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| 4. |
- Astermark, J., et al.
(författare)
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Symposium in memory of Professor Inga Marie Nilsson
- 2001
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Ingår i: Haemophilia. - : Wiley. - 1351-8216. ; 7:4, s. 401-410
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Konferensbidrag (refereegranskat)abstract
- Professor Inga Marie Nilsson (1923-99) was a pioneer in the field of bleeding and thrombo-embolic disorders and made several major scientific contributions during her career. To honour her memory, colleagues from all over the world were invited to cover several aspects of haemostasis by giving state-of-the-art lectures at an international symposium in Malmö on September 22-23, 2000, chaired by Professors Lou Aledort and Erik Berntorp. Colleagues of Professor Nilsson in Malmö gave a short introduction to each topic. A short review of the meeting will be presented.
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| 5. |
- Hedenstierna, L, et al.
(författare)
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THE ASSOCIATION BETWEEN SOCIAL STRESSORS AND DISEASE REMISSION AMONG MEN AND WOMEN WITH EARLY RHEUMATOID ARTHRITIS
- 2021
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Ingår i: ANNALS OF THE RHEUMATIC DISEASES. - : BMJ. - 0003-4967 .- 1468-2060. ; 80, s. 474-475
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The role of psychosocial conditions on the disease course of rheumatoid arthritis (RA) is getting increased attention. In our previous study, low social support and low decision latitude at work were associated with known modifiable risk factors for RA disease development, such as smoking and low educational level (1). Further, smoking and low educational level have previously been shown to be associated with worse RA disease outcome (2-4). Whether psychosocial characteristics are related to RA disease outcome needs further investigation.Objectives:To investigate the relationship between two psychosocial characteristics: low social support and low decision latitude at work, and achievement of remission in patients with RA.Methods:At inclusion in the Swedish EIRA study, incident RA cases (N=3724) and controls (N=5937), matched for age, sex and residential area, responded to a questionnaire including questions on social support and decision latitude at work. The answers were recoded into separate scores and the distribution of the scores among controls were used to define the exposures. Low social support and low decision latitude at work, respectively, among patients, were set as the level corresponding to the lowest quartile among controls, and were compared with scores corresponding to the remaining three quartiles.The outcome, disease activity score 28-joint count (DAS28) remission, defined as DAS28<2.6, was captured through linkage with the Swedish Rheumatology Quality Register (SRQ) with data available from diagnosis for 2693 out of 3700 cases for social support and for 847 out of 1248 cases for decision latitude at work.Logistic regression was used to evaluate the association between low social support or low decision latitude at work, respectively, and the chance of remission at the time-points 3 months, 12 months and 60 months after inclusion. All results were adjusted for age, sex and residential area and the fully adjusted models were also adjusted for smoking, obesity, physical activity and educational level.Results:Low social support (n=655) was associated with a reduced chance for remission at all three time points in the model adjusted for age, sex and residential area; OR 3 months 0.77 (95% CI 0.61-0.97), OR 12 months 0.78 (95% CI 0.64-0.95) OR 60 months 0.77 (95% CI 0.59-0.99). This association was diminished after further adjustment. After stratifying for sex, this association was enhanced in women but inverse among men (Figure 1).No association between low decision latitude at work (n=166) and chance for remission was observed neither in the analyses stratified for matching variables, nor in the full model. This result was only marginally changed after stratifying for sex (Figure 1).Conclusion:Low social support was associated with lower chance of remission in early RA, but the association was not independent of other risk factors for worse outcome (smoking, physical activity, obesity and low educational level).The interrelationship between social stressors and previously known risk factors for worse outcome highlights the importance of supportive actions at many levels to increase the possibility for the individual to make healthy decisions.References:[1]Hedenstierna. et al. Scand J Rheumatol. 2021:1-5.[2]Saevarsdottir, et al. Ann Rheum Dis. 2011;70(3):469-75.[3]Saevarsdottir, et al. Arthritis Rheum. 2011;63(1):26-36.[4]Jiang, et al. Arthritis Res Ther. 2015;17:317.Figure 1.Odds ratios for assiciation between social stressors and DAS 28 remissionAcknowledgements:We want to thank all the participants of the EIRA study and the clinical collaborators for their valuable contribution. We also want to thank the staff for their dedicated work with the data collection.Disclosure of Interests:None declared
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| 6. |
- Hoots, W. K., et al.
