| 1. |
- Fritzell, Peter, et al.
(författare)
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Recurrent Versus Primary Lumbar Disc Herniation Surgery: Patient-reported Outcomes in the Swedish Spine Register Swespine
- 2015
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Ingår i: Clinical Orthopaedics and Related Research. - : Ovid Technologies (Wolters Kluwer Health). - 0009-921X .- 1528-1132. ; 473:6, s. 1978-1984
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Forskningsöversikt (refereegranskat)abstract
- Lumbar disc herniation (LDH) is a common indication for lumbar spine surgery. The proportion of patients having a second surgery within 2 years varies in the literature between 0.5% and 24%, with recurrent herniation being the most common cause. Several studies have not found any relevant outcome differences between patients undergoing surgery for primary LDH and patients undergoing reoperation for a recurrent LDH, but these studies have limitations, including small sample size and retrospective design. We (1) compared patient-reported outcomes between patients operated on for primary LDH and patients reoperated on for recurrent LDH within 1 year after index surgery and (2) determined risk factors for worse outcomes. We obtained data from the Swedish National Spine Register, Swespine, where patient-reported outcomes are collected using mailed protocols at 1, 2, 5, and 10 years after surgery. Of the 13,562 patients identified who underwent LDH between January 2000 and May 2011, 13,305 (98%) underwent primary surgery for LDH and 257 (2%) underwent reoperation for a recurrent LDH within the first year. Patient-reported outcomes at 1 to 2 years were available for 8497 patients (63%), 8350 of 13,305 (63%) in the primary LDH group and 147 of 257 (57%) in the recurrent LDH group (p = 0.068). We compared leg and back pain (VAS: 0-100), function (Oswestry Disability Index [ODI]: 0-100), quality of life (EQ-5D: -0.59 to 1.0), patient satisfaction, and global assessment of leg pain between groups. We also analyzed rsik factors for worse global assessment and satisfaction. Mean (95% CI) differences in improvement between groups favoring patients with primary LDH were VAS leg pain 9 (4-14), ODI 6 (3-9), and EQ-5D 0.09 (0.04-0.15). While statistically significant, these effect sizes may be lower than the minimal clinically important differences often referred to. Percentage of satisfied patients was 79% and 58% in the primary and recurrent LDH groups, respectively (p < 0.001), and percentage of patients with no or better leg pain (global assessment) was 74% and 65%, respectively (p = 0.008). Reoperation for recurrent LDH represented the largest independent risk for dissatisfaction; this factor and smoking represented similar risks for less improvement in leg pain. Repeat surgery for a recurrent LDH was performed with good probability for improvement, although not as good as for primary LDH surgery, and patients undergoing repeated surgery were less satisfied. Studies on risk factors for recurrence are warranted. Level II, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
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| 2. |
- Nungu, Amos, 1975-, et al.
(författare)
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On Building Sustainable Broadband Networks in Rural Areas
- 2011
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Ingår i: 2011 Technical Symposium at ITU Telecom World (ITU WT11). - 9781457711480 ; , s. 135-140
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Konferensbidrag (refereegranskat)abstract
- We present research on how to build sustainablebroadband networks in rural areas of developing regions. Due toan increasing political awareness of the importance of ICT fordevelopment, many such regions are now being networked. Thespecific design considerations are due to the technical and non-technical challenges found in those areas. Our research includesa pilot implementation in rural Tanzania.
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| 3. |
- Sayed-Noor, Arkan, et al.
