| 1. |
- Ohlsson, Bodil, et al.
(författare)
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Patients with irritable bowel syndrome and dysmotility express antibodies against gonadotropin-releasing hormone in serum.
- 2011
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Ingår i: Neurogastroenterology and Motility. - : Wiley. - 1350-1925. ; 23, s. 459-1000
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Tidskriftsartikel (refereegranskat)abstract
- Background The etiology of irritable bowel syndrome (IBS) and dysmotility is in most cases unknown. Organic, pathognomonic changes have not been described. We have previously demonstrated sporadic expressions of antibodies against gonadotropin-releasing hormone (GnRH) in serum from these patients. The aim of this study was to screen for the presence of GnRH antibodies in healthy subjects and patients with gastrointestinal (GI) diseases. Methods Consecutive patients suffering from either IBS, idiopathic dysmotility, GI complaints secondary to diabetes mellitus, celiac disease or inflammatory bowel disease (IBD) were included. Healthy blood donors served as controls. Blood samples were taken for analyzing IgM and IgG antibodies against GnRH using an ELISA method. Medical records were scrutinized with respect to duration of symptoms, co-existing diseases, drug treatments, hereditary factors, and laboratory analyses. Key Results Healthy controls expressed low levels of GnRH IgM antibodies in a prevalence of 23%. The prevalence of GnRH IgM antibodies in IBS and dysmotility patients was 42% (P = 0.008), and the levels were higher (P = 0.000). Patients with diabetes mellitus expressed GnRH IgM antibodies in the same prevalence as controls (25%), but in higher levels (P = 0.02). Patients with celiac disease or IBD had the same or lower levels of antibodies. There were no associations between antibodies, other co-existing diseases or laboratory analyses. Conclusions & Inferences Higher levels of GnRH IgM antibodies were detected in patients with IBS and dysmotility, but not organic GI diseases, compared with healthy controls. These findings suggest that IBS and dysmotility to some extent may be of an autoimmune origin.
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| 2. |
- Jönsson, Daniel, et al.
(författare)
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Immunocytochemical demonstration of estrogen receptor beta in human periodontal ligament cells.
- 2004
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Ingår i: Archives of Oral Biology. - 1879-1506 .- 0003-9969. ; 49:1, s. 85-88
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Tidskriftsartikel (refereegranskat)abstract
- Two transcription associated estrogen receptor (ER) subtypes have been identified and named ERα and ERβ. In the present study we investigate the expression of these ER subtypes in cultured human periodontal ligament (PDL) cells by immunocytochemistry. ERβ immunoreactivity was observed in the nuclei of about 40% of the PDL cells, while no ERα immunoreactivity was detected. In human breast cancer MCF-7 cells, serving as positive controls, both ERα and ERβ immunoreactivities were demonstrated. No immunoreactivity was observed after omission of the primary antibodies. This study suggests that estrogen acts on gene transcription preferentially via ERβ in human PDL cells.
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| 3. |
- Bengtsson, Mariette, et al.
(författare)
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Diagnosis ofirritable bowel syndrome would be better made by gastroenterologists than primary care physicians
- 2010
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Ingår i: Gastroenterology Insights. - : MDPI AG. - 2036-7422 .- 2036-7414. ; 2:1, s. 37-40
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Tidskriftsartikel (refereegranskat)abstract
- Irritable bowel syndrome (IBS) is a common disease, and constitutes a large portion of patients admitted to gastroenterology units. We wanted to examine whether there is a need for patients with suspected IBS to have a thorough examination by a gastroenterologist to establish the diagnosis, or whether other specialist or subspecialist physicians could better or equally identify the problems. From April 2003 to April 2005, females admitted with presumed IBS and consequently scrutinized by a gastroenterologist in our department were included. They were examined by a physician to establish a diagnosis. Four years later, the medical records were again scrutinized including abdominal symptoms, laboratory analyses and X-ray findings, to check if the findings were identical to the original diagnoses. Fifty admissions were identified. Nine of the patients did not want to participate, and 2 patients did not keep the appointment. The diagnosis of IBS was confirmed in only 20 (51%) and the other 19 (49%) had another diagnosis other than IBS. At follow up, 3 patients included with the IBS diagnosis had organic diseases, and 4 with another diagnosis also had IBS. Thus, 46% of the examined women with expected IBS had another diagnosis. A thorough examination of the patient and confirmation of the symptoms by a gastroenterologist is necessary before diagnosis of IBS is confirmed. For this purpose, patients need to meet a specialist when diagnosis is uncertain.
