| 1. |
- Kindgren, Erik, 1977-, et al.
(författare)
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Prevalence of ADHD and Autism Spectrum Disorder in Children with Hypermobility Spectrum Disorders or Hypermobile Ehlers-Danlos Syndrome: A Retrospective Study
- 2021
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Ingår i: Neuropsychiatric Disease and Treatment. - : DOVE MEDICAL PRESS LTD. - 1176-6328 .- 1178-2021. ; 17, s. 379-388
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Hypermobility spectrum disorders (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS) are both characterized by generalized hypermobility, in combination with pain, affected proprioception, and pronounced fatigue. Clinical observation indicates that behavioral problems, hyperactivity, and autistic traits are overrepresented in children with those conditions. The purpose of this retrospective study was to establish the prevalence of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) among children with HSD and hEDS treated in our clinic since 2012. Subjects and Methods: Since Ehlers-Danlos syndrome (EDS) diagnostic criteria and international classification were changed in 2017, we equate the older diagnosis EDS hypermobility type with the newer hEDS and the older hypermobility syndrome with HSD. A registry search from the computerized medical record system found 201 children (88 boys, 113 girls) aged 6– 18 years who were treated at our pediatrics department with the diagnoses HSD or EDS. All medical records (113 with HSD, 88 with EDS) were reviewed, and key symptoms such as fatigue and pain, as well as diagnosis of ADHD/ASD, were recorded. Results: All EDS cases could be classified as hEDS. Of the entire study cohort, 16% had a verified ADHD diagnosis and a further 7% were undergoing ADHD diagnostic investigation. Significantly more children with hEDS had ADHD compared to children with HSD (p=0.02). In the age group 15– 16 years, 35% of those with hEDS had ADHD and, among those aged 17– 18 years, ADHD was present in 46%. Children with coexisting ADHD showed a significantly higher proportion of associated symptoms such as fatigue, sleep-problems, and urinary tract problems. ASD had been verified in 6% of the children. Of those with ASD, 92% had sleep problems. Conclusion: This study shows a strong association between HSD or hEDS and ADHD or ASD. Therefore, children with HSD or hEDS may need to be routinely screened for neuropsychiatric symptoms.
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| 2. |
- Grauman, Åsa, 1982-, et al.
(författare)
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Communicating test results from a general health checkup: the public’s preferences from a discrete choice experiment survey
- 2021
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Ingår i: Patient Related Outcome Measures. - : Springer Nature. - 1179-271X. ; 14:5, s. 649-660
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Tidskriftsartikel (refereegranskat)abstract
- Background: Health checks can detect risk factors and initiate prevention of cardiovascular diseases but there is no consensus on how to communicate the results. The aim of this study was to investigate the preferences of the general population for communicating health check results.Methods: A randomly selected sample of the Swedish population aged 40–70 years completed a discrete choice experiment survey that included questions on sociodemographics, lifestyle and health and 15 choice questions consisting of six attributes (written results, notification method, consultation time, waiting time, lifestyle recommendation and cost). Data were analyzed with a latent class analysis (LCA). Relative importance of the attributes and predicted uptake for several scenarios were estimated.Results: In the analysis, 432 individuals were included (response rate 29.6%). A three-class LCA model best fit the data. Cost was the most important attribute in all classes. Preferences heterogeneity was found for the other attributes; in Class 1, receiving consultation time and the written results were important, respondents in Class 2 dominated on costs and respondents in Class 3 found consultation time, waiting time and lifestyle recommendations to be important. Health literate respondents were more likely to belong to Class 3. The predicted uptake rates ranged from 7 to 88% for different health checks with large differences across the classes.Conclusions: Cost was most important when deciding whether to participate in a health check. Although cost was the most important factor, it is not sufficient to offer health checks free-of-charge if other requirements regarding how the test results are communicated are not in place; participants need to be able to understand their results.
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| 3. |
- Jimenez-Moreno, A. Cecilia, et al.
