| 1. |
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| 2. |
- Granberg, Dan, et al.
(författare)
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Liver embolization with trisacryl gelatin microspheres (embosphere) in patients with neuroendocrine tumors
- 2007
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Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 48:2, s. 180-185
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To report our experience of liver embolization with trisacryl gelatin microspheres (Embospheretrade mark) in patients with metastatic neuroendocrine tumors. MATERIAL AND METHODS: Fifteen patients underwent selective embolization of the right or left hepatic artery with Embosphere. One lobe was embolized in seven patients and both lobes, on separate occasions, in eight patients. Seven patients had midgut carcinoids, two had lung carcinoids, one suffered from a thymic carcinoid, and five had endocrine pancreatic tumors. Eight patients suffered from endocrine symptoms, seven of whom had carcinoid syndrome and one WDHA (watery diarrhea, hypokalemia, achlorhydria) syndrome. RESULTS: Partial radiological response was seen after eight embolizations (in six different patients), stable disease was observed after 13 embolizations (after three of these, necroses occurred), while radiological progression was noted after only two embolizations. Only two patients experienced a biochemical response. Clinical improvement of carcinoid syndrome was observed after five embolizations. There were no major complications. Fever >38 degrees C was seen after all but four embolizations, and urinary tract infections were diagnosed after eight embolizations. CONCLUSION: Selective hepatic artery embolization with Embosphere particles is a safe treatment for patients with metastatic neuroendocrine tumors and may lead to partial radiological response as well as symptomatic improvement of disabling endocrine symptoms.
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| 3. |
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| 4. |
- Malinovschi, Andrei, 1978-, et al.
(författare)
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Assessment of Global Lung Function Initiative (GLI) reference equations for diffusing capacity in relation to respiratory burden in the Swedish CArdioPulmonary bioImage Study (SCAPIS)
- 2020
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Ingår i: European Respiratory Journal. - Lausanne, Switzerland : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 56:2
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Tidskriftsartikel (refereegranskat)abstract
- The Global Lung Function Initiative (GLI) has recently published international reference values for diffusing capacity of the lung for carbon monoxide (DLCO). Lower limit of normal (LLN), i.e. the 5th percentile, usually defines impaired DLCO. We examined if the GLI LLN for DLCO differs from the LLN in a Swedish population of healthy, never-smoking individuals and how any such differences affect identification of subjects with respiratory burden.Spirometry, DLCO, chest high-resolution computed tomography (HRCT) and questionnaires were obtained from the first 15 040 participants, aged 50–64 years, of the Swedish CArdioPulmonary bioImage Study (SCAPIS). Both GLI reference values and the lambda-mu-sigma (LMS) method were used to define the LLN in asymptomatic never-smokers without respiratory disease (n=4903, of which 2329 were women).Both the median and LLN for DLCO from SCAPIS were above the median and LLN from the GLI (p<0.05). The prevalence of DLCO DLCO >GLI LLN but DLCO >GLI LLN but versus 4.5%, p<0.001), chronic airflow limitation (8.5% versus 3.9%, p<0.001) and chronic bronchitis (8.3% versus 4.4%, p<0.01) than subjects (n=13 600) with normal DLCO (>GLI LLN and >SCAPIS LLN). No differences were found with regard to physician-diagnosed asthma.The GLI LLN for DLCO is lower than the estimated LLN in healthy, never-smoking, middle-aged Swedish adults. Individuals with DLCO above the GLI LLN but below the SCAPIS LLN had, to a larger extent, an increased respiratory burden. This suggests clinical implications for choosing an adequate LLN for studied populations.
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| 5. |
- Malinovschi, Andrei, 1978-, et al.
(författare)
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Consequences of Using Post- or Prebronchodilator Reference Values in Interpreting Spirometry
- 2023
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Ingår i: American Journal of Respiratory and Critical Care Medicine. - : American Thoracic Society. - 1073-449X .- 1535-4970. ; 208:4, s. 461-471
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Tidskriftsartikel (refereegranskat)abstract
- RATIONALE: Post-bronchodilator (BD) spirometry is used for diagnosis of chronic obstructive pulmonary disease (COPD). However, pre-BD reference values are used for spirometry interpretation.OBJECTIVES: To compare the resulting prevalence rates of abnormal spirometry and study the consequences of using pre- or post-BD reference values generated within the Swedish CArdioPulmonary bioImage Study (SCAPIS) when interpreting post-BD spirometry in a general population.METHODS: SCAPIS reference values for post-BD and pre-BD spirometry were based on 10,156 and 1,498 never-smoking, healthy participants, respectively. We studied the associations of abnormal spirometry, defined by using pre- or post-BD reference values, with respiratory burden in the SCAPIS general population (28,851 individuals).MEASUREMENTS AND MAIN RESULTS: Bronchodilation resulted in higher predicted median and lower limit of normal (LLN) for FEV1/FVC ratio. The prevalence of post-BD FEV1/FVC < pre-bronchodilator LLN was 4.8% and that of post-BD FEV1/FVC < post-bronchodilator LLN was 9.9% for the general population. An additional 5.1% was identified as having an abnormal post-BD FEV1/FVC ratio and this group had more respiratory symptoms, emphysema (13.5% vs. 4.1%, p<0.001) and self-reported physician-diagnosed COPD (2.8% vs. 0.5%, p<0.001) than subjects with post-BD FEV1/FVC ratio > LLN for both pre- and post-bronchodilation).CONCLUSIONS: Pre- and post-bronchodilator spirometry reference values differ with regard to FEV1/FVC ratio. Use of post-bronchodilator reference values doubled the population prevalence of airflow obstruction; this was related to a higher respiratory burden. Using post-bronchodilator reference values when interpreting post-bronchodilator spirometry might enable identification of individuals with mild disease and be clinically relevant.
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| 6. |
- Sundström, Johan, Professor, 1971-, et al.
