1
|
Hayes D, Olsson A, Begum S, Bertotti M, Jarvis-Beesley P, Stapley E. Barriers and facilitators to social prescribing in child and youth mental health: perspectives from the frontline. Eur Child Adolesc Psychiatry 2024; 33:1465-1479. [PMID: 37405485 PMCID: PMC11098893 DOI: 10.1007/s00787-023-02257-x] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 06/27/2023] [Indexed: 07/06/2023]
Abstract
There is growing interest in the role of Social Prescribing (SP) to help promote mental well-being and support individuals with mental health difficulties. Yet, implementation of SP to children and young people (CYP) has proved slow and underdeveloped compared with adult populations. Understanding the barriers and facilitators will help key stakeholders to better embed SP for CYP into practice. Using the Theoretical Domains Framework (TDF), a comprehensive, theoretical-led framework, underpinned by 33 behaviour change theories and 128 constructs, perceived barriers and facilitators to SP were investigated. The sample comprised of 11 Link Workers and 9 individuals involved in facilitating SP with CYP, who took part in semi-structured interviews. Transcripts were analysed using a deductive thematic analysis, and themes were coded under each theoretical domain. Overall, 33 barriers and facilitators for SP were identified across 12 domains of the TDF. Under capability, barriers and facilitators were found for knowledge, skills, memory/attention/decision making processes, and behavioural regulation. For opportunity, barriers and facilitators were found for social/professional influences, as well as environmental context and resources. Finally, for motivation, domains covered included: beliefs about consequences, beliefs about capabilities, optimism, motivations/goals, reinforcement, and emotions. Findings suggest that a wide range of barriers and facilitators affect the implementation of CYP SP to improve mental health and well-being. Interventions which target different domains related to capability, opportunity and motivation should be developed to better facilitate CYP SP.
Collapse
Affiliation(s)
- D Hayes
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England.
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, England.
| | - A Olsson
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
- The Healthcare Improvement Studies (THIS) Institute, University of Cambridge, Cambridge, England
| | - S Begum
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
| | - M Bertotti
- Institute for Connected Communities, University of East London, London, England
| | - P Jarvis-Beesley
- Social Prescribing Youth Network (SPYN), Streetgames, Manchester, England
| | - E Stapley
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
| |
Collapse
|
2
|
Olsson A, Sandblom G, Franneby U, Sondén A, Gunnarsson U, Dahlstrand U. Correction to: Do postoperative complications correlate to chronic pain following inguinal hernia repair? A prospective cohort study from the Swedish Hernia Register. Hernia 2023; 27:481. [PMID: 36645564 PMCID: PMC10126029 DOI: 10.1007/s10029-023-02743-w] [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: 04/25/2023]
Affiliation(s)
- A Olsson
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
- Department of Surgery, Södersjukhuset, Stockholm, Sweden.
| | - G Sandblom
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - U Franneby
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - A Sondén
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - U Gunnarsson
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - U Dahlstrand
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
3
|
Olsson A, Woxnerud K, Kiwanuka O, Sandblom G, Stackelberg O. The TOR concept (training, operation, and rehabilitation) applied to a cohort of postpartum women with training-resistant symptomatic rectus diastasis: evaluation 1 year after surgery. BJS Open 2023; 7:7025466. [PMID: 36734959 PMCID: PMC9897176 DOI: 10.1093/bjsopen/zrac162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/13/2022] [Accepted: 11/07/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Rectus diastasis is a common sequela of pregnancy and is associated with functional disabilities such as back pain, abdominal core instability, abdominal muscle weakness, urinary incontinence, and psychological issues such as a negative body image. The aim of this study was to evaluate the effect of the TOR concept (training, operation, and rehabilitation), a novel concept for treating abdominal wall insufficiency combined with rectus diastasis, after pregnancy. TOR consists of preoperative evaluation of symptoms and custom-designed abdominal core training, tailored rectus diastasis repair, and individual progressive postoperative rehabilitation. METHODS A consecutive series of women diagnosed with rectus diastasis and core dysfunction resistant to training, underwent plication of the linea alba between 2018 and 2020. After surgery, all patients participated in an individually designed rehabilitation programme over a 4-month interval. Physical function was recorded before surgery and 1 year after surgery using the disability rating index questionnaire. Symptoms associated with core instability were recorded before and 1 year after surgery. Quality of life was assessed using the SF-36. The abdominal wall anatomy was assessed with ultrasound before and 1 year after surgery. RESULTS Seventy-one women were included and all attended 1-year follow-up. Response rate was 81.7 per cent (58) for the disability rating index, and 59.2 per cent (42) for SF-36. Self-reported physical function (disability rating index) improved in 54 of 58 patients (93.1 per cent), with a median score reduction of 91.3 per cent. Core instability symptoms decreased significantly. All SF-36 subscales improved significantly compared with preoperative scores, reaching levels similar to or higher than the normative Swedish female population. No recurrence of rectus diastasis was seen at the 1-year follow-up. CONCLUSIONS Surgical reconstruction within the TOR concept resulted in significant improvements in physical function and quality of life as well as a significant decrease in symptoms of core instability.
Collapse
Affiliation(s)
- A Olsson
- Correspondence to: Anders Olsson, PhD, Department of Clinical Science and Education and Department of Surgery, Södersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden (e-mail: )
| | - K Woxnerud
- Stockholm Hernia Center, Stockholm, Sweden,Women's Health Department, Hela Kvinnans Klinik, Stockholm, Sweden
| | - O Kiwanuka
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden,Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - G Sandblom
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden,Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - O Stackelberg
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden,Department of Surgery, Södersjukhuset, Stockholm, Sweden,Unit of Nutritional Epidemiology, Karolinska Institute, Institute of Environmental Medicine, Stockholm, Sweden
| |
Collapse
|
4
|
Woxnerud K, Sandblom G, Hedbeck C, Olsson A. Reference Data on the Normal Abdominal Wall Anatomy and Baseline Characteristics in Seventy-One Nulliparous Women. J Abdom Wall Surg 2023; 2:10940. [PMID: 38312400 PMCID: PMC10831656 DOI: 10.3389/jaws.2023.10940] [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] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/09/2023] [Indexed: 02/06/2024]
Abstract
Aims: The aim of this study was to describe the prepartum anatomy of the abdominal wall in a cohort of nulliparous women, for use as a reference for management of patients with postpartum abdominal wall insufficiency with or without rectus diastasis. Materials and Methods: Seventy-one women were examined with ultrasonography of the abdominal wall. The inter-recti distance (IRD), anatomical variations of the linea semilunaris, and the oblique muscles were assessed. The waistline was measured during activation and relaxation of the abdominal core. Participant characteristics were registered. Questionnaires regarding habitual physical activity (Baecke), low back pain (Oswestry), physical functioning (DRI), urinary incontinence (UDI-6 and IIQ-7), and quality-of-life (SF-36) were answered. Results: Mean age was 30.5 years (range 19-50 years) and mean BMI 23.5 kg/m2 (range 18-37). Ultrasonography showed a mean IRD of 10 mm (range 3-24) at the superior border of the umbilicus, 9 mm (4-20) 3 cm above the umbilicus, and 2 mm (-5-10) 2 cm below the umbilicus. The mean thickness of the linea alba was 3 mm (1.5-5) and mean distances between the lateral edge of the rectus muscle and the external, internal, and transverse oblique muscles were 12 mm (-10-28), 1 mm (-14-13) and 15 mm (-14-32) at umbilicus level. Responses to the DRI, UDI-6, IIQ-7 and Oswestry questionnaires showed generally lower scores than the normal population whereas Baecke and SF-36 scores were similar. Conclusion: This study provides baseline data on normal abdominal wall anatomy in a healthy nulliparous female cohort, as well as levels of activity, physical function, disability, and quality-of-life.
Collapse
Affiliation(s)
- K. Woxnerud
- Hela Kvinnans Klinik, Stockholm, Sweden
- Stockholm Hernia Center, Stockholm, Sweden
| | - G. Sandblom
- Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
- Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | | | - A. Olsson
- Stockholm Hernia Center, Stockholm, Sweden
- Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
5
|
Bixo L, Sandblom G, Österberg J, Stackelberg O, Bewö K, Olsson A. Association Between Inter-Recti Distance and Impaired Abdominal Core Function in Post-Partum Women With Diastasis Recti Abdominis. J Abdom Wall Surg 2022; 1:10909. [PMID: 38314149 PMCID: PMC10831648 DOI: 10.3389/jaws.2022.10909] [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] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/14/2022] [Indexed: 02/06/2024]
Abstract
Background and Aim: The definition and management of Diastasis Recti Abdominis (DRA) is under debate. This study aimed to understand the correlation between the post-partum inter-recti distance (IRD) and functional impairments associated with core instability, with the hypothesis that IRD could serve as a proxy for core instability symptoms and constitute a tool in decision-making for DRA treatment. Material and Methods: A cohort of post-partum women with abdominal core instability symptoms combined with DRA were studied. The size of IRD was measured with ultrasonography and cross-sectionally analysed against functional impairments registered with the self-report Disability Rating Index (DRI), which grades the ability to perform 12 different daily activities. Results: A total of 224 women were included in the study. In univariable analysis, IRD was associated with impairment of the activities running (p = 0.007), heavy work (p = 0.036) and exercise/sports (p = 0.047), but not with dressing, walking, sitting for long periods, standing bent over a sink, carrying a suitcase, making a bed, light manual labour or heavy lifting. No significant correlations were seen in the multivariable analysis when adjustments were made for BMI and parity. Conclusion: IRD and post-partum functional impairments had no significant correlation in multivariable analysis. The post-partum core instability condition is complex and probably associated with more factors than solely the IRD. The IRD alone does not seem to be a sufficient proxy for decision-making regarding optimal treatment. A more complete instrument to assess the post-partum abdominal core is warranted.
