| 1. |
- 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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| 2. |
- Knutsson, Johan, et al.
(författare)
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A randomized study of four different types of tympanostomy ventilation tubes : Full-term follow-up
- 2018
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - : Elsevier BV. - 0165-5876 .- 1872-8464. ; 107, s. 140-144
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the impact of tympanostomy ventilation tube material (silicone vs fluoroplastic) and shape (short vs long) regarding time to extrusion, occurrence of otorrhea, occlusion, tube removal and occurrence of persistent perforation.METHODS AND MATERIAL: Four different types of ventilation tubes were used; Long Armstrong tubes, Donaldson tubes, Shepard tubes and straight tubes, representing four specific combinations of VT material (silicone or fluoroplastic) and shape (short, double flanged or long, single flanged). Four hundred children scheduled for bilateral tube insertion were included in a randomized trial. The patients received one type of tube in the right ear and another type in the left ear. The incidence of tube extrusion and complications were monitored postoperatively every third month by an otolaryngologist.RESULTS: Twenty-two children were excluded during surgery. Out of the studied 378 children the mean age was 35.3 months. 63.8% were boys. Short tubes extruded earlier than long tubes; hazard ratio (HR) 4.84 (95% CI 3.50-6.69, p < 0.001). Long Armstrong tubes were least prone to extrude. Silicone tubes resulted in significantly longer time to first infection in a VT ear, HR 1.68 (95% CI 1.03-2.76, p = 0.039). Donaldson tubes rendered the longest mean time to first infection (p = 0.025). Infections did not affect tube extrusion rates significantly (p = 0.879). No significant differences were found regarding tube occlusion, tube extraction or persistent perforation.CONCLUSIONS: Long tubes are less prone to extrude early. Long Armstrong tubes have the least propensity to extrude early. Silicone tubes render significantly longer time to first infection. Donaldson tubes result in least infections. Infection does not affect extrusion rates significantly.LEVEL OF EVIDENCE: 1b.
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| 3. |
- Modée Borgström, Agnes, et al.
(författare)
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Occurrence of mucosa-affecting diseases of the upper airways in middle ear cholesteatoma patients : a nationwide case-control study
- 2024
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer. - 0937-4477 .- 1434-4726.
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Exploring a possible link between upper airway inflammation and the development of cholesteatoma by studying the association between mucosa-affecting diseases of the upper airways and cholesteatoma surgery.METHODS: This is a nationwide case-control study of 10,618 patients who underwent surgery for cholesteatoma in Sweden between 1987 and 2018. The cases were identified in the National Patient Register and 21,235 controls matched by age, sex and place of residency were included from national population registers. Odds ratios (OR) and corresponding 95% confidence intervals were used to assess the association between six types of mucosa-affecting diseases of the upper airways and cholesteatoma surgery.RESULTS: Chronic rhinitis, chronic sinusitis and nasal polyposis were more common in cholesteatoma patients than in controls (OR 1.5 to 2.5) as were both adenoid and tonsil surgery (OR > 4) where the strongest association was seen for adenoid surgery. No association was seen between allergic rhinitis and cholesteatoma.CONCLUSION: This study supports an association between mucosa-affecting diseases of the upper airways and cholesteatoma. Future studies should aim to investigate the mechanisms connecting mucosa-affecting diseases of the upper airways and cholesteatoma formation regarding genetic, anatomical, inflammatory and mucosa properties.
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| 4. |
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| 5. |
- Nilsson, Olof, 1978-, et al.
(författare)
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Ultrasound accurately assesses depth of invasion in T1-T2 oral tongue cancer
- 2022
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Ingår i: Laryngoscope Investigative Otolaryngology (LIO). - : John Wiley & Sons. - 2378-8038. ; 7:5, s. 1448-1455
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Tidskriftsartikel (refereegranskat)abstract
- Background: Depth of invasion (DOI) is important for the T-classification of squamous cell carcinoma of the oral tongue (SCCOT) and incorporated in the TNM 8 classification of oral cavity cancer. To determine DOI clinical palpation is performed, but the preferred radiological modality remains controversial. The aim of this study was to investigate the assessment of DOI using ultrasound (US-DOI).Methods: The DOI was assessed in 40 patients with T1-T3 SCCOT by ultrasound, palpation, computed tomography and magnetic resonance imaging (MRI). Histopathological DOI (H-DOI) was gold standard. Bland-Altman analysis was used to compare mean difference and 95% limits of agreement (LOA). Results The mean difference of US-DOI was -0.5 mm (95% LOA -4.9-4.0) compared to H-DOI and the mean difference for MRI was 3.9 mm (95% LOA -2.3-10.2). In the subgroup analysis of cT1-T2 the US-DOI mean difference was 0.1 mm and the 95% LOA limits -2.5-2.7.Conclusions: Ultrasound seems to be the most accurate method to assess DOI in T1-T2 SCCOT. MRI overestimates DOI and cannot assess a substantial proportion of the tumors. Level of Evidence 2c.
