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- Bondesson, E., et al.
(författare)
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Comorbidity between pain and mental illness - Evidence of a bidirectional relationship
- 2018
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Ingår i: European Journal of Pain. - : Wiley. - 1090-3801. ; 22:7, s. 1304-1311
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pain from various locations in the body and mental illness are common and the comorbidity between the two is well-known although the temporal relationship remains to be determined. Our aim was to follow patients over time to study if pain (here dorsalgia/abdominal pain) or fibromyalgia lead to an increased risk of developing mental illness (here depression/anxiety) and/or the reverse, that is whether patients with mental illness have an increased risk to develop pain or fibromyalgia, compared to the rest of the population. Methods: This prospective cohort study used the Skåne Healthcare Register, covering all care in the region of Skåne, southern Sweden (population ~1.3 million). The cohort included healthcare consultations in primary care, outpatient specialized care and inpatient care between 2007 and 2016 for all patients without prior registered diagnosis of mental illness or pain, aged 18 or older (n = 504,365). Results: The incidence rate ratio (IRR) for developing mental illness after pain was 2.18 (95% CI = 2.14-2.22) compared to without pain. IRR for developing pain after mental illness was 2.02 (95% CI = 1.98-2.06) compared to without mental illness. Corresponding IRR for developing mental illness after fibromyalgia was 4.05 (95% CI = 3.58-4.59) and for developing fibromyalgia after mental illness 5.54 (95% CI = 4.99-6.16). Conclusions: This study shows a bidirectional influence of similar magnitude of pain and mental illness, respectively. In monitoring patients with pain or mental illness, a focus on both conditions is thus important to develop appropriate, targeted interventions and may increase the likelihood of improved outcomes. Significance: We followed a population-based cohort over a period of 10 years, including incident cases of both exposure and outcome and found a bidirectional relationship between pain and mental illness. Clinicians need to pay attention on both conditions, in patients seeking care due to mental illness or pain.
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| 3. |
- Chomez, A., et al.
(författare)
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An imaged 15 MJup companion within a hierarchical quadruple system
- 2023
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Ingår i: Astronomy and Astrophysics. - 0004-6361 .- 1432-0746. ; 676, s. L10-L10
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Tidskriftsartikel (refereegranskat)abstract
- Context. Since 2019, the direct imaging B-star Exoplanet Abundance STudy (BEAST) at SPHERE@VLT has been scanning the surroundings of young B-type stars in order to ascertain the ultimate frontiers of giant planet formation. Recently, the 17+3-4 Myr HIP 81208 was found to host a close-in (∼50 au) brown dwarf and a wider (∼230 au) late M star around the central 2.6 M⊙ primary.Aims. Alongside the continuation of the survey, we are undertaking a complete reanalysis of archival data aimed at improving detection performances so as to uncover additional low-mass companions.Methods. We present here a new reduction of the observations of HIP 81208 using the patch covariance algorithm (PACO), a recent and powerful algorithm dedicated to processing high-contrast imaging datasets, as well as more classical algorithms and a dedicated point spread function subtraction approach. The combination of different techniques allowed for a reliable extraction of astrometric and photometric parameters.Results. A previously undetected source was recovered at a short separation from the C component of the system. Proper motion analysis provided robust evidence for the gravitational bond of the object to HIP 81208 C. Orbiting C at a distance of ∼20 au, this 15 MJup brown dwarf becomes the fourth object of the hierarchical HIP 81208 system.Conclusions. Among the several BEAST stars which are being found to host substellar companions, HIP 81208 stands out as a particularly striking system. As the first stellar binary system with substellar companions around each component ever found by direct imaging, it yields exquisite opportunities for thorough formation and dynamical follow-up studies.
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| 4. |
- Ogink, H., et al.
