| 1. |
- Johnson, Mats, 1956, et al.
(författare)
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Fatty acids in ADHD: plasma profiles in a placebo-controlled study of Omega 3/6 fatty acids in children and adolescents.
- 2012
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Ingår i: Attention Deficit and Hyperactivity Disorders. - : Springer Science and Business Media LLC. - 1866-6116 .- 1866-6647. ; 4:4, s. 199-204
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to assess baseline levels and changes in plasma fatty acid profiles in children and adolescents with ADHD, in a placebo-controlled study with Omega 3/6 supplementation, and to compare with treatment response. Seventy-five children and adolescents aged 8-18years with DSM-IV ADHD were randomized to 3months of Omega 3/6 (Equazen eye q) or placebo, followed by 3months of open phase Omega 3/6 for all. n-3, n-6, n-6/n-3 ratio, EPA and DHA in plasma were measured at baseline, 3 and 6months. Subjects with more than 25% reduction in ADHD symptoms were classified as responders. At baseline, no significant differences in mean fatty acid levels were seen across active/placebo groups or responder/non-responder groups. The 0-3month changes in all parameters were significantly greater in the active group (p<0.01). Compared to non-responders, the 6-month responders had significantly greater n-3 increase at 3months and decrease in n-6/n-3 ratio at 3 and 6months (p<0.05). Omega 3/6 supplementation had a clear impact on fatty acid composition of plasma phosphatidyl choline in active versus placebo group, and the fatty acid changes appear to be associated with treatment response. The most pronounced and long-lasting changes for treatment responders compared to non-responders were in the n-6/n-3 ratio.
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| 2. |
- Jelovsek, J Eric, et al.
(författare)
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Predicting Risk of Pelvic Floor Disorders 12 and 20 Years after Delivery.
- 2018
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Ingår i: American journal of obstetrics and gynecology. - : Elsevier BV. - 1097-6868 .- 0002-9378. ; 218:2
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Tidskriftsartikel (refereegranskat)abstract
- Little progress has been made in preventing pelvic floor disorders despite their significant health and economic impact. Identifying women at risk remains a key element in targeting prevention and planning health resource allocation strategies. Although events around the time of childbirth are clinically recognized as important predictors, it is difficult to counsel women and intervene around the time of childbirth due to an inability to accurately convey a patient's risk in the presence of multiple risk factors and the long time lapse, often decades, between obstetric events and the onset of pelvic floor disorders later in life. Prediction models and scoring systems have been used in other areas of medicine to identify patients at risk for chronic diseases. Models have been developed for use before delivery that predict short-term risk of pelvic floor disorders after childbirth but no models predicting long-term risk exist.To use variables known before and during childbirth to develop and validate prognostic models estimating risks of these disorders 12 and 20 years after delivery.Obstetric variables were collected from two cohorts: 1) women who gave birth in the United Kingdom and New Zealand (n=3763) and 2) women from the Swedish Medical Birth Register (n=4991). Pelvic floor disorders were self-reported 12 years after childbirth in the UK/NZ cohort and 20 years after childbirth in the Swedish Register. The cohorts were split so that data during the first half of the cohort's time period were used to fit prediction models and validation was performed from the second half (temporal validation). As there is currently no consensus on how to best define pelvic floor disorders from a patient's perspective, we chose to fit the data for each model using multiple outcome definitions for prolapse, urinary incontinence, fecal incontinence, 1 or more pelvic floor disorder and 2 or more pelvic floor disorders. Model accuracy was measured: 1) by ranking an individual's risk among all subjects in the cohort (discrimination) using a concordance index and 2) by observing whether the predicted probability was too high or low (calibration) at a range of predicted probabilities using visual plots.Models were able to discriminate between women who developed bothersome symptoms or received treatment, at 12 and 20 years respectively, for: pelvic organ prolapse (concordance indices 0.570, 0.627), urinary incontinence (concordance indices 0.653, 0.689), fecal incontinence (concordance indices 0.618, 0.676), ≥1 pelvic floor disorders (concordance indices 0.639, 0.675) and ≥2 pelvic floor disorders (concordance indices 0.635, 0.619). The discriminatory ability of all models is shown in Table 2. Route of delivery and family history of each pelvic floor disorder were strong predictors in most models. Urinary incontinence before and during the index pregnancy was a strong predictor for developing all pelvic floor disorders in most models 12 years after delivery. The 12 and 20-year bothersome or treatment for prolapse models were accurate when providing predictions for risk from 0% to approximately 15%. The 12-year and 20-year primiparous model began to over-predict when risk rates reached 20%. When predicting bothersome symptoms or treatment for urinary incontinence, the 12-year models were accurate when predictions ranged from approximately 5% to 60% and 20-year primiparous models were accurate between 5% and 80%. For bothersome symptoms or treatment for fecal incontinence, the 12 and 20-year models were accurate between 1% and 15% risk and began to over-predict at rates above 15% and 20%, respectively.Models may provide an opportunity before birth to identify women at low risk of developing pelvic floor disorders and institute prevention strategies such as pelvic floor muscle training, weight control or elective cesarean section for women at higher risk. Models are provided at: http://riskcalc.org/UR_CHOICE/.
