| 1. |
- Conradsson, David Moulaee, et al.
(författare)
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Employment status of people with multiple sclerosis in relation to 10-year changes in functioning and perceived impact of the disease
- 2020
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Ingår i: Multiple Sclerosis and Related Disorders. - : ELSEVIER SCI LTD. - 2211-0348 .- 2211-0356. ; 46
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although it is well known that people with multiple sclerosis (PwMS) retire from work early, little is known about how long-term changes in functioning and perceived impact of multiple sclerosis (MS) interact with sustainability of employment.Objective: To explore changes in functioning and in perceived impact of MS over 10 years, in relation to employment status of PwMS.Methods: In order to measure functioning, data on activities (walking ability, fine hand use, personal activities in daily living); participation in activities of everyday life (domestic, outdoor and leisure activities); body functions (cognitive function, fatigue, depressive symptoms); and perceived impact of MS were collected in 116 PwMS at baseline and at a 10-year follow-up. Ten-year changes were explored with the participants divided into four subgroups based on employment status at the follow-up: 1) full-time work at the 10-year follow-up; 2) part-time work at the 10-year follow-up; 3) declined from working at baseline to not working at the 10-year follow-up; and 4) not working at baseline nor at the 10-year follow-up.Results: Patterns of change in functioning for PwMS who worked showed a more apparent deterioration over 10 years among those working part-time with regard to walking ability, fatigue and depressive symptoms. Members of the subgroups who declined from working at baseline to not working at the 10-year follow-up or who were working neither at baseline nor at the follow-up deteriorated the most in functioning. The subgroup whose employment status declined from baseline to follow-up showed a significant decrease in cognitive function and an increase in perceived physical impact of the disease. All subgroups experienced a deterioration in walking ability over the 10-year span, and in all subgroups a majority had limited fine hand use over the span of the study period.Conclusion: The deterioration in functioning was most apparent in those PwMS whose employment status declined from working at baseline to not working at the 10-year follow-up. Close monitoring of work situation and frequency of activities and participation in everyday activities, as well as recurrent training of functioning, are suggested for maintaining a high level of functioning and work status, or for supporting transition to an appropriate number of working hours.
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| 2. |
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| 3. |
- Kyhlbäck, Maria, et al.
(författare)
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Postoperativ rehabilitering vid ländryggsdiskbråck
- 2011
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Ingår i: Fysioterapi. - : Fysioterapeuterna,Swedish Association of Registered Physiotherapists. - 1653-5804. ; :1, s. 32-37
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Tidskriftsartikel (refereegranskat)abstract
- Sedan några årtionden tillbaka är diskbråcksoperation en standardoperation som utförs på liknande sätt vid Sveriges ortopedkliniker. Det postoperativa omhändertagandet och rehabiliteringen av opererade patienter kan dock se olika ut, beroende på var operationen skett. Under 2008/09 har en grupp sjukgymnaster från olika delar av landet tagit fram nationella riktlinjer, baserat på vetenskaplig evidens och klinisk erfarenhet, vilket tidigare saknats för dessa patienter. Konklusionen är att sjukgymnastiken efter diskbråcksoperation bör vara inriktad på tidig, aktiv träning för att förbättra patienternas ryggfunktion och höja aktivitetsgraden efter operation, även om de positiva effekterna av den postoperativa träningen måste betraktas som kortsiktiga. En tidig återgång till aktiviteter som inkluderar ett aktivt förhållningssätt ger, förutom de kortsiktiga förbättringarna, troligen en positiv påverkan på patienternas inställning till smärta och aktivitet. Förhoppningen är att den aktuella, systematiskt sammanställda kunskapen ska bidra till diskussioner på enskilda arbetsplatser och att behandlingsrekommendationerna kan anpassas till lokala förhållanden.
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| 4. |
- Kyhlbäck, Maria, et al.
