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| 2. |
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| 3. |
- Berndtsson, Ina, 1953-, et al.
(författare)
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Long-term adjustment to living with an ileal pouch-anal anastomosis.
- 2011
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Ingår i: Diseases of the colon and rectum. - : Lippincott Williams & Wilkins. - 1530-0358 .- 0012-3706. ; 54:2, s. 193-9
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe long-term adjustment to life with an ileal pouch-anal anastomosis after surgery for ulcerative colitis, to investigate the relationship of pouch function to adjustment, and to explore factors affecting quality of life.
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| 4. |
- Carlsson, Eva, 1959, et al.
(författare)
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Concerns and quality of life before surgery and during the recovery period in patients with rectal cancer and an ostomy
- 2010
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - : Lippincott, Williams & Wilkins. - 1071-5754 .- 1528-3976. ; 37:6, s. 654-661
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Rectal cancer is the most common reason for a person to undergo ostomy surgery. The aim of this study was to assess concerns and health-related quality of life (HRQOL) before surgery and during the first 6 months following ostomy surgery in the presence of rectal cancer. SUBJECTS AND SETTINGS: The sample comprised 57 patients at a university hospital in Gothenburg, Sweden. Their median age was 66 years (range, 30-87); 35 men and 22 women participated in the study. METHODS: Participants prospectively answered questionnaires preoperatively, and at 1, 3, and 6 months postoperatively.Concerns were assessed using the rating form of the Inflammatory Bowel Disease Patient Concerns, and HRQOL was evaluated using the 36-Item Short Form Health Survey. Results were compared with population norms. RESULTS: Participants expressed concerns associated with developing cancer, being a burden on others, and related to the uncertain nature of disease. Health-related quality of life scores dropped significantly in 6 of 8 domains when preoperative scores were compared to those obtained 1 month postoperatively, but scores improved at 6 months. There were significant differences between preoperative study group scores and population norms on physical and emotional role function, social function, and for mental health domains. Significant differences persisted when population norms were compared to study group scores 6 months following surgery on all these domains except mental health. Participants identified good relations with significant others, social and leisure activities, psychological issues, and health as important for maintaining QOL. Obstacles to maintaining QOL included fatigue, pain, illness-induced limitations in life, and worries over what their new life would entail. CONCLUSION: Surgical management of rectal cancer raises concerns and profoundly impairs QOL during the first several postoperative months. © 2010 Wound, Ostomy and Continence Nurses Society.
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| 5. |
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| 6. |
- Joelsson-Alm, Eva, et al.
(författare)
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Perioperative bladder distension : a prospective study
- 2009
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Ingår i: Scandinavian Journal of Urology and Nephrology. - 0036-5599 .- 1651-2065. - 0036-5599 ; 43:1, s. 58-62
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Postoperative urinary retention and bladder distension are frequent complications of surgery. The aim of this study was to determine the incidence of perioperative bladder distension in a surgical setting and to identify predisposing factors among patients undergoing common general and orthopaedic procedures. Material and methods. This was a prospective observational study of 147 adult patients admitted to orthopaedic and surgical departments. Bladder volumes were measured with an ultrasound scanner on three occasions: after emptying the bladder before being transported to the operating theatre, and then immediately before and after surgery. Results. Thirty-three patients (22%) developed bladder distension (500 ml), eight preoperatively and 25 postoperatively. A total of 21 patients (14%) had a bladder volume 300 ml immediately before surgery. Orthopaedic patients were more likely to develop preoperative bladder distension than surgical patients and had significantly higher postvoid residual volumes. In the binary logistic regression analysis age, gender and time of anaesthesia could not predict bladder distension. Patients undergoing orthopaedic surgical procedures, however, were prone to bladder distension (odds ratio 6.87, 95% confidence interval 1.76 to 26.79, p=0.006). Conclusions. This study shows that orthopaedic surgical patients are more prone to bladder distension perioperatively. The conventional method of encouraging patients to void at the ward before being transported to the operating theatre does not necessarily mean an empty bladder at the start of the operation.