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| 3. |
- Johnson, Mats, 1956, et al.
(författare)
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Omega 3/6 fatty acids for reading in children: a randomized, double-blind, placebo-controlled trial in 9-year-old mainstream schoolchildren in Sweden
- 2017
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Ingår i: Journal of Child Psychology and Psychiatry and Allied Disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 58:1, s. 83-93
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Tidskriftsartikel (refereegranskat)abstract
- Background Previous research has shown positive effects of Omega 3/6 fatty acids in children with inattention and reading difficulties. We aimed to investigate if Omega 3/6 improved reading ability in mainstream schoolchildren. Methods We performed a 3-month parallel, randomized, double-blind, placebo-controlled trial followed by 3-month active treatment for all subjects. Mainstream schoolchildren aged 9–10 years were randomized 1:1 to receive three Omega 3/6 capsules twice daily or identical placebo. Assessments were made at baseline, 3 months, and 6 months. The primary outcome measure was the Logos test battery for evaluating reading abilities. The trial is registered with ClinicalTrials.gov, number NCT02557477. Results The study enrolled 154 children (active n = 78; placebo n = 76), of whom 122 completed the first 3 months (active n = 64; placebo n = 58) and 105 completed the whole study (active/active n = 55; placebo/active n = 50). Outcomes were assessed by per protocol (PP) and intention-to-treat (ITT) analyses. Active treatment was superior to placebo at 3 months for improvement in phonologic decoding time (PP active/placebo difference −0.16; 95% CI −0.03, −0.29; effect size (ES) .44; p = .005; and ITT ES .37; p = .036), in visual analysis time (PP active/placebo difference −0.19; 95% CI −0.05, −0.33; ES .49; p = .013; and ITT ES .40; p = .01), and for boys in phonologic decoding time (PP −0.22; 95% CI −0.03, −0.41; ES .62; p = .004). Children with ADHD-RS scores above the median showed treatment benefits in visual analysis time (PP ES .8, p = .009), reading speed per word (PP ES .61, p = .008), and phonologic decoding time per word (PP ES .85, p = .006). Adverse events were rare and mild, mainly stomach pain/diarrhea (active n = 9, placebo n = 2). Conclusions Compared with placebo, 3 months of Omega 3/6 treatment improved reading ability – specifically the clinically relevant ‘phonologic decoding time’ and ‘visual analysis time’ – in mainstream schoolchildren. In particular, children with attention problems showed treatment benefits.
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| 4. |
- Johnson, Mats, 1956, et al.
(författare)
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Open-label trial of atomoxetine hydrochloride in adults with ADHD.
- 2010
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Ingår i: Journal of Attention Disorders. - : SAGE Publications. - 1087-0547 .- 1557-1246. ; 13:5, s. 539-545
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Tidskriftsartikel (refereegranskat)abstract
- Background: While atomoxetine is an established treatment for attention-deficit/hyperactivity disorder in children, few studies have examined its efficacy for adults. Methods: Open-label trial of atomoxetine in 20 individuals with ADHD, aged 19-47 years, for 10 weeks, and a total of one year for responders. Results: Ten patients met primary efficacy criteria at 10 weeks. Only one patient completed the whole study. Six patients discontinued before 10 weeks and thirteen at 10 weeks or later, mainly because of side-effects (aggression, depressed mood, raised liver enzymes, thyroid hormones, diastolic blood pressure), decreasing efficacy or non-compliance. Conclusion: Fifty percent responded to treatment, but only one patient (5%) felt sufficient improvement to continue for one year. Dosage may have been too low, and baseline impairment too high, for atomoxetine to have sufficient effect on ADHD symptoms in our group of adults. The majority had few side-effects, but several terminated treatment because of adverse effects.
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| 5. |
- Karlsson, Per Erik, 1957, et al.