(författare)
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Risk factors for subarachnoid haemorrhage : a nationwide cohort of 950 000 adults
- 2019
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Ingår i: International Journal of Epidemiology. - : Oxford University Press. - 0300-5771 .- 1464-3685. ; 48:6, s. 2018-2025
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Subarachnoid haemorrhage (SAH) is a devastating disease, with high mortality rate and substantial disability among survivors. Its causes are poorly understood. We aimed to investigate risk factors for SAH using a novel nationwide cohort consortium.METHODS: We obtained individual participant data of 949 683 persons (330 334 women) between 25 and 90 years old, with no history of SAH at baseline, from 21 population-based cohorts. Outcomes were obtained from the Swedish Patient and Causes of Death Registries.RESULTS: During 13 704 959 person-years of follow-up, 2659 cases of first-ever fatal or non-fatal SAH occurred, with an age-standardized incidence rate of 9.0 [95% confidence interval (CI) (7.4-10.6)/100 000 person-years] in men and 13.8 [(11.4-16.2)/100 000 person-years] in women. The incidence rate increased exponentially with higher age. In multivariable-adjusted Poisson models, marked sex interactions for current smoking and body mass index (BMI) were observed. Current smoking conferred a rate ratio (RR) of 2.24 (95% CI 1.95-2.57) in women and 1.62 (1.47-1.79) in men. One standard deviation higher BMI was associated with an RR of 0.86 (0.81-0.92) in women and 1.02 (0.96-1.08) in men. Higher blood pressure and lower education level were also associated with higher risk of SAH.CONCLUSIONS: The risk of SAH is 45% higher in women than in men, with substantial sex differences in risk factor strengths. In particular, a markedly stronger adverse effect of smoking in women may motivate targeted public health initiatives.
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| 7. |
- Torén, Kjell, 1952, et al.
(författare)
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The ratio FEV1/FVC and its association to respiratory symptoms-A Swedish general population study
- 2021
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Ingår i: Clinical Physiology and Functional Imaging. - : Wiley. - 1475-0961 .- 1475-097X. ; 41:2, s. 181-191
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Tidskriftsartikel (refereegranskat)abstract
- Chronic airflow limitation (CAL) can be defined as fixed ratio of forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) any respiratory symptom. In a cross-sectional general population study, 15,128 adults (50-64 years of age), 7,120 never-smokers and 8,008 ever-smokers completed a respiratory questionnaire and performed FEV1 and FVC after bronchodilation. We calculated different ratios of FEV1/FVC from 0.40 to 1.0 using 0.70 as reference category. We analysed odds ratios (OR) between different ratios and any respiratory symptom using adjusted multivariable logistic regression. Among all subjects, regardless of smoking habits, the lowest odds for any respiratory symptom was at FEV1/FVC = 0.82, OR 0.48 (95% CI 0.41-0.56). Among never-smokers, the lowest odds for any respiratory symptom was at FEV1/FVC = 0.81, OR 0.53 (95% CI 0.41-0.70). Among ever-smokers, the odds for any respiratory symptom was lowest at FEV1/FVC = 0.81, OR 0.43 (95% CI 0.16-1.19), although the rate of inclining in odds was small in the upper part, that is FEV1/FVC = 0.85 showed similar odds, OR 0.45 (95% CI 0.38-0.55). We concluded that the odds for any respiratory symptoms continuously decreased with higher FEV1/FVC ratios and reached a minimum around 0.80-0.85, with similar results among never-smokers. These results indicate that the optimal threshold associated with respiratory symptoms may be higher than 0.70 and this should be further investigated in prospective longitudinal studies.
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| 8. |
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| 9. |
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| 10. |
- Adén, Daniel, et al.
(författare)
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An abundance study of red-giant-branch stars in the Hercules dwarf spheroidal galaxy
- 2011
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 525, s. A153-
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Tidskriftsartikel (refereegranskat)abstract
- Context. Dwarf spheroidal galaxies are some of the most metal-poor, and least luminous objects known. Detailed elemental abundance analysis of stars in these faint objects is key to our understanding of star formation and chemical enrichment in the early universe, and may provide useful information on how larger galaxies form. Aims. Our aim is to provide a determination of [Fe/H] and [Ca/H] for confirmed red-giant branch member stars of the Hercules dwarf spheroidal galaxy. Based on this we explore the ages of the prevailing stellar populations in Hercules, and the enrichment history from supernovae. Additionally, we aim to provide a new simple metallicity calibration for Stromgren photometry for metal-poor, red giant branch stars. Methods. High-resolution, multi-fibre spectroscopy and Stromgren photometry are combined to provide as much information on the stars as possible. From this we derive abundances by solving the radiative transfer equations through marcs model atmospheres. Results. We find that the red-giant branch stars of the Hercules dSph galaxy are more metal-poor than estimated in our previous study that was based on photometry alone. From this, we derive a new metallicity calibration for the Stromgren photometry. Additionally, we find an abundance trend such that [Ca/Fe] is higher for more metal-poor stars, and lower for more metal-rich stars, with a spread of about 0.8 dex. The [Ca/Fe] trend suggests an early rapid chemical enrichment through supernovae of type II, followed by a phase of slow star formation dominated by enrichment through supernovae of type Ia. A comparison with isochrones indicates that the red giants in Hercules are older than 10 Gyr.
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| 11. |
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| 12. |
- Ahlström, Håkan, et al.
(författare)
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Pancreatic neuroendocrine tumors : diagnosis with PET
- 1995
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Ingår i: Radiology. - 0033-8419 .- 1527-1315. ; 195:2, s. 333-337
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate the use of carbon-11-labeled L-dihydroxyphenylalanine (L-DOPA) and hydroxytryptophan (5-HTP) in the diagnosis of pancreatic endocrine tumors with positron emission tomography (PET). MATERIALS AND METHODS: Twenty-two consecutive patients with clinically and biochemically verified pancreatic endocrine tumors were examined with computed tomography (CT) and PET with L-DOPA alone (n = 16) or both C-11-L-DOPA and C-11-5-HTP (n = 6). RESULTS: Tumor uptake of L-DOPA was found in 11 patients, eight of whom had metastatic disease. Heterogeneity of tracer uptake was noted among different lesions in the same patient (ie, high uptake in some lesions and low uptake in others). Results in patients examined with both L-DOPA and 5-HTP correlated well, but the uptake levels of 5-HTP were higher in two of three patients with positive findings. In two additional patients, CT enabled detection of tumors not detected at PET. CONCLUSION: The current PET technique can be a valuable complement to CT in demonstration of functional pancreatic endocrine tumors, in particular, glucagonomas, but is less useful in detection of nonfunctional tumors.
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| 13. |
- Ahlström, Håkan, et al.
