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1.	Björn, Inger, 1953- (författare) Hormone replacement therapy and effects on mood 2003 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Background: During the past 5 decades, hormone replacement therapy (HRT) has been used, and appreciated for its beneficial effects, by millions of women in their menopause. As treatment for climacteric symptoms, estrogen is outstanding, and effects on hot flushes, vaginal dryness, and insomnia have been widely documented. The increased risks of venous thrombosis and breast cancer, however, restrict the use of estrogen.Estrogen treatment in women with a remaining uterus includes a progestin, added to protect the endometrium from hyperplasia and malignancies. The long-standing clinical impression, that progestin addition negatively influences mood, has been discussed in previous studies. Mood deterioration is, however, not mortal, although mood is important to the wellbeing and daily functioning of women treated with hormones. Studies of the mental side effects of HRT add to our understanding of steroid effects in the brain.Aims and methods: In our studies, we aimed to establish to what extent negative side effects cause women to discontinue HRT, and find out which drug compounds lead to mood deterioration. The questions asked were whether the type and dose of progestin and the estrogen dose during the progestin addition influence the mood and physical symptoms during sequential HRT.Compliance with HRT and reasons for discontinuing the therapy were evaluated in a retrospective longitudinal follow-up study. Treatment effects were studied in three randomized, double-blind, cross-over trials. During continuous estrogen treatment, effects of sequential addition of a progestin were studied by comparing two different progestins, medroxyprogesterone acetate (MPA) andnorethisterone acetate (NETA), comparing different doses of the same progestin, MPA, and comparing two doses of estrogen during addition of the same dose of MPA. The main outcome measure was the daily rating on mood and physical symptoms kept by the participants throughout the studies. The clinical trials were carried out at three gynecological centers in northern Sweden.Results and conclusions: Besides fear of cancer and a wish to determine whether climacteric symptoms had meanwhile disappeared, negative side effects was the most common reason or discontinuing HRT. Tension in the breasts, weight gain, a depressed mood, abdominal bloating, and irritability were the most important side effects seen both in women who continued HRT and in women who had discontinued the therapy.In our clinical trials, we showed that addition of a progestin to estrogen treatment induces cyclic mood swings characterized by tension, irritability, and depression, as well as increased breast tension, bloatedness, and hot flushes. Women with a history of premenstrual syndrome (PMS) appeared to be more sensitive to the progestin addition and responded with lower mood scores compared with women without previous PMS. In our studies, MPA provoked depressed mood to a lesser extent than did NETA. Surprisingly, the higher dose of MPA (20 mg) enhanced the mood, compared with 10 mg, when added to estrogen treatment. In women continuously treated with 3 mg estradiol, mood and physical symptoms worsened during the progestin addition, as compared with treatment with 2 mg estradiol. The negative side effects seen during sequential HRT have much in common with symptoms seen in the premenstrual dysphoric disorder (PMDD), which is a psychoneuroendocrine disorder with psychiatric expression. Explanations for treatment effects on mood are likely to be found in drug interactions with neurotransmitter systems of the brain.
2.	Björn, Inger, 1953-, et al. (författare) Increase of estrogen dose deteriorates mood during progestin phase in sequential hormonal therapy 2003 Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 88:5, s. 2026-2030 Tidskriftsartikel (refereegranskat)abstract Previous studies have indicated that the addition of progestinsduring sequential hormonal replacement therapy (HRT)causes negative mood and physical symptoms. History of premenstrualsyndrome, type of progestin, and dose of progestinhave thus far been shown to influence the progestin-inducedadverse mood symptoms during HRT.The aim of this study was to compare adverse mood effectsof two different doses of estradiol, in combination with a progestin,during postmenopausal HRT. Twenty-eight perimenopausalwomen were included in this randomized, doubleblind,crossover study comparing 2- or 3-mg continuousestradiol, with an addition of 10 mg medroxyprogesteroneacetate on d 17–28 during each treatment cycle. The mainoutcome measures were mood and physical symptoms kept ona daily rating scale. Together with the progestin, the higherdose of estrogen caused significantly more negative moodsymptoms than the lower dose. Tension, irritability, and depressedmood were all significantly augmented during theprogestin phase of cycles with 3mg estradiol (P<0.001). Physicalsymptoms also increased during the progestin phase of3-mg estradiol cycles (P<0.001), whereas positive mood symptomswere less affected. The only positive mood that changedwith estrogen dose was friendliness, which decreased duringthe progestin phase of high estradiol cycles compared withcycles with lower estradiol (P < 0.05).Our conclusion is that an increase of the estrogen doseaccentuates negativemoodand physical symptoms during theprogestin phase of sequential hormonal therapy.
3.	Björn, Inger, 1953-, et al. (författare) The impact of different doses of medroxyprogesterone acetate on mood symptoms in sequential hormonal therapy 2002 Ingår i: Gynecological Endocrinology. - : Informa Healthcare. - 0951-3590 .- 1473-0766. ; 16, s. 1-8 Tidskriftsartikel (refereegranskat)abstract The aim of this study was to compare adverse mood effects of two different doses of medroxyprogesterone acetate (MPA) during postmenopausal hormone replacement therapy (HRT) in women with and without a history of premenstrual syndrome (PMS). The study was designed as a randomized double-blind cross-over study and included 36 postmenopausal women at three health care areas in northern Sweden. The women received 2 mg estradiol continuously during five 28-day cycles and 10 mg or 20 mg MPA sequentially for 12 days during each cycle. The main outcome measures were mood and physical symptoms noted on a daily rating scale. We found that physical symptoms did not differ between 10 and 20 mg MPA. Both women with a history of PMS and women without responded with more negative mood symptoms with the lower dose of MPA. In women with previous PMS the higher dose of MPA enhanced positive mood symptoms. With respect to mood and physical symptoms, the aim to lower MPA doses in HRT is unwarranted.
4.	Bäckström, Torbjörn, 1948-, et al. (författare) Pathogenesis in menstrual cycle-linked CNS disorders. 2003 Ingår i: Annals of the New York Academy of Sciences. - : Wiley. - 0077-8923 .- 1749-6632. ; 1007, s. 42-53 Forskningsöversikt (övrigt vetenskapligt/konstnärligt)
5.	Bäckström, Torbjörn, et al. (författare) The role of hormones and hormonal treatments in premenstrual syndrome 2003 Ingår i: CNS Drugs. - 1172-7047 .- 1179-1934. ; 17:5, s. 325-342 Tidskriftsartikel (refereegranskat)abstract Premenstrual syndrome (PMS) is a menstrual cycle-linked condition with both mental and physical symptoms. Most women of fertile age experience cyclical changes but consider them normal and not requiring treatment. Up to 30% of women feel a need for treatment. The aetiology is still unclear, but sex steroids produced by the corpus luteum of the ovary are thought to be symptom provoking, as the cyclicity disappears in anovulatory cycles when a corpus luteum is not formed. Progestogens and progesterone together with estrogen are able to induce similar symptoms as seen in PMS. Symptom severity is sensitive to the dosage of estrogen. The response systems within the brain known to be involved in PMS symptoms are the serotonin and GABA systems. Progesterone metabolites, especially allopregnanolone, are neuroactive, acting via the GABA system in the brain. Allopregnanolone has similar effects as benzodiazepines, barbiturates and alcohol; all these substances are known to induce adverse mood effects at low dosages in humans and animals. SSRIs and substances inhibiting ovulation, such as gonadotrophin-releasing hormone (GnRH) agonists, have proven to be effective treatments. To avoid adverse effects when high dosages of GnRH agonists are used, add-back hormone replacement therapy is recommended. Spironolactone also has a beneficial effect, although not as much as SSRIs and GnRH agonists.
6.	Ekman, Inger, 1952, et al. (författare) Can treatment with ACE-inhibitors in elderly patients with moderate to severe heart failure be improved by a nurse-monitored structured care program? 2003 Ingår i: Heart & Lung. - 0147-9563. ; 32:1, s. 3-9 Tidskriftsartikel (refereegranskat)abstract Can treatment with angiotensin-converting enzyme inhibitors in elderly patients with moderate to severe chronic heart failure be improved by a nurse-monitored structured care program? A randomized controlled trial. OBJECTIVE: The purpose of this study was to examine whether a nurse-monitored structured care program resulted in a more effective use of angiotensin-converting enzyme (ACE) inhibitors in elderly patients compared with standard care in patients with chronic heart failure (CHF). METHODS: Hospitalized patients were screened to identify individuals with CHF, age more than 65 years, New York Heart Association classification III to IV, and no contraindications to ACE inhibitor treatment. One hundred forty-five patients were randomized to a nurse-monitored structured care program that included uptitration of enalapril to a target dose of 10 mg twice a day or to standard care. Six-month follow-up data were collected. RESULTS: The mean age of the randomized patients was 81 years. Although the proportion of patients treated with an ACE inhibitor did not differ between structured care (70%) and standard care (64%), the number of patients with the target ACE inhibitor dose was significantly higher in the structured care group (26% versus 11% in the standard care group; P <.018). Treatment had to be discontinued in 26% of the patients because of adverse effects. CONCLUSION: The patients in this study were older than in previous intervention studies and had considerable comorbidity and reduced tolerance for ACE inhibitors. ACE inhibitor treatment was underused but improved with the structured care program, although achieved treatment levels were below those in the large intervention trials in patients with CHF.
