| 1. |
- Eriksson, Hanna, et al.
(författare)
-
Brain injury markers in new-onset seizures in adults: A pilot study
- 2021
-
Ingår i: Seizure-European Journal of Epilepsy. - : Elsevier BV. - 1059-1311. ; 92, s. 62-67
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Biochemical markers of brain pathology could potentially contribute to diagnosis and prediction in epilepsy. We describe levels of five brain injury markers in adults with new-onset seizures, and assess group differences in patients with a single seizure, epilepsy, and poststroke epilepsy. Methods: In this prospective observational study, adults with new-onset seizures were recruited at Sahlgrenska University Hospital, Sweden, and concentrations of glial fibrillary acidic protein (GFAP), neurofilament light (NfL), microtubule-associated protein tau (tau), S100 calcium-binding protein (S100B), and neuron-specific enolase (NSE) were measured. Participants were categorized as epilepsy, poststroke epilepsy (PSE), or single seizure (no additional seizures). Patients were followed until a diagnosis of epilepsy or PSE, or for at least two years in single seizure cases. Results: The cohort included 23 (37%) individuals with a single seizure, 24 (39%) with epilepsy, and 15 (24%) with PSE. The concentrations of S100B were higher in patients with epilepsy and PSE than in single seizures (p = 0.0023 and p = 0.0162, respectively). The concentrations of NfL were higher in patients with PSE than in single seizures (p=0.0027). After age-normalization, levels of S100B were higher in patients with epilepsy and levels of NfL were higher in patients with PSE (p = 0.0021 and p = 0.0180). Conclusion: Levels of S100B and NfL were higher in patients with epilepsy or PSE than patients with single seizures. Further studies are needed to investigate the biomarker potential of brain injury markers as predictors of epilepsy course or indicators of epileptogenesis.
|
|
| 2. |
- Gyllensten, Hanna, 1979, et al.
(författare)
-
Physical activity with person-centered guidance supported by a digital platform or with telephone follow-up for persons with chronic widespread pain: Health economic considerations along a randomized controlled trial.
- 2024
-
Ingår i: Scandinavian Journal of Pain. - 1877-8860 .- 1877-8879. ; 24:1
-
Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate the resource use and costs associated with the co-creation of a physical activity plan for persons with chronic widespread pain (CWP) followed by support through a digital platform, compared to telephone follow-up.In this 12-month cost comparison study following up results after a randomized controlled trial, individuals with CWP, aged 20-65 years, were recruited at primary healthcare units in Western Sweden. All participants developed a person-centered health-enhancing physical activity plan together with a physiotherapist. Participants were then randomized to either an intervention group (n = 69) who had a follow-up visit after 2 weeks and was thereafter supported through a digital platform, or an active control group (n = 70) that was followed up through one phone call after a month. Costs to the health system were salary costs for the time recorded by physiotherapists when delivering the interventions.The reported time per person (2.8h during the 12 months) corresponded to costs of SEK 958 (range: 746-1,517) for the initial visits and follow-up (both study groups), and an additional 2.5h (corresponding to a mean SEK 833; range: 636-1,257) for the time spent in the digital platform to support the intervention group.After co-creation of a physical activity plan, it was more costly to support persons through a digital platform, compared to telephone follow-up.
|
|
| 3. |
- Hassellöv, Ida-Maja, 1974, et al.