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| 6. |
- Nilsson, Olof, 1978-, et al.
(författare)
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Ultrasound-assisted resection of oral tongue cancer
- 2022
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Ingår i: Acta Oto-Laryngologica. - : Taylor & Francis. - 0001-6489 .- 1651-2251. ; 142:9-12, s. 743-748
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In surgical resection of squamous cell carcinoma of the oral tongue (SCCOT), achieving clear margins is important for prognosis. Insufficient histopathological margins are common, particularly deep margins.AIMS/OBJECTIVES: The aim of the present study was to determine whether ultrasound (US)-assisted resection could decrease the proportion of insufficient histopathological deep margins in SCCOT.MATERIAL AND METHODS: 34 patients with SCCOT undergoing US-assisted resection (study group) were compared to 76 whose resections were performed without US (conventional group). Outcome measures were insufficient deep histopathological resection margins and mean difference in deep margins.RESULTS: Insufficient deep resection margins (<5.0 mm) were seen in 8 of 34 (23.5%) in the study group, compared to 31 of 76 (40.8%) in the conventional group, unadjusted RR 0.58 [95% CI 0.30-1.12; p = .11], adjusted RR 0.82 [95% CI 0.35-1.92; p = .64]. Unadjusted mean difference was 1.4 mm (95% CI 0.1-2.7, p = .04), adjusted mean difference 1.1 mm (95% CI -2.7 to 0.5, p = .19).CONCLUSIONS: Intraoperative US can visualize the deep resection margins in T1/T2 SCCOT. US-assisted resection seems to decrease the number of insufficient histopathological deep margins, though the results are not statistically significant. Comparatively good results in the conventional group is one explanation for the lack of significance.CLINICALTRIALS.GOV ID: NCT04059861.
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| 7. |
- Nyström, Ingalill, 1969, et al.
(författare)
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Forensic Art History: The Anders Ädel Pigment Dispute 1839-1841
- 2016
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Ingår i: Book of abstract. InArt conference 21-25 March 2016 Gent, Belgium.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This multidisciplinary study concerns a 19th century dispute regarding three pieces of painted furniture -a table, a chest and a small casket- decorated by the 19th century painter Anders Ädel (1809-1888) from Söderhamn, Hälsingland, Sweden. Ädel is considered as one of the foremost painters in Hälsingland. His art works - painted furniture and interiors - are displayed in museums, private homes and can also be found in some of the sites of the UNESCO World Heritage Decorated farmhouses of Hälsingland. In 1839 Ädel accused his client, the farmer Erik Olofsson, in court of having paid too little for the objects as he used more pigments than those for which he had been paid; this was after Ädel was first sued by the pigment merchant Forsberg for an unpaid bill [1,2]. Almost 180 years later scientific methods combined with historic source research have been used to understand what pigments and techniques Ädel actually used when painting the furniture. Through this study we demonstrate how multidisciplinary collaboration between natural sciences and humanities can contribute to deeper knowledge and new interpretations of historical materials. The scientific analyses were preceded by historic analyses of the juridical protocols found in archives. Non-invasive analyses using different XRF were conducted directly on the painted furniture in situ, see fig 1. Additionally, samples were taken for supplementary analyses using FT-Raman spectroscopy and DSA-ToF-MS and GC-MS. According to the judicial protocol the defendant, Olofsson, claimed that he had already paid for the artist’s materials i.e. linseed oil, lead white, red lead, cinnabar, Prussian blue, “silverglitt” (lead yellow) and "möngel" (unknown). Ädel then called in a guild painter named Blombergsson who declared that there seemed to be more pigments used in the painted furniture than those mentioned. He also believed that the work should be valued higher. Indeed, our results show that Ädel did use different pigments than those bought. For example, preliminary results show that Prussian blue was not used but rather indigo (according