| 1. |
- Bro, Tomas, et al.
(author)
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Two point four million cataract surgeries: 30 years with the Swedish National Cataract Register, 1992-2021
- 2023
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In: Journal of cataract and refractive surgery. - : Wolters Kluwer. - 1873-4502 .- 0886-3350. ; 49:8, s. 879-884
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Journal article (peer-reviewed)abstract
- The present review summarizes data collected by the Swedish National Cataract Register (NCR), which by the end of 2021 contained data for more than 2.4 million cataract surgeries between 1992 and 2021. During these 30 years, the cataract surgery rate rose from 3700 to 12 800. The coverage of NCR is very high including 93% of all cataract procedures in Sweden between 2010 and 2021. Independently of demographic changes, the proportion of operations of patients age 60 to 79 has increased while the proportion of 80 to 90+ has decreased. The median visual acuity of the first eye planned for surgery was 0.1 decimal in 1992 and has increased to 0.5 decimal in 2021. Patient-reported outcome measures have been registered with the Catquest-9SF questionnaire since 2008, demonstrating intervention at an earlier stage, but consistently favorable outcomes. Surgical complications have decreased; endophthalmitis has decreased from 0.10% to below 0.02%, and posterior capsule rupture from 2.8% to 0.6%.
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| 2. |
- Hoffmann, Mikael, et al.
(author)
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Do patients or their physicians more accurately assess long-term risk associated with hypertension? A population-based study
- 2020
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In: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 38:2, s. 166-175
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Journal article (peer-reviewed)abstract
- Objective: To compare the assessments of 10-year probability by patients and their physicians of cardiovascular complications of hypertension with actual outcomes. Design: Patients with uncomplicated hypertension treated with at least one antihypertensive drug at inclusion were followed for 10 years through mandatory national health registers. Setting: 55 primary health care centres, 11 hospital outpatient clinics in Sweden Patients: 848 patient, 212 physicians. Main outcome measures: Patients and physicians estimated the probability of hypertension-related complications with treatment (death, heart failure, acute myocardial infarction/AMI, and stroke) for each patient in 848 pairs. Estimates were compared with the clinical outcomes 10 years later using data from the Mortality Register and the National Patient Register. Results: Patients were significantly better (p < 0.001) than their physicians in estimating the average probability of heart failure compared with actual outcome data (14% vs. 24%, outcome 15%), AMI (16% vs. 26%, outcome 8%), and stroke (15% vs. 25%, outcome 11%). Patients were significantly worse (p < 0.001) at estimating the average probability of death (10% vs. 18%, actual outcome 20%). Neither the patients nor the physicians were able to distinguish reliably between low-risk and high-risk patients after adjustment for age and sex. Conclusions: Patients were better than their physicians in estimating the average probability of morbidity due to hypertension. Both the patients and their attending physicians had difficulty in estimating the individual patient’s risk of complications. The results support the use of evidence-based tools in consultations for assessing the risk of cardiovascular complications associated with hypertension.Key points • Shared decision making relies on a common understanding of risks and benefits. Tools for risk assessment of hypertension have been introduced in the last two decades. • Without tools for risk assessment, both patients and physicians had difficulties in estimating the individual patient’s risk of cardiovascular morbidity. • Patients were better than physicians in estimating actual average cardiovascular morbidity due to hypertension during a follow-up of 10 years. • The results support the use of evidence-based tools in consultations for assessing the risk of cardiovascular complications associated with hypertension. © 2020, © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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| 3. |
- Johannsson, Gudmundur, 1960, et al.
(author)
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Improved cortisol exposure-time profile and outcome in patients with adrenal insufficiency : a prospective randomised trial of a novel hydrocortisone dual-release formulation
- 2012
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In: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 97:2, s. 473-481
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Journal article (peer-reviewed)abstract
- Context: Patients with treated adrenal insufficiency (AI) have increased morbidity and mortality rate. Our goal was to improve outcome by developing a once-daily (OD) oral hydrocortisone dual-release tablet with a more physiological exposure-time cortisol profile.Objective: The aim was to compare pharmacokinetics and metabolic outcome between OD and the same daily dose of thrice-daily (TID) dose of conventional hydrocortisone tablets.Design and Setting: We conducted an open, randomized, two-period, 12-wk crossover multicenter trial with a 24-wk extension at five university hospital centers.Patients: The trial enrolled 64 adults with primary AI; 11 had concomitant diabetes mellitus (DM).Intervention: The same daily dose of hydrocortisone was administered as OD dual-release or TID.Main Outcome Measure: We evaluated cortisol pharmacokinetics.Results: Compared with conventional TID, OD provided a sustained serum cortisol profile 0-4 h after the morning intake and reduced the late afternoon and the 24-h cortisol exposure. The mean weight (difference = -0.7 kg, P = 0.005), systolic blood pressure (difference = -5.5 mm Hg, P = 0.0001) and diastolic blood pressure (difference: -2.3 mm Hg; P = 0.03), and glycated hemoglobin (absolute difference = -0.1%, P = 0.0006) were all reduced after OD compared with TID at 12 wk. Compared with TID, a reduction in glycated hemoglobin by 0.6% was observed in patients with concomitant DM during OD (P = 0.004).Conclusion: The OD dual-release tablet provided a more circadian-based serum cortisol profile. Reduced body weight, reduced blood pressure, and improved glucose metabolism were observed during OD treatment. In particular, glucose metabolism improved in patients with concomitant DM.