(författare)
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Preoperative localization of endocrine pancreatic tumours by intra-arterial dynamic computed tomography
- 1990
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Ingår i: Acta Radiologica. - 0284-1851 .- 1600-0455. ; 31:2, s. 171-175
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Tidskriftsartikel (refereegranskat)abstract
- Eleven patients with biochemically confirmed endocrine pancreatic tumours were examined with intra-arterial (i.a.) dynamic computed tomography (CT) and angiography preoperatively. Seven of the patients suffered from the multiple endocrine neoplasia type 1 (MEN-1) syndrome. All patients were operated upon and surgical palpation and ultrasound were the peroperative localization methods. Of the 33 tumours which were found at histopathologic analysis of the resected specimens in the 11 patients, 7 tumours in 7 patients were correctly localized by both i.a. dynamic CT and angiography. Six patients with MEN-1 syndrome had multiple tumours and this group of patients together had 28 tumours, of which 5 (18%) were localized preoperatively by both CT and angiography. I.a. dynamic CT, with the technique used by us, does not seem to improve the localization of endocrine pancreatic tumours, especially in the rare group of MEN-1 patients, as compared with angiography.
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| 14. |
- Alatalo, Rauno V., et al.
(författare)
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Exploitation competition influences the use of foraging sites by tits : Experimental evidence
- 1987
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Ingår i: Ecology. - : Ecological Society of America. - 0012-9658 .- 1939-9170. ; 68:2, s. 284-290
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Tidskriftsartikel (refereegranskat)abstract
- In coniferous forests of central Sweden, tits (Paridae) and the Goldcrest, Regulus regulus, exploit nonrenewable resources in their group territories during winter. The smaller and socially subordinate species, the Goldcrest and the Coal Tit, Parus ater, forage on the outermost tree parts, while the larger and dominant Willow Tit, Parus montanus, and Crested Tit, Parus cristatus, forage on the inner tree parts. We removed Coal Tits and Goldcrests in three flocks in early winter to see if their absence would cause changes in the foraging patterns of the two dominant species. In late winter, Crested Tits foraged farther outward on branches of spruce in experimental flocks than they did in the control flocks. In spruce, Willow Tits foraged nearer the trunk than Crested Tits, and they did not respond to the experiment. In pine, Willow Tits, however, did move from branches to twigs in the absence of Coal Tits and Goldcrests. The experiment indicates that exploitation competition directly based on food depletion, without any interference, may influence the use of foraging sites by tits in coniferous forests.
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| 15. |
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| 16. |
- Andersson, Andreas, 1980-
(författare)
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Utmattningsanalys av järnvägsbroar : En fallstudie av stålbroarna mellan Stockholm Central och Söder Mälarstrand, baserat på teoretiska analyser och töjningsmätningar
- 2009
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Föreliggande avhandling omfattar en fallstudie av utmattningsrisken för järnvägsbroarna mellan Stockholm Central och Söder Mälarstrand. Ett stort antal utmattningssprickor i broarna över Söderström och Söder Mälarstrand har sedan länge varit kända. I samband med en bärighetsutredning av sträckan har ett stort antal anslutningspunkter i samtliga broar identifierats som kritiska avseende utmattningsrisk. Sträckan är den mest trafikerade i Sverige och de förenklade beräkningsmetoder som anges i Banverkets föreskrift för bärighetsberäkningar är i vissa fall inte tillämpliga. De formella bärighetsberäkningarna har visat på flerfaldiga överskridanden i utnyttjandegrad gällande utmattning. I de punkter som beräkningarna visar störst risk för utmattning har inga sprickor påträffats, trots omfattande förbandsbesiktningar. Beräkningarna baseras på typiserade spänningskollektiv och givet antal spänningsväxlingar, oberoende av den aktuella trafikmängden. Enligt bärighetsnormen ges möjlighet att beakta den verkliga trafikmängden baserat på historiskt bruttotonnage och typiserade trafiklaster. Dessa beräkningar har utförts och visar på ännu större risk för utmattning, jämfört med den förenklade metoden. I syfte att på ett ännu mer nyanserat sätt uppskatta utmattningsrisken har en metod använts, baserat på uppskattning av den faktiska trafikmängden och dess fördelningar. Beräkningarna baseras på trafikdata tillgänglig från Banverket. Metoden är tillämplig på andra järnvägsbroar på andra sträckor. Utöver teoretiska beräkningar har töjningsmätningar utförts. Under 2006 utförde dåvarande Carl Bro AB töjningsmätningar på bro över Söder Mälarstrand och viadukt söder om Söder Mälarstrand, avseende några enskilda tågöverfarter. Under 2008 utförde KTH Brobyggnad omfattande töjningsmätningar på bro över Söderström, avseende all trafik under en månads tid.
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| 17. |
- Andersson, Torbjörn, et al.
(författare)
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Effects of Interferon on Tumor Tissue Content in Liver Metastases of Human Carcinoid Tumors
- 1990
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Ingår i: Cancer Research. - 0008-5472 .- 1538-7445. ; :50, s. 3413-3415
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Tidskriftsartikel (refereegranskat)abstract
- In 21 patients ultrasound-guided cutting biopsies, from carcinoid metastases of the liver, were taken before and after therapy with α-interferon. Each biopsy was examined under light microscopy and the amount of tumor tissue and connective tissue was quantified and then correlated to objective response to interferon therapy. A significant reduction of the amount of tumor tissue, in spite of unaltered metastatic size and a corresponding increase in connective tissue, was seen after interferon therapy. A more pronounced reduction of tumor tissue occurred after long-term interferon therapy. A positive correlation between objective therapy response and tumor tissue reduction was also present. Patients responding poorly, or not at all, to therapy did not show any significant decrease in tumor tissue. Since treatment with immune response modifiers is expected to increase in the near future, it is important to choose the right investigations for therapy monitoring, and since all patients in this investigation had unchanged tumor size on repeated radiological examinations, it is obvious that microscopic examination of core biopsies is a better method for evaluating effects of long-term therapy than tumor size measurement with radiological techniques. Further, the results may indicate that interferon exerts a cytotoxic effect on carcinoid tumor cells in vivo.
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| 18. |
- Andréasson, Maia, 1960, et al.
(författare)
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Swedish CLARIN activities
- 2009
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Ingår i: Proceedings of the Nodalida 2009 workshop on CLARIN activities in the Nordic countries. NEALT Proceedings Series. - 1736-6305. ; 5, s. 1-5
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Konferensbidrag (refereegranskat)
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| 19. |
- Andréasson, Maia, et al.
