| 1. |
- Bobjer, Johannes, et al.
(författare)
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Location of retroperitoneal lymph node metastases in upper tract urothelial carcinoma : results from a prospective lymph node mapping study
- 2023
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Ingår i: European Urology Open Science. - : Elsevier. - 2666-1691 .- 2666-1683. ; 57, s. 37-44
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is limited information on the distribution of retroperitoneal lymph node metastases (LNMs) in upper tract urothelial carcinoma (UTUC).Objective: To investigate the location of LNMs in UTUC of the renal pelvis or proximal ureter and short-term complications after radical nephroureterectomy (RNU) with lymph node dissection (LND).Design, setting, and participants: This was a prospective Nordic multicenter study (four university hospitals, two county hospitals). Patients with clinically suspected locally advanced UTUC (stage >T1) and/or clinical lymph node–positive (cN+) disease were invited to participate. Participants underwent RNU and fractionated retroperitoneal LND using predefined side-specific templates.Outcome measurements and statistical analysis: The location of LNMs in the LND specimen and retroperitoneal lymph node recurrences during follow-up was recorded. Postoperative complications within 90 d of surgery were ascertained from patient charts. Descriptive statistics were used.Results and limitations: LNMs were present in the LND specimen in 23/100 patients, and nine of 100 patients experienced a retroperitoneal recurrence. Distribution per side revealed LNMs in the LND specimen in 11/38 (29%) patients with right-sided tumors, for whom the anatomically larger, right-sided template was used, in comparison to 12/62 (19%) patients with left-sided tumors, for whom a more limited template was used. High-grade complications (Clavien grade ≥3) within 90 d of surgery were registered for 13/100 patients. The study is limited in size and not powered to assess survival estimates.Conclusions: The suggested templates that we prospectively applied for right-sided and left-sided LND in patients with advanced UTUC included the majority of LNMs. High-grade complications directly related to the LND part of the surgery were limited.Patient summary: This study describes the location of lymph node metastases in patients with cancer in the upper urinary tract who underwent surgery to remove the affected kidney and ureter. The results show that most metastases occur within the template maps for lymph node surgery that we investigated, and that this surgery can be performed with few severe complications.
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| 2. |
- Andersson, Magnus, et al.
(författare)
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Fiskbestånd och miljö i hav och sötvatten : Resurs- och miljööversikt 2012
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Detta är den nionde utgåvan av den samlade översikten över fisk- och kräftdjursbeståndens status i våra vatten. Kunskap om fiskbestånden och miljön är en förutsättning för att utnyttjandet av fiskresurserna skall bli bärkraftigt. För svenska vattenområden beskrivs miljöutvecklingen i ett ekosystemsperspektiv, dels för att tydliggöra fiskens ekologiska roll och beskriva yttre miljöfaktorer som påverkar fiskbestånden, dels för att belysa fiskets effekter på miljön.Fiskbestånd och miljö i hav och sötvatten är utarbetad av Sveriges lantbruksuniversitet (SLU), Institutionen för akvatiska resurser (SLU Aqua), på uppdrag av Havs- och vattenmyndigheten. Rapporten sammanfattar utveckling och beståndsstatus för de kommersiellt viktigaste fisk- och kräftdjursarterna i våra vatten. Bedömningar och förvaltningsråd är baserade på Internationella Havsforskningsrådets (ICES) rådgivning, SLU Aquas nationella och regionala provfiskedata, samt yrkesfiskets rapportering.
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| 3. |
- Holm, Alexander, et al.
(författare)
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Patients' perspective on prostatic artery embolization : A qualitative study
- 2021
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Ingår i: SAGE Open Medicine. - : SAGE Open. - 2050-3121. ; 9, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim was to describe the patients' experience of undergoing prostatic artery embolization.Methods: A retrospective qualitative interview study was undertaken with 15 patients of mean age 73 years who had undergone prostatic artery embolization with a median duration of 210 min at two medium sized hospitals in Sweden. The reasons for conducting prostatic artery embolization were clean intermittent catheterization (n = 4), lower urinary tract symptoms (n = 10) or haematuria (n = 1). Data were collected through individual, semi-structured telephone interviews 1-12 months after treatment and analysed using qualitative content analysis.Results: Four categories with sub-categories were formulated to describe the results: a diverse experience; ability to control the situation; resumption of everyday activities and range of opinions regarding efficacy of outcomes. Overall, the patients described the procedure as painless, easy and interesting and reported that while the procedure can be stressful, a calm atmosphere contributed to achieving a good experience. Limitations on access to reliable information before, during and after the procedure were highlighted as a major issue. Practical ideas for improving patient comfort during the procedure were suggested. Improved communications between treatment staff and patients were also highlighted. Most patients could resume everyday activities, some felt tired and bruising caused unnecessary worry for a few. Regarding functional outcome, some patients described substantial improvement in urine flow while others were satisfied with regaining undisturbed night sleep. Those with less effect were considering transurethral resection of the prostate as a future option. Self-enrolment to the treatment and long median operation time may have influenced the results.Conclusions: From the patients' perspective, prostatic artery embolization is a well-tolerated method for treating benign prostate hyperplacia.
