| 1. |
- Börjesson, Annica, et al.
(författare)
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Lived experiences of closeness to a person using Anabolic androgenic steroids a next of kin perspective
- 2023
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - 1748-2623 .- 1748-2631. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Anabolic androgenic steroids (AAS) are used for their aesthetic and performance-enhancing effects and are associated with physical and psychological side effects. Behavioural changes/side effects as mood swings, aggressiveness, depression, potency problems, anxiety, and emotional coldness have been reported by next of kin to people using AAS.Methods: This phenomenological study is based on the reflective lifeworld research approach. Interviews were conducted with twelve next of kin about their experiences of living close to persons using AAS.Results: Next of kin to persons using AAS are particularly vulnerable because they experience little opportunity to influence their situation. Their given and safe context is lost, and their lives are circumscribed by feelings of insecurity, fear, powerlessness, and grief. Feelings of loneliness develop when their problems are not noticed by others and support is lacking from family and society.Conclusions: Our research adds important knowledge on how the use of AAS affects next of kin. Understanding is required to approach the lifeworld of next of kin with flexibility and empathy in their difficulties and vulnerability. Healthcare professionals and other concerned professions need to be aware of next of kin existential needs to be able to meet and support them in their life situation.
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| 2. |
- Börjesson, Annica
(författare)
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Side effects and experiences of doping with anabolic androgenic steroids in men and women
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Anabolic androgenic steroids (AAS) are mainly used in non-medical conditions for aesthetic and performance- enhancing purposes. The use of AAS is a growing public health problem and a concern in society due to side effects. Men and women use AAS despite their known negative effects and unknown long-term risks. The research in this thesis aimed to study somatic and psychiatric side effects, describe patterns of use, compare self-reported doping agent use with urine test results and to describe AAS usersʼ lived experiences. The approaches in this thesis have been both quantitative (Studies I-IV) and qualitative (Studies V-VI) and were focused on use of AAS outside the field of sports. Study I was an experimental study and included eleven healthy male volunteers administered with a single dose of nandrolone. The aim was to study endocrine and cardiovascular effects. The results showed that luteinising hormone, follicle stimulating hormone and testosterone were suppressed for 14 days after administration. Cholesterol and an enzyme involved in the cholesterol synthesis were increased and hence AAS may be a risk factor for cardiovascular diseases even in low doses. Studies II and III were descriptive studies with eight women and fifty-six men who contacted healthcare (Anti-Doping Hot-Line) on their own initiative. The aim was to identify the pattern of doping agent use in women and compare with similar data reported in men. We also aimed to identify psychiatric and personality disorders and to measure anxiety and depression in men using Structured Clinical Interviews Diagnosis -I and -II, the Brief Scale for Anxiety and the Montgomery Asberg Depression Rating Scale. The participants were interviewed about demographics, details of their AAS use and other co-used substances. They were also asked about motives, side effects they experienced and family background. Both men and women expressed a concern for side effects but there were very few who wanted professional help to terminate their AAS use. Classical side effects of AAS were reported and women contacted healthcare at an earlier stage of use. Women were introduced to AAS by a man in a close relationship. Male individuals diagnosed with a personality disorder showed a significantly increased risk of reporting aggressive feelings/behaviour, suicidal thoughts/attempts and criminality. It was more common that men used injections, higher doses of AAS and several different AAS substances per cycle compared with women. Study IV was an experimental and descriptive study with thirty men and six women who self-reported use of AAS and other performance-enhancing substances within the past year. Our aim was to identify which doping agents could be detected in doping test. The results showed that as many as 50% and 100 % respectively of current male and female testosterone users may escape a doping test. This indicates that AAS users outside the field of sports using only testosterone as a doping agent may not be identified by the routine tests currently used. In men, luteinising hormone and follicle stimulating hormone were normalised within 6-12 months. Haematocrit and haemoglobin values were shown to be high in male current users compared with previous users whereas all women displayed normal values. Thus, cessation of AAS use may reduce the risk of cardiovascular diseases relatively fast. Studies V and VI were qualitative studies with twelve women and twelve men using AAS. The studies applied a phenomenological approach aimed to describe AAS usersʼ lived experiences of using AAS. Our aim was to deepen the understanding about womenʼs and menʼs use of AAS. The results showed that it is an existential challenge to achieve the perfect body. Body dissatisfaction were mastered by hard training, strict diet and the use of AAS. Low self-esteem is compensated for by self-control, discipline and performance. For women it is an arduous endeavour to balance the substances’ side effects with desired femininity. For men the new self-identity stimulates respect by being impressive, prominent and dominant. The use of AAS means living with lies and the fear of being discovered, which may lead to consequences and feelings of not being genuine. The built-up body is fragile from both an existential and a biological perspective, self-esteem can quickly be destroyed in the absence of confirmation and acceptance from others or the substances may damage the body in the form of side effects. Conclusions and reflection: Our studies show that AAS use is associated with many somatic and psychiatric side effects. However, regardless of the perceived side effects, many choose to continue with their AAS use. The fact that the use of AAS is illegal does not prevent those who want to from achieving their goals. A non-judgemental attitude would facilitate the meeting between AAS users and healthcare as it could lead to users experiencing trust and security and would encourage open and honest communication.