(författare)
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Swedish CLARIN Activities
- 2009
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Ingår i: Proceedings of the NODALIDA 2009 workshop Nordic Perspectives on the CLARIN Infrastructure of Language Resources. - : Northern European Association for Language Technology (NEALT). ; , s. 1-5
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Konferensbidrag (refereegranskat)abstract
- Although Sweden has yet to allocate funds specifically intended for CLARIN activities, there are some ongoing activities which are directly relevant to CLARIN, and which are explicitly linked to CLARIN. These activities have been funded by the Committee for Research Infrastructures and its subcommittee DISC (Database Infrastructure Committee) of the Swedish Research Council.
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| 20. |
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| 21. |
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| 22. |
- Appelros, Peter, et al.
(författare)
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Trends in baseline patient characteristics during the years 1995-2008 : observations from Riks-Stroke, the Swedish Stroke Register.
- 2010
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Ingår i: Cerebrovascular Diseases. - : S. Karger AG. - 1015-9770 .- 1421-9786. ; 30:2, s. 114-119
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Reported improvements in outcome in stroke patients treated in hospital are often attributed to advances in stroke care. However, secular trends in patient characteristics that are present already on admission to hospital may also contribute to improved outcome. METHODS: Time trends for baseline data (289,854 stroke admittances) in Riks-Stroke, the Swedish national quality register for stroke care, were analyzed for the years 1995 through 2008. The following data were included: number of strokes for each year, age, sex, risk factors, stroke subtype, stroke severity, functional status and need of external home service before the stroke. RESULTS: The number of annually reported strokes increased until 2005. The proportion of recurrent strokes decreased from 28.0 to 25.9%. The mean age at first-ever stroke increased in women, but not in men. The proportion of smokers dropped, and the proportion of patients who had treated hypertension increased. The stroke severity decreased in men. The prestroke functional status (walking, dressing, toileting) improved in both sexes over these years. More patients lived alone in 2008 than in 1995, and more had home help service. CONCLUSIONS: Many baseline parameters in Riks-Stroke have changed over the years. This has consequences for the interpretation of outcome data. Some changes may be due to inclusion bias, others due to alterations in general health, evolution of vascular risk factors or demographics.
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| 23. |
- Asplund, Kjell, et al.
(författare)
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Country comparisons of human stroke research since 2001 : a bibliometric study
- 2012
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Ingår i: Stroke. - : American Heart Association. - 0039-2499 .- 1524-4628. ; 43:3, s. 830-837
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: This is the first bibliometric comparison between countries of the development of stroke research over time. METHODS: Clinical and epidemiological articles on stroke published 2001 to mid-2011 were identified in Science Citation Index Expanded. Article fractions, citation fractions, h-index, and international collaboration were calculated using the BibExcel software and adjusted for population size and gross domestic product. RESULTS: The United States dominated with 28.7% of the sum of article fractions and 36.2% of the sum of citation fractions. The United States, Japan, the United Kingdom, and Germany together accounted for 52.1% of articles and 61.0% of citations. When adjusted for population size or gross domestic product, several small European countries, together with Israel and Taiwan, ranked the highest. Per population, there was a negative association (r=0.60) between burden of stroke (disability-adjusted life-years lost) and number of articles per population. In China, South Korea, and Singapore, the annual growth of stroke articles was more than twice the worldwide average. Whereas multinational collaboration was common within Europe and North America, it was relatively uncommon between Asian countries. CONCLUSIONS: The Big 4 in scientific literature on stroke, as to both number of articles and citations, are the United States, Japan, the United Kingdom, and Germany. Many small European countries have, in relation to their size, a high scientific production. Several countries with rapidly expanding economies have very fast growth of scientific production on stroke. Our results emphasize the need for stroke research in countries with a high population burden of stroke and they highlight the role of multinational collaboration.
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| 24. |
- Asplund, Kjell, et al.
(författare)
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Effects of Extending the Time Window of Thrombolysis to 4.5 Hours : Observations in the Swedish Stroke Register (Riks-Stroke)
- 2011
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Ingår i: Stroke. - New York : American Heart Association. - 0039-2499 .- 1524-4628. ; 42:9, s. 2492-2497
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose: The European Cooperative Acute Stroke Study (ECASS) III trial and Safe Implementation of Thrombolysis in Stroke–International Stroke Thrombolysis Register (SITS-ISTR) data were published in 2008. Riks-Stroke, the Swedish Stroke Register, was used to explore how thrombolysis in the 3- to 4.5-hour window has been spread in different hospitals and patient groups and what effects this has had on treatment within 3 hours.Methods: All 76 hospitals in Sweden admitting patients with acute stroke participate in Riks-Stroke. During the study period, January 2003 to June 2010, 92 150 18- to 80-year-old patients were hospitalized for acute ischemic stroke.Results: After the publication of the ECASS III results in the third quarter of 2008, thrombolysis in the 3- to 4.5-hour window increased from 0.5% before publication to 2.1% in 2010. Thrombolysis in the 3- to 4.5-hour window spread somewhat faster in men than women (P=0.04) but at a similar rate in different age groups. The use of thrombolysis within 3 hours after onset of symptoms increased successively from 0.9% in 2003 to 6.6% in late 2008 and then it stabilized at 6%. The median time from arrival to the hospital to start of treatment remained unchanged at 66 to 69 minutes before and after 2008 (P=0.06).Conclusions: Since the end of 2008, there has been a rapid nationwide dissemination of thrombolysis in the 3- to 4.5-hour window, whereas rates in the <3-hour window have leveled off. The extended time window has not affected door-to-needle time.
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| 25. |
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| 26. |
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| 27. |
- Asplund, Kjell, et al.
(författare)
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Malnutrition in hospitalized elderly patients
- 1985
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Ingår i: Nutrition, immunity and illness in the elderly. - New York : Pergamon Press. - 0080324045 ; , s. 213-227
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Konferensbidrag (refereegranskat)
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| 28. |
- Asplund, Kjell, et al.