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| 4. |
- Lundström, Karl-Johan, et al.
(författare)
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Short-term ciprofloxacin prophylaxis for prostate biopsy and risk of aortic aneurysm : nationwide, population-based cohort study
- 2021
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Ingår i: Scandinavian journal of urology. - : Taylor & Francis Group. - 2168-1805 .- 2168-1813. ; 55:3, s. 221-226
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The use of quinolones has recently been questioned due to reports on side effects including an increased risk of aortic aneurysm. The aim of the study was to examine the risk of aortic aneurysm (AA) after short-term ciprofloxacin as prophylaxis for prostate biopsy.Materials and Methods: We used the Prostate Cancer data Base Sweden and investigated 192,024 prostate biopsy exposures vs. 554,974 non-exposures for risk of AA. Prostate biopsy was used as a proxy for quinolone use as short-term ciprofloxacin is the recommended and documented prophylaxis in Sweden for this procedure. The outcome was the hazard ratio (HR) of AA in men who underwent a biopsy vs. those that did not.Results: The absolute risk of AA was small, 39/10,000 person years for all AÁs and for ruptured AÁs 3.5/10,000 person years. In multivariate analyses, there were small, non-significant increases in risk of all AA’s (adjusted HR = 1.13, 95% CI: 0.91 to 1.39) and ruptured AÁs (adjusted HR = 1.05, 95% CI: 0.52 to 2.15) in men who underwent biopsy. A significantly increased risk of AA was observed in men diagnosed with high-risk prostate cancer on biopsy (HR = 1.50, 95% CI: 1.15–2.21). The use of prostate biopsy as a proxy for exposure to ciprofloxacin was a limitation of the study.Conclusions: Short-term ciprofloxacin was not associated with an increased risk of aortic aneurysm and the increased risk in men with high-risk prostate cancer was likely due detection bias caused by imaging more commonly performed in these men.
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| 5. |
- Styrke, Johan, et al.
(författare)
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Current routines for antibiotic prophylaxis prior to transrectal prostate biopsy : a national survey to all urology clinics in Sweden.
- 2020
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Ingår i: F1000 Research. - : F1000 Research Ltd. - 2046-1402. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: The risk of infection after transrectal ultrasound (TRUS)-guided prostate biopsies is increasing. The aim of the study was to assess the use of antibiotic prophylaxis for prostate biopsy in Sweden. Methods: All public and private urology clinics reporting to the National Prostate Cancer Register of Sweden received a survey on TRUS-biopsy prophylaxis. Results: Of the 84 clinics surveyed, 76 replied (90%). If no risk factors for infection were present, a single dose of ciprofloxacin 750 mg was used by 50 clinics (66%). Multiple doses of ciprofloxacin 500 or 750 mg (n=14; 18%) or a single dose of trimethoprim-sulfamethoxazole 160/800 mg (n=7; 9%) were other common prophylaxes. Most clinics gave the prophylaxes immediately before the biopsy (n=41; 54%). Urine dipstick was used by 30 clinics (39%) and rectal enema by six (8%). In patients with high risk of infection, the survey mirrors a large variety of regiments used. Conclusions: The preference to use a single dose of ciprofloxacin 750 mg is in accordance with the Swedish national guidelines for patients with a low risk of infection. Better compliance to the guideline recommendation to use a urine dipstick would probably increase the number of patients classified as having an increased risk of infection. Being classified as a high-risk patient should lead to an extended duration of antibiotic prophylaxis, however, the variety of regimens used in the high-risk group reflects an inability to treat these patients in a standardized fashion and also highlights a need for more clear-cut guidelines. Pre-biopsy identification of high-risk patients is an important issue to tackle for the urologic clinics in order to reduce the number of infections.
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| 6. |
- Wagenius, Magnus, et al.
(författare)
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Factors influencing stone-free rate of Extracorporeal Shock Wave Lithotripsy (ESWL) : a cohort study
- 2022
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Ingår i: Scandinavian journal of urology. - : Taylor & Francis. - 2168-1805 .- 2168-1813. ; 56:3, s. 237-243
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the success rate of Extracorporeal Shock Wave Lithotripsy (ESWL) therapy and identify relevant treatment-specific factors affecting stone-free rate (SFR) after ESWL.Materials and methods: All ESWL treatments in the years 2016-2019, in angelholm Hospital, Skane, Sweden were analysed retrospectively. Primary outcome was stone-free rate (SFR) at 3 months. Univariate logistic regression was used followed by multivariable regression. Lasso analysis was made to adjust for treatment-specific factors such as age, stone size, skin-to-stone distance (SSD), stone attenuation, number of treatments, stone location and presence of a urinary stent.Results: Factors affecting successful ESWL treatment were lower age (p < 0.001), smaller stone size and volume (both p = 0.001). SSD, stone attenuation, sex, laterality and drainage did not have an effect on SFR in this study. After the first ESWL treatment session, 46.7% of the patients were stone-free.Conclusion: Results indicate that stone size and age are the most predictive factors for ESWL outcome. Based on this, we present a simple model for prediction of SFR after ESWL, to be used when counseling patients before ESWL treatment.
