| 1. |
- Leta, Tesfaye H., et al.
(author)
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Periprosthetic Joint Infection After Total Knee Arthroplasty With or Without Antibiotic Bone Cement
- 2024
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In: JAMA Network Open. - 2574-3805. ; 7:5, s. 2412898-2412898
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Journal article (peer-reviewed)abstract
- Importance: Despite increased use of antibiotic-loaded bone cement (ALBC) in joint arthroplasty over recent decades, current evidence for prophylactic use of ALBC to reduce risk of periprosthetic joint infection (PJI) is insufficient. Objective: To compare the rate of revision attributed to PJI following primary total knee arthroplasty (TKA) using ALBC vs plain bone cement. Design, Setting, and Participants: This international cohort study used data from 14 national or regional joint arthroplasty registries in Australia, Denmark, Finland, Germany, Italy, New Zealand, Norway, Romania, Sweden, Switzerland, the Netherlands, the UK, and the US. The study included primary TKAs for osteoarthritis registered from January 1, 2010, to December 31, 2020, and followed-up until December 31, 2021. Data analysis was performed from April to September 2023. Exposure: Primary TKA with ALBC vs plain bone cement. Main Outcomes and Measures: The primary outcome was risk of 1-year revision for PJI. Using a distributed data network analysis method, data were harmonized, and a cumulative revision rate was calculated (1 - Kaplan-Meier), and Cox regression analyses were performed within the 10 registries using both cement types. A meta-analysis was then performed to combine all aggregated data and evaluate the risk of 1-year revision for PJI and all causes. Results: Among 2 168 924 TKAs included, 93% were performed with ALBC. Most TKAs were performed in female patients (59.5%) and patients aged 65 to 74 years (39.9%), fully cemented (92.2%), and in the 2015 to 2020 period (62.5%). All participating registries reported a cumulative 1-year revision rate for PJI of less than 1% following primary TKA with ALBC (range, 0.21%-0.80%) and with plain bone cement (range, 0.23%-0.70%). The meta-analyses based on adjusted Cox regression for 1 917 190 TKAs showed no statistically significant difference at 1 year in risk of revision for PJI (hazard rate ratio, 1.16; 95% CI, 0.89-1.52) or for all causes (hazard rate ratio, 1.12; 95% CI, 0.89-1.40) among TKAs performed with ALBC vs plain bone cement. Conclusions and Relevance: In this study, the risk of revision for PJI was similar between ALBC and plain bone cement following primary TKA. Any additional costs of ALBC and its relative value in reducing revision risk should be considered in the context of the overall health care delivery system.
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| 2. |
- Leta, Tesfaye H., et al.
(author)
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The use of antibiotic-loaded bone cement and systemic antibiotic prophylactic use in 2,971,357 primary total knee arthroplasties from 2010 to 2020: an international register-based observational study among countries in Africa, Europe, North America, and Oceania
- 2023
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In: Acta Orthopaedica. - 1745-3674 .- 1745-3682. ; 94, s. 416-425
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Journal article (peer-reviewed)abstract
- Background and purpose — Antibiotic-loaded bone cement (ALBC) and systemic antibiotic prophylaxis (SAP) have been used to reduce periprosthetic joint infection (PJI) rates. We investigated the use of ALBC and SAP in primary total knee arthroplasty (TKA). Patients and methods — This observational study is based on 2,971,357 primary TKAs reported in 2010–2020 to national/regional joint arthroplasty registries in Australia, Den-mark, Finland, Germany, Italy, the Netherlands, New Zealand, Norway, Romania, South Africa, Sweden, Switzerland, the UK, and the USA. Aggregate-level data on trends and types of bone cement, antibiotic agents, and doses and duration of SAP used was extracted from participating registries. Results — ALBC was used in 77% of the TKAs with variation ranging from 100% in Norway to 31% in the USA. Palacos R+G was the most common (62%) ALBC type used. The primary antibiotic used in ALBC was gentamicin (94%). Use of ALBC in combination with SAP was common practice (77%). Cefazolin was the most common (32%) SAP agent. The doses and duration of SAP used varied from one single preoperative dosage as standard practice in Bolzano, Italy (98%) to 1-day 4 doses in Norway (83% of the 40,709 TKAs reported to the Norwegian arthroplasty register). Conclusion — The proportion of ALBC usage in primary TKA varies internationally, with gentamicin being the most common antibiotic. ALBC in combination with SAP was common practice, with cefazolin the most common SAP agent. The type of ALBC and type, dose, and duration of SAP varied among participating countries.
