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Träfflista för sökning "WFRF:(Höglund Mattias) ;pers:(Ohlsson Mattias)"

Sökning: WFRF:(Höglund Mattias) > Ohlsson Mattias

  • Resultat 1-10 av 13
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1.
  • Tragardh, Elin, et al. (författare)
  • Referring physicians underestimate the extent of abnormalities in final reports from myocardial perfusion imaging
  • 2012
  • Ingår i: EJNMMI Research. - 2191-219X. ; 2:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background It is important that referring physicians and other treating clinicians properly understand the final reports from diagnostic tests. The aim of the study was to investigate whether referring physicians interpret a final report for a myocardial perfusion scintigraphy (MPS) test in the same way that the reading nuclear medicine physician intended. Methods After viewing final reports containing only typical clinical verbiage and images, physicians in nuclear medicine and referring physicians (physicians in cardiology, internal medicine, and general practitioners) independently classified 60 MPS tests for the presence versus absence of ischemia/infarction according to objective grades of 1 to 5 (1 = no ischemia/infarction, 2 = probably no ischemia/infarction, 3 = equivocal, 4 = probable ischemia/infarction, and 5 = certain ischemia/infarction). When ischemia and/or infarction were thought to be present in the left ventricle, all physicians were also asked to mark the involved segments based on the 17-segment model. Results There was good diagnostic agreement between physicians in nuclear medicine and referring physicians when assessing the general presence versus absence of both ischemia and infarction (median squared kappa coefficient of 0.92 for both). However, when using the 17- segment model, compared to the physicians in nuclear medicine, 12 of 23 referring physicians underestimated the extent of ischemic area while 6 underestimated and 1 overestimated the extent of infarcted area. Conclusions Whereas referring physicians gain a good understanding of the general presence versus absence of ischemia and infarction from MPS test reports, they often underestimate the extent of any ischemic or infarcted areas. This may have adverse clinical consequences, and thus the language in final reports from MPS tests might be further improved and standardized.
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2.
  • Ansari, David, et al. (författare)
  • Analysis of the Influence of HLA-A Matching Relative to HLA-B and -DR Matching on Heart Transplant Outcomes
  • 2015
  • Ingår i: Transplantation direct. - 2373-8731. ; 1:9
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: There are conflicting reports on the effect of donor-recipient HLA matching on outcomes in heart transplantation. The objective of this study was to investigate the effects of HLA-A matching relative to HLA-B and -DR matching on long-term survival in heart transplantation.METHODS: A total of 25 583 patients transplanted between 1988 and 2011 were identified from the International Society for Heart and Lung Transplantation registry. Transplants were divided into 2 donor-recipient matching groups: HLA-A-compatible (no HLA-A mismatches) and HLA-A-incompatible (1-2 HLA-A mismatches). Primary outcome was all-cause mortality. Secondary outcomes were graft failure-, cardiovascular-, infection-, or malignancy-related deaths.RESULTS: The risk of all-cause mortality 15 years after transplantation was higher for HLA-A-compatible (vs HLA-A-incompatible) grafts in patients who had HLA-B-, HLA-DR-, or HLA-B,DR-incompatible grafts (P = 0.027, P = 0.007, and P = 0.002, respectively) but not in HLA-B- and/or HLA-DR-compatible grafts. This was confirmed in multivariable Cox regression analysis where HLA-A compatibility (vs HLA-A incompatibility) was associated with higher mortality in transplants incompatible for HLA-DR or HLA-B and -DR (hazard ratio [HR], 1.59; 95% confidence interval [95% CI], 1.11-2.28; P = 0.012 and HR, 1.69; 95% CI, 1.17-2.43; P = 0.005, respectively). In multivariable analysis, the largest compromise in survival for HLA-A compatibility (vs HLA-incompatibility) was for chronic rejection in HLA-B- and -DR-incompatible grafts (HR, 1.91; 95% CI, 1.22-3.01; P = 0.005).CONCLUSIONS: Decreased long-term survival in heart transplantation was associated with HLA-A compatibility in HLA-B,DR-incompatible grafts.
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3.
  • Ansari, Daniel, et al. (författare)
  • CODUSA - Customize Optimal Donor Using Simulated Annealing In Heart Transplantation.
  • 2013
  • Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 3:May,30
  • Tidskriftsartikel (refereegranskat)abstract
    • In heart transplantation, selection of an optimal recipient-donor match has been constrained by the lack of individualized prediction models. Here we developed a customized donor-matching model (CODUSA) for patients requiring heart transplantations, by combining simulated annealing and artificial neural networks. Using this approach, by analyzing 59,698 adult heart transplant patients, we found that donor age matching was the variable most strongly associated with long-term survival. Female hearts were given to 21% of the women and 0% of the men, and recipients with blood group B received identical matched blood group in only 18% of best-case match compared with 73% for the original match. By optimizing the donor profile, the survival could be improved with 33 months. These findings strongly suggest that the CODUSA model can improve the ability to select optimal match and avoid worst-case match in the clinical setting. This is an important step towards personalized medicine.
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4.
  • Bergenfeldt, Henrik, et al. (författare)
  • ABO-Identical Blood Group Matching Has No Survival Benefit for AB Heart Transplant Recipients.
  • 2015
  • Ingår i: Annals of Thoracic Surgery. - : Elsevier BV. - 1552-6259 .- 0003-4975. ; 99:3, s. 762-769
  • Tidskriftsartikel (refereegranskat)abstract
    • Although identical blood group matching is preferred, it is uncertain if this results in improved survival and, if so, how large the survival benefits are. Earlier studies have yielded conflicting results and are mostly based on single-center cohorts with few long-term results. Recipients with blood group AB are of particular interest regarding nonidentical blood group matching because they may receive organs from all blood groups. We wanted to test the hypothesis that ABO-identical matching results in superior survival in recipients with blood group AB.