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| 7. |
- Ahlbeck Bergendahl, Ida, et al.
(författare)
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Fisk- och skaldjursbestånd i hav och sötvatten 2016 : Resursöversikt
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I rapporten kan du ta del av bedömningen som görs av situationen för bestånd som regleras inom ramen för EU:s gemensamma fiskeripolitik (GFP). Bedömningarna baseras på det forskningssamarbete och den rådgivning som sker inom det Internationella Havsforskningsrådet (ICES).De bestånd som förvaltas nationellt baseras på de biologiska underlagen, och rådgivningen i huvudsak på den forskning och övervakning samt analys som bedrivs av Institutionen för akvatiska resurser vid Sveriges lantbruksuniversitet (SLU Aqua) samt yrkesfiskets rapportering.Rapporten omfattar 41 fiskarter uppdelade i olika bestånd, samt sju skal- och blötdjursarter.Nytt för årets upplaga är kapitlet om ekosystemtjänster. Avsnittet beskriver de fördelar människan får genom ekosystemen, till exempel hur fisk och skaldjur kommer till nytta för människan genom föda, rekreation och biologisk mångfald. Nytt för i år är också att rapportens diagram och figurer anpassats för läsare med defekt färgseende.Översikten är utarbetad av SLU Aqua på uppdrag av Havs- och vattenmyndigheten.
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| 8. |
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| 9. |
- Ahlbeck Bergendahl, Ida, et al.
(författare)
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Fisk- och skaldjursbestånd i hav och sötvatten 2017 : Resursöversikt
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I rapporten kan du ta del av bedömningen som görs av situationen för bestånd som regleras inom ramen för EU:s gemensamma fiskeripolitik (GFP). Bedömningarna baseras på det forskningssamarbete och den rådgivning som sker inom det Internationella Havsforskningsrådet (ICES).De bestånd som förvaltas nationellt baseras på de biologiska underlagen, och rådgivningen i huvudsak på den forskning och övervakning samt analys som bedrivs av Institutionen för akvatiska resurser vid Sveriges lantbruksuniversitet (SLU Aqua) samt yrkesfiskets rapportering.Rapporten omfattar 41 fiskarter och sju skaldjursarter.Nytt för i år är att vi även beskriver fritidsfisket mer utförligt. Det fisket får allt större betydelse för utvecklingen av många av Sveriges bestånd av fisk- och skaldjur, till exempel sötvattens- och kustlevande arter som abborre, gädda, gös, lax, röding och öring, liksom marina arter som torsk och hummerÖversikten är utarbetad av SLU Aqua på uppdrag av Havs- och vattenmyndigheten.
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| 10. |
- Bryhn, Andreas, et al.
(författare)
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Fisk- och skaldjursbestånd i hav och sötvatten 2019 : Resursöversikt
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Fisken i havet är en resurs som rör sig fritt över nationella gränser. EU har därför en gemensam fiskeripolitik (GFP). Många arter som är viktiga för Sverige regleras inte i GFP och förvaltas därför nationellt.Denna rapport syftar till att:beskriva utvecklingen av fiskeripolitikenförklara den nuvarande politikens mål och regelverk och dess relation till mål och regler på miljöområdetförklara politikens nationella genomförande och det nationella handlingsutrymmetexemplifiera hur Havs- och vattenmyndigheten arbetat med att reglera fisket.
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| 11. |
- Bryhn, Andreas, et al.
(författare)
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Fisk- och skaldjursbestånd i hav och sötvatten 2020 : Resursöversikt
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I rapporten kan du ta del av bedömningen som görs av situationen för bestånd som regleras inom ramen för EU:s gemensamma fiskeripolitik (GFP). Bedömningarna baseras på det forskningssamarbete och den rådgivning som sker inom det Internationella Havsforskningsrådet (ICES). Totalt redovisas underlag och råd för 48 fisk- och skaldjursarter.De bestånd som förvaltas nationellt baseras på de biologiska underlagen, och rådgivningen i huvudsak på den forskning och övervakning samt analys som bedrivs av Institutionen för akvatiska resurser vid Sveriges lantbruksuniversitet (SLU Aqua) samt yrkesfiskets rapportering.