(författare)
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Secondary prophylaxis with recombinant activated factor VII improves health-related quality of life of haemophilia patients with inhibitors
- 2008
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Ingår i: Haemophilia. - : Wiley. - 1351-8216 .- 1365-2516. ; 14:3, s. 466-466
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Tidskriftsartikel (refereegranskat)abstract
- Haemophilia patients with inhibitors characteristically have impaired joint function and reduced health-related quality of life (HRQoL). This analysis examined whether secondary prophylaxis with recombinant activated factor VII (rFVIIa) improves HRQoL vs. conventional on-demand therapy in patients with haemophilia with inhibitors and frequent bleeds. After a 3-month preprophylaxis period, 22 patients received daily rFVIIa prophylaxis (90 or 270 mu g kg(-1)) for 3 months, followed by 3 months' postprophylaxis. Days of hospitalization, absence from school/work and mobility aids requirements were recorded. HRQoL was assessed by EuroQoL (EQ-5D) questionnaire, visual analogue scale (VAS), derived Time to Trade-Off (TTO) scores and Quality Adjusted Life Years (QALYs). rFVIIa prophylaxis significantly (P < 0.0001) reduced bleeding frequency vs. prior on-demand therapy. Hospitalization (5.9% vs. 13.5%; P = 0.0026) and absenteeism from school/work (16.7% vs. 38.7%; P = 0.0127) decreased during prophylaxis; these effects tended to be maintained during postprophylaxis. HRQoL (evaluated by EQ-5D) tended to improve during and after rFVIIa prophylaxis. Notably, pain decreased and mobility increased in 40.9% and 27.3% of patients, respectively, at the end of the postprophylaxis period vs. preprophylaxis. Median VAS score increased from 66 to 73 (P = 0.048), and TTO scores suggested better HRQoL (0.62 vs. 0.76; P = 0.054) during postprophylaxis than preprophylaxis. Small to moderate changes in effect sizes were reported for VAS and TTO scores. Median QALYs were 0.68 (VAS) and 0.73 (TTO). Reductions in bleeding frequency with secondary rFVIIa prophylaxis were associated with improved HRQoL vs. on-demand therapy.
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| 7. |
- Schramm, W., et al.
(författare)
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Haemophilia Care in Europe: the ESCHQoL study
- 2012
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Ingår i: Haemophilia. - : Wiley. - 1351-8216. ; 18:5, s. 729-737
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine the clinical conditions of patients with haemophilia within Europe as recommended by the European Commission. In this multicentre, cross-sectional, ambispective study, conducted within 21 European countries patients' clinical data were collected, amongst others haemophilia type, severity, treatment pattern, use of factor products, bleeding, orthopaedic joint scores and infections. A total of 1400 patients, 84.3% with haemophilia A and 15.7% with haemophilia B were enrolled by 42 centres between 2004 and 2006. Thereof, 417 were children (30.0%) and 983 were adults (70.0%). About 70% of patients had severe factor deficiency (<1%). More than half of the adults were carriers of chronic infections (12.6% HIV, 55.8% HCV), compared to only 3.8% children (no HIV, 2.9% HCV). Patients were grouped according to per capita amount of clotting factor used in patients' region of residence in 2005: region 1: >5 IU; region 2: 25 IU; region 3: <2 IU. Paediatric and adult patients in region 3 had median numbers of three and eight joint bleeds, respectively, with worse joint scores compared to region 1 with zero and one bleed. Prophylactic therapy was used in only 31.3% children and 8.9% adults with severe haemophilia in region 3 compared to 93.7% and 54.1%, respectively, in region 1. Statistical analysis revealed that residence in areas with low factor consumption/availability is the most prominent risk factor for joint disease. Access of European patients with haemophilia to optimal care with safe factor VIII concentrates is limited and depends on the region of residence.