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| 7. |
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| 8. |
- Lindholm, Elisabet, 1946, et al.
(författare)
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Ostomy-Related Complications After Emergent Abdominal Surgery : A 2-Year Follow-up Study.
- 2013
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - 1071-5754 .- 1528-3976. ; 40:6, s. 603-610
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to prospectively evaluate ostomy-related complications and describe ostomy configuration in patients undergoing acute abdominal surgery.SUBJECTS AND SETTING: The study sample comprised 144 patients with a median age of 67 years (IOR: 53.5-78 years) who underwent an intestinal ostomy as part of an acute abdominal surgical procedure. The research setting was the surgical and gynecological clinics at the Sahlgrenska University Hospital in Gothenburg, Sweden.METHODS: Ostomy configuration, diameter, height, and the presence of stomal and peristomal complications were assessed by a WOC nurse 1 to 2 times while in hospital, once at the ostomy outpatient clinic 2 weeks after discharge, and at 3, 6, 12, and 24 months following ostomy creation.RESULTS: The types of ostomies evaluated were end colostomy (58%), end ileostomy (18%), loop ileostomy (17%), and loop colostomy (7%). Most stomal or peristomal complications occurred within 1 year after surgery (31 of 57; 54.4%). Necrosis, separation, and stenosis were most common in patients with an end colostomy. Peristomal skin complications occurred in 45% of subjects during the first 6 months after surgery. The ostomy's diameter decreased significantly during the hospital course and over the first 2 weeks following hospital discharge in patients with end colostomy (P < .0001), end ileostomy (P < .0081), loop ileostomy (P = .008), and loop colostomy (ns). Patients with a low ostomy had peristomal skin problems ranging between 21% and 57% over this time period. The frequency of using a pouching system that incorporated convexity was highest in the case of loop ileostomy, used in 67% at 6 months.CONCLUSION: During the first 2 weeks after discharge, the physical configuration of the ostomy evolves and the pouching system must be frequently adjusted by a WOC nurse. Stomal and peristomal complications are prevalent during the first 2 postoperative years and especially during the first 6 months.
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| 9. |
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| 10. |
- Persson, Eva, 1953, et al.
(författare)
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Experiences of living with increased risk of developing colorectal and gynaecological cancer in individuals with no identified gene mutation
- 2012
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 26:1, s. 20-27
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Tidskriftsartikel (refereegranskat)abstract
- Background: In most families with familial cancers, mutations have not been demonstrated; thus, healthy individuals cannot be tested for mutation status. As a consequence, many persons at risk of familial cancer live with an unknown, but presumably high, risk of developing cancer.Aim: The aim of this study was to describe individuals’ perceptions of living with an increased isk of colorectal and gynaecologic cancer where the gene mutation is unknown.Methods: Interviews were conducted with 30 individuals with familial colorectal cancer. These ersons have no known mutation and therefore should be considered presumptive carriers. In onnection with the interviews, all participants were offered to take part in a surveillance programme consisting of a colonoscopy and gynaecological examinations. The interview ranscriptions were analysed by the use of qualitative content analysis.Results: Two themes emerged from the analyses: first, living under a threat with two ubthemes, threat awareness and distancing oneself from the threat. The second theme, living with uncertainty, was divided into four subthemes: influencing one’s family, being on the safe side, facing emotions evoked by examinations and trust and disappointment to the medical services.Conclusion: These persons live with a lifelong uncertainty with a varying intensity depending on what happens throughout the life trajectory. They have no diagnosis or patient group to elate to; therefore, the entire situation is often perceived as abstract. Thus, providing nformation and counselling needs to be more deeply elucidated, and we need to address both ituational and existential ways of uncertainty. This will, however, require professionals of all disciplines to understand the meaning of uncertainty and help ensure that its adverse effects re decreased with adequate nursing interventions.
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| 11. |
- Persson, Eva, et al.