(författare)
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Patient Preferences in Rare Diseases: A Qualitative Study in Neuromuscular Disorders to Inform a Quantitative Preference Study
- 2021
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Ingår i: Patient. - : Springer Science and Business Media LLC. - 1178-1653 .- 1178-1661.
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionIt has become increasingly important to include patient preference information in decision-making processes for drug development. As neuromuscular disorders represent multisystem, debilitating, and progressive rare diseases with few treatment options, this study aimed to explore unmet health care needs and patient treatment preferences for two neuromuscular disorders, myotonic dystrophy type 1 (DM1) and mitochondrial myopathies (MM) to inform early stages of drug development.MethodsFifteen semi-structured interviews and five focus group discussions (FGDs) were held with DM1 and MM adult patients and caregivers. Topics discussed included (1) reasons for study participation; (2) disease signs/symptoms and their impact on daily lives; (3) top desired benefits; and (4) acceptability of risks and tolerance levels for a hypothetical new treatment. Data were analyzed following a thematic ‘code’ approach.ResultsA total of 52 participants representing a wide range of disease severities participated. ‘Muscle strength’ and ‘energy and endurance’ were the disease-related unmet needs most often mentioned. Additionally, improved ‘balance’, ‘cognition’ and ‘gut function’ were the top desired treatment benefits, while ‘damage to the liver, kidneys or eyes’ was the most concerning risk. Factors influencing their tolerance to risks related to previously having experienced the risk and differentiation between permanent and temporary risks. A few differences were elicited between patients and caregivers.ConclusionsThis qualitative study provided an open forum to elicit treatment-desired benefits and acceptable risks to be established by patients themselves. These findings can inform decisions for developing new treatments and the design of clinical trials for DM1 and MM.
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| 4. |
- Pinto, Cathy Anne, et al.
(författare)
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Comparing Patient Preferences for Antithrombotic Treatment During the Acute and Chronic Phases of Myocardial Infarction: A Discrete-Choice Experiment
- 2021
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Ingår i: Patient. - : Springer Science and Business Media LLC. - 1178-1653 .- 1178-1661.
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAntithrombotic drugs are used as preventive treatment in patients with a prior myocardial infarction (MI) in both the acute and chronic phases of the disease. To support patient-centered benefit–risk assessment, it is important to understand the influence of disease stage on patient preferences.ObjectiveThe aim of this study was to examine patient preferences for antithrombotic treatments and whether they differ by MI disease phase.MethodsA discrete-choice experiment was used to elicit preferences of adults in the acute (≤ 365 days before enrolment) or chronic phase (> 365 days before enrolment) of MI for key ischemic events (risk of cardiovascular [CV] death, non-fatal MI, and non-fatal ischemic stroke) and bleeding events (risk of non-fatal intracranial hemorrhage and non-fatal other severe bleeding). Preference data were analyzed using the multinomial logit model. Trade-offs between attributes were calculated as the maximum acceptable increase in the risk of CV death for a decrease in the risk of the other outcomes. To assess the potential effect of sociodemographic and clinical characteristics on patient preferences, subgroups were introduced as interaction terms in logit models.ResultsThe evaluable population included 155 patients with MI in the acute phase of disease and 180 in the chronic phase. The overall population was 82% male, mean age was 64.2 ± 9.6 years, and 93% had not experienced bleeding events or key ischemic events other than MI. Patients valued reduction in the risk of non-fatal intracranial hemorrhage more than CV death (p < 0.01) and CV death more than non-fatal ischemic events (p < 0.01). Preferences were similar in the acute and chronic populations (p = 0.17). However, older patients valued reduction in risk of MI more than younger patients (p = 0.04), and patients with bleeding risk factors valued reduction in the risk of CV death (p = 0.01) and MI (p = 0.01) less than patients without bleeding risk factors. Also, patients who were at high risk of future ischemic events valued reduction of the risk of CV death less than those at low risk (p = 0.01).ConclusionPatient preferences for antithrombotic treatments were unaffected by disease stage but varied by bleeding risk and other factors. This heterogeneity in preferences is an important consideration because it can affect the benefit–risk balance and the acceptability of antithrombotic treatments to patients.Key PointsPatient preferences for antithrombotic treatment attributes were similar between the acute and chronic phases of myocardial infarction.Patients with myocardial infarction are willing to accept significant increases in the mortality risk to avoid increases in non-fatal bleeding events.
