| 1. |
- Gard, Anna, et al.
(författare)
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Quality of life of ice hockey players after retirement due to concussions
- 2020
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Ingår i: Concussion. - : Future Medicine. - 2056-3299. ; 5:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sports-related concussion (SRC) is increasingly recognized as a potential health problem in ice hockey. Quality of life (QoL) in players retiring due to SRC has not been thoroughly addressed. Materials & methods: QoL using the Sports Concussion Assessment Tool 5th Edition, Impact of Event Scale-Revised and Short Form Health Survey was measured in Swedish ice hockey players who retired due to persistence of postconcussion symptoms or fear of attaining additional SRC. Results: A total of 76 players were assessed, on average of 5 years after their most recent SRC. Overall, retired players had a high burden of postconcussion symptoms and reduced QoL. Conclusion: Retired concussed ice hockey players have a reduced QoL, particularly those retiring due to postconcussion symptoms. Symptom burden should be continuously evaluated and guide the decision to retire.
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| 2. |
- Jansson, Sven-Arne, et al.
(författare)
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Severe asthma is related to high societal costs and decreased health related quality of life
- 2020
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 162
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of the present study was to estimate the societal costs and the key cost drivers for patients with severe asthma in Sweden. In addition, health-related quality of life (HRQOL) and morbidity of patients with severe asthma is described. Methods: The study population comprised adults with severe asthma recruited from a large asthma cohort within the Obstructive Lung Disease in Northern Sweden (OLIN) studies. During 2017, patients were interviewed quarterly over telephone regarding their resource utilization and productivity losses. Results: Estimated mean annual asthma-related costs per patient with severe asthma amounted to (sic)6,500, of which approximately (sic)2400 and (sic)4100 were direct and indirect costs, respectively. The main cost drivers for direct costs were hospitalizations followed by drugs: approximately (sic)1000 and (sic)800, respectively. Patients on treatment with regular oral corticosteroids (OCS) had greater direct costs compared with those without regular OCS treatment. Co-morbid conditions were common and the costs were substantial also for co-morbid conditions, with a total cost of approximately (sic)4200. The OCS group had significantly lower HRQOL compared to the non-OCS group. Conclusions: The societal costs due to severe asthma were substantial. Costs for co-morbid conditions contributed substantially to both direct and indirect costs. The direct costs were significantly higher in the maintenance OCS-group compared to the non-maintenance OCS-group. These results indicate a need for improved management and treatment regimens for patients with severe asthma.
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| 3. |
- Lassmann-Klee, P. G., et al.
(författare)
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Parallel gradients in F-ENO and in the prevalences of asthma and atopy in adult general populations of Sweden, Finland and Estonia - A Nordic EpiLung study
- 2020
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 173
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of asthma is higher in Sweden and Finland than in neighbouring eastern countries including Estonia. Corresponding difference in bronchial eosinophilic inflammation could be studied by FENO measurements. We aimed to compare FENO in adult general populations of Sweden, Finland, and Estonia, to test the plausibility of the west-east disparity hypothesis of allergic diseases. We conducted clinical interviews (N = 2658) with participants randomly selected from the general populations in Sweden (Stockholm and dOrebro), Finland (Helsinki), and Estonia (Narva and Saaremaa), and performed FENO (n = 1498) and skin prick tests (SPT) in 1997-2003. The median (interquartile range) of FENO (ppb) was 15.5 (9.3) in Sweden, 15.4 (13.6) in Finland and 12.5 (9.6) in Estonia. We found the lowest median FENO values in the Estonian centres Saaremaa 13.1 (9.5) and Narva 11.8 (8.6). In the pooled population, asthma was associated with FENO >= 25 ppb, odds ratio (OR) 3.91 (95% confidence intervals: 2.29-6.32) after adjusting for SPT result, smoking, gender and study centre. A positive SPT test increased the likelihood of asthma OR 3.19 (2.02-5.11). Compared to Saaremaa, the likelihood of having asthma was higher in Helsinki OR 2.40 (1.04-6.02), Narva OR 2.45 (1.05-6.19), dOrebro OR 3.38 (1.59-8.09), and Stockholm OR 5.54 (2.18-14.79). There was a higher prevalence of asthma and allergic airway inflammation in adult general populations of Sweden and Finland compared to those of Estonia. Atopy and elevated FEND level were independently associated with an increased risk of asthma. In conclusion, the findings support the earlier west-east disparity hypothesis of allergic diseases.
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| 4. |
- Nilsson, Ulf, et al.