(författare)
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Stoma-related complications and stoma size – a 2-year follow up
- 2010
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Ingår i: Colorectal Disease. - : Blackwell Publishing Ltd. - 1462-8910 .- 1463-1318. ; 12:10, s. 971-976
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Aim The purpose of the study was to prospectively describe stoma configuration and evaluate stoma-related complications and their association with possible risk factors. Method All elective patients (n = 180) operated on with a formation of colostomy, ileostomy or loop-ileostomy between 2003 and 2005 were included in the study. Follow up took place on the ward postoperatively and five times during 2 years after discharge. On these occasions the diameter and height of the stoma were recorded. Complications such as peristomal skin problems, necrosis, leakage caused by a low stoma, stenosis, granuloma formation, prolapse and peristomal hernia formation were evaluated. Results Most complications occurred 2 weeks after discharge; 53% of patients with colostomies, 79% with loop-ileostomies and 70% of patients with end-ileostomy had one or more complications. The most common complication was skin problems and it was most common in patients with end-ileostomies (60%) and loop-ileostomies (73%). Postoperatively at ward review, the most common complication was necrosis, which occurred in 20% of patients with a colostomy. Granuloma formation was most frequent in colostomies. Almost all patients with an end-ileostomy and loop-ileostomy with a height lower than 20 mm had leakage and skin problems as had half of the patients with a colostomy height lower than 5 mm. Conclusion To prevent stoma-related complications, it is important to produce an adequate height of the stoma, with early and regular follow ups and adjustment of the appliance. To work closely in collaboration with the colorectal surgeons is of utmost important to provide feedback and in turn, to improve stoma outcome.
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| 12. |
- Suleman Khan, Muhammad, et al.
(författare)
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Pharmacogenetics, Plasma Concentrations, Clinical Signs and EEG During Propofol Treatment
- 2014
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Ingår i: Basic & Clinical Pharmacology & Toxicology. - : Wiley. - 1742-7835 .- 1742-7843. ; 115:6, s. 565-570
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Tidskriftsartikel (refereegranskat)abstract
- A variety of techniques have been developed to monitor the depth of anaesthesia. Propofols pharmacokinetics and response vary greatly, which might be explained by genetic polymorphisms. We investigated the impact of genetic variations on dosage, anaesthetic depth and recovery after total intravenous anaesthesia with propofol. A total of 101 patients were enrolled in the study. The plasma concentration of propofol during anaesthesia was measured using high-performance liquid chromatography. EEG was monitored during the surgical procedure as a measure of anaesthetic depth. Pyrosequencing was used to determine genetic polymorphisms in CYP2B6, CYP2C9, the UGTIA9-promotor and the GABRE gene. The correlation between genotype and to plasma concentration at the time of loss of consciousness (LOC), the total induction dose, the time to anaesthesia, eye opening and clearance were investigated. EEG monitoring showed that the majority of the patients had not reached a sufficient level of anaesthetic depth (subdelta) at the time of loss of consciousness despite a high induction dose of propofol. Patients with UGT1A9-331C/T had a higher propofol clearance than those without (p=0.03) and required a higher induction dose (p=0.03). The patients with UGT1A9-1818T/C required a longer time to LOC (p=0.03). The patients with CYP2C9*2 had a higher concentration of propofol at the time of LOC (p=0.02). The polymorphisms in the metabolizing enzymes and the receptor could not explain the large variation seen in the pharmacokinetics of propofol and the clinical response seen. At LOC, the patients showed a large difference in EEG pattern.
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| 13. |
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| 14. |
- Andersson, Charlotta, et al.
