| 1. |
- Jansson, Henrik, et al.
(författare)
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Type 2 diabetes and risk for periodontal disease: a role for dental health awareness
- 2006
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Ingår i: Journal of Clinical Periodontology. - 1600-051X .- 0303-6979. ; 33:6, s. 408-414
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several studies have found correlations between diabetes and an increased prevalence of periodontitis. Objective: To analyse, in a group of subjects with type 2 diabetes (T2D), (i) the association between medical characteristics and severe periodontal disease and (ii) dental care habits and knowledge of oral health. Methods: One hundred and ninety-one subjects with T2D were examined. Based on assessment of marginal bone height in panoramic radiographs, two periodontal subgroups were identified: one periodontally diseased (PD+) and one periodontally healthy (PD-) group. All subjects completed a questionnaire about their medical and oral health. Results: Twenty per cent of the subjects were classified as PD+. This was verified by clinical parameters. PD+ individuals had higher haemoglobin A1c (HbA1c) levels (p=0.033) and higher prevalences of cardiovascular complications (p=0.012). They were also less likely to be of Scandinavian origin (p=0.028) and more likely to smoke (p < 0.001) than the PD- group. The PD+ group rated their oral health as poor (p < 0.0001) and believed that T2D had an influence on their oral status (p < 0.0001). Conclusion: The best predictor for severe periodontal disease in subjects with T2D is smoking followed by HbA1c levels. T2D subjects should be informed about the increased risk for periodontal disease when suffering from T2D.
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| 2. |
- Gudmundsson, Petri, et al.
(författare)
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Head to head comparisons of two modalities of perfusion adenosine stress echocardiography with simultaneous SPECT
- 2009
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Ingår i: Cardiovascular Ultrasound. - : BioMed Central. - 1476-7120. ; 7:19
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Tidskriftsartikel (refereegranskat)abstract
- Background: Real-time perfusion (RTP) contrast echocardiography can be used during adenosine stress echocardiography (ASE) to evaluate myocardial ischemia. We compared two different types of RTP power modulation techniques, angiomode (AM) and high-resolution grayscale (HR), with 99mTc-tetrofosmin single-photon emission computed tomography (SPECT) for the detection of myocardial ischemia. Methods: Patients with known or suspected coronary artery disease (CAD), admitted to SPECT, were prospectively invited to participate. Patients underwent RTP imaging (SONOS 5500) using AM and HR during Sonovue® infusion, before and throughout the adenosine stress, also used for SPECT. Analysis of myocardial perfusion and wall motion by RTP-ASE were done for AM and HR at different time points, blinded to one another and to SPECT. Each segment was attributed to one of the three main coronary vessel areas of interest. Results: In 50 patients, 150 coronary areas were analyzed by SPECT and RTP-ASE AM and HR. SPECT showed evidence of ischemia in 13 out of 50 patients. There was no significant difference between AM and HR in detecting ischemia (p = 0.08). The agreement for AM and HR, compared to SPECT, was 93% and 96%, with Kappa values of 0.67 and 0.75, respectively (p < 0.001). Conclusion: There was no significant difference between AM and HR in correctly detecting myocardial ischemia as judged by SPECT. This suggests that different types of RTP modalities give comparable data during RTP-ASE in patients with known or suspected CAD.
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| 3. |
- Gudmundsson, Petri, et al.
(författare)
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Quantitative detection of myocardial ischaemia by stress echocardiography; a comparison with SPECT
- 2009
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Ingår i: Cardiovascular Ultrasound. - : BioMed Central. - 1476-7120. ; 7:28
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Real-time perfusion (RTP) adenosine stress echocardiography (ASE) can be used to visually evaluate myocardial ischaemia. The RTP power modulation technique angio-mode (AM), provides images for off-line perfusion quantification using Qontrast® software, generating values of peak signal intensity (A), myocardial blood flow velocity (β) and myocardial blood flow (Axβ). By comparing rest and stress values, their respective reserve values (A-r, β-r, Axβ-r) are generated. We evaluated myocardial ischaemia by RTP-ASE Qontrast® quantification, compared to visual perfusion evaluation with 99mTc-tetrofosmin singlephoton emission computed tomography (SPECT). Methods and Results: Patients admitted to SPECT underwent RTP-ASE (SONOS 5500) using AM during Sonovue® infusion, before and throughout adenosine stress, also used for SPECT. Visual myocardial perfusion and wall motion analysis, and Qontrast® quantification, were blindly compared to one another and to SPECT, at different time points off-line. We analyzed 201 coronary territories (left anterior descendent [LAD], left circumflex [LCx] and right coronary [RCA] artery territories) in 67 patients. SPECT showed ischaemia in 18 patients and 19 territories. Receiver operator characteristics and kappa values showed significant agreement with SPECT only for β-r and Axβ-r in all segments: area under the curve 0.678 and 0.665; P < 0.001 and < 0.01, respectively. The closest agreements were seen in the LAD territory: kappa 0.442 for both β-r and Axβ- r; P < 0.01. Visual evaluation of ischaemia showed good agreement with SPECT: accuracy 93%; kappa 0.67; P < 0.001; without non-interpretable territories. Conclusion: In this agreement study with SPECT, RTP-ASE Qontrast® quantification of myocardial ischaemia was less accurate and less feasible than visual evaluation and needs further development to be clinically useful.
