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| 3. |
- Blöndal, Viiu, et al.
(författare)
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Multimorbidity in asthma, association with allergy, inflammatory markers and symptom burden, results from the Swedish GA2LEN study
- 2021
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Ingår i: Clinical and Experimental Allergy. - : Wiley. - 0954-7894 .- 1365-2222. ; 51:2, s. 262-272
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Tidskriftsartikel (refereegranskat)abstract
- Background: Asthma is common worldwide and a large part of subjects with asthma have concomitant allergic multimorbidity in the form of rhinitis and/or eczema. Objective: The aim of this study is to investigate whether the presence of allergic multimorbidity in asthma relates to allergic sensitization, allergic and respiratory symptoms, quality of life, inflammatory markers, lung function, use of medication and background factors. Methods: A total of 437 asthmatics from the (GA2LEN) cross-sectional survey in Sweden were grouped depending on the presence of rhinitis and/or eczema. The impact of allergic multimorbidity was assessed in terms of allergic sensitization, allergic and respiratory symptoms, quality of life, type-2 inflammatory markers (exhaled nitric oxide, eosinophil activation markers, periostin), lung function, use of medication and background factors. Results: Subjects with asthma, rhinitis and eczema were more likely to be sensitized to seasonal allergens (67% vs 32%, P<.001), food allergens (54% vs 18%, P<.001) and to have a higher degree of sensitization than subjects with only asthma (23% vs 10%, P<.001). Subjects with allergic multimorbidity more often had allergic reactions to food (28% vs 10%, P=.002), more respiratory symptoms and anxiety/depression (40% vs, 14%, P<.001) than subjects with only asthma, despite having similar levels of type 2 inflammatory markers. Individuals with allergic multimorbidity were more likely to be diagnosed with asthma before the age of 12 (48% vs 27%, P=.016) and to have maternal heredity for allergy (53% vs 33%, P=.011) than subjects with only asthma. Conclusion and clinical relevance: Asthmatics with allergic multimorbidity are more likely to be sensitized to seasonal aeroallergens, food allergens and they have a higher degree of sensitization compared with those with only asthma. Allergic multimorbidity is associated with respiratory and allergy symptoms, anxiety and/or depression. © 2020 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd
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| 6. |
- Hellgren, R, et al.
(författare)
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The association between breast cancer risk factors and background parenchymal enhancement at dynamic contrast-enhanced breast MRI
- 2020
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Ingår i: Acta radiologica (Stockholm, Sweden : 1987). - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 61:12, s. 1600-1607
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Tidskriftsartikel (refereegranskat)abstract
- Background parenchymal enhancement (BPE) of normal tissue at breast magnetic resonance imaging is suggested to be an independent risk factor for breast cancer. Its association with established risk factors for breast cancer is not fully investigated. Purpose To study the association between BPE and risk factors for breast cancer in a healthy, non-high-risk screening population. Material and Methods We measured BPE and mammographic density and used data from self-reported questionnaires in 214 healthy women aged 43–74 years. We estimated odds ratios for the univariable association between BPE and risk factors. We then fitted an adjusted model using logistic regression to evaluate associations between BPE (high vs. low) and risk factors, including mammographic breast density. Results The majority of women had low BPE (84%). In a multivariable model, we found statistically significant associations between BPE and age ( P = 0.002) and BMI ( P = 0.03). We did find a significant association between systemic progesterone medication and BPE, but due to small numbers, the results should be interpreted with caution. The adjusted odds ratio for high BPE was 3.1 among women with density D (compared to B) and 2.1 for density C (compared to B). However, the association between high BPE and density was not statistically significant. We did not find statistically significant associations with any other risk factors. Conclusion Our study confirmed the known association of BPE with age and BMI. Although our results show a higher likelihood for high BPE with increasing levels of mammographic density, the association was not statistically significant.
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| 7. |
- Akerblom, H., et al.
