| 44201. |
- Karlsson, Karolina, 1975, et al.
(author)
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Interventions for peri-implantitis and their effects on further bone loss: A retrospective analysis of a registry-based cohort
- 2019
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In: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 46:8, s. 872-879
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Journal article (peer-reviewed)abstract
- Objective The aim of the present study was to assess interventions and their consequences with regard to further bone loss at sites diagnosed with peri-implantitis. Materials and Methods In 2017, records of 70 patients diagnosed with moderate/severe peri-implantitis at >= 1 implant sites 4 years earlier were obtained. Changes of marginal bone levels during the study period assessed on radiographs and predictors of disease progression were identified by Cox regression and mixed linear modelling. Patient files were analysed for professional interventions related to the treatment of peri-implantitis. Results Mean bone loss (+/- SD) at implants diagnosed with moderate/severe peri-implantitis was 1.1 +/- 2.0 mm over the observation period of 3.3 years. While non-surgical measures including submucosal and/or supra-mucosal cleaning of implants were provided to almost all patients, surgical treatment of peri-implantitis was limited to a subgroup (17 subjects). Surgically treated implant sites demonstrated a mean bone loss of 1.4 +/- 2.4 mm prior to surgical intervention, while only minor changes (0.2 +/- 1.0 mm) occurred after therapy. Clinical parameters (bleeding/suppuration on probing and probing depth) assessed at diagnosis were statistically significant predictors of disease progression. Conclusions Non-surgical procedures were insufficient to prevent further bone loss at implant sites affected by moderate/severe peri-implantitis. Surgical treatment of peri-implantitis markedly diminished the progression of bone loss. Clinical assessments of bleeding on probing and probing depth at diagnosis predicted further bone loss.
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| 44202. |
- Karlsson, Karolina, 1975, et al.
(author)
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Occurrence and clustering of complications in implant dentistry
- 2020
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In: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 31:10, s. 1002-1009
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Journal article (peer-reviewed)abstract
- Objectives The aim was to evaluate the overall occurrence and potential clustering of biological and technical complications in implant dentistry. Material and Methods 596 patients provided with implant-supported reconstructions were evaluated for the occurrence of (a) technical complications, (b) peri-implantitis and (c) implant loss during a period of 9 years. Time and type of event were scored, and potential risk factors were explored through parametric modelling of survival and hazards. Clustering of complications was assessed at the patient level, and patient satisfaction was evaluated by questionnaire completed at the 9-year examination. Results 42% of patients were affected by technical and/or biological complications during the 9-year observation period. Extent of therapy (Hazard Ratio 2.5: patients with partial jaw restorations; HR 3.9: patients with full jaw restorations) and a history of periodontitis (HR 1.6) were identified as risk factors. While technical complications occurred mostly as isolated events, 41% of subjects identified with peri-implantitis and 52% of subjects with implant loss also presented with other complications. The hazard for technical complications and implant loss peaked at 0.7 years and 0.2 years, respectively, while the hazard for peri-implantitis was consistent throughout the observation period. The overall proportion of satisfied patients at 9 years was high (95%), and only minor differences between individuals with and without complications were noted. Conclusions Complications following implant-supported restorative therapy were common findings. Extent of therapy and periodontitis were identified as risk factors. While technical complications occurred in an isolated pattern, peri-implantitis and implant loss demonstrated clustering with other types of complications.
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| 44203. |
- Karlsson, Kåre, et al.
(author)
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Stress response in Swedish ambulance personnel during priority-1 alarms
- 2020
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In: Australasian Journal of Paramedicine. - : SAGE Publications. - 2202-7270. ; 17, s. 1-7
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Journal article (peer-reviewed)abstract
- Introduction Ambulance personnel consider themselves as being healthy, but studies show they often suffer from stress-related illnesses. However, research on the causes of these stress-related illnesses is limited. This study aimed to examine the stress response of Swedish of ambulance personnel during priority-1 alarms. Methods During 90 priority-1 alarms salivary cortisol concentrations were measured at alarm and after end of alarm, and heart rates measured every 15 seconds. Thirteen men and six women participated in the study. A questionnaire with background data was collected. Non-parametric statistical tests were used. Results Elevated heart rate (median +34.7%) was associated with the actual priority-1 alarm, and during the alarm for women. Median salivary cortisol concentrations at alarm and after end of alarm (14.0 and 14.2 nmol/L respectively) showed non-significant differences. There were individual non-identical responses to the alarms. Alarms concerning traffic accidents, fast track and children generated the highest cortisol concentrations. The stress response showed non-significant differences in age, gender or level of education. Salivary cortisol concentrations and response were lower in the afternoon shift (2pm to 8pm). Conclusion The alarm causes increased heart rate at the group level but with individual different responses. Predefined fast track schedules and traffic accidents appear to generate measurable stress. Cortisol concentration follows normal diurnal variation of cortisol regarding time point for priority-1 alarms. Time of day does not affect the heart rate. © 2020, Paramedics Australasia. All rights reserved.