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| 8. |
- Brink, M, et al.
(författare)
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PULMONARY FIBROSIS IN EARLY RHEUMATOID ARTHRITIS IN RELATION TO GENETIC LOCI AND INDIVIDUAL ACPA SPECIFICITIES
- 2022
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Ingår i: ANNALS OF THE RHEUMATIC DISEASES. - : BMJ. - 0003-4967 .- 1468-2060. ; 81, s. 203-204
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Pulmonary manifestations in rheumatoid arthritis (RA) are common comorbidities but the underlying mechanisms are largely unknown. We found in a previous study 3 SNPs associated with pulmonary fibrosis (PF); rs35705950 (MUC5B), rs111521887 (TOLLIP), and rs2609255 (FAM13A) besides age, rheumatoid factor positivity and methotrexate treatment.ObjectivesTo evaluate for the added value of a multiplex of anti-citrullinated peptide antibodies (ACPA) for the development of pulmonary fibrosis (PF) in an inception cohort of RA patients.MethodsA total of 1184 patients with early RA were consecutively included and followed prospectively from the date of diagnosis (index date) until death or until 31 December 2016. The diagnosis of PF was based on high resolution tomography. The presence of 21 ACPA fine specificities were analysed in plasma sampled at index date, using a custom-made microarray chip (Thermo Fisher Scientific, Uppsala, Sweden). Data on both ACPA and genetic data was available for 841 RA patients, of whom 50 developed PF. Associations were analysed using logistic regression analysis and presented as the odds ratio (OR) with the 95% confidence interval (CI). Models were adjusted for sex, age, DAS28 and presence of RF at RA diagnosis, smoking ever, and HLA-SE and in a second step for the three SNPs (.rs35705950, rs111521887 and rs2609255), respectively.ResultsIn unadjusted analyses eight ACPA reactivities were found associated with PF development (p< 0.05-0.001). The number of ACPA reactivities was related to PF development, both in crude and adjusted models (p<0.05 for both). In models concomitantly adjusted for the three SNPs (rs35705950, rs111521887 and rs2609255) respectively, in addition to mentioned adjustments the number of ACPA reactivities (p<0.05 for all three nmodels), Vim60-75 (p<0.05, in all three models), Fibβ62–78 (72) (p<0.001-p<0.05) and F4-CIT-R (p<0.01-p<0.05) were all found significantly associated to PF development irrespective of the SNPs.ConclusionThe development of PF in an inception cohort of RA patients was associated both with risk genes and, independently of the risk genes, the presence of certain ACPA, and the number of ACPA reactivities.References[1]Jönsson E, et al. Pulmonary fibrosis in relation to genetic loci in an inception cohort of patients with early rheumatoid arthritis from northern Sweden. Rheumatology (Oxford). 2021 May 16:keab441. doi: 10.1093/rheumatology/keab441.AcknowledgementsI have no acknowledgements to declare. The staff and patients at the departments of rheumatology in northern Sweden.Disclosure of InterestsNone declared
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| 9. |
- Charrieau, Laurie M., et al.