(författare)
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Association of Gastric Bypass Surgery With Risk of Developing Diabetic Retinopathy Among Patients With Obesity and Type 2 Diabetes in Sweden: An Observational Study
- 2021
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Ingår i: Jama Ophthalmology. - : American Medical Association (AMA). - 2168-6165 .- 2168-6173. ; 139:2, s. 200-205
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Knowledge of the incidence and progression of diabetic retinopathy (DR) after gastric bypass surgery (GBP) in patients with obesity and diabetes could guide the management of these patients. OBJECTIVE To investigate the incidence of diabetic ocular complications in patients with type 2 diabetes after GBP compared with the incidence of diabetic ocular complications in a matched cohort of patients with obesity and diabetes who have not undergone GBP. DESIGN, SETTING, AND PARTICIPANTS Data from 2 nationwide registers in Sweden, the Scandinavian Obesity Surgery Registry and the National Diabetes Register, were used for this cohort study. A total of 5321 patients with diabetes from the Scandinavian Obesity Surgery Registry who had undergone GBP from January 1, 2007, to December 31, 2013, were matched with 5321 patients with diabetes from the National Diabetes Register who had not undergone GBP, based on sex, age, body mass index (BMI), and calendar time (2007-2013). Follow-up data were obtained until December 31, 2015. Statistical analysis was performed from October 5, 2018, to September 30, 2019. EXPOSURE Gastric bypass surgery. MAIN OUTCOMES AND MEASURES Incidence of new DR and other diabetic ocular complications. RESULTS The study population consisted of 5321 patients who had undergone GBP (3223 women [60.6%]; mean [SD] age, 49.0 [9.5] years) and 5321 matched controls (3395 women [63.8%]; mean [SD] age, 47.1 [11.5] years). Mean (SD) follow-up was 4.5 (1.6) years. The mean (SD) BMI and hemoglobin A1c concentration at baseline were 42.0 (5.7) and 7.6%(1.5%), respectively, in the GBP group and 40.9 (7.3) and 7.5%(1.5%), respectively, in the control group. The mean (SD) duration of diabetes was 6.8 (6.3) years in the GBP group and 6.4 (6.4) years in the control group. The risk for new DR was reduced in the patients who underwent GBP (hazard ratio, 0.62 [95% CI, 0.49-0.78]; P <.001). The dominant risk factors for development of DR at baseline were diabetes duration, hemoglobin A1c concentration, use of insulin, glomerular filtration rate, and BMI. CONCLUSIONS AND RELEVANCE This nationwide matched cohort study suggests that there is a reduced risk of developing new DR associated with GBP, and no evidence of an increased risk of developing DR that threatened sight or required treatment. (c) 2021 American Medical Association. All rights reserved.
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| 10. |
- Duffy, Stephen W., et al.
(författare)
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Mammography screening reduces rates of advanced and fatal breast cancers : Results in 549,091 women
- 2020
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Ingår i: Cancer. - : John Wiley & Sons. - 0008-543X .- 1097-0142. ; 126:13, s. 2971-2979
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death.Methods: Among 549,091 women, covering approximately 30% of the Swedish screening‐eligible population, the authors calculated the incidence rates of 2473 breast cancers that were fatal within 10 years after diagnosis and the incidence rates of 9737 advanced breast cancers. Data regarding each breast cancer diagnosis and the cause and date of death of each breast cancer case were gathered from national Swedish registries. Tumor characteristics were collected from regional cancer centers. Aggregated data concerning invitation and participation were provided by Sectra Medical Systems AB. Incidence rates were analyzed using Poisson regression.Results: Women who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years (relative risk, 0.59; 95% CI, 0.51‐0.68 [P < .001]) and a 25% reduction in the rate of advanced breast cancers (relative risk, 0.75; 95% CI, 0.66‐0.84 [P < .001]).Conclusions: Substantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens.
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| 11. |
- Emilsson, Össur Ingi, et al.