7.	Kull, Inger, et al. (författare) Astma/KOL-mottagningar i primärvård ger effektivt omhändertagande 2008 Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 105:42, s. 2937-2940 Tidskriftsartikel (refereegranskat)abstract Astma och KOL (kroniskt obstruktiv lungsjukdom) har blivit allt vanligare, och möjligheterna till både korrekt diagnos och förbättrad behandling har ökat under det senaste decenniet, vilket ställer nya krav på hälso- och sjukvården. Korrekt diagnos, adekvat patientutbildning och rökslutarstöd är högt prioriterade åtgärder. Ett strukturerat omhändertagande med en välfungerande astma/KOL-mottagning i primärvården underlättar och förbättrar vården av denna stora patientgrupp. I artikeln föreslås nya kriterier för astma/KOL-mottagningar i primärvård.
8.	Lindholm, Åsa, et al. (författare) Effect of sibutramine on weight reduction in women with polycystic ovary syndrome : a randomized, double-blind, placebo-controlled trial 2008 Ingår i: Fertility and Sterility. - : Elsevier BV. - 0015-0282 .- 1556-5653. ; 89:5, s. 1221-1228 Tidskriftsartikel (refereegranskat)abstract OBJECTIVE: To examine the efficacy of sibutramine together with brief lifestyle modification for weight reduction in obese women with polycystic ovary syndrome (PCOS). DESIGN: Investigator-initiated, multicenter, double-blind, randomized, parallel-group clinical trial. SETTING: Departments of Obstetrics and Gynecology in primary care, referral centers, and private practice. PATIENT(S): Forty-two patients with confirmed PCOS were included in the study, and 34 patients completed the study. INTERVENTION: Sibutramine 15 mg once daily together with brief lifestyle modification was compare with placebo together with brief lifestyle modification. MAIN OUTCOME MEASURE(S): The primary endpoint was to assess weight loss. Secondary endpoints included the efficacy of sibutramine for treatment of menstrual pattern and cardiovascular risk factors. RESULT(S): After 6 months the sibutramine group had lost 7.8 +/- 5.1 kg compared with a weight loss of 2.8 +/- 6.2 kg in the placebo group. Sibutramine treatment resulted in significant decreases in apolipoprotein B, apolipoprotein B/apolipoprotein A ratio, triglycerides, and cystatin C levels. CONCLUSION(S): Sibutramine in combination with lifestyle intervention results in significant weight reduction in obese patients with PCOS. In addition to the weight loss, sibutramine seems to have beneficial effects on metabolic and cardiovascular risk factors.
9.	Malmenström, Malin, et al. (författare) Patients with psychiatric disorders in gynecologic practice--a three year follow-up. 2006 Ingår i: J Psychosom Obstet Gynaecol. - 0167-482X. ; 27:1, s. 17-22 Tidskriftsartikel (refereegranskat)
10.	Tilling, Björn, et al. (författare) Astma/KOL-mottagning i primärvård : Nya kriterier 2008 Ingår i: Allmänsmedicin. - 0281-3513. ; 5, s. 9-13 Tidskriftsartikel (refereegranskat)
11.	Agelii, Monica Leu, et al. (författare) Misdiagnosis of Rheumatoid Arthritis in a Long-Term Cohort of Early Arthritis Based on the ACR-1987 Classification Criteria 2022 Ingår i: Open Access Rheumatology: Research and Reviews. - 1179-156X. ; 14, s. 187-194 Tidskriftsartikel (refereegranskat)abstract Objective: Correct diagnosis of early rheumatoid arthritis (RA) is essential for optimal treatment choices. No pathognomonic test is available, and diagnosis is based on classification criteria, which can result in misdiagnosis. Here, we examined the differences between actual and misdiagnosed RA cases in a long-term cohort of patients included based on the ACR-1987 classification criteria. Methods: Patients in the BARFOT (Better Anti-Rheumatic PharmacOTherapy) cohort (n=2543) with at least four follow-up visits during the initial 5 years from enrolment were assessed, and a change in diagnosis was reported by the treating rheumatologist. The groups were analysed with respect to the individual classification criteria, antibodies to citrullinated proteins (ACPA), disease activity (DAS28) and radiographic changes from inclusion up to 2 years. Results: Forty-five patients (1.8%) were misdiagnosed (RA-change group). When compared to those in the RA-change group, the patients who kept their diagnosis (RA-keep) were more often RF positive (64% vs 21%, p<0.001) or ACPA positive (59% vs 8%, p<0.001). They were also more likely to fulfil more than four ACR-1987 criteria (64% vs 33%, p<0.001) and to have radiographic changes at inclusion (RA-keep 27% vs RA-change 12%, p=0.04). The groups had a similar evolution of DAS28 and its components as well as of radiological joint destruction. Conclusion: Diagnosis of RA according to the ACR-1987 criteria had a high precision in this long-term cohort. A diagnosis of RA should be re-evaluated in patients who do not fulfil more than four ACR-1987 criteria especially in patients negative for RF.
12.	Ahlstrand, Inger, et al. (författare) Pain and Daily Activities in Rheumatoid Arthritis 2012 Ingår i: Disability and Rehabilitation. - : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 34:15, s. 1245-1253 Tidskriftsartikel (refereegranskat)abstract The aim of this study was to describe experiences of pain and its relationship to daily activities in people with rheumatoid arthritis (RA). Method. Seven semi-structured focus group discussions were conducted with 33 men and women of different ages with RA. Data were analysed with content analysis. Results. Pain affected everyday life and may be a barrier to perform valued activities. Regarding the impact of pain on participation and independence, personal factors and the social environment were found to be important. It could be a struggle to find the right activity balance, since it was easy to be overactive, triggering subsequent elevation of pain levels. However, the participants also described activities as a mediator of pain and a distraction from it.Conclusion. The relationship between pain and daily activities in RA was complex. Pain as an impairment was expressed to be related to activity limitations and participation restrictions, as well as to contextual factors. These findings highlight the clinical importance of paying attention to the complexity of pain and its relation to daily activities and participation.
13.	Ahlstrand, Inger, et al. (författare) Smärta och dagliga aktiviteter vid Reumatoid artrit ur ett patientperspektiv 2011 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Bakgrund: Smärta vid Reumatoid artrit (RA) ärett välkänt symtom som orsakar lidande ochaktivitetsbegränsning. Traditionellt mäts smärtainom reumatologin som smärtintensitet på enVisuell Analog Skala (VAS). Kunskapen kring hurpatienter med RA upplever smärta och dess konsekvenser är begränsad. Patientens egenbeskrivning behövs som underlag för behandlingsplanering och för att utveckla nya metoderför att beskriva problematiken.Syfte: Syftet med studien är att beskriva smärtavid RA ur ett patientperspektiv med fokus på hursmärtan påverkar dagliga aktiviteter.Metod: Patienter med diagnostiserad RA i syd-östra Sverige identifierades via Svenska Reumatologiregistret. Urvalet baserades på minst 5 årssjukdomsduration och minst 40 mm smärtintensitet på VAS vid de två senaste besöken på reumatologklinik. Sammanlagt 33 patienter, 7 män och26 kvinnor, deltog i sju fokusgrupper. Gruppernaformades utifrån kön och ålder. Intervjuguideninnehöll frågor som: Hur beskriver patienter medRA sin smärta? Vad påverkar smärtan? Vilkakonsekvenser har smärtan för aktivitetsutförande,aktivitetsbalans och undvikande av aktivitet? Enkvalitativ innehållsanalys görs.Resultat/förväntat resultat: Analyser hittills visar patienternas frustration över att inteklara det man vill eller behöver göra, beroendeav andra, minskade möjligheter till delaktigheti sociala sammanhang. Och närståendes betydelse. Analyserna visar att smärtan är relaterad till Göteborg6-8 april 201134trötthet, stress och sinnesstämning och att arbeteeller andra aktiviteter medverkar till att glömmabort smärtan och uppehålla förmåga. Analysenslutförs under hösten.Konklusion: Denna studie förväntas genererany angelägen kunskap om och förståelse försmärta.