(författare)
-
Miljörisker sjunkna vrak
- 2014
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Arbetet med en nationell strategi för hantering av miljöfarliga vrak påbörjades 2007 med Statskontorets utredning Vrak och ägarlösa båtar, men ingen enskild myndighet har tilldelats övergripande ansvar för vrakfrågan. Utöver ansvarsfrågan har också förväntade höga kostnader för inspektion och sanering av vrak fördröjt det fortsatta arbetet. Ett steg närmare en nationell strategi redovisas här genom regeringsuppdraget Miljörisker sjunkna vrak. Genom samordning och ökat informationsutbyte mellan berörda myndigheter finns stor potential att minska de förväntade kostnaderna för inspektion av vrak och omgivande miljö. Om den föreslagna strategin antas, beräknas informationsläget avseende vraken att snabbt förbättras så att det år 2030 inte längre finns några potentiellt miljöfarliga vrak i svenska vatten.Havs- och vattenmyndigheten (HaV) och Naturvårdsverket har idag delat ansvar för övervakning och åtgärdande av miljögifter i marin miljö. Mot denna bakgrund hade det varit naturligt att låta HaV få ett övergripande ansvar för hantering av miljöfarliga vrak. Genom flexibelt upplägg avseende tidsramar bedöms övervakning och inspektion av potentiellt miljöfarliga vrak kunna utföras genom att HaV ger de berörda myndigheterna uppdrag; kartering och sjömätning (Sjöfartsverket), ROV och dykinspektion (Kustbevakningen och/eller Försvarsmakten), sediment- och bottenförhållanden (Statens geologiska undersökning). En förutsättning är dock väl fungerande samverkan och kommunikation mellan berörda myndigheter. Existerande plattformar för detta finns redan på såväl operativ nivå i form av Projekt ”Sjöstjärnan” - samordning och samverkan mellan myndigheter avseende information och inhämtning av djup- och bottendata; respektive högsta ledningsnivå i form av Samordningsgruppen för havs- och vattenmiljöfrågor (SamHav).Enligt Sjöfartsverkets tidigare inventering (Miljörisker från fartygsvrak, 2011) finns det utmed Sveriges kust knappt tre tusen vrak som inte kan avskrivas utan vidare informationsinhämtning. Drygt trehundra av dessa klassades som potentiellt miljöfarliga. Av dessa har 31 listats som de sannolikt mest miljöfarliga vraken. Listan över de 31 vraken har därför varit utgångspunkt för projektet Miljörisker sjunkna vrak, vars syfte var att ta fram en metod för prioritering och inspektion av potentiellt miljöfarliga vrak.Undervattensinspektion av vrak är kostsamt och kostnaden ökar kraftigt om vrakets läge är otillgängligt. Av de 31 vraken valdes därför nio relativt lättillgängliga vrak ut för noggrannare arkivstudier, samt sjömätning. Utifrån informationen från arkivstudierna och sjömätningen gjordes ett ytterligare urval om fyra vrak (Altnes, Skytteren, Thetis och Villon), vilka även inspekterades med ROV och/eller dykare. Huvudsyftet var att, inför och under arbetet med inspektionerna, utarbeta Standard Operating Procedures (SOPs) som framgent kan användas som stöd inför kommande operationer rörande potentiellt miljöfarliga vrak.Under arbetet med inspektionerna observerades inte några pågående läckage av olja från vraken. Trots denna positiva information är det viktigt att komma ihåg att endast bevis på tomma tankar kan fullt ut avskriva vraken från listan över potentiellt miljöfarliga vrak. Även om det under projektets fältarbete inte observerades läckage av olja, finns dokumenterade läckage sedan tidigare (senast 2008-04-26) för Skytteren. Noterbart är också att Kustbevakningen 2014-06-29, fick rycka ut för att omhänderta olja som börjat läcka efter vraket Immen, norr om Gotska Sandön. Immen var inte med bland fallstudieobjekten i projektet.I tillägg till undervattensinspektion placerades strömmätningsutrustning ut vid vraken Skytteren och Villon. Strömdata kan sedan användas för att modellera ett hypotetiskt spill av olja från ett vrak och ge en indikation på var läckage av olja kan tänkas påverka den marina miljön negativt. Exempel på sådana negativa effekter kan vara försämrad förmåga hos sedimentlevande organismer att omsätta näringsämnen, vilket i sin tur kan påverka hela det marina ekosystemet. Strömdata är också ett viktigt underlag för utformning av övervakningsprogram, exempelvis med passiva provtagare för att detektera läckage av miljöfarlig substans från vrak.Samtlig insamlad data kommer att användas för att validera riskbedömningsverktyget VRAKA, som möjliggör resurseffektiv prioritering av vilka vrak som bör undersökas och/eller saneras. VRAKA, SOPs för inspektion, samt tillgång till specifik kompetens för utvärdering av samtliga resultat är nyckelelement för att kunna presentera en tillförlitlig riskbedömning av potentiellt miljöfarliga vrak. Havs- och vattenmyndigheten skulle kunna vara lämplig myndighet med huvudansvar för miljöfarliga vrak, i operativ samverkan med övriga berörda myndigheter.
|
|
| 4. |
|
|
| 5. |
- Hassellöv, Ida-Maja, 1974, et al.
