| 1. |
- Nilsson, Hanna, et al.
(författare)
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Is preoperative physical activity related to post-surgery recovery? : A cohort study of patients with breast cancer
- 2016
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of our study is to assess the association between preoperative level of activity and recovery after breast cancer surgery measured as hospital stay, length of sick leave and self-assessed physical and mental recovery. Design: A prospective cohort study. Setting: Patients included were those scheduled to undergo breast cancer surgery, between February and November 2013, at two participating hospitals in the Western Region of Sweden. Participants: Patients planned for breast cancer surgery filled out a questionnaire before, as well as at 3 and 6 weeks after the operation. The preoperative level of activity was self-assessed and categorised into four categories by the participants using the 4-level SaltinGrimby Physical Activity Level Scale (SGPALS). Main outcome measure: Our main outcome was postoperative recovery measured as length of sick leave, in-hospital stay and self-assessed physical and mental recovery. Results: 220 patients were included. Preoperatively, 14% (31/220) of participants assessed themselves to be physically inactive, 61% (135/220) to exert some light physical activity (PA) and 20% (43/220) to be more active (level 3+4). Patients operated with mastectomy versus partial mastectomy and axillary lymph node dissection versus sentinel node biopsy were less likely to have a short hospital stay, relative risk (RR) 0.88 (0.78 to 1.00) and 0.82 (0.70 to 0.96). More active participants (level 3 or 4) had an 85% increased chance of feeling physically recovered at 3 weeks after the operation, RR 1.85 (1.20 to 2.85). No difference was seen after 6 weeks. Conclusions: The above study shows that a higher preoperative level of PA is associated with a faster physical recovery as reported by the patients 3 weeks post breast cancer surgery. After 6 weeks, most patients felt physically recovered, diminishing the association above. No difference was seen in length of sick leave or self-assessed mental recovery between inactive or more active patients.
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| 2. |
- Täljemark, Jakob, et al.
(författare)
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The coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide Swedish twin study
- 2017
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Ingår i: Journal of Eating Disorders. - : Springer Science and Business Media LLC. - 2050-2974. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Restrictive eating problems are rare in children but overrepresented in those with neurodevelopmental problems. Comorbidities decrease wellbeing in affected individuals but research in the area is relatively scarce. This study describes phenotypes, regarding psychiatric and gastrointestinal comorbidities, in children with restrictive eating problems. Methods: A parental telephone interview was conducted in 9- or 12-year old twins (n = 19,130) in the Child and Adolescent Twin Study in Sweden. Cases of restrictive eating problems and comorbid problems were established using the Autism, Tics-AD/HD and other Comorbidities inventory, parental reports of comorbidity as well as data from a national patient register. In restrictive eating problem cases, presence of psychiatric and gastrointestinal comorbidity was mapped individually in probands and their co-twin. Two-tailed Mann-Whitney U tests were used to test differences in the mean number of coexisting disorders between boys and girls. Odds ratios were used to compare prevalence figures between individuals with or without restrictive eating problems, and Fisher exact test was used to establish significance. Results: Prevalence of restrictive eating problems was 0.6% (concordant in 15% monozygotic and 3% of dizygotic twins). The presence of restrictive eating problems drastically increased odds of all psychiatric problems, especially autism spectrum disorder in both sexes (odds ratio = 11.9 in boys, odds ratio = 10.1 in girls), obsessive-compulsive disorder in boys (odds ratio = 11.6) and oppositional defiant disorder in girls (odds ratio = 9.22). Comorbid gastrointestinal problems, such as lactose intolerance (odds ratio = 4.43) and constipation (odds ratio = 2.91), were the most frequent in girls. Boy co-twins to a proband with restrictive eating problems generally had more psychiatric problems than girl co-twins and more girl co-twins had neither somatic nor any psychiatric problems at all. Conclusions: In children with restrictive eating problems odds of all coexisting psychiatric problems and gastrointestinal problems are significantly increased. The study shows the importance of considering comorbidities in clinical assessment of children with restrictive eating problems.