(författare)
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Testbäddar för utveckling av högskolepedagogik i framtidens lärandemijöer
- 2024
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Konferensbidrag (refereegranskat)abstract
- Learning Lab är Akademiska Hus koncept med testbäddar som i nära samverkan med lärosäten utformas för att främja innovation, forskning om och utveckling av framtidens lärandemiljöer. En testbädd utgörs av en fysisk plats där rumsdesign, pedagogik, teknik, m.m ges utrymme att prototypas, utforskas och utvärderas för att generera erfarenheter och kunskaper om våra lärandemiljöer. För närvarande driver Akademiska Hus Learning Lab på tre orter tillsammans med Göteborgs universitet, Umeå universitet och Örebro universitet. Miljöerna är designade med olika fokusområden men med en gemensam inriktning – att utforska samspelet mellan pedagogik, sociala förutsättningar, rum och teknik – i syfte att driva högskolepedagogisk utveckling.Syftet med rundabordssamtalet äratt diskutera hur konceptet med testbäddar kan spridas vidare samtatt dela erfarenheter från testbäddarnas arbete med att arbeta med högskolepedagogisk utveckling och utforskandet av fysiska och hybrida lärandemiljöer samtatt stimulera erfarenhetsutbyte inför gemensamma frågeställningar kring högskolepedagogisk utveckling i skärningspunkt mellan pedagogik, rum & teknikRundabordssamtalet genomförs genom att representanter från respektive Learning Lab tillsammans med projektgruppen från Akademiska hus leder ett samtal om hur vi kan sätta pedagogiken i centrum vid utveckling av lärandemiljöer, hur vi skapar nödvändiga stödstrukturer för lärare som utforskar lärandemiljöer och utmaningarna i samverkan inom och mellan lärosätena.Rundabordssamtalet avslutas genom en gemensam digital dokumentation av deltagarnas samtal som görs tillgänglig för konferensens deltagare genom qr-kod/länk efter rundabordssamtalet.För att uppmuntra till deltagande så synliggörs några frågeställningar som rundabordssamtalet strävar efter att behandla:Learning Lab är ett uttryck för en kontext där högskolepedagogisk utveckling uppmuntras, stöttas och utvärderas. Hur uttrycker sig samma fenomen på andra håll utanför Learning Labs ramar?Vilka samtalsforum finns idag där fokus omfattar didaktisk spatial kompetens?Hur upplevs samverkan/samarbete mellan stödfunktioner som IT, lokalförsörjning m.m. i relation till högskolepedagogisk utveckling vid lärosätet? Mellan lärosäten?Hur ser den idealiska lärmiljön ut för en given undervisningssituation med förankring i min pedagogiska grundsyn?
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| 15. |
- Andersson, Helene
(författare)
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MRSA and other resistant bacteria : prevalence, patient and staff experiences, wounds and infection control
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Antibiotic resistance has become a major and serious global problem in healthcare. Limited treatment options for infections caused by these organisms can lead to increased morbidity and mortality. Sweden has a low prevalence of antibiotic resistance compared to most other countries but this presents an increasing problem for society and healthcare even in Sweden. The overall aim of this thesis was to illuminate potential problems related to antibiotic resistance from different perspectives: assessing the prevalence of resistant bacteria methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) or other resistant bacteria, and associated wound types, patient and health staff experiences when confronted with resistant bacteria infection, and the occurrence of such infections in the nursing home environment. In the first study a total of 2172 patients admitted to hospital or as out-patient visit at a University hospital during one day were examined with the purpose to identify all wounds, wound types and wound characteristics, and to identify bacteria in all wounds, particularly MRSA, VRE and multi-resistant Gramnegative rods. Four hundred and eight (19%) patients had a total of 668 wounds. Of these, 248 wounds, from 216 patients were cultured. Two unknown MRSA-patients were identified. No patient with VRE was found and there was a low prevalence of other multi-resistant bacteria. In the second study fifteen patients with MRSA infected wounds were interviewed. The aim was to ascertain and describe patients’ knowledge, perceptions and experiences of being MRSA-positive. The interviews were analyzed according to qualitative content analysis. From the analysis three categories and one overall theme were identified. Results showed that information about the MRSA diagnosis often caused a shock-like reaction. The patients’ perception of being MRSA-positive was that it was stigmatizing like the plague or leprosy; they felt dirty and a severe threat to their environment. Fears of infecting someone else and being rejected were commonly expressed. Knowledge and empathy from staff involved in their care was crucial to optimise patients’ experiences. Staff’s needs of education to meet patients’ demands for information, and to prevent spread of antibiotic contamination was essential. In the third study eight