Collapse
Affiliation(s)
- L. Bixo
- Department of Surgery, Mora Hospital, Mora, Sweden
| | - G. Sandblom
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
- Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - J. Österberg
- Department of Surgery, Mora Hospital, Mora, Sweden
- Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - O. Stackelberg
- Department of Surgery, Södersjukhuset, Stockholm, Sweden
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - K. Bewö
- Department of Surgery, Mora Hospital, Mora, Sweden
| | - A. Olsson
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
- Stockholm Hernia Center, Stockholm, Sweden
| |
Collapse
|
6
|
Olsson A. P-095 RECTUS DIASTASIS REPAIR: VARIATIONS OF POSTPARTUM ABDOMINAL WALL ANATOMICAL CHANGES PROPOSE A TAILORED SURGICAL REPAIR. EARLY RESULTS OF THE EXTENDED REPAIR TECHNIQUE STUDY. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
A pregnancy can result in permanent anatomical changes such as a persistent rectus diastasis (RD), a widened linea semilunaris and retracted oblique muscles. The diverse anatomical changes contribute to the abdominal deformation and may present in a variety of combinations. A standardized suture repair of the RD may not be sufficient in severe abdominal wall deformation cases. This observational cohort study evaluated an extended repair technique.
Method
A cohort of 44 postpartum women with training resistant core instability symptoms planned for surgical repair were examined with ultrasonography prior to surgery. Participants with severe anatomical changes i.e. diastasis of the linea semilunaris exceeding one cm, were offered an extended repair, re-approximation of both linea alba and linea semilunaris. Results were evaluated with ultrasonography and the Disability Rating Index (DRI), two and twelve months after surgery.
A standardized rectus diastasis suture repair was used in 24 participants with an isolated rectus diastasis. A combined repair with reapproximation of both the linea alba and the linea semilunaris was performed in 20 participants.
Results
Preoperative mean rectus diastasis (widest measurement) was 45 mm (30–75 mm), a mean diastasis of the linea semilunaris (umbilical level) of 15 mm (0–35 mm).
There were no recurrencies at the 12-month follow-up. Early results showed significant improvements of physical function (DRI) but no differences between the two repair technique groups.
Conclusion
The extended repair seems to be a safe and sufficient repair technique in cases with a RD combined with a linea semilunaris diastasis.
Collapse
Affiliation(s)
- A Olsson
- Department of Clinical Science and Education, Karolinska Institutet , Stockholm , Sweden
| |
Collapse
|
7
|
Olsson A, Sandblom G, Franneby U, Sondén A, Gunnarsson U, Österberg J, Dahlstrand U. OC-038 RISK FOR CONTRALATERAL INGUINAL HERNIA REPAIR FOLLOWING PRIMARY UNILATERAL HERNIA REPAIR – A REGISTER-BASED STUDY. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
To investigate the incidence as well as the factors predictive for a subsequent hernia repair on the contralateral side following a primary unilateral hernia repair.
Material & Methods
Prospective population-based study of data from the Swedish Hernia Register based on 151,297 patients operated with an index unilateral inguinal hernia mesh repair using open and endo-laparoscopic technique, during 2007–2019. Incidence, predictive factors and time to a contralateral hernia repair was analysed.
Results
There were 7.4% registered contralateral hernia repairs with a median time of 2.7 years to a subsequent contralateral repair following the index unilateral hernia repair. Median follow-up time was 7.5 years. Significant predictors for a subsequent contralateral hernia were, male sex (HR 1.78, 95% CI 1.61–1.97), high age (HR 1.01 95% CI 1.006–1.009), medial inguinal hernia (HR 1.05, 95% CI 1.003–1.098), combined inguinal hernia (HR 1.10, 95% CI 1.03–1.18), hernia defect size 1.5–3.0 cm (HR 1.10, 95% CI 1.03–1.17), hernia defect size > 3 cm (HR 1.36, 95% CI 1.27–1.45) and a repair on the left side (HR 1.30, 95% CI 1.25–1.35). Endo-laparoscopic repairs and obesity were associated with a lower incidence of a later contralateral repair.
Conclusion
If the relevant risk factors, i.e., male sex, high age, large hernia defect size, medial or combined hernia, are present at a unilateral endo-laparoscopic groin hernia repair and the decision has been shared with the patient, exploration of the contralateral groin and prophylactic mesh placement may be considered.
Collapse
Affiliation(s)
- A Olsson
- Department of Clinical Science and Education, Karolinska Institutet , Stockholm , Sweden
| | - G Sandblom
- Department of Clinical Science and Education, Karolinska Institutet , Stockholm , Sweden
| | - U Franneby
- Department of Clinical Science, Intervention and Technology (CLINTEC)), Karolinska Institutet , Stockholm , Sweden
| | - A Sondén
- Department of Clinical Science and Education, Karolinska Institutet , Stockholm , Sweden
| | - U Gunnarsson
- Department of Surgical and perioperative sciences, division of surgery, Umeå Universitet , Umeå , Sweden
| | - J Österberg
- Department of Clinical Science, Intervention and Technology (CLINTEC)), Karolinska Institutet , Stockholm , Sweden
| | - U Dahlstrand
- Department of Clinical Science, Intervention and Technology (CLINTEC)), Karolinska Institutet , Stockholm , Sweden
| |
Collapse
|
8
|
Woxnerud K, Sandblom G, Olsson A. OC-063 BASELINE DATA AND NORMAL ANATOMY OF THE ABDOMINAL WALL IN AN OBSERVATIONAL PROSPECTIVE COHORT STUDY OF NULLIPAROUS WOMEN. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
The aim of this study was to describe the pre-partum anatomy of the abdominal wall in a cohort of nulliparous women, with the main purpose to use as a reference for management of patients with postpartum abdominal core instability.
Materials & Methods
Seventy consecutive women were examined with ultrasonography measuring inter-recti distance (IRD), anatomical variations of linea semilunaris and the oblique muscles. Waistline was assessed during activated and relaxed abdominal core. Participant characteristics were registered. Questionnaires regarding habitual physical activity (Baecke), low back pain (Oswestry), physical functioning (DRI), urinary incontinence (UDI-6 and IIQ-7) and quality of life (SF-36) were answered.
Results
Response rate was 100%. Mean age was 30.5 years (19–50), mean BMI 23.5 kg/m2 (18.4–37.1). Ultrasonography showed a mean IRD 1.02 mm (0.27–2.35) at the superior border of the umbilicus, 0.93 mm (0.36–2.01) three cm above the umbilicus, 0.21 mm (-0.53–0.98) two cm below the umbilicus; mean thickness of the linea alba 0.28 mm (0.15–0.5); mean distance between the lateral lining of the rectus muscle and the external, internal and transverse oblique muscles of respectively 1.19 (-0.99–2.82), 0.09 mm (-1.37–1.3) and 1.46 mm (-1.36–3.19) at umbilicus level. Responses to the questionnaires showed overall low values on DRI, UDI-6, IIQ-7 and Oswestry; and overall values on Baecke and SF-36 similar to the normative population.
Conclusions
This study provides baseline data on the normal abdominal wall anatomy as well as mean values of activity, physical function, disabilities and quality of life, in a healthy nulliparous female cohort.
Collapse
Affiliation(s)
- K Woxnerud
- Womens Health, Hela Kvinnans Klinik , Stockholm , Sweden
| | - G Sandblom
- Department of Clinical Science and Education, Karolinska Institutet , Stockholm , Sweden
| | - A Olsson
- Department of Clinical Science and Education, Karolinska Institutet , Stockholm , Sweden
| |
Collapse
|
9
|
Acar K, Horntvedt O, Cabrera A, Olsson A, Ingvar M, Lebedev AV, Petrovic P. COVID-19 conspiracy ideation is associated with the delusion proneness trait and resistance to update of beliefs. Sci Rep 2022; 12:10352. [PMID: 35725585 PMCID: PMC9208343 DOI: 10.1038/s41598-022-14071-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 06/01/2022] [Indexed: 11/09/2022] Open
Abstract
The rapid spread of conspiracy ideas associated with the recent COVID-19 pandemic represents a major threat to the ongoing and coming vaccination programs. Yet, the cognitive factors underlying the pandemic-related conspiracy beliefs are not well described. We hypothesized that such cognitive style is driven by delusion proneness, a trait phenotype associated with formation of delusion-like beliefs that exists on a continuum in the normal population. To probe this hypothesis, we developed a COVID-19 conspiracy questionnaire (CCQ) and assessed 577 subjects online. Their responses clustered into three factors that included Conspiracy, Distrust and Fear/Action as identified using principal component analysis. We then showed that CCQ (in particular the Conspiracy and Distrust factors) related both to general delusion proneness assessed with Peter's Delusion Inventory (PDI) as well as resistance to belief update using a Bias Against Disconfirmatory Evidence (BADE) task. Further, linear regression and pathway analyses suggested a specific contribution of BADE to CCQ not directly explained by PDI. Importantly, the main results remained significant when using a truncated version of the PDI where questions on paranoia were removed (in order to avoid circular evidence), and when adjusting for ADHD- and autistic traits (that are known to be substantially related to delusion proneness). Altogether, our results strongly suggest that pandemic-related conspiracy ideation is associated with delusion proneness trait phenotype.
Collapse
Affiliation(s)
- K Acar
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden.
| | - O Horntvedt
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Cabrera
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - M Ingvar
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A V Lebedev
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - P Petrovic
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| |
Collapse
|
10
|
Fager C, Gebäck T, Hjärtstam J, Röding M, Olsson A, Lorén N, von Corswant C, Särkkä A, Olsson E. Correlating 3D porous structure in polymer films with mass transport properties using FIB-SEM tomography. Chemical Engineering Science: X 2021. [DOI: 10.1016/j.cesx.2021.100109] [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: 11/13/2022] Open
|
11
|
Olsson A, Thoren I, Mohammad M, Rylance R, Platonov P, Sparv D, Erlinge D. Christmas holiday triggers of myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Christmas holidays have been associated with the highest incidence of myocardial infarction (MI). We wanted to assess possible triggers of MI during Christmas.