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| 3. |
- Feng, Xin, et al.
(author)
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Aerodynamic characteristics in upper airways among orthodontic patients and its association with adenoid nasopharyngeal ratios in lateral cephalograms
- 2021
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In: BMC Medical Imaging. - : BioMed Central. - 1471-2342. ; 21:1
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Journal article (peer-reviewed)abstract
- Background Adenoid hypertrophy among orthodontic patients may be detected in lateral cephalograms. The study investigates the aerodynamic characteristics within the upper airway (UA) by means of computational fluid dynamics (CFD) simulation. Furthermore, airflow features are compared between subgroups according to the adenoidal nasopharyngeal (AN) ratios. Methods This retrospective study included thirty-five patients aged 9-15 years having both lateral cephalogram and cone beam computed tomography (CBCT) imaging that covered the UA region. The cases were divided into two subgroups according to the AN ratios measured on the lateral cephalograms: Group 1 with an AN ratio < 0.6 and Group 2 with an AN ratio >= 0.6. Based on the CBCT images, segmented UA models were created and the aerodynamic characteristics at inspiration and expiration were simulated by the CFD method for the two groups. The studied aerodynamic parameters were pressure drop (Delta P), maximum midsagittal velocity (V-ms), maximum wall shear stress (P-ws), and minimum wall static pressure (P-w). Results The maximum V-ms exhibits nearly 30% increases in Group 2 at both inspiration (p = 0.013) and expiration (p = 0.045) compared to Group 1. For the other aerodynamic parameters such as Delta P, the maximum P-ws, and minimum P-w, no significant difference is found between the two groups. Conclusions The maximum V-ms seems to be the most sensitive aerodynamic parameter for the groups of cases. An AN ratio of more than 0.6 measured on a lateral cephalogram may associate with a noticeably increased maximum V-ms, which could assist clinicians in estimating the airflow features in the UA.
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| 4. |
- Feng, Xin, et al.
(author)
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Effect of Rapid Maxillary Expansion on Upper Airway Morphology : A Retrospective Comparison of Normal Patients versus Patients with Enlarged Adenoid Tissue
- 2021
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In: Journal of Clinical Pediatric Dentistry. - : JOURNAL PEDODONTICS INC. - 1053-4628 .- 1557-5268. ; 45:3, s. 208-215
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Journal article (peer-reviewed)abstract
- Objectives The present study evaluated the effect of rapid maxillary expansion (RME) on the morphology of the upper airway (UA) by calculating cross-sectional areas and volumes and comparing the effect in patients with a normal-sized adenoid with the effect in patients with an enlarged adenoid. Study design: Seventeen patients met the inclusion criteria. We constructed 3D models of the UA on cone-beam computed tomography images to calculate cross-sectional areas and volumes at the levels of the nasopharyngeal, retropalatal, and retroglossal airways. Patients were divided into two groups: group 1 was comprised of patients with an adenoidal nasopharyngeal (AN) ratio < 0.6 and group 2 with an AN ratio >= 0.6. Paired samples t-tests assessed any area and volumetric changes of the UA after RME. Changes in degree of nasal obstruction, calculated as the AN ratio, was then compared for the two groups. An independent samples t-test compared volumetric changes in the nasopharynx between the two groups before and after RME. Results Changes in cross-sectional areas and volumes of the UA due to RME were not significant. The effects of RME on AN ratio (11 % vs 0 %) and nasopharyngeal volume (36.8 % vs 5.97%) were somewhat larger in group 2 patients who had adenoid-associated nasal obstruction compared with group 1 patients with a normal-sized adenoid; however, the differences were not significant. Conclusions After RME, the patients with an enlarged adenoid had more increases in nasopharyngeal volume compared with those with normal adenoid, despite there was no significant difference.
