infectious Disease Control, SE-171 82 Solna, Sweden
- Department of Microbiology, Tumor Biology, and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - B. Henriques-Normark
- *Department of Bacteriology, Swedish Institute for Infectious Disease Control, SE-171 82 Solna, Sweden
- Department of Microbiology, Tumor Biology, and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
- To whom correspondence may be addressed. E-mail: or
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Abstract
OBJECTIVES To elucidate risk factors for high state anxiety in women referred for colposcopy. DESIGN Prospective cohort study. SETTING Department of Gynaecology, Malmö University Hospital, Sweden. POPULATION A total of 100 consecutive women referred for colposcopy for the first time after an abnormal cervical smear. METHODS Women in the study group completed prior to colposcopy the State-Trait Anxiety Inventory, the Montgomery-Asberg Depression Rating Scale-self-rate, and were interviewed about their psychosocial situation. MAIN OUTCOME MEASURES Variables related to high state anxiety were determined in bivariate and multiple logistic regression analysis. RESULTS High depression scores and the wording of the referral letter for colposcopy were related to high state anxiety in a multivariate analysis. Women with high depression scores had a nine-fold risk for higher levels of state anxiety and did not respond with lower state anxiety levels after information and examination. Women who received a letter stating 'some changes' were at a five-fold increased risk for high levels of state anxiety than those who received a letter stating 'light changes'. CONCLUSION A depressive mood and the wording of the referral letter for colposcopy after an abnormal smear were predictive of high state anxiety levels.
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Affiliation(s)
- C Hellsten
- Department of Obstetrics and Gynaecology, Malmö University Hospital, Lund University, Malmö, Sweden.
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Sjöström K, Spindler C, Ortqvist A, Kalin M, Sandgren A, Kühlmann-Berenzon S, Henriques-Normark B. Clonal and Capsular Types Decide Whether Pneumococci Will Act as a Primary or Opportunistic Pathogen. Clin Infect Dis 2006; 42:451-9. [PMID: 16421787 DOI: 10.1086/499242] [Citation(s) in RCA: 182] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2005] [Accepted: 09/08/2005] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide. The role of the different capsular and clonal types in invasive disease severity remains to be defined. METHODS Disease severity and disease type were correlated to age, underlying disease, capsular serotype, and clonal type of the causative agent for 494 adult patients with invasive pneumococcal disease. RESULTS Pneumococcal isolates of serotypes 1 and 7F were genetically homogenous, had the highest potential to infect previously healthy individuals, and were not causing deaths. Also, type 1 isolates were only found among younger adults, whereas other serotypes were mainly found among elderly persons (e.g., type 23F). Some serotypes and/or clones were more prone to cause more-severe disease, as observed by high APACHE II scores calculated at admission, and were also associated with a high mortality (e.g., clones of type 3 and 11A). We found no evidence of an impact of penicillin resistance on disease severity and disease type. CONCLUSIONS We suggest that clones with capsular types 1 and 7F, which are known to have a high invasive disease potential, behave as primary pathogens, whereas clones with other capsular types with a lower relative risk of causing invasive disease are more opportunistic, primarily affecting patients with underlying disease. Disease caused by the latter group, however, was more severe, even in previously healthy individuals.