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| 4. |
- Leosdottir, Margret, et al.
(författare)
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Myocardial structure and function by echocardiography in relation to glucometabolic status in elderly subjects from 2 population-based cohorts : a cross-sectional study
- 2010
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Ingår i: American Heart Journal. - : Elsevier BV. - 1097-6744 .- 0002-8703. ; 159:3, s. 4-420
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Left ventricular (LV) diastolic dysfunction has been associated with impaired glucometabolic status. However, studies of older subjects are lacking. We examined associations between echocardiographic indices of LV diastolic function and LV mass index (LVMI) and glucometabolic status among middle-aged and elderly subjects free from heart disease, hypothesizing that the associations would be comparative to younger cohorts.METHODS: We examined the Age Gene/Environment Susceptibility Reykjavik Study (Iceland; n = 607, 76 +/- 6 years) and the Malmö Preventive Project Re-Examination Study (MPP-RES) cohorts (Sweden; n = 1,519, 67 +/- 6 years), evaluating associations with multivariable regression analysis.RESULTS: In the Age Gene/Environment Susceptibility Reykjavik Study, LVMI was positively correlated with glycosylated hemoglobin (HbA1c) (P = .001). Otherwise, echocardiographic variables were not associated with glucometabolic status. In the MPP-RES, LVMI increased with increasing glucometabolic disturbance among both older (70-80 years) and middle-aged (57-69 years) subjects. Among older subjects, HbA1c was positively correlated with 2 variables reflecting LV diastolic function: late transmitral peak flow velocity (A) (P = .001) and early transmitral peak flow velocity (E)/early diastolic peak tissue velocity (Em) (P = .046). In middle-aged MPP-RES subjects, increasing glucometabolic disturbance was correlated with increasing late diastolic peak tissue velocity (Am) (P = .002) and, after age adjustment, with increasing A (P = .001) and decreasing Em/Am (P = .009). With age adjustment, Am and A were positively correlated with fasting glucose and HbA1c.CONCLUSIONS: Contrary to our hypothesis, in 2 independent cohorts of older individuals, associations between glucometabolic status and LV diastolic function were generally weak. These contrast with previous reports, as well as with observations among middle-aged subjects in the present study. Changes in LV diastolic function may be more age-related than associated with glucose metabolism in older subjects.
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| 5. |
- Mangrio, Elisabeth, et al.
(författare)
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Antibiotic use among 8-month-old children in Malmö, Sweden--in relation to child characteristics and parental sociodemographic, psychosocial and lifestyle factors.
- 2009
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Ingår i: BMC Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 9:May 8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In the county of Scania, Sweden, antibiotic use among small children is among the highest in the country. The aim of this study was to investigate the associations between antibiotic use among 8-month-old children in Malmö and characteristics of the child as well as parental sociodemographic characteristics, lifestyle factors, and psychosocial support. METHODS: The study was a population-based cross-sectional survey. The study population consisted of children who visited the Child Health Care (CHC) centres in Malmö for their 8-month health checkup during 2003-2006 and whose parents answered a self-administered questionnaire (n = 7266 children). The questionnaire was distributed to parents of children registered with the CHC and invited for an 8-month checkup during the study period. RESULTS: The odds of using antibiotics increased as parental educational level decreased. Using high educational level as a reference group, low maternal educational level was associated with an increased antibiotic use for the child, odds ratio (OR) = 1.61 (95% CI: 1.34-1.93). Furthermore, children whose parents were born outside Sweden showed higher antibiotic use, OR = 1.43 (95% CI: 1.24-1.65), in comparison with children whose parents were born in Sweden. Exposure to environmental smoking, parental experience of economic stress, and a low level of emotional support increased the odds for antibiotic use. Boys had higher odds of use of antibiotics than girls, OR = 1.40 (95% CI: 1.25-1.57). Having a low birth weight, having an allergy and having siblings also increased the odds for early antibiotic use, while breastfeeding seemed to have a protective role. CONCLUSION: There were clear associations between parental factors such as sociodemographic, psychosocial and lifestyle factors and antibiotic use at this early stage of life. Several characteristics of the child also affected the use of antibiotics.