nurses and seven assistant nurses from different hospital wards and nursing homes were interviewed regarding their experiences of caring for MRSA-positive patients. Qualitative content analysis was carried out when analysing the data and three themes were identified during the process. Stress and too high workload were factors which were described to cause concerns in the caring situation. A major concern was that nurses felt at risk of becoming infected themselves and then transmitting the infection to other patients and to family members. Knowledge and ignorance about MRSA affected the nurses’ caring; ignorance made them afraid and insecure while knowledge and understanding shaped confidence in their role as caregivers. In the fourth study 560 residents in a total of 67 wards, in nine nursing homes were investigated for prevalence of MRSA, VRE and extended-spectrum β-lactamase (ESBL) - producing Enterobacteriaceae and if carriage of resistant bacteria was related to antibiotic treatment, other risk factors and/or staff´s adherence to guidelines for infection control. In all 296 staff members were interviewed and observed. No resident was positive for MRSA or VRE. Fifteen residents were found to be ESBL-positive. Usage of antibiotics was higher in wards where ESBL-positive residents were detected and there was an indication that there was transmission of ESBL between residents. Staff´s adherence to infection control guidelines sometimes revealed shortcomings but no significant difference regarding adherence to the guidelines could be found. In conclusion: Prevalence of MRSA appears low in both hospitalized patients, out-patients and nursing home residents. Adherence to infection control guidelines among healthcare staff, however, needs further improvement. MRSA colonized patients experienced psychological pressure and stigmatization. Knowledge and empathy from staff involved in their care is crucial to optimise patients’ experiences. Staff education to meet patients' demands for information and the prevention of contamination is essential
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| 16. |
- Arvidsson, Eva, 1959-, et al.
(författare)
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Vägen framåt
- 2013
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Ingår i: Att välja rättvist. - Lund : Studentlitteratur AB. ; , s. 207-214
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Som vi visat har utvecklingen av metoder och strukturer för öppna prioriteringar i Sverige kommit långt. Många frågor återstår likväl. Under vårt arbete med denna bok har vi identifierat ett antal förbättringsområden och utmaningar som vi avslutningsvis vill lyfta fram. Det rör sig om vilka som ska delta i prioriteringarna, tydliggörande av värdegrunden, behov av bättre kunskap, baserad på både vetenskaplig metod och erfarenhet, och fortsatt utveckling av prioriteringsprocesser på olika nivåer och i olika sammanhang. Även om vi i Sverige skulle nå en god enighet kring principer och kriterier för prioriteringar så kommer vi alltid finna många olika sätt att praktiskt lösa specifika prioriteringsproblem.
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| 17. |
- Berggren, Eva, 1955-, et al.
(författare)
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Creating an Entrepreneurial region
- 2008
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Ingår i: Bridging the Functional and Territorial views on Regional Entrepreneurship and Development. - Örebro : Forum för småföretagsforskning. - 9189301277 ; , s. 35-54
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 18. |
- Berggren, Eva, 1955-, et al.
(författare)
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Creating an entrepreneurial region : Two waves of academic spin-offs from Halmstad University
- 2009
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Ingår i: European Planning Studies. - : Taylor & Francis. - 0965-4313 .- 1469-5944. ; 17:8, s. 1171-1189
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Tidskriftsartikel (refereegranskat)abstract
- This article presents a Swedish case study of the regional effects of academic spin-offs. It is based on empirical data from Halmstad University and the Halmstad region, on the west coast of Sweden. The Halmstad case functions as an illustration of co-existing territorial and functional rationales, where a “rurban” lifestyle is combined with an increasingly “pracademic” knowledge. Spillover effects of university research (directly as well as indirectly) in the form of academic spin-offs have been traced over time. In doing so, we are able to identify two waves of academic entrepreneurship with direct and indirect regional effects. These waves contribute to the strengthening of the regional entrepreneurship and the attractiveness of the region. The establishment and (early) actions of the university can be seen as a stone that was thrown in the water, causing several waves to appear in the region. Whether these waves will be reinforced enough to create an entrepreneurial region, or just slowly disappear as rings on the water, also depends on the creation of an absorptive capacity and construction of the regional innovation system.