Method
A nationwide, retrospective postal survey with case-control design. All individuals suffering a MI during the Christmas holidays 2018 and 2019 in Sweden were identified through the SWEDEHEART registry and a control group matched in age and gender with chronic coronary syndrome who did not seek medical attention during Christmas, were asked for participation. Subjects completed a questionnaire asking them to rate 27 potential MI-triggers as having occurred more or less than usual.
Results
A total of 189 patients suffering a MI on Christmas Eve, Christmas Day, or Boxing Day and 157 patients in control-group responded to the questionnaire, representing response rates of 66% and 62%, respectively. Patients with MI on Christmas experienced more stress (36.7% vs 20.9%, p=0.002), depression (20.9% vs 10.5%, p=0.024) and worry (25.9% vs 10.1%, p<0.001) compared to the control-group. The food and sweets-consumption were increased in both groups, but to a greater extent in the control-group (33.0% vs 49.7%, p=0.002 and 32.4% vs 43.3, p=0.031). There were no increases in quarrels, anger, economic worries or reduced compliance with medication.
Conclusions
Patients suffering MI on Christmas holiday experienced higher levels of stress and emotional distress compared to patients with chronic coronary syndrome, possibly explaining the phenomenon of holiday heart attack. Understanding what factors increase the number of MI on Christmas may help reduce the excess number of MIs and cardiovascular burden.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Swedish Heart and Kund FoundationSwedish Scientific Research Council
Collapse
Affiliation(s)
- A Olsson
- Lund University, Cardiology, Lund, Sweden
| | - I Thoren
- Skane University Hospital, Lund, Sweden
| | - M Mohammad
- Lund University, Cardiology, Lund, Sweden
| | - R Rylance
- Lund University, Cardiology, Lund, Sweden
| | - P Platonov
- Lund University, Cardiology, Lund, Sweden
| | - D Sparv
- Lund University, Cardiology, Lund, Sweden
| | - D Erlinge
- Lund University, Cardiology, Lund, Sweden
| |
Collapse
|
12
|
Gustavsen S, Olsson A, Søndergaard HB, Andresen SR, Sørensen PS, Sellebjerg F, Oturai A. The association of selected multiple sclerosis symptoms with disability and quality of life: a large Danish self-report survey. BMC Neurol 2021; 21:317. [PMID: 34399707 PMCID: PMC8365982 DOI: 10.1186/s12883-021-02344-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background People with multiple sclerosis (MS) experience a wide range of unpredictable and variable symptoms. The symptomatology of MS has previously been reported in large sample registry studies; however, some symptoms may be underreported in registries based on clinician-reported outcomes and how the symptoms are associated with quality of life (QoL) are often not addressed. The aim of this study was to comprehensively evaluate the frequency of selected MS related symptoms and their associations with disability and QoL in a large self-report study. Methods We conducted a cross-sectional questionnaire survey among all patients at the Danish Multiple Sclerosis Center, Copenhagen University Hospital, Denmark. The questionnaire included information on clinical and sociodemographic characteristics, descriptors of QoL and disability, as well as prevalence and severity of the following MS symptoms: impaired ambulation, spasticity, chronic pain, fatigue, bowel and bladder dysfunction, and sleep disturbances. Results Questionnaires were returned by 2244/3606 (62%). Participants without MS diagnosis or incomplete questionnaires were excluded, n = 235. A total of 2009 questionnaires were included for analysis (mean age 49.4 years; mean disease duration 11.7 years; and 69% were women). The most frequently reported symptoms were bowel and bladder dysfunction (74%), fatigue (66%), sleep disturbances (59%), spasticity (51%) and impaired ambulation (38%). With exception of fatigue and sleep disturbances, all other symptoms increased in severity with higher disability level. Invisible symptoms (also referred to as hidden symptoms) such as fatigue, pain and sleep disturbances had the strongest associations with the overall QoL. Conclusion We found invisible symptoms highly prevalent, even at mild disability levels. Fatigue, pain and sleep disturbances had the strongest associations with the overall QoL and were more frequently reported in our study compared with previous registry-based studies. These symptoms may be underreported in registries based on clinician reported outcomes, which emphasizes the importance of including standardized patient reported outcomes in nationwide registries to better understand the impact of the symptom burden in MS.
Collapse
Affiliation(s)
- S Gustavsen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.
| | - A Olsson
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - H B Søndergaard
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - S R Andresen
- Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - P S Sørensen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - F Sellebjerg
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - A Oturai
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| |
Collapse
|
13
|
Olsson A, Fahlén E, Tornemo M, Oleröd G, Hultén L, Sandstedt J. Multivariate analysis by OPLS as a novel tool to identify cause of variation between assays for direct LDL measurement in frozen and fresh plasma samples. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
14
|
Olsson A, Kiwanuka O, Sandblom G, Stackelberg O. Evaluation of functional outcomes following rectus diastasis repair-an up-to-date literature review. Hernia 2021; 25:905-914. [PMID: 34302558 PMCID: PMC8370918 DOI: 10.1007/s10029-021-02462-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/16/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Over the last decade rectus diastasis has gained attention as a condition that may benefit from surgery. Numerous surgical techniques have been presented but scientifically proper studies reporting functional outcome are few and evidence is incomplete. The aim of this up-to-date review is to analyse the outcomes of rectus diastasis repair in recently published papers, focusing on functional changes following surgery. METHOD A comprehensive search in PubMed and Web of Science was performed. Suitable papers were selected using titles and abstracts with terms suggesting surgical treatment of rectus diastasis. All abstracts were scrutinised, and irrelevant studies excluded in four stages. Reports providing original data, including outcome assessment following surgery, were included. RESULT Ten papers with a total of 780 patients were found to fulfil the search criteria. Study design, surgical procedure, follow-up time, functional outcome and assessment instruments were compiled. All included studies reported improvements in a variety of functional aspects regardless of surgical method. The outcomes assessed include core stability, back pain, abdominal pain, posture, urinary incontinence, abdominal muscle strength and quality of life. CONCLUSION The results of this review show that surgical repair of rectus diastasis is a safe and effective treatment that improves functional disability. However, the absence of standardized instruments for assessing outcome makes it impossible to compare studies. Since indications for surgery are relative and related to core function, valid instruments for assessing indication and outcome are needed to ensure benefit of the procedure.
Collapse
Affiliation(s)
- A Olsson
- Department of Clinical Science and Education, Södersjukhuset, and Department of Surgery, Södersjukhuset, Karolinska Institute, Sjukhusbacken 10, 11883, Stockholm, Sweden.
| | - O Kiwanuka
- Department of Clinical Science and Education, Södersjukhuset, and Department of Surgery, Södersjukhuset, Karolinska Institute, Sjukhusbacken 10, 11883, Stockholm, Sweden
| | - G Sandblom
- Department of Clinical Science and Education, Södersjukhuset, and Department of Surgery, Södersjukhuset, Karolinska Institute, Sjukhusbacken 10, 11883, Stockholm, Sweden
| | - O Stackelberg
- Department of Clinical Science and Education, Södersjukhuset, and Department of Surgery, Södersjukhuset, Karolinska Institute, Sjukhusbacken 10, 11883, Stockholm, Sweden.,Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
15
|
Lebedev AV, Acar K, Garzón B, Almeida R, Råback J, Åberg A, Martinsson S, Olsson A, Louzolo A, Pärnamets P, Lövden M, Atlas L, Ingvar M, Petrovic P. Psychedelic drug use and schizotypy in young adults. Sci Rep 2021; 11:15058. [PMID: 34301969 PMCID: PMC8302700 DOI: 10.1038/s41598-021-94421-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Abstract
Despite recently resurrected scientific interest in classical psychedelics, few studies have focused on potential harms associated with abuse of these substances. In particular, the link between psychedelic use and psychotic symptoms has been debated while no conclusive evidence has been presented. Here, we studied an adult population (n = 1032) with a special focus on young (18–35 years) and healthy individuals (n = 701) to evaluate the association of psychedelic drug use with schizotypy and evidence integration impairment typically observed in psychosis-spectrum disorders. Experimental behavioural testing was performed in a subsample of the subjects (n = 39). We observed higher schizotypy scores in psychedelic users in the total sample. However, the effect size was notably small and only marginally significant when considering young and healthy subjects (Cohen’s d = 0.13). Controlling for concomitant drug use, none of our analyses found significant associations between psychedelic use and schizotypal traits. Results from experimental testing showed that total exposure to psychedelics (frequency and temporal proximity of use) was associated with better evidence integration (Cohen’s d = 0.13) and a higher sensitivity of fear responses (Cohen’s d = 1.05) to the effects instructed knowledge in a reversal aversive learning task modelled computationally with skin conductance response and pupillometry. This effect was present even when controlling for demographics and concomitant drug use. On a group level, however, only difference in sensitivity of fear responses to instructed knowledge reached statistical significance. Taken together, our findings suggest that psychedelic drug use is only weakly associated with psychosis-like symptoms, which, in turn, is to a large extent explained by psychiatric comorbidities and use of other psychoactive substances. Our results also suggest that psychedelics may have an effect on flexibility of evidence integration and aversive learning processes, that may be linked to recently suggested therapeutic effects of psychedelic drugs in non-psychotic psychiatric populations.