(författare)
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Postoperativ rehabilitering vid ländryggsdiskbråck
- 2011
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Ingår i: Fysioterapi. - Stockholm. - 1653-5804. ; :1, s. 32-37
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund och syfte:Under 2008 har en grupp sjukgymnaster tagit fram nationella behandlingsriktlinjer för patienter som genomgått diskbråcksoperation. Syftet var att dessa skulle baseras på vetenskaplig evidens och klinisk erfarenhet.Metoder:Litteratursökning gjordes i sju olika databaser, sökningen omfattade randomiserade, kontrollerade studier under tidsperioden 1990-2008. Inkluderade studier granskades utifrån ett modifierat kvalitetsindex enligt SBU (Statens Beredning för medicinsk Utvärdering). För bevisvärdering av studieresultat användes SBU:s gradering högt, medelhögt och lågt bevisvärde. Evidensgrad för olika sjukgymnastiska metoder som förekom i de inkluderade studierna kategoriserades i enlighet med SBU:s nivåer för vetenskaplig evidens; starkt vetenskapligt underlag, måttligt starkt vetenskapligt underlag, begränsat vetenskapligt underlag och otillräckligt vetenskapligt underlag. Resultat:Sexton artiklar som uppfyllde kriterierna för granskning inkluderades i granskningen.Baserat på dessa studier finns måttligt stark evidens för att aktiv träning som inkluderar ett mer aktivt förhållningssätt är mer effektiv på kort sikt än mer försiktig/passiv träning och förhållningssätt (< 6 månader efter operation). Det finns ett starkt vetenskapligt stöd för att den aktiva träningen inte påverkar smärta och funktion på lång sikt (ett år efter operation), liksom att tidig, aktiv träning inte ökar komplikationsrisken efter operation. Det vetenskapliga stödet är begränsat vad gäller de positiva effekterna av enbart råd om fysisk aktivitet, motsägande beträffande effekten av övervakad träning jämfört med hemträning och otillräckligt beträffande effekten av beteendemedicinskt inriktad träning.Konklusion:Sjukgymnastiken efter diskbråcksoperation bör ha ett aktivt förhållningssätt inkluderande tidig, aktiv träning för att förbättra patienternas ryggfunktion och höja aktivitetsgraden efter operation.
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| 5. |
- Persson, Mia, et al.
(författare)
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A new improved distributed e-healthcare system based on open standards for depression treatment
- 2012
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Ingår i: ICICS '12 Proceedings of the 3rd International Conference on Information and Communication Systems. - New York, NY, USA : ACM Digital Library. - 9781450313278 ; , s. 1-6
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The use of open standards to promote responsible and available design in Internet-based healthcare systems is examined by using theoretical notations and recent research results from the literature. Moreover, empirical data will be gathered from a case study on an e-healthcare system for depression treatment. Our contribution is to initiate a discussion aiming at increasing the awareness on appropriate conceptual models for Internet-based depression treatment. Moreover, an up-to-date e-healthcare system, based on open standards and implemented with requirements of an Internet-based system treating patients suffering from depressions, is proposed.
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| 6. |
- Rasmussen, Eva Rye, et al.
(författare)
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Genome-wide association study of angioedema induced by angiotensin-converting enzyme inhibitor and angiotensin receptor blocker treatment.
- 2020
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Ingår i: The Pharmacogenomics Journal. - : Springer Science and Business Media LLC. - 1470-269X .- 1473-1150. ; 20:6, s. 770-783
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Tidskriftsartikel (refereegranskat)abstract
- Angioedema in the mouth or upper airways is a feared adverse reaction to angiotensin-converting enzyme inhibitor (ACEi) and angiotensin receptor blocker (ARB) treatment, which is used for hypertension, heart failure and diabetes complications. This candidate gene and genome-wide association study aimed to identify genetic variants predisposing to angioedema induced by these drugs. The discovery cohort consisted of 173 cases and 4890 controls recruited in Sweden. In the candidate gene analysis, ETV6, BDKRB2, MME, and PRKCQ were nominally associated with angioedema (p < 0.05), but did not pass Bonferroni correction for multiple testing (p < 2.89 × 10-5). In the genome-wide analysis, intronic variants in the calcium-activated potassium channel subunit alpha-1 (KCNMA1) gene on chromosome 10 were significantly associated with angioedema (p < 5 × 10-8). Whilst the top KCNMA1 hit was not significant in the replication cohort (413 cases and 599 ACEi-exposed controls from the US and Northern Europe), a meta-analysis of the replication and discovery cohorts (in total 586 cases and 1944 ACEi-exposed controls) revealed that each variant allele increased the odds of experiencing angioedema 1.62 times (95% confidence interval 1.05-2.50, p = 0.030). Associated KCNMA1 variants are not known to be functional, but are in linkage disequilibrium with variants in transcription factor binding sites active in relevant tissues. In summary, our data suggest that common variation in KCNMA1 is associated with risk of angioedema induced by ACEi or ARB treatment. Future whole exome or genome sequencing studies will show whether rare variants in KCNMA1 or other genes contribute to the risk of ACEi- and ARB-induced angioedema.