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| 12. |
- Fridriksson, Jon Örn, et al.
(författare)
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Long-term adverse effects after retropubic and robot-assisted radical prostatectomy : Nationwide, population-based study
- 2017
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Ingår i: Journal of Surgical Oncology. - : Wiley. - 0022-4790 .- 1096-9098. ; 116:4, s. 500-506
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objectives: Surgery for prostate cancer is associated with adverse effects. We studied long-term risk of adverse effects after retropubic (RRP) and robot-assisted radical prostatectomy (RARP).Methods: In the National Prostate Cancer Register of Sweden, men who had undergone radical prostatectomy (RP) between 2004 and 2014 were identified. Diagnoses and procedures indicating adverse postoperative effects were retrieved from the National Patient Register. Relative risk (RR) of adverse effects after RARP versus RRP was calculated in multivariable analyses adjusting for year of surgery, hospital surgical volume, T stage, Gleason grade, PSA level at diagnosis, patient age, comorbidity, and educational level.Results: A total of 11 212 men underwent RRP and 8500 RARP. Risk of anastomotic stricture was lower after RARP than RRP, RR for diagnoses 0.51 (95%CI = 0.42-0.63) and RR for procedures 0.46 (95%CI = 0.38-0.55). Risk of inguinal hernia was similar after RARP and RRP but risk of incisional hernia was higher after RARP, RR for diagnoses 1.48 (95%CI = 1.01-2.16), and RR for procedures 1.52 (95%CI = 1.02-2.26).Conclusions: The postoperative risk profile for RARP and RRP was quite similar. However, risk of anastomotic stricture was lower and risk of incisional hernia higher after RARP.
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| 13. |
- Grabe, Magnus J., et al.
(författare)
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Tailored perioperative antimicrobial prophylaxis in urological surgery : myth or reality?
- 2017
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Ingår i: Current Opinion in Urology. - 0963-0643 .- 1473-6586. ; 27:2, s. 112-119
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Forskningsöversikt (refereegranskat)abstract
- Purpose of review The controversies surrounding perioperative antimicrobial prophylaxis (AMP) are about the use and especially misuse of antibiotics. The overall lack of evidence to facilitate a rational perioperative AMP policy in urological surgery and the postoperative infectious complications remain a challenge. Therefore, a basic tool to aid decision-making would be useful. A model based on the patients' risk factors, the level of contamination and grading of surgical procedures is discussed.Recent findings A series of studies have shown that infectious complications and healthcare-associated infections remain consistently at an average of 10%, with a great variation in frequency dependent on the patients' preoperative status and the type, severity and contamination level of the surgical procedure. Preoperative patient assessment and preparation are key factors for well tolerated surgery and recovery. Adherence to the guidelines appears to reduce both the prescription of antimicrobials and the total costs without risking the patient outcome. Several studies of a series of interventions such as cystoscopy, endoscopic stone surgery and selected clean-contaminated interventions give support to the model. Bacteriuria, upgrading the patient to the contaminated level, requires preoperative control.Summary The discussed model assists the urologists in decision-making on perioperative AMP and contributes to a responsible use of antibiotics.
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| 14. |
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| 15. |
- Hansson, Julia, et al.
(författare)
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HOPE - Hydrogen fuel cells solutions in Nordic shipping. Project summary : A Nordic Maritime Transport and Energy Research Programme Project
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The Nordic countries aim for a carbon-neutral Nordic region. Maritime transport is one of the key remaining sectors to decarbonize and is important from a Nordic perspective due to the relatively large Nordic involvement in this industry. The HOPE project addresses how regional shipping in the Nordic region can do the transition to become fossil-free. The project aims at clarifying the potential role of hydrogen based marine solutions in reducing the Nordic greenhouse gas (GHG) emissions. In the centre of the project is a ship concept where a typical RoPax-vessel with operating distances of around 100 nautical miles is designed for including operation with hydrogen as fuel and fuel cells for energy conversion. The overall design of the concept ship is compared with selected other fuel alternatives from a cost perspective. Further, both the conditions for designing such a ship and the consequences are studied. The conditions include technical design and costs of fuel systems and handling, powertrains etc. but also an analysis of barriers and drivers for the realisation of hydrogen solutions for shipping, such as economic, legal, and policy issues. For example, in terms of drivers, policy options needed to accelerate the uptake of hydrogen based marine solutions are assessed. Strategies and the potential of producing these fuels in the Nordic region are also reviewed from a shipping perspective. A realistic potential for uptake of these technologies/fuels by Nordic shipping are assessed and the benefits regarding lower emissions of GHGs and air pollutants are estimated. This report summarizes the assessments made in the HOPE project including main findings.
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| 16. |
- Jakobsson, Ebbe, et al.
(författare)
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Chronic Pain After Groin Hernia Surgery in Women: A Patient-reported Outcome Study Based on Data From the Swedish Hernia Register.