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Affiliation(s)
- K Sjöström
- Department of Bacteriology, Swedish Institute for Infectious Disease Control, Karolinska University Hospital, Solna, Sweden
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Ponjavic V, Eksandh L, Andréasson S, Sjöström K, Bakall B, Ingvast S, Wadelius C, Ehinger B. Clinical expression of Best's vitelliform macular dystrophy in Swedish families with mutations in the bestrophin gene. Ophthalmic Genet 1999; 20:251-7. [PMID: 10617923 DOI: 10.1076/opge.20.4.251.2270] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [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: 11/03/2022]
Abstract
OBJECTIVE To examine the clinical phenotype of three Swedish families with Best's vitelliform macular dystrophy (BMD) and three different mutations in the recently identified bestrophin gene. METHODS Three families, including 13 patients, were examined clinically using visual acuity testing, electro-oculography, fundus inspection, and fundus photography. The mutations were previously determined by direct sequence analysis of the individual exons in the bestrophin gene. RESULTS The largest family (SL76), with the Y85K (T357C) mutation in the bestrophin gene, demonstrated a clinical phenotype characterized by a variable degree of visual acuity reduction and a marked intrafamilial variability in macular pathology. The electro-oculograms, however, demonstrated similar results in all patients regardless of the severity of the macular dysfunction. The smallest family (SL3), with the mutation V9A (T130C) in the bestrophin gene, and the family (SL2) with the mutation D104E (C416A) demonstrated a similar clinical phenotype. The majority of patients (11/13 examined subjects) had a binocular visual acuity of 20/63 or better at a late stage of the disease course, indicating a relatively good prognosis for visual acuity in this specific phenotype. The ophthalmoscopic changes were followed in one of the patients for 38 years and in three of the patients for 19 years and showed that the macular appearance seems to be stable after adolescence. CONCLUSIONS Patients with BMD and mutations in the bestrophin gene have a similar clinical phenotype characterized by a variable, but relatively moderate visual acuity reduction, atrophic changes in the macula, and pathological results of the electro-oculograms. The macular appearance remains essentially unchanged through the atrophic stage (stage IV) in the majority of patients, indicating a stationary disease course associated with this specific genotype.
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Affiliation(s)
- V Ponjavic
- Department of Ophthalmology, University Hospital, Lund, Sweden.
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Abstract
The aim of this study was to determine whether the frequency and quality of reported life events during the 6 months before pregnancy to mid-pregnancy influence gestational age at birth. Seventy nulliparous women were studied at 12 and 25 gestational weeks with a 64-item self-rated life event questionnaire developed for obstetric groups. Life events were categorised into eight psychosocial areas according to the diagnostic and statistic manual (DSM-III-R). The women rated each experienced event as strainful or not strainful. Gestational age was determined by ultrasound biometry before 20 gestational weeks. The number of life events during the following periods was recorded from 6 months before pregnancy to 12 gestational weeks, from 12 gestational weeks to 25 gestational weeks, from 6 months before pregnancy to 25 gestational weeks. No significant relationships were found between the number of reported life events and pregnancy duration. Life events in different psychosocial areas also did not influence gestational age at birth. A non-significant relationship (p = 0.06) was found between pregnancy duration and the number of strainful events reported from 6 months before pregnancy to 25 gestational weeks, shorter pregnancy duration being found in women reporting many strainful events. Our findings suggest that life events in general do not influence pregnancy duration. However, if they are perceived as strainful, pregnancy length tends to decrease.
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Affiliation(s)
- K Sjöström
- Department of Psychiatry, University of Lund, Malmö University Hospital, Sweden
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Abstract
The consequences of falls among hospital patients are a great problem, for the patient, the family and society, and cost billions of dollars. In Sweden, almost one-third of all hip fractures occur in the hospital population. Despite this, very few prevention strategies have been developed and tested. In this study, a risk assessment and recording programme in relation to the risk of falling among patients in a geriatric department at a Swedish hospital was implemented. The records of all patients admitted to a geriatric unit during one year, and a stratified random sample of patient records, constituting the control group from the year before, were reviewed. No recording of assessments regarding the patients' risk of falling, and no preventive nursing interventions, were found in the records of the control group. The study group, however, increased the recording of risk assessment to 96%. Only implemented nursing interventions were found in the patients' records, despite the fact that Swedish law makes it obligatory for the registered nurse to record both the planning and implementation of nursing care. In the study group there were explicit descriptions of problems of concern for nursing regarding the patients' risk of falling in less than one-third of the records, the nursing care plans were rare, and the evaluations were not satisfactory. Nursing interventions consisted mostly of information or education, promotion of patient participation, and structuring of the environment. There was no agreement on any standard-care plan. Recording of falls was found more often in the study group than in the control group (probably due to more careful recording), but the proportion of injuries in relation to falls was higher in the control group. The results of this study may be used as a baseline for developing a nursing strategy and documentation relating to falls.