14.	Ahlström, Björn, 1972-, et al. (författare) Normaliserande processer av ojämlika villkor 2020. - 1 Ingår i: Att arbeta för lika villkor. - Lund : Studentlitteratur AB. - 9789144135045 ; , s. 213-234 Bokkapitel (refereegranskat)
15.	Ajeganova, S., et al. (författare) Long-term fracture risk in rheumatoid arthritis: impact of early sustained DAS28-remission and restored function, progressive erosive disease, body mass index, autoantibody positivity and glucocorticoids. A cohort study over 10 years 2023 Ingår i: BMC Rheumatology. - 2520-1026. ; 7:1 Tidskriftsartikel (refereegranskat)abstract BackgroundRisk of fragility fractures in patients with rheumatoid arthritis (RA) is increased. Disease-related inflammation in RA is associated with low Bone Mineral Density (BMD). However, effects of specific disease factors on fracture occurrence and whether or not such disease effects are independent of BMD are unknown.MethodsAnalysis of fracture outcome in the prospective cohort of 2557 patients with early RA (67% women, mean age 58.1 & PLUSMN; 15.6 years) during an observation period of 10.6 & PLUSMN; 4.7 years. In 602 patients BMD was measured at baseline. The first major fragility fractures were considered. Kaplan-Meier and Cox regression analysis, adjusted for traditional factors, prior fracture, disease activity and period of inclusion, were used to estimate the risk of the outcome.ResultsDuring follow-up fracture occurred in 352 patients (13.8%), a rate of 13/1000 p-y. A proportional risk reduction for the outcome was associated with Body Mass Index (BMI) at baseline, BMI & GE; 30 kg/m(2), and over the first two years sustained Disease Activity Score (DAS28)-remission, DAS28-low disease activity and Health Assessment Questionnaire (HAQ) & LE; 0.5. The proportional risk elevation for fractures was associated with BMI & LE; 20 kg/m(2), DAS28 at baseline, 6-month and at 1-year, cumulative DAS28 over the two years, RF, erosion score progression at 2-year, HAQ score and HAQ & GE; 1 at 6-month and 1-year and showed a trend for ACPA positivity. The estimated fracture risk was increased in users of glucocorticoids (GC), associated with a higher GC-dosage at follow-ups and a higher cumulative dosage over two years, independently of disease activity. With adjustment for BMD, there was no difference in fracture outcome by exposure to GC. The effects of a higher BMI, DAS28-remission and low HAQ & LE; 0.5 attained at 6-month of treatment initiation and sustained up to 2 years, RF, ACPA, and erosion score progression at 2-year were independent of low BMD.ConclusionsThis analysis supports importance of RA-specific risk factors in early RA for future major fragility fractures. Treat-to-target strategy and restored functional capacity in early RA-disease are important to prevent fractures. Autoantibody positivity, progressively erosive disease, and low weight could have additional value for personalized fracture preventive strategies in early RA.
16.	Aleksandrova, Krasimira, et al. (författare) Inflammatory and metabolic biomarkers and risk of liver and bilary tract cancer 2014 Ingår i: Hepatology. - : Wiley-Blackwell. - 0270-9139 .- 1527-3350. ; 60:3, s. 858-871 Tidskriftsartikel (refereegranskat)abstract Obesity and associated metabolic disorders have been implicated in liver carcinogenesis; however there is little data on the role of obesity-related biomarkers on liver cancer risk. We studied prospectively the association of inflammatory and metabolic biomarkers with risks of hepatocellular carcinoma (HCC), intra-hepatic bile duct (IBD) and gallbladder and bilary tract cancers outside of the liver (GBTC) in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC). Over an average of 7.7 years, 296 participants developed HCC (n=125), GBTC (n=137) or IBD (n=34). Using risk set sampling, controls were selected in a 2:1 ratio and matched for recruitment center, age, sex, fasting status, time of blood collection. Baseline serum concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), C-peptide, total, high-molecular-weight (HMW) adiponectin, leptin, fetuin-a, and glutamatdehydrogenase (GLDH) were measured and incidence rate ratios (IRRs) and 95% confidence intervals (CI-s) estimated using conditional logistic regression. After adjustment for lifestyle factors, diabetes, hepatitis infection and adiposity measures, higher concentrations of CRP, IL-6, C-peptide and non-HMW adiponectin were associated with higher risk of HCC (IRR per doubling of concentrations = 1.22; 95%CI = 1.02-1.46, P=0.03; 1.90; 95%CI = 1.30-2.77, P=0.001; 2.25; 95%CI = 1.43-3.54, P=0.0005 and 2.09; 95%CI = 1.19-3.67, P=0.01, respectively). CRP was associated also with risk of GBTC (IRR = 1.22; 95%CI = 1.05-1.42, P=0.01). GLDH was associated with risks of HCC (IRR = 1.62; 95%CI = 1.25-2.11, P=0.0003) and IBD (IRR = 10.5; 95%CI = 2.20-50.90, P=0.003). The continuous net reclassification index was 0.63 for CRP, IL-6, C-peptide and non-HMW adiponectin, and 0.46 for GLDH indicating good predictive ability of these biomarkers. Conclusion: Elevated levels of biomarkers of inflammation and hyperinsulinemia are associated with a higher risk of HCC, independent of obesity and established liver cancer risk factors.
17.	Ameur, Adam, et al. (författare) SweGen : a whole-genome data resource of genetic variability in a cross-section of the Swedish population 2017 Ingår i: European Journal of Human Genetics. - : NATURE PUBLISHING GROUP. - 1018-4813 .- 1476-5438. ; 25:11, s. 1253-1260 Tidskriftsartikel (refereegranskat)abstract Here we describe the SweGen data set, a comprehensive map of genetic variation in the Swedish population. These data represent a basic resource for clinical genetics laboratories as well as for sequencing-based association studies by providing information on genetic variant frequencies in a cohort that is well matched to national patient cohorts. To select samples for this study, we first examined the genetic structure of the Swedish population using high-density SNP-array data from a nation-wide cohort of over 10 000 Swedish-born individuals included in the Swedish Twin Registry. A total of 1000 individuals, reflecting a cross-section of the population and capturing the main genetic structure, were selected for whole-genome sequencing. Analysis pipelines were developed for automated alignment, variant calling and quality control of the sequencing data. This resulted in a genome-wide collection of aggregated variant frequencies in the Swedish population that we have made available to the scientific community through the website https://swefreq.nbis.se. A total of 29.2 million single-nucleotide variants and 3.8 million indels were detected in the 1000 samples, with 9.9 million of these variants not present in current databases. Each sample contributed with an average of 7199 individual-specific variants. In addition, an average of 8645 larger structural variants (SVs) were detected per individual, and we demonstrate that the population frequencies of these SVs can be used for efficient filtering analyses. Finally, our results show that the genetic diversity within Sweden is substantial compared with the diversity among continental European populations, underscoring the relevance of establishing a local reference data set.
18.	Anderson, Henrik, 1975- (författare) Development of Electroacoustic Sensors for Biomolecular Interaction Analysis 2009 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Biomolecular interaction analysis to determine the kinetics and affinity between interacting partners is important for the fundamental understanding of biology, as well as for the development of new pharmaceutical substances. A quartz crystal microbalance instrument suitable for kinetics and affinity analyses of interaction events was developed. The functionality of the sensor system was demonstrated by development of an assay for relative affinity determination of lectin-carbohydrate interactions.Sensor surfaces allowing for effective immobilization of one interacting partner is a key functionality of a biosensor. Here, three different surfaces and immobilization methods were studied. First, optimized preparation conditions for sensor surfaces based on carboxyl-terminated self assembled monolayers were developed and were demonstrated to provide highly functional biosensor surfaces with low non-specific binding. Second, a method allowing for immobilization of very acidic biomolecules based on the use of an electric field was developed and evaluated. The electric field made it possible to immobilize the highly acidic C-peptide on a carboxylated surface. Third, a method for antibody immobilization on a carboxyl surface was optimized and the influence of immobilization pH on the immobilization level and antigen binding capacity was thoroughly assessed. The method showed high reproducibility for a set of antibodies and allowed for antibody immobilization also at low pH.Three broadly different strategies to increase the sensitivity of electroacoustic sensors were explored. A QCM sensor with small resonator electrodes and reduced flow cell dimensions was demonstrated to improve the mass transport rate to the sensor surface. The use of polymers on QCM sensor surfaces to enhance the sensor response was shown to increase the response of an antibody-antigen model system more than ten-fold. Moreover, the application of high frequency thin film bulk acoustic resonators for biosensing was evaluated with respect to sensing range from the surface. The linear detection range of the thin film resonator was determined to be more than sufficient for biosensor applications involving, for instance, antibody-antigen interactions. Finally, a setup for combined frequency and resistance measurements was developed and was found to provide time resolved data suitable for kinetics determination.
19.	Andersson, Inger, et al. (författare) Kvasivetenskap hindrar ett hållbart jord- och skogsbruk 2011 Ingår i: Dagens nyheter. - 1101-2447. Tidskriftsartikel (populärvet., debatt m.m.)