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| 5. |
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| 6. |
- Shekhawat, Pooja Kanwar, et al.
(författare)
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Serendipita indica : Harnessing its versatile potential for food and nutritional security
- 2021
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Ingår i: Physiological and molecular plant pathology. - : Elsevier. - 0885-5765 .- 1096-1178. ; 116
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Tidskriftsartikel (refereegranskat)abstract
- Quantity as well as quality of food is a major concern for increasing human population. Serendipita indica, a root endophytic fungus, has multifarious applications in agriculture. It increases nutrient and water uptake, carbon assimilation efficiency and stress-resistance which in turn enhances the growth and yield of plants. Moreover, it improves contents of minerals, fatty acids and essential oil, composition of oil, and fruit firmness in different plants. It also enhances the production of secondary metabolites having medicinal properties. This review highlights the role of Serendipita indica in increasing crop production and improving food quality. The underlying mechanism has also been illustrated.
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| 7. |
- Hayer, Juliette, et al.
(författare)
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Four novel picornaviruses detected in Magellanic Penguins (Spheniscus magellanicus) in Chile
- 2021
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Ingår i: Virology. - : Elsevier BV. - 0042-6822 .- 1178-122X. ; 560, s. 116-123
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Tidskriftsartikel (refereegranskat)abstract
- Members of the Picornaviridae family comprise a significant burden on the poultry industry, causing diseases such as gastroenteritis and hepatitis. However, with the advent of metagenomics, a number of picornaviruses have now been revealed in apparently healthy wild birds. In this study, we identified four novel viruses belonging to the family Picornaviridae in healthy Magellanic penguins, a near threatened species. All samples were subsequently screened by RT-PCR for these new viruses, and approximately 20% of the penguins were infected with at least one of these viruses. The viruses were distantly related to members of the genera Hepatovirus, Tremovirus, Gruhelivirus and Crahelvirus. Further, they had more than 60% amino acid divergence from other picornaviruses, and therefore likely constitute novel genera. Our results demonstrate the vast undersampling of wild birds for viruses, and we expect the discovery of numerous avian viruses that are related to hepatoviruses and tremoviruses in the future.
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| 8. |
- Kjellsdotter, Anna, et al.
(författare)
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Together for the future – development of a digital website to support chronic obstructive pulmonary disease self-management : A qualitative study
- 2021
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Ingår i: Journal of Multidisciplinary Healthcare. - : Dove Medical Press Ltd. - 1178-2390 .- 1178-2390. ; 14, s. 757-766
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Tidskriftsartikel (refereegranskat)abstract
- Background: Symptom burden, impaired functional performance and decreased quality of life are not only consequences of the underlying physiological disorder chronic obstructive pulmonary disease (COPD) but also dependent on a patient’s ability to learn to live with and manage their illness. A digital website may be important for empowering patients with COPD to learn about and self-manage their illness. The aim of this study was to describe a developing process of a digital COPD-web as a part of a self-management education program for persons living with COPD. Methods: A qualitative approach with a phenomenological perspective was used. The study was based on group and individual interviews with a multidisciplinary COPD-team and patients who developed the COPD-web. Results: The developing process appears as a person-centred and holistic self-care approach both in content and development. Developing a digital COPD-web requires ongoing multi-disciplinary collaboration and spawns a sense of pride that reinforces shared responsibility. The phenomenon consists of four constituents: learning by participating in development, the patient perspective as guiding approach, responsibility and motivation as driving forces and digital technology as a knowledge arena. Conclusion: The results indicate that constructive collaboration between a multidisciplinary COPD-team and patients as co-creators in an ongoing creative and reflective process is a key concept to develop a digital COPD-web with a holistic approach. Digital resources in the future might create time and space for reflective conversations in a COPD-web with virtual chatrooms.