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| 5. |
- Gil, Elisabeth G., et al.
(author)
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Dental caries in children and adolescents with juvenile idiopathic arthritis and controls : a multilevel analysis
- 2021
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In: BMC Oral Health. - : BioMed Central. - 1472-6831. ; 21:1
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Journal article (peer-reviewed)abstract
- Background Optimal utilization of dental caries data is crucial in epidemiological research of individuals with juvenile idiopathic arthritis (JIA). The aims were to: explore whether caries is more prevalent among children and adolescents with JIA compared to controls; examine presence of caries according to JIA group, socio-behavioral and intraoral characteristics, and the extent to which surface-specific caries varies between and within individuals; assess whether surface-specific caries varies according to JIA group and dentition; and investigate whether disease-specific clinical features of JIA are associated with presence of caries. Methods In this comparative cross-sectional study, calibrated dentists examined index teeth (primary 2. molars, 1. permanent molars) of 4-16-year-olds with JIA (n = 219) and matched controls (n = 224), using a detailed caries diagnosis system (including enamel caries). JIA-specific characteristics were assessed by pediatric rheumatologists and socio-behavioral information collected by questionnaires. Multilevel mixed-effect logistic regressions reporting odds ratios (OR) with 95% confidence interval (CI) were applied (caries at surface level as outcome variable). Potential confounders were adjusted for, and the effect of dependency of surface-specific caries data was estimated by calculating intra-class correlation coefficients (ICC). Results At individual level, no significant difference in caries prevalence was found between individuals with JIA and controls, regardless of inclusion of enamel caries. Proportion of enamel lesions exceeded dentine lesions. JIA was not associated with presence of caries, but in both groups, low maternal educational level was associated with presence of caries (OR: 2.07, 95% CI: 1.24-3.46). Occlusal and mesial surfaces, compared to buccal surfaces, had generally higher OR according to presence of caries than distal and lingual surfaces (ICC = 0.56). Surface-specific caries in the permanent dentition differed significantly according to group affiliation. Some JIA disease-specific variables were suggested to associate with presence of caries. Conclusions No overall difference in caries prevalence between individuals with JIA and controls was observed, but for both groups, low maternal educational level and tooth surface associated with presence of caries. Associations between JIA disease-specific variables and presence of caries cannot be excluded. Due to predominance of enamel lesions, the potential of preventative dental strategies is considerable.
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| 6. |
- Gil, Elisabeth Grut, et al.
(author)
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Dental plaque and gingival bleeding in adolescents with juvenile idiopathic arthritis and controls : a multilevel analysis
- 2023
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In: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 81:1, s. 50-65
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To explore whether plaque and gingival bleeding are more frequently experienced by adolescents with juvenile idiopathic arthritis (JIA) compared to matched controls without JIA; explore whether surface- and site-specific periodontal outcomes vary between the two groups; and for participants with JIA, investigate associations between disease-specific features and periodontal outcomes.MATERIAL AND METHODS: In this comparative cross-sectional study, selected surfaces, and sites of index teeth in 10-16-year-olds with JIA and matched controls were examined by modified versions of Simplified Oral Hygiene Index (OHI-S) and Gingival Bleeding Index (GBI). Mixed-effects logistic regressions, reporting odds ratios (OR) with 95% confidence interval (CI), were applied. Intra-class correlation coefficients (ICCs) were calculated to quantify the degree of dependency of measures within the same individual.RESULTS: > 0 (OR = 2.33, 95% CI: 1.47 - 3.67, ICC = 0.45) and GBI > 0 (OR = 1.54, 95% CI: 1.10 - 2.16, ICC = 0.41 and 0.30). Surface-specific distribution of plaque varied among the two groups.CONCLUSIONS: Our results highlight the importance of increased awareness of oral health care in patients with JIA and that surface- and site-specific differences in periodontal outcomes exist between individuals with JIA and controls. Few JIA disease-specific variables associated with plaque or gingival bleeding.