(författare)
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Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease
- 2020
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Ingår i: Respiratory Research. - : Springer Nature. - 1465-9921 .- 1465-993X. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIschemic heart disease is common in COPD and associated with worse prognosis. This study aimed to investigate the presence and prognostic impact of biomarkers of myocardial injury and ischemia among individuals with COPD and normal lung function, respectively.MethodsIn 2002–04, all individuals with airway obstruction (FEV1/VC < 0.70, n = 993) were identified from population-based cohorts, together with age and sex-matched non-obstructive referents. At re-examination in 2005, spirometry, Minnesota-coded ECG and analyses of high-sensitivity cardiac troponin I (hs-cTnI) were performed in individuals with COPD (n = 601) and those with normal lung function (n = 755). Deaths were recorded until December 31st, 2010.ResultsHs-cTnI concentrations were above the risk stratification threshold of ≥5 ng/L in 31.1 and 24.9% of those with COPD and normal lung function, respectively. Ischemic ECG abnormalities were present in 14.8 and 13.4%, while 7.7 and 6.6% had both elevated hs-cTnI concentrations and ischemic ECG abnormalities. The 5-year cumulative mortality was higher in those with COPD than those with normal lung function (13.6% vs. 7.7%, p < 0.001). Among individuals with COPD, elevated hs-cTnI both independently and in combination with ischemic ECG abnormalities were associated with an increased risk for death (adjusted hazard ratio [HR]; 95% confidence interval [CI] 2.72; 1.46–5.07 and 4.54; 2.25–9.13, respectively). Similar associations were observed also among individuals with COPD without reported ischemic heart disease.ConclusionsIn this study, elevated hs-cTnI concentrations in combination with myocardial ischemia on the electrocardiogram were associated with a more than four-fold increased risk for death in a population-based COPD-cohort, independent of disease severity.
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| 5. |
- Sundbaum, Johanna, et al.
(författare)
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MTHFR, TYMS and SLCO1B1 polymorphisms and adverse liver effects of methotrexate in rheumatoid arthritis
- 2020
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Ingår i: Pharmacogenomics (London). - London : Future Medicine. - 1462-2416 .- 1744-8042. ; 21:5, s. 337-346
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate whether variants of MTHFR, TYMS and SLCO1B1 are associated with alanine aminotransferase (ALT) elevation in rheumatoid arthritis patients starting methotrexate (MTX).Patients & Methods: Clinical and laboratory data were collected from the start of MTX treatment. Genotyping of MTHFR, TYMS and SLCO1B1 was performed. Univariate and multiple logistic regression were used for statistical analysis.Results: 34 out of 369 patients experienced ALT >1.5xULN less than 6 months from start. MTHFR A1298C (rs1801131) was nominally associated with an ALT > 1.5 xULN within 6 months after the start of MTX (OR = 1.7 [95% CI: 1.04–2.9]; p = 0.03), but did not pass correction for multiple testing. A multiple model containing MTHFR 1298C and clinical factors predicted the outcome (C-statistic 0.735). TYMS and SLCO1B1 were not associated with the outcome.Conclusions: A model containing MTHFR 1298C and clinical factors might predict risk of early ALT elevation.
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| 6. |
- Domellöf, Erik, 1970-, et al.
(författare)
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Risk for Behavioral Problems Independent of Cognitive Functioning in Children Born at Low Gestational Ages
- 2020
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Ingår i: Frontiers in Pediatrics. - : Frontiers Media S.A.. - 2296-2360. ; 8:311
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to investigate cognitive and behavioral outcomes in relation to gestational age (GA) in school-aged children born preterm (PT). Results from the Wechsler Intelligence Scale for Children, 4th edition (WISC-IV), and the Child Behavior Checklist (CBCL) were analyzed in 51 children (mean age: 7.8 years [range: 7.0–8.7]) born PT (mean GA: 31 weeks [range: 23–35]; birth weight, mean: 1,637 g [range:404–2,962]) with the majority (96%) having no diagnosed cognitive, sensory, or motor impairments. The control group included 57 age-matched typically developing children (mean age: 7.9 years [range: 6.2–8.7]) born full-term (FT). Children born PT, extremelyPT (GA < 28) in particular, showed significantly lower cognitive performance and higher behavioral problem scores compared with children born FT. GA was found to predict aspects of both cognitive functioning and behavioral problems within the PT group, with lower GA being related to both poorer cognitive outcomes and elevated affective and attention-deficit/hyperactivity problems. Global cognitive functioning did not independently predict aspects of behavioral outcomes. Findings demonstrate that, even in children born PT without severe perinatal and/or postnatal complications and receiving active perinatal care, a short gestation is an evident risk factor for long-term negative effects on mental health independent of cognitive functioning. Additional findings suggest that both reduced growth and lower parental educational level may contribute to increased risk for poorer cognitive and behavioral functioning in children born PT.
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| 7. |
- Engström, Åsa, et al.
