| 1. |
- Aagaard, Knut E., et al.
(författare)
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Factors associated with healing failure after early repair of acute, trauma-related rotator cuff tears
- 2023
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Ingår i: Journal of Shoulder and Elbow Surgery. - : MOSBY-ELSEVIER. - 1058-2746 .- 1532-6500. ; 32:10, s. 2074-2081
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Tidskriftsartikel (refereegranskat)abstract
- Background: Healing failure after rotator cuff repair is a challenging problem. Acute, trauma-related tears are considered a separate entity and are often treated surgically. The aim of this study was to identify factors associated with healing failure in previously asymptomatic patients with trauma-related rotator cuff tears treated with early arthroscopic repair. Methods: This study included 62 consecutively recruited patients (23% women; median age, 61 years; age range, 42-75 years) with acute symptoms in a previously asymptomatic shoulder and a magnetic resonance imaging–verified full-thickness rotator cuff tear after shoulder trauma. All patients were offered, and underwent, early arthroscopic repair, during which a biopsy specimen was harvested from the supraspinatus tendon and analyzed for signs of degeneration. Of the patients, 57 (92%) completed 1-year follow-up and underwent assessment of repair integrity on magnetic resonance images according to the Sugaya classification. Risk factors for healing failure were investigated using a causal-relation diagram where age, body mass index, tendon degeneration (Bonar score), diabetes mellitus, fatty infiltration (FI), sex, smoking, tear location regarding integrity of the rotator cable, and tear size (number of ruptured tendons and tendon retraction) were included and analyzed. Results: Healing failure at 1 year was identified in 37% of patients (n = 21). A high degree of FI of the supraspinatus muscle (P = .01), a tear location including disruption of rotator cable integrity (P = .01), and old age (P = .03) were associated with healing failure. Tendon degeneration as determined by histopathology was not associated with healing failure at 1-year follow-up (P = .63). Conclusion: Older age, increased FI of the supraspinatus muscle, and a tear including disruption of the rotator cable increased the risk of healing failure after early arthroscopic repair in patients with trauma-related full-thickness rotator cuff tears.
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| 2. |
- Adolfsson, Lars, 1955-, et al.
(författare)
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The Adolfsson-Björnsson Activity Scale (ABAS) Improves Description of Patient Characteristics
- 2022
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Ingår i: Archives of Clinical and Biomedical Research. - : Fortune Journals. - 2572-5017. ; 06:02, s. 408-417
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: Age and gender have been regarded important for surgical decision making and used as inclusion criteria for clinical trials. Individual demands and level of activity have been less considered. A self-administered scale, defining subjectively assessed level of activity involving the upper extremities was therefore developed. The primary purpose of this study was to present the scale. Secondarily to investigate its reliability and correlation with age and gender.Patients and Methods: A scale with 8 categories ranging from extremely demanding to non-demanding activities, separated according to hand dominance, was constructed. Reliability testing was performed on 103 healthy individuals of both genders with a wide age range (20-86). 241 patients, median age 58 years (range 18-97), with different upper extremity injuries completed the scale. Participants were instructed to mark activities representative for their normal activity level. Correlation with age and gender was then investigated using Spearman Correlation Coefficient (SCC).Results: The level of activity ranged from 1, corresponding tominimal use of the arm, to 8 defined as elite sports. For test-retest Intraclass Correlation Coefficient (ICC) was 0.89 for the dominant and 0.90 for the non-dominant arm. Correlations between gender, age and level of activity were weak.Interpretation: The scale was found reliable and feasible to use. Age and gender were weakly correlated with level of activity and patients with low and high activities found in all ages and both genders. The activity scale allows improved description of patients included in clinical trials and can aid in treatment decision making but is primarily not intended for measurement of treatment outcome.
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| 3. |
- Adolfsson, Lars, et al.
(författare)
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Union of Scaphoid Waist Fractures in Adults Despite No or Minimal Immobilization : a Report of Five Cases
- 2020
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Ingår i: SN Comprehensive Clinical Medicine. - : Springer. - 2523-8973. ; 2:4, s. 491-495
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Tidskriftsartikel (refereegranskat)abstract
- Traditionally scaphoid waist fractures have been treated with a long period, 10–12 weeks, of immobilization in a plaster cast until radiological union. The long period of immobilization sometimes infers great discomfort for the patients. To avoid this, surgical treatment with screw fixation has for the last decade been advocated as an option also for undisplaced fractures. In this report, we present five cases with undisplaced scaphoid waist fractures that have healed both radiologically and clinically without any immobilization at all or after a very short period of protection in a cast. These observations challenge the current treatment guidelines.
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| 4. |
- Ahnström, Johan, et al.
(författare)
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Farmers and nature conservation: What is known about attitudes, context factors and actions affecting conservation?
- 2009
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Ingår i: Renewable Agriculture and Food Systems. - 1742-1705 .- 1742-1713. ; 24, s. 38-47
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Tidskriftsartikel (refereegranskat)abstract
- Farmers' attitudes towards viability of specific conservation practices or actions strongly impact their decisions on adoption and change. This review of 'attitude' information reveals a wide range of perceptions about what conservation means and what the impacts of adoption will mean in economic and environmental terms. Farmers operate in a tight financial situation, and in parts of the world they are highly dependent on government subsidies, and cannot afford to risk losing that support. Use of conservation practices is most effective when these are understood in the context of the individual farm, and decisions are rooted in land and resource stewardship and long-term concerns about health of the farm and the soil. The attitudes of farmers entering agri-environmental schemes decide the quality of the result. A model is developed to show how attitudes of the farmer, the farming context and agri-environmental schemes interact and thus influence how the farming community affects nature and biodiversity. As new agri-environmental schemes are planned, agricultural development specialists need to recognize the complexity of farmer attitudes, the importance of location and individual farmer circumstances, and the multiple factors that influence decisions. We provide these insights and the model to conservation biologists conducting research in farming areas, decision makers who develop future agri-environmental schemes, educators training tomorrow's extension officers and nature conservationists, and researchers dealing with nature conservation issues through a combination of scientific disciplines.
