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  • Araghi, Marzieh, et al. (författare)
  • Smokeless tobacco (snus) use and colorectal cancer incidence and survival : Results from nine pooled cohorts
  • 2017
  • Ingår i: Scandinavian Journal of Public Health. - SAGE Publications. - 1403-4948. ; 45:8, s. 741-748
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: Although smoking is considered to be an established risk factor for colorectal cancer, the current evidence on the association between smokeless tobacco and colorectal cancer is scant and inconclusive. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess this association. Methods: A total of 417,872 male participants from nine cohort studies across Sweden were followed up for incidence of colorectal cancer and death. Outcomes were ascertained through linkage to health registers. We used shared frailty models with random effects at the study level to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During 7,135,504 person-years of observation, 4170 men developed colorectal cancer. There was no clear association between snus use and colorectal cancer overall. Exclusive current snus users, however, had an increased risk of rectal cancer (HR 1.40: 95% CI 1.09, 1.79). There were no statistically significant associations between snus use and either all-cause or colorectal cancer-specific mortality after colorectal cancer diagnosis. Conclusions: Our findings, from a large sample, do not support any strong relationships between snus use and colorectal cancer risk and survival among men. However, the observed increased risk of rectal cancer is noteworthy, and in merit of further attention.
  • Arver, Brita, et al. (författare)
  • Bilateral Prophylactic Mastectomy in Swedish Women at High Risk of Breast Cancer: A National Survey.
  • 2011
  • Ingår i: Annals of Surgery. - Lippincott Williams & Wilkins. - 1528-1140. ; 253:6, s. 1147-1154
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND/OBJECTIVE:: This study attempted a national inventory of all bilateral prophylactic mastectomies performed in Sweden between 1995 and 2005 in high-risk women without a previous breast malignancy. The primary aim was to investigate the breast cancer incidence after surgery. Secondary aims were to describe the preoperative risk assessment, operation techniques, complications, histopathological findings, and regional differences. METHODS:: Geneticists, oncologists and surgeons performing prophylactic breast surgery were asked to identify all women eligible for inclusion in their region. The medical records were reviewed in each region and the data were analyzed centrally. The BOADICEA risk assessment model was used to calculate the number of expected/prevented breast cancers during the follow-up period. RESULTS:: A total of 223 women operated on in 8 hospitals were identified. During a mean follow-up of 6.6 years, no primary breast cancer was observed compared with 12 expected cases. However, 1 woman succumbed 9 years post mastectomy to widespread adenocarcinoma of uncertain origin. Median age at operation was 40 years. A total of 58% were BRCA1/2 mutation carriers. All but 3 women underwent breast reconstruction, 208 with implants and 12 with autologous tissue. Four small, unifocal, invasive cancers and 4 ductal carcinoma in situ were found in the mastectomy specimens. The incidence of nonbreast related complications was low (3%). Implant loss due to infection/necrosis occurred in 21 women (10%) but a majority received a new implant later. In total, 64% of the women underwent at least 1unanticipated secondary operation. CONCLUSIONS:: Bilateral prophylactic mastectomy is safe and efficacious in reducing future breast cancer in asymptomatic women at high risk. Unanticipated reoperations are common. Given the small number of patients centralization seems justified.
  • Holm, Jonas, et al. (författare)
  • Improvement of cycloid psychosis following electroconvulsive therapy.
  • 2017
  • Ingår i: Nordic journal of psychiatry. - 1502-4725. ; 71:6, s. 405-410
  • Tidskriftsartikel (refereegranskat)abstract
    • The treatment of choice for cycloid psychosis has traditionally been electroconvulsive therapy (ECT), but there is a lack of studies on its effectiveness.The primary aim of this register study was to determine the rates of remission and response after ECT for cycloid psychosis. The secondary aim was to examine possible predictors of outcome.Data were obtained from the National Quality Register for ECT in Sweden. The study population was patients (n = 42) who received ECT for acute polymorphic psychotic disorder without symptoms of schizophrenia or for cycloid psychosis between 2011-2015 in 13 hospitals. Remission and response rates were calculated using Clinical Global Impression-Severity (CGI-S) and -Improvement scores, respectively. Variables with possible predictive value were tested using Chi-square and Fisher's exact test.The response rate was 90.5%. The remission rate was 45.2%. Of 42 patients, 40 improved their CGI-S score after ECT (p < 0.001). The mean number of ECT treatments was 2.5 for non-responders and 7.0 for responders (p = 0.010). The mean number of ECT treatments did not differ significantly between remitters and non-remitters (7.2 vs 6.1, p = 0.31). None of the other investigated potential predictors was statistically significantly associated with outcome.ECT is an effective treatment for cycloid psychosis. Future studies need to compare the outcome of ECT to that of other treatment strategies.The high response rate with ECT indicates that cycloid psychosis is a clinically useful diagnosis.
  • Jarrick, Simon, 1977-, et al. (författare)
  • Mortality in IgA Nephropathy : A Nationwide Population-Based Cohort Study.