Collapse
Affiliation(s)
- Alexander V Lebedev
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden.
| | - K Acar
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - B Garzón
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Department of Psychology, University of Gothenburg, Göteborg, Sweden
| | - R Almeida
- Stockholm University Brain Imaging Center (SUBIC), Stockholm University, Stockholm, Sweden
| | - J Råback
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Åberg
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - S Martinsson
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Louzolo
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - P Pärnamets
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden.,Department of Psychology, New York University, New York, USA
| | - M Lövden
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Department of Psychology, University of Gothenburg, Göteborg, Sweden
| | - L Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA.,National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA.,National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Martin Ingvar
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - P Petrovic
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| |
Collapse
|
16
|
Olsson A, Gustavsen S, Langkilde AR, Hansen TH, Sellebjerg F, Bach Søndergaard H, Oturai AB. Circulating levels of tight junction proteins in multiple sclerosis: Association with inflammation and disease activity before and after disease modifying therapy. Mult Scler Relat Disord 2021; 54:103136. [PMID: 34247104 DOI: 10.1016/j.msard.2021.103136] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/19/2021] [Accepted: 06/29/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Tight junction proteins contribute to maintenance of epithelial and endothelial barriers such as the intestinal barrier and the blood brain barrier (BBB). Increased permeability of these barriers has been linked to disease activity in MS and there is currently a lack of easily accessible biomarkers predicting disease activity in MS. AIM To investigate whether levels of circulating tight junction proteins occludin and zonula occludens-1 (ZO-1) are associated with biomarkers of inflammation and disease activity; and to determine whether they could serve as clinical biomarkers. METHODS We prospectively included 72 newly diagnosed patients with relapsing remitting MS or clinically isolated syndrome with no prior disease modifying therapy (DMT) use and 50 healthy controls (HCs). Patients were followed with blood samples, 3 tesla MRI, and clinical evaluation for 12 months. Occludin, ZO-1, calprotectin and soluble urokinase-type plasminogen activator receptor (suPAR) were measured by ELISA; serum neurofilament light (NfL) and IL-6 by single-molecule array (SIMOA). The mRNA expression of IFNG, IL1R1, IL10, IL1B, ARG1 and TNF was measured by quantitative real time polymerase chain reaction (qPCR) in whole blood. RESULTS Plasma occludin levels were higher in MS patients compared with HCs. After 12 months on DMT, occludin levels were reduced by approximately 25% irrespective of 1st or 2nd line DMT (p<0.001). Furthermore, NfL and calprotectin levels were significantly reduced by 31% and 29%, respectively. Occludin and ZO-1 did not correlate with biomarkers of inflammation and did not predict disease activity at baseline or after 12 months. CONCLUSIONS Higher levels of occludin suggest an increased permeability of the BBB and/or the intestinal barrier in MS patients. The reduction of occludin after 12 months on DMTs might reflect repair of these barriers upon treatment. However, plasma levels of ZO-1 and occludin could not predict clinical or MRI disease activity as determined by regression and ROC-curve analysis. Our results do not indicate a clear clinically relevant role for circulating tight junction proteins as biomarkers of disease activity in MS and further investigations in larger cohorts are needed to clarify this issue.
Collapse
Affiliation(s)
- A Olsson
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.
| | - S Gustavsen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - A R Langkilde
- Department of Radiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - T H Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - F Sellebjerg
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - H Bach Søndergaard
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - A B Oturai
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| |
Collapse
|
17
|
Ogmundsdottir Michelsen H, Sjolin I, Back M, Gonzalez M, Olsson A, Sandberg C, Schiopu A, Leosdottir M. Effect of a lifestyle-focused electronic patient support application on risk factor management in post-myocardial infarction patients – a randomized controlled trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiac rehabilitation (CR) is central in reducing morbidity and mortality after myocardial infarction (MI). However, the fulfillment of guideline recommended CR targets is unsatisfactory. eHealth offers new possibilities to improve clinical care.
Purpose
The aim of this study was to assess the efficacy of a mobile device application to support adherence to lifestyle advice and self-control of risk factors as a complement to traditional CR after MI.
Method
This unblinded multi-centre randomized controlled trial included 150 patients with MI (81% men, 60.4±8.8 years). All patients in the intervention (INT) and control (CON) groups participated in a 1-year CR program. Additionally, INT patients (n=101) received access to the mobile device application for 25 weeks post-MI where information about lifestyle (i.e., diet, physical activity, smoking), modifiable risk factors (i.e., weight, blood pressure (BP)), and symptoms could be registered. The software provided direct positive feedback and lifestyle advice. Data was reviewed twice weekly by the CR nurse. The primary outcome was change in sub-maximal exercise capacity (W) between an exercise test 2-weeks post MI and at follow-up 4 month later. Secondary outcomes included changes in lifestyle and modifiable risk factors including body mass index, waist circumference, blood-lipids, fasting glucose and HbA1c, between baseline and 2-week, 2-month and 1-year follow-up visits. Regression analysis was used, adjusting for relevant baseline variables.
Results
Participation in CR was high, with 96% of INT patients and 98% of the CON patients attending the 1-year follow-up visit. Forty-six percent of the INT patients and 57% of the CON patients attended centre-based exercise training (p=0.1). In the INT group 86% logged data in the application at least once. Adherence, defined as logging data at least twice per week, was 92% in week 1 and 57% in week 25. There was a numerical trend toward better exercise capacity improvement in the INT group (INT +14.4±19.0 vs. CON +10.3±16.1 W, p=0.2) although differences were non-significant. INT patients achieved larger BP reduction at 2-weeks (systolic) and 2-months (systolic and diastolic) (Figure). At 2-months 70% vs. 46% of smokers in the INT vs CON groups had quit smoking, and at 1-year the respective percentages were 57% vs. 36%. The number of smokers in the study was however low (n=33) and the differences non-significant. For other secondary endpoints no differences were observed.
Conclusion
Complementing CR with a mobile device application improved BP during the first months after MI, and non-significant trends towards better exercise capacity and higher smoking cessation rates were observed. Even though the differences were non-significant in our small study sample, they indicate that using eHealth in the form of a mobile device application could clinically benefit post-MI patients participating in CR.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Governmental funding of clinical research within the National Health Services in Sweden.
Collapse
Affiliation(s)
| | - I Sjolin
- Lund University, Department of Clinical Sciences, Malmo, Sweden
| | - M Back
- Linkoping University, Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linkoping, Sweden
| | - M Gonzalez
- Umea University, Department of Public Health and Clinical Medicine, Cardiology, Umea, Sweden
| | - A Olsson
- Skane University Hospital, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - C Sandberg
- Umea University, Department of Public Health and Clinical Medicine, Cardiology, Umea, Sweden
| | - A Schiopu
- Lund University, Department of Clinical Sciences, Malmo, Sweden
| | - M Leosdottir
- Lund University, Department of Clinical Sciences, Malmo, Sweden
| |
Collapse
|
18
|
Carlstedt A, Bringman S, Egberth M, Emanuelsson P, Olsson A, Petersson U, Pålstedt J, Sandblom G, Sjödahl R, Stark B, Strigård K, Tall J, Theodorsson E. Management of Diastasis of the Rectus Abdominis Muscles: Recommendations for Swedish National Guidelines. Scand J Surg 2020; 110:452-459. [PMID: 32988320 PMCID: PMC8551433 DOI: 10.1177/1457496920961000] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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] [Indexed: 12/13/2022]
Abstract
Background: Diastasis of the rectus abdominis muscle is a common condition. There are no generally accepted criteria for diagnosis or treatment of diastasis of the rectus abdominis muscle, which causes uncertainty for the patient and healthcare providers alike. Methods: The consensus document was created by a group of Swedish surgeons and based on a structured literature review and practical experience. Results: The proposed criteria for diagnosis and treatment of diastasis of the rectus abdominis muscle are as follows: (1) Diastasis diagnosed at clinical examination using a caliper or ruler for measurement. Diagnostic imaging by ultrasound or other imaging modality, should be performed when concurrent umbilical or epigastric hernia or other cause of the patient’s symptoms cannot be excluded. (2) Physiotherapy is the firsthand treatment for diastasis of the rectus abdominis muscle. Surgery should only be considered in diastasis of the rectus abdominis muscle patients with functional impairment, and not until the patient has undergone a standardized 6-month abdominal core training program. (3) The largest width of the diastasis should be at least 5 cm before surgical treatment is considered. In case of pronounced abdominal bulging or concomitant ventral hernia, surgery may be considered in patients with a smaller diastasis. (4) When surgery is undertaken, at least 2 years should have elapsed since last childbirth and future pregnancy should not be planned. (5) Plication of the linea alba is the firsthand surgical technique. Other techniques may be used but have not been found superior. Discussion: The level of evidence behind these statements varies, but they are intended to lay down a standard strategy for treatment of diastasis of the rectus abdominis muscle and to enable uniformity of management.