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| 5. |
- Arnell, Malin
(författare)
-
Avhandling / Av_handling (Dissertation / Through_action)
- 2016
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Konstnärligt arbete (övrigt vetenskapligt/konstnärligt)abstract
- If we are being-of-the-world, how can we ever avoid participation? From this question Avhandling / Av_handling (Dissertation / Through_ action) unfolds. It invites to engage in an ongoing continuum of entanglements, where the moment of connection is unavoidable. This invitation demands that we are attentive to our mutual co-constitutiveness, that we take responsibility for what gets excluded as well as what comes to matter.Avhandling / Av_handling (Dissertation / Through_action) introduces, purposes and explores a specific format, the live dissertation, an academic instance that demands performative responses during the public defense. It is a dissertation in choreography written through space-time-language-matter with and for human and more-than-human bodies, and other discursive-material becomings. By this Avhandling / Av_handling (Dissertation / Through_action) recognizes the force of what Karen Barad conceptualized as ethico-onto-epistemologocial engtanglements through intra-action. It engages a posthumanist and agential-realist reworking of the notion of performativity, in which all bodies (not only human bodies) come to matter through the world’s performativity—its iterative intra-activity. In this framework, knowledge is made as a direct material engagement, a cutting together-apart—a process by which cuts enact violence but also open up and rework agential conditions of possibility.During Avhandling / Av_handling (Dissertation / Through_ action) diffractive choreographic methods and techniques, which had been developed through diverse intra-active studies—actions, collaborations, and works that span throughout 2010-2016, were re-activated, applied, manifested, and experienced. These practices were made present through specific agential forces that enacted them—such as breath, text, touch, voice, vegetation, spatial proximity, motion, distance, asphalt, material walls and material voids (the reactor hole), pain, and disgust. These practices also enacted processes of queering causality, agency and relationality, and dislocating authority, while (my / the / our) human and more-than-human body / bodies pursued embodied affinities, and a state of becoming-with. Through these re-activated intra-active studies Avhandling / Av_handling (Dissertation / Through_action) examines and articulates choreography and performance as ever-present negotiations of vulnerability, intimacy, force, and power as enactments that are of-the-world.As part of the choreographic practice Sugar Rush Productions | Maria Åkesson together with Tsomak Oga, Sooz Romero, and Debora Vega were video documenting Avhandling / Av_handling (Dissertation / Through_action). This documentation together with other remains (as a non-representative residue) will be made available after the defense here: dissertationthroughaction.space
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| 6. |
- Bergeå, Hanna, et al.
(författare)
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Dialogprocessen om allemansrätten : underlag för utveckling av dialogmetodik och dialogkompetens
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Under 2012 och 2013 har avdelningen för Miljökommunikation vid SLU fungerat som rådgivare till Naturvårdsverket i planeringen och genomförandet av en dialogprocess om allemansrätten och dess tillämpning. Denna rapport har tillkommit som ett avslutande led i detta uppdrag. Syftet med rapporten är att stödja utveckling av dialogmetodik och dialogkompetens inom naturresurshanteringen genom att redogöra för och kritiskt diskutera de erfarenheter som vi gjort av att arbeta med en omtvistad och komplex samhällsfråga genom dialog. I rapporten redogör vi för de tankar och teorier som har väglett planeringen av dialogprocessen och diskuterar vad vi, så här i efterhand, anser att vi kunde ha gjort annorlunda. Syftet med rapporten är alltså inte att diskutera dialogprocessens innehåll och/eller hur olika aktörer och intressen ser på frågor som rör allemansrätten. Rapporten ska ses som ett underlag för hur den som ansvarar för en dialogprocess bör planera, genomföra och förhålla sig till deltagarna och det som sker. Rapporten består av följande fem delar: 1. Viktiga förutsättningar och ramar för upplägg och planering av dialogprocessen 2. Händelseutvecklingen i de fem möten som processen bestod av 3. Deltagarnas åsikter om processen, vad de tycker att de lärt sig 4. Deltagarnas rapportering av lärdomar från dialogprocessen till sina hemorganisationer 5. Diskussioner och rekommendationer
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| 7. |
- Björnsson Hallgren, Hanna, 1976-, et al.
(författare)
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A specific exercise strategy for patients with subacromial pain significantly reduced the need for surgery : one-year results of a randomised controlled study
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: A specific exercise strategy focusing on eccentric exercises, for treating sbacromial pain has in a previous study been found effective at three-month followup.The aim of the present study was to investigate if the positive short-term results were maintained after one year. A further aim was to examine if baseline clinical score, rotator cuff status and radiological findings influenced the choice of surgery.Methods: 97 patients on the waiting-list for arthroscopic subacromial decompression were in the first study randomized to a three-month specific exercise strategy or unspecific exercises (controls). Patients were examined with radiology, ultrasound and assessed with clinical scores: primary Constant-Murley score. After three months of exercises the patients were asked if they still wanted surgery and this option was available until the one-year follow-up. All patients were re-assessed with clinical scores one year after inclusion or one year after surgical intervention and the number of patients that had chosen surgery in each group was compared. The baseline Constant-Murley score and the status of subacromial structures were analyzed in relation to patient's choice of surgery.Results: The positive short-term effect (improved shoulder function and pain) of the specific exercises was maintained after one-year. Compared to the three-month followup all patients had improved significantly (p < 0.0001) in Constant-Murley score. The number of patients that had chosen surgery in the control exercise group (63%) was significantly larger (p < 0.0001) than in the specific exercise group (24%). Patients that had chosen surgery had a significantly lower baseline Constant-Murley score and significantly more often a full-thickness tear. Patients with partial-thickness tears did not differ from those with intact cuff tendons.Conclusions: The positive short-term outcomes after specific exercises were maintained after one year and reduced the need of surgery significantly more than the unspecific control exercises. Patients with low baseline clinical score and/or a full-thickness tear significantly more often chose surgery.Level of evidence: I, Randomized controlled trail according to Consort statement.