(författare)
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The Association of On-Admission Blood Hemoglobin, C-Reactive Protein, and Serum Creatinine With 2-Year Mortality of Patients With Femoral Neck Fractures
- 2021
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Ingår i: Geriatric Orthopaedic Surgery & Rehabilitation. - : SAGE Open. - 2151-4585 .- 2151-4593. ; 12, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The mortality of femoral neck fracture (FNF) is high and every effort should be made to identify and manage any possible risk factors. The aim of this study was to evaluate whether on-admission hemoglobin (Hb) level, C-reactive protein (CRP), and serum creatinine were associated with 2-year mortality after FNF.Patients and Methods: In this retrospective observational cohort study, we considered for inclusion all displaced FNF patients 65 years and above treated with hemi-arthroplasty between February 2011 and May 2015. We documented the age, sex, cognitive status, and American Society of Anesthesiologists (ASA) classification. The Hb level, CRP, and serum creatinine were measured. The medical records were followed up for 2 years. We fitted different crude and adjusted Cox proportional hazards models to examine whether Hb level <100 g/L, CRP >20 mg/L, and serum creatinine >100 μmol/L were associated with the 2-year mortality, adjusted for age, sex, and ASA class.Results: A total of 290 patients [208 females (72%), mean age 84 years] were included in the study. More than 50% of patients had impaired cognition and ASA class 3–4. Of the 290 patients, 38.3% (n = 111) had died within 2 years after surgery. Mortality among males was 46.3% (n = 38) while mortality among females was 35,1% (n = 73), p = 0.07. We found that on-admission Hb level <100 g/L was associated with 2-year mortality (HR = 3.3, 95% CI: 1.3–8.3, p < 0.01) while CRP >20 mg/L and serum creatinine >100 μmol/L were not associated with 2-year mortality (p = 0.89 and p = 0.31, respectively).Conclusion: On-admission Hb level <100 g/L, but not CRP >20 mg/L and serum creatinine >100 μmol/L, was associated with 2-year mortality. These results can help healthcare providers identify high-risk FNF patients who probably would benefit from optimized perioperative medical management.
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| 4. |
- Abrikosov, Igor, et al.
(författare)
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Phase Stability and Elasticity of TiAlN
- 2011
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Ingår i: Materials. - : MDPI. - 1996-1944 .- 1996-1944. ; 4:9, s. 1599-1618
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Tidskriftsartikel (refereegranskat)abstract
- We review results of recent combined theoretical and experimental studies of Ti1−xAlxN, an archetypical alloy system material for hard-coating applications. Theoretical simulations of lattice parameters, mixing enthalpies, and elastic properties are presented. Calculated phase diagrams at ambient pressure, as well as at pressure of 10 GPa, show a wide miscibility gap and broad region of compositions and temperatures where the spinodal decomposition takes place. The strong dependence of the elastic properties and sound wave anisotropy on the Al-content offers detailed understanding of the spinodal decomposition and age hardening in Ti1−xAlxN alloy films and multilayers. TiAlN/TiN multilayers can further improve the hardness and thermal stability compared to TiAlN since they offer means to influence the kinetics of the favorable spinodal decomposition and suppress the detrimental transformation to w-AlN. Here, we show that a 100 degree improvement in terms of w-AlN suppression can be achieved, which is of importance when the coating is used as a protective coating on metal cutting inserts.
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| 5. |
- Al-Amiry, Bariq, et al.
(författare)
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Kinesiophobia and its association with functional outcome and quality of life 6-8 years after total hip arthroplasty
- 2022
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Ingår i: Acta Orthopaedica et Traumatologica Turcica. - : AVES. - 1017-995X .- 2589-1294. ; 56:4, s. 252-255
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to assess the incidence and severity of kinesiophobia, and to determine the relationship between Tampa Scale of Kinesiophobia (TSK) scores, functional outcome and quality of life (QoL) 6-8 years after Total Hip Arthroplasty (THA).Methods: 161 patients (78 male and 83 female) with unilateral primary osteoarthritis (OA) treated with THA between September 2010 and December 2013 were included in this study. Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and EQ-5D scores were measured preoperatively. At 6-8 years follow-up, these scores were repeated and TSK scores were also measured. According to the TSK, patients were divided into two groups for further comparisons and analysis: without kinesiophobia (TSK-score ≤ 36) and with kinesiophobia (TSK-score >36).Results: There were 99 patients (61.5%) with no kinesiophobia (TSK score ≤ 36, TSK mean 28.4, SD 4.7) and 62 patients (38.5%) with kinesiophobia (TSK score > 36, TSK mean 42.8, SD 5.3). Patients with and without kinesiophobia were not statistically different regarding age, sex or body mass index. (P = 0.20, P = 0.99, P = 0.22, respectively). In the group with no kinesiophobia, the mean 6-8 years WOMAC was 12.4 (SD 15.6), while the absolute delta (Δ) value between preoperative and 6-8 years WOMAC was 46.2 (SD 20.4), compared to the group with kinesiophobia where the mean 6-8 years WOMAC was 32.2 (SD 23.4), while the absolute delta (Δ) value between preoperative and 6-8 years WOMAC was 32.3 (SD 25.5): both P < 0.001. The group with no kinesiophobia had a mean 6-8 years EQ-5D of 0.81 (SD 0.22), while the absolute delta (Δ) value between preoperative and 6-8 years EQ-5D was 0.44 (SD 0.26), compared to the group with kinesiopho-bia where the mean 6-8 years EQ-5D was 0.57 (SD 0.23), while the absolute delta (Δ) value between preoperative and 6-8 years EQ-5D was 0.33 (SD 0.26): P < 0.001 and P = 0.03, respectively. TSK scores were associated with worse WOMAC and EQ-5D scores, higher proportion of dependence on walking aids and increased THArelated adverse events (all P < 0.05).Conclusion: This study has shown us that there is a high incidence of kinesiophobia 6-8 years after surgery and treating kinesiophobia early after THA might improve the outcome.Level of Evidence: Level IV, Therapeutic Study.
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| 6. |
- André, Frida, et al.
(författare)
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The prevalence of gaming and gambling in a child and adolescent psychiatry unit
- 2022
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Ingår i: Journal of Public Health Research. - : SAGE Publications. - 2279-9028 .- 2279-9036. ; 11:2
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Tidskriftsartikel (refereegranskat)abstract
- Background:Gaming and gambling are frequently reported from child and adolescent psychiatry and school health care. Swedish epidemiological data show that 1.3% of the population meet the criteria for gambling disorder. Risk factors are male gender, young age, single status and being born outside Sweden. Both problem gaming and gambling are associated with compulsion, psychiatric and physical symptoms, impaired cognitive development and school performance. Based on the limited knowledge and the need for more research into these behaviours among young individuals, the present study aimed to look at the prevalence of gaming and gambling in patients at the child and adolescent psychiatry department (CAP) in Skåne, a region in the south of Sweden.Design and methods:The overall aim is to explore gaming and gambling in a child and youth population. Children aged 8–18 years (N = 144) from CAP in Skåne were assessed with two self-screening instruments: GASA (Game Addiction Scale for Adolescents) and NODS-CLiP (NORC Diagnostic Screen for Gambling Problems). Information were collected regarding type of care, housing situation and diagnosis.Results:Thirty-three percent of the study participants showed problem/addictive gaming. Fifty-two percent of the males in the study showed problem/addictive gaming. Forty-four percent of the subjects with ADHD showed problem/addictive gaming. Eleven percent of the study participants showed problem gambling.Conclusions:The present study reports hitherto unreported figures of problem gaming and gambling. Our results show the importance of screening children and adolescents for these conditions when admitting subjects to CAP in/outpatient care.
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| 7. |
- Araghi, Marzieh, et al.
(författare)
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Smokeless tobacco (snus) use and colorectal cancer incidence and survival : Results from nine pooled cohorts
- 2017
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 45:8, s. 741-748
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Although smoking is considered to be an established risk factor for colorectal cancer, the current evidence on the association between smokeless tobacco and colorectal cancer is scant and inconclusive. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess this association.METHODS: A total of 417,872 male participants from nine cohort studies across Sweden were followed up for incidence of colorectal cancer and death. Outcomes were ascertained through linkage to health registers. We used shared frailty models with random effects at the study level to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).RESULTS: During 7,135,504 person-years of observation, 4170 men developed colorectal cancer. There was no clear association between snus use and colorectal cancer overall. Exclusive current snus users, however, had an increased risk of rectal cancer (HR 1.40: 95% CI 1.09, 1.79). There were no statistically significant associations between snus use and either all-cause or colorectal cancer-specific mortality after colorectal cancer diagnosis.CONCLUSIONS: Our findings, from a large sample, do not support any strong relationships between snus use and colorectal cancer risk and survival among men. However, the observed increased risk of rectal cancer is noteworthy, and in merit of further attention.