- 2022
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Ingår i: Annals of surgery. - : Lippincott Williams & Wilkins. - 1528-1140 .- 0003-4932. ; 275:2, s. 213-219
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate chronic pain 1 year after surgery, and risk factors for chronic pain after groin hernia repair in women.Groin hernia surgery in women is less frequently studied than in men. Chronic pain is common after groin hernia surgery and remains an important area with room for improvement. Previous studies are small or inconclusive. Guidelines recommend timely repair of all female groin hernias.From the Swedish Hernia Register 4021 female and 37,542 male patients operated between September 1, 2012 and August 30, 2017 responded to a patient-reported outcome questionnaire (response rate 70.0%) 1 year after primary groin hernia surgery. Multivariable analysis was performed to compare chronic postoperative pain in women with men as a control group, and to evaluate risk factors for chronic pain in women.Among women operated for groin hernia, 18% suffered chronic postoperative pain. The risk for chronic pain was significantly higher for women [odds ratio 1.3 (95% confidence interval 1.16-1.46). Three risk factors for chronic pain in women were found: high body mass index, high American Society of Anesthesiologists classification, and femoral hernia. No differences in chronic pain in women were seen when comparing surgical methods or emergency versus elective surgery.Almost one-fifth of women suffered of chronic pain affecting daily activity after groin hernia repair. Chronic pain was more common for women than men. In view of the high-rate chronic postoperative pain, further research on management strategies in female groin hernia is warranted.
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| 17. |
- Jivén, Karl, et al.
(författare)
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Concept design and environmental analysis of a fuel cell RoPax vessel - Report in the HOPE (Hydrogen fuel cells solutions in shipping in relation to other low carbon options) project
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This report includes a ship concept design developed for a RoPax ship (a ferry transporting passengers and goods) with hydrogen fuel cell propulsion for intended operations on the route Frederikshavn (Denmark) to Gothenburg (Sweden). The assessments, performed within the HOPE (Hydrogen fuel cells solutions in shipping in relation to other low carbon options – a Nordic perspective) project, shows that it is technically feasible to build and operate such a ship with existing technology for the studied route between these two Nordic countries. Also, the costs of such a concept are assessed and compared to other fuel options including: battery-electric propulsion, electro-ammonia, electro-methanol, biomass-based methane, or fossil liquefied natural gas (LNG), as well as conventional fossil marine gas oil (MGO).The overall result from the comparative analysis of the estimated costs is that the hydrogen fuel cell ship, when assuming current or near future costs for the technology and the hydrogen, is estimated to be some 25 percent more expensive than a conventional fossil fuelled (MGO) RoPax ship (when including costs for emissions in the EU emission trading scheme). However, the cost developments are uncertain. In the case that fuel cell prices, and hydrogen prices, are decreasing, and todays cost levels of emission allowances in the EU emission trading scheme (ETS) increase, the hydrogen fuel cell ship could possibly be operated at lower total costs compared to the MGO fuelled ship.A cost benefit analysis was also performed, comparing costs linked to the technical implementation of hydrogen fuel cell solutions in shipping (with a private and social perspective) to benefits in terms of reduced external costs linked to lower emissions and potential subsides. The cost benefit assessment also confirms that the investment from a private perspective is not cost effective and that additional subsidies may be needed for investments in fuel cell hydrogen technology to take place. The cost effectiveness from a social perspective is strongly dependent on values of highly uncertain parameters.The impacts of emissions of hydrogen as fuel in a Nordic context were assessed for deployment scenarios for hydrogen and fuel cell solutions in Nordic shipping. There is a considerable potential for emission reductions both in terms of CO2, nitrogen oxides (NOX), sulphur dioxide (SO2) and particulate matter (PM) linked to the implementation of hydrogen and fuel cells in Nordic shipping, particularly in the RoPax segment, representing 30% of total CO2 emissions in 2018. Considering the relatively long lifetime of vessels, investments must be made soon to enable a hydrogen powered shipping fleet in the near future. Since it is currently not economically viable with hydrogen and fuel cells vessels there is need for subsidies and investments in pilots to develop solutions and speed up the process.
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| 18. |
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| 19. |
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| 20. |
- Lundström, Karl-Johan, et al.
