| 1961. |
- Strömqvist, Fredrik, et al.
(författare)
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Lumbar disc herniation surgery in children: outcome and gender differences.
- 2016
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Ingår i: European Spine Journal. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 25:2, s. 657-663
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Tidskriftsartikel (refereegranskat)abstract
- Lumbar disc herniation (LDH) in children is rare. Few studies have evaluated the outcome of surgery and none in a prospective study design.
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| 1962. |
- Strömqvist, Fredrik, et al.
(författare)
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Outcome of surgical treatment of lumbar disc herniation in young individuals.
- 2015
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Ingår i: The Bone & Joint Journal. - 2049-4408. ; 97B:12, s. 1675-1682
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Tidskriftsartikel (refereegranskat)abstract
- Lumbar disc herniation (LDH) is uncommon in youth and few cases are treated surgically. Very few outcome studies exist for LDH surgery in this age group. Our aim was to explore differences in gender in pre-operative level of disability and outcome of surgery for LDH in patients aged ≤ 20 years using prospectively collected data. From the national Swedish SweSpine register we identified 180 patients with one-year and 108 with two-year follow-up data ≤ 20 years of age, who between the years 2000 and 2010 had a primary operation for LDH. Both male and female patients reported pronounced impairment before the operation in all patient reported outcome measures, with female patients experiencing significantly greater back pain, having greater analgesic requirements and reporting significantly inferior scores in EuroQol (EQ-5D-index), EQ-visual analogue scale, most aspects of Short Form-36 and Oswestry Disabilities Index, when compared with male patients. Surgery conferred a statistically significant improvement in all registered parameters, with few gender discrepancies. Quality of life at one year following surgery normalised in both males and females and only eight patients (4.5%) were dissatisfied with the outcome. Virtually all parameters were stable between the one- and two-year follow-up examination. LDH surgery leads to normal health and a favourable outcome in both male and female patients aged 20 years or younger, who failed to recover after non-operative management. Cite this article: Bone Joint J 2015;97-B:1675-82.
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| 1963. |
- Strömqvist, Fredrik, et al.
(författare)
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Predictive outcome factors in the young patient treated with lumbar disc herniation surgery
- 2016
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Ingår i: Journal of Neurosurgery: Spine. - 1547-5654 .- 1547-5646. ; 25:4, s. 448-455
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to evaluate predictive factors for outcome after lumbar disc herniation surgery in young patients. METHODS: In the national Swedish spine register, the authors identified 180 patients age 20 years or younger, in whom preoperative and 1-year postoperative data were available. The cohort was treated with primary open surgery due to lumbar disc herniation between 2000 and 2010. Before and 1 year after surgery, the patients graded their back and leg pain on a visual analog scale, quality of life by the 36-Item Short-Form Health Survey and EuroQol-5 Dimensions, and disability by the Oswestry Disability Index. Subjective satisfaction rate was registered on a Likert scale (satisfied, undecided, or dissatisfied). The authors evaluated if age, sex, preoperative level of leg and back pain, duration of leg pain, pain distribution, quality of life, mental status, and/or disability were associated with the outcome. The primary end point variable was the grade of patient satisfaction. RESULTS: Lumbar disc herniation surgery in young patients normalizes quality of life according to the 36-Item Short- Form Health Survey, and only 4.5% of the patients were unsatisfied with the surgical outcome. Predictive factors for inferior postoperative patient-reported outcome measures (PROM) scores were severe preoperative leg or back pain, low preoperative mental health, and pronounced preoperative disability, but only low preoperative mental health was associated with inferiority in the subjective grade of satisfaction. No associations were found between preoperative duration of leg pain, distribution of pain, or health-related quality of life and the postoperative PROM scores or the subjective grade of satisfaction. CONCLUSIONS: Lumbar disc herniation surgery in young patients generally yields a satisfactory outcome. Severe preoperative pain, low mental health, and severe disability increase the risk of reaching low postoperative PROM scores, but are only of relevance clinically (low subjective satisfaction) for patients with low preoperative mental health.
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| 1964. |
- Strömqvist, Fredrik, et al.
