| 1. |
- Bergström, Göran, 1964, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 2. |
- Bergström, Göran, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - : Wolters Kluwer. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 3. |
- Börjesson, Erik, et al.
(författare)
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Symptoms and ECG changes precede sudden cardiac death in hypertrophic cardiomyopathy-A nationwide study among the young in Sweden.
- 2022
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 17:9
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Tidskriftsartikel (refereegranskat)abstract
- Hypertrophic cardiomyopathy (HCM) is a major cause of sudden cardiac death (SCD) in the young. We aimed to characterize detailed family history, symptoms, hospital utilization and ECG changes before SCD.We extracted all cases suffering SCD with HCM from the SUDDY cohort, which includes all cases of SCD between 2000-2010 in Sweden among individuals aged 0-35 years along with their controls. We gathered data from mandatory national registries, autopsy reports, medical records, ECGs (including military conscripts), and detailed family history from an interview-based questionnaire (with relatives, post-mortem).Thirty-eight cases (7 female), mean age 22 years, with HCM were identified. Among these, 71% presented with possible cardiac symptoms (chest pain [26%], syncope [22%], palpitations [37%]), before death; 69% received medical care (vs 21% in controls) within 180 days before death. The majority (68%) died during recreational activity (n = 14) or exercise/competitive sports (n = 12). Fifteen (39%) had a known cardiac disorder prior to death, with HCM being diagnosed pre-mortem in nine cases. 58% presented with abnormal ECG recordings pre-mortem, and 50% had a positive family history (1st-3rd generation) for heart disease.In this comprehensive, nationwide study of SCD due to HCM, 87% (33/38) of cases had one or more abnormality prior to death, including cardiac symptoms, a positive family history, known cardiac disease or ECG abnormalities. They sought medical care prior death, to a larger extent than controls. These findings suggest that cardiac screening should be expanded beyond competitive athletes to aid SCD prevention in the young population with HCM.
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| 4. |
- Isaksson, Mats, 1961, et al.
(författare)
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Assessing 131I in thyroid by non-spectroscopic instruments - a European intercomparison exercise
- 2019
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Ingår i: Radiation Measurements. - : Elsevier BV. - 1350-4487 .- 1879-0925. ; 128:September
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Tidskriftsartikel (refereegranskat)abstract
- One of the issues of the Open Project for the European Radiation Research Area (OPERRA) was human thyroid monitoring in case of a large scale nuclear accident. This issue was covered in task 5.4 as project “CaThyMARA” (Child and Adult Thyroid Monitoring After Reactor Accident), which included several aspects of thyroid monitoring, e.g. screening of facilities able to perform thyroid monitoring in the European countries, dose estimation, modelling of detector response, and two intercomparison exercises. The intercomparison described in this paper focused on thyroid monitoring by non-spectrometric instruments, including gamma cameras and other instruments that were considered available for measurements made by members of the public. A total of 12 facilities from 7 European countries have participated and 43 various measuring devices have been evaluated. The main conclusion of this intercomparison is that the ability to make assessments of 131I activity in the thyroid to the exposed population after an accidental release must, on the average, be considered as good among the European laboratories taking part in this study. This intercomparison also gave the participants the possibility to calibrate the measuring devices for thyroid measurements of children where this procedure was not available before. A comprehensive report of the intercomparison is given.
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| 5. |
- Öhman, Marie, 1958-
(författare)
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Kropp och makt i rörelse
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Body and Power in MotionThis dissertation is concerned with body and politics, or, more specifi cally body, power and governance. The central question is how specifi c individuals and bodies are constituted in the teaching of Physical Education (PE) in school. Inspired by Foucault’s work and the research fi eld that emanates from the concept of governmentality, one of the ambitions is to develop a method that facilitates the study of power and governance processes in teachers’ and students’ interactive actions and dealings. With the aid of this approach, 15 video-recorded physical education lessons in 5 Swedish nine-year compulsory schools are analysed in order to demonstrate how governance processes are included in the work and activities in terms of how the processes of governance–self-governance are staged, and the direction this takes. In using the term direction I am here referring to the content the governance is aiming towards, where the question of which subjects and bodies are constituted is of substantial interest. This means that the study not only focuses on what is done, but also on the way in which it is done, i.e. it analyses both process and content.The results show that physical exertion and the desire for physical work is a thread that runs though the analysed material. It is mainly scientifi c knowledge about the body that is referred to in actual teaching practice. This is displayed through the use of a scientifi cally inspired language when talking about the body, where effects on muscles and degrees of oxygen intake are considered in connection with the physical activities. In connection with physical exertion, pupils are encouraged to do their best, try the activities on offer, cooperate with others and face challenges. In line with the governmentality perspective’s problematisation of the process governance–self-governance, the study highlights a governance mentality that is not characterised by coercion, but is rather directed towards different components of willingness where the students are expected to be participatory, take responsibility and govern their own actions in the direction of that which is most desirable and reasonable. The willingness component appears as the actual hub of character-building, were the students ought to be physically active, should want to do their best, be willing to try, should want to show solidarity and should want to defeat the others. The process of governance–self-governance is staged as different ways of appealing to one’s willingness in the activities studied. Specifi c governance techniques are used to support and promote self-governance work, i.e. different forms of encouragement strengthen the correct action, emphasising physical exertion as pleasurable and focuses on the fact that we are all involved in a common project. In the dissertation it is shown how the body is included in a socio-political context. Through the body the individual is turned into a participant of physical projects concerned with becoming a certain kind of social citizen. The body thus symbolises the complex encounter between the individual and society. In this way the study demonstrates and highlights tendencies that are evident in modern society. It is thus a narrative that indicates how we all become part of a discourse system.