(författare)
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Association between lung function decline and obstructive sleep apnoea: the ALEC study
- 2021
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Ingår i: Sleep and Breathing. - : Springer Science and Business Media LLC. - 1520-9512 .- 1522-1709. ; 25, s. 587-596
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To study changes in lung function among individuals with a risk of obstructive sleep apnoea (OSA), and if asthma affected this relationship. Methods We used data from the European Community Respiratory Health Survey II and III, a multicentre general population study. Participants answered questionnaires and performed spirometry at baseline and 10-year follow-up (n= 4,329 attended both visits). Subjects with high risk for OSA were identified from the multivariable apnoea prediction (MAP) index, calculated from BMI, age, gender, and OSA symptoms at follow-up. Asthma was defined as having doctor's diagnosed asthma at follow-up. Primary outcomes were changes in forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) from baseline to follow-up. Results Among 5108 participants at follow-up, 991 (19%) had a high risk of OSA based on the MAP index. Participants with high OSA risk more often had wheeze, cough, chest tightness, and breathlessness at follow-up than those with low OSA risk. Lung function declined more rapidly in subjects with high OSA risk (low vs high OSA risk [mean +/- SD]: FEV1 = - 41.3 +/- 24.3 ml/year vs - 50.8 +/- 30.1 ml/year; FVC = - 30.5 +/- 31.2 ml/year vs - 45.2 +/- 36.3 ml/year). Lung function decline was primarily associated with higher BMI and OSA symptoms. OSA symptoms had a stronger association with lung function decline among asthmatics, compared to non-asthmatics. Conclusion In the general population, a high probability of obstructive sleep apnoea was related to faster lung function decline in the previous decade. This was driven by a higher BMI and more OSA symptoms among these subjects. The association between OSA symptoms and lung function decline was stronger among asthmatics.
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| 12. |
- Guimarães, Jean R.D., et al.
(författare)
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Simultaneous radioassays of bacterial production and mercury methylation in the periphyton of a tropical and a temperate wetland
- 2006
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Ingår i: Journal of Environmental Management. - : Elsevier BV. - 0301-4797 .- 1095-8630. ; 81:2, s. 95-100
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Tidskriftsartikel (refereegranskat)abstract
- Laboratory radioassays were made to study mercury (Hg) methylation together with bacterial production in the periphyton of two aquatic macrophytes, the submerged Myriophyllum spicatum, from a constructed wetland in Sweden and the floating Eichhornia crassipes, from a eutrophied tropical lake in Brazil. Time course incubations were made by addition of 203HgCl2 and the methylmercury formed was extracted at pre-defined time intervals. Bacterial production (14C-leucine incorporation) was measured at the same time intervals, with plants removed from parallel incubations made with and without addition of cold HgCl2. For E. crassipes, higher methylmercury production was observed at elevated bacterial production, whereas for M. spicatum, the bacterial production was significantly lower, and Hg methylation was below the detection limit. The combined results confirm the importance of microbial processes for Hg methylation, although other factors are known to influence this process in complex ways. The addition of Hg did not significantly influence bacterial production, while the incubation temperatures used (25 and 35 1C) resulted in different methylation rates. Radiotracer techniques for measurements of bacterial production such as 14C-leucine uptake can provide useful insights into the Hg cycle in aquatic environments, and our data suggest that they may be used as a proxy of mercury methylation potentials.
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| 13. |
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| 14. |
- Hedenbro, Jan, et al.
(författare)
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Formation of the Scandinavian Obesity Surgery Registry, SOReg
- 2015
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Ingår i: Obesity Surgery. - : Springer Science and Business Media LLC. - 0960-8923 .- 1708-0428. ; 25:10, s. 1893-1900
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Tidskriftsartikel (refereegranskat)abstract
- Obesity surgery is expanding, the quality of care is ever more important, and learning curve assessment should be established. A large registry cohort can show long-term effects on obesity and its comorbidities, complications, and long-term side effects of surgery, as well as changes in health-related quality of life (QoL). Sweden is ideally suited to the task of data collection and audit, with universal use of personal identification numbers, nation-wide registries permitting cross-matching to analyze causes of death, in-hospital care, and health-related absenteeism. In 2004, the Scandinavian Obesity Surgery Registry (SOReg) was initiated and government financing secured. A project group created a national database covering all public as well as private hospitals. Data entry was to be made online, operative definitions of comorbidity were formed, and complication severity scored. Several forms of audit were devised. After pilot studies, the system has been running in its present form since 2007. Since 15 January 2013, SOReg covers all bariatric surgery centers in Sweden. The number of operations in the database exceeded 40,000 (March 2014), with a median follow-up of 2.94 years. Audit shows that > 98 % of data are correct. All results are publicized annually on the Internet. Using this systematic approach, it has been possible to cover > 99 % of all bariatric surgery, cross-matching our data with nation-wide registries for in-hospital care, cause of death, and permitting regular nation-wide audit. Several scientific studies have used, or are using, what seems to be the most comprehensive database in obesity surgery.