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| 8. |
- Björnsson Hallgren, Hanna, et al.
(författare)
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A specific exercise strategy reduced the need for surgery in subacromial pain patients
- 2014
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 48:19, s. 1431-1436
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose A programme based on eccentric exercises for treating subacromial pain was in a previous study found effective at 3-month follow-up. The purposes of the present study were to investigate whether the results were maintained after 1 year and whether the baseline Constant-Murley score, rotator cuff status and radiological findings influenced the outcome. Patients and methods 97 patients on the waiting list for arthroscopic subacromial decompression had been randomised to a specific exercise programme or unspecific exercises (controls). After 3 months of exercises, the patients were asked whether they still wanted surgery and this option was available until a 1-year follow-up. 1 year after inclusion or 1 year after surgery, the number of patients who decided to have surgery in each group was compared. The choice of surgery was related to the baseline Constant-Murley score, ultrasound and radiographs taken at inclusion. Results All patients had improved significantly (pless than0.0001) in the Constant-Murley score at the 1-year follow-up. Significantly more patients in the control group decided to have surgery (63%) than those in the specific exercise group (24%; pless than0.0001). Patients who decided to have surgery had a significantly lower baseline Constant-Murley score and more often a full-thickness tear. Patients with partial tears did not differ from those with intact tendons. Interpretation The positive short-term results of specific exercises were maintained after 1 year, and this exercise strategy reduces the need for surgery. Full-thickness tear and a low baseline Constant-Murley score appear to be a predictive marker for a less good outcome.
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| 9. |
- Björnsson Hallgren, Hanna Cecilia, 1976-, et al.
(författare)
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Elevated plasma levels of TIMP-1 in patients with rotator cuff tear
- 2012
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 83:5, s. 523-528
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose:Extracellular matrix remodelling is altered in rotator cuff tears,16partly due to altered expression of matrix metalloproteinases (MMPs) and their inhibitors. It is unclear if this altered expression can be traced as changes in plasma protein levels.The purposes were to measure the plasma level of MMPs and their tissue inhibitors (TIMPs) inpatients with rotator cuff tears and to relate changes in the pattern of MMP and TIMP levels with the extent of the rotator cuff tear.Methods: Blood samples were collected from 17 patients, median 61 (range 39-77) years, with sonographically verified rotator cuff tears (partial- or full-thickness). These were compared with 16 gender and age matched control persons with sonographically intact rotator cuffs. Plasma levels of MMPs and TIMPs were measured simultaneously using Luminex technology and ELISA.Results: The plasma level of TIMP-1 was elevated in patients with rotator cuff tears, especially in those with full-thickness tears. The levels of TIMP-1, TIMP-3 and MMP-9 were higher in patients with full-thickness tears compared to those with partial-thickness tears, but only TIMP-1 was different from controls.Interpretation: The observed elevation of TIMP-1 in plasma might reflect local pathological processes in or around the rotator cuff, or a genetic predisposition in these patients. That levels of TIMP-1 and certain MMP´s was found to differ between partial and full thickness tears may reflect the extent of the lesion or different aetiology and pathomechanisms.
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| 10. |
- Björnsson Hallgren, Hanna C, et al.
(författare)
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Specific exercises for subacromial pain : Good results maintained for 5 years
- 2017
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Ingår i: Acta Orthopaedica. - : Taylor & Francis. - 1745-3674 .- 1745-3682. ; 88:6, s. 600-605
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose — We have previously shown that specific exercises reduced the need for surgery in subacromial painpatients at 1-year follow-up. We have now investigated whetherthis result was maintained after 5 years and compared the outcomesof surgery and non-surgical treatment.Patients and methods — 97 patients were included in the previouslyreported randomized study of patients on a waiting list forsurgery. These patients were randomized to specifi c or unspecifi cexercises. After 3 months of exercises the patients were asked ifthey still wanted surgery and this was also assessed at the present5-year follow-up. The 1-year assessment included Constant–Murley score, DASH, VAS at night, rest and activity, EQ-5D, andEQ-VAS. All these outcome assessments were repeated after 5years in 91 of the patients.Results — At the 5-year follow-up more patients in the specifi cexercise group had declined surgery, 33 of 47 as compared with16 of 44 (p = 0.001) in the unspecifi c exercise group. The meanConstant–Murley score continued to improve between the 1- and5-year follow-ups in both surgically and non-surgically treatedgroups. On a group level there was no clinically relevant changebetween 1 and 5 years in any of the other outcome measuresregardless of treatment.Interpretation — This 5-year follow-up of a previously publishedrandomized controlled trial found that specifi c exercisesreduced the need for surgery in patients with subacromial pain.Patients not responding to specifi c exercises may achieve similargood results with surgery. These fi ndings emphasize that a specifi cexercise program may serve as a selection tool for surgery.