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| 4. |
- Kowar, J., et al.
(author)
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Causes of Death in Implant Patients Treated in the Edentulous Jaw: A Comparison between 2098 Deceased Patients and the Swedish National Cause of Death Register
- 2019
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In: International Journal of Dentistry. - : Hindawi Limited. - 1687-8728 .- 1687-8736.
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Journal article (peer-reviewed)abstract
- Background. Previous research has reported an association between tooth loss and patient mortality, while the cause of death has not been elucidated. Objective. The purpose was to describe and compare the cause of death in implant patients treated consecutively in the edentulous arch with a reference population. Methods. Altogether, 3902 patients were included between 1986 and 2014. Data on the causes of death for deceased patients were compared to the Swedish National Cause of Death Register for a comparable time period. Standardised mortality ratios (SMRs) were calculated based on gender and age and tested for statistical significance. Results. Most deceased patients (2,098) died from diseases in the circulatory system (CVD; 42%) and from cancers (26%). SMR indicated a generally increased mortality (total group) compared to the reference population during inclusion (P < 0.05; 1986-2014). Patients treated early (1986-1996) showed a lower SMR compared to patients treated later (P < 0.05; 1997-2014) especially related to CVDs. Younger patients (<60 years at surgery) showed an increased mortality due to CVDs when treated late (1997-2014; SMR = 5.4, P < 0.05). Elderly patients (>79 years at surgery) showed a significantly lower mortality in almost all observed causes of death (1986-2014; P < 0.05) with also a significantly lower mortality due to CVDs during the early period (1986-1996; SMR = 0.3, P < 0.05). Conclusion. An overall increased mortality was observed for the edentulous implant patient compared to the reference population. Elderly patients (>79 years) showed significantly lower mortality for all causes of death independent of the time period of implant surgery. Younger patients (<60 years) present an increased risk for early mortality related to CV D. SMR for all causes of death increased for patients treated late (1997-2014) as compared to patients treated early (1986-1996).
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| 5. |
- Kowar, J., et al.
(author)
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Mortality in Edentulous Patients: A Registry-Based Cohort Study in Sweden Comparing 8463 Patients Treated with Removable Dentures or Implant-Supported Dental Prostheses
- 2021
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In: International Journal of Dentistry. - : Hindawi Limited. - 1687-8728 .- 1687-8736. ; 2021
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Journal article (peer-reviewed)abstract
- Objectives. The purpose of this study was to investigate if edentulism is associated with all-cause mortality. The aims were to analyze the association between age, socioeconomic factors, and mortality in edentulous patients treated with either removable dentures or implant-supported prostheses. Methods. All patients who became edentulous according to the Swedish Social Insurance Agency (SSIA) between 2009 and 2013 (N = 8463) were analyzed regarding prosthetic treatment, age, gender, and socioeconomic status. The patients were divided into two groups, depending on whether they were treated with dental implants (implant group; IG) or with conventional removable dentures (denture group; DG). Data on mortality for all included individuals were obtained from the Swedish National Cause of Death Register and compared to a reference population. Cumulative survival rates were calculated, and a multivariable regression analysis for the included variables was performed. Results. Between 2009 and 2018, 2192 of the patients (25.9%) were treated with implant-supported dental prostheses (IG) and 6271 patients (74.1%) were treated with removable dentures without support of dental implants (DG). Altogether 2526 patients (30%) died until December 31, 2019, and the overall mortality was significantly higher for the DG compared to the IG during follow-up (p<0.001). Younger edentulous patients (<= 59 years) presented a higher mortality than the reference population, while implant patients over 79 years of age demonstrated a lower mortality. The final results from the multivariable logistic analysis showed that lower equalized disposable income (EDI) and the choice of conventional removable dentures are the most important factors for increased patient mortality (p<0.001). Conclusions. Edentulous patients have an overall higher mortality compared to a reference population. Low socioeconomic status increases all-cause mortality. Individuals treated with dental implants show statistically significant lower 10-year mortality compared to patients treated with conventional removable dentures, regardless of socioeconomic status.
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| 6. |
- Lind, Lars, et al.