(författare)
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Surgical Treatment of Lumbar Disc Herniation in Different Ages : Evaluation of 11,237 Patients
- 2017
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Ingår i: The Spine Journal. - : Elsevier BV. - 1529-9430. ; 17:11, s. 1577-1585
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Tidskriftsartikel (refereegranskat)abstract
- Surgical treatment of lumbar disc herniation (LDH) may lead to different outcomes in young, middle-aged, and elderly patients. However, no study has, by the same data ascertainment, evaluated referral pattern, improvement, and outcome in different age strata.
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| 1965. |
- Strömqvist, Fredrik, et al.
(författare)
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The outcome of lumbar disc herniation surgery is worse in old adults than in young adults : A study of 14,090 individuals in the Swedish Spine Surgery Register (SweSpine)
- 2016
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 87:5, s. 516-521
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose — The outcome of surgical treatment of lumbar disc herniation (LDH) has been thoroughly evaluated in middle-aged patients, but less so in elderly patients. Patients and methods — With validated patient-reported outcome measures (PROMs) and using SweSpine (the national Swedish Spine Surgery Register), we analyzed the preoperative clinical status of LDH patients and the 1-year postoperative outcome of LDH surgery performed over the period 2000–2012. We included 1,250 elderly patients (≥ 65 years of age) and 12,840 young and middle-aged patients (aged 20–64). Results — Generally speaking, elderly patients were referred for LDH surgery with worse PROM scores than young and middle-aged patients, they improved less by surgery, they experienced more complications, they had inferior 1-year postoperative PROM scores, and they were less satisfied with the outcome (with all differences being statistically significant). Interpretation — Elderly patients appear to have a worse postoperative outcome after LDH surgery than young and middle-aged patients, they are referred to surgery with inferior clinical status, and they improve less after the surgery.
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| 1966. |
- Sun, Xiaojiao, et al.
(författare)
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Polypeptide conjugates that bind chitinases
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Polypeptide conjugates formed from members of a designed set of polypeptides and the chitinase inhibitors pentoxifylline, C4B3 and C5B1 were evaluated for affinity and selectivity towards chitinases. The polypeptide conjugate 4C37L34-P was found to recognize and bind chitinases from the fungal species Aspergillus nidulans and Neurospora crassa, as well as from the fungus Trichoderma viride and the bacterial strain Streptomyces griseus. The small organic molecule pentoxifylline and the polypeptide 4C37L34 both contributed to binding of the chitinases and the affinity of the polypeptide conjugate was significantly enhanced in comparison with that of pentoxifylline with an affinity that was on the order of 2-3 orders of magnitude higher than that of pentoxyfylline. In view of the large numbers of chitinases present in nature the recognition and detection of groups of chitinases using one binder molecule for many enzymes may be an advantageous approach.
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| 1967. |
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| 1968. |
- Sundberg, Martin, et al.
(författare)
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Pubertal bone growth in the femoral neck is predominantly characterized by increased bone size and not by increased bone density-a 4-year longitudinal study.
- 2003
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 14:7, s. 548-558
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Tidskriftsartikel (refereegranskat)abstract
- Fragility fractures are correlated to reduced bone size and/or reduced volumetric bone density (vBMD). These region-specific deficits may originate from reduced mineral accrual and/or reduced skeletal growth during the first 2 decades of life. Before pathological development can be defined, normal skeletal growth must be described. To evaluate growth of bone size, accrual of bone mineral content (BMC), areal bone mineral density (aBMD) and vBMD in a population-based cohort, 44 boys and 42 girls were followed by annual measurements from the age of 12 to 16 (attendance rates 90–100%). Segmental bone length, bone width, BMC, aBMD and vBMD were measured by dual-energy X-ray absorptiometry (DXA). Data were compared with predicted adult peak, as determined in 36 men aged 27.7±4.6 years and 44 women aged 26.8±4.9 years. Growth in width of the femoral neck precedes accrual of BMC in the femoral neck in both genders up to age 15. The girls were at all ages closer to their predicted adult peak in both bone width and BMC compared with the boys except in the femoral neck. As femoral neck vBMD had reached its predicted adult peak already at 12 years in both genders, the increase in femoral neck BMC and femoral neck aBMD from age 12 to 16 was most likely to be explained by the increase in bone size. In boys the peak velocity growth was recorded at ~14 years for BMC, height, width and lean mass. Growth from the age of 12 to 16 seems to build a bigger but not a denser skeleton in the femoral neck.
