| 1. |
- Arlien-Soborg, Mai C., et al.
(författare)
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Acromegaly management in the Nordic countries: A Delphi consensus survey
- 2024
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Ingår i: CLINICAL ENDOCRINOLOGY. - : WILEY. - 0300-0664 .- 1365-2265.
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveAcromegaly is associated with increased morbidity and mortality if left untreated. The therapeutic options include surgery, medical treatment, and radiotherapy. Several guidelines and recommendations on treatment algorithms and follow-up exist. However, not all recommendations are strictly evidence-based. To evaluate consensus on the treatment and follow-up of patients with acromegaly in the Nordic countries.MethodsA Delphi process was used to map the landscape of acromegaly management in Denmark, Sweden, Norway, Finland, and Iceland. An expert panel developed 37 statements on the treatment and follow-up of patients with acromegaly. Dedicated endocrinologists (n = 47) from the Nordic countries were invited to rate their extent of agreement with the statements, using a Likert-type scale (1-7). Consensus was defined as >= 80% of panelists rating their agreement as >= 5 or <= 3 on the Likert-type scale.ResultsConsensus was reached in 41% (15/37) of the statements. Panelists agreed that pituitary surgery remains first line treatment. There was general agreement to recommend first-generation somatostatin analog (SSA) treatment after failed surgery and to consider repeat surgery. In addition, there was agreement to recommend combination therapy with first-generation SSA and pegvisomant as second- or third-line treatment. In more than 50% of the statements, consensus was not achieved. Considerable disagreement existed regarding pegvisomant monotherapy, and treatment with pasireotide and dopamine agonists.ConclusionThis consensus exploration study on the management of patients with acromegaly in the Nordic countries revealed a relatively large degree of disagreement among experts, which mirrors the complexity of the disease and the shortage of evidence-based data.
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| 2. |
- Thorell, Anna, et al.
(författare)
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Microbial invasion of the amniotic cavity is associated with impaired cognitive and motor function at school age in preterm children.
- 2020
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Ingår i: Pediatric research. - : Springer Science and Business Media LLC. - 1530-0447 .- 0031-3998. ; 87:5, s. 924-931
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Tidskriftsartikel (refereegranskat)abstract
- Chorioamnionitis is an important cause of preterm delivery. Data on neurodevelopmental outcome in exposed infants are inconsistent due to difficulties in diagnosing intrauterine infection/inflammation and lack of detailed long-term follow-up. We investigate cognitive and motor function in preterm infants at early school age and relate the findings to bacteria in amniotic fluid obtained by amniocentesis (microbial invasion of the amniotic cavity (MIAC)) or placenta findings of histological chorioamnionitis (HCA) or fetal inflammatory response syndrome (FIRS).Sixty-six infants with gestational age <34 weeks at birth and without major disabilities were assessed using WISC-III and the Bruininks-Oseretsky Test of Motor Proficiency. Results were corrected for gestational age and sex.Children exposed to MIAC had significantly lower scores for full-scale IQ and verbal IQ compared to the non-MIAC group and the difference in full-scale IQ remained after correction for confounding factors. The MIAC group had also significantly lower motor scores after correction. In contrast, motor function was not affected in infants exposed to HCA or FIRS and differences between groups for cognitive scores were lost after corrections.Exposure to bacteria in amniotic fluid is associated with lower motor and cognitive scores in school age preterm infants without major disabilities.
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| 3. |
- Johnsson, Anna, et al.
(författare)
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A single exercise session improves side-effects of chemotherapy in women with breast cancer : an observational study
- 2019
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Ingår i: BMC Cancer. - : BMC. - 1471-2407. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: To measure changes in four common chemotherapy related side-effects (low energy, stress, nausea and pain) immediately after a single exercise session within the first week after treatment.Methods: Thirty-eight patients with chemotherapy-treated breast cancer, participating in a multi-centre randomised controlled study, the Physical Training and Cancer study (Phys-Can) were included in this sub-study. The Phys-Can intervention included endurance and resistance training. Before and after a single training session (endurance or resistance) within the first week of chemotherapy, energy and stress were measured with the Stress-Energy Questionnaire during Leisure Time, and nausea and pain were assessed using a Visual Analog Scale 0-10. Paired t-tests were performed to analyse the changes, and linear regression was used to analyse associations with potential predictors.Results: Thirty-eight participants performed 26 endurance training sessions and 31 resistance training sessions in the first week after chemotherapy. Energy and nausea improved significantly after endurance training, and energy, stress and nausea improved significantly after resistance training. Energy increased (p = 0.03 and 0.001) and nausea decreased (p = 0.006 and 0.034) immediately after a single session of endurance or resistance training, and stress decreased (p = 0.014) after resistance exercise.Conclusions: Both endurance and resistance training were followed by an immediate improvement of common chemotherapy-related side-effects in patients with breast cancer. Patients should be encouraged to exercise even if they suffer from fatigue or nausea during chemotherapy.
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| 4. |
- Johnsson, Anna, et al.