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| 3. |
- Börjesson, Annica, et al.
(författare)
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Women's Experiences of Using Anabolic Androgenic Steroids
- 2021
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Ingår i: Frontiers in Sports and Active Living. - : Frontiers Media SA. - 2624-9367. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Anabolic androgenic steroids are used by women to increase their muscle mass and because of their performance-enhancing effects. Despite permanent/high risk of side effects, knowledge is inadequate. Our aim has been to deepen understanding about women's use of anabolic androgenic steroids. This phenomenological study is based on the reflective lifeworld research (RLR) approach. Lifeworld interviews were conducted with 12 women, aged 21-56 years, about their experiences of using anabolic steroids. The results show that women experience a sense of pride when they successfully achieve their goals. This is the driving force, triggering tension between suffering and success. Our research adds important knowledge from a reflective lifeworld perspective and shows that women's use of anabolic androgenic steroids is a complex phenomenon. Understanding and knowledge are important in order to be able to meet and support women in their fears and difficulties.
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| 4. |
- Börjesson, Stefan, 1979-, et al.
(författare)
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A link between the newly described colistin resistance gene mcr-9 and clinical Enterobacteriaceae isolates carrying blaSHV-12 from horses in Sweden
- 2020
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Ingår i: Journal of Global Antimicrobial Resistance. - : Elsevier. - 2213-7165 .- 2213-7173. ; 20, s. 285-289
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this study was to investigate the occurrence of the newly described transferable colistin resistance gene mcr-9 in extended-spectrum β-lactamase (ESBL)-producing clinical Enterobacteriaceae isolates from horses in Sweden.METHODS: A total of 56 whole-genome sequenced ESBL-producing Enterobacteriaceae isolates from horses were subjected to in silico detection of antimicrobial resistance genes and identification of plasmid replicons types. The colistin minimum inhibitory concentration (MIC) for mcr-positive isolates was determined by broth microdilution. Relatedness between Enterobacteriaceae carrying mcr genes was determined by multilocus sequence typing (MLST) and core genome MLST.RESULTS: Thirty ESBL-producing Enterobacteriaceae isolates from horses were positive for the colistin resistance gene mcr-9. These isolates included Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca and Citrobacter freundii and belonged to diverse MLST sequence types within each species. Two of the mcr-9-containing isolates originated from the same horse. All mcr-9-positive isolates had colistin MICs below or equal to the EUCAST epidemiological cut-off value of 2 mg/L and were negative for the two potential regulatory genes qseB-like and qseC-like for mcr-9. Except for one isolate carrying only blaTEM-1B, all of the isolates carried blaSHV-12 and blaTEM-1B, and were all considered multidrug-resistant as they harboured genes encoding resistance to aminoglycosides, chloramphenicol, fosfomycin, macrolides, quinolones, sulfonamides, trimethoprim and tetracyclines. Plasmid replicon types IncHI2 and IncHI2A were detected in all mcr-9-positive isolates.CONCLUSION: The occurrence of mcr-9 was common among clinical ESBL-producing Enterobacteriaceae isolates from horses in Sweden and was linked to the ESBL-encoding gene blaSHV-12 and plasmid replicon types IncHI2 and IncHI2A.