(författare)
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The effects of multiple stressors on the distribution of coastal benthic foraminifera: A case study from the Skagerrak-Baltic Sea region
- 2018
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Ingår i: Marine Micropaleontology. - : Elsevier BV. - 0377-8398. ; 139, s. 42-56
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Tidskriftsartikel (refereegranskat)abstract
- Coastal ecosystems are subjected to both large natural variability and increasing anthropogenic impact on environmental parameters such as changes in salinity, temperature, and pH. This study documents the distribution of living benthic foraminifera under the influence of multiple environmental stressors in the Skagerrak-Baltic Sea region. Sediment core tops were studied at five sites along a transect from the Skagerrak to the Baltic Sea, with strong environmental gradients, especially in terms of salinity, pH, calcium carbonate saturation and dissolved oxygen concentration in the bottom water and pore water. We found that living foraminiferal densities and species richness were higher at the Skagerrak station, where the general living conditions were relatively beneficial for Foraminifera, with higher salinity and Ωcalc in the water column and higher pH and oxygen concentration in the bottom and pore water. The most common species reported at each station reflect the differences in the environmental conditions between the stations. The dominant species were Cassidulina laevigata and Hyalinea balthica in the Skagerrak, Stainforthia fusiformis, Nonionella aff. stella and Nonionoides turgida in the Kattegat and N. aff. stella and Nonionellina labradorica in the Öresund. The most adverse conditions, such as low salinity, low Ωcalc, low dissolved oxygen concentrations and low pH, were noted at the Baltic Sea stations, where the calcareous tests of the dominant living taxa Ammonia spp. and Elphidium spp. were partially to completely dissolved, probably due to a combination of different stressors affecting the required energy for biomineralization. Even though Foraminifera are able to live in extremely varying environmental conditions, the present results suggest that the benthic coastal ecosystems in the studied region, which are apparently affected by an increase in the range of environmental variability, will probably be even more influenced by a future increase in anthropogenic impacts, including coastal ocean acidification and deoxygenation.
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| 10. |
- Forsblad-d'Elia, H, et al.
(författare)
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Biomechanical Properties of Common Carotid Arteries Assessed by Circumferential 2D Strain and β Stiffness Index in Patients With Ankylosing Spondylitis
- 2021
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Ingår i: The Journal of rheumatology. - : The Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 48:3, s. 352-360
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Tidskriftsartikel (refereegranskat)abstract
- Ankylosing spondylitis (AS) is associated with an elevated risk of cardiovascular disease (CVD) related to atherosclerosis, preceded by arterial stiffness. We aimed to examine common carotid artery (CCA) biomechanical properties using ultrasound to calculate β stiffness index (indicating arterial stiffness) and, a more recently developed technique, 2-dimensional (2D) speckle tracking strain (indicating arterial motion and deformation, strain) to (1) compare with age- and sex-matched controls, and (2) analyze relationships between strain and stiffness with disease characteristics and traditional risk factors for CVD in patients with AS.Methods.In this cross-sectional study, a cohort of 149 patients with AS, mean age 55.3 ± 11.2 years, 102 (68.5%) men, and 146 (98%) HLA-B27–positive, were examined. Bilateral CCA were examined for circumferential 2D strain and β stiffness index. A subgroup of 46 patients was compared with 46 age- and sex-matched controls, both groups without hypertensive disease, diabetes, myocardial infarction, or stroke.Results.Mean bilateral circumferential 2D strain was lower in AS patients compared with controls (7.9 ± 2.6% vs 10.3 ± 1.9%, P < 0.001), whereas mean bilateral β stiffness index was higher (13.1 ± 1.7 mmHg/mm vs 12.3 ± 1.3 mmHg/mm, P = 0.02). In multivariable linear regression analyses, strain was associated with age, erythrocyte sedimentation rate, history of anterior uveitis, and treatment with conventional synthetic disease-modifying antirheumatic drugs (DMARD) and/or biological DMARD (R2 0.33), while stiffness was associated with age (R2 0.19).Conclusion.Both CCA circumferential 2D strain and β stiffness index differed between patients with AS and controls. Strain was associated with AS-related factors and age, whereas only age was associated with stiffness, suggesting that the obtained results reflect different pathogenic vascular processes.
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| 11. |
- Graham, J. B., et al.