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| 4. |
- Bertl, Kristina, et al.
(författare)
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Health-related quality of life aspects of the ‘Periodontitis prevalence in ulcerative colitis and Crohn's disease’ (PPCC) cohort
- 2023
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Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 50:12, s. 1601-1620
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To assess whether oral health problems affect disease-specific quality of life (QoL) of inflammatory bowel disease (IBD) patients, and vice versa, whether IBD affects oral-health-related QoL.Materials and Methods: Individuals reporting IBD and matched controls were surveyed on general anamnestic information, oral-health-related questions and the Oral Health Impact Profile (OHIP)-5. IBD patients were additionally surveyed on years since diagnosis, disease activity and severity as well as health-related QoL (Short Inflammatory Bowel Disease Questionnaire, sIBDQ). OHIP-5 and sIBDQ were defined as primary outcome parameters, and several predictors and confounders were used in adjusted univariable and multivariable regression analyses.Results: Answers from 1108 IBD patients and 3429 controls were analysed. Compared with controls, IBD patients reported significantly more frequently an oral impact on daily life and worse oral-health-related QoL, with Crohn's disease (CD) patients being more severely affected than ulcerative colitis (UC) patients. The diagnosis of UC and CD, having <20 teeth, severe periodontitis and stressful daily-life experience were associated with a higher prevalence of poor oral-health-related QoL. Among IBD patients, an impaired IBD-specific, health-related QoL was significantly associated with the diagnosis of CD and depression, IBD activity and severity, having <20 teeth, presence of oral lesions and stressful daily-life experience, while a longer time since diagnosis was significantly associated with an improved IBD-specific, health-related QoL.Conclusions: The results of the present study indicate, for the first time, that oral health problems are associated with an impairment of IBD-specific health-related QoL, and vice versa, IBD is associated with an impaired oral health-related QoL. This emphasizes the potential advantages of including dental professionals in the multi-disciplinary treatment teams of IBD patients.
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| 5. |
- Knutsson, Kerstin, et al.
(författare)
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Clinicians' management strategies for patients with dyspepsia: a qualitative approach
- 2005
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Ingår i: BMC Gastroenterology. - 1471-230X. ; 5:15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Symptoms from the upper gastrointestinal tract are frequently encountered in clinical practice and may be of either organic or functional origin. For some of these conditions, according to the literature, certain management strategies can be recommended. For other conditions, the evidence is more ambiguous. The hypothesis that guided our study design was twofold: Management strategies and treatments suggested by different clinicians vary considerably, even when optimal treatment is clear-cut, as documented by evidence in the literature. Clinicians believe that the management strategies of their colleagues are similar to their own. Methods: Simulated case histories of four patients with symptoms from the upper gastrointestinal tract were presented to 27 Swedish clinicians who were specialists in medical gastroenterology, surgery, and general practice and worked at three hospitals in the southern part of Sweden. The patients' histories contained information on the patient's sex and age and the localisation of the symptoms, but descriptions of subjective symptoms and findings from examinations differed from history to history. Interviews containing open-ended questions were conducted. Results: For the same patient, the management strategies and treatments suggested by the clinicians varied widely, as did the strategies suggested by clinicians in the same speciality. Variation was more pronounced if the case history noted symptoms but no organic findings than if the case history noted unambiguous findings and symptoms. However, even in cases with a consensus in the scientific literature on treatment, the variations in clinicians' opinion on management were pronounced. Conclusion: Despite these variations, the clinicians believed that the decisions made by their colleagues would be similar to their own. The overall results of this study indicate that we as researchers must make scientific evidence comprehensible and communicate evidence so that clinicians are able to interpret and implement it in practice. Of particular significance is that scientific evidence leads to an evidence-based care which is effective clinical practice and to the promotion of health from the perspective of the patient, together with cost-effectiveness as a priority.
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| 6. |
- Lindqvist, Daniel, et al.
