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Åkerström F, Holmström L, Topolovic M, Drca N. Wide QRS complex tachycardia: Elucidating the mechanism by atrial pacing maneuvers. Heart Rhythm 2024; 21:484-487. [PMID: 38154601 DOI: 10.1016/j.hrthm.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Affiliation(s)
- Finn Åkerström
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Lung Diseases Unit, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
| | | | - Mirko Topolovic
- Cardiology Department, Pediatric Clinic, University Medical Center, Ljubljana, Slovenia
| | - Nikola Drca
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Lung Diseases Unit, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
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Hookana I, Holmström L, Eskuri MAE, Pakanen L, Ollila MM, Kiviniemi AM, Kenttä T, Vähätalo J, Tulppo M, Lepojärvi ES, Piltonen T, Perkiömäki J, Tikkanen JT, Huikuri H, Junttila MJ. Characteristics of women with ischemic sudden cardiac death. Ann Med 2023; 55:2258911. [PMID: 37795698 PMCID: PMC10557538 DOI: 10.1080/07853890.2023.2258911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Sudden cardiac death (SCD) is a significant mode of death causing 15-20% of all deaths in high-income countries. Coronary artery disease (CAD) is the most common cause of SCD in both sexes, and SCD is often the first manifestation of underlying CAD in women. This case-control study aimed to determine the factors associated with SCD due to CAD in women. METHODS The study group consisted of women with CAD-related SCD (N = 888) derived from the Fingesture study conducted in Northern Finland from 1998 to 2017. All SCDs underwent medicolegal autopsy. The control group consisted of women with angiographically verified CAD without SCD occurring during the 5-year-follow-up (N = 610). To compare these groups, we used medical records, autopsy findings, echocardiograms, and electrocardiograms (ECGs). RESULTS Subjects with SCD were older (73.2 ± 11.3 vs. 68.8 ± 8.0, p < 0.001) and were more likely to be smokers or ex-smokers (37.1% vs. 27.6%, p = 0.045) compared to control patients. The proportion of subjects with prior myocardial infarction (MI) was higher in controls (46.9% vs. 41.4% in SCD subjects, p = 0.037), but in contrast, SCD subjects were more likely to have underlying silent MI (25.6% vs. 2.4% in CAD controls, p < 0.001). Left ventricular hypertrophy (LVH) was more common finding in SCD subjects (70.9% vs. 55.1% in controls, p < 0.001). Various electrocardiographic abnormalities were more common in subjects with SCD, including higher heart rate, atrial fibrillation, prolonged QTc interval, wide or fragmented QRS complex and early repolarization. The prevalence of Q waves and T inversions did not differ between the groups. CONCLUSIONS Underlying LVH and previous MI with myocardial scarring are common and often undiagnosed in women with CAD-related SCD. These results suggest that untreated CAD with concomitant myocardial disease is an important factor in SCD in women.
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Affiliation(s)
- I. Hookana
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - L. Holmström
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - M. A. E. Eskuri
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - L. Pakanen
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, Oulu, Finland
- Department of Forensic Medicine, Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - M. M. Ollila
- Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - A. M. Kiviniemi
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - T. Kenttä
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - J. Vähätalo
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - M. Tulppo
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - E. S. Lepojärvi
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - T. Piltonen
- Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - J. Perkiömäki
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - J. T. Tikkanen
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - H. V. Huikuri
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - M. J. Junttila
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
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Rydwik E, Anmyr L, Regardt M, McAllister A, Zarenoe R, Åkerman E, Orrevall Y, Bragesjö M, Dahl O, Kemani MK, Nordstrand L, Ekman U, Holmström L, Nygren-Bonnier M. ReCOV: recovery and rehabilitation during and after COVID-19 - a study protocol of a longitudinal observational study on patients, next of kin and health care staff. BMC Sports Sci Med Rehabil 2021; 13:70. [PMID: 34193260 PMCID: PMC8243048 DOI: 10.1186/s13102-021-00299-9] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/10/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The knowledge of the long-term consequences of covid-19 is limited. In patients, symptoms such as fatigue, decreased physical, psychological, and cognitive function, and nutritional problems have been reported. How the disease has affected next of kin, as well as staff involved in the care of patients with covid-19, is also largely unknown. The overall aim of this study is therefore three-fold: (1) to describe and evaluate predictors of patient recovery, the type of rehabilitation received and patients' experiences of specialized rehabilitation following COVID-19 infection; (2) to study how next of kin experienced the hospital care of their relative and their experiences of the psychosocial support they received as well as their psychological wellbeing; (3) to describe experiences of caring for patients with COVID-19 and evaluate psychological wellbeing, coping mechanisms and predictors for development of psychological distress over time in health care staff. METHODS This observational longitudinal study consists of three cohorts; patients, next of kin, and health care staff. The assessments for the patients consist of physical tests (lung function, muscle strength, physical capacity) and questionnaires (communication and swallowing, nutritional status, hearing, activities of daily living, physical activity, fatigue, cognition) longitudinally at 3, 6 and 12 months. Patient records auditing (care, rehabilitation) will be done retrospectively at 12 months. Patients (3, 6 and 12 months), next of kin (6 months) and health care staff (baseline, 3, 6, 9 and 12 months) will receive questionnaires regarding, health-related quality of life, depression, anxiety, sleeping disorders, and post-traumatic stress. Staff will also answer questionnaires about burnout and coping strategies. Interviews will be conducted in all three cohorts. DISCUSSION This study will be able to answer different research questions from a quantitative and qualitative perspective, by describing and evaluating long-term consequences and their associations with recovery, as well as exploring patients', next of kins' and staffs' views and experiences of the disease and its consequences. This will form a base for a deeper and better understanding of the consequences of the disease from different perspectives as well as helping the society to better prepare for a future pandemic.