20.	Angerås, Oskar, 1976, et al. (författare) Impact of Thrombus Aspiration on Mortality, Stent Thrombosis, and Stroke in Patients with ST-Segment-Elevation Myocardial Infarction: A Report From the Swedish Coronary Angiography and Angioplasty Registry 2018 Ingår i: Journal of the American Heart Association. - : John Wiley & Sons. - 2047-9980. ; 7:1 Tidskriftsartikel (refereegranskat)abstract Background-Thrombus aspiration is still being used in a substantial number of patients despite 2 large randomized clinical trials showing no favorable effect of routine thrombus aspiration during primary percutaneous coronary intervention in patients with STsegment- elevation myocardial infarction. The aim of this observational study was to evaluate the impact of thrombus aspiration on mortality, stent thrombosis, and stroke using all available data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Methods and Results--We identified 42 829 consecutive patients registered in SCAAR between January 2005 and September 2014 who underwent percutaneous coronary intervention for ST-segment-elevation myocardial infarction. Thrombus aspiration was used in 25% of the procedures. We used instrumental variable analysis with administrative healthcare region as the treatmentpreference instrumental variable to evaluate the effect of thrombus aspiration on mortality, stent thrombosis, and stroke. Thrombus aspiration was not associated with mortality at 30 days (risk reduction: -1.2; 95% confidence interval [CI] , -5.4 to 3.0; P=0.57) and 1 year (risk reduction: -2.4; 95% CI, -7.6 to 3.0; P=0.37). Thrombus aspiration was associated with a lower risk of stent thrombosis both at 30 days (risk reduction: -2.7; 95% CI, -4.1 to -1.4; P < 0.001) and 1 year (risk reduction: -3.5; 95% CI, -5.3 to -1.7; P < 0.001). In-hospital stroke and neurologic complications did not differ between groups (risk reduction: 0.1; 95% CI, -0.8 to 1.1; P=0.76). Conclusions--Mortality was not different between the groups. Thrombus aspiration was associated with decreased risk of stent thrombosis. Our study provides important evidence for the external validity of previous randomized studies regarding mortality.
21.	Angerås, Oskar, 1976, et al. (författare) TCT-157 Pretreatment with heparins and glycoprotein IIb/IIIa receptor inhibitors is associated with improved patency of infarct related-artery in STEMI - A report from SCAAR. 2016 Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 1558-3597 .- 0735-1097. ; 68:18 Suppl 1 Tidskriftsartikel (refereegranskat)
22.	Arvidsson, Inger, et al. (författare) Betydelsen av fysiska och psykosociala riskfaktorer för sjukdom/besvär i muskler och leder - En uppföljningsstudie av kvinnor inom vård och skola 2015 Rapport (övrigt vetenskapligt/konstnärligt)abstract Vi har upprättat en kohort med 1591 kvinnor från fem vanliga yrken: Operationssköterskor (Op), anestesisköterskor (Ane), undersköterskor på operation (Usk), biomedicinska analytiker som gör ultraljudsundersökningar (BMA) samt lärarinnor (Lär). Enkät har skickats ut vid baseline och i genomsnitt ca 28 månader därefter. Data från uppföljningen är inte analyserade ännu, varför rapporten enbart omfattar resultat från baseline. Fallen definierades baserat på kombinationen av frekvens och intensitet av rapporterade besvär. Samband mellan smärttillstånd och arbetsbelastning, individ- och livsstilsfaktorer analyserades med multivariat analys, backward proceedure. Samband påvisades för nacken med högt mekaniskt index, lågt fysiskt index, missnöje med datorarbetsplatsens utformning, höga krav, låg kontroll, höga känslomässiga krav, låga sensoriska krav samt låg ålder. axlarna med högt mekaniskt index, missnöjd med datorarbetsplatsens utformning, krav och lite egen tid för återhämtning. handleder/händer med högt mekaniskt index, höga krav, låg kontroll, hög ålder, högt BMI och inga/få hemmavarande barn. ländryggen med högt mekaniskt index, höga krav, låg kontroll, låga sensoriska krav, hög ålder, högt BMI och lite egen tid för återhämtning. fötterna med högt BMI, högt fysiskt index, hög ålder, höga krav, inga eller få hemmavarande barn samt låg kontroll. De ergonomiska problem som framkommit vid intervjuerna av operationspersonal har presenterats för studenter på Lunds tekniska högskola. Ett särskilt problem avsåg de statiska, obekväma och ansträngande arbetsställningarna som uppkom då operationssjuksköterskorna assisterade under operationer. Med hjälp av en operationhake höll de isär såret under operationen. Haken har ett grepp som tvingar Op till ett böjt och icke funktionellt handgrepp. Studenterna tog fram prototyp för en hållare till haken, som ger möjlighet till en mer ergonomisk handledsställning, samt att byta hand vid behov under operationen. Hållaren till haken utvärderas f n på två operationsavdelningar.
23.	Arvidsson, Inger, et al. (författare) Burnout among Swedish school teachers - a cross-sectional analysis 2016 Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 16:1 Tidskriftsartikel (refereegranskat)abstract Background: Teachers are at high risk of stress-related disorders. This study aimed to examine the occurrence of burnout in a sample of Swedish school-teachers, to test a combined measure of three burnout dimensions on the individual level, to characterize associations between burnout and factors encountered during work and leisure time, and to explore any differences between the genders. Methods: A questionnaire of occupational, sociodemographic and life-style factors was answered by 490 teachers in school years 4-9. Outcome measures were (a) the single burnout dimensions of exhaustion, cynicism and professional efficacy (Maslach Burnout Inventory-General Survey), and (b) a combined measure based on high or low values in the three dimensions. The combined measure was used to stratify the study population into four levels (0-3) of burnout. Multivariable Poisson regression was applied on level 2 + 3 vs. level 0 + 1, for variables that we considered as relevant risk factors for burn out. Results: Half of the teachers reported low values in all three dimensions (level 0), whereas 15 were classified as having high burnout in at least two out of the three dimensions (level 2 + 3), and 4 % in all three dimensions (level 3). Almost all psychosocial factors were incrementally more unfavourably reported through the rising levels of burnout, and so were dissatisfaction with the computer workstation, pain, sleep problems and lack of personal recovery. There was no association between gender and rising levels of overall burnout (p > 0.30). Low self-efficacy, poor leadership, high job demands and teaching in higher grades were the variables most clearly associated with burnout in multivariable Poisson regression. Conclusions: Even if circa 50 % of the teachers appear do well with respect to burnout, the results points to the need of implementing multifaceted countermeasures that may serve to reduce burnout.
24.	Arvidsson, Inger, et al. (författare) Cross-sectional associations between occupational factors and musculoskeletal pain in women teachers, nurses and sonographers. 2016 Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 17:1 Tidskriftsartikel (refereegranskat)abstract It is usually assumed that musculoskeletal pain is associated with both the physical workload and the psychosocial work environment, as well as with personal and lifestyle factors. This study aims to ascertain the prevalence of musculoskeletal pain in women with varying or different occupational exposures, and to explore the associations between musculoskeletal pain and the occupational and personal factors.
25.	Arvidsson, Inger, et al. (författare) Discrepancies in pain presentation caused by adverse psychosocial conditions as compared to pain due to high physical workload? 2012 Ingår i: Work: A Journal of Prevention, Assessment & Rehabilitation. - 1875-9270. ; 41, s. 2472-2475 Tidskriftsartikel (refereegranskat)abstract Disorders in the musculoskeletal system have been associated with a high physical workload as well as psychosocial and individual factors. It is however not obvious which of these factors that is most important to prevent. Musculoskeletal disorders in neck and upper extremity was assessed by interview and clinical examination in 79 teachers and 93 assisting nurses, all females. Psychosocial work environment was assessed by questionnaire. The physical workload was recorded by technical measurements of postures, movements and muscular load, in 9 teachers and 12 nurses. The physical workload was lower among the teachers, but they had a more demanding psychosocial work environment. Among the nurses, but not in the teachers, the neck-shoulder disorders were associated with a high body mass index (BMI). The teachers reported neck-shoulder complaints to a higher extent than the nurses, but had much lower prevalence of diagnoses in the clinical examination (12% vs. 25%; POR 0.3 CI 0.1 - 1.2; adjusted for age and BMI). The results suggest that adverse psychosocial conditions among the teachers give rise to a different kind of pain in the neck-shoulder region than from physical overload, troublesome but not as severe as the one afflicting the nurses.
26.	Axelsson, Ove, et al. (författare) CME/CPD in obstetrics and Gynecology in the nordic countries 2000 Annan publikation (populärvet., debatt m.m.)