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| 7. |
- Gil, Elisabeth G., et al.
(author)
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Oral health-related quality of life in 4–16-year-olds with and without juvenile idiopathic arthritis
- 2022
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In: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 22:1
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Journal article (peer-reviewed)abstract
- Background: Few studies have investigated oral health-related quality of life (OHRQoL) in young individuals with juvenile idiopathic arthritis (JIA). Aims were to investigate whether OHRQoL differs between children and adolescents with JIA compared to controls without JIA, while adjusting for socio-demographic-, behavioral- and oral health-related covariates. Furthermore, to explore whether socio-behavioral and oral health-related covariates of OHRQoL vary according to group affiliation and finally, specifically for individuals with JIA, to investigate whether disease-specific features associate with OHRQoL. We hypothesized that participants with JIA have poorer OHRQoL compared to participants without JIA. Methods: In this comparative cross-sectional study participants with JIA (n = 224) were matched to controls without JIA (n = 224). OHRQoL was assessed according to Early Childhood Oral Health Impact Scale (ECOHIS) (4–11-years-olds) and the child version of Oral Impacts on Daily Performances (Child-OIDP) (12–16-years-olds). JIA-specific characteristics were assessed by pediatric rheumatologists and socio-demographic, behavioral and self-reported oral health information collected by questionnaires. Index teeth were examined for caries by calibrated dentists. Multiple variable analyses were performed using logistic regression, reporting odds ratio (OR) and 95% confidence interval (CI). Two-way interactions were tested between group affiliation and the socio-behavioral- and oral health-related variables on the respective outcome variables. Results: In total, 96 participants with JIA and 98 controls were evaluated according to ECOHIS, corresponding numbers for Child-OIDP was 125 and 124. Group affiliation was not associated with impaired ECOHIS or Child-OIDP in adjusted analyses (OR = 1.95, 95% CI 0.94–4.04 and OR = 0.99, 95% CI 0.46–2.17, respectively). Female adolescents with JIA were more likely than males to report oral impacts according to Child-OIDP. Continued activity or flare was found to adversely affect Child-OIDP, also self-reported outcome measures in JIA associated with Child-OIDP. Conclusions: This study did not provide consistent evidence to confirm the hypothesis that children and adolescents with JIA are more likely to have impaired OHRQoL compared to their peers without JIA. However, female adolescents with JIA were more likely than males to report impacts on OHRQoL. Furthermore, within the JIA group, adolescents with continued disease activity, flare or reporting pain, physical disability, had higher risk than their counterparts of impaired OHRQoL.
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| 8. |
- Gülcan, Ferda, et al.
(author)
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Exploring the association of dental care utilization with oral impacts on daily performances (OIDP) : a prospective study of ageing people in Norway and Sweden
- 2018
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In: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 76:1, s. 21-29
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To explore the association of dental health care utilization with oral impacts on daily performances (OIDP) across time focusing ageing Norwegian and Swedish adults adjusting for predisposing, enabling, and need related-factors as defined by Andersen's model.METHODS: Data were based on Norwegian and Swedish 1942 birth-cohorts conducted in 2007 (age 65) and 2012 (age 70). In Norway, the response rates ranged from 54% to 58%. Corresponding figures in Sweden were from 72% to 73%. Self-administered questionnaires assessed OIDP, dental care utilization and predisposing, enabling and need related factors. Logistic regression with robust variance estimation was used to adjust for clustering in repeated data.RESULTS: Significant covariates of OIDP were satisfaction with dental services, dental care avoidance due to financial constraints, frightening experience with dental care during childhood and patient initiated dental visiting. Frequency and regularity of dental attendance were associated with OIDP in the Swedish cohort, only.CONCLUSIONS: In spite of country differences in the public co-financing of dental care, dental care utilization indicators were associated with OIDP across time in both cohorts. Encouraging regular and dentist initiated visiting patterns and strengthening beliefs in keeping own teeth could be useful in attempts to reduce poor oral health related quality of life in ageing people.