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| 15. |
- Hogenkamp, Pleunie S., et al.
(författare)
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Higher resting-state activity in reward-related brain circuits in obese versus normal-weight females independent of food intake
- 2016
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Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 40:11, s. 1687-1692
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In response to food cues, obese vs normal-weight individuals show greater activation in brain regions involved in the regulation of food intake under both fasted and sated conditions. Putative effects of obesity on task-independent low-frequency blood-oxygenation-level-dependent signals-that is, resting-state brain activity-in the context of food intake are, however, less well studied.OBJECTIVE: To compare eyes closed, whole-brain low-frequency BOLD signals between severely obese and normal-weight females, as assessed by functional magnetic resonance imaging (fMRI).METHODS: Fractional amplitude of low-frequency fluctuations were measured in the morning following an overnight fast in 17 obese (age: 39±11 years, body mass index (BMI): 42.3±4.8 kg m(-)(2)) and 12 normal-weight females (age: 36±12 years, BMI: 22.7±1.8 kg m(-)(2)), both before and 30 min after consumption of a standardized meal (~260 kcal).RESULTS: Compared with normal-weight controls, obese females had increased low-frequency activity in clusters located in the putamen, claustrum and insula (P<0.05). This group difference was not altered by food intake. Self-reported hunger dropped and plasma glucose concentrations increased after food intake (P<0.05); however, these changes did not differ between the BMI groups.CONCLUSION: Reward-related brain regions are more active under resting-state conditions in obese than in normal-weight females. This difference was independent of food intake under the experimental settings applied in the current study. Future studies involving males and females, as well as utilizing repeated post-prandial resting-state fMRI scans and various types of meals are needed to further investigate how food intake alters resting-state brain activity in obese humans.International Journal of Obesity advance online publication, 28 June 2016; doi:10.1038/ijo.2016.105.
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| 16. |
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| 17. |
- Kierkegaard, Amelie, et al.
(författare)
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Bioconcentration of Several Series of Cationic Surfactants in Rainbow Trout
- 2021
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Ingår i: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 55:13, s. 8888-8897
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Tidskriftsartikel (refereegranskat)abstract
- Cationic surfactants have a strong affinity to sorb to phospholipid membranes and thus possess an inherent potential to bioaccumulate, but there are few measurements of bioconcentration in fish. We measured the bioconcentration of 10 alkylamines plus two quaternary ammonium compounds in juvenile rainbow trout at pH 7.6, and repeated the measurements at pH 6.2 for 6 of these surfactants. The BCF of the amines with chain lengths <= C-14 was positively correlated with chain length, increasing similar to 0.5 log units per carbon. Their BCF was also pH dependent and approximately proportional to the neutral fraction of the amine in the water. The BCFs of the quaternary ammonium compounds showed no pH dependence and were >2 orders of magnitude less than for amines of the same chain length at pH 7.6. This indicates that systemic uptake of permanently charged cationic surfactants is limited. The behavior of the quaternary ammonium compounds and the two C-16 amines studied was consistent with previous observations that these surfactants accumulate primarily to the gills and external surfaces of the fish. At pH 7.6 the BCF exceeded 2000 L kg(-1) for 4 amines with chains >= C-13, showing that bioconcentration can be considerable for some longer chained cationic surfactants.
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| 18. |
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| 20. |
- Salvadó, Joan A., et al.