(författare)
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Patient dissatisfaction with acute stroke care
- 2009
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Ingår i: Stroke. - : American Heart Association, Inc.. - 0039-2499 .- 1524-4628. ; 40:12, s. 3851-3856
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Riks-Stroke, the Swedish Stroke Register, was used to explore patient characteristics and stroke services as determinants of patient dissatisfaction with acute in-hospital care. METHODS: All 79 hospitals in Sweden admitting acute stroke patients participate in Riks-Stroke. During 2001 to 2007, 104,876 patients (87% of survivors) responded to a follow-up questionnaire 3 months after acute stroke; this included questions on satisfaction with various aspects of stroke care. RESULTS: The majority (>90%) were satisfied with acute in-hospital stroke care. Dissatisfaction was closely associated with outcome at 3 months. Patient who were dependent regarding activities of daily living, felt depressed, or had poor self-perceived general health were more likely to be dissatisfied. Dissatisfaction with global acute stroke care was linked to dissatisfaction with other aspects of care, including rehabilitation and support by community services. Patients treated in stroke units were less often dissatisfied than patients in general wards, as were patients who had been treated in a small hospital (vs medium or large hospitals) and patient who had participated in discharge planning. In multivariate analyses, the strongest predictor of dissatisfaction with acute care was poor outcome (dependency regarding activities of daily living, depressed mood, poor self-perceived health). CONCLUSIONS: Dissatisfaction with in-hospital acute stroke care is part of a more extensive complex comprising poor functional outcome, depressive mood, poor self-perceived general health, and dissatisfaction not only with acute care but also with health care and social services at large. Several aspects of stroke care organization are associated with a lower risk of dissatisfaction.
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| 29. |
- Asplund, Kjell, et al.
(författare)
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The Riks-Stroke story : building a sustainable national register for quality assessment of stroke care
- 2011
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Ingår i: International Journal of Stroke. - : SAGE Publications. - 1747-4930 .- 1747-4949. ; 6:2, s. 99-108
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Tidskriftsartikel (refereegranskat)abstract
- Background Riks-Stroke, the Swedish Stroke Register, is the world's longest-running national stroke quality register (established in 1994) and includes all 76 hospitals in Sweden admitting acute stroke patients. The development and maintenance of this sustainable national register is described. Methods Riks-Stroke includes information on the quality of care during the acute phase, rehabilitation and secondary prevention of stroke, as well as data on community support. Riks-Stroke is unique among stroke quality registers in that patients are followed during the first year after stroke. The data collected describe processes, and medical and patient-reported outcome measurements. The register embraces most of the dimensions of health-care quality (evidence-based, safe, provided in time, distributed fairly and patient oriented). Result Annually, approximately 25 000 patients are included. In 2009, approximately 320 000 patients had been accumulated (mean age 76-years). The register is estimated to cover 82% of all stroke patients treated in Swedish hospitals. Among critical issues when building a national stroke quality register, the delicate balance between simplicity and comprehensiveness is emphasised. Future developments include direct transfer of data from digital medical records to Riks-Stroke and comprehensive strategies to use the information collected to rapidly implement new evidence-based techniques and to eliminate outdated methods in stroke care. Conclusions It is possible to establish a sustainable quality register for stroke at the national level covering all hospitals admitting acute stroke patients. Riks-Stroke is fulfilling its main goals to support continuous quality improvement of Swedish stroke services and serve as an instrument for following up national stroke guidelines.
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| 30. |
- Asplund, Martin, et al.
(författare)
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Line-blanketed model atmospheres for R Coronae Borealis stars and hydrogen-deficient carbon stars
- 1997
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Ingår i: ASTRONOMY AND ASTROPHYSICS. - : SPRINGER VERLAG. - 0004-6361. ; 318:2, s. 521-534
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Tidskriftsartikel (refereegranskat)abstract
- We have constructed line-blanketed model atmospheres for the hydrogen-deficient and carbon-rich R Coronae Borealis (RCrB) stars, as well as for the similar hydrogen-deficient carbon (HdC) stars and the cool extreme helium (EHe) stars. Improved continuum o
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| 31. |
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| 32. |
- Axelsson, Karin, et al.
(författare)
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Eating problems and nutritional status during hospital stay of patients
- 1989
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Ingår i: Journal of the American Dietetic Association. - 0002-8223 .- 1878-3570. ; 89:6, s. 1092-6
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Tidskriftsartikel (refereegranskat)abstract
- Eating problems and nutritional status were studied in a consecutive series of patients who had had strokes. From this cohort, 32 subjects (mean age 73 years) with a hospital stay of 21 days or more are described. Eating problems were identified by direct participant observations of the patients' eating behavior, interviews on admission, inspections of the mouth, and discussions with the patients. Nutritional status was assessed by weight, triceps skinfold thickness (TSF), arm muscular circumference (AMC), plasma albumin, serum transferrin, and plasma prealbumin on admission and then weekly. Eating problems were identified in 27 patients. In a general linear hypothesis program, poor nutritional status 3 weeks after admission was found to be associated with (in decreasing order) low self-care performance, poor nutritional status on admission, male sex, intravenous energy-containing fluids, advanced age, paresis of the right arm, and eating problems. Factors other than eating problems seem to be important for undernutrition in patients with strokes during hospital stay. AD - Department
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| 33. |
- Azeez, Ahmed, 1991-
(författare)
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High-Temperature Durability Prediction of Ferritic-Martensitic Steel
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Materials used for high-temperature steam turbine sections are generally subjected to harsh environments with temperatures up to 625 °C. The superior creep resistance of 9–12 % Cr ferritic-martensitic steels makes them desirable for those critical steam turbine components. Additionally, the demand for fast and frequent steam turbine start-ups, i.e. flexible operations, causes accelerated fatigue damage in critical locations, such as grooves and notches, at the high-temperature inner steam turbine casing. A durability assessment is necessary to understand the material behaviour under such high temperatures and repeated loading, and it is essential for life prediction. An accurate and less conservative fatigue life prediction approach is achieved by going past the crack initiation stage and allowing controlled growth of cracks within safe limits. Besides, beneficial load-temperature history effects, i.e. warm pre-stressing, must be utilised to enhance the fracture resistance to cracks. This dissertation presents the high-temperature durability assessment of FB2 steel, a 9-12 % Cr ferritic-martensitic steam turbine steel.Initially, isothermal low-cycle fatigue testing was performed on FB2 steel samples. A fatigue life model based on finite element strain range partitioning was utilised to predict fatigue life within the crack initiation phase. Two fatigue damage regimes were identified, i.e. plastic- and creep-dominated damage, and the transition between them depended on temperature and applied total strain. Cyclic deformation and stress relaxation behaviour were investigated to produce an elastic-plastic and creep material model that predicts the initial and mid-life cyclic behaviour of the FB2 steel.Furthermore, the thermomechanical fatigue crack growth behaviour of FB2 steel was studied. Crack closure behaviour was observed and accounted for numerically and experimentally, where crack growth rate curves collapsed into a single curve. Interestingly, the collapsed crack growth curves coincided with isothermal crack growth tests performed at the minimum temperature of the thermomechanical crack growth tests. In addition, hold times and changes in the minimum temperature of the thermomechanical fatigue cycle did not influence crack closure behaviour.Finally, warm pre-stressing effects were explored for FB2 steel. A numerical prediction model was produced to predict the increase in the apparent fracture toughness. Warm pre-stressing effects can benefit the turbine life by enhancing fracture resistance and allowing longer fatigue cracks to grow within safe limits.