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| 6. |
- Ohlsson, Bodil, et al.
(författare)
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A prospective evaluation of the diagnostic value of video capsule endoscopy in patients initially classified as irritable bowel syndrome
- 2009
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Ingår i: European journal of internal medicine. - : Science direct. - 0953-6205 .- 1879-0828. ; 20:1, s. 48-52
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Tidskriftsartikel (refereegranskat)abstract
- Background Irritable bowel syndrome (IBS) is characterized by chronic gastrointestinal dysfunction in the absence of detectable organic disease. The recently developed technique, video capsule endoscopy (CE), has been shown to be much more sensitive than traditional enterography in detecting mucosal changes in the small intestine. This study was performed to see if any earlier, not detectable by other standard methods, mucosal changes could be found in the small intestine in patients diagnosed as having IBS. Methods All consecutive women who, over the past five years, had received a well-founded diagnosis of IBS at the Department of Medicine were identified. Twenty-eight women, mean age 36 ± 12 years were willing to participate in the study. They underwent a CE after a pre-test with a dummy capsule. The actual IBS activity was estimated by the validated Gastrointestinal Symptom Rating Scale (GSRS) and Psychological General Well-Being (PGWB) Index questionnaires. Results The duration of the IBS symptoms was a mean of 10 years (range 3–25). Symptoms were present, according to the scores of the GSRS and the PGWB index, at the time the patients underwent the CE. In the majority, 24 of 27 IBS patients examined, no specific small intestinal lesions were seen on CE. In two patients, CE revealed multiple small intestinal lesions such as ulcerations and/or erosions, and in one patient a duodenal ulceration. Conclusion In the vast majority of patients who fulfil the symptom criteria of IBS, no pathological mucosal lesions can be found by CE explaining the symptomatology. However, a subgroup of these patients may benefit from investigation by CE to reconsider the diagnosis.
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| 7. |
- Tollemar, Victor, et al.
(författare)
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Histopathological Grading of Oral Mucosal Chronic Graft-versus-Host Disease : Large Cohort Analysis
- 2020
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Ingår i: Biology of blood and marrow transplantation. - : Elsevier. - 1083-8791 .- 1523-6536. ; 26:10, s. 1971-1979
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Tidskriftsartikel (refereegranskat)abstract
- Graft-versus-host disease (GVHD) can manifest as acute or chronic complications in patients after hematopoietic cell transplantation (HCT). Oral chronic GVHD (cGVHD) occurs in approximately 70% of HCT recipients and includes lichenoid-like mucosal reactions, restricted mouth opening, and salivary gland dysfunction. However, the underlying histopathological presentation remains to be validated in large cohorts. We characterized the histopathological features of oral mucosal cGVHD and devised a scoring model in a large patient cohort (n = 112). Oral mucosal biopsy sections (n = 303) with and without oral cGVHD were identified from archived and current HCT recipients with additional healthy controls. Histological screening was performed on hematoxylin and eosin-stained and periodic acid-Schiff-stained sections. A points-based grading tool (0 to 19, grade 0 to IV) was established based on intraepithelial lymphocytes and band-like inflammatory infiltrate, atrophic epithelium with basal cell liquefaction degeneration, including apoptosis, as well as separation of epithelium and pseudo-rete ridges. Validation involved 62 biopsy specimens, including post-HCT (n = 47) and healthy (n = 15) specimens. Remaining biopsy specimens (n = 199) were blindly graded by 3 observers. Histological severity was correlated with clinical diagnostic and distinctive features, demonstrating a spectrum of individual patient severity, including frequent signs of subclinical GVHD in healthy mucosa. However, oral cGVHD presented with significantly higher (P < .001) scores compared with HCT controls, with moderate to high positive likelihood ratios for inflammatory infiltrate, exocytosis, and basal membrane alterations. The grade II-IV biopsy specimens demonstrated a histopathological diagnosis of active mucosal lichenoid-like cGVHD, highlighting the importance of correlating clinical presentation with the dynamic histopathological processes for improved patient stratification. In addition, this tool could be used for assessing treatments, pathological processes, and immune cellular content to provide further insight into this debilitating disease.
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| 8. |
- Shahgaldi, Kambiz, et al.