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| 11. |
- Björnsson Hallgren, Hanna Cecilia, 1976-
(författare)
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Treatment of subacromial pain and rotator cuff tears
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Shoulder pain is very common, affecting 14-21 % of the population at some time during their lifetime. The aims of this thesis were to improve the understanding of various aspects concerning the pathogenesis and treatment of subacromial pain and rotator cuff tears. Patients and healthy individuals were examined and compared in five studies:Study I) Seventy patients were retrospectively examined, clinically and with ultrasound, 15 years after arthroscopic subacromial decompression. All patients had an intact rotator cuff at surgery. Ultrasound showed significantly fewer rotator cuff tears compared to the prevalence of asymptomatic tears reported in the literature for the same age group. This indicates that arthroscopic subacromial decompression might protect the rotator cuff.Study II) Forty-two patients were retrospectively examined, clinically and with ultrasound, 39 months (mean) after an acute rotator cuff repair. All patients had pseudoparalysis after trauma, a full thickness tear and no previous history of shoulder symptoms. A delay in surgical treatment of three months and the number of tendons injured did not affect the outcome. Age affected outcome negatively.Study III) Plasma samples from 17 patients with cuff tears and 16 plasma samples from healthy age- and gender-matched controls were collected and analysed regarding the levels of matrix metalloproteinases and their inhibitors, TIMP1-4. Elevated levels of TIMP-1 were found in the patients with cuff tears compared to controls. Higher levels of TIMP-1, TIMP-3 and MMP-9 were found in patients with full-thickness tears compared to patients with partial-thickness tears.Study IV) Ninety-seven patients with longstanding subacromial pain, on the waiting-list for arthroscopic subacromial decompression, were prospectively randomised to specific shoulder exercises or control exercises for three months. Thereafter they were clinically examined and asked if they still wanted surgery. The specific shoulder exercises focusing on eccentric exercise for the rotator cuff and scapula stabilisers were found to be effective in reducing subacromial pain and improving shoulder function, thereby reducing the need for surgery.Study V) All patients including those operated, in Study IV were re-examined after one year using clinical assessment scores. The option of surgery was continuously available up to the one-year follow-up. Ultrasound and radiological examinations performed at inclusion were analysed in relation to the choice of surgery. The positive effects of the specific exercise programme were maintained after one year and significantly fewer patients in this group chose surgery. Surgery was significantly more often chosen by patients who had a low baseline shoulder score, and/or a full thickness rotator cuff tear. All patients showed significant improvement in the clinical scores one year after inclusion or one year after surgery.These results support the concept that subacromial pain has a multifactorial aetiology and that the first line of treatment should be specific shoulder exercises. When conservative treatment fails, an acceptable result can be achieved with arthroscopic subacromial decompression. The rotator cuff status is important to consider when treating and studying these patients.
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| 12. |
- Björnsson Hallgren, Hanna, et al.
(författare)
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Good outcome after repair of trauma-related anterosuperior rotator cuff tearsda prospective cohort study
- 2021
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Ingår i: Journal of shoulder and elbow surgery. - : MOSBY-ELSEVIER. - 1058-2746 .- 1532-6500. ; 30:7, s. 1636-1646
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Tidskriftsartikel (refereegranskat)abstract
- Background: Anterosuperior rotator cuff tears with a displaced long head of the biceps tendon are most often trauma-related, and patients with these conditions often present with severe pain and shoulder dysfunction. Repair of the subscapularis and supraspinatus and a biceps tenodesis or a tenotomy are the recommended treatments based on retrospective studies. The aim of this study was to prospectively evaluate clinical and structural treatment outcome in a cohort of trauma-related anterosuperior injuries in patients with previously healthy shoulders. Materials and methods: Patients seeking care for a suspected rotator cuff injury after shoulder trauma were screened according to a protocol including clinical examination, baseline scoring with Western Ontario Rotator Cuff Index (WORC) and numeric rating scale of pain, ultrasound, and magnetic resonance imaging (MRI). Those with anterosuperior injuries were offered surgical treatment, structured postoperative physiotherapy, and inclusion in the present study with 1-year follow-up, including MRI, baseline scores, Constant-Murley score, and Patient Global Impression of Change. Thirty-three patients (78% men) with a mean age of 59 (40-76) years were included. Results: All patients had a biceps pulley lesion, a displaced biceps tendon, and incomplete full-thickness subscapularis and supraspinatus tears. Six patients declined surgery. At follow-up, the operated patients reached a median WORC score of 86% and a median change from baseline to follow-up of 50% (P = .0001). Pain decreased (P = .0001) at rest, at night, and during activity. The median Constant-Murley score was 86% of the contralateral nonoperated shoulder, 58% of the contralateral abduction strength recovered after surgery, and 86% reported that they were recovered or much improved. All repairs and tenodeses healed except for 2 supraspinatus tendons. The 6 nonoperated patients reached a median WORC score of 90, a change in the median value from baseline to follow-up of 31, but reported more pain, and a smaller proportion considered themselves as recovered or much improved. In all patients, the 1-year MRIs had signal changes in the upper muscular portion of subscapularis, consistent with fatty infiltration, regardless of operative or nonoperative treatment. Conclusion: Anterosuperior rotator cuff injury with an associated pulley lesion and displaced long head of the biceps tendon may be treated successfully with surgery as the majority of patients in our cohort clinically recovered or were much improved without pain after a year. With a 1-year perspective, nonoperatively treated patients may also reach a reasonable clinical outcome. Independently of treatment or tendon healing, residual subscapularis muscle injury was seen, which may have long-term implications. (C) 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.
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| 13. |
- Björnsson Hallgren, Hanna, et al.
(författare)
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Neither critical shoulder angle nor acromion index were related with specific pathology 20 years later!