(författare)
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Epidemiology of hydrocele and spermatocele; incidence, treatment and complications
- 2019
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Ingår i: Scandinavian journal of urology. - : Taylor & Francis. - 2168-1805 .- 2168-1813. ; 53:2-3, s. 134-138
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To estimate the incidence of men seeking specialized care and receiving treatment for hydro or spermatocele complaints. Also, to determine the risk of complications of treatment.Materials and methods: The total number of men living in Sweden each year from 2005 to 2014 was used to calculate incidence and age distribution of adult (≥18 years) men seeking specialized healthcare with either hydro or spermatocele. This was done by using nationwide registries, mandatory by law. They contain information on primary or discharge diagnosis, procedure codes and antibiotic prescriptions. Also, complication rates comparing aspiration (with or without sclerotherapy) and conventional surgery were analysed.Results: The incidence of men with either hydro or spermatocele diagnosis in specialized healthcare was ∼100/100,000 men. The treatment incidence was 17/100,000 men. Orchiectomy was used as primary treatment in 2.4% of cases. The risk of experiencing a complication was clinically and statistically significantly increased with conventional surgery as compared with aspiration, 17.5% (1607/9174) vs 4.6% (181/3920), corresponding to relative risk of 3.79 (95% CI = 3.27–4.40). Hematoma and infections were the most common complications.Conclusion: Hydro and spermatoceles are common, affecting elderly men. Aspiration seems advantageous with respect to complications and can be recommended due to the benign course of the disease. The indication for conventional surgery might be questioned such as the use of orchiectomy as primary treatment.
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| 21. |
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| 22. |
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| 23. |
- Lundström, Karl-Johan, et al.
(författare)
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Nationwide Population Based Study of Infections after Transrectal Ultrasound Guided Prostate Biopsy
- 2014
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Ingår i: Journal of Urology. - : Ovid Technologies (Wolters Kluwer Health). - 0022-5347 .- 1527-3792. ; 192:4, s. 1116-1122
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Transrectal ultrasound guided biopsy is the gold standard for detecting prostate cancer but international reports suggest that increasing risks are associated with the procedure. We estimated incidence and risk factors for infection after prostate biopsy as well as 90-day mortality using a nationwide Swedish sample.Material and Methods: We performed a population based study of 51,321 men from PCBaSe between 2006 and 2011. Primary outcome measures were dispensed prescriptions of antibiotics for urinary tract infection and hospitalization with a discharge diagnosis of urinary tract infection. Multivariable logistic regression was used to examine risk factors for infection in men who underwent prostate biopsy.Results: During the 6 months before biopsy the background incidence of urinary tract infection was approximately 2%. Within 30 days after biopsy 6% of the men had a dispensed prescription for urinary tract antibiotics and 1% were hospitalized with infection. The strongest risk factors for an antibiotic prescription were prior infection (OR 1.59, 95% CI 1.45-1.73), high Charlson comorbidity index (OR 1.25, 95% CI 1.11-1.41) and diabetes (OR 1.32, 95% CI 1.17-1.49). Risk of an antibiotic prescription after biopsy decreased from 2006 to 2011 (OR 0.79, 95% CI 0.70-0.90) but the risk of hospital admission increased (OR 2.14, 95% CI 1.58-2.94). No significant increase was observed in 90-day mortality.Conclusions: Severe infections with hospitalization after prostate biopsy are increasing in Sweden. The risk of post-biopsy infection is highest in men with a history of urinary tract infection and those with significant comorbidities.
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| 24. |
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| 25. |
- Lundström, Karl-Johan, 1977-
(författare)
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Outcomes and complications in surgical and urological procedures
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background:Minor procedures in surgery and urology such as groin hernia and hydrocele repair, as well as prostate biopsies are very frequently done in routine practice. Complications and insufficient outcomes thus affecting many patients and the cumulative effect of this are of major importance in a population perspective.Aim:To explore complications and outcomes of surgical or diagnostic procedures and possible risk factors or predictors for adverse effects. Methods: By using both national quality and administrative registers, and by complementing registers with patient reported outcome measures, examine outcomes such as complications, persistent pain and recurrences. Also, in the case of hydro and spermatoceles, report incidence numbers. Further, by using a randomized trial, explore minimally invasive procedure such as sclerotheraphy compared to conventional surgery in respect to cure and adverse events.Results:When comparing with the open anterior mesh repair, endoscopic technique is advantageous in respect to the patient reported outcome of persistent pain. The drawback was an increased risk of postoperative complications and reoperation for recurrence. Incidence numbers for hydro and spematocele were 100/100000 men. Aspiration (± sclerotherapy) had a significantly lower rate of complications as compared to conventional surgery. In the interim analysis of the randomized trial, comparing sclerotherapy to Lord´s procedure for hydroceles, the cure rate was similar between treatments. Definite conclusions cannot be made due to the risk of type 2 errors, and the study will thus continue. In the case of trans-rectal prostate biopsy, the rates increased every year during the study time frame, up to an approximate risk of two per cent in 2012 for hospital readmission within 30 days, without an increased mortality within 30 days.Conclusions:The open anterior mesh procedure is still the preferred method for groin hernia repair in routine surgical practice. Hydro and spermatocele surgery is associated with high rates of complications, and the indication for repair should be scrutinized. The rates of infection after prostate biopsy is increasing and methods to reduce unnecessary biopsies as well as improved prophylaxis should be investigated.