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Affiliation(s)
- G Udén
- Centre of Caring Sciences, Lund University, Sweden
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Abstract
The aim of this study was to investigate if fetal circulation is affected by maternal anxiety. 37 nulliparous women were studied prospectively in the third trimester of pregnancy, with self-rate tests of anxiety (STAI). Doppler ultrasound examination of the umbilical artery and fetal middle cerebral artery was performed at 37-40 gestational weeks. The pulsatility index (PI) was calculated and corrected for heart rate. The women were divided into groups of increasing levels of anxiety. The fetuses of women with high trait anxiety scores had significantly higher PI values in the umbilical artery (p = 0.0056), significantly lower PI values in the fetal middle cerebral artery (p = 0.0029) and significantly lower cerebro-umbilical PI ratios (p = 0.0002), suggesting a change in blood distribution in favor of brain circulation in the fetuses. Maternal weight, weight-increase, height, age, marital status, smoking habits, drinking habits and socio-economic factors known to affect fetal well-being did not interfere with these findings. No significant differences in birth-weight, length and head circumference were found between infants born to mothers with higher trait anxiety levels compared to mothers with lower trait anxiety levels. Our results suggest that maternal stress, in terms of trait anxiety, influences fetal cerebral circulation.
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Affiliation(s)
- K Sjöström
- Department of Psychiatry, University of Lund, Malmö University Hospital, Sweden
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Abstract
Evidence that history of obstetric complications (OCs) may contribute to the development of schizophrenia has generated renewed focus on characteristics of mothers of preschizophrenics. We studied the relationship between increased history of obstetric complications (OCs) and maternal age, parity, and social class in 70 Research Diagnosis Criteria schizophrenic patients vs 70 demographically matched controls. The sample has previously been studied concerning OC rates in schizophrenic patients, their relationship to other presumptive etiological factors, as well as head circumference at birth. Parity was the only maternal characteristic significantly associated with increased OCs in mothers of preschizophrenics. As compared with nulliparous control mothers, nulliparous mothers of preschizophrenics had significantly increased rates of total OCs and labour/delivery complications, while primi- and multiparous mothers of preschizophrenics (vs parity-matched control mothers) did not have increased rates of OCs. Abnormal labour length was significantly increased in the nulliparous mothers of preschizophrenics. Previous findings of significantly reduced head circumference at birth in preschizophrenic neonates vs controls were reconfirmed selectively in the nulliparous group.
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Affiliation(s)
- E Cantor-Graae
- Department of Psychiatry, University of Lund, Malmö, Sweden
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17
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Kernell A, Dedorsson I, Johansson B, Wickström CP, Ludvigsson J, Tuvemo T, Neiderud J, Sjöström K, Malmgren K, Kanulf P, Mellvig L, Gjötterberg M, Sule J, Persson LA, Larsson LI, Aman J, Dahlquist G. Prevalence of diabetic retinopathy in children and adolescents with IDDM. A population-based multicentre study. Diabetologia 1997; 40:307-10. [PMID: 9084969 DOI: 10.1007/s001250050679] [Citation(s) in RCA: 57] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Vision-threatening diabetic retinopathy can be prevented if it is diagnosed before becoming too advanced. Since diabetic retinopathy has been reported to occur only rarely before the end of pubertal development, children and adolescents are seldom included in screening programmes. We invited 780 children and adolescents with insulin-dependent diabetes mellitus diagnosed before the age of 15.0 years (disease duration of < 12 years) and who were older than 9.0 years at the time of examination from eight regions of Sweden. Retinal examination was performed with stereoscopic fundus photograph. The photograph were rated according to a modified Airlie House classification. The dropouts (223/780, 28.6%) were significantly older and with a longer duration of diabetes than the examined children (p < 0.001 and 0.001, respectively). Photographs from 557 patients aged (median [interquartile range]:14.6 [12.4-17.0]) years and with a diabetes duration of 8.0 (5.5-9.9) years were evaluated. Retinopathy was demonstrated in 81 patients (14.5%):66 with background retinopathy, 2 with microaneurysms and hard exudates, 12 with preproliferative retinopathy, 1 with proliferative retinopathy. Preproliferative retinopathy was diagnosed in a 12.8-year-old girl in pubertal stage 3 and an 11.8-year-old boy in pubertal stage 2, and proliferative retinopathy was found in a 21.5-year-old girl. Retinopathy was demonstrated in 6% and 18% of patients in pubertal stages 1 and 5, respectively. The overall prevalence of retinopathy in this population may even be higher since the dropouts were older and had a longer duration of diabetes. Since background and preproliferative retinopathy were found in children before puberty, we recommend including children and adolescents in screening programmes for diabetic retinopathy from the age of 10 years.