- 2021
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer. - 0942-2056 .- 1433-7347. ; 29:8, s. 2648-2655
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The critical shoulder angle (CSA) and the acromion index (AI) are measurements of acromial shape reported as predictors of degenerative rotator cuff tears (RCT) and glenohumeral osteoarthritis (GH OA). Whether they are the cause or effect of shoulder pathologies is uncertain since pre-morbid radiographs most often are lacking. The main aim of this study was to investigate if CSA or AI were related to the development of RCT or GH OA after 20 years. A secondary aim was to investigate if the CSA and AI had changed over time. Methods In the hospital archive, 273 preoperative plain shoulder radiographs were found of patients scheduled for elective surgery other than cuff repair and arthroplasty. Forty-five images fulfilled the strict criteria published by Suter and Henninger (2015) and were used to measure CSA and AI with two independent assessors. No patient had any sign of OA in the index radiographs or any information in the medical records indicating RCT. After a median of 20 (16-22) years, 30 of these patients were radiologically re-examined with bilateral true frontal views and ultrasound of the rotator cuff. There were 19 men (20 study shoulders) and 11 females (12 study shoulders). Results Mean age at follow-up was 56 (32-78) years. There was no correlation between CSA (r = 0.02) (n.s) or AI (r = - 0.13) (n.s) in the primary radiographs and OA at follow-up. Nor was any correlation found between index CSA (r = 0.12) (n.s) or AI (r = - 0.13) (n.s) and RCT at follow-up. Mean difference in CSA was - 1.7 (- 10-3) degrees and mean AI difference was - 0.04 (- 0.13-0.09) between the first and the second radiographs, 20 years later. Bilaterally, mean CSA was 32 and AI 0.61 at follow-up. Conclusion In this study, no correlation between the CSA, AI and development of OA or RCT could be found. The mean CSA and AI decreased over a 20-year period but the difference was very small. No difference was found between the study shoulders and the contralaterals. These findings question previously reported etiological associations between scapular anatomy and the development of OA or RCT and thereby the use of these calculations as the basis of treatment.
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| 14. |
- Björnsson Hallgren, Hanna, et al.
(författare)
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Ultrasonographic examination of acute soft tissue lesions in the elbow has good inter-rater reliability and acceptable agreement with magnetic resonance imaging
- 2024
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Ingår i: Journal of shoulder and elbow surgery. - : MOSBY-ELSEVIER. - 1058-2746 .- 1532-6500. ; 33:7, s. 1615-1623
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ultrasonography (US) has been suggested as a valuable complement to clinical and radiologic examinations in elbow trauma. Magnetic resonance imaging (MRI) has been the method of choice, despite fair to moderate inter -rater reliability (IRR). US has potential advantages but is assessor dependent and the IRR scarcely examined. The primary aim of the present study was to investigate IRR for US and secondarily interobserver agreement (IOA) between US and MRI in the acute phase after elbow trauma. Acute phase was defined as 2 weeks and, if applicable, the following weekend. The hypothesis was that US reliability would be at least substantial for complete muscle or ligament lesions. Methods: A total of 116 patients (50 men, median age 47 [range 19-87] years) who had an elbow trauma with dislocation and/or fracture were included. Exclusion criteria were prior injury to the same elbow, and US and/or MRI not possible within 16 days. During US, the condition of muscle origins at the epicondyles and collateral and annular ligament complexes was recorded in a predesigned protocol, with the alternatives intact, partially or completely torn. Seventy-two patients had a second US examination the same day by an independent upper extremity surgeon, and 58 of the 116 patients underwent an MRI before or after the US, evaluated by 2 radiologists using the same protocol. IOA and IRR between assessors and modalities were analyzed with kappa statistics and interpreted according to Landis and Koch. Perfect agreement (PA) was reported in percentages. Results: US examination within 2 weeks was feasible with tolerable discomfort. Defining muscle origins and ligaments as intact or completely torn, the US IRR ranged from substantial to near perfect (kappa 0.63-1, PA 93%-100%). Intact tissues vs. tear (partial and complete tear combined) or intact vs. partial vs. complete tear resulted in kappa values from moderate to substantial and PA 74%-96% with lowest reliability for the muscle origins. The IOA between MRI and US ranged from fair to near perfect for no tear vs. complete tear (kappa 0.25-1, PA 65%-100%). Agreement between no tear and tear (partial and complete together) ranged from fair to substantial (0.25-0.66, PA 63%-89%) and no tear vs. partial or complete tear ranged from fair to moderate (0.25-0.53, PA 50%-79%). Conclusion: US in the acute setting is suitable and reliable for diagnosis of ligament injuries in the elbow and is in addition fast, cheap, and easily accessible. The agreement with MRI seems to vary with the structure assessed and severity of the lesions, ranging from fair to near perfect. Level of evidence: Level III; Diagnostic Study (c) 2024 The Author(s). This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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| 15. |
- Bremer, Hanna, et al.
(författare)
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ILF2 and ILF3 are autoantigens in canine systemic autoimmune disease
- 2018
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Ingår i: Scientific Reports. - : NATURE PUBLISHING GROUP. - 2045-2322. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Dogs can spontaneously develop complex systemic autoimmune disorders, with similarities to human autoimmune disease. Autoantibodies directed at self-antigens are a key feature of these autoimmune diseases. Here we report the identification of interleukin enhancer-binding factors 2 and 3 (ILF2 and ILF3) as autoantigens in canine immune-mediated rheumatic disease. The ILF2 autoantibodies were discovered in a small, selected canine cohort through the use of human protein arrays; a method not previously described in dogs. Subsequently, ILF3 autoantibodies were also identified in the same cohort. The results were validated with an independent method in a larger cohort of dogs. ILF2 and ILF3 autoantibodies were found exclusively, and at a high frequency, in dogs that showed a speckled pattern of antinuclear antibodies on immunofluorescence. ILF2 and ILF3 autoantibodies were also found at low frequency in human patients with SLE and Sjogren's syndrome. These autoantibodies have the potential to be used as diagnostic biomarkers for canine, and possibly also human, autoimmune disease.