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| 9. |
- Gülcan, Ferda, et al.
(author)
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Inequality in oral health related to early and later life social conditions : a study of elderly in Norway and Sweden
- 2015
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In: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831. ; 15
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Journal article (peer-reviewed)abstract
- Background: A life course perspective recognizes influences of socially patterned exposures on oral health across the life span. This study assessed the influence of early and later life social conditions on tooth loss and oral impacts on daily performances (OIDP) of people aged 65 and 70 years. Whether social inequalities in oral health changed after the usual age of retirement was also examined. In accordance with "the latent effect life course model", it was hypothesized that adverse early-life social conditions increase the risk of subsequent tooth loss and impaired OIDP, independent of later-life social conditions.Methods: Data were obtained from two cohorts studies conducted in Sweden and Norway. The 2007 and 2012 waves of the surveys were used for the present study. Early-life social conditions were measured in terms of gender, education and country of birth, and later-life social conditions were assessed by working status, marital status and size of social network. Logistic regression and Generalized Estimating Equations (GEE) were used to analyse the data. Inverse probability weighting (IPW) was used to adjust estimates for missing responses and loss to follow-up.Results: Early-life social conditions contributed to tooth loss and OIDP in each survey year and both countries independent of later-life social conditions. Lower education correlated positively with tooth loss, but did not influence OIDP. Foreign country of birth correlated positively with oral impacts in Sweden only. Later-life social conditions were the strongest predictors of tooth loss and OIDP across survey years and countries. GEE revealed significant interactions between social network and survey year, and between marital status and survey year on tooth loss.Conclusion: The results confirmed the latent effect life course model in that early and later life social conditions had independent effects on tooth loss and OIDP among the elderly in Norway and Sweden. Between age 65 and 70, inequalities tooth loss related to marital status declined, and inequalities related to social network increased.
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| 10. |
- Gülcan, Ferda, et al.
(author)
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Social predictors of less frequent dental attendance over time among older people : population-averaged and person-specific estimates
- 2016
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In: Community Dentistry and Oral Epidemiology. - Hoboken, USA : Wiley-Blackwell. - 0301-5661 .- 1600-0528. ; 44:3, s. 263-273
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Journal article (peer-reviewed)abstract
- Objectives: Longitudinal studies considering social disparities in the utilization of dental services are scarce. Repeated measures should be accounted for by the use of appropriate statistical methods. The purpose of this study was first to describe the patterns of less frequent dental attendance (less than once a year) over time from the age of 65-70 in Norwegian and Swedish 1942 cohorts. Second, this study estimated the influence of predisposing, enabling and need-related social predictors using marginal model with robust variance estimators and random intercept model, RIM, to account for the clustered structure of the repeated observations. Third, the study aimed to compare the estimates of associations between social predictors and less frequent dental attendance derived from marginal and random intercept models.Methods: In 2007 and 2012, all residents born in 1942 in selected counties of Norway and Sweden were invited to participate in a questionnaire survey. In Norway, the response rate was 58.0% (n = 4211) in 2007 and 54.5% (n = 3733) in 2012 with a follow-up rate of 70%. The corresponding figures in Sweden were 73.1% (n = 6078) and 72.2% (n = 5697), with a follow-up rate of 80%. Marginal and random intercept models were fitted for population-averaged and person-specific estimates. Design effects were calculated by comparing the results from ordinary logistic regression analyses and the marginal model with robust variance estimators. The proportion of the total variation due to differences between persons was reported using the intraclass correlation coefficient (ICC).Results: Less frequent dental attendance declined from 14.5% to 12.2% in Norway and from 13.6% to 12.9% in Sweden. According to marginal and random intercept models, time-invariant (gender, country of birth, education) and time-variant social predictors (working status, social network, marital status, smoking and perceived health) contributed to less frequent dental attendance. A likelihood ratio test confirmed that adjustment for clustered observations was appropriate. The ICC was 0.90 in Norway and 0.85 in Sweden.Conclusions: The prevalence of less frequent dental attendance was low and dropped by increasing age from 65 to 70 years. Both at population and at person-specific levels, being advantaged on social aspects protects against less frequent dental attendance after 65 years of age in the Norwegian and Swedish cohorts investigated.