(författare)
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A strategic tool to improve long-term health outcomes in clinical practice: SHOR driver and association diagram
- 2020
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Ingår i: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1353-4505 .- 1464-3677. ; 32:1, s. 20-27
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Tidskriftsartikel (refereegranskat)abstract
- Quality problem or issue: An over-arching principle of healthcare governance in Sweden is to achieve as much health for as many patients as possible given the available resources. With high life expectancy and increased years lived with non-communicable diseases, more effective interventions in prevention and control of non-communicable diseases are needed in order to ensure high-quality healthcare. Initial assessment: Few publications have described a generic and resource-effective method of implementing the perspective of health outcomes in relation to costs in a clinical Swedish university hospital context. To fill this gap, a generic method was developed at Sahlgrenska University hospital in Gothenburg, Sweden. Choice of solution: A System-based driver and association diagram of Health Outcomes in relation to available Resources (SHOR) was developed. The SHOR driver and association diagram comprised different perspectives: health, patient, process, research and cost perspectives. It enabled the translation from long-term health outcomes to applications in clinical practice. Implementation: Three patient groups exemplify the use and implementation of the method of SHOR association and driver diagram; bipolar disorder (psychiatry), primiparous women with spontaneous onset of labour, (obstetric care) and chronic obstructive pulmonary disease (somatic care). Evaluation:The SHOR driver and association diagram enabled a structure to monitor and support quality development towards maximised health outcomes in relation to available resources and associated total costs for a specific patient group. Lessons learned :This method has connected clinical practice, management and research and has been used for both strategic and operational purposes.
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| 5. |
- Squicciarini, V., et al.
(författare)
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A scaled-up planetary system around a supernova progenitor
- 2022
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 664
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Tidskriftsartikel (refereegranskat)abstract
- Context. Virtually all known exoplanets reside around stars with M < 2.3 M⊙ either due to the rapid evaporation of the protostellar disks or to selection effects impeding detections around more massive stellar hosts.Aims. To clarify if this dearth of planets is real or a selection effect, we launched the planet-hunting B-star Exoplanet Abundance STudy (BEAST) survey targeting B stars (M > 2.4 M⊙) in the young (5-20 Myr) Scorpius-Centaurus association by means of the high-contrast spectro-imager SPHERE at the Very Large Telescope.Methods. In this paper we present the analysis of high-contrast images of the massive (M - 9 M⊙) star μ2 Sco obtained within BEAST. We carefully examined the properties of this star, combining data from Gaia and from the literature, and used state-of-the-art algorithms for the reduction and analysis of our observations.Results. Based on kinematic information, we found that μ2 Sco is a member of a small group which we label Eastern Lower Scorpius within the Scorpius-Centaurus association. We were thus able to constrain its distance, refining in turn the precision on stellar parameters. Around this star we identify a robustly detected substellar companion (14.4 ± 0.8 MJ)at a projected separation of 290 ± 10 au, and a probable second similar object (18.5 ± 1.5 MJ) at 21 ± 1 au. The planet-to-star mass ratios of these objects are similar to that of Jupiter to the Sun, and the flux they receive from the star is similar to those of Jupiter and Mercury, respectively.Conclusions. The robust and the probable companions of μ2 Sco are naturally added to the giant 10.9 MJ planet recently discovered by BEAST around the binary b Cen system. While these objects are slightly more massive than the deuterium burning limit, their properties are similar to those of giant planets around less massive stars and they are better reproduced by assuming that they formed under a planet-like, rather than a star-like scenario. Irrespective of the (needed) confirmation of the inner companion, μ2 Sco is the first star that would end its life as a supernova that hosts such a system. The tentative high frequency of BEAST discoveries is unexpected, and it shows that systems with giant planets or small-mass brown dwarfs can form around B stars. When putting this finding in the context of core accretion and gravitational instability formation scenarios, we conclude that the current modeling of both mechanisms is not able to produce this kind of companion. The completion of BEAST will pave the way for the first time to an extension of these models to intermediate and massive stars.
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| 8. |
- Enochsson, L, et al.