(author)
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Obesity is associated with coronary artery stenosis independently of metabolic risk factors : the population-based SCAPIS study
- 2022
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In: Atherosclerosis. - : Elsevier. - 0021-9150 .- 1879-1484. ; 362, s. 1-10
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Journal article (peer-reviewed)abstract
- Background and aims: Previous studies reported divergent results on whether metabolically healthy obesity is associated with increased coronary artery calcium and carotid plaques. We investigated this in a cross-sectional fashion in a large, well-defined, middle-aged population using coronary CT angiography (CCTA) and carotid ultrasound. Methods: In the SCAPIS study (50–65 years, 51% female), CCTA and carotid artery ultrasound were performed in 23,674 individuals without clinical atherosclerotic disease. These subjects were divided into six groups according to BMI (normal weight, overweight, obese) and the presence of metabolic syndrome (MetS) according to the NCEP consensus criteria. Results: The severity of coronary artery stenosis was increased in individuals with obesity without MetS compared to normal-weight individuals without MetS (OR 1.47, 95%CI 1.34–1.62; p < 0.0001), even after adjusting for non-HDL-cholesterol and several lifestyle factors. Such difference was not observed for the presence of carotid artery plaques (OR 0.94, 95%CI 0.87–1.02; p = 0.11). Obese or overweight individuals without any MetS criteria (except the waist criterion) showed significantly more pronounced stenosis in the coronary arteries as compared to the normal-weight individuals, while one criterion was needed to show increased plaque prevalence in the carotid arteries. High blood pressure was the most important single criterion for increased atherosclerosis in this respect. Conclusions: Individuals with obesity without MetS showed increased severity of coronary artery stenosis, but no increased occurrence of carotid artery plaques compared to normal-weight individuals without MetS, further emphasizing that obesity is not a benign condition even in the absence of MetS.
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| 7. |
- Lundström, Mats, et al.
(author)
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Ten-year trends of immediate sequential bilateral cataract surgery (ISBCS) as reflected in the Swedish National Cataract Register
- 2024
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In: Acta Ophthalmologica. - : WILEY. - 1755-375X .- 1755-3768. ; 102:1, s. 68-73
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Journal article (peer-reviewed)abstract
- Purpose: To analyse trends of ISBCS reported to the Swedish National Cataract Register (NCR) over a 10-year period.Methods: Since 2010 the NCR contains social security number of all individuals in the list of parameters reported to NCR after each cataract procedure. Bilateral surgeries were mapped out using social security numbers. When dates of both-eye surgeries are identical for an individual it is classified as an immediate sequential bilateral cataract surgery (ISBCS). This study includes all data reported during the period 1st of January 2010 to 31st of December 2019. During the study period 113 cataract surgery clinics affiliated to the NCR reported their data on consecutive cataract cases.Results: For the whole period 54 194 ISBCS were reported. The total number of bilateral cataract extractions was 422 300. There was a significant trend of increasing ISBCS over time with linear regression (Beta = 1.75, p < 0.001). In ISBCS the occurrence of an ocular comorbidity decreased over time. The use of a capsular tension ring was significantly more common in ISBCS than in delayed sequential bilateral cataract surgery (DSBCS). All other measures taken during surgery were more common in DSBCS. The use of multifocal IOL was significantly more frequent in ISBCS compared to DSBCS (p < 0.001).Conclusions: The use of ISBCS has increased over the study period. The operated eyes have less risk factors than eyes going through a DSBCS, but both ocular comorbidities and surgical complications occur in ISBCS eyes.
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| 8. |
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| 9. |
- Nilsson, Anders, 1958, et al.
(author)
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The Artelon CMC spacer compared with tendon interposition arthroplasty.
- 2010
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In: Acta orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 81:2, s. 237-44
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Journal article (peer-reviewed)abstract
- The Artelon CMC spacer is designed for surgical treatment of osteoarthritis (OA) in the carpometacarpal joint of the thumb (CMC-I). Good results using this degradable device were previously presented in a pilot study. We now present results from a larger randomized, controlled, multicenter study.
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| 10. |
- Norman, Kerstin, et al.
(author)
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Working conditions and health among female and male employees at a call center in Sweden.
- 2004
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In: American journal of industrial medicine. - : Wiley. - 0271-3586 .- 1097-0274. ; 46:1, s. 55-62
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Journal article (peer-reviewed)abstract
- BACKGROUND: The call center industry is one of the most expansive labor market sectors in Sweden today. The purpose of this study was to investigate the working conditions and symptoms among employees at a call center in Sweden. METHODS: This study represents the cross-sectional baseline survey, which was part of a prospective cohort study. Fifty-seven call center workers were compared with a reference group of 1,459 professional computer users from other occupations. A questionnaire covered physical and psychosocial working conditions and symptoms during the last month. Structured observations in accordance with an ergonomic checklist were used to assess workstation design during the subject's ordinary work. RESULTS: The call center group had worked for a shorter time in their present tasks and spent longer continuous time in front of the computer than the reference group. There were deficiencies in workspace, keyboard- and input device placement. The subjects reported poor support from their immediate supervisor, low control and limited opportunities to influence their work. A higher proportion of the call center group reported musculoskeletal symptoms. CONCLUSION: The call center operators were exposed to working conditions that in other studies have indicated an increased risk of developing musculoskeletal disorders. The study also shows that young computer operators in the call center group with a short working career had a higher prevalence of neck- and upper extremity symptoms than older computer workers in other labor market sectors.
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