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| 11. |
- Hysing, Mari, et al.
(author)
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Chronic physical illness and mental health in children. Results from a large-scale population study.
- 2007
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In: Journal of Child Psychology and Psychiatry, and Allied Disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 48:8, s. 785-792
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Journal article (peer-reviewed)abstract
- BACKGROUND: The aim of the present study was to evaluate the sensitivity and specificity of the Strengths and Difficulties Questionnaire (SDQ) in detecting emotional and behavioural problems among children with chronic illness (CI). METHODS: Parents and teachers of a population of primary school children in Norway (n = 9430) completed a questionnaire including the SDQ, and a question about chronic illness. A total of 74% (n = 7007) of the parents participated. A sub-sample (n = 1040) was given a psychiatric diagnostic evaluation according to the Development and Well-Being Assessment (DAWBA). RESULTS: According to parent reports, 537 (8%) children had a CI. The SDQ revealed an increased risk of emotional and behavioural problems in children with CI as compared with non-CI peers, both among boys (OR = 2.10 CI 95% 1.56-2.83) and girls (OR = 2.11 CI 95% 1.49-2.99). Children with CI also showed an increased risk of psychiatric disorder as assessed by the DAWBA (OR = 1.70 CI 95% 1.04-2.85). Both the sensitivity and specificity of the SDQ in predicting a psychiatric diagnosis were high, even when only information from parents was included. CONCLUSION: Children with CI in the general population are at increased risk of behavioural and emotional problems and psychiatric disorders. Given its high sensitivity and specificity the SDQ might work well as a screening instrument for behaviour/emotional problems and psychiatric disorder in children with CI.
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| 12. |
- Larsen, Olav Inge, et al.
(author)
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Antimicrobial effects of three different treatment modalities on dental implant surfaces.
- 2017
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In: The Journal of oral implantology. - 1548-1336. ; 43:6, s. 429-436
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Journal article (peer-reviewed)abstract
- Resolution of peri-implant inflammation and re-osseointegration of peri-implantitis affected dental implants seem to be dependent on bacterial decontamination. The aims of the this study were to evaluate the antimicrobial effects of three different instrumentations on a micro-textured dental implant surface contaminated with an avirulent or a virulent Porphyromonas gingivalis strain and to determine alterations to the implant surface following instrumentation. Forty-five dental implants (Straumann SLA) were allocated to three treatment groups: Er:YAG laser, chitosan brush, and titanium curette (10 implants each), a positive (10 implants) and a negative (five implants) control. Each treatment group and the positive control were split into subgroups of five implants subsequently contaminated with either the avirulent or virulent P. gingivalis strain. The antimicrobial effect of instrumentation was evaluated using checkerboard DNA-DNA hybridization. Implant surface alterations were determined using a light interferometer. Instrumentation significantly reduced the number of attached P. gingivalis (p<0.001) with no significant differences among groups (p=0.310). A significant overall higher median score was found for virulent compared with avirulent P. gingivalis strains (p=0.007); the Er:YAG laser uniquely effective removing both bacterial strains. The titanium curette significantly altered the implant surface micro-texture. Neither the Er:YAG laser nor the chitosan brush significantly altered the implant surface. The three instrumentations appear to have a similar potential to remove P. gingivalis. The titanium curette significantly altered the microstructure of the implant surface.
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| 13. |
- Pedersen, Alma B., et al.