(författare)
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Contrasting composition of terrigenous organic matter in the dissolved, particulate and sedimentary organic carbon pools on the outer East Siberian Arctic Shelf
- 2016
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Ingår i: Biogeosciences. - : Copernicus GmbH. - 1726-4170 .- 1726-4189. ; 13:22, s. 6121-6138
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Tidskriftsartikel (refereegranskat)abstract
- Fluvial discharge and coastal erosion of the permafrost-dominated East Siberian Arctic delivers large quantities of terrigenous organic carbon (Terr-OC) to marine waters. The composition and fate of the remobilized Terr-OC needs to be better constrained as it impacts the potential for a climate-carbon feedback. In the present study, the bulk isotope (delta C-13 and Delta C-14) and macromolecular (lignin-derived phenols) composition of the cross-shelf exported organic carbon (OC) in different marine pools is evaluated. For this purpose, as part of the SWERUS-C3 expedition (July-September 2014), sediment organic carbon (SOC) as well as water column (from surface and near-bottom seawater) dissolved organic carbon (DOC) and particulate organic carbon (POC) samples were collected along the outer shelves of the Kara Sea, Laptev Sea and East Siberian Sea. The results show that the Lena River and the DOC may have a preferential role in the transport of Terr-OC to the outer shelf. DOC concentrations (740-3600 mu g L-1) were 1 order of magnitude higher than POC (20-360 mu g L-1), with higher concentrations towards the Lena River plume. The delta C-13 signatures in the three carbon pools varied from -23.9 +/- 1.9 parts per thousand in the SOC, 26.1 +/- 1.2 parts per thousand in the DOC and 27.1 +/- 1.9 parts per thousand in the POC. The Delta C-14 values ranged between 395 +/- 83 (SOC), 226 +/- 92 (DOC) and 113 +/- 122 parts per thousand(POC). These stable and radiocarbon isotopes were also different between the Laptev Sea and the East Siberian Sea. Both DOC and POC showed a depleted and younger trend off the Lena River plume. Further, the Pacific inflow and the sea-ice coverage, which works as a barrier preventing the input of young DOC and POC, seem to have a strong influence in these carbon pools, presenting older and more enriched delta C-13 signatures under the sea-ice extent. Lignin phenols exhibited higher OC-normalized concentrations in the SOC (0.10-2.34 mg g(-1) OC) and DOC (0.08-2.40 mg g(-1) OC) than in the POC (0.03-1.14 mg g(-1) OC). The good relationship between lignin and Delta C-14 signatures in the DOC suggests that a significant fraction of the outer-shelf DOC comes from young Terr-OC. By contrast, the slightly negative correlation between lignin phenols and Delta C-14 signatures in POC, with higher lignin concentrations in older POC from near-bottom waters, may reflect the off-shelf transport of OC from remobilized permafrost in the nepheloid layer. Syringyl/vanillyl and cinnamyl/vannillyl phenol ratios presented distinct clustering between DOC, POC and SOC, implying that those pools may be carrying different Terr-OC of partially different origin. Moreover, 3,5-dihydroxybenzoic acid to vanillyl phenol ratios and p-coumaric acid to ferulic acid ratios, used as a diagenetic indicators, enhanced in POC and SOC, suggesting more degradation within these pools. Overall, the key contrast between enhanced lignin yields both in the youngest DOC and the oldest POC samples reflects a significant decoupling of terrestrial OC sources and pathways.
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| 21. |
- Samperio Ventayol, Pilar, et al.