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| 16. |
- Carlsson, Annika, et al.
(författare)
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Concomitant Enzyme-Linked Immunosorbent Assay Measurements of Rat Insulin, Rat C-Peptide, and Rat Proinsulin from Rat Pancreatic Islets : Effects of Prolonged Exposure to Different Glucose Concentrations
- 2010
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Ingår i: Endocrinology. - : The Endocrine Society. - 0013-7227 .- 1945-7170. ; 151:10, s. 5048-5052
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Tidskriftsartikel (refereegranskat)abstract
- Until now, there have been few assays to measure C-peptide and proinsulin in the rat. We used a well-established rat insulin ELISA and validated two novel ELISAs for rat C-peptide and rat/mouse proinsulin to examine secretion and content of insulin, proinsulin, and C-peptide from rat islets cultured for 72 h at different glucose concentrations in culture medium. To examine long-term effects in vitro rather than short-term effects of exposure to low, normal, and high glucose, the exposure time to the different glucose concentrations was set to 72 h. The measurement uncertainty of the values obtainable from the ELISAs was determined by calculation of the variation pattern from the intraassay variation generated by unknown samples, and repeatability was determined by analysis of controls. The precision study and the analysis of controls confirm that the validated ELISAs for rat C-peptide and proinsulin would be useful for further studies on the effects of preculture in different glucose concentrations. The higher the glucose concentration used during the 72-h culture period of rat islets, the higher insulin, C-peptide and proinsulin values were obtained in a subsequent short-term glucose-challenge experiment. The proportion of proinsulin to insulin secreted increased, as did islet content, with increasing glucose concentration during preculture. We also observed a nonequimolar, glucose-dependent secretion and content of rat insulin over rat C-peptide after culture at 11.1 and 28 mM glucose.
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| 17. |
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| 18. |
- Dahl, Ulrika, 1970-, et al.
(författare)
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Figurative fragments of a politics of location in desire
- 2012
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Ingår i: Emergent Writing Methodologies in Feminist Studies. - London/New York : Routledge. - 9780415897440 - 9780203155332 ; , s. 178-183, s. 178-183
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Bokkapitel (refereegranskat)
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| 19. |
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| 20. |
- DETTMER, Anne, et al.
(författare)
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The Choice of Antibiotic Prophylaxis Influences the Infection Reoperation Rate in Primary Shoulder Arthroplasty : Analysis From the Swedish Shoulder Arthroplasty Register
- 2023
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Ingår i: Clinical Orthopaedics and Related Research. - : Lippincott Williams & Wilkins. - 0009-921X .- 1528-1132. ; 481:4, s. 728-734
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Periprosthetic joint infection is a serious complication and a major reason for revision surgery after primary shoulder arthroplasty. The prophylactic antibiotics for primary shoulder arthroplasty that have predominantly been used in Sweden are cloxacillin and clindamycin. To address Cutibacteriumacnes, benzylpenicillin has recently increasingly been added to cloxacillin, but it is unclear which antibiotic prophylaxis regimen is the most effective to prevent periprosthetic joint infection.QUESTIONS/PURPOSES: After controlling for baseline differences among patients such as age, gender, previous surgery, cement fixation, and arthroplasty type, was the risk of reoperation for infection higher in patients who received cloxacillin than in those who received clindamycin or the combination of benzylpenicillin and cloxacillin?METHODS: Data from the Swedish Shoulder Arthroplasty Register were used for this study. The inclusion criterion was registered antibiotic prophylaxis in primary arthroplasty. Between January 1, 1999, and December 31, 2019, 22,470 primary shoulder arthroplasties, including total shoulder, hemiarthroplasty, and reverse shoulder arthroplasties, were entered into the Swedish Shoulder Arthroplasty Register. Reporting of antibiotic prophylaxis to the register was introduced on January 1, 2013. Since then, the completeness of information on the type of antibiotic prophylaxis in the reports has been 85.3%. Consequently, 10,706 arthroplasties were eligible and fulfilled the inclusion criterion of reported antibiotic prophylaxis. A further 129 were excluded because of unusual prophylaxis regimens, leaving 10,577 shoulder arthroplasties for analysis. The Swedish Shoulder Arthroplasty Register gathers information from all 60 hospitals performing shoulder arthroplasty in Sweden, and through a comparison with the National Patient Register, it has been estimated that more than 90% of all primary shoulder arthroplasties and shoulder reoperations are reported to the register. The age of the study population ranged between 16 and 98 years; the mean age at the primary surgery was 70 ± 10 years for the entire cohort, with a mean age of 67 ± 10 years and 72 ± 9 years for men and women, respectively. The mean observation period was 989 ± 669 days. From 2013 to 2019, there was a clear change in prophylaxis; in particular, the use of the combination of benzylpenicillin and cloxacillin increased dramatically and the use of cloxacillin alone decreased. Clindamycin prophylaxis increased moderately. The primary study endpoint was reported reoperation for infection. In the register, this is defined as repeat procedures of any kind, including biopsy, lavage of the joint, or revision, defined as secondary surgery in which a component was exchanged, removed, or added. To compare the reoperation rate in relation to the different antibiotics used, which changed over time, we controlled for age, gender, previous surgery, cement fixation, and arthroplasty type using a Cox proportional hazards model.RESULTS: When adjusting for age, gender, previous surgery, cement fixation, and arthroplasty type, cloxacillin prophylaxis was associated with an increased relative risk of reoperation for infection compared with the combination of cloxacillin and benzylpenicillin (hazard ratio [HR] 2.40 [95% confidence interval (CI) 1.35 to 4.25]; p = 0.003) and compared with clindamycin alone (HR 1.78 [95% CI 1.11 to 2.85]; p = 0.02). No difference was found between the cloxacillin and benzylpenicillin combination and clindamycin (HR 0.74 [95% CI 0.42 to 1.32]; p = 0.31).CONCLUSION: Our results indicate that prophylaxis against C. acnes may be warranted in shoulder arthroplasty. Because the absolute number of infections was low and infections could have been underreported to the register, our results should be interpreted with caution. There is no available information about the causative microorganisms. The study lays the groundwork for further investigations of antibiotic prophylaxis regimens in shoulder arthroplasty. Because large randomized controlled trials would be impractical to perform, prospective register-based randomized controlled studies might be a viable method.LEVEL OF EVIDENCE: Level Ⅲ, therapeutic study.