(författare)
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Immediate increase in perceived energy after exercise during the course of chemotherapy treatment for breast cancer
- 2022
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 58
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Exercise during chemotherapy has beneficial long-term effects on women with breast cancer, but shortterm beneficial changes have been less investigated. Though short-term changes may be important as a encouraging factor, this study aimed to investigate immediate changes in self-reported energy, stress, nausea and pain following a single exercise session during chemotherapy.Methods: Forty-six women who were exercising while undergoing adjuvant chemotherapy for breast cancer were included between October 2016 and April 2018. Self-reported energy and stress were assessed before, immediately after and 3 h after exercise sessions by the Stress-Energy Questionnaire. On the same questionnaire nausea and pain were assessed by a Visual Analog Scale. The measurements were completed at four time points during cycles 2 and 5 of the 6-cycle chemotherapy course.Results: Energy level increased immediately after a single exercise session for three out of four periods during the chemotherapy course (p < 0.01), with a larger increase when energy was lower before the session (p < 0.01). Three hours after the exercise session, the energy was about the same level as before the exercise session. Stress decreased immediately after the session during cycle two (p < 0.01) but not cycle five. There were no changes in nausea or pain.Conclusions: Patients undergoing chemotherapy should be informed not only about the long-term advantages of exercise, but also immediate benefits in terms of increased energy. The energy increase both while exercise in the beginning and toward the end of the chemotherapy course, this short-term advantageous consequence may strengthen patients' motivation to exercise. Clinicians should also inform patients that exercise does not seem to worsen nausea and pain.
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| 5. |
- Olsson, Ingrid, 1960-, et al.
(författare)
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Mentorship made life more fun for plain language workers
- 2023
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Ingår i: PLAIN E-journal. ; 5:2, s. 6-9
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- With a mentorship program, the Language Council of Sweden connected plain language workers just starting their work with experienced plain language experts. The program created interesting meetings and made the plain language work evenmore fun and a bit less lonely.One of the tasks for the Language Council is to monitor how the plain language section of the Language Act is obeyed by the public agencies. The plain language section requires public language to be simple and comprehensible. To find out more about this, we at the Language Council conduct a national survey every five years. According to our last survey,in 2019, as many as 81% of Swedish public agencies answered that they hadworked with plain languageduring the last two years. This is a great result.
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| 6. |
- Rodríguez-Varela, Ricardo, et al.
(författare)
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The genetic history of Scandinavia from the Roman Iron Age to the present
- 2023
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Ingår i: Cell. - : Elsevier. - 0092-8674 .- 1097-4172. ; 186:1, s. 32-46
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Tidskriftsartikel (refereegranskat)abstract
- We investigate a 2,000-year genetic transect through Scandinavia spanning the Iron Age to the present, based on 48 new and 249 published ancient genomes and genotypes from 16,638 modern individuals. We find regional variation in the timing and magnitude of gene flow from three sources: the eastern Baltic, the British-Irish Isles, and southern Europe. British-Irish ancestry was widespread in Scandinavia from the Viking period, whereas eastern Baltic ancestry is more localized to Gotland and central Sweden. In some regions, a drop in current levels of external ancestry suggests that ancient immigrants contributed proportionately less to the modern Scandinavian gene pool than indicated by the ancestry of genomes from the Viking and Medieval periods. Finally, we show that a north-south genetic cline that characterizes modern Scandinavians is mainly due to the differential levels of Uralic ancestry and that this cline existed in the Viking Age and possibly earlier.
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| 7. |
- Rystedt, Ingrid, 1965-, et al.
(författare)
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Integrerad behandling av missbruk och psykisk sjukdom : Pilotimplementering inom LVM-vården
- 2021
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Rapport (populärvet., debatt m.m.)abstract
- Samsjuklighet bland personer med missbruk och/eller beroende är vanligt förekommande. Exempelvis är psykiska sjukdomar tre gånger så vanligt hos de som missbrukar alkohol, jämfört med hos personer som inte gör det. Särskilt vanligt förekommande är samsjuklighet av missbruk och psykiska sjukdomar bland klienter som befinner sig i missbruksvårdens sammanhang. Tidigare forskning har visat att behandling av missbruk och beroende med psykiatrisk samsjuklighet är mest effektiv när insatserna integreras. Trots detta saknas sådan behandling på bred basis. Syftet med föreliggande projekt var att pilottesta integrerad behandling i LVM-vårdens kontext, med huvudfokus på genomförbarhet och hållbarhet. Ett underordnat syfte var att beskriva effekterna av sådan behandling. Två behandlingsmodeller pilottestades vid tre SiS-institutioner. Den ena modellen, Integrating Combined Therapies (ICT), pilottestades vid två institutioner och den andra modellen, Enhanced Illness Management and Recovery (E-IMR), testades vid en institution. Totalt ingick 70 klienter i ICT-behandlingsgruppen, och elva klienter i E-IMR-gruppen. Utöver detta intervjuades 14 anställda vid de tre olika institutionerna. Implementeringen av E-IMR tog inte fäste, huvudsakligen på grund av yttre organisatoriska omständigheter. Vad gäller ICT, tyder resultaten på att modellen är genomförbar inom LVM-vården. Likaså föreligger goda tecken på hållbarhet. Det är dock viktigt att beakta att denna pilotimplementering är en relativt liten studie där det inte funnits någon kontrollgrupp. Utifrån designen på forskningsprojektet går det därför inte att dra säkra slutsatser om de positiva effekter av ICT som observera
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