Collapse
Affiliation(s)
- A Carlstedt
- Department of Surgery, Karlstad Central Hospital, Karlstad, Sweden
| | - S Bringman
- Department of Surgery, Södertälje Hospital, Stockholm, Sweden.,Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden
| | - M Egberth
- Department of Surgery, Mora hospital, Mora, Sweden
| | - P Emanuelsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
| | - A Olsson
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Clinic of Surgery, Capio CFTK, Stockholm, Sweden
| | - U Petersson
- Department of Surgery, Skåne University Hospital, Lund University, Malmö, Sweden
| | - J Pålstedt
- Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery, Ersta Hospital, Stockholm, Sweden
| | - G Sandblom
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - R Sjödahl
- Department of Surgery, Linköping University Hospital, Linköping, Sweden
| | - B Stark
- Department of Molecular Medicine and Surgery, Karolinska Institute, Solna, Sweden
| | - K Strigård
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - J Tall
- Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery, Ersta Hospital, Stockholm, Sweden
| | - E Theodorsson
- Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| |
Collapse
|
19
|
Wistrand-Yuen P, Olsson A, Skarp KP, Friberg L, Nielsen E, Lagerbäck P, Tängdén T. Evaluation of polymyxin B in combination with 13 other antibiotics against carbapenemase-producing Klebsiella pneumoniae in time-lapse microscopy and time-kill experiments. Clin Microbiol Infect 2020; 26:1214-1221. [DOI: 10.1016/j.cmi.2020.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/17/2020] [Accepted: 03/10/2020] [Indexed: 12/17/2022]
|
20
|
Schüz J, Kovalevskiy E, Moissonnier M, Olsson A, Hashim D, Kromhout H, Kashanskiy S, Chernov O, Bukhtiyarov I, Ostroumova E. Comparison of Two Information Sources for Cause-of-Death Follow-up in the Russian Federation: The Asbest Chrysotile Cohort Study. Methods Inf Med 2020; 59:9-17. [PMID: 32535878 PMCID: PMC7446113 DOI: 10.1055/s-0040-1710381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/26/2020] [Indexed: 10/28/2022]
Abstract
BACKGROUND The Asbest chrysotile cohort was set up in Asbest town, Sverdlovsk oblast, Russian Federation, among the current and former workforce of the world's largest operating chrysotile mine and its processing mills, to investigate cancer risk in relation to occupational exposure to chrysotile. OBJECTIVES The cohort of 35,837 people was followed-up for mortality using cause-of-death information from official death certificates issued by the Civil Act Registration Office (ZAGS) of Sverdlovsk oblast from 1976 to 2015. Data were also retrieved from the electronic cause-of-death registry of the Medical Information Analytical Centre (MIAC) of Sverdlovsk oblast, which was launched in 1990 and operates independently of ZAGS. The objectives were to compare the completeness of record linkage (RL) with ZAGS and with MIAC, and to compare the agreement of cause-of-death information obtained from ZAGS and from MIAC, with a focus on malignant neoplasms. METHODS RL completeness of identifying cohort members in ZAGS and in MIAC was compared for the period 1990 to 2015. In the next step, for the comparison of the retrieved cause-of-death information, 5,463 deaths (1,009 from cancer) were used that were registered in 2002 to 2015, when causes of death were coded using International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) nomenclature by MIAC. For ZAGS, original cause-of-death text from the death certificates was obtained and then coded according to ICD-10 by the International Agency for Research on Cancer/World Health Organization (IARC/WHO). Agreement was evaluated at various levels of detail, and reasons for any disagreements between the MIAC and the IARC/WHO ICD-10-coded cancer diagnosis were systematically explored. RESULTS A total of 10,886 deaths were obtained from all avenues of follow-up for the period 1990 to 2015 in the cohort; 10,816 (99.4%) of these were found in ZAGS. This percentage was 88.3% if only automated deterministic RL was used and 99.4% when deterministic RL was complemented with manual searches of cohort members. Comparison of the cause-of-death information showed agreement of 97.9% at the ICD-10 main group level between ZAGS (coded by IARC/WHO) and MIAC. Of 1,009 cancer deaths, 679 (67.3%) cases had identical coding, 258 (25.6%) cases corresponded at the three-character ICD-10 level, 36 (3.6%) had codes that were within the same anatomical or morphological cluster, and for only 36 (3.6%) cases were major discrepancies identified. Altogether, the agreement between IARC/WHO coding of cause-of-death information from ZAGS and MIAC coding of malignant neoplasms was therefore 96.4%. CONCLUSIONS RL completeness and agreement of cause-of-death information obtained from ZAGS and from MIAC were both very high. This is reassuring for the quality of cancer mortality follow-up of the Asbest chrysotile cohort. For future epidemiological studies in the Russian Federation, ZAGS appears to be a reliable information source for mortality follow-up, if the automated RL is complemented with manual searches of cohort members. MIAC is a good resource for prospective studies.
Collapse
Affiliation(s)
- J. Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - E. Kovalevskiy
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health,” Moscow, Russian Federation
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - M. Moissonnier
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - A. Olsson
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - D. Hashim
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - H. Kromhout
- Institute of Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - S. Kashanskiy
- Yekaterinburg Medical Research Center for Prophylaxis and Health Protection in Industrial Workers, Yekaterinburg, Russian Federation
| | - O. Chernov
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health,” Moscow, Russian Federation
| | - I. Bukhtiyarov
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health,” Moscow, Russian Federation
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - E. Ostroumova
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| |
Collapse
|
21
|
Jorhem L, Afthan G, Cumont G, Dypdahl HP, Gadd K, Havre GN, Julshamn K, Kaverud K, Lind B, Loimaranta J, Merseburg M, Olsson A, Piepponen S, Sundstrom B, Uppstad BJ, Waaler T, Winnerstam L. Determination of Metals in Foodstuffs by Atomic Absorption Spectrophotometry after Dry Ashing: NMKL Interlaboratory Study of Lead, Cadmium, Zinc, Copper, Iron, Chromium, and Nickel. J AOAC Int 2020. [DOI: 10.1093/jaoac/76.4.798] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
An interlaboratory study of a method for determination of lead, cadmium, zinc, copper, iron, chromium, and nickel in foodstuffs by atomic absorption spectrophotometry (AAS) after dry ashing at 450°C was conducted in 16 laboratories. The study was preceded by a practice round of familiarization samples and another round in which solutions were distributed and the metals were determined directly by AAS. The study included 5 different foods (liver paste, apple sauce, minced fish, wheat bran, and milk powder) and 2 composite diets. A single analysis was carried out on each sample. Suitable sample combinations were used as split level combinations for determination of the repeatability standard deviation. The relative reproducibility standard deviation for each of the elements ranged as follows: lead, 74-18% at 0.025-0.28 mg/kg; cadmium, 80-11% (0.002-0.51 mg/kg); zinc, 12-7% (44- 72 mg/kg); copper, 47-10% (0.48-41 mg/kg); iron, 35-9% (2-228 mg/kg); chromium, 48-21 % (0.008- 0.22 mg/kg); nickel, 64-39% (0.025-0.39 mg/kg).
Collapse
Affiliation(s)
- Lars Jorhem
- Swedish National Food Administration, PO Box 622, S-751 26 Uppsala, Sweden
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Jorhem L, Afthan G, Cumont G, Dypdahl HP, Gadd K, Havre GN, Julshamn K, Kåverud K, Lind B, Loimaranta J, Merseburg M, Olsson A, Piepponen S, Sundström B, Uppstad BJ, Waaler T, Winnerstam L. Determination of Metals in Foods by Atomic Absorption Spectrometry after Dry Ashing: NMKL1 Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/83.5.1204] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A method for determination of lead, cadmium, zinc, copper, and iron in foods by atomic absorption spectrometry (AAS) after dry ashing at 450°C was collaboratively studied in 16 laboratories. The study was preceded by a practice round of familiarization samples and another round in which solutions were distributed and the metals were determined directly by AAS. The study included 5 different foods (liver paste, apple sauce, minced fish, wheat bran, and milk powder) and 2 simulated diets. A single analysis was carried out with each sample. Suitable sample combinations were used as split-level combinations for determination of the repeatability standard deviation. The reproducibility relative standard deviation for each of the elements ranged from 20 to 50% for lead concentrations of 0.040–0.25 mg/kg, from 12 to 352% for cadmium concentrations of 0.001–0.51 mg/kg, from 4 to 8% for zinc concentrations of 0.7–38 mg/kg, from 7 to 45% for copper concentrations of 0.51–45 mg /kg, and from 11 to 14% for iron concentrations of 4–216 mg/kg.
Collapse
Affiliation(s)
- Lars Jorhem
- National Food Administration, Chemistry Division 2, Box 622, S-751 26 Uppsala, Sweden
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
McCann Haworth S, Zhuge Z, Nihlén C, Olsson A, Weitzberg E, Lundberg J, Krmar R, Nasiell J, Carlstrom M. Preeclampsia is associated with increased erythrocyte arginase activity and compromised nitric oxide bioactivity compared with healthy pregnant women. Pregnancy Hypertens 2019. [DOI: 10.1016/j.preghy.2019.08.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
24
|
Olsson A, Samuelsson M. P580Performance evaluation of dual vs. single lead automatic, real-world arrhythmic ECG recordings. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Detection of treatment-demanding paroxysmal arrhythmias can be difficult. Use of single lead ECG recordings for detection of Atrial Fibrillation (AF) has shown to lead to high false positive discovery rates, and requirements of additional manual clinical interpretation or 12-lead ECG to reach satisfactory diagnostic precision. Use of sequential, dual-lead ECG recordings for detection of AF has indicated significant clinical improvement in detection yield of AF and reduction of false positive discovery rates as compared to single lead-ECG.
Methods
The Coala Heart Monitor (Coala Life AB, Stockholm Sweden) system was evaluated by manual interpretation of 1,000 consecutive anonymous printouts of chest- and thumb-ECG waveforms, without any exclusion. The anonymized printouts contained three 10 s. strips of ECG at 25 mm/s, including mean heart rate, RR median and any user-provided annotation but with personal identification and algorithm analysis results blinded. The recordings were derived from actual Coala users with no training, control or influence, under a defined time period. The prevalence of cardiac conditions in the user population was unknown.
The blinded recordings were manually interpreted by a trained cardiologist. The interpretation was compared with the automatic analysis performed by an enhanced algorithm in the Coala Cloud to evaluate ECG signal performance and to calculate performance metrics of a combination of sequential dual chest- and thumb-ECG measurements as compared to the clinical performance metrics of singe lead ECG measurements only.
Results Metric Result using dual chest- and thumb-ECG and P-wave detection algorithm Result based on single lead thumb-ECG only Prevalence of AF in the recordings 14.4% (143 of 990 recordings) 14.4% (143 of 990 recordings) Percentage of recordings with ECG quality good enough to permit manual interpretation. 99,2% (8 of 998 non-readable) 98,7% (13 of 998 non-readable) Negative predictive value (NPV) for detecting AF 0.992 0.995 Positive predictive value (PPV) for detecting AF 0.872 0.647 False positive discovery rate 12.8% 35,3% Sensitivity for detecting AF 0.951 0.972 Specificity for detecting AF 0.976 0.909 Accuracy 0.973 0.919
Conclusion
Based on 1,000 real-world recordings the combination of dual chest- and thumb-ECG with P-wave detection yielded significantly higher Positive Predictive Values as compared to single lead ECG measurements. Dual chest- and thumb-ECG reduced false positive AF indications from 35,3% for single lead-ECG to 12,8% using combined chest- and thumb-ECG with P-wave detection.