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| 5. |
- Börjesson, Stefan, 1979-, et al.
(författare)
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Introduction of quinolone resistant Escherichia coli to Swedish broiler population by imported breeding animals
- 2016
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Ingår i: Veterinary Microbiology. - : Elsevier. - 0378-1135 .- 1873-2542. ; 194, s. 74-78
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Tidskriftsartikel (refereegranskat)abstract
- During recent years a rapid increase of quinolone resistant Escherichia coli have been noted in the Swedish broiler population, despite the lack of a known selective pressure. The current study wanted to investigate if imported breeding birds could be a source for the quinolone resistant E. coli. The occurrence of quinolone resistant E. coli was investigated, using selective cultivation with nalidixic acid, in grand-parent birds on arrival to Sweden and their progeny. In addition, sampling in hatcheries and empty cleaned poultry houses was performed. Clonality of isolates was investigated using a 10-loci multiple-locus variable number tandem repeat analysis (MLVA). To identify the genetic basis for the resistance isolates were also analysed for occurrence of plasmid-mediated quinolone resistance (PMQR) determinants and characterization of chromosomal mutations. E. coli resistant to nalidixic acid occurred in grandparent birds imported to Sweden for breeding purposes. Four predominant MLVA types were identified in isolates from grandparent birds, parent birds and broilers. However, resistant E. coli with identical MLVA patterns were also present in hatcheries and poultry houses suggesting that the environment plays a role in the occurrence. Nalidixic acid resistance was due to a mutation in the gyrA gene and no PMQR could be identified. The occurrence of identical clones in all levels of the production pyramid points to that quinolone resistant E. coli can be introduced through imported breeding birds and spread by vertical transmission to all levels of the broiler production pyramid.
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| 6. |
- Börjesson, Stefan, 1979-, et al.
(författare)
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Low occurrence of extended-spectrum cephalosporinase producing Enterobacteriaceae and no detection of methicillin-resistant coagulase-positive staphylococci in healthy dogs in Sweden
- 2020
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Ingår i: Acta Veterinaria Scandinavica. - : BioMed Central (BMC). - 0044-605X .- 1751-0147. ; 62
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Tidskriftsartikel (refereegranskat)abstract
- Sweden has a long tradition of monitoring occurrence of antibiotic resistant bacteria in both animals and humans, but there currently is no organised and harmonized monitoring on carriage of Enterobacteriaceae producing extended-spectrum beta-lactamase (ESBL), plasmid-mediated AmpC beta-lactamase (pAmpC), or methicillin-resistant coagulase positive staphylococci e.g. methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus pseudintermedius (MRSP) in dogs. The aim of the current study was therefore to determine the prevalence of ESBL/pAmpC producing Enterobacteriaceae and methicillin-resistant coagulase positive staphylococci in healthy dogs in Sweden, and to phenotypically and genotypically characterize any identified isolates. It was shown that 0.9% (95% confident interval 0.3-2.7%) of the dogs (n = 325) carried multi-resistant ESBL-producing Escherichia coli, but that no methicillin-resistant coagulase positive staphylococci could be detected. In conclusion, the occurrence of multi-drug resistant bacteria remains rare among healthy dogs in Sweden. In addition, the ESBL-producing E. coli identified showed genetic characteristics related to those reported from humans.
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| 7. |
- Börjesson, Stefan, 1979-, et al.
(författare)
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Methicillin-resistant Staphylococcus pseudintermedius in Sweden
- 2012
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Ingår i: Microbial Drug Resistance. - : Mary Ann Liebert. - 1076-6294 .- 1931-8448. ; 18:6, s. 597-603
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Tidskriftsartikel (refereegranskat)abstract
- Staphylococcus pseudintermedius is an opportunistic pathogen that is one of the most frequent causes of infections in dogs. In Europe, there are increasing reports of methicillin-resistant S. pseudintermedius (MRSP), and in Sweden, MRSP has also been more frequently isolated during recent years. However, there is limited knowledge regarding the epidemiology and genetic relationship among the Swedish isolates. This study therefore investigated the genetic relationship of MRSP isolated from companion animals in Sweden. In the study, MRSP isolates taken in the period January 2008-June 2010 from a total of 226 dogs and cats were characterized by spa typing, pulsed-field gel electrophoresis, and antimicrobial susceptibility testing. In addition, the geographical distribution of the isolates based on year of isolation and genetic typing was determined using a geographical information system. One multiresistant clonal lineage dominated among Swedish MRSP isolates, corresponding to the European winning lineage ST71-J-t02-SCCmec II-III. Furthermore, the geographical dissemination of MRSP corresponded to areas with high dog densities, centered on the three major cities in Sweden where the largest animal hospitals are situated.