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| 6. |
- Aagaard, Philip, et al.
(författare)
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Tidig repolarisation på EKG - Definitioner, prevalens och prognostisk betydelse.
- 2015
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Ingår i: Läkartidningen. - 1652-7518. ; 112
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Tidskriftsartikel (refereegranskat)abstract
- Early repolarization defined as antero-lateral ST-segment elevation exists in 1-2 % of the general population and has been considered a benign ECG finding for decades. However, early repolarization, defined as infero-lateral J-waves, has in recent studies been associated with an increased - albeit low - risk of sudden and cardiovascular death. This ECG pattern is present in 3-13% of the general population. However, exercise training can induce all types of early repolarization, and the prevalence in the athletic population rises to 20-90%. There is large variability between sports (higher in endurance athletes) and also throughout the season (higher during times of peak fitness). In athletes, early repolarization, regardless of type, is considered benign. In asymptomatic non-athletes, the absolute risk is too low to use this ECG finding in clinical practice. In individuals with J-wave syndrome, on the other hand, ICD implantation should be strongly considered to prevent sudden cardiac death.
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| 7. |
- af Geijerstam, Agnes, et al.
(författare)
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Fitness, strength and severity of COVID-19: a prospective register study of 1 559 187 Swedish conscripts
- 2021
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 11:7
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the possible connection between cardiorespiratory fitness (CRF) and muscle strength in early adulthood and severity of COVID-19 later in life. Design Prospective registry-based cohort study. Participants 1 559 187 Swedish men, undergoing military conscription between 1968 and 2005 at a mean age of 18.3 (SD 0.73) years. Main outcome measures Hospitalisation, intensive care or death due to COVID-19 from March to September 2020, in relation to CRF and muscle strength. Results High CRF in late adolescence and early adulthood had a protective association with severe COVID-19 later in life with OR (95% CI) 0.76 (0.67 to 0.85) for hospitalisation (n=2 006), 0.61 (0.48 to 0.78) for intensive care (n=445) and 0.56 (0.37 to 0.85) for mortality (n=149), compared with the lowest category of CRF. The association remains unchanged when controlled for body mass index (BMI), blood pressure, chronic diseases and parental education level at baseline, and incident cardiovascular disease before 2020. Moreover, lower muscle strength in late adolescence showed a linear association with a higher risk of all three outcomes when controlled for BMI and height. Conclusions Physical fitness at a young age is associated with severity of COVID-19 many years later. This underscores the necessity to increase the general physical fitness of the population to offer protection against future viral pandemics.
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| 8. |
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| 9. |
- Alkasrawi, Malek, et al.
(författare)
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The effect of Tween-20 on simultaneous saccharification and fermentation of softwood to ethanol
- 2003
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Ingår i: Enzyme and Microbial Technology. - 0141-0229. ; 33:1, s. 71-78
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Tidskriftsartikel (refereegranskat)abstract
- Simultaneous sacchatification and fermentation (SSF) of steam-pretreated wood constitutes an attractive process configuration for ethanol production from biomass. However, the high enzyme addition in SSF contributes to a high process cost. In this study we explore the effect of the non-ionic surfactant Tween-20 as an additive in SSE Tween-20 addition at 2.5 g/l had several positive effects on SSF: (i) the ethanol yield was increased by 8%; (ii) the amount of enzyme loading could be reduced by 50%, while maintaining a constant yield; (iii) the enzyme activity increased in the liquid fraction at the end of SSF, probably by preventing unproductive binding of the cellulases to lignin, which could facilitate enzyme recovery; (iv) the time required to attain maximum ethanol concentration was reduced. Surfactants as an additive in SSF can significantly lower the operational cost of the process. However, less expensive surfactants must be investigated. (C) 2003 Elsevier Science Inc. All rights reserved.
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| 10. |
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