(författare)
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Plasma circulating cell-free mitochondrial DNA in social anxiety disorder
- 2022
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Ingår i: Psychoneuroendocrinology. - : Elsevier. - 0306-4530 .- 1873-3360. ; 148
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate plasma levels of circulating cell-free mitochondrial DNA (ccf-mtDNA) in patients with social anxiety disorder (SAD) and healthy controls (HC).METHODS: In this study, 88 participants (46 patients with SAD and 42 HCs) were enrolled and both ccf-mtDNA and peripheral blood mononuclear cells (PBMC) mtDNA copy number (mtDNA-cn) were measured at up to three times per individual (9-11 weeks apart). SAD patients also received cognitive behavioral therapy (CBT) between the second and third time-point.RESULTS: SAD patients had significantly lower ccf-mtDNA compared to HCs at all time points, but ccf-mtDNA did not change significantly after CBT, and was not associated with severity of anxiety symptoms. Plasma ccf-mtDNA did not significantly correlate with PBMC mtDNA-cn in patients.CONCLUSION: This is the first report of lower ccf-mtDNA in patients with an anxiety disorder. Our findings could reflect a more chronic illness course in SAD patients with prolonged periods of psychological stress leading to decreased levels of ccf-mtDNA, but future longitudinal studies are needed to confirm or refute this hypothesis.
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| 7. |
- Madsen, Gorm Roager, et al.
(författare)
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The Impact of Periodontitis on Inflammatory Bowel Disease Activity
- 2023
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Ingår i: Inflammatory Bowel Diseases. - : Oxford University Press. - 1078-0998 .- 1536-4844. ; 29:3, s. 396-404
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Tidskriftsartikel (refereegranskat)abstract
- Background Inflammatory bowel disease (IBD) and periodontitis are chronic, progressive, inflammatory diseases with similarly complex pathogeneses that involve an interplay between dysbiotic microbiota and dysregulated immune-inflammatory responses. However, whether the presence of periodontitis is associated with IBD activity and/or its severity remains unknown. Methods An online, questionnaire-based study was answered by 1093 patients with IBD, comprising 527 patients with Crohn's disease and 566 patients with ulcerative colitis. The survey included questions on social demographics; oral health, including the Periodontal Screening Score (PESS); and IBD-related characteristics, including validated disease indices. Results Irrespective of disease subtype, patients with a reduced number of teeth and those with self-reported severe periodontitis scored significantly higher on the IBD disability index (number of teeth: coefficient, 4.93 [95% confidence interval {CI}, 1.21-8.66; P = .010]; periodontitis: coefficient, 3.54 [95% CI, 0.27-6.80; P = .034]) and reported increased disease activity in the preceding 12 months (number of teeth: odds ratio [OR], 1.91 [95% CI, 1.36-2.69; P < .001]; periodontitis: OR, 1.71 [95% CI, 1.27-2.31; P < .001]). There was also evidence of a weak association between self-reported severe periodontitis and current disease activity (OR, 1.33; 95% CI, 0.95-1.86; P = .099). However, IBD severity, as a composite parameter of a history of surgery due to IBD and/or treatment with biological therapy, was not associated with possessing a reduced number of teeth (OR, 1.18; 95% CI, 0.77-1.80; P = .451), nor with self-reported severe periodontitis (OR, 1.15; 95% CI, 0.79-1.66; P = .467). Conclusions Periodontitis and tooth loss were significantly associated with increased IBD-related disability and more disease activity in the preceding 12 months. Our results suggest that greater attention should be paid to IBD patients' oral health. Lay Summary In this questionnaire-based study among 1093 patients with inflammatory bowel disease (IBD), we demonstrated a significant association between the presence of periodontitis and more IBD disease activity in the last 12 months, as well as increased IBD disability.
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| 8. |
- Bengtsson, Mariette, et al.
(författare)
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Evaluation of gastrointestinal symptoms in different patient groups using the visual analogue scale for irritable bowel syndrome (VAS-IBS)
- 2011
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Ingår i: BMC Gastroenterology. - : BioMed Central. - 1471-230X. ; 122:11
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background: Irritable bowel syndrome (IBS) and gastrointestinal (GI) dysmotility disorders have a similar clinical picture, although dysmotility disorders require the attention of a specialist. Patients with primary Sjögren’s syndrome (pSS) have also been described to suffer from IBS-like symptoms. No objective marker is available to distinguish between the patients. A visual analogue scale has been developed for IBS patients (VAS-IBS) to measure treatment response of GI symptoms and well-being in patients with IBS. The aim of the present study was to examine if VAS-IBS could be used to compare the degree of GI complaints in different patient populations, to get an objective marker to differentiate between the patients. Methods: The VAS-IBS consists of 7 VAS scales, namely, abdominal pain, diarrhoea, constipation, bloating and flatulence, vomiting and nausea, psychological well-being and the intestinal symptoms’ influence on daily life. Consecutive female patients suffering from IBS, dysmotility disorders and pSS were asked to complete the VAS-IBS questionnaire when visiting the out-patient clinics. In addition, a control population consisting of healthy female volunteers was included. Results: Healthy volunteers had almost no GI symptoms, whereas all 3 patient groups expressed symptoms. There was no statistical significant difference between IBS and dysmotility in any of the scales besides vomiting and nausea (p = 0.044). Except for constipation, patients with pSS had less severe symptoms than the others. Conclusion: The VAS-IBS questionnaire could be used to assess the level of GI symptoms. However, VAS scores do not help the clinicians to differentiate between IBS and other dysmotility disturbances.