27.	Baker, Jacqueline Roshelli, et al. (författare) Prediagnostic blood selenium status and mortality among patients with colorectal cancer in western european populations 2021 Ingår i: Biomedicines. - : MDPI. - 2227-9059. ; 9:11 Tidskriftsartikel (refereegranskat)abstract A higher selenium (Se) status has been shown to be associated with lower risk for colorectal cancer (CRC), but the importance of Se in survival after CRC diagnosis is not well studied. The associations of prediagnostic circulating Se status (as indicated by serum Se and selenoprotein P (SELENOP) measurements) with overall and CRC-specific mortality were estimated using multi-variable Cox proportional hazards regression among 995 CRC cases (515 deaths, 396 from CRC) in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Se and SELENOP serum concentrations were measured on average 46 months before CRC diagnosis. Median follow-up time was 113 months. Participants with Se concentrations in the highest quintile (≥100 µg/L) had a multivariable-adjusted hazard ratio (HR) of 0.73 (95% CI: 0.52–1.02; Ptrend = 0.06) for CRC-specific mortality and 0.77 (95% CI: 0.57–1.03; Ptrend = 0.04) for overall mortality, compared with the lowest quintile (≤67.5 µg/L). Similarly, participants with SELENOP concentrations in the highest (≥5.07 mg/L) compared with the lowest quintile (≤3.53 mg/L) had HRs of 0.89 (95% CI: 0.64–1.24; Ptrend = 0.39) for CRC-specific mortality and 0.83 (95% CI: 0.62–1.11; Ptrend = 0.17) for overall mortal-ity. Higher prediagnostic exposure to Se within an optimal concentration (100–150 µg/L) might be associated with improved survival among CRC patients, although our results were not statistically significant and additional studies are needed to confirm this potential association. Our findings may stimulate further research on selenium’s role in survival among CRC patients especially among those residing in geographic regions with suboptimal Se availability.
28.	Berggren, Anna M., et al. (författare) Short‐chain fatty acid content and pH in caecum of rats fed various sources of starch 1995 Ingår i: Journal of the Science of Food and Agriculture. - : Wiley. - 0022-5142 .- 1097-0010. ; 68:2, s. 241-248 Tidskriftsartikel (refereegranskat)abstract Caecal pH and contents of short‐chain fatty acids (SCFA) were registered in rats fed three potential sources of resistant starch (RS); raw pea starch, raw potato starch, and an RS‐enriched preparation obtained from wheat starch by autoclaving and enzymatic incubation. Small intestinal digestibility and delivery of RS to the hind‐gut in the case of raw starches were determined by analysis of faecal starch in animals treated with antibiotics to prevent hind‐gut fermentation. RS content in the RS‐enriched preparation was determined as total starch remaining in an enzymatic gravimetric dietary fibre residue. The fermentability of RS was estimated from the faecal recovery of starch in normal animals with intact hind‐gut microflora. Approximately 35 g per 100 g and 32 g per 100 g were RS in the case of raw potato starch and the RS‐enriched preparation, respectively, versus only 1 g per 100 g in the case of raw pea starch. The caecal pH decreased with all test diets, being most significant with raw potato starch. SCFA production and faecal bulking were negligible with raw pea starch, whereas both raw potato starch and the RS‐enriched preparation significantly increased these parameters. The fermentability of RS in raw potato starch and the RS‐enriched preparation was similar, or about 60–70%. If calculated on basis of fermented amount, RS in raw potato starch was more potent in generating SCFA (49 μmol g−1) than in the RS‐enriched preparation (19 μmol g−1). RS in raw potato starch also displayed the highest faecal bulking capacity. In fact, the faecal dry weight increased more than expected merely from delivery of RS. The relative proportion in caecal contents of acetic‐, propionic‐ and butyric acid was 70, 17 and 8%, respectively, with no significant differences between the three sources of RS.
29.	Berggren, Anna, et al. (författare) Short-chain fatty acid content and pH in caecum of rats given various sources of carbohydrates 1993 Ingår i: Journal of the Science of Food and Agriculture. - : Wiley. - 0022-5142 .- 1097-0010. ; 63:4, s. 397-406 Tidskriftsartikel (refereegranskat)abstract The caecal content of short‐chain fatty acids (SCFA; acetic, propionic and butyric acid), caecal pH, fermentability and dry matter digestibility (DMD) were examined through balance experiments in rats fed 11 various indigestible carbohydrates. The following carbohydrate sources were incorporated into test diets: cellulose, oat husk, wheat bran, oat bran, pea fibre, linseed fibre, low methoxylated (LM)‐pectin, guargum, β‐glucans, neosugar and raffinose. The indigestible carbohydrates, except for those in wheat bran, oat husk and cellulose, were highly fermented, ie > 90%. Caecal pH varied between 5·6 and 7·8, with neosugar and raffinose causing the lowest pH and the fibre‐free diet and the diet with oat husk the highest. The caecal pool sizes of SCFA were highest with raffinose, β‐glucans, LM‐pectin, guargum and linseed fibre (335‐400 μmol) while pea fibre, wheat bran, oat bran and neosugar gave intermediate levels (137–227 μmol). The pool size with oat husk and cellulose was similar as with the basal diet (45–64 μmol). A high proportion of propionic acid was obtained with guargum and linseed fibre, whereas acetic acid was the predominant product in case of LM‐pectin. On the other hand, linseed fibre gave a remarkably low proportion of butyric acid. The quantity fermented and caecal pH correlated well to the amount of SCFA with most materials (r = 0·96 and r = −0·87, respectively), an exception was neosugar and in case of fermentability also oat bran. DMD values with most of the easily fermented carbohydrates were high (>96%). Exceptions were diets with β‐glucans and oat bran which caused low DMD values, about 93%. It is concluded that indigestible carbohydrates may differ in ability to lower caecal pH and to form SCFA during fermentation.
30.	Bergström, Göran, 1964, et al. (författare) Low socioeconomic status of a patient's residential area is associated with worse prognosis after acute myocardial infarction in Sweden. 2015 Ingår i: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 182, s. 141-147 Tidskriftsartikel (refereegranskat)abstract Previous studies have established a relationship between socioeconomic status (SES) and survival in coronary heart disease. Acute cardiac care in Sweden is considered to be excellent and independent of SES. We studied the influence of area-level socioeconomic status on mortality after hospitalization for acute myocardial infarction (AMI) between 1995 and 2013 in the Gothenburg metropolitan area, which has little over 800,000 inhabitants and includes three city hospitals.
31.	Bergström, Maria, et al. (författare) Like the worst toothache you've had - How people with rheumatoid arthritis describe and manage pain 2017 Ingår i: Scandinavian Journal of Occupational Therapy. - : TAYLOR & FRANCIS LTD. - 1103-8128 .- 1651-2014. ; 24:6, s. 468-476 Tidskriftsartikel (refereegranskat)abstract Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease often associated with disability. Despite new treatments, pain and activity limitations are still present. Objectives: To describe how persons with RA experience and manage pain in their daily life. Methods: Seven semi-structured focus groups (FGs) were conducted and analyzed using content analysis. Results: The analysis revealed four categories: 1) Pain expresses itself in different ways referred to pain as overwhelming, aching or as a feeling of stiffness. 2) Mitigating pain referred to the use of heat, cold, medications and activities as distractions from the pain. 3) Adapting to pain referred to strategies employed as coping mechanisms for the pain, e.g. planning and adjustment of daily activities, and use of assistive devices. 4) Pain in a social context referred to the participants social environment as being both supportive and uncomprehending, the latter causing patients to hide their pain. Conclusions: Pain in RA is experienced in different ways. This emphasizes the multi-professional team to address this spectrum of experiences and to find pain management directed to the individual experience that also include the persons social environment.
32.	Bjerrum, Louise Bruland, et al. (författare) Acute effects of light during daytime on central aspects of attention and affect : a systematic review 2024 Ingår i: Biological Psychology. - : Elsevier. - 0301-0511 .- 1873-6246. ; 192 Forskningsöversikt (refereegranskat)abstract Light regulates both image- and various non-image forming responses in humans, including acute effects on attention and affect. To advance the understanding of light's immediate effects, this systematic review describes the acute effects of monochromatic/narrow bandwidth and polychromatic white light during daytime on distinct aspects of attention (alertness, sustained attention, working memory, attentional control and flexibility), and measures of affect (self-report measures, performance-based tests, psychophysiological measures) in healthy, adult human subjects. Original, peer-reviewed (quasi-) experimental studies published between 2000 and May 2024 were included according to predefined inclusion and exclusion criteria. Study quality was assessed, and results were synthesized across aspects of attention and affect and grouped according to light interventions; monochromatic/narrowband-width or polychromatic white light (regular white, bright white, and white with high correlated color temperature (CCT)). Results from included studies (n = 62) showed that alertness and working memory were most affected by light. Electroencephalographic markers of alertness improved the most with exposure to narrow bandwidth long-wavelength light, regular white, and white light with high CCT. Self-reported alertness and measures of working memory improved the most with bright white light. Results from studies testing the acute effects on sustained attention and attentional control and flexibility were inconclusive. Performance-based and psychophysiological measures of affect were only influenced by narrow bandwidth long-wavelength light. Polychromatic white light exerted mixed effects on self-reported affect. Studies were strongly heterogeneous in terms of light stimuli characteristics and reporting of light stimuli and control of variables influencing light's acute effects.