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6.
  • Kaboteh, Reza, et al. (författare)
  • Bone Scan Index: a prognostic imaging biomarker for high-risk prostate cancer patients receiving primary hormonal therapy.
  • 2013
  • Ingår i: EJNMMI research. - 2191-219X. ; 3:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The objective of this study was to explore the prognostic value of the Bone Scan Index (BSI) obtained at the time of diagnosis in a group of high-risk prostate cancer patients receiving primary hormonal therapy. Methods: This was a retrospective study based on 130 consecutive prostate cancer patients at high risk, based on clinical stage (T2c/T3/T4), Gleason score (8 to 10) and prostate-specific antigen (PSA) (> 20 ng/mL), who had undergone whole-body bone scans < 3 months after diagnosis and who received primary hormonal therapy. BSI was calculated using an automated method. Cox proportional-hazards regression models were used to investigate the association between clinical stage, Gleason score, PSA, BSI and survival. Discrimination between prognostic models was assessed using the concordance index (C-index). Results: In a multivariate analysis, Gleason score (p = 0.01) and BSI (p < 0.001) were associated with survival, but clinical stage (p = 0.29) and PSA (p = 0.57) were not prognostic. The C-index increased from 0.66 to 0.71 when adding BSI to a model including clinical stage, Gleason score and PSA. The 5-year probability of survival was 55% for patients without metastases, 42% for patients with BSI < 1, 31% for patients with BSI = 1 to 5, and 0% for patients with BSI > 5. Conclusions: BSI can be used as a complement to PSA to risk-stratify high-risk prostate cancer patients at the time of diagnosis. This imaging biomarker, reflecting the extent of metastatic disease, can be of value both in clinical trials and in patient management when deciding on treatment.
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7.
  • Medved, Dennis, et al. (författare)
  • Improving prediction of heart transplantation outcome using deep learning techniques
  • 2018
  • Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; :8
  • Tidskriftsartikel (refereegranskat)abstract
    • The primary objective of this study is to compare the accuracy of two risk models, International Heart Transplantation Survival Algorithm (IHTSA), developed using deep learning technique, and Index for Mortality Prediction After Cardiac Transplantation (IMPACT), to predict survival after heart transplantation. Data from adult heart transplanted patients between January 1997 to December 2011 were collected from the UNOS registry. The study included 27,860 heart transplantations, corresponding to 27,705 patients. The study cohorts were divided into patients transplanted before 2009 (derivation cohort) and from 2009 (test cohort). The receiver operating characteristic (ROC) values, for the validation cohort, computed for one-year mortality, were 0.654 (95% CI: 0.629–0.679) for IHTSA and 0.608 (0.583–0.634) for the IMPACT model. The discrimination reached a C-index for long-term survival of 0.627 (0.608–0.646) for IHTSA, compared with 0.584 (0.564–0.605) for the IMPACT model. These figures correspond to an error reduction of 12% for ROC and 10% for C-index by using deep learning technique. The predicted one-year mortality rates for were 12% and 22% for IHTSA and IMPACT, respectively, versus an actual mortality rate of 10%. The IHTSA model showed superior discriminatory power to predict one-year mortality and survival over time after heart transplantation compared to the IMPACT model.
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8.
  • Nilsson, Johan, et al. (författare)
  • Human Leukocyte Antigen-Based Risk Stratification in Heart Transplant Recipients-Implications for Targeted Surveillance
  • 2019
  • Ingår i: Journal of the American Heart Association. - 2047-9980. ; 8:15
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Human leukocyte antigen (HLA) matching isn't routinely performed in heart transplantation. Novel allograft perfusion methods may make HLA matching feasible. The purpose of this study is to reexamine whether HLA mismatch may be used in risk stratification to improve outcomes in heart transplantation. Methods and Results We analyzed 34 681 recipients undergoing heart transplantation between 1987 and 2013. We used HLAMatchmaker to quantify HLA eplet mismatches and Cox regression for analysis of time to graft loss. Recipients with 4 mismatched HLA-DR/DQ alleles and >40 eplets reached an adjusted hazard ratio (HR) for graft loss of 1.17 (95% CI 1.07-1.28) and 1.11 (95% CI 1.03-1.21), respectively. We found significant interaction between recipient age and numbers of HLA-DR/DQ allele and eplet mismatches resulting in an adjusted HR of 1.78 (95% 1.13-2.80) and 1.82 (95% CI, 1.23-2.70), respectively. HR for both interaction terms was 0.99 (95% CI, 0.98-1.00). Risk of graft loss was more pronounced after 1 year, where recipient <40 years with 4 mismatched HLA-DR/DQ alleles and >40 eplets had an adjusted HR of 1.51 (95% CI 1.12-2.03) and 1.32 (95% CI 1.02-1.70), respectively. Pre-sensitized recipients with panel reactive antibodies >10% had an adjusted HR=1.27 (95% CI 1.16-1.40) for graft loss within 1 year but not thereafter. HLA eplet mismatch was independent of panel reactive antibodies on reduction of graft loss within and after 1 year, P (interaction)=0.888 and 0.389. Conclusions HLA mismatch may be used in risk stratification for intensified post-transplant surveillance and therapy.
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10.
  • Nilsson, Johan, et al. (författare)
  • The International Heart Transplant Survival Algorithm (IHTSA): A New Model to Improve Organ Sharing and Survival.
  • 2015
  • Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Heart transplantation is life saving for patients with end-stage heart disease. However, a number of factors influence how well recipients and donor organs tolerate this procedure. The main objective of this study was to develop and validate a flexible risk model for prediction of survival after heart transplantation using the largest transplant registry in the world.
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