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Affiliation(s)
- A Kernell
- Department of Paediatrics, University Hospital, Linköping, Sweden
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Jönsson L, Sjöström K, Häggström I, Nyman PO. Characterization of a laccase gene from the white-rot fungus Trametes versicolor and structural features of basidiomycete laccases. Biochim Biophys Acta 1995; 1251:210-5. [PMID: 7669813 DOI: 10.1016/0167-4838(95)00104-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A gene coding for the multi-copper phenol oxidase laccase has been isolated from the white-rot basidiomycete Trametes versicolor. The gene, which is preceded by a TATA box and a pyrimidine-rich region, is predicted to contain ten introns. The mature translation product, preceded by a 22-residue signal peptide, should consist of 498 residues. Comparisons with Edman degradation data of peptides from T. versicolor laccase strongly suggest that two disulfide bridges are formed by Cys-85/Cys-487 and Cys-117/Cys-205, respectively. The encoded protein contains five Cys, and the sequence surrounding the remaining Cys-452 is consistent with its involvement in the ligation of type-1 copper. Alignment of sequences indicates that T. versicolor laccase displays a Phe at the position corresponding to a residue (Met in ascorbate oxidase and azurin) considered important for the reduction potential of type-1 copper proteins.
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Cantor-Graae E, McNeil TF, Sjöström K, Nordström LG, Rosenlund T. Obstetric complications and their relationship to other etiological risk factors in schizophrenia. A case-control study. J Nerv Ment Dis 1994; 182:645-50. [PMID: 7964673 DOI: 10.1097/00005053-199411000-00008] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The history of obstetric complications was studied in 70 Research Diagnostic Criteria schizophrenic patients and 70 demographically matched controls from the same delivery series, using information prospectively recorded at birth. Schizophrenic patients were exposed to greater numbers of obstetric complications than their matched controls. Rates of obstetric complications were enhanced in patients born during the winter months (January-April) and in patients with no family history of psychosis in first- and second-degree biological relatives. Winter birth was associated with absence of family history of psychosis. Analyses by gender indicated that the relationship between obstetric complications and these other risk factors may be more relevant for male patients. The results suggest that the seasonal effect in schizophrenia may be due partially to seasonal variation in obstetric complications and that obstetric complications and winter birth may represent a distinctively separate etiological mechanism from that of inferred genetic risk for schizophrenia.
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Affiliation(s)
- E Cantor-Graae
- Department of Psychiatry, University of Lund, Malmö General Hospital, Sweden
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20
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Abstract
The new McNeil-Sjöström Scale for obstetric complications (OCs), as well as scales of Lewis et al. (Schizophrenia: Scientific progress. Oxford University Press, 1989) and Parnas et al. (British Journal of Psychiatry, 140, 416-420, 1982), were applied to the OC histories of 70 singleton schizophrenics and 70 demographically-matched controls from the same hospital delivery series, using blindly assessed hospital pregnancy and birth record information. With the McNeil-Sjöström scale, schizophrenics were found to have significantly increased rates of OCs for the total reproduction, as well as for labor-delivery and the neonatal period but not for pregnancy. Significant increases in OCs in these schizophrenics were also found in scores produced by the Lewis et al. scale but not by the Parnas et al. scale. Further application of these three scales to OC data obtained through parental report for 23 monozygotic (MZ) twin pairs discordant and 10 pairs concordant for schizophrenia, as well as seven normal control MZ pairs, showed a significant difference in OC rates across the different twin pair groups, when assessed by the McNeil-Sjöström and Parnas et al. scales, but not by the Lewis et al. scale. The particular scoring system used in a study is thus of considerable importance not only for findings concerning OC histories of schizophrenics vs. controls, but also for the relationship between OCs and other presumed etiological factors in schizophrenia. Among the three scales, the McNeil-Sjöström scale provided the most sensitive assessment of OC history for schizophrenics.