(author)
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Similar early mortality risk after cemented compared with cementless total hip arthroplasty for primary osteoarthritis : data from 188,606 surgeries in the Nordic Arthroplasty Register Association database
- 2021
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In: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 92:1, s. 47-53
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Journal article (peer-reviewed)abstract
- Background and purpose — Current literature indicates no difference in 90-day mortality after cemented compared with cementless total hip arthroplasty (THA). However, previous studies are hampered by potential selection bias and suboptimal adjustment for comorbidity confounding. Therefore, we examined the comorbidity-adjusted mortality up to 90 days after cemented compared with cementless THA performed due to osteoarthritis. Patients and methods — Using the Nordic Arthroplasty Register Association database, 2005–2013, we included 108,572 cemented and 80,034 cementless THA due to osteoarthritis. We calculated the Charlson comorbidity index of each patient based on data from national patient registers. The Kaplan–Meier method was used to estimate unadjusted all-cause mortality. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for 14, 30-, and 90-day mortality comparing cemented with cementless THA, adjusting for age, sex, comorbidity, nation, and year of surgery. Results — Cumulative all-cause mortality within 90 days was 0.41% (CI 0.37–0.46) after cemented and 0.26% (CI 0.22–0.30) after cementless THA. The adjusted HR for cemented vs. cementless fixation was 0.97 (CI 0.79–1.2), and similar risk estimates were obtained for mortality within 14 (adjusted HR 0.91 [CI 0.64–1.3]) and 30 days (adjusted HR 0.94 [CI 0.71–1.3]). We found no clinically relevant differences in mortality between cemented and cementless THA in analyses stratified by age, sex, Charlson comorbidity index, or year of surgery. Interpretation — After adjustment for comorbidity as an important confounder, we observed similar early mortality between the 2 fixation techniques.
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| 14. |
- Posserud, Maj-Britt, et al.
(author)
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The prevalence of autism spectrum disorders: impact of diagnostic instrument and non-response bias.
- 2010
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In: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 45:3, s. 319-327
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Journal article (peer-reviewed)abstract
- BACKGROUND: A large part of the variability in rates of autism spectrum disorders (ASD) across studies is non-aetiologic, and can be explained by differences in diagnostic criteria, case-finding method, and other issues of study design. AIM: To investigate the effects on ASD prevalence of two methodological issues; non-response bias and case ascertainment. We compared the findings of using a semi-structured parent interview versus in-depth clinical assessment, including an ASD specific interview. We further explored whether including information on non-responders affected the ASD prevalence estimate. METHOD: A total population of 7- to 9-year olds (N = 9,430) was screened for ASD with the autism spectrum screening questionnaire (ASSQ) in the Bergen Child Study (BCS). Children scoring above the 98th percentile on parent and/or teacher ASSQ were invited to participate in the second and subsequently in the third phase of the BCS where they were assessed for ASD using the Development and Well-Being Assessment (DAWBA), and the Diagnostic Interview for Social and Communication disorders (DISCO), respectively. RESULTS: Clinical assessment using DISCO confirmed all DAWBA ASD cases, but also diagnosed additional cases. DISCO-generated minimum prevalence for ASD was 0.21%, whereas estimated prevalence was 0.72%, increasing to 0.87% when adjusting for non-responders. The DAWBA estimate for the same population was 0.44%. CONCLUSION: Large variances in prevalence rates across studies can be explained by methodological differences. Both information about assessment method and non-response are crucial when interpreting prevalence rates of ASD.
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| 15. |
- Røsland, Anders, et al.
(author)
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Periodontitis is associated with airflow obstruction in the Malmö Offspring Dental Study.
- 2023
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X.