Collapse
Affiliation(s)
- A Olsson
- Karolinska Institute, Stockholm, Sweden
| | - M Samuelsson
- Royal Institute of Technology, Stockholm, Sweden
| |
Collapse
|
25
|
Leosdottir M, Sjolin I, Sandberg C, Olsson A, Back M, Schiopu A, Gonzalez M, Ogmundsdottir Michelsen H. P2684Blood pressure lowering by using a self-care focused smartphone application for patients after myocardial infarction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
We have previously shown that complementing traditional cardiac rehabilitation (CR) with a web-based smartphone application designed to support self-control of risk factors can improve secondary prevention outcomes, including lower blood pressure (BP).
Purpose
To explore possible explanations for better BP control among patients with myocardial infarction (MI) receiving access to a smartphone application as a complement to traditional CR, compared to patients receiving traditional CR alone.
Methods
Data from a multi-centre randomized controlled trial that included 150 patients with MI (81% men, 60.4±8.8 years) was used. All patients participated in traditional CR. In addition, patients in the intervention group (APP, n=101) had access to the application. Patients received automated positive feedback on normal values and all registered data was viewed by CR nurses twice weekly. As previously reported, APP patients achieved a 9 mmHg larger reduction in systolic BP than usual care (UC) patients at 2-months follow-up (p=0.02). In the current analysis we assessed differences between APP and UC patients in the number of visits and telephone contacts with the CR clinic, number of reported BP measurements and number and type of interventions on account of out-of-range BP during the first 6 months of follow-up, using Mann-Whitney and chi-square tests.
Results
There was no difference in the median (IQR) number of visits to a CR nurse or physician (APP 2 (2–3) vs UC 2 (2–3), p=0.8) or telephone contacts ((APP 2 (1–4) vs UC 2 (1–4), p=0.8) between the groups. Approximately one in ten telephone contacts were initiated because of BP, with no difference between the groups (p=0.8). Out of 101 APP patients 75 reported BP values through the application, ranging from 1–175 BP values/patient (median 6 (IQR 0–34)). Most measurements (90%) were normal. Grouping clinic visits, telephone contacts due to BP and BP reports through the application as a composite for the number of BP measurements the CR personnel were exposed to during follow-up, there was a significant difference between the groups (APP 9 (4–36) vs UC 3 (2–3), p<0.0001). There was a small non-significant difference between the groups in the proportion of patients where an intervention was performed by the CR nurse on account of out-of-range BP (i.e. medication adjustments, new measurement scheduled) (APP 22% vs UC 12%, p=0.1).
Conclusion
While CR personnel were exposed to significantly more BP measurements from patients using a self-care focused smartphone application as a complement to traditional CR, most BP measurements reported through the application were normal and there was no difference in the number of interventions performed on account of out-of-range BP values. Automated positive feedback on in-range BP measurements, increased patient responsibility with better adherence to BP lowering medication could be possible explanations to improved BP control.
Acknowledgement/Funding
The faculty of Medicine, Lund University, Lund, Sweden
Collapse
Affiliation(s)
- M Leosdottir
- Skane University Hospital, Department of Cardiology and Department of Clinical Sciences, Lund University, Malmo, Sweden
| | - I Sjolin
- Skane University Hospital, Department of Cardiology and Department of Clinical Sciences, Lund University, Malmo, Sweden
| | - C Sandberg
- Umea University, Heart centre and Department of Public Health and Clinical Medicine, Cardiology, Umea, Sweden
| | - A Olsson
- Skane University Hospital, Department of Cardiology and Department of Clinical Sciences, Lund University, Malmo, Sweden
| | - M Back
- Linkoping University, Department of Medical and Health Sciences, Division of Physiotherapy, Linkoping, Sweden
| | - A Schiopu
- Skane University Hospital, Department of Cardiology and Department of Clinical Sciences, Lund University, Malmo, Sweden
| | - M Gonzalez
- Commonwealth Scientific Research and Industrial Organization, Brisbane, Australia
| | - H Ogmundsdottir Michelsen
- Skane University Hospital, Department of Cardiology and Department of Clinical Sciences, Lund University, Malmo, Sweden
| |
Collapse
|
26
|
Olsson A, Samuelsson M. P1456Evaluation of an enhanced, cloud-based AF-detection algorithm based on real-world arrhythmic recordings. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cloud-based solutions offer the ability to centrally and continuously enhance detection algorithms for arrhythmias such as Atrial Fibrillation (AF) based on generated data.
Methods
The Coala Heart Monitor (Coala) system was evaluated by manual interpretation of 1,000 consecutive anonymous printouts of chest- and thumb-ECG waveforms, without any exclusion. The anonymized printouts were blinded from algorithm analysis, apart from gender and age within a 10-year span. The recordings were derived from actual Coala users in Sweden with no training, control or influence, under a defined time period. The prevalence of cardiac conditions in the user population was unknown. The blinded recordings were manually interpreted by a trained cardiologist.
The interpretation was compared with the automatic analysis performed by an algorithm in the Coala Cloud to evaluate ECG signal performance and calculate performance metrics.
An enhanced algorithm utilizing P-wave detection was then evaluated on the data set and compared with the performance metrics of the existing algorithm.
Results Metric Results with current algorithm Results with enhanced algorithm Prevalence of AF in the recordings 14.4% (143 of 990 recordings) 14.4% (143 of 990 recordings) Sensitivity for detecting AF 0.972 (95% CI = 0.930–0.992) 0.951 Specificity for detecting AF 0.946 (95% CI = 0.928–0.960) 0.976 Negative predictive value for detecting AF 0.995 (95% CI = 0.987–0.999) 0.992 Positive predictive value for detecting AF 0.751 (95% CI = 0.683–0.812) 0.872 Accuracy 0.950 0.973
Conclusion
The enhanced algorithm was found to improve the Positive Predictive Value for detecting AF as compared to the existing algorithm (0.872 vs 0.751). The reduced sensitivity for the enhanced algorithm was due to 3 consecutive recordings from a single individual who had misplaced the Coala with corresponding altered morphology of the ECG signal. The recordings were still reported as having an irregular rhythm by the algorithm.
The evolution demonstrates that cloud-based systems offer an ability to enhance detection accuracy by using reference data to train algorithms.
Collapse
Affiliation(s)
- A Olsson
- Karolinska Institute, Stockholm, Sweden
| | | |
Collapse
|
27
|
Olsson A, Kiwanuka O, Wilhelmsson S, Sandblom G, Stackelberg O. Cohort study of the effect of surgical repair of symptomatic diastasis recti abdominis on abdominal trunk function and quality of life. BJS Open 2019; 3:750-758. [PMID: 31832581 PMCID: PMC6887686 DOI: 10.1002/bjs5.50213] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 06/26/2019] [Indexed: 11/30/2022] Open
Abstract
Background During pregnancy, women are at risk of developing persistent symptomatic diastasis recti abdominis (DRA), which may have a detrimental effect on their physical function and quality of life (QoL). The aim of this prospective cohort study was to determine the effect of surgical repair of DRA on abdominal trunk function, urinary incontinence and QoL in postpartum women with trunk instability symptoms resistant to training. Methods Postpartum women with diagnosed DRA and training‐resistant symptoms underwent double‐row plication of the linea alba. Abdominal trunk function was evaluated as the primary endpoint using a multimodal examination tool, the Abdominal Trunk Function Protocol. Recurrence was assessed by CT, urinary incontinence was evaluated using the Urogenital Distress Inventory (UDI‐6) and Incontinence Impact Questionnaire (IIQ‐7), and QoL was assessed with the Short Form 36 (SF‐36®) questionnaire. All subjects were examined before and 1 year after surgery. Results Sixty women were recruited. There was no DRA recurrence at the 1‐year follow‐up. Self‐reported abdominal trunk function had improved in 98 per cent of patients, with a mean score improvement of 79·1 per cent. In the physiological tests monitored by a physiotherapist, 76 per cent performed better and endured exercise tests longer than before surgery. All SF‐36® subscales improved significantly compared with preoperative scores and reached levels similar to, or higher than, the normative Swedish female population. For the UDI‐6 and IIQ‐7, 47 and 37 per cent respectively reported fewer symptoms at follow‐up than before surgery, and 13 and 8 per cent respectively reported more symptoms. Conclusion In this series of postpartum women presenting with DRA and symptoms of trunk instability resistant to training, surgical reconstruction resulted in a significant improvement in abdominal trunk function, urinary incontinence and QoL.
Collapse
Affiliation(s)
- A Olsson
- Department of Clinical Science and Education Karolinska Institutet, Södersjukhuset Stockholm Sweden.,Department of Surgery, Södersjukhuset Karolinska University Hospital Stockholm Sweden
| | - O Kiwanuka
- Department of Clinical Science and Education Karolinska Institutet, Södersjukhuset Stockholm Sweden.,Department of Surgery, Södersjukhuset Karolinska University Hospital Stockholm Sweden
| | - S Wilhelmsson
- Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function Karolinska University Hospital Stockholm Sweden
| | - G Sandblom
- Department of Clinical Science and Education Karolinska Institutet, Södersjukhuset Stockholm Sweden.,Department of Surgery, Södersjukhuset Karolinska University Hospital Stockholm Sweden
| | - O Stackelberg
- Department of Clinical Science and Education Karolinska Institutet, Södersjukhuset Stockholm Sweden.,Unit of Cardiovascular and Nutritional Epidemiology Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden.,Department of Surgery, Södersjukhuset Karolinska University Hospital Stockholm Sweden
| |
Collapse
|
28
|
Olsson A, Alfredsson J, Thelander M, Svedjeholm R, Berglund JS, Berg S. Activated platelet aggregation is transiently impaired also by a reduced dose of protamine. SCAND CARDIOVASC J 2019; 53:355-360. [PMID: 31476919 DOI: 10.1080/14017431.2019.1659396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Protamine reduces platelet aggregation after cardiopulmonary bypass (CPB). We studied the inhibitory effect of a reduced protamine dose, the duration of impaired platelet function and the possible correlation to postoperative bleeding. Design: Platelet function was assessed by impedance aggregometry in 30 patients undergoing cardiac surgery with CPB at baseline, before protamine administration, after 70% and 100% of the calculated protamine dose, after 20 minutes and at arrival to the intensive care unit. Adenosine diphosphate (ADP), thrombin receptor activating peptide-6 (TRAP), arachidonic acid (AA) and collagen (COL) were used as activators. Blood loss was measured during operation and three hours after surgery. Results are presented as median (25th-75th percentile). Results: Platelet aggregation decreased markedly after the initial dose of protamine (70%) with all activators; ADP 89 (71-110) to 54 (35-78), TRAP 143 (116-167) to 109 (77-136), both p < .01; AA 25 (16-49) to 17 (12-24) and COL 92 (47-103) to 60 (38-81) U, both p < .05. No further decrease was seen after 100% protamine. The effect was transient and after twenty minutes platelet aggregation had started to recover; ADP 76 (54-106), TRAP 138 (95-158), AA 20 (10-35), COL 70 (51-93) U. Blood loss during operation correlated to aggregometry measured at baseline and after protaminization. Conclusions: Protamine after CPB induces a marked decrease in platelet aggregation already at a protamine-heparin ratio of 0.7:1. The impairment seems to be transient and recovery had started after 20 minutes.