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Affiliation(s)
- T F McNeil
- Department of Psychiatry, University of Lund, Malmö, Sweden
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Cantor-Graae E, McNeil TF, Torrey EF, Quinn P, Bowler A, Sjöström K, Rawlings R. Link between pregnancy complications and minor physical anomalies in monozygotic twins discordant for schizophrenia. Am J Psychiatry 1994; 151:1188-93. [PMID: 8037254 DOI: 10.1176/ajp.151.8.1188] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The aim of the current study was to explore the relevancy of early pregnancy complications for the development of minor physical anomalies in monozygotic twins discordant and concordant for schizophrenia. METHOD Pregnancy complications and minor physical anomalies were independently assessed in 22 discordant, 10 concordant, and six normal comparison monozygotic twin pairs. RESULTS Complications occurring during early pregnancy were associated with a higher frequency of minor physical anomalies in the total group and in the discordant twin pairs particularly. While no significant differences in anomaly rates were observed among the discordant, concordant, and normal comparison groups, the discordant ill twins showed a trend toward having more anomalies than their well co-twins. CONCLUSIONS Complications occurring early in pregnancy are relevant for the development of minor physical anomalies and may be of particular importance for the development of these anomalies in twin pairs discordant for schizophrenia.
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Cantor-Graae E, McNeil TF, Rickler KC, Sjöström K, Rawlings R, Higgins ES, Hyde TM. Are neurological abnormalities in well discordant monozygotic co-twins of schizophrenic subjects the result of perinatal trauma? Am J Psychiatry 1994; 151:1194-9. [PMID: 8037255 DOI: 10.1176/ajp.151.8.1194] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Neurological abnormalities found in schizophrenic subjects and their healthy relatives have raised questions concerning etiology. The aim of the present study was to investigate the genetic and environmental antecedents of neurological impairment in monozygotic twins discordant for schizophrenia, with particular focus on the well discordant twins. The etiological factors of interest were history of obstetric complications, family history of psychosis, history of substance abuse, and history of postnatal cerebral trauma. METHOD History of obstetric complications, including information from pregnancy through the neonatal period, and data on neurological "hard" and "soft" signs were obtained blindly and separately for each member of 22 monozygotic twin pairs discordant for schizophrenia and seven normal comparison monozygotic twin pairs. Clinical and family interviews provided information about background factors. RESULTS Degree of neurological impairment in the well discordant monozygotic twins was significantly positively related to history of both neonatal and total obstetric complications. None of the three other background factors investigated was related to degree of neurological impairment in the ill or well co-twins. CONCLUSIONS The contribution of obstetric complications to the current level of neurological impairment in well discordant co-twins suggests that the spectrum of neuroabnormality, ranging from neurological signs to schizophrenia, in monozygotic discordant twins may be the result of subtle gene-environment interaction.
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McNeil TF, Cantor-Graae E, Torrey EF, Sjöström K, Bowler A, Taylor E, Rawlings R, Higgins ES. Obstetric complications in histories of monozygotic twins discordant and concordant for schizophrenia. Acta Psychiatr Scand 1994; 89:196-204. [PMID: 8178679 DOI: 10.1111/j.1600-0447.1994.tb08092.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Histories of obstetric complications (OCs) during pregnancy, labor-delivery and the neonatal period were investigated by detailed maternal report for 23 monozygotic (MZ) twin pairs discordant for schizophrenia, 10 MZ twin pairs concordant for schizophrenia and 7 normal MZ control pairs. Statistically significant differences in OC rates were found across these 3 groups. OCs being most frequent in discordant pairs and least frequent in normal control pairs. Labor complications were significantly more frequent in discordant than concordant pairs. OC rates were equivalent in sick and well discordant twins. The results provide evidence for the role of OCs in the development of schizophrenia, complications at the time of birth being especially associated with the development of schizophrenia in discordant twins.