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| 44204. |
- Karlsson, Karolina, 1975, et al.
(author)
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Technical complications following implant-supported restorative therapy performed in Sweden
- 2018
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In: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 29:6, s. 603-611
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Journal article (peer-reviewed)abstract
- ObjectiveThe aim of this study was to evaluate the occurrence and consequences of technical complications in implant-supported restorative therapy. Material & MethodsThe occurrence and consequences of technical complications in implant-supported restorative therapy over a mean follow-up period of 5.3years were assessed based on documentation in files from 2,666 patients. Risk indicators were identified by the use of survival models, considering repeated events. Results were expressed as hazard ratios (HR) including 95% confidence intervals. ResultsTechnical complications occurred in 24.8% of the patients. Chipping and loss of retention were the most common, affecting 11.0% and 7.9% of supraconstructions, respectively, while implant-related complications (e.g., implant fracture) were rare. More than 50% of the affected patients experienced technical complications more than once and almost all reported complications led to interventions by a dental professional. The extent of the supraconstruction was the strongest risk indicator for both chipping (HR<0.2) and loss of retention (HR>3). ConclusionOver a 5-year period, technical complications in implant-supported restorative therapy occurred frequently and their management required professional intervention.
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| 44205. |
- Karlsson, Katarina, 1963-, et al.
(author)
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The Children's Action-Reaction Assessment Tool (CARAT) as an observational technique for assessing symptom management : An initial validation study with children aged 3–7 years undergoing needle procedures
- 2021
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In: Journal for Specialists in Pediatric Nursing. - : Blackwell Publishing Ltd. - 1539-0136 .- 1744-6155.
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Journal article (peer-reviewed)abstract
- Purpose:For many children, needle procedures are fearful events that are often painful. The first step in symptom management is to assess the child's pain and fear, and the next step is to use coping strategies to provide symptom relief for children who experience or feel pain and fear during procedures. The Children's Action–Reaction Assessment Tool (CARAT) is built on action–reaction strategies. This study aimed to determine the inter-rater reliability of the CARAT when used during needle procedures with 3- to 7-year-old children.Design and Methods:We used a quantitative approach in which 21 children were observed by two independent observers during needle procedures to evaluate the inter-rater reliability of the CARAT. Data were analysed with descriptive statistics, and the observation scores were calculated with an intraclass correlation coefficient (ICC) test on SPSS for Windows, version 25.Results:The completed CARAT indicated the use of action–reaction strategies. Neither action nor reaction strategies were frequently used. The parents were seldom involved in the procedure. The inter-rater reliability showed a sufficient correlation between the observers.Practice Implications:This study showed promising results for the inter-rater reliability of the CARAT, which can be used to facilitate care for children. The observational tool can be used to assess the use of action–reaction strategies in conjunction with needle procedures in children aged 3–7 years.
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| 44206. |
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| 44207. |
- Karlsson, Linda, et al.
(author)
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Cerebrospinal fluid reference proteins increase accuracy and interpretability of biomarkers for brain diseases.
- 2024
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In: Nature Communications. - 2041-1723. ; 15:1
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Journal article (peer-reviewed)abstract
- Cerebrospinal fluid (CSF) biomarkers reflect brain pathophysiology and are used extensively in translational research as well as in clinical practice for diagnosis of neurological diseases, e.g., Alzheimer's disease (AD). However, CSF biomarker concentrations may be influenced by non-disease related inter-individual variability. Here we use a data-driven approach to demonstrate the existence of inter-individual variability in mean standardized CSF protein levels. We show that these non-disease related differences cause many commonly reported CSF biomarkers to be highly correlated, thereby producing misleading results if not accounted for. To adjust for this inter-individual variability, we identified and evaluated high-performing reference proteins which improved the diagnostic accuracy of key CSF AD biomarkers. Our reference protein method attenuates the risk for false positive findings, and improves the sensitivity and specificity of CSF biomarkers, with broad implications for both research and clinical practice.
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| 44208. |
- Karlsson, Lene, et al.