to FT-Raman spectra). Analysis of the green paint shows that Ädel used a mixture of green pigments including one that contains copper and arsenic indicating emerald green. In conclusion, the forensic evidence gathered so far in this study suggests that Ädel rather painted with slightly different pigments than those the client Olofsson had purchased for the commission. Apart from this, the judicial protocols give an insight of what pigments Ädel had access to and when combined with the scientific analyses this information can give historic evidence of the artist's materials and painting technique. Acknowledgment: The presented study is part of a larger interdisciplinary project “A holistic study of Decorated Farmhouses of Hälsingland”, in which methods from natural and historical sciences are applied to the decorative folk arts and crafts in the farmhouses of Hälsingland, UNSCO World Heritage. The project is four years long and funded by the Swedish Research Council. The study is a collaboration between different researchers: conservation scientists, chemists, physicists, conservators, art historians and ethnologists and the project participants besides the authors are: Yvonne Fors1,3, chemist, Dep. of Cons, GU/Dep. of Cons. science, RAÄ Thomas Zack, geologist, Earth Science, University of Gothenburg Aleksandar Matic, physicist, Applied Physics, Chalmers Florian Nitze, physicist, Dep. of Chemical and Biological Engineering, Chalmers Susanne Wilken, physicist, Applied Physics, Chalmers The project is also collaborating with other experts such as: Sven Isaksson, Archeologist, Archeological Research lab, University of Stockholm Lars Nylander, Antiquarian, Hälsinglands museum, Hudiksvall Mélanie Platzgummer, World heritage coordinator Bollnäs county. Lena Landström, World heritage coordinator, Gävleborg county administrative board Photographer: Yngve Söderquist, Ljusdalsbygdens museum, Ljusdal References: [1]Västra Hälsinglands domsaga, Dombok för Ljusdals Tingslag 1838-1839, Vol. AI.a:17: Vårtinget 1839 §67, Hösttinget 1839 §45. Landsarkivet Härnösand. [2]Västra Hälsinglands domsaga, Dombok för Ljusdals Tingslag 1840-1841, Vol. A1.a:18: Vårtinget 1840 §55, Hösttinget 1840 §48, Vårtinget 1841 §48. Landsarkivet Härnösand.
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| 8. |
- Olaison, Sara, 1976-, et al.
(författare)
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Hearing Outcomes After Ossiculoplasty With Bone or Titanium Prostheses : A Nationwide Register-Based Study
- 2024
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Ingår i: Clinical Otolaryngology. - : John Wiley & Sons. - 1749-4478 .- 1365-2273.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study compares hearing outcomes of two prosthesis materials, bone and titanium, used in ossiculoplasty.DESIGN: This retrospective nationwide registry-based study uses data systematically collected by the Swedish Quality Registry for Ear Surgery (SwedEar). SETTING: The data were obtained from clinics in Sweden that perform ossiculoplasty.PARTICIPANTS: Patients who underwent ossiculoplasty using either bone or titanium prostheses were registered in SwedEar between 2013 and 2019.MAIN OUTCOME MEASURES: Hearing outcome expressed as air-bone gap (ABG) gain.RESULTS: The study found no differences between bone and titanium for ABG or air conduction (AC) for either partial ossicular replacement prostheses (PORP) or total ossicular replacement prostheses (TORP). In a comparison between PORP and TORP for ABG and AC outcomes, regardless of the material used, PORP showed a small advantage, with an additional improvement of 3.3 dB (95% CI [confidence interval], 0.1-4.4) in ABG and 2.2 dB (95% CI, 1.7-4.8) in AC. In secondary surgery using TORP, titanium produced slightly better results for high-frequency pure tone average. The success rate, a postoperative ABG ≤20 dB, was achieved in 62% of the operations for the whole group.CONCLUSION: Both bone and titanium used to reconstruct the ossicular chain produce similar hearing outcomes for both PORP and TORP procedures. However, titanium may be a preferable option for secondary surgeries involving TORP. The success rate, a postoperative ABG ≤20 dB, is consistent with other studies, but there is room for improvement in patient selection criteria and surgical techniques.
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