(författare)
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Bacterial detection by NAIP/NLRC4 elicits prompt contractions of intestinal epithelial cell layers
- 2021
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 118:16
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Tidskriftsartikel (refereegranskat)abstract
- The gut epithelium serves to maximize the surface for nutrient and fluid uptake, but at the same time must provide a tight barrier to pathogens and remove damaged intestinal epithelial cells (IECs) without jeopardizing barrier integrity. How the epithelium coordinates these tasks remains a question of significant interest. We used imaging and an optical flow analysis pipeline to study the dynamicity of untransformed murine and human intestinal epithelia, cultured atop flexible hydrogel supports. Infection with the pathogen Salmonella Typhimurium (S.Tm) within minutes elicited focal contractions with inward movements of up to similar to 1,000 IECs. Genetics approaches and chimeric epithelial monolayers revealed contractions to be triggered by the NAIP/NLRC4 inflammasome, which sensed type-III secretion system and flagellar ligands upon bacterial invasion, converting the local tissue into a contraction epicenter. Execution of the response required swift sublytic Gasdermin D pore formation, ion fluxes, and the propagation of a myosin contraction pulse across the tissue. Importantly, focal contractions preceded, and could be uncoupled from, the death and expulsion of infected IECs. In both two-dimensional monolayers and three-dimensional enteroids, multiple infection-elicited contractions coalesced to produce shrinkage of the epithelium as a whole. Monolayers deficient for Caspase-1(-11) or Gasdermin D failed to elicit focal contractions but were still capable of infected IEC death and expulsion. Strikingly, these monolayers lost their integrity to a markedly higher extent than wild-type counterparts. We propose that prompt NAIP/NLRC4/Caspase-1/Gasdermin D/myosin-dependent contractions allow the epithelium to densify its cell packing in infected regions, thereby preventing tissue disintegration due to the subsequent IEC death and expulsion process.
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| 23. |
- Siilin, H., et al.
(författare)
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The proximal gastric pouch invariably contains acid-producing parietal cells in Roux-en-Y gastric bypass
- 2005
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Ingår i: Obes Surg. ; 15:6, s. 771-7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Roux-en-Y gastric bypass (RYGBP) is well tolerated and effective in ameliorating diseases common to morbidly obese patients. A potential drawback, however, is the risk for stomal ulcers, probably due to acid and peptic digestion of the mucosa in the proximal Roux limb. METHODS: In 23 RYGBP patients (mean BMI 45 kg/m(2), age 39 years), the gastro-jejunostomy was performed by circular stapler and the gastric suture ring retrieved for histological examination. 13 consecutive patients received our standard totally transected 4 x 3 cm proximal gastric pouch. The anvil was passed transgastricly and reference biopsies were taken from the gastrotomy in the corpus of the stomach. In the last 10 patients, the pouch size was reduced to 2 x 3 cm by a modified surgical technique. RESULTS: All suture rings from the standard pouches consisted of corpus-fundus mucosa with a large amount of parietal cells, histologically identical to the reference biopsies from the gastrotomy. Also, the 10 suture rings from the modified small pouches contained corpus-fundus mucosa. In 5 of these samples, cardiac mucosa was found, but only in a small segment (6 mm). In addition, 3 patients had esophageal epithelium in the suture ring. CONCLUSION: The proximal pouch invariably contains acid-producing parietal cells. In order to reduce acid production and, hence, the risk of stomal ulcers, the pouch has to be made as small as possible.
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| 24. |
- Sima, Eduardo, et al.
(författare)
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Differences in Early Complications between Circular and Linear Stapled Gastrojejunostomy in Laparoscopic Gastric Bypass
- 2014
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Ingår i: Obesity Surgery. - : Springer Science and Business Media LLC. - 0960-8923 .- 1708-0428. ; :4, s. 599-603
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDLaparoscopic gastric bypass (LGBP) is the most common bariatric procedure worldwide. The gastrojejunostomy can be stapled with a circular or linear stapler, each with their own specific advantages. We have evaluated differences in postoperative complications between the two techniques.METHODSWe studied operative data and postoperative complications in 560 patients (79.8 % females, median age 42, BMI 42.5) operated with LGBP between 2008 and 2012 at our center. The gastrojejunostomy was initially performed using a circular stapler (CS) in 288 patients and later by linear stapler (LS) in 272. Complications, operative time, and length of stay were retrieved from our database. The risk of developing a port site infection was evaluated with multivariate logistic regression.RESULTSPort site infections were more common with CS than LS, 5.2 and 0.4 %, respectively (p < 0.01). Multivariate analysis demonstrated CS to be an independent risk factor for port site infections (OR 16.3 (2.09-126), p < 0.01), as well as for stomal ulcers (OR 10.1, 1.15-89, p = 0.04). Major postoperative complications remained unchanged (anastomotic leak 1.0 vs. 1.1 %, abscess 0.7 vs. 0.4 %), while operative time and length of stay were found to be shorter using the LS (122 vs. 83 min, p < 0.001 and 4 vs. 3 days, p < 0.001).CONCLUSIONSThe linear stapled technique yielded lower incidence of port site infections, probably by avoiding the passage of a contaminated circular stapler through the abdominal wall. No difference in major complications was seen, but operative time was shorter using a linear stapler instead of a circular stapler.