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Affiliation(s)
- T F McNeil
- Department of Psychiatry, Lund University, Malmõ, Sweden
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24
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Sjöström K, Ou J, Whitney C, Johnson B, Darveau R, Engel D, Page RC. Effect of treatment on titer, function, and antigen recognition of serum antibodies to Actinobacillus actinomycetemcomitans in patients with rapidly progressive periodontitis. Infect Immun 1994; 62:145-51. [PMID: 8262620 PMCID: PMC186079 DOI: 10.1128/iai.62.1.145-151.1994] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Although periodontal treatment by scaling and root planing (SCRP) is known to induce bacteremia, the effect of this procedure on the host immune response is not known. We have determined pre- and post-SCRP immunoglobulin G antibody titers to antigens of Actinobacillus actinomycetemcomitans in the sera of 22 patients with rapidly progressive periodontitis. We also assessed the ability of these sera to enhance phagocytosis and killing of A. actinomycetemcomitans by human polymorphonuclear leukocytes by using a polymorphonuclear leukocyte chemiluminescence (CL) assay. Specific anti-A. actinomycetemcomitans antibody titers were significantly increased at 6 and 12 months after beginning treatment, and CL values were significantly increased at 12 months, whereas mean interproximal pocket depths were significantly decreased at 12 months after beginning treatment. When patients were classified as either seropositive (twice the median titer of control subjects; n = 10) or seronegative (n = 12), both median titers and CL values were significantly increased for the seronegative group at 6 and 12 months after treatment. In the seropositive group, only the median titer was significantly increased at 12 months. Western blot (immunoblot) patterns for six seronegative and six seropositive patients differed remarkably at the baseline. Before treatment, all of the seropositive patients recognized high-molecular-mass lipopolysaccharide (LPS) and a large number of protein components. Patterns were virtually unaffected by therapy. Before treatment, only one of the seronegative patients recognized the LPS smear and none reacted strongly with protein components. Following treatment, slight LPS staining was observed for five of six seronegative patients and detection of protein bands was enhanced in all cases. We conclude that treatment by SCRP induces a humoral immune response, especially in seronegative patients, and that response may play a role in the observed beneficial effects of periodontal treatment.
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Affiliation(s)
- K Sjöström
- Department of Periodontics, School of Dentistry, University of Washington, Seattle 98195
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25
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Underwood K, Sjöström K, Darveau R, Lamont R, Schenkein H, Gunsolley J, Page R, Engel D. Serum antibody opsonic activity against Actinobacillus actinomycetemcomitans in human periodontal diseases. J Infect Dis 1993; 168:1436-43. [PMID: 8245527 DOI: 10.1093/infdis/168.6.1436] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Actinobacillus actinomycetemcomitans is frequently associated with severe periodontitis. Many periodontitis patients have elevated levels of serum IgG antibodies to A. actinomycetemcomitans, but the role of these antibodies is unknown. This study evaluated the functional capacity of anti-A. actinomycetemcomitans IgG antibody to enhance phagocytosis of A. actinomycetemcomitans by polymorphonuclear leukocytes. Chemoluminescence assays were done using sera from 64 subjects, 61 of whom had severe periodontitis; results were compared with the subject's anti-A. actinomycetemcomitans IgG titer and avidity. There was a strong correlation between chemoluminescence and antibody log titer (P < .00001) and a weak correlation between chemoluminescence and antibody avidity (P < .05). The results support the hypothesis that anti-A. actinomycetemcomitans IgG antibodies are important in promoting phagocytosis and killing of A. actinomycetemcomitans. Subjects who develop high levels of highly avid antibodies against A. actinomycetemcomitans may have greater resistance to continued or repeated infection by this pathogen.