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Journal article (peer-reviewed)abstract
- AIM: To investigate the association between periodontitis and lung function in the Malmö Offspring Dental Study.MATERIALS AND METHODS: In all 1001 individuals (49.9% female, mean age: 44.6) from Malmö Offspring Dental Study were included. Periodontitis was assessed by a full-mouth examination protocol including bleeding on probing and classified according to the American Academy of Periodontology/Center for Disease Control definitions. Forced expiratory volume in 1 s (FEV1 ) and forced vital capacity (FVC) were expressed as absolute values and %predicted according to Global Lung Function Initiative reference values. FEV1 , FVC and FEV1 /FVC were analysed in relation to periodontal status using linear regression.RESULTS: Severe periodontitis was found in 7% of the population. Adjusted regression models showed significant associations between lung function and severe periodontitis with 2.1 unit lower FEV1 /FVC ratio (95% CI: -3.91, -0.23) and odds ratio (adjusted) of 2.56 (95% CI: 1.40, 4.75, p = .003) for airflow obstruction (FEV1 /FVC less than the lower limit of normal) if having severe periodontitis. Lower values of %predicted FEV1 and %predicted FVC, but not FEV1 /FVC, were found in individuals with >25% bleeding on probing.CONCLUSIONS: Severe periodontitis was associated with lower FEV1 /FVC ratio and airflow obstruction in the present cohort. More large-scale prospective studies and intervention studies are required for a comprehensive evaluation.
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| 16. |
- Røsland, Anders, et al.
(author)
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Periodontitis is associated with airflow obstruction in the Malmö Offspring Dental Study
- 2024
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 51:1, s. 86-96
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Journal article (peer-reviewed)abstract
- AIM: To investigate the association between periodontitis and lung function in the Malmö Offspring Dental Study.MATERIALS AND METHODS: In all 1001 individuals (49.9% female, mean age: 44.6) from Malmö Offspring Dental Study were included. Periodontitis was assessed by a full-mouth examination protocol including bleeding on probing and classified according to the American Academy of Periodontology/Center for Disease Control definitions. Forced expiratory volume in 1 s (FEV1 ) and forced vital capacity (FVC) were expressed as absolute values and %predicted according to Global Lung Function Initiative reference values. FEV1 , FVC and FEV1 /FVC were analysed in relation to periodontal status using linear regression.RESULTS: Severe periodontitis was found in 7% of the population. Adjusted regression models showed significant associations between lung function and severe periodontitis with 2.1 unit lower FEV1 /FVC ratio (95% CI: -3.91, -0.23) and odds ratio (adjusted) of 2.56 (95% CI: 1.40, 4.75, p = .003) for airflow obstruction (FEV1 /FVC less than the lower limit of normal) if having severe periodontitis. Lower values of %predicted FEV1 and %predicted FVC, but not FEV1 /FVC, were found in individuals with >25% bleeding on probing.CONCLUSIONS: Severe periodontitis was associated with lower FEV1 /FVC ratio and airflow obstruction in the present cohort. More large-scale prospective studies and intervention studies are required for a comprehensive evaluation.
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| 17. |
- Åstrøm, Anne Nordrehaug, et al.
(author)
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Avoidance of dental appointment due to cost and consequences for oral health-related quality of life: 25-yr follow-up of Swedish adults
- 2021
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In: European Journal of Oral Sciences. - : Wiley-Blackwell. - 0909-8836 .- 1600-0722. ; 129:3
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Journal article (peer-reviewed)abstract
- We explored how socio-demographic and personal characteristics contribute to avoidance of dental appointment due to cost over time from age 55 (in 1997) to 75 (in 2017) and assessed the implications for oral health-related quality of life. In 1992, 6346 residents born in 1942 consented to participate in a prospective questionnaire survey, and 3060 (48.2%) of them completed postal follow-ups every fifth year until 2017. Oral health-related quality of life was assessed using the Oral Impact on Daily Performance inventory. The frequency of avoidance of dental appointment due to cost declined from 7.0% (in 1997) to 5.4% (in 2017), whereas the frequency of oral impacts declined from 26.0% in 2007 to 24.0% in 2017. Generalized Estimating Equation models revealed that avoidance of dental appointments due to cost was more likely reported in 1997 (OR: 1.5: 1.2-1.8) than in 2017, more likely in low educated people, and less likely in those using private dental care services. Avoidance of dental appointment due to cost was associated with impaired oral health-related quality of life. Social inequalities in avoidance of dental appointment due to cost and oral impacts did not vary across time but persisted into older ages despite the dental health care reforms that had been implemented.
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