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Affiliation(s)
- E Rydwik
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Solna, Sweden.
| | - L Anmyr
- Women's Health and Allied Health Professionals Theme, Department of Social Work in Health, Karolinska University Hospital, Solna, Sweden
- Department of CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - M Regardt
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Solna, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - A McAllister
- Women's Health and Allied Health Professionals Theme, Medical Unit Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden
- CLINTEC, Division of Speech-Language Pathology, Karolinska Institutet, Stockholm, Sweden
| | - R Zarenoe
- Women's Health and Allied Health Professionals Theme, Department of Social Work in Health, Karolinska University Hospital, Solna, Sweden
| | - E Åkerman
- Perioperative Medicine and Intensive Care Function, Department of Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
| | - Y Orrevall
- Women's Health and Allied Health Professionals Theme, Medical Unit Clinical Nutrition, Karolinska University Hospital, Stockholm, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - M Bragesjö
- Department of Clinical Neuroscience, Division of Psychology Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology Karolinska University Hospital, Solna, Sweden
| | - O Dahl
- Perioperative Medicine and Intensive Care Function, Department of Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
| | - M K Kemani
- Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology Karolinska University Hospital, Solna, Sweden
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - L Nordstrand
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology Karolinska University Hospital, Solna, Sweden
| | - U Ekman
- Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology Karolinska University Hospital, Solna, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Huddinge, Sweden
| | - L Holmström
- Department of Clinical Neuroscience, Division of Psychology Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology Karolinska University Hospital, Solna, Sweden
| | - M Nygren-Bonnier
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Solna, Sweden
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Zetterqvist V, Holmström L, Maathz P, Wicksell RK. Pain avoidance predicts disability and depressive symptoms three years later in individuals with whiplash complaints. Acta Anaesthesiol Scand 2017; 61:445-455. [PMID: 28233304 DOI: 10.1111/aas.12874] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 12/06/2016] [Accepted: 01/23/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Longstanding symptoms due to whiplash are commonly associated with decreased levels of emotional and physical functioning. To date, there is strong empirical support for the relationship between psychological in/flexibility and pain-related functioning, but the predictive role for future health is largely unknown. Hence, the aim of this study was to investigate if psychological in/flexibility (i.e. avoidance and cognitive fusion) predicted pain disability and depressive symptoms 3 years later in individuals with whiplash complaints. METHODS Data were collected at baseline and at a 3 year follow-up from 368 members of a national patient organization for people with whiplash-associated disorder. In a series of hierarchical regression analyses, background variables, pain related variables, psychological distress and psychological inflexibility at baseline were evaluated as predictors of levels of pain disability and depressive symptoms at follow-up. RESULTS Results showed that psychological inflexibility, and more specifically avoidance, was a unique predictor of pain disability and depressive symptoms, also when controlling for background variables, pain related variables and psychological distress. Level of education was also found to predict both pain disability and symptoms of depression. Lastly, pain variability predicted pain disability, and anxiety predicted depressive symptoms. CONCLUSION Pain avoidance significantly predicted pain disability and depressive symptoms 3 years later. Although tentative, results warrant more studies to further explore the importance of pain avoidance for future health.