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| 3. |
- Magnusson, J, et al.
(författare)
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A kinetic study in adults with food hypersensitivity assessed as eosinophil activation in fecal samples
- 2003
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Ingår i: Clinical and Experimental Allergy. - : Wiley. - 0954-7894 .- 1365-2222. ; 33:8, s. 1052-1059.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Immune-mediated food hypersensitivity affecting the gut is difficult to evaluate, and objective tools to diagnose local gastrointestinal (GI) inflammatory reactions are lacking. OBJECTIVES: To determine whether allergic manifestations in adults with a history of food-related GI symptoms could be assessed in feces during symptomatic and non-symptomatic periods, using the surrogate markers, eosinophil cationic protein (ECP), eosinophil protein X (EPX) and myeloperoxidase (MPO). METHODS: Thirteen subjects with food hypersensitivity-related GI symptoms, confirmed by a positive double-blind placebo-controlled food challenge (DBPCFC), were subjected to an open kinetic food challenge design for 6 weeks. Symptoms were recorded and scored during the 3-week study period and stool samples were obtained every day. The surrogate markers ECP, EPX and MPO were measured in the supernatants from feces samples. RESULTS: A significant increase in abdominal pain, distension and flatulence was observed during challenge, with a gradual decrease during elimination diet. Both between days and subjects, EPX levels were more frequently increased compared to ECP and MPO. Individuals with a history of a short duration of symptoms had significantly higher mean levels of EPX and MPO than those with a longer duration of symptoms. CONCLUSIONS: An overall increase in levels of eosinophil markers, in particular EPX, was observed in feces from patients with food-related GI symptoms. However, rather than being a tool to differentiate symptomatic from non-symptomatic periods, EPX might be used for detecting an ongoing clinical or subclinical chronic inflammation, that may have an impact on the patient's clinical course of GI symptoms.
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| 4. |
- Berndtsson, Ina
(författare)
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Stoma-related complications after stoma construction in emergency surgery.
- 2009
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Ingår i: 10th European congress for nurses with interest in stomacare. Portugal, Porto, June 14-17, 2009..
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Konferensbidrag (refereegranskat)abstract
- PURPOSE; Prospectively longitudinal study of the frequency and type of stoma-related complications after stoma construction in emergency surgery. METHOD; 153 patients were operated acutely with a colostomy, ileostomy or loop-ileostomy formation between April 2003 and March 2005 at the Sahlgrenska University Hospital in Gothenburg, Sweden. The postoperative follow up took place in the ward and another five times two years after discharge. On these occasions diameter, height and shape of the ostomy were recorded. Peristomal skin problems, necrosis, leakage due to low ostomy, stenosis, granuloma, prolapse and peristomal hernia were evaluated. Use of convexity appliance was also documented. RESULTS were based on 144 patients 85 women and 59 men with a median age of 67 (range 23-98) years. The ostomy diameter size was postoperatively on the ward median 34 (r 22-80) mm but had reduced to 25 (r 22-60) mm in two weeks. Postoperatively on the ward 31% of colostomy was oval, and 24% of the ileostomy. After 12 months was 21% of the colostomy oval. Irrespective of ostomy types the most common complication was skin problems, most frequent in those with loop ileostomy (48%) hernia was most common in patients with colostomy (26%) at 12 months of follow-up. A patient may have developed more complications such as necrosis of stomin as the cause of this even skin problems. The patients with ileostomy used convexity appliance common in 6 month (67%) and the patients with colostomy in one year (29%). CONCLUSION This study shows that while skin problems dominated in ileostomy patients (48% in loop ileostomies) peristomal hernia was the most common complication in colostomy patients (26%). Early stoma nurse assistance in the acute phase and regular postoperative follow-up subsequently is very important.
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| 5. |
- Carlsson, Eva, et al.
(författare)
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Stomibandagering
- 2008. - 1
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Ingår i: Stomi- och tarmopererad : ett helhetsperspektiv - ett helhetsperspektiv. - Lund : Studentlitteratur. - 9789144047478 ; , s. 69-81
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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