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| 21. |
- Ellinger, Frank, et al.
(författare)
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Magnetically controlled growing rod treatment for early-onset scoliosis: analysis of 52 consecutive cases demonstrates improvement of coronal deformity
- 2023
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Ingår i: Journal of spine surgery (Hong Kong). - : OSS Press Ltd. - 2414-4630 .- 2414-469X. ; 9:3, s. 259-268
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Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose of this study was to report the radiographic results and complications of magnetically controlled growing rod (MCGR) treatment in patients with early-onset scoliosis (EOS).Methods: Patient records and radiographs from a consecutive series of patients treated with MCGR for EOS at two Swedish institutions were reviewed retrospectively. Radiographic analysis included Cobb angle, T1-T12 height, T1-S1 height, thoracic kyphosis, and lung height. Subgroup analyses were performed on primary versus conversion cases and single versus dual rods using one-way analysis of variance (ANOVA) and independent samples t-test.Results: Fifty-two cases treated with MCGR (24 single rods, 28 dual rods) were included from local surgical records into this cohort study, 32 primary and 20 converted from other growth friendly surgical treatment. Mean age at MCGR implantation was 7.4 (2.0-14.6) years old in the primary group and 9.3 (5.0-16.1) years old in the converted group. Mean follow-up time was 3.7 (2.0-7.6) years. Mean (standard deviation; SD) Cobb angle of the major curve changed from 62° (17°) preoperatively to 42° (16°) postoperatively to 46° (18°) at final follow-up (P<0.001). Mean (SD) overall thoracic kyphosis changed from 41° (19°) preoperatively to 32° (14°) postoperatively to 39° (17°) at final follow-up (P=0.018). Mean T1-T12 height was 177 mm (34 mm) preoperatively, 183 mm (35 mm) immediate postoperative and 199 mm (35 mm) at final follow-up (P=0.047). The mean T1-T12 height increased significantly in the primary group but not in the converted group. The number of surgeries was 114 (78 planned, 36 unplanned). The rate of unplanned surgeries did not differ significantly between single and dual rods. The total number of complications was 70 of which 38 were implant related. The overall mean complication rate was 1.4 (0-4). There were no significant differences in complication rates between subgroups.Conclusions: MCGR treatment enabled and maintained correction of spinal deformity while allowing spinal growth. There were no significant differences in complication rates or unplanned surgeries between the groups treated with single or dual rods.
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| 22. |
- Hallgren, Hanna, 1972, et al.
(författare)
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A case of exclusion: Bodily writing and textual acting – the lesbian letters on stage.
- 2017
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Ingår i: The 2017 biennal PARSE conference on EXCLUSION.
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Konferensbidrag (refereegranskat)abstract
- Our presentation is a transdisciplinary trans art collaboration between performing arts and literary composition. It circles around a visionary research question: through which texts and performances can excluded historical voices and bodies be materialised? I.e. can some of the complexities of their experiences be shaped through a processual and methodological intra-action between performative writing and performing arts? Since the opposite of truth (Greek alethia) is not non truth, but forgetfulness (Greek lethe), our ambition is as well to remember and include forgotten voices and bodies as a means to create an aesthetic truth. Thus, we orient ourselves towards a bodily writing and a textual acting. We will investigate the renegotiating potential in the relation body – literary/dramatic text, and how bodies normally excluded from subjectivity in the public space with the theatrical line as a position can insist on ambiguous states of desire and thus enter into a becoming as existential and ethical subjects. We will use writing and performing as our experimental methods of inquiry, and our methodological aim is to blend, re-shape, interrupt, diffract and extend our different art and research forms. We are working with the theme “excluded voices/bodies” though focusing on letters from Swedish lesbian women sent to the writer and translator Eva Alexanderson (1911-1994) in the 1960s and 1970s as our main source of material. Alexanderson was the first lesbian woman who came out on a national level in Sweden. As a response to her novel Kontradans [Square dance] (1969), which tells the love story of two women, Alexanderson received a lot of letters from women all around Sweden. The letters, that are preserved at KvinnSam - National Resource Library for Gender Studies at University of Gothenburg, tell about lesbian everyday life; fear, hope, love and feelings of exclusion connected to one’s sexual orientation. Alexanderson’s archive also contains materials such as “Novel about a lesbian woman in the 1950s” and extended writing on sex liberalism. These materials will also be taken into account in our bodily and textual trans art work of remembrance.