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| 9. |
- Andersson, Pia, et al.
(författare)
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Impaired oral health in older orthopaedic in-care patients : The influence of medication and morbidity
- 2021
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Ingår i: Clinical Interventions in Aging. - : Dove Medical Press Ltd.. - 1176-9092 .- 1178-1998. ; 16, s. 1691-1702
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Fall-related injuries are prevalent in older patients and often lead to increased morbidity, medication, and impaired functions. We studied older trauma patients with the aim to describe their oral health in comparison to morbidity and medication. Material and Methods: The study included 198 patients, ≥65 years, admitted with an orthopedic trauma. Oral examinations included number of natural teeth, dental implants, missing, decayed and restored teeth, root remnants, and pocket depth. Data on comorbidities and medication were assembled. Statistical analyses were carried out with logistic regression models, adjusted for age, gender, comorbidity, and polypharmacy. Results: Overall, 198 patients participated, 71% women, mean age 81 years (±7.9), 85% resided in their own homes, 86% had hip fractures. Chronic diseases and drug use were present in 98.9%, a mean of 6.67 in Charlson comorbidity index (CCI), 40% heart diseases, 17% diabetes, and 14% dementia. Ninety-one percent were dentate (181), mean number of teeth 19.2 (±6.5), 24% had decayed teeth, 97% filled teeth, 44% <20 teeth, and 26% oral dryness. DFT (decayed, filled teeth) over mean were identified in patients with diabetes (p=0.037), COPD (p=0.048), polypharmacy (p=0.011), diuretics (p=0.007), and inhalation drugs (p=0.032). Use of ≥2 strong anticholinergic drugs were observed in patients with <20 teeth and DFT over mean (p=0.004, 0.003). Adjusted for age, gender, CCI, and polypharmacy. Conclusion: The study showed that impaired oral health was prevalent in older trauma patients and that negative effects on oral health were significantly associated with chronic diseases and drug use. The results emphasize the importance of identifying orthogeriatric patients with oral health problems and to stress the necessity to uphold good oral care during a period when functional decline can be expected.
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| 10. |
- Andersén, Heidi, et al.
(författare)
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Influence of childhood exposure to a farming environment on age at asthma diagnosis in a population-based study
- 2021
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Ingår i: Journal of Asthma and Allergy. - : Dove Press. - 1178-6965. ; 14, s. 1081-1091
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Asthma is a heterogeneous disease, and factors associated with different asthma phenotypes are poorly understood. Given the higher prevalence of farming exposure and late diagnosis of asthma in more rural Western Finland as compared with the capital of Helsinki, we investigated the relationship between childhood farming environment and age at asthma diagnosis.Methods: A cross-sectional population-based study was carried out with subjects aged 20– 69 years in Western Finland. The response rate was 52.5%. We included 3864 participants, 416 of whom had physician-diagnosed asthma at a known age and with data on the childhood environment. The main finding was confirmed in a similar sample from Helsinki. Participants were classified as follows with respect to asthma diagnosis: early diagnosis (0– 11 years), intermediate diagnosis (12–39 years), and late diagnosis (40–69 years).Results: The prevalence of asthma was similar both without and with childhood exposure to a farming environment (11.7% vs 11.3%). Allergic rhinitis, family history of asthma, ex-smoker, occupational exposure, and BMI ≥ 30 kg/m2 were associated with a higher like-lihood of asthma. Childhood exposure to a farming environment did not increase the odds of having asthma (aOR, 1.10; 95% CI, 0.87–1.40). It did increase the odds of late diagnosis (aOR, 2.30; 95% CI, 1.12–4.69), but the odds were lower for early (aOR, 0.49; 95% CI, 0.30–0.80) and intermediate diagnosis of asthma (aOR, 0.75; 95% CI, 0.47–1.18).Conclusion: Odds were lower for early diagnosis of asthma and higher for late diagnosis of asthma in a childhood farming environment. This suggests a new hypothesis concerning the etiology of asthma when it is diagnosed late.
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