(författare)
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Laparoscopic vs open appendectomy in overweight patients
- 2001
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Ingår i: Surgical Endoscopy. - : Springer Science and Business Media LLC. - 0930-2794 .- 1432-2218. ; 15:4, s. 387-392
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Tidskriftsartikel (refereegranskat)abstract
- Background: Laparoscopic appendectomy (LA) has been associated with a faster recovery and less postoperative pain than the open technique. However, few data are available on the clinical outcome of LA in overweight patients. Methods: A group of 106 patients with a body mass index (BMI) > 26.4, representing the upper quintile of 500 prospectively randomized patients, were included in the study. They were randomized to undergo either laparoscopic or open appendectomy (OA). Operating and anesthesia times, postoperative pain, complications, hospital stay, functional index (1 week postoperatively), sick leave, and time to full recovery were documented. Results: In OA, the operating time for overweight patients was significantly longer than that for patients in the normal weight range (40 vs 35 min, p < 0.05). In LA, there was no difference in operating time between the normal and overweight patients. Overweight patients who underwent LA had longer operating and anesthesia times than their OA counterparts (55 vs 40 min, p < 0.001, and 125 vs 100 min, p < 0.001, respectively). Postoperative pain was significantly greater in overweight patients who underwent OA than in those treated with the laparoscopic technique. Postoperative pain was also significantly greater in overweight patients subjected to OA than in patients of normal weight after 4 weeks, the clinical significance may, however, be of less importance since the values are low (0.26 vs 0.09, p < 0.05). There were no significant differences between the two operating techniques in terms of complications. Hospital stay was longer for overweight patients than for normal-weight patients undergoing OA (3.0 vs 2.0, p < 0.01). The functional index did not differ between any group of patients. Sick leave was longer for overweight patients who underwent OA than for normal-weight patients treated with the same technique (17 vs 13 days, p < 0.01). In the laparoscopic group, however, there were no differences between the overweight and normal-weight patients. Time to full recovery was greater in overweight patients subjected to OA than in the overweight patients in the LA group (22 vs 15 days, p < 0.001). Conclusion: In this study, overweight patients who were submitted to LA had less postoperative pain and a faster postoperative recovery than overweight patients who had OA. LA also abolished some of the negative effects that overweight had on operating time, hospital stay, and sick leave with the open technique. However, anesthesia and operating times were significantly longer in LA for both overweight patients and those with a normal BMI.
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| 9. |
- Enochsson, L, et al.
(författare)
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The Fenyo-Lindberg scoring system for appendicitis increases positive predictive value in fertile women - A prospective study in 455 patients randomized to either laparoscopic or open appendectomy
- 2004
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Ingår i: Surgical Endoscopy. - : Springer Science and Business Media LLC. - 0930-2794 .- 1432-2218. ; 18:10, s. 1509-1513
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Tidskriftsartikel (refereegranskat)abstract
- Background: Suspected appendicitis is one of the most common indications for acute laparotomy or laparoscopy. The negative laparotomy and laparoscopy rates are high, often in the range of 15-30%, and especially high in some groups of patients such as women of child-bearing age and young patients. Different scoring systems have been introduced in order to improve diagnostic accuracy. The aim of the present study was to analyse the outcome of the Fenyo-Lindberg scoring system in a prospectively randomized multicenter trial and to analyze how well the score performed in stratified subgroups. Methods: The variables of the Fenyo-Lindberg scoring system were collected in a prospective study comparing laparoscopic and open surgery in suspected appendicitis and with four participating centers. None of the hospitals had used the scoring system previously. Since surgeons were unfamiliar with the score, they could not use it as a diagnostic aid. When comparing the score with the clinical outcome, retrospectively, the investigators interpreting the score were blinded regarding the surgical outcome. Results: Positive predictive value (PPV) of the Fenyo-Lindberg score was higher than that of the surgeon's clinical diagnosis in the patient cohort [0.90 vs 0.79 (p < 0.001)]. The score demonstrated an improvement of PPV in women [0.83 vs 0.70 (p < 0.01)]. PPV was increased in women between 15 and 50 years of age. In women aged 15-30 years and 31-50 years PPV increased from 0.69 to 0.82 and 0.68 to 0.86, respectively (p < 0.01). Both the sensitivity (0.77) and the specificity (0.69) of the score were, however, low. Conclusion: The Fenyo-Lindberg score is an inexpensive clinical tool that may improve the diagnostic accuracy for acute appendicitis in women of childbearing age, which is a group of patients where the diagnostic accuracy usually is low and where the arsenal of diagnostic tools such Lis Computed tomography is limited because of radiation. The low specificity of the score in women of childbearing age must, however, be kept in mind.
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