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| 7. |
- Söderström, Torbjörn, et al.
(författare)
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5alfa-reductase 2 polymorphisms as risk factors in prostate cancer
- 2002
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Ingår i: Pharmacogenetics. - : Ovid Technologies (Wolters Kluwer Health). - 0960-314X .- 1473-561X. ; 12:4, s. 307-12
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Tidskriftsartikel (refereegranskat)abstract
- Prostate cancer is a significant cause of death in Western countries and is under the strong influence of androgens. The steroid 5alpha-reductase 2 catalyzes the metabolism of testosterone into the more potent androgen dihydrotestosterone in the prostate gland. The enzyme is a target in pharmacological treatment of benign prostatic hyperplasia using specific inhibitors such as finasteride. Makridakis et al. have characterized the V89L and A49T polymorphisms in recombinant expression systems. The L allelic variant has a lower Vmax/Km ratio than the V variant. In the A49T polymorphism, the T variant has an increased Vmax/Km ratio. We performed a population-based case-control study of the impact of the SRD5A2 V89L and A49T polymorphisms on the risk of prostate cancer. We also studied the relation between the genotypes and age at diagnosis, tumor, node, metastasis stage, differentiation grade, prostate specific antigen and heredity. The study included 175 prostate cancer patients and 159 healthy controls that were matched for age. There was an association with SRD5A2 V89L LL genotype and metastases at the time of diagnosis, OR 5.67 (95% CI 1.44-22.30) when adjusted for age, differentiation grade, T-stage and prostate specific antigen. Heterozygous prostate cancer cases that carried the SRD5A2 A49T AT genotype were significantly younger than cases that carried the AA genotype, (mean age 66 years vs 71, P = 0.038). The SRD5A2 V89L and A49T polymorphisms were, however, not associated with altered prostate cancer risk. Further studies of the V89L polymorphism may lead to better understanding of the etiology of prostate cancer metastases.
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| 8. |
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| 9. |
- Albertsson, Per, 1964, et al.
(författare)
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Astatine-211 based radionuclide therapy: Current clinical trial landscape
- 2023
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Ingår i: Frontiers in Medicine. - : Frontiers Media SA. - 2296-858X. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Astatine-211 (At-211) has physical properties that make it one of the top candidates for use as a radiation source for alpha particle-based radionuclide therapy, also referred to as targeted alpha therapy (TAT). Here, we summarize the main results of the completed clinical trials, further describe ongoing trials, and discuss future prospects.
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| 10. |
- Axelsson, Anna, et al.
(författare)
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Patient reported long-term side effects on bowel function and anal pain in anal cancer survivors-3-and 6-year results from the Swedish national ANCA study
- 2023
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Ingår i: COLORECTAL DISEASE. - 1462-8910 .- 1463-1318.
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Tidskriftsartikel (refereegranskat)abstract
- AimThe primary therapeutic option for anal cancer treatment is chemoradiotherapy resulting in 80% survival. The aim of this study was to assess long-term bowel function impairment and anal pain at 3 and 6 years after anal cancer diagnosis, based on a hypothesis of an increase in impairment over time. A secondary aim was to investigate if chemoradiotherapy increased the risk for bowel impairment, compared to radiotherapy alone.MethodThe ANal CAncer study (ANCA) consists of a national Swedish cohort of patients diagnosed with anal cancer between 2011-2013. Patients within the study were invited to respond to a study-specific questionnaire at 3- and 6-years after diagnosis. Descriptive analyses for the primary endpoint and ordinal logistic regressions for secondary endpoint were performed.ResultsA total of 388 patients (84%) were included in the study. At 3 years of follow-up, 264 patients were alive. A total of 195 of these patients (74%) answered a study specific questionnaire, and at 6 years 154 patients (67%). Fifty-seven percent experienced bowel urgency at both 3 and 6 years. There was an increased risk for repeated bowel movement within 1 h (OR 2.44 [95% CI: 1.08-5.61, p = 0.03]) at 3 years in patients who had been treated by chemoradiation compared to radiotherapy alone.ConclusionsImpairment in bowel function and anal pain after anal cancer treatment should be expected and remains after 6 years. This suggests that long-term follow-up may be necessary in some form after customary follow-up. The addition of chemotherapy increases long-term side effects of bowel function.
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