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| 26. |
- Lundström, Karl-Johan, et al.
(författare)
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Patient-reported rates of chronic pain and recurrence after groin hernia repair
- 2018
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Ingår i: British Journal of Surgery. - : John Wiley & Sons. - 0007-1323 .- 1365-2168. ; 105:1, s. 106-112
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Tidskriftsartikel (refereegranskat)abstract
- Background: The effectiveness of different procedures in routine surgical practice for hernia repair with respect to chronic postoperative pain and reoperation rates is not clear.Methods: This was prospective cohort study based on a unique combination of patient-reported outcomes and national registry data. Virtually all patients with a groin hernia repair in Sweden between September 2012 and April 2015 were sent a questionnaire 1 year after surgery. Persistent pain, defined as at least "pain present, cannot be ignored, and interferes with concentration on everyday activities' in the past week was the primary outcome. Reoperation for recurrence recorded in the register was the secondary outcome.Results: In total, 22 917 patients (response rate 75.5 per cent) who had an elective unilateral groin hernia repair were analysed. Persistent pain present 1 year after hernia repair was reported by 15.2 per cent of patients. The risk was least for endoscopic total extraperitoneal (TEP) repair (adjusted odds ratio (OR) 0.84, 95 per cent c.i. 0.74 to 0.96), compared with open anterior mesh repair. TEP repair had an increased risk of reoperation for recurrence (adjusted OR 2.14, 1.52 to 2.98), as did open preperitoneal mesh repair (adjusted OR 2.34, 1.42 to 3.71) at 2.5-year follow-up. No other methods of repair differed significantly from open anterior mesh repair.Conclusion: The risk of significant pain 1year after groin hernia repair in routine surgical practice was 15.2 per cent. This figure was lower in patients who had surgery by an endoscopic technique, but at the price of a significantly higher risk of reoperation for recurrence.
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| 27. |
- Lundström, Karl-Johan, et al.
(författare)
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Risk factors for complications in Groin Hernia surgery : A National register study
- 2012
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Ingår i: Annals of Surgery. - Philasdelphia, PA, USA : Lippincott Williams & Wilkins. - 0003-4932 .- 1528-1140. ; 255:4, s. 784-788
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aims to analyze and identify risk factors for postoperative complications and analyze the relative risk of reoperation for recurrence for respective complication. Background: The outcome of groin hernia surgery is evaluated mostly by comparing recurrence rates and long-term pain. The aim of this observational population-based registry study was to identify risk factors for postoperative complications and analyze the relative risk of reoperation for recurrence for respective complication. Methods: Using data from the nationwide Swedish Hernia Register between 1998 and 2009, 150,514 herniorrhaphies were analyzed with respect to postoperative complications occurring within 30 days of surgery. Results: Risk factors significantly affecting the rate of postoperative complications were laparoscopic repair (odds ratio [OR] 1.35, 95% confidence interval [CI] 1.24-1.47) and open preperitoneal techniques (OR: 1.31, 95% CI: 1.15-1.49), with open anterior mesh as reference category. Other significant risk factors were general (OR: 1.30, 95% CI: 1.23-1.37) and regional anesthesia (OR: 1.53, 95% CI: 1.43-1.63), with local anesthesia as reference category, emergency procedures (OR: 1.53, 95% CI: 1.43-1.63); recurrent hernia repair (OR: 1.39, 95% CI: 1.27-1.52); femoral hernia (OR: 1.30, 95% CI: 1.14-1.48); aged older than 65 years (OR: 1.26, 95% CI: 1.21-1.31); and duration of surgery exceeding 50 minutes (OR: 1.27, 95% CI: 1.22-1.33). Conclusions: Open anterior approach and surgery under local anesthesia are associated with less risk of postoperative complications.
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| 28. |
- Lundström, Karl-Johan, et al.
(författare)
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Small bowel obstruction and abdominal pain after robotic versus open radical prostatectomy
- 2016
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Ingår i: Scandinavian journal of urology. - : Informa UK Limited. - 2168-1805 .- 2168-1813. ; 50:3, s. 155-159
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to examine whether intraperitoneal robot-assisted surgery leads to small bowel obstruction (SBO), possibly caused by the formation of intra-abdominal adhesions.Materials and methods: In total, 7256 men treated by intraperitoneal robot-assisted radical prostatectomy (RARP) and 9787 men treated by retropubic radical prostatectomy (RRP) in 2005-2012 were identified in the Prostate Cancer data Base Sweden (PCBaSe). Multivariable Cox proportional hazards models were used to calculate the risk of readmission for SBO, SBO-related surgery and admissions due to abdominal pain up to 5 years postoperatively.Results: During the first postoperative year, the risk of readmission for SBO was higher after RARP than after RRP [hazard ratio (HR) 1.92, 95% confidence interval (CI) 1.14-3.25] but after 5 years there was no significant difference (HR 1.28, 95% CI 0.86-1.91), and there was no difference in the risk of SBO surgery during any period. The risk of admission for abdominal pain was significantly increased after RARP during the first year (HR 2.24, 95% CI 1.50-3.33) but not after 5 years (HR 1.23, 95% CI 0.92-1.63).Conclusion: Intraperitoneal RARP had an increased risk of SBO and abdominal pain in the short term during the first year, but not in the long term, compared to RRP.