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| 8. |
- Brabec, Jan, et al.
(författare)
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Separating Glioma Hyperintensities From White Matter by Diffusion-Weighted Imaging With Spherical Tensor Encoding
- 2022
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Ingår i: Frontiers in Neuroscience. - : Frontiers Media SA. - 1662-4548 .- 1662-453X. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Tumor-related hyperintensities in high b-value diffusion-weighted imaging (DWI) are radiologically important in the workup of gliomas. However, the white matter may also appear as hyperintense, which may conflate interpretation.Purpose: To investigate whether DWI with spherical b-tensor encoding (STE) can be used to suppress white matter and enhance the conspicuity of glioma hyperintensities unrelated to white matter.Materials and Methods: Twenty-five patients with a glioma tumor and at least one pathology-related hyperintensity on DWI underwent conventional MRI at 3 T. The DWI was performed both with linear and spherical tensor encoding (LTE-DWI and STE-DWI). The LTE-DWI here refers to the DWI obtained with conventional diffusion encoding and averaged across diffusion-encoding directions. Retrospectively, the differences in contrast between LTE-DWI and STE-DWI, obtained at a b-value of 2,000 s/mm2, were evaluated by comparing hyperintensities and contralateral normal-appearing white matter (NAWM) both visually and quantitatively in terms of the signal intensity ratio (SIR) and contrast-to-noise ratio efficiency (CNReff).Results: The spherical tensor encoding DWI was more effective than LTE-DWI at suppressing signals from white matter and improved conspicuity of pathology-related hyperintensities. The median SIR improved in all cases and on average by 28%. The median (interquartile range) SIR was 1.9 (1.6 - 2.1) for STE and 1.4 (1.3 - 1.7) for LTE, with a significant difference of 0.4 (0.3 -0.5) (p < 10-4, paired U-test). In 40% of the patients, the SIR was above 2 for STE-DWI, but with LTE-DWI, the SIR was below 2 for all patients. The CNReff of STE-DWI was significantly higher than of LTE-DWI: 2.5 (2 - 3.5) vs. 2.3 (1.7 - 3.1), with a significant difference of 0.4 (-0.1 -0.6) (p < 10-3, paired U-test). The STE improved CNReff in 70% of the cases. We illustrate the benefits of STE-DWI in three patients, where STE-DWI may facilitate an improved radiological description of tumor-related hyperintensity, including one case that could have been missed out if only LTE-DWI was inspected.Conclusion: The contrast mechanism of high b-value STE-DWI results in a stronger suppression of white matter than conventional LTE-DWI, and may, therefore, be more sensitive and specific for assessment of glioma tumors and DWI-hyperintensities.
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| 9. |
- Brulin, Christine, et al.
(författare)
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Physical and psychosocial work related risk factors associated with musculoskeletal symptoms among home care personnel
- 1998
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Ingår i: Scandinavian journal of caring sciences. - 0283-9318. ; 12:2, s. 104-110
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this cross-sectional study was to investigate physical and psychosocial aspects of the work environment, sociodemographic data and certain lifestyle factors, and the relationship between these variables and complaints in the shoulder/neck and low back area among female home care personnel. A questionnaire was completed by 361 randomly selected women. Multiple logistic regression analyses were conducted to evaluate the importance of several exposure factors for complaints in the shoulder/neck and low back areas. The results of this study clearly indicate that 'standing in forward-bent and twisted postures' can be viewed as a risk factor for shoulder/neck pain. A combination of this physical exposure and 'no possibility of influencing the planning of work' gave an increase in odds ratio, indicating an interaction between these two exposure indices. However, this interaction was not found for low back pain. 'Standing in forward-bent and twisted postures', 'standing in awkward positions' and whether the subject had children staying at home were significantly correlated to complaints about the low back. In fact, the latter factor decreased the risk of having complaints. The results indicated that certain physical and psychosocial work risk factors could influence shoulder/neck and low back pain.
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| 10. |
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