33.	Björck, Inger, et al. (författare) On the digestibility of starch in wheat bread - studies in vitro and in vivo 1986 Ingår i: Journal of Cereal Science. - 0733-5210. ; 4:1, s. 1-11 Tidskriftsartikel (refereegranskat)abstract The digestibility of starch in white wheat bread was studied. Raw wheat starch and raw wheat flour were used as reference materials. The extent of digestion and absorption in vivo was evaluated through balance experiments in rats given test diets with and without addition of the antibiotic, Nebacitin, to reduce the fermentation in the hind-gut. As judged from a high faecal recovery of dietary fibre constituents in rats fed a wheat flour diet with Nebacitin, this drug significantly reduced the microbial activity in the hind-gut. Only minute amounts of starch could be detected in faeces of rats whether Nebacitin was present or not, indicating that pure wheat starch as well as starch in wheat bread and raw wheat flour was almost completely digested and absorbed in the rat small intestine. However, during baking, a fraction of the starch (0·6%–0·9%, dry basis) was rendered resistant to enzyme digestion in vitro unless solubilised in KOH. This modified starch fraction also remained undigested in vivo, but was readily metabolised by the hind-gut microorganisms, thus having physiological properties similar to those of dietary fibre. It is therefore recommended that resistant starch formed during baking (i.e. that rendered resistant to enzymic digestion as measured in vitro) should be regarded as dietary fibre rather than as dietary starch.
34.	Björn, Camilla, et al. (författare) Anti-infective efficacy of the lactoferrin-derived antimicrobial peptide HLR1r 2016 Ingår i: Peptides. - : Elsevier BV. - 0196-9781 .- 1873-5169. ; 81, s. 21-28 Tidskriftsartikel (refereegranskat)abstract Antimicrobial peptides (AMPs) have emerged as a new class of drug candidates for the treatment of infectious diseases. Here we describe a novel AMP, HLR1r, which is structurally derived from the human milk protein lactoferrin and demonstrates a broad spectrum microbicidal action in vitro. The minimum concentration of HLR1r needed for killing >= 99% of microorganisms in vitro, was in the range of 3-50 mu g/ml for common Gram-negative and Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), and for the yeast Candida albicans, when assessed in diluted brain-heart infusion medium. We found that HLR1r also possesses anti-inflammatory properties as evidenced by inhibition of tumor necrosis factor alpha (TNF-alpha) secretion from human monocyte-derived macrophages and by repression of interleukin-6 (IL-6) and plasminogen activator inhibitor-1 (PAI-1) secretion from human mesothelial cells, without any cytotoxic effect observed at the concentration range tested (up to 400 mu g/ml). HLR1r demonstrated pronounced anti-infectious effect in in vivo experimental models of cutaneous candidiasis in mice and of excision wounds infected with MRSA in rats as well as in an ex vivo model of pig skin infected with S. aureus. In conclusion, HLR1r may constitute a new therapeutic alternative for local treatment of skin infections. (C) 2016 Elsevier Inc. All rights reserved.
35.	Björn, Inger, et al. (författare) Adverse mood effects during postmenopausal hormone treatment in relation to personality traits. 2006 Ingår i: Climacteric. - : Informa UK Limited. - 1369-7137 .- 1473-0804. ; 9:4, s. 290-297 Tidskriftsartikel (refereegranskat)
36.	Björn, Inger, 1953-, et al. (författare) Drug related negative side effects is a common reason for poor compliance in hormone replacement therapy 1999 Ingår i: Maturitas. - : Elsevier. - 0378-5122 .- 1873-4111. ; 32:2, s. 77-86 Tidskriftsartikel (refereegranskat)abstract Objectives: The reasons for poor compliance with hormone replacement therapy (HRT) and, in particular drug-related reasons, have not yet been fully elucidated. In this study, a cohort of peri- or postmenopausal women—mainly workers from a small town and surrounding rural area—was studied. The aim of the study was to investigate why some women never start or discontinue HRT, even when great effort has been made to inform and fulfill the demands of the patient. Methods: All women who were given a HRT prescription at a gynecological practice between September 1991 and December 1992 participated in a longitudinal study. A written questionnaire was mailed to these patients in 1996. Data from the questionnaire was supplemented with information from the medical records. Care of patients included initial information, follow-up within 4 months, yearly visits supplemented with contacts on demand. Results: 356 women received the questionnaire, among which 92% replied. A total of 2% never started HRT. Seventy-five percent continued the therapy for more than 3 years. Reasons for discontinuing HRT were negative side-effects (35%), desire to find out if climacteric symptoms had ended (26%), fear of cancer and thrombosis (25%), weariness of bleeding (19%) and a wish to deal with the problems ‘naturally’ (15%). Conclusions: Compliance with HRT can be high if adequate information is given and follow-ups are made. The main reason for poor compliance was negative side-effects, most likely progestin-related. The results of this study suggest that the future challenge will be to minimize negative side-effects of HRT.
37.	Björn, Inger, 1953-, et al. (författare) Negative mood changes during hormone replacement therapy : a comparison between two progestogens 2000 Ingår i: American Journal of Obstetrics and Gynecology. - : Elsevier. - 0002-9378 .- 1097-6868. ; 183:6, s. 1419-1426 Tidskriftsartikel (refereegranskat)abstract Objective: The aim of this study was to compare side effects of medroxyprogesterone acetate and norethindrone acetate during postmenopausal hormone replacement therapy in women with and without a history of premenstrual syndrome. Study Design: Fifty-one postmenopausal women were randomly selected in a double-blind crossover study. The women received 2 mg of estradiol continuously during five 28-day cycles and 10 mg of medroxyprogesterone or 1 mg of norethindrone sequentially for 12 days of each cycle. Daily symptom rating scales were kept. Results: The women showed cyclic changes, with negative mood and physical symptoms culminating during the late progestogen phase and positive mood during the estrogen-only phase. Symptoms declined with time but remained after 5 months. Women with a history of premenstrual syndrome responded strongly to both progestogens. Medroxyprogesterone acetate induced less negative and more positive mood symptoms than norethindrone in women with no history of premenstrual syndrome. In both groups medroxyprogesterone caused more physical symptoms than norethindrone. Conclusion: The addition of medroxyprogesterone to estrogen is preferable to norethindrone with respect to mood symptoms in women without a history of premenstrual syndrome.
38.	Broman, Tina, et al. (författare) Diversities and Similarities in PFGE profiles of Campylobacter jejuni isolated from Migrating Birds and Humans 2004 Ingår i: Journal of Applied Microbiology. ; 96, s. 834-843 Tidskriftsartikel (refereegranskat)
39.	Bryl-Górecka, Paulina, et al. (författare) Microvesicles in plasma reflect coronary flow reserve in patients with cardiovascular disease. 2021 Ingår i: American journal of physiology. Heart and circulatory physiology. - : American Physiological Society. - 1522-1539 .- 0363-6135. ; 320:5 Tidskriftsartikel (refereegranskat)abstract High levels of microvesicles (MVs), a type of extracellular vesicles, are detected in several pathological conditions. We investigated the connection between coronary flow reserve (CFR), a prognostic clinical parameter that reflects blood flow in the heart, with levels of MVs and their cargo, from plasma of cardiovascular patients. The PROFLOW study consists of 220 patients with prior myocardial infarction and measured CFR with transthoracic echocardiography. The patients were divided into high and low CFR groups. Plasma MVs were captured with acoustic trapping. Platelet and endothelial-derived MVs were measured with flow cytometry and MV lysates were analyzed with proteomic panels against cardiovascular biomarkers. Flow cytometry was further applied to identify cellular origin of biomarkers. Our data shows a negative correlation between MV concentration and CFR values. Platelet and endothelial MV levels were significantly increased in plasma from the low CFR group. CFR negatively correlates with the levels of several proteomic biomarkers and the low CFR group exhibited higher concentrations of these proteins in MVs. Focused analysis of one of the MV proteins, B Cell Activating Factor (BAFF), revealed platelet and not leukocyte origin and release upon proinflammatory stimulus. Higher levels of MVs carrying an elevated concentration of proatherogenic proteins, circulate in plasma in patients with low CFR, a marker of vascular dysfunction, reduced blood flow and poor prognosis. Our findings demonstrate a potential clinical value of MVs as biomarkers and possible therapeutic targets against endothelial deterioration.