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| 34. |
- Azeez, Ahmed, 1991-
(författare)
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High-Temperature Fatigue in a Steam Turbine Steel : Modelling of Cyclic Deformation and Crack Closure
- 2021
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Existing conventional thermal power plants are retrofitted for flexible operations to assist the transition toward more renewable energies. The deployment of many renewable energy power plants is necessary to achieve a clean environment with less pollution. However, the intermittent nature of renewable energies, due to weather changes, and the lack of efficient large energy storage systems put renewables at a disadvantage. Flexible operations of power plants imply fast and frequent start-ups. Thus, retrofitted power production plants can be utilised as an energy backup to satisfy the immediate demand during peak energy times or when renewable energies are suddenly limited. Large thermal power plants generally employ steam turbines with high inlet temperature and pressure steam conditions. Materials used for components at the high-temperature turbine sections are expected to withstand harsh environments. The use of 9-12 % Cr martensitic steels is desirable due to, among other things, their superior resistance to creep for temperatures up to 625 °C. Retrofitting for flexible operations put steam turbine components under high-temperature fatigue loading conditions different from how they were designed before. The flexible operations could lead to fatigue cracking at critical locations, such as grooves and notches at the inner steam turbine casing. Thus, fatigue behaviour understanding of steam turbine materials under such loading conditions is essential for components life prediction. Accurate and less conservative fatigue life prediction approach is necessary to extend the turbine components life, which reduces waste and provides economic benefits. This can be done by extending operations past crack initiation phase and allowing controlled propagation of cracks in the components. Within the 9-12 % Cr steel class, the martensitic steam turbine steel called FB2 is studied under high-temperature fatigue. This includes investigating high-temperature fatigue life behaviour, cyclic deformation behaviour, stress relaxation behaviour, and crack propagation behaviour along with crack closure behaviour. This was achieved by experimentally testing samples made from FB2 steel under isothermal low cycle fatigue, isothermal fatigue crack propagation, and thermomechanical fatigue crack propagation.
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| 35. |
- Azeez, Ahmed, et al.
(författare)
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Low Cycle Fatigue Modelling of Steam Turbine Rotor Steel
- 2019
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Ingår i: 9th International Conference Materials Structure & Micromechanics of Fracture (MSMF9). - : Elsevier. ; , s. 149-154, s. 149-154
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Konferensbidrag (refereegranskat)abstract
- Materials in steam turbine rotors are subjected to cyclic loads at high temperature, causing cracks to initiate and grow. To allow for more flexible operation, accurate fatigue models for life prediction must not be overly conservative. In this study, fully reversed low cycle fatigue tests were performed on a turbine rotor steel called FB2. The tests were done isothermally, within temperature range of room temperature to 600 °C, under strain control with 0.8-1.2 % total strain range. Some tests included hold time to calibrate the short-time creep behaviour of the material. Different fatigue life models were constructed. The life curve in terms of stress amplitude was found unusable at 600 °C, while the life curve in terms of total strain or inelastic strain amplitudes displayed inconsistent behaviour at 500 °C. To construct better life model, the inelastic strain amplitudes were separated into plastic and creep components by modelling the deformation behaviour of the material, including creep. Based on strain range partitioning approach, the fatigue life depends on different damage mechanisms at different strain ranges. This allowed the formulation of life curves based on plasticity or creep domination, which showed creep domination at 600 °C, while at 500 °C, creep only dominates for higher strain range.
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| 36. |
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| 37. |
- Babusiaux, C., et al.
(författare)
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Observational Hertzsprung-Russell diagrams
- 2018
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 616
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Tidskriftsartikel (refereegranskat)abstract
- Context. Gaia Data Release 2 provides high-precision astrometry and three-band photometry for about 1.3 billion sources over the full sky. The precision, accuracy, and homogeneity of both astrometry and photometry are unprecedented. Aims. We highlight the power of the Gaia DR2 in studying many fine structures of the Hertzsprung-Russell diagram (HRD). Gaia allows us to present many different HRDs, depending in particular on stellar population selections. We do not aim here for completeness in terms of types of stars or stellar evolutionary aspects. Instead, we have chosen several illustrative examples. Methods. We describe some of the selections that can be made in Gaia DR2 to highlight the main structures of the Gaia HRDs. We select both field and cluster (open and globular) stars, compare the observations with previous classifications and with stellar evolutionary tracks, and we present variations of the Gaia HRD with age, metallicity, and kinematics. Late stages of stellar evolution such as hot subdwarfs, post-AGB stars, planetary nebulae, and white dwarfs are also analysed, as well as low-mass brown dwarf objects. Results. The Gaia HRDs are unprecedented in both precision and coverage of the various Milky Way stellar populations and stellar evolutionary phases. Many fine structures of the HRDs are presented. The clear split of the white dwarf sequence into hydrogen and helium white dwarfs is presented for the first time in an HRD. The relation between kinematics and the HRD is nicely illustrated. Two different populations in a classical kinematic selection of the halo are unambiguously identified in the HRD. Membership and mean parameters for a selected list of open clusters are provided. They allow drawing very detailed cluster sequences, highlighting fine structures, and providing extremely precise empirical isochrones that will lead to more insight in stellar physics. Conclusions. Gaia DR2 demonstrates the potential of combining precise astrometry and photometry for large samples for studies in stellar evolution and stellar population and opens an entire new area for HRD-based studies.