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| 8. |
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| 9. |
- Movérare-Skrtic, Sofia, et al.
(författare)
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The estrogen receptor antagonist ICI 182,780 can act both as an agonist and an inverse agonist when estrogen receptor α AF-2 is modified.
- 2014
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 1091-6490. ; 111:3, s. 1180-1185
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Tidskriftsartikel (refereegranskat)abstract
- The bone-sparing effect of estrogen is primarily mediated via estrogen receptor (ER) α, which stimulates target gene transcription through two activation functions (AFs), AF-1 in the N-terminal and AF-2 in the ligand-binding domain. It was recently demonstrated that the ER antagonist ICI 182,780 (ICI) acts as an ER agonist in uterus of mice with mutations in the ERα AF-2. To evaluate the estrogen-like effects of ICI in different tissues, ovariectomized wild-type mice and mice with mutations in the ERα AF-2 (ERαAF-2(0)) were treated with ICI, estradiol, or vehicle for 3 wk. Estradiol increased the trabecular and cortical bone mass as well as the uterine weight, whereas it reduced fat mass, thymus weight, and the growth plate height in wild-type but not in ERαAF-2(0) mice. Although ICI had no effect in wild-type mice, it exerted tissue-specific effects in ERαAF-2(0) mice. It acted as an ERα agonist on trabecular bone mass and uterine weight, whereas no effect was seen on cortical bone mass, fat mass, or thymus weight. Surprisingly, a pronounced inverse agonistic activity was seen on the growth plate height, resulting in enhanced longitudinal bone growth. In conclusion, ICI uses ERα AF-1 in a tissue-dependent manner in mice lacking ERαAF-2, resulting in no effect, agonistic activity, or inverse agonistic activity. We propose that ERα lacking AF-2 is constitutively active in the absence of ligand in the growth plate, enabling ICI to act as an inverse agonist.
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| 10. |
- Myrenås, Mattias, et al.
(författare)
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Clonal spread of Escherichia coli resistant to cephalosporins and quinolones in the Nordic broiler production
- 2018
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Ingår i: Veterinary Microbiology. - : Elsevier. - 0378-1135 .- 1873-2542. ; 213, s. 123-128
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Tidskriftsartikel (refereegranskat)abstract
- The intestinal flora of healthy broilers can contain Escherichia coli resistant to extended spectrum cephalosporins (ESC) and fluoroquinolones (FQ), representing a possible public health problem. We investigated the clonal epidemiology of E. coli with reduced susceptibility to ESC or FQ in broilers in three Nordic countries interconnected by a common source of breeding animals. Isolates (n = 319 and n = 132 non-wild type for ESC and FQ, respectively) from Norwegian, Swedish and Icelandic production originated mainly from the intestinal flora of broilers at the age of 20-35 days. Genetic relationships were investigated by ten loci multilocus variable number tandem repeat analyses (MLVA) and representative isolates of inter-Nordic clusters were subjected to multilocus sequence typing (MLST). Antimicrobial susceptibility data based on minimum inhibitory concentrations was compiled. Approximately one third of the ESC non-wild type isolates, including isolates from all three countries, clustered together. These isolates belonged to sequence type (ST) 38 and contained blaCMY-2. The FQ non-wild type isolates were more genetically diverse, but related isolates occurred in more than one country. MLST typing showed clusters belonging to ST10, ST355, ST349, ST665 and ST93. Our study demonstrated inter-Nordic distribution of E. coli ST38 with blaCMY-2, suggesting clonal proliferation as a contributing factor for spread of ESC resistance in the broiler production. The international trade in breeding material may explain introduction of resistant E. coli. The reason for their success and the success of certain clonal lineages in broiler production not exposed to antimicrobial selection pressure is currently unknown.
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