40.	Bryl-Górecka, Paulina, et al. (författare) Microvesicles in plasma reflect coronary flow reserve in patients with cardiovascular disease 2021 Ingår i: American Journal of Physiology - Heart and Circulatory Physiology. - 0363-6135. ; 320:5, s. 2147-2160 Tidskriftsartikel (refereegranskat)abstract High levels of microvesicles (MVs), a type of extracellular vesicles, are detected in several pathological conditions. We investigated the connection between coronary flow reserve (CFR), a prognostic clinical parameter that reflects blood flow in the heart, with levels of MVs and their cargo, from plasma of patients with cardiovascular disease. The PROFLOW study consists of 220 patients with prior myocardial infarction and measured CFR with transthoracic echocardiography. The patients were divided into high and low CFR groups. Plasma MVs were captured with acoustic trapping. Platelet- and endothelial-derived MVs were measured with flow cytometry, and vesicle lysates were analyzed with proteomic panels against cardiovascular biomarkers. Flow cytometry was further applied to identify cellular origin of biomarkers. Our data show a negative correlation between MV concentration and CFR values. Platelet and endothelial MV levels were significantly increased in plasma from the low CFR group. CFR negatively correlates with the levels of several proteomic biomarkers, and the low CFR group exhibited higher concentrations of these proteins in MVs. Focused analysis of one of the MV proteins, B cell activating factor (BAFF), revealed platelet and not leukocyte origin and release upon proinflammatory stimulus. Higher levels of MVs carrying an elevated concentration of proatherogenic proteins circulate in plasma in patients with low CFR, a marker of vascular dysfunction, reduced blood flow, and poor prognosis. Our findings demonstrate a potential clinical value of MVs as biomarkers and possible therapeutic targets against endothelial deterioration.
41.	Chapman, Henry N, et al. (författare) Femtosecond X-ray protein nanocrystallography. 2011 Ingår i: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 470:7332, s. 73-7 Tidskriftsartikel (refereegranskat)abstract X-ray crystallography provides the vast majority of macromolecular structures, but the success of the method relies on growing crystals of sufficient size. In conventional measurements, the necessary increase in X-ray dose to record data from crystals that are too small leads to extensive damage before a diffraction signal can be recorded. It is particularly challenging to obtain large, well-diffracting crystals of membrane proteins, for which fewer than 300 unique structures have been determined despite their importance in all living cells. Here we present a method for structure determination where single-crystal X-ray diffraction 'snapshots' are collected from a fully hydrated stream of nanocrystals using femtosecond pulses from a hard-X-ray free-electron laser, the Linac Coherent Light Source. We prove this concept with nanocrystals of photosystem I, one of the largest membrane protein complexes. More than 3,000,000 diffraction patterns were collected in this study, and a three-dimensional data set was assembled from individual photosystem I nanocrystals (∼200nm to 2μm in size). We mitigate the problem of radiation damage in crystallography by using pulses briefer than the timescale of most damage processes. This offers a new approach to structure determination of macromolecules that do not yield crystals of sufficient size for studies using conventional radiation sources or are particularly sensitive to radiation damage.
42.	Cornelissen, Johannes H C, et al. (författare) Global negative vegetation feedback to climate warming responses of leaf litter decomposition rates in cold biomes 2007 Ingår i: Ecology Letters. - : Wiley. - 1461-023X .- 1461-0248. ; 10:7, s. 619-627 Tidskriftsartikel (refereegranskat)abstract Whether climate change will turn cold biomes from large long-term carbon sinks into sources is hotly debated because of the great potential for ecosystem-mediated feedbacks to global climate. Critical are the direction, magnitude and generality of climate responses of plant litter decomposition. Here, we present the first quantitative analysis of the major climate-change-related drivers of litter decomposition rates in cold northern biomes worldwide.Leaf litters collected from the predominant species in 33 global change manipulation experiments in circum-arctic-alpine ecosystems were incubated simultaneously in two contrasting arctic life zones. We demonstrate that longer-term, large-scale changes to leaf litter decomposition will be driven primarily by both direct warming effects and concomitant shifts in plant growth form composition, with a much smaller role for changes in litter quality within species. Specifically, the ongoing warming-induced expansion of shrubs with recalcitrant leaf litter across cold biomes would constitute a negative feedback to global warming. Depending on the strength of other (previously reported) positive feedbacks of shrub expansion on soil carbon turnover, this may partly counteract direct warming enhancement of litter decomposition.
43.	Dahlberg, Jenny, et al. (författare) Ten years transmission of the new variant of Chlamydia trachomatis in Sweden : prevalence of infections and associated complications 2018 Ingår i: Sexually Transmitted Infections. - : BMJ Publishing Group Ltd. - 1368-4973 .- 1472-3263. ; 94:2, s. 100-104 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: In 2006, a new variant of Chlamydia trachomatis (nvCT) was discovered in Sweden. It has a deletion in the plasmid resulting in failed detection by the single target systems from Abbott and Roche used at that time, whereas the third system used, from Becton Dickinson (BD), detects nvCT. The proportion of nvCT was initially up to 65% in counties using Abbott/Roche systems. This study analysed the proportion of nvCT from 2007 to 2015 in four selected counties and its impact on chlamydia-associated complications.METHODS: C. trachomatis-positive specimens collected from 2007 to 2015 were analysed by a specific PCR to identify nvCT cases. Genotyping was performed by multilocus sequence typing (MLST) and ompA sequencing. Ectopic pregnancy and pelvic inflammatory disease records were extracted from the national registers.RESULTS: In total, 5101 C. trachomatis-positive samples were analysed. The nvCT proportion significantly decreased in the two counties using Roche systems, from 56% in 2007 to 6.5% in 2015 (p<0.001). In the two counties using BD systems, a decrease was also seen, from 19% in 2007 to 5.2% in 2015 (p<0.001). Fifteen nvCT cases from 2015 and 102 cases from 2006 to 2009 had identical MLST profiles. Counties using Roche/Abbott systems showed higher mean rates of ectopic pregnancy and pelvic inflammatory disease compared with counties using BD systems.CONCLUSIONS: The nvCT proportion has decreased in all counties and converged to a low prevalence irrespective of previous rates. Genotyping showed that nvCT is clonal and genetically stable. Failing detection only marginally affected complication rates.
44.	Dahlén, Elin, et al. (författare) Sibship and dispensing patterns of asthma medication in young children : a population based study 2019 Ingår i: Pharmacoepidemiology & Drug Safety. - Stockholm : Karolinska Institutet, Dept of Medical Epidemiology and Biostatistics. - 1053-8569 .- 1099-1557. Tidskriftsartikel (refereegranskat)abstract Purpose: Our aim was to study the association between sibship and dispensing patterns of asthma medication in young children, focusing on incidence and persistence, and taking sibship status, asthma diagnoses, and siblings’ medication into account. Methods: A register-based cohort study including all children (n=50,546) born in Stockholm, Sweden 2006–2007, followed up during 2006–2014. Exposure was sibling status; outcome was incidence of dispensed asthma medication and persistence over time. A Cox-model was used to study the association between sibship and asthma medication. Persistence was defined using two different time windows (4- and 18-months) in a refill sequence model including siblings’ and unrelated control children’s medication. Results: After one year of age, the adjusted hazard ratio of dispensed asthma medication was 0.85 (95%CI 0.80–0.90) among children with siblings compared to singletons. The estimated proportion of children with persistent controller medication was 7.2% (4-month model) and 64.5% (18-month model). When including the siblings’ controller medication, the estimated proportion was 8.8% (4-months) and 7.8% for control children (relative risk, RR 0.89, 95%CI 0.81-0.98). The persistence was lower for those with siblings compared to singletons (adj. RR 0.72, 95%CI 0.62-0.85 for 4-months) with similar estimates for older, younger, and full siblings and regardless of asthma diagnoses. Conclusions: Siblings have different dispensing patterns of asthma medications compared to singletons regardless of asthma diagnoses. After including the siblings’ asthma medication and compared with control children, the proportion of children with persistent medication increased which may indicate that siblings share asthma medications.
45.	Derwig, Mariette, et al. (författare) eHealth usage among parents to premature or surgically treated neonates: associations with eHealth literacy, healthcare satisfaction or satisfaction with an eHealth device 2023 Ingår i: BMC Pediatrics. - 1471-2431. ; 23 Tidskriftsartikel (refereegranskat)abstract BackgroundA specific eHealth device, a surf tablet, was developed for bridging between advanced in-hospital care and children’s homes. Since little is known about determinators for parental eHealth usage, the study’s aim was to explore if parents’ usage of the device was associated with their eHealth literacy, or their satisfaction with their child’s healthcare or with the specific surf tablet.MethodsIn this explorative usage and questionnaire study, parents to neonates who were discharged home after advanced in-hospital care were included. Their surf tablet usage at maximum 30 days after discharge was reported as frequency (%) of active days (usage days/days having the device) and median number of tablet activities (chat and photo) per usage day. eHealth literacy (eHealth Literacy Questionnaire; eHLQ), healthcare satisfaction (PedsQL Healthcare Satisfaction Generic Module), and satisfaction with the surf tablet were explored regarding tablet usage. Statistics were described in median (range) and (%) using non-parametric and regression models (p ResultsParents to 32 children (11 premature, 21 operated) were included. Active days with eHealth communication using the device was 39% (9.0/29.5), with 2.0 (1.0-4.2) usage occasions per active day. Activity on the tablet was higher among parents reporting to be very satisfied or satisfied with the device (n = 25) compared with neutral/dissatisfied parents (n = 7) (2.8 vs. 2.2 vs. 1.6 activities) (p = 0.030), while their frequency of active days did not differ (31.6% vs. 38.3% vs. 40%) (p = 0.963). A higher eHealth literacy was not associated with frequency of active days (0.926 (0.652–1.317); p = 0.659) or number of eHealth activities (0.973 (0.758–1.250); p = 0.825). Healthcare satisfaction was not associated with higher frequency of active days 0.996 (0.983–1.009; p = 0.519); neither was number of eHealth activities 1.001 (0.991–1.011; p = 0.883).ConclusionIn this study, eHealth usage was associated with parental satisfaction with the specific eHealth device, but not with eHealth literacy or healthcare satisfaction. To assure equal access to healthcare when using eHealth, the user-friendliness of the device seems to be crucial, and technical support needs to be in place.