(författare)
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The Malmo polymorphism of coagulation factor IX, an immunologic polymorphism due to dimorphism of residue 148 that is in linkage disequilibrium with two other F.IX polymorphisms
- 1988
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Ingår i: American Journal of Human Genetics. - 0002-9297. ; 42:4, s. 573-580
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Tidskriftsartikel (refereegranskat)abstract
- A mouse monoclonal antibody (MAB 9,9) to coagulation factor IX (F.IX) detects a polymorphism in the plasma of normal people. Its epitope has been narrowed down to <6 amino acids in the activation peptide of the X-linked F.IX protein. The activation peptide contains a dimorphism - Thr:Ala - at position 148 of the protein. Using synthetic oligonucleotides, we have demonstrated that (1) the F.IX which reacts with 9.9 has Thr at position 148 and (2) that which does not has Ala. Positive reactors (148(thr)) are designated Malmo A, and negative reactors (148(ala)) are designated Malmo B. The plasma levels of AA women are indistinguishable from those of A men, and both B men and BB women are null against MAB 9.9. The plasma level of Malmo A in AB women is approximately half that of AA women, and 'lyonization' is clearly operating in the heterozygotes. The dimorphism is in strong linkage disequilibrium with two other intragenic RFLPs, TaqI and XmnI. Furthermore, intragenic crossing-over - including double crossing-over - appears to have occurred between the three sites. Seven of the eight possible haplotypes have been identified, five in men and two others in women. The immunoassay that identifies ~50% of the AB women in the pool of Malmo A females with 95% confidence identifies men unambiguously as A or B. The assay would be very useful for population-genetic studies of the Malmo epitope if the studies were limited to men.
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| 18. |
- Ljung, Karl, et al.
(författare)
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Recent Increased Loading of Carbonaceous Pollution from Biomass Burning in the Baltic Sea
- 2022
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Ingår i: ACS Omega. - : American Chemical Society (ACS). - 2470-1343. ; 7, s. 35102-35108
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Tidskriftsartikel (refereegranskat)abstract
- Black carbon (BC), spheroidal carbonaceous particles (SCP), and polycyclic aromatic hydrocarbons (PAH) are carbonaceous pollutants affecting the climate, environment, and human health. International regulations limit their emissions, and the present emissions are followed by monitoring programs. However, the monitoring programs have limited spatio-temporal coverage and only span the last decades. We can extend the knowledge of historical emission rates by measuring pollution levels in radiometrically dated marine and lacustrine sediment sequences. Here we present measurements of BC, SCP, and PAH from a sediment sequence sampled in the Öresund strait, between Denmark and Sweden and dated back to CE 1850. Our data show a massive increase in the burial rates of all measured pollutants starting in the 1940s. The pollution deposition peaked in the 1970-1980s and declined through the 1990s. However, the declining trend was reversed in the 2000s. Source appointment of PAHs shows a relatively higher contribution of emissions from wood-burning since CE 2000. This coincides with a change towards the increased use of biomass for both municipal and regional energy production in Scandinavia. Our results demonstrate that changes in energy production have caused changes in the delivery of carbonaceous pollution to marine environments. The increase in particle emissions from wood burning is potentially posing a future environmental and health risk.
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| 19. |
- Ljung, L., et al.
(författare)
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Good response on tumour necrosis factor inhibitors is associated with a decreased risk of acute coronary syndrome in patients with rheumatoid arthritis
- 2014
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Ingår i: Scandinavian Journal of Rheumatology. - : Informa Healthcare. - 0300-9742 .- 1502-7732. ; 43:Suppl. 127 Meeting Abstract OP11/PP156, s. 8-8
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Inflammatory activity, as well as traditional cardiovascular risk factors, is thought to underlie the increased risk of coronary disease in patients with rheumatoid arthritis (RA). We therefore wanted to evaluate whether the level of response to tumour necrosis factor inhibitors (TNFi) in RA are associated with the risk of acute coronary syndrome (ACS).Method: All patients with RA and no previous ischaemic heart disease who started treatment with a first TNFi during 2001–2010 as registered in the Swedish Biologics Register were identified. Of the patients (n ¼ 6615) at risk for exposure (i.e. EULAR response at 5 3 months), response data was available for 75% (n¼ 4938). For each patient, five matched referents were selected randomly from the Population Register. Follow-up was maximized to 1 and 2 years, respectively. The outcome, incident ACS, was defined as a primary discharge diagnosis of myocardial infarction or unstable angina, or myocardial infarction as the underlying cause of death. Incidence rates were calculated and adjusted Cox proportional hazard regression models were used for risk estimations.Results: During the first year of follow-up, 33 cases of ACS occurred among the patients. The risk (hazard ratio, HR) of ACS for good responders compared with none responders, fully adjusted, was 0.26 (95% CI 0.08–0.83), and for moderate responders compared with no responders 0.81 (95% CI 0.36–1.79). Compared with the general population no increase in the risk of ACS was observed among good responders (HR 0.74, 95% CI 0.27–2.06). The lower risk of ACS among good responders was also noted during 2 years of follow-up.Conclusions: Good EULAR response after 5 months of treatment with TNFi in RA patients was associated with a significantly decreased risk of ACS. In patients with good response on therapy, no significant increase in the risk of ACS was detectable in comparison with the risk in the general population during the 2 years after the evaluation.