Collapse
Affiliation(s)
- A Olsson
- Department of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Cardio-Thoracic Surgery, Blekinge Hospital, Karlskrona, Sweden
| | - J Alfredsson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Cardiology, Linköping University, Linköping, Sweden
| | - M Thelander
- Department of Cardio-Thoracic Surgery, Blekinge Hospital, Karlskrona, Sweden
| | - R Svedjeholm
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Cardio-Thoracic and Vascular Surgery, Linköping University, Linköping, Sweden
| | - J Sanmartin Berglund
- Department of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden
| | - S Berg
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Cardiovascular Anesthesia and Intensive Care, Linköping University, Linköping, Sweden
| |
Collapse
|
29
|
Hasselbalch IC, Søndergaard HB, Koch-Henriksen N, Olsson A, Ullum H, Sellebjerg F, Oturai AB. The neutrophil-to-lymphocyte ratio is associated with multiple sclerosis. Mult Scler J Exp Transl Clin 2018; 4:2055217318813183. [PMID: 30515298 PMCID: PMC6262498 DOI: 10.1177/2055217318813183] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/12/2018] [Accepted: 10/14/2018] [Indexed: 12/20/2022] Open
Abstract
Background Subtypes of white blood cell counts are known biomarkers of systemic inflammation and a high neutrophil-to-lymphocyte ratio (NLR) has been associated with several autoimmune diseases. Few studies have investigated the NLR in multiple sclerosis (MS). Objective To examine the association between NLR, MS and disability measured by the MS severity score (MSSS). Methods Patients were included from the Danish Multiple Sclerosis Biobank. Information on patient NLR was obtained just before their first treatment and clinical information was provided by the Danish Multiple Sclerosis Treatment Register. Information on NLR from controls was collected from the Danish Blood Donor Study. Patients and controls were 1:2 propensity score matched by baseline confounders. Results Propensity score matching left 740 of 743 MS patients and 1420 of 4691 controls for further analyses. Odds-ratio (OR) was 3.64 (95% confidence interval 2.87–4.60, p < 0.001) for MS disease per unit increase of logarithmically transformed NLR (ln-NLR), corresponding to an OR of 2.68 for each doubling of NLR. Mean NLR was 2.12 for patients and 1.72 for controls (p < 0.001). Ln-NLR correlated weakly with patient MSSS (R2 = 0.019, p = 0.008). Conclusion Patients with early MS had increased levels of NLR compared to healthy controls and NLR was weakly correlated with MSSS.
Collapse
Affiliation(s)
- I C Hasselbalch
- Danish Multiple Sclerosis Center, University of Copenhagen, Denmark
| | - H B Søndergaard
- Danish Multiple Sclerosis Center, University of Copenhagen, Denmark
| | - N Koch-Henriksen
- The Danish Multiple Sclerosis Registry, University of Copenhagen, Denmark.,Department of Clinical Epidemiology, University of Aarhus, Denmark
| | - A Olsson
- Danish Multiple Sclerosis Center, University of Copenhagen, Denmark
| | - H Ullum
- Department of Clinical Immunology, University of Copenhagen, Copenhagen, Denmark
| | - F Sellebjerg
- Danish Multiple Sclerosis Center, University of Copenhagen, Denmark
| | - A B Oturai
- Danish Multiple Sclerosis Center, University of Copenhagen, Denmark
| |
Collapse
|
30
|
Forsgren C, Olsson A, Candamio Amato M, Johannesson U. The Impact of Robotic Assisted Total Laparoscopic Hysterectomy on Pelvic Floor Function and Sexual Function. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
31
|
Olsson A, Oturai AB, Søndergaard HB, Sellebjerg F, Oturai PS. Bone microarchitecture and bone mineral density in multiple sclerosis. Acta Neurol Scand 2018; 137:363-369. [PMID: 29270986 DOI: 10.1111/ane.12884] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) patients are at increased risk of reduced bone mineral density (BMD) and fractures. The aetiology of bone loss in MS is unclear. Trabecular bone score (TBS) is a novel analytical tool that provides a measurement of the bone microarchitecture. Decreased TBS predicts increased fracture risk independently of BMD. To date, no studies have investigated TBS in MS patients. OBJECTIVES To assess bone quality in MS patients by TBS and to evaluate potential risk factors that may affect BMD and TBS in patients with MS. METHODS Two hundred sixty MS patients were included. TBS was calculated using TBS iNsight software (MediMaps® ). Multivariable regression analyses were performed with information on smoking, alcohol, glucocorticoid (GC) treatment, sun exposure, physical activity, vitamin D and BMI. RESULTS Trabecular bone score was not significantly different from an age-matched reference population. Low TBS was associated with high age (P = .014) and smoking (P = .03). Smoking and physical inactivity were associated with low BMD in spine (P = .034, P = .032). GC treatment was not associated with TBS. CONCLUSION We could not find altered TBS values among MS patients, suggesting that BMD alone, and not the bone microarchitecture, is affected in MS. However, larger studies are needed to verify these findings and to establish the role of TBS in MS. As in the background population, physical activity and non-smoking habits are associated with better bone health in MS.
Collapse
Affiliation(s)
- A. Olsson
- Department of Neurology; Danish Multiple Sclerosis Center; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
| | - A. B. Oturai
- Department of Neurology; Danish Multiple Sclerosis Center; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
| | - H. B. Søndergaard
- Department of Neurology; Danish Multiple Sclerosis Center; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
| | - F. Sellebjerg
- Department of Neurology; Danish Multiple Sclerosis Center; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
| | - P. S. Oturai
- Department of Clinical Physiology; Nuclear Medicine and PET; Rigshospitalet; Copenhagen Denmark
| |
Collapse
|
32
|
Haaker J, Olsson A. Neuropharmacology of social fear learning. PHARMACOPSYCHIATRY 2017. [DOI: 10.1055/s-0037-1606410] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- J Haaker
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
33
|
Olsson A, Ljung R, Hellgren M, Berntorp E, Baghaei F. Phenotype and genotype comparisons in carriers of haemophilia A. Haemophilia 2016; 22:e235-7. [DOI: 10.1111/hae.12928] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2016] [Indexed: 11/26/2022]
Affiliation(s)
- A. Olsson
- Department of Haematology and Coagulation Disorders Sahlgrenska University Hospital Gothenburg Sweden
| | - R. Ljung
- Department of Paediatrics Centre for Thrombosis and Haemostasis Skåne University Hospital Lund University Malmö Sweden
| | - M. Hellgren
- Department of Obstetrics and Gynaecology Institute of Clinical Science Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - E. Berntorp
- Centre for Thrombosis and Haemostasis Skåne University Hospital Lund University Malmö Sweden
| | - F. Baghaei
- Department of Haematology and Coagulation Disorders Sahlgrenska University Hospital Gothenburg Sweden
| |
Collapse
|
34
|
Behrens T, Groß I, Siemiatycki J, Conway DI, Jöckel KH, Olsson A, Kromhout H, Straif K, Schüz J, Hovanec J, Kendzia B, Pesch B, Brüning T. Is occupational prestige an independent risk factor for lung cancer? Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.014] [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: 11/13/2022] Open
|
35
|
Hovanec J, Siemiatycki J, Conway D, Jöckel KH, Olsson A, Schüz J, Straif K, Kromhout H, Kendzia B, Pesch B, Brüning T, Behrens T. Lungenkrebs und sozio-ökonomischer Status: die SYNERGY-Studie. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
36
|
Olsson A, Hellgren M, Berntorp E, Baghaei F. Association between bleeding tendency and health-related quality of life in carriers of moderate and severe haemophilia. Haemophilia 2015; 21:742-6. [DOI: 10.1111/hae.12796] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2015] [Indexed: 12/22/2022]
Affiliation(s)
- A. Olsson
- Department of Haematology and Coagulation Disorders; Sahlgrenska University Hospital; Gothenburg Sweden
| | - M. Hellgren
- Department of Antenatal Care; Närhälsan; Primary Care; Västra Götaland Sweden
- Institute of Clinical Science; Department of Obstetrics and Gynaecology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - E. Berntorp
- Lund University; Centre for Thrombosis and Haemostasis; Skåne University Hospital; Malmö Sweden
| | - F. Baghaei
- Department of Haematology and Coagulation Disorders; Sahlgrenska University Hospital; Gothenburg Sweden
| |
Collapse
|
37
|
Olsson A, Oturai DB, Sørensen PS, Oturai PS, Oturai AB. Short-term, high-dose glucocorticoid treatment does not contribute to reduced bone mineral density in patients with multiple sclerosis. Mult Scler 2015; 21:1557-65. [DOI: 10.1177/1352458514566417] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 11/27/2014] [Indexed: 11/15/2022]
Abstract
Background: Patients with multiple sclerosis (MS) are at increased risk of reduced bone mineral density (BMD). A contributing factor might be treatment with high-dose glucocorticoids (GCs). Objectives: The objective of this paper is to assess bone mass in patients with MS and evaluate the importance of short-term, high-dose GC treatment and other risk factors that affect BMD in patients with MS. Methods: A total of 260 patients with MS received short-term high-dose GC treatment and had their BMD measured by dual x-ray absorptiometry. BMD was compared to a healthy age-matched reference population ( Z-scores). Data regarding GCs, age, body mass index (BMI), serum 25(OH)D, disease duration and severity were collected retrospectively and analysed in a multiple linear regression analysis to evaluate the association between each risk factor and BMD. Results: Osteopenia was present in 38% and osteoporosis in 7% of the study population. Mean Z-score was significantly below zero, indicating a decreased BMD in our MS patients. Multiple linear regression analysis showed no significant association between GCs and BMD. In contrast, age, BMI and disease severity were independently associated with both lumbar and femoral BMD. Conclusion: Reduced BMD was prevalent in patients with MS. GC treatment appears not to be the primary underlying cause of secondary osteoporosis in MS patients.