(författare)
-
Miljörisker sjunkna vrak II. Undersökningsmetoder och miljöaspekter
- 2015
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- During 2015 the Swedish Maritime Administration continued the second phase of thegovernmental task Environmental risks from sunken wrecks which first report was finalized2014-10-31 (Dnr: 1399-14-01942-6).The main conclusions from the 2014 report remain; for future handling of potentially pollutingshipwrecks it is recommended that the Swedish Agency for Water and Marine Management isgiven a coordinating responsibility in close cooperation with other competent nationalauthorities, such as Swedish Maritime Administration, Swedish Coastguard, Swedish NationalMaritime Museums, the Geological Survey of Sweden, SMHI, Swedish EPA, and SwedishCivil Contingencies Agency. Through coordination of wreck related operations and activitieswithin the concerned competent authorities’ ordinary areas of responsibility, resourceefficiency is improved. The estimated extra cost for implementation of a national strategy forhandling of the wrecks are estimated to be 10-15 MSEK which should be allocated to thecompetent authorities by the Swedish Agency for Water and Marine Management.The conclusions from 2014 was reinforced during 2015, e.g. through the validation of the riskassessment model VRAKA, which is now available in a first operative version. Additionalecotoxicological experiments on the development of tolerance against PAHs in meiofauna andmicroorganism communities were conducted in a field study in Brofjorden. The mainconclusions from this work is that comprehensive analyzes of PAHs should include alkylatedPAHs, and that exposure to PAHs over time can lead to tolerance development in ammoniumoxidizing bacteria, at the expense of their ability to perform the essential ecosystem servicenitrification.Continued measurements of the bottom currents were made at the wrecks Villon and Skytteren,and at the dumping area west of Måseskär. Measurement series yielded important informationon how measuring equipment at the wreck can be deployed in an optimized way in futuremonitoring program; to calculate the possible spreading of pollution from a wreck, currentmeasurements should be performed upstream from the wreck site, while sensors for thedetection of, for example, oil should be put into the turbulence downstream of the wreck.The current measurement instruments (RDCP) deployed at the Måseskär dump site was trawledup after only three weeks of measurements, but still gave valuable information on the extensivebottom trawling that resuspend (stir up) sediments. Earlier geochemical surveys have shownsignificantly elevated arsenic concentrations in the area and sediment resuspension greatlyincreased the risk for spread of any contaminants in the area. Trawling is not prohibited in thearea, and the current lack of knowledge regarding potential effects on human health whenconsuming seafood from dump areas calls for reflection upon the suitability of trawling in thearea.In addition to the current measurements Swedish Maritime Administration and the SwedishNavy conducted hydrographic survey with multibeam and side scan sonar and ROVinvestigation of the wrecks in the dumping area at Måseskär. 28 wrecks were found, and ROVinvestigation showed cargo holds with dumped torpedoes or mines and other containers in some SjöfartsverketDnr: 1399-14-01942-156of the wrecks. There is some discrepancy between the previously measured elevated arsenicconcentrations in the Måseskär area and recently presented data from historical archives thatdoes not support the theory that chemical weapons were dumped in the area. However, there isa very good correlation between the dominant current direction in the area, and the highestmeasured arsenic concentrations in the area downstream of the wrecks, suggesting some formof arsenic source in the area.
|
|
| 6. |
- Jonasson, Hanna, 1981-, et al.