(författare)
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Negative impact of ozone on the stem basal area increment of mature Norway spruce in south Sweden
- 2006
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Ingår i: Forest Ecology and Management. - : Elsevier BV. - 0378-1127. ; 232:1-3, s. 146-151
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Tidskriftsartikel (refereegranskat)abstract
- The relative annual basal area increment of mature Norway spruce trees in south-central Sweden during 9 years was used as the response variable and analysed in relation to ozone exposure, meteorological conditions, soil moisture and stand characteristics. The method used was a modified multiple regression analysis, allowing for dependencies between observations from the same plots. The selected statistical model explained 91% of the variation in the annual relative basal area increment. The strongest explanatory variable was the stand basal area, followed by the temperature sum and the soil moisture index. After these three variables, the ozone index was the most important variable. Its effect was negative and highly significant. The average daylight ozone concentration gave a slightly better model fit as compared to the accumulated exposure during daylight hours above a threshold of 40 nmol mol−1 (AOT40). The predicted effect of ozone within the range of annual ozone exposures found in this study (18008700 nmol mol−1 h AOT40), was in absolute values a 0.8% decrease in the relative annual basal area increment. This could be compared with the mean relative annual increment measured during the study period of 4.6%. Our results provide statistical evidence that ground level ozone can have a negative impact on the stem growth of mature Norway spruce trees under field conditions.
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| 6. |
- Stranne, Johan, 1970, et al.
(författare)
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Influence of age and changes over time on erectile dysfunction: Results from two large cross-sectional surveys 11 years apart.
- 2013
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Ingår i: Scandinavian journal of urology and nephrology. - : Informa UK Limited. - 1651-2065 .- 2168-1805 .- 2168-1813. ; 47:3, s. 198-205
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective.The aim was to explore how erectile dysfunction (ED) correlates with increasing age and a number of demographic, physical and lifestyle factors. Material and methods. A questionnaire was sent to a random sample (10 458) of men living in Gothenburg, Sweden, in 1992. The men were from the age cohorts 45, 50, 55 years, etc., up to the age of 85 or older. An analogous survey was sent to a random sample (10 845) of men of age cohorts 46, 51, 56 years, etc., in 2003. The prevalence of ED from the different age cohorts assessed on the two specific occasions 11 years apart was compared with a number of factors. Results.The response rates were 74.2% in 1992 and 68.7% in 2003. Within each survey the rate of ED increased with age at the same time as sexual activity decreased. This was paralleled by an increase in concomitant morbidity, intake of medications and alcohol consumption. The proportion of smokers and body mass index (BMI) decreased and the frequency of physical exercise increased until the age cohorts 70-71 years (1992) and 80-81 years (2003). Comparing the surveys, there was increased ED and decreased sexual activity over time despite an increase in exercise and decrease in smoking. In a multivariate analysis age, living alone, concomitant medication and smoking were the factors that significantly affected the risk of reporting ED. Conclusion. Despite a seemingly healthier lifestyle in 2003 compared with 1992, the rate of ED increased in the population, highlighting the importance of assessing lifestyle factors when examining ED patients.
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| 7. |
- Stranne, Johan, 1970, et al.
(författare)
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The rate of deterioration of erectile function increases with age: results from a longitudinal population based survey
- 2019
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Ingår i: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 53:2-3, s. 161-165
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Tidskriftsartikel (refereegranskat)abstract
- Background: Increasing age as a risk factor for erectile dysfunction (ED) is in most studies assumed to be a linear function. If this is not the case the assumption could lead to bias, e.g. when men of different ages are compared in interventional studies on ED. Objective: To explore the risk of developing ED over time for men from different age groups. Materials and methods: A questionnaire was sent to a number of male residents in Gothenburg, Sweden, in 1992 (n = 10,458). Men were randomly selected according to year of birth to obtain several cohorts at 5-year intervals of ages 45, 50, 55 years, etc., up to the age of 85 or older. In 2003 an analogous, slightly expanded, questionnaire was sent to a random sample of men from the age cohorts 46, 51 years, etc. (n = 10,845). A total of 4072 men received both surveys, thereby constituting a group of men followed longitudinally for 11 years. The future risk of developing ED in the different age cohorts, adjusted for a number of ED risk factors, was then assessed. Results: A total of 3257 men responded to both questionnaires (response rate = 80%, age range = 56–103 years). The risk of having ED increased substantially with increasing age, both within each survey and longitudinally between the surveys. The adjusted risk of developing ED within the next 11 years increased with a factor of 10, from 1.8% at the age of 45 years at baseline to as much as 11.4% at the age of 65 years. Conclusion: Age as a risk-factor for ED is a non-linear function and should be adjusted as such to avoid bias when including men of different ages in interventional studies on ED.
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