(författare)
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Losing the identity of a hockey player : the long-term effects of concussions
- 2020
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Ingår i: Concussion. - : Future Medicine. - 2056-3299. ; 5:2
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To describe what suffering multiple concussions meant for former semi-professional or professional hockey players who were forced to end their career. Results: Nine former Swedish hockey players, who once played on national or professional teams were interviewed. The interviews were analyzed with reference to hermeneutic phenomenology to interpret and explain their experiences. The theme of losing one’s identity as a hockey player was constructed from five subthemes: being limited in everyday life, returning to the hockey stadium as soon as possible, forming a post career identity, lacking understanding and support, and preventing injuries by respecting other players. Conclusion: The former hockey players struggled with developing their off-the-ice identities and with finding other sources of meaning for their lives.Lay abstractDespite considerable attention to improving the initial management of concussions suffered by hockey players, few studies have examined their long-term effects. In response, the study reported here aimed to describe what suffering multiple concussions meant for former semi-professional or professional hockey players who were forced to end their career. Nine former Swedish hockey players, who once played on national or professional teams were interviewed and the interviews were analyzed in order to interpret and explain their experiences. The overall theme was formulated as losing one’s identity as a hockey player. In conclusion, the former hockey players seem to struggle with developing their off-the-ice identities and with finding other sources of meaning for their lives.
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| 8. |
- Jacobsson, Lars, et al.
(författare)
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Functioning and disability from 10 to 16 years after traumatic brain injury
- 2020
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Ingår i: Acta Neurologica Scandinavica. - : John Wiley & Sons. - 0001-6314 .- 1600-0404. ; 141:2, s. 115-122
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesWith increased long‐term survival after traumatic brain injury (TBI), there is a need to understand the life situation many years after the injury. In this study, we have assessed persons on average 16 years after their injury and determined changes over 6 years in overall outcome, living condition, marital status and vocational situation, and in their functioning and disability.Materials & MethodsIndividuals (n = 49, mean age 45 years, 28‐70 years) who were assessed 6‐15 years (average 10 years) post‐TBI were reassessed 12‐21 years after their injury (average 16 years) using internationally established TBI outcome measures.ResultsFrom the first to the second assessment, overall outcome using the Glasgow Outcome Scale (GOS) was stable for a large majority and no significant changes in marital status or vocational situation was found. There was some significant, but very small, decline regarding cognitive function, home integration and social integration. In the multiple regression analysis, there was a small significant decline in the Mayo‐Portland Adaptability Inventory (MPAI‐4) Adjustment subscale score for women with a moderate‐to‐severe injury.ConclusionsThe very small changes over 6 years imply that persons with a TBI can reach and maintain a stable level of functioning many years post‐TBI. Women with a moderate‐to‐severe TBI seem to be more vulnerable and may experience a small decline in some aspects of their functioning related to anxiety, depression, irritability, pain and headache and fatigue. The relatively small sample requires further studies to confirm these findings.
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| 9. |
- Nyberg, Lars, 1966-, et al.
(författare)
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Biological and environmental predictors of heterogeneity in neurocognitive ageing : Evidence from Betula and other longitudinal studies
- 2020
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Ingår i: Ageing Research Reviews. - : Elsevier. - 1568-1637 .- 1872-9649. ; 64
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Forskningsöversikt (refereegranskat)abstract
- Individual differences in cognitive performance increase with advancing age, reflecting marked cognitive changes in some individuals along with little or no change in others. Genetic and lifestyle factors are assumed to influence cognitive performance in aging by affecting the magnitude and extent of age-related brain changes (i.e., brain maintenance or atrophy), as well as the ability to recruit compensatory processes. The purpose of this review is to present findings from the Betula study and other longitudinal studies, with a focus on clarifying the role of key biological and environmental factors assumed to underlie individual differences in brain and cognitive aging. We discuss the vital importance of sampling, analytic methods, consideration of non-ignorable dropout, and related issues for valid conclusions on factors that influence healthy neurocognitive aging.
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| 10. |
- Strömbäck, Ulrica, et al.
(författare)
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To be seen as a unique person after suffering a second myocardial infarction : Expressed needs of patients and descriptions of personnel
- 2020
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 57
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThe aim of this study was to describe patients’ expressed needs during cardiac rehabilitation after suffering a second myocardial infarction in comparison to personnel’s descriptions of how they work with these patients.Research methodologyA descriptive qualitative design. Interviews were conducted with patients affected by two myocardial infarctions and registered nurses, physiotherapists and cardiologists working with cardiac rehabilitation. Data were analysed with qualitative content analysis.FindingsAn interpretation of the underlying meaning in the categories was formulated into one theme: ‘To be seen as a unique person’. Patients expressed a need for individualised care; they wanted the cardiac rehabilitation to be customised to their condition and prognosis; however, they did not perceive their care was individualised. Personnel described the importance of the care being individualised, although they had guidelines to follow. It was crucial for them to see the individual and discover what was important for each patient.ConclusionsThere was a shared opinion from patients and personnel that individual care is essential. Using the concept and working in accordance with person-centred care could meet the patients’ need for individualised care.
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