(author)
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Characteristics and outcome of primary resistant disease in paediatric acute myeloid leukaemia
- 2023
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In: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 201:4, s. 757-765
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Journal article (peer-reviewed)abstract
- A significant proportion of events in paediatric acute myeloid leukaemia (AML) are caused by resistant disease (RD). We investigated clinical and biological characteristics in 66 patients with RD from 1013 children with AML registered and treated according to the NOPHO-AML 93, NOPHO-AML 2004, DB AML-01 and NOPHO-DBH AML 2012 protocols. Risk factors for RD were age10 years or older and a white-blood-cell count (WBC) of 100 x 10(9)/L or more at diagnosis. The five-year overall survival (OS) was 38% (95% confidence interval [CI]: 28%-52%). Of the 63 children that received salvage therapy with chemotherapy, 59% (N = 37) achieved complete remission (CR) with OS 57% (95% CI: 42%-75%) compared to 12% (95% CI: 4%-35%) for children that did not achieve CR. Giving more than two salvage chemotherapy courses did not increase CR rates. OS for all 43 patients receiving allogeneic haematopoietic stem cell transplantation (HSCT) was 49% (95% CI: 36%-66%). Those achieving CR and proceeding to HSCT had an OS of 56% (95% CI: 41%-77%, N = 30). This study showed that almost 40% of children with primary resistant AML can be cured with salvage therapy followed by HSCT. Children that did not achieve CR after two salvage courses with chemotherapy did not benefit from additional chemotherapy.
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| 44209. |
- Karlsson, Lene, et al.
(author)
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Fusion transcript analysis reveals slower response kinetics than multiparameter flow cytometry in childhood acute myeloid leukaemia
- 2022
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In: International Journal of Laboratory Hematology. - : Wiley. - 1751-5521 .- 1751-553X. ; 44:6, s. 1094-1101
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Journal article (peer-reviewed)abstract
- Introduction Analysis of measurable residual disease (MRD) is increasingly being implemented in the clinical care of children and adults with acute myeloid leukaemia (AML). However, MRD methodologies differ and discordances in results lead to difficulties in interpretation and clinical decision-making. The aim of this study was to compare results from reverse transcription quantitative polymerase chain reaction (RT-qPCR) and multiparameter flow cytometry (MFC) in childhood AML and describe the kinetics of residual leukaemic burden during induction treatment. Methods In 15 children who were treated in the NOPHO-AML 2004 trial and had fusion transcripts quantified by RT-qPCR, we compared MFC with RT-qPCR for analysis of MRD during (day 15) and after induction therapy. Eight children had RUNX1::RUNX1T1, one CBFB::MYH11 and six KMT2A::MLLT3. Results When >= 0.1% was used as cut-off for positivity, 10 of 22 samples were discordant. The majority (9/10) were MRD positive with RT-qPCR but MRD negative with MFC, and several such cases showed the presence of mature myeloid cells. Fusion transcript expression was verified in mature cells as well as in CD34 expressing cells sorted from diagnostic samples. Conclusions Measurement with RT-qPCR suggests slower response kinetics than indicated from MFC, presumably due to the presence of mature cells expressing fusion transcript. The prognostic impact of early measurements with RT-qPCR remains to be determined.
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| 44210. |
- Karlsson, Louise, 1993, et al.
(author)
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Good functional outcomes after endoscopic treatment for greater trochanteric pain syndrome
- 2023
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In: Journal of Experimental Orthopaedics. - : Springer Science and Business Media LLC. - 2197-1153. ; 10:1
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Journal article (peer-reviewed)abstract
- Purpose: Greater trochanteric pain syndrome (GTPS) is a term covering different conditions generating lateral hip pain. Recalcitrant cases may require surgery but there are only a few studies evaluating endoscopic treatment. This study aimed to evaluate the outcome of endoscopically treated GTPS at minimum two years postoperatively using patient-reported outcome measures (PROMs), and to assess the complication rate associated with endoscopic surgery. Methods: A total of 33 patients, mean age 43.2years, 88% women, with a mean symptom duration of 3.5years, were included in the study. A total of 36 operated hips were included. Pre- and at minimum two years postoperatively the patients completed questionnaires consisting of the International Hip Outcome Tool (iHOT-12) and the Hip Sports Activity scale (HSAS), the Visual analogue scale for overall hip function (VAS-OHF), the Copenhagen Hip and Groin Outcome Score (HAGOS), the EuroQoL-5 Dimension Questionnaire (EQ-5D) and the EQ-VAS. Complications were assessed using the Clavien-Dindo classification. Results: Median follow-up time was 24.5months postoperatively. Statistically significant improvements were seen for the following PROMs (p < 0.05); iHOT-12 (36.3 vs 54.0), HAGOS different subscores (40.8 vs 59.0, 46.5 vs 62.6, 29.9 vs 53.1, 33.5 vs 51.4, 20.7 vs 41.4, 23.4 vs 43.3), EQ-VAS (55.9 vs 63.3) and EQ-5D (0.392 vs 0.648). VAS-OHF and HSAS did not reach significance. There was a 71% satisfaction rate with the surgery. Three Clavien-Dindo grade 1 and one grade 2 complications were registered postoperatively, with 41% of patients achieving PASS for iHOT-12 at two years follow-up. Conclusion: Endoscopic surgery for greater trochanteric pain syndrome improved patient-reported outcomes and the procedure was associated with low risk of complications. Level of evidence: Level IV.
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