Collapse
Affiliation(s)
- A Olsson
- Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet Copenhagen University Hospital, Denmark
| | - DB Oturai
- Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet Copenhagen University Hospital, Denmark
| | - PS Sørensen
- Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet Copenhagen University Hospital, Denmark
| | - PS Oturai
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Denmark
| | - AB Oturai
- Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet Copenhagen University Hospital, Denmark
| |
Collapse
|
38
|
Olsson A, Hellgren M, Berntorp E, Holmström M, Baghaei F. Bleeding phenotype in carriers of haemophilia A does not correlate with thrombin generation. Haemophilia 2014; 21:e111-3. [PMID: 25422177 DOI: 10.1111/hae.12585] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2014] [Indexed: 11/30/2022]
Affiliation(s)
- A Olsson
- Department of Haematology and Coagulation Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | | | | | | |
Collapse
|
39
|
Iveson P, Ahmad R, Bapat M, Morrison M, Olsson A, Meijer A. Preparation and biological evaluation of a 99mTc labelled fibroblast activation protein inhibitor. Nucl Med Biol 2014. [DOI: 10.1016/j.nucmedbio.2014.05.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
40
|
|
41
|
Olsson A, Baghaei F, Berntorp E, Hellgren M. P-005 Bleeding tendency in Swedish carriers of haemophilia A and B. Thromb Res 2013. [DOI: 10.1016/s0049-3848(13)70051-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
42
|
Carducci M, Armstrong A, Häggman M, Stadler W, Gingrich J, Assikis V, Forsberg G, Olsson A, Nordle Ö, Pili R. Tasquinimod Mechanism of Action Biomarkers: Correlation with PFS and Survival in Men with Metastatic Castrate Resistant Prostate Cancer Treated in a Randomized Phase 2 Trial. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33477-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
43
|
Campbell HA, Dwyer RG, Fitzgibbons S, Klein CJ, Lauridsen G, McKeown A, Olsson A, Sullivan S, Watts ME, Westcott DA. Prioritising the protection of habitat utilised by southern cassowaries Casuarius casuarius johnsonii. ENDANGER SPECIES RES 2012. [DOI: 10.3354/esr00397] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
44
|
Olsson A, Phalen D. Medetomidine immobilisation and atipamezole reversal in large estuarine crocodiles (Crocodylus porosus) using metabolically scaled dosages. Aust Vet J 2012; 90:240-4. [DOI: 10.1111/j.1751-0813.2012.00907.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
45
|
Olsson A, Borgquist S, Butt S, Zackrisson S, Landberg G, Manjer J. Tumour-related factors and prognosis in breast cancer detected by screening. Br J Surg 2011; 99:78-87. [PMID: 22068957 DOI: 10.1002/bjs.7757] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2011] [Indexed: 11/08/2022]
Abstract
BACKGROUND Breast cancer detected by screening has an unexplained prognostic advantage beyond stage shift compared with cancers detected clinically. The aim was to investigate biological factors in invasive breast cancer, with reference to mode of detection and rate of death from breast cancer. METHODS Histology, oestrogen receptor α and β, progesterone receptor, human epidermal growth factor receptor (HER) 2, cyclin D1, p27, Ki-67 and perinodal growth were analysed in 466 tumours from a prospective cohort, the Malmö Diet and Cancer Study. Using logistic regression, odds ratios were calculated to investigate the relationship between tumour characteristics and mode of detection. The same tumour factors were analysed in relation to standard prognostic features. Death from breast cancer was analysed using Cox regression with adjustments for standard tumour factors; differences following adjustment were analysed by means of Freedman statistics. RESULTS None of the biological tumour characteristics varied with mode of detection of breast cancer. After adjustment for age, tumour size, axillary lymph node involvement (ALNI) and grade, women with cancer detected clinically had an increased risk of death from breast cancer (hazard ratio 2·48, 95 per cent confidence interval 1·34 to 4·59), corresponding to a 37·2 per cent difference compared with the unadjusted model. Additional adjustment for biological tumour factors studied caused only minor changes. CONCLUSION None of the biological tumour markers investigated explained the improved prognosis in breast cancer detected by screening. None of the factors was related to ALNI, suggesting that other mechanisms may be responsible for tumour spread.
Collapse
Affiliation(s)
- A Olsson
- Departments of Surgery and Cancer Study, Skåne University Hospital, Malmö, Sweden.
| | | | | | | | | | | |
Collapse
|
46
|
Peters S, Kromhout H, Olsson A, Wuchmann HE, Bruske I, Consonni D, Landi MT, Caporaso N, Siemiatycki J, Richiardi L, Mirabelli D, Simonato L, Gustavsson P, Plato N, Jockel KH, Ahrens W, Pohlabeln H, Boffetta P, Brennan P, Zaridze D, Cassidy A, Lissowska J, Szeszenia-Dabrowska N, Rudnai P, Fabianova E, Forastiere F, Bencko V, Foretova L, Janout V, Stucker I, Dumitru RS, Benhamou S, Bueno-de-Mesquita B, Kendzia B, Pesch B, Straif K, Bruning T, Vermeulen R. Occupational exposure to organic dust increases lung cancer risk in the general population. Occup Environ Med 2011. [DOI: 10.1136/oemed-2011-100382.151] [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: 11/04/2022]
|
47
|
Lomnytska MI, Becker S, Bodin I, Olsson A, Hellman K, Hellström AC, Mints M, Hellman U, Auer G, Andersson S. Differential expression of ANXA6, HSP27, PRDX2, NCF2, and TPM4 during uterine cervix carcinogenesis: diagnostic and prognostic value. Br J Cancer 2010; 104:110-9. [PMID: 21119665 PMCID: PMC3039821 DOI: 10.1038/sj.bjc.6605992] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background: Cytology-based diagnostics of squamous cervical cancer (SCC) precursor lesions is subjective and can be improved by objective markers. Methods: IHC-based analysis of ANXA6, HSP27, peroxiredoxin 2 (PRDX2), NCF2, and tropomyosin 4 (TPM4) during SCC carcinogenesis. Results: Expression of ANXA6, HSP27, PRDX2, and NCF2 in the cytoplasm of dysplastic cells increased from cervical intraepithelial neoplasia 2/3 (CIN2/3) to microinvasive cancer. Invasive SCC showed lower expression of TPM4 than CIN and normal epithelium. CIN2/3 with the highest sensitivity and specificity differed from normal epithelium by cytoplasmic expression of HSP27. Patients with cytoplasmic HSP27 expression in SCC deviating from that observed in normal epithelium had worse relapse-free (P=0.019) and overall (P=0.014) survival. Invasive SCC with the highest sensitivity and specificity differed from normal epithelium by expression of PRDX2 and TPM4 in the cytoplasm, from CIN2/3 by the expression of ANXA6 and TPM4 in the cytoplasm, and from microinvasive SCC by the expression of PRDX2 and ANXA6 in the cytoplasm. The number of sporadic ANXA6+ cells between the atypical cells increased from CIN2/3 to invasive SCC. Conclusion: Detection of expression changes of the proteins ANXA6, HSP27, PRDX2, NCF2, and TPM4 in SCC precursor lesions may aid current cytological and pathological diagnostics and evaluation of prognosis.
Collapse
Affiliation(s)
- M I Lomnytska
- Department of Obstetrics and Gynecology, Institute for Clinical Science and Technology, CLINTEC, Karolinska University Hospital, Huddinge, Karolinska Institutet, Stockholm SE-14186, Sweden.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Kendzia B, Gustavsson P, Pohlabeln H, Ahrens W, Jöckel K, Olsson A, Gross I, Brüske I, Wichmann H, Merletti F, Mirabelli D, Boffetta P, Straif K, Brüning T, Pesch B. Cigarette smoking and lung cancer – Risk estimates for the major histological types from a pooled analysis of European case-control studies. Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1266688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
49
|
Olsson A, Lindahl C, Holme I, Fayyad R, Faergeman O, Kastelein J, Tikkanen M, Lytken Larsen M, Pedersen T. P178 CORONARY PATIENTS REACHING LDL-CHOLESTEROL < 2.0 mmol/L HAVE THE LOWEST RISK OF CARDIOVASCULAR EVENTS DURING STATIN TREATMENT: THE IDEAL STUDY. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70245-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
50
|
Olsson A, Lindahl C, Fayyad R, Bhatia S, Holme I. Abstract: P824 CAN LIPID/APOLIPOPROTEIN FACTORS ACCOUNT FOR RESIDUAL RISK IN PATIENTS ATTAINING CURRENT LDL-C TARGETS? ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71178-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|