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| 22. |
- Lundin, Björn, et al.
(författare)
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An MRI scale for assessment of haemophilic arthropathy from the International Prophylaxis Study Group.
- 2012
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Ingår i: Haemophilia. - : Wiley. - 1351-8216. ; 18:6, s. 962-970
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Tidskriftsartikel (refereegranskat)abstract
- Evaluation of prophylactic treatment of haemophilia requires sensitive methods. To design and test a new magnetic resonance imaging (MRI) scale for haemophilic arthropathy, two scales of a combined MRI scoring scheme were merged into a single scale which includes soft tissue and osteochondral subscores. Sixty-one joint MRI's of 46 patients with haemophilia were evaluated by four radiologists using the new and older scales. Forty-six of the joints were evaluated using two X-ray scales. For all MRI scores, interreader agreement and correlations with X-ray scores and lifetime number of haemarthroses were analysed. The interreader agreement intraclass correlation coefficient was 0.82, 0.89 and 0.88 for the soft tissue and osteochondral subscores and the total score, as evaluated according to the new MRI scale, compared to 0.80 and 0.89 as for the older scales. The total score and osteochondral subscore according to the new scale, as well as scores according to the older scales were correlated (P < 0.01) with number of haemarthroses (Spearman correlation 0.35-0.68) and with the X-ray scores (Spearman correlation 0.40-0.76), but no correlation (P > 0.05) was found between the soft tissue subscore of the new MRI scale and the X-ray scores. The new MRI scale is simpler to apply than the older and has similar reader reliability and correlation with lifetime number of haemarthroses, and by separating soft tissue and osteochondral changes it gives additional information. The new scale is useful for analyses of early and moderate stages of arthropathy, and may help to evaluate prophylactic haemophilia treatment.
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| 23. |
- Morris, A, et al.
(författare)
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The Development of a Multidisciplinary System to Understand Causal Factors in Road Crashes
- 2006
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Ingår i: 42nd Annual Human Factors and Ergonomics Society of Australia Conference 2006, HFESA 2006. - 9781622769599 ; , s. 31-38
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The persistent lack of crash causation data to help inform and monitor road and vehicle safety policy is a major obstacle. Data are needed to assess the performance of road and vehicle safety stakeholders and is needed to support the development of further actions. A recent analysis conducted by the European Transport Safety Council identified that there was no single system in place that could meet all of the needs and that there were major gaps including in-depth crash causation information. This paper describes the process of developing a data collection and analysis system designed to fill these gaps. A project team with members from 7 countries was set up to devise appropriate variable lists to collect crash causation information under the following topic levels: accident, road environment, vehicle, and road user, using two quite different sets of resources: retrospective detailed police reports (n=1300) and prospective, independent, on-scene accident research investigations (n=1000). Data categorisation and human factors analysis methods based on Cognitive Reliability and Error Analysis Method (Hollnagel, 1998) were developed to enable the causal factors to be recorded, linked and understood. A harmonised, prospective "on-scene" method for recording the root causes and critical events of road crashes was developed. Where appropriate, this includes interviewing road users in collaboration with more routine accident investigation techniques. The typical level of detail recorded is a minimum of 150 variables for each accident. The project will enable multidisciplinary information on the circumstances of crashes to be interpreted to provide information on the causal factors. This has major applications in the areas of active safety systems, infrastructure and road safety, as well as for tailoring behavioural interventions. There is no direct model available internationally that uses such a systems based approach.
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