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| 2. |
- Ahl, Jonas, et al.
(författare)
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Bacterial aetiology in ventilator-associated pneumonia at a Swedish university hospital
- 2010
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 1651-1980 .- 0036-5548. ; 42:6-7, s. 469-474
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Tidskriftsartikel (refereegranskat)abstract
- Ventilator-associated pneumonia (VAP) is a common complication of respiratory support and is associated with increased mortality, morbidity and costs, and a prolonged stay in the intensive care unit. Scandinavian data on the aetiology in VAP are lacking. We hereby present a retrospective study on the aetiology of VAP diagnosed by protective specimen brush culture at Malmo University Hospital in relation to early-and late-onset VAP, antibiotic treatment and the incidence of drug-resistant bacteria. Patients registered with a diagnosis of VAP between January 2004 and September 2007 were included in the study. Sixty-five of 109 patients diagnosed with VAP met the inclusion criteria, and 103 bacterial isolates were cultured from these patients. The most common findings among the 65 VAP episodes were Enterobacteriaceae (28), Pseudomonas aeruginosa (13), Haemophilus influenzae (12) and Staphylococcus aureus (8). Patients with no antibiotic treatment at the onset of VAP had significantly more H. influenzae (p = 0.035) and Gram-positive pathogenic bacteria (p = 0.019). There was no difference in incidence of P. aeruginosa between early-and late-onset VAP. Resistant bacteria were found in 18% of the patients.
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| 3. |
- Ahlqvist, Emma, et al.
(författare)
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Novel subgroups of adult-onset diabetes and their association with outcomes : a data-driven cluster analysis of six variables
- 2018
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Ingår i: The Lancet Diabetes and Endocrinology. - 2213-8587 .- 2213-8595. ; 6:5, s. 361-369
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDiabetes is presently classified into two main forms, type 1 and type 2 diabetes, but type 2 diabetes in particular is highly heterogeneous. A refined classification could provide a powerful tool to individualise treatment regimens and identify individuals with increased risk of complications at diagnosis.MethodsWe did data-driven cluster analysis (k-means and hierarchical clustering) in patients with newly diagnosed diabetes (n=8980) from the Swedish All New Diabetics in Scania cohort. Clusters were based on six variables (glutamate decarboxylase antibodies, age at diagnosis, BMI, HbA1c, and homoeostatic model assessment 2 estimates of β-cell function and insulin resistance), and were related to prospective data from patient records on development of complications and prescription of medication. Replication was done in three independent cohorts: the Scania Diabetes Registry (n=1466), All New Diabetics in Uppsala (n=844), and Diabetes Registry Vaasa (n=3485). Cox regression and logistic regression were used to compare time to medication, time to reaching the treatment goal, and risk of diabetic complications and genetic associations.FindingsWe identified five replicable clusters of patients with diabetes, which had significantly different patient characteristics and risk of diabetic complications. In particular, individuals in cluster 3 (most resistant to insulin) had significantly higher risk of diabetic kidney disease than individuals in clusters 4 and 5, but had been prescribed similar diabetes treatment. Cluster 2 (insulin deficient) had the highest risk of retinopathy. In support of the clustering, genetic associations in the clusters differed from those seen in traditional type 2 diabetes.InterpretationWe stratified patients into five subgroups with differing disease progression and risk of diabetic complications. This new substratification might eventually help to tailor and target early treatment to patients who would benefit most, thereby representing a first step towards precision medicine in diabetes.
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- Anderberg, Mats, 1961-, et al.