46.	Djukic, Ika, et al. (författare) Early stage litter decomposition across biomes 2018 Ingår i: Science of the Total Environment. - : Elsevier. - 0048-9697 .- 1879-1026. ; 628, s. 1369-1394 Tidskriftsartikel (refereegranskat)abstract Through litter decomposition enormous amounts of carbon is emitted to the atmosphere. Numerous large-scale decomposition experiments have been conducted focusing on this fundamental soil process in order to understand the controls on the terrestrial carbon transfer to the atmosphere. However, previous studies were mostly based on site-specific litter and methodologies, adding major uncertainty to syntheses, comparisons and meta-analyses across different experiments and sites. In the TeaComposition initiative, the potential litter decomposition is investigated by using standardized substrates (Rooibos and Green tea) for comparison of litter mass loss at 336 sites (ranging from −9 to +26 °C MAT and from 60 to 3113 mm MAP) across different ecosystems. In this study we tested the effect of climate (temperature and moisture), litter type and land-use on early stage decomposition (3 months) across nine biomes. We show that litter quality was the predominant controlling factor in early stage litter decomposition, which explained about 65% of the variability in litter decomposition at a global scale. The effect of climate, on the other hand, was not litter specific and explained <0.5% of the variation for Green tea and 5% for Rooibos tea, and was of significance only under unfavorable decomposition conditions (i.e. xeric versus mesic environments). When the data were aggregated at the biome scale, climate played a significant role on decomposition of both litter types (explaining 64% of the variation for Green tea and 72% for Rooibos tea). No significant effect of land-use on early stage litter decomposition was noted within the temperate biome. Our results indicate that multiple drivers are affecting early stage litter mass loss with litter quality being dominant. In order to be able to quantify the relative importance of the different drivers over time, long-term studies combined with experimental trials are needed.
47.	Dworeck, Christian, et al. (författare) Radial artery access is associated with lower mortality in patients undergoing primary PCI : a report from the SWEDEHEART registry 2020 Ingår i: European Heart Journal. - : Sage Publications. - 2048-8726 .- 2048-8734. ; 9:4, s. 323-332 Tidskriftsartikel (refereegranskat)abstract Objectives: The purpose of this observational study was to evaluate the effects of radial artery access versus femoral artery access on the risk of 30-day mortality, inhospital bleeding and cardiogenic shock in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention.Methods: We used data from the SWEDEHEART registry and included all patients who were treated with primary percutaneous coronary intervention in Sweden between 2005 and 2016. We compared patients who had percutaneous coronary intervention by radial access versus femoral access with regard to the primary endpoint of all-cause death within 30 days, using a multilevel propensity score adjusted logistic regression which included hospital as a random effect.Results: During the study period, 44,804 patients underwent primary percutaneous coronary intervention of whom 24,299 (54.2%) had radial access and 20,505 (45.8%) femoral access. There were 2487 (5.5%) deaths within 30 days, of which 920 (3.8%) occurred in the radial access and 1567 (7.6%) in the femoral access group. After propensity score adjustment, radial access was associated with a lower risk of death (adjusted odds ratio (OR) 0.70, 95% confidence interval (CI) 0.55-0.88,P = 0.025). We found no interaction between access site and age, gender and cardiogenic shock regarding 30-day mortality. Radial access was also associated with a lower adjusted risk of bleeding (adjusted OR 0.45, 95% CI 0.25-0.79,P = 0.006) and cardiogenic shock (adjusted OR 0.41, 95% CI 0.24-0.73,P = 0.002).Conclusions: In patients with ST-elevation myocardial infarction, primary percutaneous coronary intervention by radial access rather than femoral access was associated with an adjusted lower risk of death, bleeding and cardiogenic shock. Our findings are consistent with, and add external validity to, recent randomised trials.
48.	Egberg Thyme, Karin, 1943-, et al. (författare) Art therapy and self-image : A 5-year follow-up art therapy RCT study of women diagnosed with breast cancer 2022 Ingår i: Palliative & Supportive Care. - : Cambridges Institutes Press. - 1478-9515 .- 1478-9523. ; 20:4, s. 482-490 Tidskriftsartikel (refereegranskat)abstract Mål: Denna uppföljningsstudie om upplevd självbild och psykofysisk nöd/psykiska symptom baserades på en ranomiserad kontrollerad studie av konstterapi på kvinnor med bröstcancer.Metod: Syftet var att undersöka de långsiktiga effekterna av tidsbegränsad konstterapi med hjälp av instrumenten Strukturanalys av socialt beteende (SASB) och Symptom Check List-90 (SCL-90).Resultat: Tre anslutningskluster i SASB visade signifikanta förändringar efter terapin: Autonomt jag (kluster 1), Accepterande själv (kluster 2) och Älskande själv (kluster 3). Klusterna 2 och 3 fortsatte att förändras till förmån för interventionsgruppen vid den 5-åriga uppföljningen. Det fanns inga signifikanta skillnader i SCL-90-resultaten mellan interventionsgruppen och kontrollgruppen i uppföljningsstudien.Betydelse av resultat: Konstterapiinterventionen var både terapeutisk och psyko-pedagogisk. Slutsatsen av denna studie är att närmar sig känslor genom tidsbegränsad konstterapi verkar ha en långvarig effekt på det vidhäftande beteende som visas i SASB-modellen efter intervention, och denna effekt förblev 5 år senare.
49.	Ehn Börjesson, Stina-Mina, 1964-, et al. (författare) Enterococcus spp in wastewater and in mallards (Anas platyrhynchos) exposed to wastewater wetland 2013 Ingår i: International Journal of Environmental Protection. - 2226-6437. ; 3:10, s. 1-12 Tidskriftsartikel (refereegranskat)abstract In this study, twelve Mallards living in an artificial wastewater wetland were exposed to treated wastewater containing 1 x 103- 4 x 103 enterococci 100 ml-1 for a period of 55 days. Faecal samples were collected before, during and after exposure and analysed for Enterococcus spp. The isolates were phenotyped using the PhenePlateTM system. 270 Enterococcus spp. of Mallard origin were analysed, together with 116 Enterococcus spp. isolates from treated wastewater and from incoming raw wastewater. In general, the Mallard and wastewater enterococci isolates belonged to different phenotypes, although several sharing identical phenotypic profiles were found. One E. faecalis phenotype was found in Mallards before, during and after exposure to treated wastewater, as well as in raw and treated wastewater. Our results indicate that there is a common source of enterococci for Mallards and humans. We propose an increased focus on emissions of human bacteria and on systems that mediate their transfer to wild animals.
50.	Ehn Börjesson, Stina-Mina, et al. (författare) Enterococcus spp in wastewater and in mallards (Anas platyrhynchos) exposed to wastewater wetland 2013 Ingår i: International Journal of Environmental Protection. - 2226-6437. ; 3:10, s. 1-12 Tidskriftsartikel (refereegranskat)abstract In this study, twelve Mallards living in an artificial wastewater wetland were exposed to treated wastewater containing 1 x 103- 4 x 103 enterococci 100 ml-1 for a period of 55 days. Faecal samples were collected before, during and after exposure and analysed for Enterococcus spp. The isolates were phenotyped using the PhenePlateTM system. 270 Enterococcus spp. of Mallard origin were analysed, together with 116 Enterococcus spp. isolates from treated wastewater and from incoming raw wastewater. In general, the Mallard and wastewater enterococci isolates belonged to different phenotypes, although several sharing identical phenotypic profiles were found. One E. faecalis phenotype was found in Mallards before, during and after exposure to treated wastewater, as well as in raw and treated wastewater. Our results indicate that there is a common source of enterococci for Mallards and humans. We propose an increased focus on emissions of human bacteria and on systems that mediate their transfer to wild animals.

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