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| 38. |
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| 39. |
- Berglund, Erik, 1971-
(författare)
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Library Communication Among Programmers Worldwide
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Programmers worldwide share components and jointly develop components on a global scale in contemporary software development. An important aspect of such library-based programming is the need for technical communication with regard to libraries – library communication. As part of their work, programmers must discover, study, and learn as well as debate problems and future development. In this sense, the electronic, networked media has fundamentally changed programming by providing new mechanisms for communication and global interaction through global networks such as the Internet. Today, the baseline for library communication is hypertext documentation. Improvements in quality, efficiency, cost and frustration of the programming activity can be expected by further developments in the electronic aspects of library communication.This thesis addresses the use of the electronic networked medium in the activity of library communication and aims to discover design knowledge for communication tools and processes directed towards this particular area. A model of library communication is provided that describes interaction among programmer as webs of interrelated library communities. A discussion of electronic, networked tools and processes that match such a model is also provided. Furthermore, research results are provided from the design and industrial valuationof electronic reference documentation for the Java domain. Surprisingly, the evaluation did not support individual adaptation (personalization). Furthermore, global library communication processes have been studied in relation to open-source documentation and user-related bug handling. Open-source documentation projects are still relatively uncommon even in open-source software projects. User-related Open-source does not address the passive behavior users have towards bugs. Finally, the adaptive authoring process in electronic reference documentation is addressed and found to provide limited support for expressing the electronic, networked dimensions of authoring requiring programming skill by technical writers.Library communication is addressed here by providing engineering knowledge with regards to the construction of practical electronic, networked tools and processes in the area. Much of the work has been performed in relation to Java library communication and therefore the thesis has particular relevancefor the object-oriented programming domain. A practical contribution of the work is the DJavadoc tool that contributes to the development of reference documentation by providing adaptive Java reference documentation.
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| 40. |
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| 41. |
- Bergström, Göran, 1964, et al.
(författare)
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Body weight at age 20 and in midlife is more important than weight gain for coronary atherosclerosis: Results from SCAPIS.
- 2023
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Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 373, s. 46-54
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Tidskriftsartikel (refereegranskat)abstract
- Elevated body weight in adolescence is associated with early cardiovascular disease, but whether this association is traceable to weight in early adulthood, weight in midlife or to weight gain is not known. The aim of this study is to assess the risk of midlife coronary atherosclerosis being associated with body weight at age 20, body weight in midlife and body weight change.We used data from 25,181 participants with no previous myocardial infarction or cardiac procedure in the Swedish CArdioPulmonary bioImage Study (SCAPIS, mean age 57 years, 51% women). Data on coronary atherosclerosis, self-reported body weight at age 20 and measured midlife weight were recorded together with potential confounders and mediators. Coronary atherosclerosis was assessed using coronary computed tomography angiography (CCTA) and expressed as segment involvement score (SIS).The probability of having coronary atherosclerosis was markedly higher with increasing weight at age 20 and with mid-life weight (p<0.001 for both sexes). However, weight increase from age 20 until mid-life was only modestly associated with coronary atherosclerosis. The association between weight gain and coronary atherosclerosis was mainly seen in men. However, no significant sex difference could be detected when adjusting for the 10-year delay in disease development in women.Similar in men and women, weight at age 20 and weight in midlife are strongly related to coronary atherosclerosis while weight increase from age 20 until midlife is only modestly related to coronary atherosclerosis.
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| 42. |
- Bergström, Göran, 1964, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 43. |
- Bergström, Göran, et al.
(författare)
-
Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
-
Ingår i: Circulation. - : Wolters Kluwer. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 44. |
- Bergström, Mats, et al.
(författare)
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In vivo demonstration of enzyme activity in endocrine pancreatic tumors : decarboxylation of carbon-11-DOPA to carbon-11-dopamine
- 1996
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Ingår i: Journal of Nuclear Medicine. - 0161-5505 .- 1535-5667. ; 37:1, s. 32-37
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Tidskriftsartikel (refereegranskat)abstract
- METHODS:We used PET to characterize the uptake and decarboxylation of 11C-L-DOPA in vivo in two patients with endocrine pancreatic tumors: one glucagonoma and one gastrinoma.RESULTS:With L-DOPA labeled with 11C in the beta position, in which the radioactive label follows the molecule through decarboxylation to dopamine, significant uptake was observed in the tumors. With L-DOPA labeled in the carboxyl group, in which the label is rapidly eliminated from the tissue as 11CO2 if decarboxylation takes place, an almost complete lack of uptake is noted.CONCLUSION:This study shows that, using selective position labeling, an in vivo action of enzymatic activity can be observed with PET and that significant decarboxylation occurs in the tested endocrine pancreatic tumors. Also, marked retention of radioactivity occurs after treatment with somatostatin analogs. It is hypothesized that this is a reflection of a reduction of exocytosis which is induced by this treatment.
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| 45. |
- Bernspång, Birgitta, 1951-, et al.
(författare)
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Motor and perceptual impairments in acute stroke patients : effects on self-care ability
- 1987
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Ingår i: Stroke. - : Lippincott Williams & Wilkins. - 0039-2499 .- 1524-4628. ; 18:6, s. 1081-1086
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Tidskriftsartikel (refereegranskat)abstract
- The relative importance of motor, perceptual, and some cognitive functions for self-care ability was analyzed in a representative sample of 109 subjects within 2 weeks of acute stroke. Forty-nine patients (45%) were dependent or partly dependent in self-care. Profound motor dysfunction was present in 39%, low-order perceptual deficits in 10%, high-order perceptual deficits in 60%, and disorientation in time and space in 13% of the patients. There was a significant covariation between motor function and self-care ability and between low-order perception and orientation function. Low-order and high-order perception covaried only weakly. Discriminant analyses showed that the actual level of self-care proficiency could be correctly predicted in 70% of the cases by the 4 indexes of motor function, low-order perception, high-order perception, and orientation. The dominating predictor was motor function, and the next highest was high-order perception. When a program for early training is designed with the aim to alleviate long-term self-care disability after stroke, correct assessment of motor and perceptual functions in the individual stroke patient is essential.
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| 46. |
- Bhattacharyya, Anirban, et al.
(författare)
-
ESS RF Source and Spoke Cavity Test Plan
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This report describes the test plan for the first high power RF source, ESS prototype double spoke cavity and ESS prototype cryomodule at the FREIA Laboratory.
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| 47. |
- Bjerg, Anders, 1982, et al.
(författare)
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Gas, dust, and fumes exposure is associated with mite sensitization and with asthma in mite-sensitized adults
- 2015
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Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 70:5, s. 604-607
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Tidskriftsartikel (refereegranskat)abstract
- Occupational exposure to gas, dust, and fumes (GDF) increases the risk of asthma and eczema. We investigated the role of sensitization in the association between GDF and allergic conditions. A population-based sample of 788 adults from the West Sweden Asthma Study completed questionnaires and skin prick tests. After adjustment for confounders, GDF exposure was associated with a doubled risk of sensitization to mites, but not with other allergens. Mite sensitization also modified the effect of GDF on asthma. In mite-sensitized subjects, GDF was associated with physician-diagnosed asthma, adjusted OR 2.9 (1.2-7.2), and with wheeze, OR 2.4 (1.1-5.3). In non-mite-sensitized subjects, the corresponding ORs were 1.1 (0.5-2.6) and 0.6 (0.3-1.3). GDF was independently associated with eczema regardless of mite sensitization, but not with rhinitis. These novel findings suggest that components of GDF may act as adjuvants that facilitate sensitization to mites and that mite-sensitized individuals may be especially susceptible to inhalant occupational exposures.