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| 23. |
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| 24. |
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| 25. |
- Hallgren, Hanna, 1972-
(författare)
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Att äta och att sova
- 2015
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Ingår i: Tydningen. - Uppsala : Litteraterna. - 2001-4570. ; :17-18, s. 74-75
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 26. |
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| 27. |
- Hallgren, Hanna, 1972-, et al.
(författare)
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Being each others dog : or the figure wanders on alone
- 2014
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Ingår i: A Valentine for Gertrud Stein: The Reception of Getrud Stein in the Arts and Humanities. 8-10 april 2014. Hosted by the Ubiversity of Copenhagen, Denmark and co-organized with Ghent Univeristy and Linköping Univeristy. - : University of Copenhagen.
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Konferensbidrag (refereegranskat)
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| 28. |
- Hallgren, Hanna, 1972-
(författare)
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Berättelser – Motberättelser
- 2014
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Ingår i: Eftertankens Följetong. - Stockholm : Stiftelsen Nordens Biskops Arnö. - 9789198100211 ; , s. 151-171
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 29. |
- Hallgren, Hanna, 1972-
(författare)
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Berättelser – Motberättelser
- 2008
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Ingår i: Utflukt. Performativ text. ; :2/3, s. 11-25
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 30. |
- Hallgren, Hanna, 1972
(författare)
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Burqa
- 2003
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Bok (övrigt vetenskapligt/konstnärligt)
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| 31. |
- Hallgren, Hanna
(författare)
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Burqa : dikter
- 2003
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Bok (populärvet., debatt m.m.)
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| 32. |
- Hallgren, Hanna, 1972
(författare)
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Den akademiska tiden
- 2015
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Ingår i: Curie – en tidning från Vetenskapsrådet.
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Annan publikation (övrigt vetenskapligt/konstnärligt)
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| 33. |
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| 34. |
- Hallgren, Hanna, 1972
(författare)
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Det som övar annorlunda likt ett hjärta
- 2016
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Ingår i: Diktsamlingen Det som övar annorlunda likt ett hjärta publicerades 2016-20-12 av bokförlaget Pequod Press, Malmö Dikter ur samlingen har också publicerats i Om detta sjunger vi inte ensamma : Dikter till samtiden och världen, Bokförlaget ETC 2016 (Stockholm), s. 57-61(se http://varuhuset.etc.se/PICTURE/18786-45-omdetta_omslag_webb_hires.jpg http://varuhuset.etc.se/PICTURE/18787-45-omdetta_medverkande.jpg Recensioner och artiklar: http://www.sydsvenskan.se/2016-03-15/ju-mer-vi-ar-tillsammans http://www.arbetarbladet.se/kultur/jorgensdotter-bakom-ny-bok-med-poeter-som-vill-forandra-varlden http://howsoftthisprisonis.blogspot.se/2016/02/om-detta-sjunger-vi-inte-ensamma-dikter.html http://www.nytid.fi/2016/03/poesi-mot-stangda-granser/ http://www.popularpoesi.se/artiklar/nummer-28/varlden-ar-ett-slukhal-av-morker-poesi-som-trost-och-kamp-i-om-detta-sjunger-vi-inte-ensamma/) samt i Litterär kalender. 2014-15 /De Nio, Norstedts 2015 (Stockholm), s. 35–38 (ISBN 9789113066592). - Malmö : Pequod Press.
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Konstnärligt arbete (övrigt vetenskapligt/konstnärligt)
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| 35. |
- Hallgren, Hanna, 1972
(författare)
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Det som övar annorlunda likt ett hjärta – att skriva mellan akademi och poesi
- 2016
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Ingår i: gränser, mobilitet, mobilisering – g16. Nationell konferens för genusforskning, Linköping 23-25 november 2016.
-
Konferensbidrag (refereegranskat)abstract
- Paperpresentationen rymde uppläsning ur boken Det som övar annorlunda likt ett hjärta (Malmö, 2016) samt hantverksmässiga och forskningsorienterade insikter rörande skrivande mellan akademi och poesi.
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| 36. |
- Hallgren, Hanna, 1972-
(författare)
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Det transversala språket : Att förnimma världen
- 2005
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Ingår i: Intersektionalitet – ett användbart begrepp inom genusforskningen (keynote vid konferens i Norrköping).
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Konferensbidrag (refereegranskat)
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| 37. |
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| 38. |
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| 39. |
- Hallgren, Hanna
(författare)
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Det transversala språket : sista ordet
- 2006
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Ingår i: Kvinnovetenskaplig tidskrift. - 0348-8365. ; :1, s. 86-92
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 40. |
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| 41. |
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| 42. |
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| 43. |
- Hallgren, Hanna, 1972
(författare)
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Dikter
- 2015
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Ingår i: Litterär kalender. 2014-15 /De Nio. - Stockholm : Norstedts. - 9789113066592 ; , s. 35-38
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 44. |
- Hallgren, Hanna, 1972
(författare)
-
Dikter
- 2011
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Ingår i: 32/2011. Trettiotvå poeter tjugohundraelva. - Stockholm : Albert Bonniers förlag. - 9789100126933
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 45. |
- Hallgren, Hanna, 1972-
(författare)
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Dikter
- 2015
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Ingår i: De Nio - Litterär Kalender 2015. - Stockholm : Norstedts Förlag. - 9789113066592 ; , s. 37-40
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Bokkapitel (populärvet., debatt m.m.)
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| 46. |
- Hallgren, Hanna, 1972-
(författare)
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Dikter ur Burqa
- 2005
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Ingår i: Audiatur. - Bergen : Audiatur.
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Bokkapitel (populärvet., debatt m.m.)
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| 47. |
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| 48. |
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| 49. |
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| 50. |
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