  • 2019
  • Ingår i: Journal of the American Society of Nephrology. - American Society of Nephrology. - 1046-6673 .- 1533-3450. ; 30:5, s. 866-876
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>BACKGROUND:</strong> The clinical course of IgA nephropathy (IgAN) varies from asymptomatic nonprogressive to aggressive disease, with up to one in four patients manifesting ESRD within 20 years of diagnosis. Although some studies have suggested that mortality appears to be increased in IgAN, such studies lacked matched controls and did not report absolute risk.</p><p><strong>METHODS:</strong> We conducted a population-based cohort study in Sweden, involving patients with biopsy-verified IgAN diagnosed in 1974-2011; main outcome measures were death and ESRD. Using data from three national registers, we linked 3622 patients with IgAN with 18,041 matched controls; we also conducted a sibling analysis using 2773 patients with IgAN with 6210 siblings and a spousal analysis that included 2234 pairs.</p><p><strong>RESULTS:</strong> During a median follow-up of 13.6 years, 577 (1.1%) patients with IgAN died (10.67 per 1000 person-years) compared with 2066 deaths (0.7%) in the reference population during a median follow-up of 14.1 years (7.45 per 1000 person-years). This corresponded to a 1.53-fold increased risk and an absolute excess mortality of 3.23 per 1000 person-years (equaling one extra death per 310 person-years) and a 6-year reduction in median life expectancy. Similar increases in risk were seen in comparisons with siblings and spouses. IgAN was associated with one extra case of ESRD per 54 person-years. Mortality preceding ESRD was not significantly increased compared with controls, spouses, or siblings. Overall mortality did not differ significantly between patients with IgAN-associated ESRD and patients with ESRD from other causes.</p><p><strong>CONCLUSIONS:</strong> Patients with IgAN have an increased mortality compared with matched controls, with one extra death per 310 person-years and a 6-year reduction in life expectancy.</p>
  • Lincke, Alisa, 1989-, et al. (författare)
  • Diabetes Information in Social Media
  • 2018
  • Ingår i: Proceedings of the 11th International Symposium on Visual Information Communication and Interaction (VINCI '18). - ACM Publications. - 978-1-4503-6501-7 ; s. 104-105
  • Konferensbidrag (refereegranskat)abstract
    • <p>Social media platforms have created new ways for people to communicate and express themselves. Thus, it is important to explore how e-health related information is generated and disseminated in these platforms. The aim of our current efforts is to investigate the content and flow of information when people in Sweden use Twitter to talk about diabetes related issues. To achieve our goals, we have used data mining and visualization techniques in order to explore, analyze and cluster Twitter data we have collected during a period of 10 months. Our initial results indicate that patients use Twitter to share diabetes related information and to communicate about their disease as an alternative way that complements the traditional channels used by health care professionals.</p>
  • Lundberg, Jonas, 1964-, et al. (författare)
  • Towards a language independent Twitter bot detector
  • 2019
  • Ingår i: Proceedings of 4th Conference of The Association Digital Humanities in the Nordic Countries : Copenhagen, March 6-8 2019. - Copenhagen : University of Copenhagen. ; s. 308-319
  • Konferensbidrag (refereegranskat)abstract
    • <p>This article describes our work in developing an application that recognizes automatically generated tweets. The objective of this machine learning application is to increase data accuracy in sociolinguistic studies that utilize Twitter by reducing skewed sampling and inaccuracies in linguistic data. Most previous machine learning attempts to exclude bot material have been language dependent since they make use of monolingual Twitter text in their training phase. In this paper, we present a language independent approach which classifies each single tweet to be either autogenerated (AGT) or human-generated (HGT). We define an AGT as a tweet where all or parts of the natural language content is generated automatically by a bot or other type of program. In other words, while AGT/HGT refer to an individual message, the term bot refers to non-personal and automated accounts that post content to online social networks. Our approach classifies a tweet using only metadata that comes with every tweet, and we utilize those metadata parameters that are both language and country independent. The empirical part shows good success rates. Using a bilingual training set of Finnish and Swedish tweets, we correctly classified about 98.2% of all tweets in a test set using a third language (English).</p>
  • Lundberg, Jonas, et al. (författare)
  • When Is the Deep Inferior Epigastric Artery Flap Indicated for Breast Reconstruction in Patients not Treated With Radiotherapy?
  • 2014
  • Ingår i: Annals of Plastic Surgery. - Lippincott Williams & Wilkins. - 1536-3708. ; 73:1, s. 105-113
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: It is controversial whether breast reconstruction with a microvascular free flap should be done without restrictions in patients who have not had radiotherapy. Many regard it as too expensive, but some consider it better and more economically advantageous than an implant reconstruction. METHODS: Databases of publications were searched to find out under what conditions is it suitable to offer a deep inferior epigastric perforator (DIEP) or a transverse rectus abdominis myocutaneous flap to normalize the body's appearance in a woman whose breast(s) had been removed for cancer or to prevent the development of breast cancer. The effect of breast reconstruction with DIEP flaps was analyzed, taking account of the following factors: general satisfaction (quality of life), aesthetic satisfaction (cosmesis), and morbidity. To find out which factors were of potential importance, we recorded age, hypertension, whether scars from previous abdominal surgery were present, microcirculation, whether the patient was overweight or obese, and costs of the procedure. RESULTS: Patients planning to have DIEP flaps should be willing to stop smoking at least 4 weeks before and after the procedure and have a body mass index of less than 30 kg/m to avoid a higher risk of complications. Because of the paucity of papers, it is difficult to recommend one approach over the other when considering general satisfaction, aesthetic satisfaction, and health economics. However, economical long-term outcome is highly dependent on the initial costs of each procedure and the cumulative costs of complications for each reconstruction method. CONCLUSIONS: The scientific foundation of assessment of methods of techniques of breast reconstruction is weak. Therefore, it is important that future studies should present more comparable series, highlight the long-term effects in high-quality studies, to provide the patients with optimal results without undue risks and to avoid financial burdens on society.
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