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| 29. |
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| 30. |
- Lundström, Karl, et al.
(författare)
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Kattegat cod numbers at age eaten by harbor seals
- 2017
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Ingår i: Report of the Benchmark Workshop on Baltic Stocks (WKBALT), 7–10 February 2017, Copenhagen, Denmark. ICES CM 2017/ACOM:30. ; , s. 97-107
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 31. |
- Neimane, Aleksija, et al.
(författare)
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Emergence of the Zoonotic Biliary Trematode Pseudamphistomum truncatum in Grey Seals (Halichoerus grypus) in the Baltic Sea
- 2016
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:10, s. e0164782-
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Tidskriftsartikel (refereegranskat)abstract
- The biliary trematode Pseudamphistomum truncatum parasitizes a wide range of fish-eating mammals, including humans. Here we report the emergence of this parasite in grey seals (Halichoerus grypus) in the Baltic Sea. One hundred eighty-three of 1 554 grey seals (11.9%) examined from 2002–2013 had detectable hepatobiliary trematode infection. Parasite identification was confirmed as P. truncatum by sequencing the ITS2 region of a pool of five to 10 trematodes from each of ten seals collected off the coast of seven different Swedish counties. The proportion of seals parasitized by P. truncatum increased significantly over time and with increasing age of seals. Males were 3.1 times more likely to be parasitized than females and animals killed in fishery interactions were less likely to be parasitized than animals found dead or hunted. There was no significant difference in parasitism of seals examined from the Gulf of Bothnia versus those examined from the Baltic Proper. Although the majority of infections were mild, P. truncatum can cause severe hepatobiliary disease and resulted in liver failure in at least one seal. Because cyprinid fish are the second intermediate host for opisthorchiid trematodes, diets of grey seals from the Baltic Sea were analysed regarding presence of cyprinids. The proportion of gastrointestinal tracts containing cyprinid remains was ten times higher in seals examined from 2008 to 2013 (12.2%) than those examined from 2002 to 2007 (1.2%) and coincided with a general increase of trematode parasitism in the host population. The emergence and relatively common occurrence of P. truncatum in grey seals signals the presence of this parasite in the Baltic Sea ecosystem and demonstrates how aquatic mammals can serve as excellent sentinels of marine ecosystem change. Investigation of drivers behind P. truncatum emergence and infection risk for other mammals, including humans, is highly warranted.
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| 32. |
- Sandström, Alfred, et al.
(författare)
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Fisk- och skaldjursbestånd i hav och sötvatten 2018 : Resursöversikt
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Den 14:e utgåvan av den samlade resursöversikten av fisk- och kräftdjursbeståndens status i våra vatten.I rapporten kan du ta del av bedömningen som görs av situationen för bestånd som regleras inom ramen för EU:s gemensamma fiskeripolitik (GFP). Bedömningarna baseras på det forskningssamarbete och den rådgivning som sker inom det Internationella Havsforskningsrådet (ICES).De bestånd som förvaltas nationellt baseras på de biologiska underlagen, och rådgivningen i huvudsak på den forskning och övervakning samt analys som bedrivs av Institutionen för akvatiska resurser vid Sveriges lantbruksuniversitet (SLU Aqua) samt yrkesfiskets rapportering.Rapporten omfattar 41 fiskarter och åtta skaldjursarter.Nytt för i år är att flodkräftan och signalkräftan har fått egna presentationer. Vi har även ett nytt kapitel "Hållbarhetsbedömning av fisk- och skaldjursbestånd i havsområden runt Sverige”. Det består av en sammanfattning av den årliga bedömningen av hållbarheten i nyttjandet av fisk- och skaldjursbestånd i kust och hav runt Sverige. Bedömningenär baserad på de senaste tre åren vilket möjliggör en jämförelse över tid iantalet hållbart nyttjade bestånd. Jämförelsen visar inga tydliga förändringar över de senaste tre åren.Det finns ett nytt avsnitt i kapitlet ”Från biologi till förvaltning” om hur Havs- och vattenmyndighetens tillståndsgivning går till, och hur bedömningen baseras på resursöversikten vid ansökan om fiskelicens eller annan tillståndsgivning. Kapitlet har också utökats med ett avsnitt där SCB:s fritidsfiskeundersökning beskrivs och hur resultatet används i beståndsanalyserna.
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