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| 19. |
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| 20. |
- Berggren, Eva, 1955-
(författare)
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Student Entrepreneurs : The Influence of University, Entrepreneurship Education and Research
- 2009
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This licentiate thesis deals with the questions if and how entrepreneurship education and access to research at university stimulate student start-ups. The phenomenon of student entrepreneurs is approached in three empirical studies. In the first study mail questionnaires were sent out to former entrepreneurship students at three universities in Sweden, in order to find out if the students’ entrepreneurial behaviour was influenced by education. The second study explores differences in communication skills and the handling of liabilities of newness between entrepreneurs with entrepreneurship education at university and/or previous start-up experience. Student entrepreneurs are compared with a control group of randomly chosen Swedish entrepreneurs. In the third study, the influence from university research on student entrepreneurship as well as direct and indirect regional effects are examined through interviews with university spin-offs around Halmstad University. Entrepreneurship education at university is found to influence entrepreneurial behaviour, to increase the student’s awareness of business opportunities and to result in high start-up frequency early in life. The student entrepreneurs perceive fewer problems to handle some aspects of liability of newness as well as communicative skills in terms of openness and adaptation. Other-orientation is on the other hand supported by previous start-up experience. Hence, with experience from both entrepreneurship education and previous start-up, the students seem well prepared for future start-ups. The case study show multiple and long term indirect effects from student entrepreneurship in developing an entrepreneurial region. Established student entrepreneurs support less experienced student entrepreneurs by linking them to supplementary resources. Students are found to shoulder an important role as academic entrepreneurs in interaction with other individuals connected to the university.
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| 21. |
- Brorsson, Anna Lena, 1964-, et al.
(författare)
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Does treatment with an insulin pump improve glycaemic control in children and adolescents with type 1 diabetes? : A retrospective case-control study
- 2015
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Ingår i: Pediatric Diabetes. - : Hindawi Limited. - 1399-543X .- 1399-5448. ; 16:7, s. 546-553
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate long-term effects on glycaemic control, ketoacidosis, serious hypoglycaemic events, insulin requirements, and body mass index standard deviation scores (BMI-SDS) in children and adolescents with type 1 diabetes starting on continuous subcutaneous insulin infusion (CSII) compared with children and adolescents treated with multiple daily injections (MDI).METHODS: This retrospective case-control study compares 216 patients starting CSII with a control group on MDI (n = 215), matched for glycated hemoglobin (HbA1c), sex, and age during a 2-yr period. Variables collected were gender, age, HbA1c, insulin requirement, BMI, BMI-SDS, ketoacidosis, and serious hypoglycaemic events.RESULTS: In the CSII group there was an improvement in HbA1c after 6 and 12 months compared with the MDI group. For boys and girls separately the same effect was detected after 6 months, but only for boys after 12 months. The incidence of ketoacidosis was higher in the CSII group compared with the MDI group (2.8 vs. 0.5/100 person-yr). The incidences of severe hypoglycaemic episodes per 100 person-yr were three in the CSII group and six in the MDI group (p < 0.05). After 6, 12, and 24 months, the insulin requirement was higher in the MDI group.CONCLUSIONS: This study shows that treatment with CSII resulted in an improvement in HbA1c levels up to 1 yr and decreased the number of severe hypoglycaemic events, but the frequency of ketoacidosis increased. The major challenge is to identify methods to maintain the HbA1c improvement, especially among older children and teenagers, and reduce the frequency of ketoacidosis.
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| 22. |
- Carlsson, Eva, 1959, et al.