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Affiliation(s)
- V. Zetterqvist
- Behavioural Medicine Pain Treatment Services; Karolinska University Hospital; Stockholm Sweden
- Department of Neuroscience; Uppsala University; Uppsala Sweden
| | - L. Holmström
- Behavioural Medicine Pain Treatment Services; Karolinska University Hospital; Stockholm Sweden
- Department of Women's and Children's Health; Karolinska Institutet; Stockholm Sweden
| | - P. Maathz
- Behavioural Medicine Pain Treatment Services; Karolinska University Hospital; Stockholm Sweden
- Department of Psychology; Uppsala University; Uppsala Sweden
| | - R. K. Wicksell
- Behavioural Medicine Pain Treatment Services; Karolinska University Hospital; Stockholm Sweden
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
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Kemani MK, Zetterqvist V, Kanstrup M, Holmström L, Wicksell RK. A validation of the pain interference index in adults with long-standing pain. Acta Anaesthesiol Scand 2016; 60:250-8. [PMID: 26310686 DOI: 10.1111/aas.12599] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 06/30/2015] [Accepted: 07/10/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chronic pain is a major health problem and more knowledge is needed regarding the interference of pain on behaviors in different life domains. Clinically useful and statistically sound pain interference measures are highly important. Studies on youths have shown that the Pain Interference Index (PII) is a reliable and valid instrument that is sensitive to change following behavioral treatment. This measure may also have utility for adults, but no study has so far evaluated the statistical properties of the PII for long-standing pain in adults. METHODS Data were collected from 239 consecutive adults with non-specific chronic pain referred to a tertiary pain clinic. We investigated the factor structure of items using a principal component analysis. Cronbach's alpha was calculated to assess internal consistency. The questionnaire's ability to predict levels of, e.g., disability was analyzed by means of regression analyses. RESULTS Analyses illustrated the adequacy of a one-factor solution with six items. Cronbach's alpha (0.85) suggested a satisfactory internal consistency among items. The PII explained significant amounts of variance in pain disability, physical, and mental health-related quality of life and depression, suggesting concurrent criteria validity. CONCLUSION The PII is a brief questionnaire with reliable and valid statistical properties to assess pain interference in adults. Other studies support the reliability and validity of PII for use with youths, and now the PII can be used to analyze the influence of pain on behaviors across age groups. Potentially, the PII can also be used as an outcome measure in clinical trials.
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Affiliation(s)
- M. K. Kemani
- Behavioural Medicine Pain Treatment Services; Pain Center; Karolinska University Hospital; Stockholm Sweden
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
| | - V. Zetterqvist
- Behavioural Medicine Pain Treatment Services; Pain Center; Karolinska University Hospital; Stockholm Sweden
- Department of Behavioral Sciences and Learning; Linköping University; Linköping Sweden
| | - M. Kanstrup
- Behavioural Medicine Pain Treatment Services; Pain Center; Karolinska University Hospital; Stockholm Sweden
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
| | - L. Holmström
- Behavioural Medicine Pain Treatment Services; Pain Center; Karolinska University Hospital; Stockholm Sweden
- Department of Women's and Children's Health; Karolinska Institutet; Stockholm Sweden
| | - R. K. Wicksell
- Behavioural Medicine Pain Treatment Services; Pain Center; Karolinska University Hospital; Stockholm Sweden
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
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Lennartsson F, Holmström L, Eliasson AC, Flodmark O, Forssberg H, Tournier JD, Vollmer B. Advanced fiber tracking in early acquired brain injury causing cerebral palsy. AJNR Am J Neuroradiol 2014; 36:181-7. [PMID: 25169928 DOI: 10.3174/ajnr.a4072] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Diffusion-weighted MR imaging and fiber tractography can be used to investigate alterations in white matter tracts in patients with early acquired brain lesions and cerebral palsy. Most existing studies have used diffusion tensor tractography, which is limited in areas of complex fiber structures or pathologic processes. We explored a combined normalization and probabilistic fiber-tracking method for more realistic fiber tractography in this patient group. MATERIALS AND METHODS This cross-sectional study included 17 children with unilateral cerebral palsy and 24 typically developing controls. DWI data were collected at 1.5T (45 directions, b=1000 s/mm(2)). Regions of interest were defined on a study-specific fractional anisotropy template and mapped onto subjects for fiber tracking. Probabilistic fiber tracking of the corticospinal tract and thalamic projections to the somatosensory cortex was performed by using constrained spherical deconvolution. Tracts were qualitatively assessed, and DTI parameters were extracted close to and distant from lesions and compared between groups. RESULTS The corticospinal tract and thalamic projections to the somatosensory cortex were realistically reconstructed in both groups. Structural changes to tracts were seen in the cerebral palsy group and included splits, dislocations, compaction of the tracts, or failure to delineate the tract and were associated with underlying pathology seen on conventional MR imaging. Comparisons of DTI parameters indicated primary and secondary neurodegeneration along the corticospinal tract. Corticospinal tract and thalamic projections to the somatosensory cortex showed dissimilarities in both structural changes and DTI parameters. CONCLUSIONS Our proposed method offers a sensitive means to explore alterations in WM tracts to further understand pathophysiologic changes following early acquired brain injury.