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Affiliation(s)
- K Underwood
- Dept. of Periodontics, University of Washington, Seattle 98195
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26
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Sjöström K, Darveau R, Page R, Whitney C, Engel D. Opsonic antibody activity against Actinobacillus actinomycetemcomitans in patients with rapidly progressive periodontitis. Infect Immun 1992; 60:4819-25. [PMID: 1398993 PMCID: PMC258236 DOI: 10.1128/iai.60.11.4819-4825.1992] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Actinobacillus actinomycetemcomitans has been closely associated with early-onset, severe periodontitis, and such patients often have serum immunoglobulin G (IgG) antibodies reactive with antigens of this gram-negative pathogen. We examined the functionality and potential importance of these antibodies. The opsonic activity against A. actinomycetemcomitans of sera from 30 patients with rapidly progressive periodontitis (RPP) and from 28 periodontally normal subjects was tested by using polymorphonuclear leukocyte (PMN) chemiluminescence and bactericidal assays. Peak chemiluminescence values correlated strongly with killing observed in the PMN-dependent bactericidal assay (r = 0.88; P < 0.001). Neither the mean IgG titer nor the mean peak chemiluminescence differed significantly between the two groups. However, when the relationship between chemiluminescence and titer was examined, regression analysis showed that antibodies present in low-titer normal sera were significantly more effective at opsonizing A. actinomycetemcomitans than antibodies present in low-titer RPP patient sera (P = 0.04). Thus, periodontally normal individuals may be better able than RPP patients to clear A. actinomycetemcomitans in early stages of colonization, and anti-A. actinomycetemcomitans antibodies in RPP patients may be relatively ineffective in preventing infection by this organism.
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Affiliation(s)
- K Sjöström
- Department of Periodontics, School of Dentistry, University of Washington, Seattle 98195
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Vassilatos V, Taralas G, Sjöström K, Björnbom E. Catalytic cracking of tar in biomass pyrolysis gas in the presence of calcined dolomite. CAN J CHEM ENG 1992. [DOI: 10.1002/cjce.5450700524] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Kaukonen JP, Sjöström K. Bilateral one-stage total hip replacement in rheumatoid arthritis and SPA. Arch Orthop Trauma Surg (1978) 1983; 101:179-81. [PMID: 6870506 DOI: 10.1007/bf00436768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Sixteen cases of bilateral total one-stage hip replacements in patients with rheumatoid arthritis or ankylosing spondylitis are reviewed. Special reference is given to peroperative problems, complications, and indications in a hospital with on intensive care unit. The indications are discussed and the results compared with larger series published earlier in literature. One-stage procedure proves to be a proper alternative in cases with severe bilateral disease. The rate of complications is comparable to that of unilateral procedures. A marked decrease in time consumption can be achieved.
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Mathies B, Sjöström K, Raunio P. Evaluation of 350 sciatic blocks in rheumatoid foot surgery. Arch Orthop Unfallchir 1977; 87:171-5. [PMID: 843291 DOI: 10.1007/bf00415205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Sciatic block with Mepivacaine (3-4 mg/kg) revealed successful in 91.9% of 340 rheumatoid patients with Keller/Clayton operation. In unsufficient blocks (8.1%) supplementary anesthesia by femoral nerve block, reblocking the sciatic nerve or local anesthetics secondarily gave good operating conditions. In three cases it was necessary to use additional spinal anesthesia. The concomitant sympathetic block gives an immediate cessation of sweating and a long lasting evaluation of skin temperature.
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Abstract
Oral intake of amphetamine may cause the development of a schizophrenia-like paranoid psychosis (Monroe and Drell 1947, Connell 1958, Kiloh and Brandon 1962). Intravenous abuse of the drug causes more intense psychotic manifestations dominated by vivid visual and auditory hallucinations (Connell 1958, Kramer et al. 1967, Rylander 1967, Cohen 1968). In the present investigation a rating scale, was designed for the study of amphetamine psychosis in 15 intravenous abusers. A preliminary report of this work has been given earlier (Jönsson and Gunne 1969).
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