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| 9. |
- Ek, Malin, et al.
(författare)
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Gastrointestinal Symptoms in Women With Endometriosis and Microscopic Colitis in Comparison to Irritable Bowel Syndrome : A Cross-Sectional Study
- 2021
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Ingår i: Turkish Journal of Gastroenterology. - : AVES. - 1300-4948 .- 2148-5607. ; 32:10, s. 819-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Gastrointestinal (GI) symptoms similar to irritable bowel syndrome (IBS) are often present in women with endometriosis and microscopic colitis (MC). The objective of this study was to estimate GI symptoms in IBS, endometriosis, and MC, to compare the clinical expression of the diseases. Methods: Women with IBS, endometriosis, and MC were identified by diagnosis codes at a tertiary center. The patients had to complete the visual analog scale for IBS to estimate specific GI symptoms. Women fulfilling Rome III criteria for IBS were diagnosed as IBS (n = 109) and divided into subgroups depending on predominating symptoms. Women diagnosed with endometriosis (n = 158) and MC (n = 88) were evaluated whether they also fulfilled the Rome III criteria for IBS. Results: Women with IBS experienced aggravated abdominal pain, diarrhea, bloating and flatulence, nausea and vomiting, the urgency to defecate, the sensation of incomplete evacuation and intestinal symptom's influence on daily life, and impaired psychological wellbeing, compared to women with endometriosis. When patients with endometriosis also fulfilled the criteria for IBS, all symptoms in the 2 cohorts, except intestinal symptom's influence on daily life, were equal. Women with IBS or diarrhea-predominated IBS experienced aggravated abdominal pain, bloating and flatulence, intestinal symptom's influence on daily life, and impaired psychological well-being compared to MC, but at equal levels as MC with IBS-like symptoms. Conclusions: Women with IBS generally experience aggravated GI symptoms and impaired psychological well-being compared to endometriosis and MC. Patients with endometriosis or MC, in combination with IBS, express similar symptoms as patients with sole IBS.
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| 10. |
- Jakobsson, Jenny, et al.
(författare)
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Patient-reported recovery after enhanced colorectal cancer surgery : a longitudinal six-month follow-up study
- 2014
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Ingår i: International Journal of Colorectal Disease. - : Springer. - 0179-1958 .- 1432-1262. ; 29:8, s. 989-998
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Tidskriftsartikel (refereegranskat)abstract
- Syfte: Konceptet enhanced recovery after surgery (ERAS) är en modern vårdregim och många studier har bekräftat dess positiva inverkan på återhämtningen efter kolorektal kirurgi. Det finns dock sparsamt med kunskap om patienternas fortsatta återhämtning efter utskrivning. Därav var syftet med denna studie att beskriva patientrapporterad återhämtning efter kolorektal cancerkirurgi enligt ERAS från utskrivningsdagen till 1 och 6 månader efter kirurgi. Metod: Mätningar gjordes vid utskrivning, efter 1 månad och sex månader efter operation med hjälp av frågeformuläret Postoperative Recovery Profile (PRP). Totalt 119 patienter vilka opererats med rektumamputation, rektumresektion och kolonresektion svarade vid alla tre mättillfälle. Resultat: Global Score of Recovery visade att inga patienter upplevde sig som helt återhämtade vid utskrivning. Efter rektumresektion upplevde många sig som inte alls återhämtad. En månad efter kirurgi rapporterade patienter som återhämtade sig efter kolonresektion signifikanta förbättringar i 11 av 17 item samtidigt som patienter efter rektumamputation inte visade någon signifikant förbättring. Istället visades högre nivåer av problem gällande item som fatigue, muskelsvaghet och nedstämdhet. Rektumresektioner rapporterade signifikanta förbättringar mellan 1 och 6 månader efter kirurgi gällande 7 av 19 item. Dock urskiljde sig det item som handlade om gastrointestinal funktion då patienterna upplevde en signifikant försämring vid 6 månader efter operation. Sammanfattning: Denna studie belyser skillnaderna mellan olika grupper av patienter och skillnaderna i deras återhämtning. Detta visar på olika behov av stöd efter utskrivning.
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