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Affiliation(s)
- F Lennartsson
- From the Department of Neuroradiology (F.L., O.F.), Karolinska University Hospital, Stockholm, Sweden Departments of Clinical Neurosciences (F.L., O.F.)
| | - L Holmström
- Women's and Children's Health (L.H., A.-C.E., H.F., B.V.), Karolinska Institute, Stockholm, Sweden
| | - A-C Eliasson
- Women's and Children's Health (L.H., A.-C.E., H.F., B.V.), Karolinska Institute, Stockholm, Sweden
| | - O Flodmark
- From the Department of Neuroradiology (F.L., O.F.), Karolinska University Hospital, Stockholm, Sweden Departments of Clinical Neurosciences (F.L., O.F.)
| | - H Forssberg
- Women's and Children's Health (L.H., A.-C.E., H.F., B.V.), Karolinska Institute, Stockholm, Sweden
| | - J-D Tournier
- The Florey Institute of Neuroscience and Mental Health (J.-D.T.), Melbourne, Victoria, Australia Department of Medicine (J.-D.T.), University of Melbourne, Victoria, Australia Centre for the Developing Brain (J.-D.T.) Department of Biomedical Engineering (J.-D.T.), Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | - B Vollmer
- Women's and Children's Health (L.H., A.-C.E., H.F., B.V.), Karolinska Institute, Stockholm, Sweden Clinical Neurosciences, Clinical and Experimental Sciences (B.V.), Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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Kanstrup M, Holmström L, Ringström R, Wicksell R. Insomnia in paediatric chronic pain and its impact on depression and functional disability. Eur J Pain 2014; 18:1094-102. [DOI: 10.1002/j.1532-2149.2013.00450.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2013] [Indexed: 11/11/2022]
Affiliation(s)
- M. Kanstrup
- Behavior Medicine Pain Treatment Services; Karolinska University Hospital; Solna Sweden
- Department of Clinical Neuroscience; Karolinska Institutet; Solna Sweden
| | - L. Holmström
- Behavior Medicine Pain Treatment Services; Karolinska University Hospital; Solna Sweden
- Department of Women's and Children's Health; Karolinska Institutet; Solna Sweden
| | - R. Ringström
- Department of Psychology; Uppsala University; Sweden
| | - R.K. Wicksell
- Behavior Medicine Pain Treatment Services; Karolinska University Hospital; Solna Sweden
- Department of Clinical Neuroscience; Karolinska Institutet; Solna Sweden
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Godtliebsen F, Holmström L, Miettinen A, Erästö P, Divine DV, Koc N. Pairwise scale space comparison of time series with application to climate research. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2011jc007546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Holmström L, Malmström JE. [Amantadine in an outbreak of influenza A. Good therapeutic and preventive effect]. Lakartidningen 1994; 91:1947-9. [PMID: 8189946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Holmström L, Nyman B, Rosengren M, Wallander S, Ripa T. Outbreaks of infections with erythromycin-resistant group A streptococci in child day care centres. Scand J Infect Dis 1990; 22:179-85. [PMID: 2113310 DOI: 10.3109/00365549009037900] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Erythromycin-resistant group A streptococci (ERGAS) are considered rare in Sweden. In the county of Halland (240,000 inhabitants) in southern Sweden, we had 294 isolates of ERGAS between January 1984 and June 1985. Almost all strains were of T-type 12 and only resistant to erythromycin (MIC values approximately 8 g/l). Seven child day care centres (DCC) were involved in the outbreaks and on average 49% of all children were infected in each outbreak. Employees were seldom infected (8%), but parents and siblings more often (23% and 36%). One course of phenoxymethylpenicillin succeeded in eradicating ERGAS from 75% of those infected. The ERGAS strains are now established in southern Sweden and account for about 2% of all group A streptococcal infections in the county of Halland.
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Affiliation(s)
- L Holmström
- Department of Infectious Diseases, County Hospital, Halmstad, Sweden
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Bergström K, Holmström L, Lodin H, Nylén O, Wilbrand H. [Transverse tomography with Mimer 3]. Nord Med 1971; 85:633. [PMID: 5580907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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