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| 1969. |
- Sundbom, Magnus, et al.
(författare)
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Early Changes in Ghrelin following Roux-en-Y Gastric Bypass : Influence of Vagal Nerve Functionality?
- 2007
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Ingår i: Obesity Surgery. - : Springer Science and Business Media LLC. - 0960-8923 .- 1708-0428. ; 17:3, s. 304-310
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Tidskriftsartikel (refereegranskat)abstract
- Background Roux-en-Y gastric bypass (RYGBP) effectively produces massive weight reduction, improving health in morbidly obese patients. The mechanisms for the weight loss, and the fate of the excluded gastric mucosa, are not fully clarified. To what extent the appetite-stimulating gastric peptide ghrelin is affected remains controversial. Methods Circulating concentrations of ghrelin, pancreatic polypeptide (PP), pepsinogen I (PGI) and gastrin were examined in 15 morbidly obese patients (median BMI 45 kg/m2) preoperatively, and on days 1, 2, 4, 6 and at months 1, 6 and 12 after RYGBP. Results Ghrelin levels fell on postoperative day 1 and increased after 1 month to preoperative levels, and rose further at 6 and 12 months. PP concentrations decreased on day 1 and subsequently returned to preoperative levels. PGI levels peaked transiently the first days after surgery and subsequently declined to lower than preoperative levels. Gastrin levels were gradually reduced postoperatively. Conclusion Ghrelin and PP fall transiently after surgery, possibly due to vagal dysfunction, and ultimately, as weight loss ensues, ghrelin secretion increases to higher than preoperative levels. The RYBGP procedure affects the gastric mucosa, as reflected by a transient increase in circulating PGI, and subsequently, the mucosa in the excluded stomach is at rest, as shown by low levels of PGI and gastrin.
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| 1970. |
- Sundh, Daniel, 1985, et al.
(författare)
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Increased Cortical Porosity in Older Men With Fracture
- 2015
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Ingår i: Journal of Bone and Mineral Research. - : Wiley. - 1523-4681 .- 0884-0431. ; 30:9, s. 1692-1700
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Tidskriftsartikel (refereegranskat)abstract
- Cortical porosity increases with age and affects bone strength, but its association with fracture in older men is unknown. The aim of this study was to investigate whether cortical porosity is associated with prevalent fractures in older men. A subsample of 456 men aged 80.2 +/- 3.5 (mean +/- SD) years, with available high-resolution peripheral quantitative computed tomography measurements at the tibia from the 5-year follow-up exam, was drawn from the prospective MrOS Gothenburg study. Dual-energy X-ray absorptiometry was used to measure areal bone mineral density (aBMD). Data on physical activity, calcium intake, medications, diseases, and smoking were collected on questionnaires at the follow-up exam. Of 87 men (19.1%) with fracture at or after age 50 years (all fracture group), 52 (11.4%) had had a self-reported fracture before the baseline exam and 35 (7.7%) had had an X-ray-verified fracture between baseline and follow-up. Men in the all-fracture group and in the X-ray-verified group had 15.8% (13.2%+/- 4.9% versus 11.4%+/- 3.8%; p < 0.001) and 21.6% (14.1%+/- 5.2% versus 11.6%+/- 3.9%; p < 0.01) higher cortical porosity, respectively, than men in the nonfracture group. The independent associations between bone microstructure parameters and fracture were tested using multivariate logistic regression with age, height, weight, calcium intake, smoking, physical activity, medications, and diseases as covariates. Cortical porosity was independently associated with any fracture (reported or X-ray-verified; OR per SD increase 1.49; 95% confidence interval (CI), 1.17 to 1.90) and with any X-ray-verified fracture alone (OR 1.73; 95% CI, 1.23 to 2.42). Including aBMD (spine or hip, respectively) in the multivariate logistic regression above revealed that cortical porosity was associated with any fracture (OR 1.54; 95% CI, 1.17 to 2.01) and with X-ray-verified fracture alone (OR 1.49; 95% CI, 1.00 to 2.22). Cortical porosity was associated with prevalence of fracture even after adjustment for aBMD. (c) 2015 American Society for Bone and Mineral Research.
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