(författare)
-
In vivo characterization of light scattering properties of human skin in the 475- to 850-nm wavelength range in a Swedish cohort
- 2018
-
Ingår i: Journal of Biomedical Optics. - : SPIE - International Society for Optical Engineering. - 1083-3668 .- 1560-2281. ; 23:12
-
Tidskriftsartikel (refereegranskat)abstract
- We have determined in vivo optical scattering properties of normal human skin in 1734 subjects, mostly with fair skin type, within the Swedish CArdioPulmonary bioImage Study. The measurements were performed with a noninvasive system, integrating spatially resolved diffuse reflectance spectroscopy and laser Doppler flowmetry. Data were analyzed with an inverse Monte Carlo algorithm, accounting for both scattering, geometrical, and absorbing properties of the tissue. The reduced scattering coefficient was found to decrease from 3.16 ± 0.72 to 1.13 ± 0.27 mm-1 (mean ± SD) in the 475- to 850-nm wavelength range. There was a negative correlation between the reduced scattering coefficient and age, and a significant difference between men and women in the reduced scattering coefficient as well as in the fraction of small scattering particles. This large study on tissue scattering with mean values and normal variation can serve as a reference when designing diagnostic techniques or when evaluating the effect of therapeutic optical systems.
|
|
| 7. |
- Larsson, Alexandra C, 1986, et al.
(författare)
-
Self-Assessed Aspects of Health 3 Months after COVID-19 Hospitalization-A Swedish Cross-Sectional Study
- 2022
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 19:13
-
Tidskriftsartikel (refereegranskat)abstract
- It is not yet fully understood how the patients self-assess their overall health in the early recovery after COVID-19 and if certain patient groups are more prominent in perceived long-time effects of COVID-19. The aim of this study was to describe self-assessed aspects of health in body function, activity and participation 3 months after hospitalization due to COVID-19 and identify difference between groups depending in age, sex and level of hospital care. This cross-sectional study consists of self-assessed aspects of health and recovery in 168 participants (mean age 64 years old, 69% men) previously hospitalized patients due to COVID-19. We have previously published data, from hospital discharge, on this cohort were predominantly the older patients and previous ICU-treated participants were affected. In this study there were differences in between groups. Of the study population 72% perceived fatigue, 64% respiratory difficulties, 37% perceived symptoms of anxiety. Three-months after COVID-19 this cohort was overall still affected. The recovery process is multifaced and the cohort heterogeneous, hence the rehabilitation needs to be highly individualized, and the follow-up of this patient group is of importance regardless of age, sex and previous level of hospital care.
|
|
| 8. |
- Larsson, Charlotta, 1981, et al.
(författare)
-
Suicide after colorectal cancer-a national population-based study
- 2024
-
Ingår i: COLORECTAL DISEASE. - 1462-8910 .- 1463-1318.
-
Tidskriftsartikel (refereegranskat)abstract
- AimA cancer diagnosis is often associated with physical as well as emotional distress. Previous studies indicate a higher risk for suicide in patients diagnosed with cancer. The aim of this study was to investigate the prevalence of death by suicide in a national cohort of patients with newly diagnosed colorectal cancer compared with a matched control group to determine if patients with colorectal cancer had an increased incidence of death by suicide.MethodThis national Swedish cohort was retrieved from the register-based research database CRCBaSe, which includes all patients diagnosed with colorectal cancer between 1997-2006 (rectal) and 2008-2016 (colon) and six controls for each patient matched by age, sex, and county. Cause specific mortality due to suicide was modelled using Cox proportional hazards model and adjusted for known risk factors.ResultsThe main analysis included patients operated for colorectal cancer, 55 578 patients compared with 307 888 controls. The first year after diagnosis the hazard ratio (HR) for suicide among patients operated for colorectal cancer was 1.86 (CI: 1.18-2.95) compared to controls. Suicide was more common among men than women (HR 2.08; 1.26-3.42 vs. 1.09; 0.32-3.75). A subgroup analysis of the 9198 patients who did not undergo surgery after diagnoses found a seven-fold increase of suicide (HR 7.03; 3.10-15.91).ConclusionSuicide after surgery for colorectal cancer was almost twice as high as in the control group, mainly driven by excess mortality among men. Although the cases were few in the subgroup of nonoperated patients, the considerably higher risk of suicide indicates that more resources might be needed in this group. Evaluation of risk factors for suicide among patients with colorectal cancer should be performed for early identification of individuals at risk.
|
|
| 9. |
- Larsson, Hanna, 1981-, et al.