(författare)
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Mer än varannan ungdom med alkohol- och narkotikaproblem i öppenvården har erfarenhet av utsatthet i barndomen
- 2019
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Ingår i: Socialmedicinsk Tidskrift. - Stockholm : Karolinska Institutet. - 0037-833X. ; 96:6, s. 786-799
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Tidskriftsartikel (refereegranskat)abstract
- Det finns idag få svenska studier som undersöker erfarenheter av utsattheti barndom hos ungdomar med drogproblem, särskilt inom öppenvården.Den här studien analyserade erfarenheter av försummelse och övergreppunder barndomen hos ungdomar (medelålder 18 år) som påbörjat öppenvårdsbehandlingför drogproblem. Resultaten visade att många ungdomarhade erfarenheter av försummelse och övergrepp i barndomen. Erfarenhetav utsatthet i barndomen var också relaterat till upplevda problem i uppväxtfamiljen,t.ex. ekonomiska svårigheter, missbruk, psykisk ohälsa och våld ifamiljen. Resultaten pekar på att det är angeläget att även utreda utsattheti barndomen bland ungdomar i behandling för drogproblem, särskilt då det idag finns god evidens för att psykiatrisk samsjuklighet (t.ex. traumareaktionoch drogproblem) bör behandlads samtidigt för att uppnå bäst effekt.
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| 7. |
- Anderberg, Mats, et al.
(författare)
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Mer än varannan ungdom med alkohol- och narkotikaproblem i öppenvården har erfarenhet av utsatthet i barndomen
- 2019
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Ingår i: Socialmedicinsk Tidskrift. - 0037-833X. ; 96:6, s. 786-799
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Tidskriftsartikel (refereegranskat)abstract
- Few Swedish studies investigated experiences of childhood maltreatment in adolescents with substance use problems, especially in outpatient care. This study analyzed experiences of neglect and abuse during childhood in adol- escents (mean age 18 years) who started outpatient treatment for substance use problems. The results showed that several of them had experience of child maltreatment. Child maltreatment was also related to perceived pro- blems in the upbringing family, e.g. financial difficulties, substance use pro- blems, mental illness and violence in the family. This indicate the importance to investigate experiences of child maltreatment among adolescents in tre- atment for substance use problems, especially since there is evidence to- day that psychiatric co-morbidity (e.g. trauma reaction and drug problems) should be treated simultaneously to achieve the best effect.
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| 9. |
- Baldanzi, Gabriel, et al.
(författare)
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Accelerometer-based physical activity is associated with the gut microbiota in 8416 individuals in SCAPIS.
- 2024
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Ingår i: EBioMedicine. - : Elsevier. - 2352-3964. ; 100
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous population-based studies investigating the relationship between physical activity and the gut microbiota have relied on self-reported activity, prone to reporting bias. Here, we investigated the associations of accelerometer-based sedentary (SED), moderate-intensity (MPA), and vigorous-intensity (VPA) physical activity with the gut microbiota using cross-sectional data from the Swedish CArdioPulmonary bioImage Study.METHODS: In 8416 participants aged 50-65, time in SED, MPA, and VPA were estimated with hip-worn accelerometer. Gut microbiota was profiled using shotgun metagenomics of faecal samples. We applied multivariable regression models, adjusting for sociodemographic, lifestyle, and technical covariates, and accounted for multiple testing.FINDINGS: Overall, associations between time in SED and microbiota species abundance were in opposite direction to those for MPA or VPA. For example, MPA was associated with lower, while SED with higher abundance of Escherichia coli. MPA and VPA were associated with higher abundance of the butyrate-producers Faecalibacterium prausnitzii and Roseburia spp. We observed discrepancies between specific VPA and MPA associations, such as a positive association between MPA and Prevotella copri, while no association was detected for VPA. Additionally, SED, MPA and VPA were associated with the functional potential of the microbiome. For instance, MPA was associated with higher capacity for acetate synthesis and SED with lower carbohydrate degradation capacity.INTERPRETATION: Our findings suggest that sedentary and physical activity are associated with a similar set of gut microbiota species but in opposite directions. Furthermore, the intensity of physical activity may have specific effects on certain gut microbiota species.FUNDING: European Research Council, Swedish Heart-Lung Foundation, Swedish Research Council, Knut and Alice Wallenberg Foundation.
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