(författare)
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The Prevalence of Ostomy-related Complications 1 Year after Ostomy Surgery: A Prospective, Descriptive, Clinical Study
- 2016
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Ingår i: Ostomy/Wound Management. - 0889-5899. ; 62:10, s. 34-48
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Tidskriftsartikel (refereegranskat)abstract
- Despite advancements in the creation and care of stomas, ostomy and peristomal skin complications are common immediately following surgery as well as in the months and years thereafter. A prospective study to determine the prevalence of ostomy and peristomal skin complications and the influence of ostomy configuration on such complications was conducted 1 year after ostomy surgery among all patients at a university hospital in Sweden. All participants received regular (10 to 14 days post discharge, 6 weeks, 3 months, 6 months, and 1 year post surgery) ostomy follow-up care by a wound ostomy continence (WOC) nurse. All consecutive elective and emergency patients who had undergone surgery to create a colostomy (end colostomy), end ileostomy, or loop ileostomy were eligible to participate. Patients who were reoperated during their first year post-surgery, patients with a urostomy, and patients with double ostomies were excluded from the study. Patient data collected included age, gender, diagnosis, elective or emergency surgery, open or laparoscopic surgical procedure, presence of a colorectal surgeon specialist at surgery, type of ostomy (colostomy, end ileostomy, loop ileostomy), preoperative ostomy siting, counseling, body mass index, American Society of Anesthesiologists classification, and radiation and/or chemotherapy status. Ostomies were evaluated by 4 WOC nurses as to stoma configuration, convexity use, patient self-sufficiency in stoma care, and complications. All 207 patients (53% women) who were eligible agreed to participate in the study. Patient median age was 70 years (range 19-94); 74% underwent elective surgery. Main diagnoses were colorectal cancer (62%) and inflammatory bowel disease (19%). Ostomy types were: colostomy (71%), end ileostomy (26%), and loop ileostomy (3%). One or more complications occurred in 35% of the patients (27% ostomy complications, 11% peristomal skin complications). A colostomy hernia was the most common surgical complication (20%), and significantly more women (69%) and emergency surgeries were noted among patients with a colostomy and an ostomy height of ≤5 mm. The use of convexity was significantly more common among patients with a stoma height of ≤5 mm than patients with stomas >5 mm (P ≤ 0.016) and among patients having emergency operations than among patients having elective surgery (P ≤ 0.045). Of the emergency surgeries, 37% had not been ostomy-sited (P <0.0001). With regular WOC nurse follow-up, the prevalence of peristomal skin complications in this population was low, and adequate ostomy height might have prevented the frequent use of convexity. Explorative studies are needed that consider differences in body configuration when determining optimal stoma height, especially for patients who require emergency surgery.
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| 23. |
- Cavelier, L, et al.
(författare)
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MtDNA mutations in maternally inherited diabetes : presence of the 3397 ND1 mutation previously associated with Alzheimer's and Parkinson's disease
- 2001
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Ingår i: Hereditas. - : Springer Science and Business Media LLC. - 0018-0661 .- 1601-5223. ; 135:1, s. 65-70
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Tidskriftsartikel (refereegranskat)abstract
- Mutations in the mitochondrial tRNA(leu) (UUR) gene have been associated with diabetes mellitus and deafness. We screened for the presence of mtDNA mutations in the tRNA(leu) (UUR) gene and adjacent ND1 sequences in 12 diabetes mellitus pedigrees with a possible maternal inheritance of the disease. One patient carried a G to A substitution at nt 3243 (tRNA(leu) (UUR) gene) in heteroplasmic state. In a second pedigree a patient had an A to G substitution at nt 3397 in the ND1 gene. All maternal relatives of the proband had the 3397 substitution in homoplasmic state. This substitution was not present in 246 nonsymptomatic Caucasian controls. The 3397 substitution changes a highly conserved methionine to a valine at aa 31 and has previously been found in Alzheimer's (AD) and Parkinson's (PD) disease patients. Substitutions in the mitochondrial ND1 gene at aa 30 and 31 have associated with a number of different diseases (e.g. AD/PD, MELAS, cardiomyopathy and diabetes mellitus, LHON, Wolfram-syndrome and maternal inherited diabetes) suggesting that changes at these two codons may be associated with very diverse pathogenic processes. In a further attempt to search for mtDNA mutations outside the tRNAleu gene associated with diabetes, the whole mtDNA genome sequence was determined for two patients with maternally inherited diabetes and deafness. Except for substitutions previously reported as polymorphisms, none of the two patients showed any non-synonymous substitutions either in homoplasmic or heteroplasmic state. These results imply that the maternal inherited diabetes and deafness in these patients must result from alterations of nuclear genes and/or environmental factors.