(författare)
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Three-dimensional echocardiography using single-heartbeat modality decreases variability in measuring left ventricular volumes and function in comparison to four-beat technique in atrial fibrillation
- 2010
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Ingår i: Cardiovascular Ultrasound. - : Springer Science and Business Media LLC. - 1476-7120. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Three dimensional echocardiography (3DE) approaches the accuracy of cardiac magnetic resonance in measuring left ventricular (LV) volumes and ejection fraction (EF). The multibeat modality in comparison to single-beat (SB) requires breath-hold technique and regular heart rhythm which could limit the use of this technique in patients with atrial fibrillation (AF) due to stitching artifact. The study aimed to investigate whether SB full volume 3DE acquisition reduces inter-and intraobserver variability in assessment of LV volumes and EF in comparison to four-beat (4B) ECG-gated full volume 3DE recording in patients with AF. Methods: A total of 78 patients were included in this study. Fifty-five with sinus rhythm (group A) and 23 having AF (group B). 4B and SB 3DE was performed in all patients. LV volumes and EF was determined by these two modalities and inter-and intraobserver variability was analyzed. Results: SB modality showed significantly lower inter-and intraobserver variability in group B in comparison to 4B when measuring LV volumes and EF, except for end-systolic volume (ESV) in intraobserver analysis. There were significant differences when calculating the LV volumes (p < 0.001) and EF (p < 0.05) with SB in comparison to 4B in group B. Conclusion: Single-beat three-dimensional full volume acquisition seems to be superior to four-beat ECG-gated acquisition in measuring left ventricular volumes and ejection fraction in patients having atrial fibrillation. The variability is significantly lower both for ejection fraction and left ventricular volumes.
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| 9. |
- Ahlner-Elmqvist, Marianne, et al.
(författare)
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Characteristics and Quality of Life of Patients Who Choose Home Care at the End of Life
- 2008
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Ingår i: Journal of Pain and Symptom Management. - : Elsevier Inc.. - 0885-3924 .- 1873-6513. ; 36:3, s. 217-227
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Tidskriftsartikel (refereegranskat)abstract
- Cancer patients with advanced disease and short-survival expectancy were given hospitalbased advanced home care (AHC) or conventional care (CC), according to their preference. The two groups were compared at baseline to investigate whether there were differences between the AHC and the CC patients that may help explain their choice of care. The patients were consecutively recruited over 2½ years. Sociodemographic and medical data, and the health-related quality of life (HRQL) of the two groups were compared. HRQL was assessed using a self-reporting questionnaire, including the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQC30), the Impact of Event Scale (IES), five questions about social support, and two items concerning general well-being. The AHC group showed significantly poorer functioning on all the EORTC QLQ-C30 scales and an overall higher symptom burden than the CC patients. Fewer of the AHC patients were receiving cancer treatment. The AHC patients had lived longer with their cancer diagnosis, had a significantly shorter survival after study enrollment, and a significantly poorer performance status. The major differences between the two groups seemed to be related to being at different stages in their disease. The results indicate that patients are reluctant to accept home care until absolutely necessary due to severity of functioning impairments and symptom burden. These findings should be taken into consideration in planning palliative care services. J Pain Symptom Manage 2008;36:217e227. 2008 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
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| 10. |
- Jönsson, Daniel, et al.
(författare)
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Demonstration of mitochondrial oestrogen receptor beta and oestrogen-induced attenuation of cytochrome c oxidase subunit I expression in human periodontal ligament cells.
- 2007
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Ingår i: Archives of Oral Biology. - : Elsevier BV. - 1879-1506 .- 0003-9969. ; 52:7, s. 669-676
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Periodontal ligament (PDL) cells express oestrogen receptor beta (ERbeta) protein, but cellular functions regulated by ERbeta in these cells have not been identified. In this study we determine if ERbeta is localised to mitochondria and if oestrogen regulates mitochondrial function in human PDL cells obtained from teeth extracted for orthodontic reasons. DESIGN: Subcellular distribution of ERbeta was determined by confocal microscopy of cells co-stained with ERbeta antibody and the mitochondrion-selective probe MitoTracker and by immunogold electron microscopy. Expression of the mitochondrial enzyme cytochrome c oxidase subunit I, involved in oxidative phosphorylation, was determined by Western blotting in cells treated with or without physiological concentrations of the endogenous oestrogen 17beta-oestradiol. RESULTS: ERbeta immunoreactivity was observed both in the nuclei and the cytoplasm. MitoTracker-labelling was observed in the cytoplasm, especially in the perinuclear region, but not in the nuclei. Co-localisation of ERbeta and MitoTracker was observed in cells derived from both male and female subjects. Mitochondrial localisation of ERbeta was confirmed by immunogold electron microscopy. Cells treated with or without 17beta-oestradiol (100 nM) displayed an identical pattern of staining for mitochondria. Treatment with 100 nM 17beta-oestradiol attenuated cytochrome c oxidase subunit I expression by about 30%, while combined treatment with 17beta-oestradiol and the ER blocker ICI 182780 (10 microM) had no effect. CONCLUSION: This study demonstrates mitochondrial localisation of ERbeta and oestrogen-induced decrease in the expression of cytochrome c oxidase subunit I in human PDL cells, suggesting that oestrogen probably via ERbeta influences mitochondrial function and PDL cell energy
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