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| 48. |
- Bjerg, Anders, 1982, et al.
(författare)
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Higher Risk of Wheeze in Female than Male Smokers. Results from the Swedish GA(2)LEN Study
- 2013
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Women who smoke have higher risk of lung function impairment, COPD and lung cancer than smoking men. An influence of sex hormones has been demonstrated, but the mechanisms are unclear and the associations often subject to confounding. This was a study of wheeze in relation to smoking and sex with adjustment for important confounders. Methods In 2008 the Global Allergy and Asthma European Network (GA2LEN) questionnaire was mailed to 45.000 Swedes (age 16–75 years), and 26.851 (60%) participated. “Any wheeze”: any wheeze during the last 12 months. “Asthmatic wheeze”: wheeze with breathlessness apart from colds. Results Any wheeze and asthmatic wheeze was reported by 17.3% and 7.1% of women, vs. 15.8% and 6.1% of men (both p<0.001). Although smoking prevalence was similar in both sexes, men had greater cumulative exposure, 16.2 pack-years vs. 12.8 in women (p<0.001). Most other exposures and characteristics associated with wheeze were significantly overrepresented in men. Adjusted for these potential confounders and pack-years, current smoking was a stronger risk factor for any wheeze in women aged <53 years, adjusted odds ratio (aOR) 1.85 (1.56–2.19) vs. 1.60 (1.30–1.96) in men. Cumulative smoke exposure and current smoking each interacted significantly with female sex, aOR 1.02 per pack-year (p<0.01) and aOR 1.28 (p = 0.04) respectively. Female compared to male current smokers also had greater risk of asthmatic wheeze, aOR 1.53 vs. 1.03, interaction aOR 1.52 (p = 0.02). These interactions were not seen in age ≥53 years. Discussion In addition to the increased risk of COPD and lung cancer female, compared to male, smokers are at greater risk of significant wheezing symptoms in younger age. This became clearer after adjustment for important confounders including cumulative smoke exposure. Estrogen has previously been shown to increase the bioactivation of several compounds in tobacco smoke, which may enhance smoke-induced airway inflammation in fertile women.
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| 49. |
- Bjerg, Anders, 1982, et al.
(författare)
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Increase in pollen sensitization in Swedish adults and protective effect of keeping animals in childhood
- 2016
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Ingår i: Clinical and Experimental Allergy. - : Wiley. - 0954-7894 .- 1365-2222. ; 46:10, s. 1328-1336
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To date, most studies of the "allergy epidemic" have been based on self-reported data. There is still limited knowledge on time trends in allergic sensitization, especially among adults.OBJECTIVE: To study allergic sensitization, its risk factors, and time trends in prevalence.METHODS: Within West Sweden Asthma Study (WSAS) a population-based sample of 788 adults (17-60y) underwent skin prick tests (SPT) for 11 aeroallergens 2009-2012. Specific IgE was analyzed in 750 of the participants. Those aged 20-46y (n=379) were compared with the European Community Respiratory Health Survey sample aged 20-46y from the same area (n=591) in 1991-1992.RESULTS: Among those aged 20-46y the prevalence of positive SPT to pollen increased; timothy from 17.1% to 29.0% (p<0.001) and birch from 15.6% to 23.7% (p=0.002) between 1991-1992 and 2009-2012. Measurements of specific IgE confirmed these increases. Prevalence of sensitization to all other tested allergens was unchanged. In the full WSAS sample aged 17-60y any positive SPT was seen in 41.9%, and the dominating sensitizers were pollen (34.3%), animals (22.8%) and mites (12.6%). Pollen sensitization was strongly associated with rhinitis, whereas indoor allergens were more associated with asthma. Growing up with livestock or furred pets decreased the risk of sensitization, adjusted odds ratio 0.53 (0.28-0.995) and 0.68 (0.47-0.98) respectively.CONCLUSION: Pollen sensitization has increased in Swedish adults since the early 1990's, while the prevalence of sensitization to other allergens has remained unchanged. This is one plausible explanation for the increase in rhinitis 1990-2008 in Swedish adults, during which time the prevalence of asthma, which is more associated with perennial allergens, was stable. Contact with animals in childhood seems to reduce the risk of sensitization well into adulthood. One major factor contributing to the rise in pollen allergy is a significant increase in levels of birch and grass pollen over the past three decades.
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| 50. |
- Bjerg, Anders, 1982, et al.
(författare)
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The association between asthma and rhinitis is stable over time despite diverging trends in prevalence
- 2015
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 109:3, s. 312-319
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite the well-known association between asthma and rhinitis, in Swedish adults the prevalence of rhinitis rose from 22% to 31% between 1990 and 2008 while asthma prevalence was unchanged. We tested whether the association of rhinitis with asthma was stable over time using the same population-based databases. Methods: Two surveys of adults (20-44 years) living in three regions of Sweden, carried out in 1990 (n = 8982) and 2008 (n = 9156) were compared. Identical questions regarding respiratory symptoms, asthma and rhinitis were used. Asthmatic wheeze: Wheeze with breathlessness apart from colds. Current asthma: Asthma attacks and/or asthma medication use. Results: Subjects with rhinitis had level time trends in asthmatic wheeze, current asthma and most nocturnal respiratory symptoms between 1990 and 2008, adjusted for age, sex, area and smoking. Any wheeze however decreased slightly. In never-smokers asthma symptoms were similarly associated with rhinitis in 1990 and 2008: any wheeze OR 4.0 vs. 4.4 (p = 0.339); asthmatic wheeze OR 6.0 vs. 5.9 (p = 0.937); and current asthma OR 9.6 vs. 7.7 (p = 0.213). In the whole population there were decreases in the asthma symptoms most closely associated to smoking, which decreased by half 1990-2008. Conversely current asthma, which was strongly associated with rhinitis and not with smoking, increased (p < 0.001). Conclusions: The association of rhinitis with asthma was stable between 1990 and 2008. The pattern in the time trends of asthma outcomes strongly suggests that decreased smoking counterbalanced the driving effect of increased rhinitis on asthma prevalence. The findings illustrate the public health benefits of decreased smoking. (c) 2015 Elsevier Ltd. All rights reserved.
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