(författare)
-
Patients’ experiences regarding severe leg wound infection associated with coronary artery bypass grafting : A qualitative study
- 2023
-
Ingår i: Journal of Vascular Nursing. - : Elsevier. - 1062-0303 .- 1532-6578. ; 41:1, s. 12-18
-
Tidskriftsartikel (refereegranskat)abstract
- IntroductionCoronary artery bypass grafting (CABG) is the most common cardiac surgery throughout the world. The most commonly used graft is the saphenous vein. Wound healing complications related to saphenous vein harvesting are common, with reported surgical site infection rates ranging from 2% to 20%. Surgical site infection can be long-lasting, and the wound healing can be difficult and also presumably troublesome for the patient. CABG patients’ experiences of severe infection in the harvesting site have not been studied before.Aim: The aim of this study was to describe patients’ experiences associated with acquiring a severe infection in the harvesting site after CABG.Method A qualitative study with descriptive design was conducted at the department of vascular and cardiothoracic surgery in a Swedish university hospital from May to December 2018. Patients diagnosed with a severe surgical site infection in the harvesting site following CABG were included. Data from 16 face-to-face interviews were analysed with inductive qualitative content analysis.Result The main category, varying impact on body and mind, was the core of the patients’ experiences of severe wound infection in the harvesting site after CABG. Two generic categories were identified: physical impact and thoughts about the complication. The patients described experiencing different degrees of pain, anxiety, and limitation in daily life.Conclusion These findings indicate that a severe infection in the harvesting site after CABG was experienced as an important issue with varying impact. Overall, the participants experienced pain, anxiety, and limitations in daily life. However, most of them were satisfied with the outcome after the wound had healed. Patients should be advised to seek care at an early stage if symptoms of infection occur. Improved individual pain management is needed for those with severe pain, and varied experiences imply a need for person-centred care.
|
|
| 10. |
- Larsson, Hanna, 1981-, et al.
(författare)
-
Perioperative routines and surgical techniques for saphenous vein harvesting in CABG surgery : a national cross-sectional study in Sweden
- 2020
-
Ingår i: Journal of Cardiothoracic Surgery. - : BioMed Central (BMC). - 1749-8090. ; 15:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The saphenous vein is the most commonly used conduit for coronary artery bypass grafting (CABG). Wound healing complications related to saphenous vein harvesting are common, with reported surgical site infection rates ranging from 2 to 20%. Patients' risk factors, perioperative hygiene routines, and surgical technique play important roles in wound complications. Here we describe the perioperative routines and surgical methods of Swedish operating theatre (OT) nurses and cardiac surgeons.METHODS: A national cross-sectional survey with descriptive design was conducted to evaluate perioperative hygiene routines and surgical methods associated with saphenous vein harvesting in CABG. A web-based questionnaire was sent to OT nurses and cardiac surgeons at all eight hospitals performing CABG surgery in Sweden.RESULTS: Responses were received from all hospitals. The total response rate was 62/119 (52%) among OT nurses and 56/111 (50%) among surgeons. Chlorhexidine 5 mg/mL in 70% ethanol was used at all eight hospitals. The OT nurses almost always (96.8%) performed the preoperative skin disinfection, usually for three to 5 minutes. Chlorhexidine was also commonly used before dressing the wound. Conventional technique was used by 78.6% of the surgeons, "no-touch" by 30.4%, and both techniques by 9%. None of the surgeons used endoscopic vein harvesting. Type of suture and technique used for closing the wound differed markedly between the centres.CONCLUSIONS: In this article we present insights into the hygiene routines and surgical methods currently used by OT nurses and cardiac surgeons in Sweden. The results indicate both similarities and differences between the centres. Local traditions might be the most important factors in determining which procedures are employed in the OT. There is a lack of evidence-based hygiene routines and surgical methods.
|
|