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| 24. |
- Cordtz, Rene Lindholm, et al.
(författare)
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Haematological malignancies in patients with psoriatic arthritis overall and treated with TNF inhibitors : a Nordic cohort study
- 2022
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Ingår i: RMD Open. - : BMJ Publishing Group Ltd. - 2056-5933. ; 8:2
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To evaluate the risk of haematological malignancies in patients with psoriatic arthritis (PsA) overall, and in relation to treatment with tumour necrosis factor inhibitors (TNFi).Methods We identified that patients with PsA starting a first TNFi from the clinical rheumatology registers (CRR) in the five Nordic countries (n=10 621) and biologics-naive PsA patients from (1) the CRR (n=18 705) and (2) the national patient registers (NPR, n=27 286, Sweden and Denmark) from 2006 through 2019. For Sweden and Denmark, general population comparators were matched 5:1 to PsA patients on birth year, year at start of follow-up and sex. By linkage to the national cancer registers in all countries, we collected information on haematological malignancies overall, and categorised into lymphoid or myeloid types. We estimated incidence rate ratios (IRRs) with 95% CIs using modified Poisson regression for TNFi-treated versus biologics-naive PsA patients and versus the general population adjusted for age, sex, calendar period and country.Results During 59 827 person-years, 40 haematological malignancies occurred among TNFi-treated patients with PsA resulting in a pooled IRR of 0.96 (0.68-1.35) versus biologics-naive PsA from CRR and an IRR of 0.84 (0.64-1.10) versus biologics-naive PsA from NPR. The IRR of haematological malignancies in PsA overall versus general population comparators was 1.35 (1.17-1.55). The estimates were largely similar for lymphoid and myeloid malignancies.Conclusions Treatment with TNFi in patients with PsA was not associated with an increased incidence of haematological malignancies. Conversely, a moderately increased underlying risk was seen in patients with PsA compared with the general population.
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- Dahlgren, Liselotte, et al.
(författare)
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Human papillomavirus is more common in base of tongue than in mobile tongue cancer and is a favorable prognostic factor in base of tongue cancer patients.
- 2004
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 112:6, s. 1015-9
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Tidskriftsartikel (refereegranskat)abstract
- The frequency of human papilloma virus (HPV) and its influence on clinical outcome was analyzed retrospectively in pre-treatment paraffin embedded biopsies from 110 patients with tongue cancer. The presence of HPV DNA was examined in 85 mobile tongue tumors and 25 base of tongue tumors by a polymerase chain reaction (PCR) with 2 general primer pairs, GP5+/6+ and CPI/IIG. When HPV-DNA was found, HPV-type specific primers and direct sequencing were used for HPV sub-type verification. Twelve of 110 (10.9%) samples were HPV-positive; 9 for HPV-16, 1 for HPV-33, 1 for HPV-35 and 1 could not be analyzed because of shortage of DNA. HPV was significantly more common in base of tongue tumors (10/25, 40.0%) compared to tumors of the mobile tongue (2/85, 2.3%). The influence of HPV on clinical outcome in mobile tongue cancer could not be studied, due to that HPV was present in too few cases. Of the 19 patients with base of tongue cancer that were included in the survival analysis, however, 7 patients with HPV-positive base of tongue cancer had a significantly favorable 5-year survival rate compared to the 12 HPV-negative patients. In conclusion, HPV is significantly more common in base of tongue cancer than in mobile tongue cancer, and has a positive impact on disease-specific survival in patients with base of tongue cancer.
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