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| 25. |
- Sjoblom, A., et al.
(författare)
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The influence of humic substances on the speciation and bioavailability of dissolved mercury and methylmercury, measured as uptake by Chaoborus larvae and loss by volatilization
- 2000
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Ingår i: Science of the Total Environment. - 0048-9697 .- 1879-1026. ; 261:1-3, s. 115-124
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Tidskriftsartikel (refereegranskat)abstract
- The influence of dissolved humic substances (HS) on the bioavailability of dissolved inorganic and methyl mercury (Hg) was quantified by measuring the direct uptake of 203Hg in Chaoborus larvae using laboratory microcosms containing artificial freshwater. The animals were exposed individually in triplicate aquaria at 10 different concentrations of HS covering the whole range found in natural freshwaters (0-110 mg C l-1). Mercury-203 concentrations were monitored repeatedly in the same individuals and in their ambient water during up to 10 days. Near-steady state Hg concentrations in Chaoborus were usually reached within 5 days. The bioconcentration factor (BCF, direct uptake only) for the larvae in the absence of HS was 0.55 ± 0.09 (S.E.) ml individual-1 for inorganic Hg and 5.3 ± 0.7 ml individual-1 for methyl Hg, thus showing a 10-fold difference. Normalizing to the organic carbon content of the larvae yields a BCF(OC) in the absence of HS of 2.8 ± 0.4 x 103 ml (gC)-1 for inorganic Hg and 2.7 ± 0.3 x 104 ml (gC)-1 for methyl Hg. The uptake of both inorganic and methyl Hg decreased markedly with increasing concentration of HS. For inorganic Hg, the decrease in uptake was most pronounced at HS concentrations below 0.2 mg C l-1. For methyl Hg, the relationship between uptake and log([HS]) was sigmoid, showing a reduction by >90% when increasing HS concentrations from 1 to 50 mg C l-1. Similar patterns were observed for losses of Hg from the water phase, mainly through volatilization. These results have implications for both the biouptake and the abiotic cycling of Hg in natural ecosystems and suggest that most dissolved inorganic Hg is bound to dissolved organic matter in most natural freshwaters, whereas dissolved methyl Hg is bound only in humic waters. Assuming that only free aqueous Hg is taken up by the organisms, the rather simple methodology employed here can be used for estimating distribution coefficients (K(OC)) for Hg between HS and water. In this study, the K(OC) values were 2.5 ± 0.7 (S.E.) x 107 ml (gC)-1 for inorganic Hg and 1.5 ± 0.6 x 105 ml (gC)-1 for methyl Hg. Values of similar magnitude were derived from observed losses of Hg from the water phase, supporting the assumption of an immobilization of both inorganic and methyl Hg by HS. The strong negative influence of dissolved HS on the bioavailability of both inorganic and methyl Hg in freshwater suggests that the high Hg levels often found in fish from humic lakes in the boreal forest zone cannot be explained alone by direct uptake of methyl Hg from the water phase into biota at low trophic levels. (C) 2000 Elsevier Science B.V.
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| 30. |
- Sundbom, Elisabet, et al.
(författare)
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Psychodynamic features in borderline personality disorder identified by a subliminal test, the Defense Mechanism Test.
- 1989
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Ingår i: Acta Psychiatrica Scandinavica. - 0001-690X .- 1600-0447. ; 80:1, s. 101-5
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-seven psychiatric inpatients, diagnosed according to DSM-III and the Diagnostic Interview for Borderline (DIB), and 7 healthy controls were tested with the Defense Mechanism Test (DMT), a test of subliminal perception based on psychoanalytic theory. In the test a specific stimulus is presented subliminally in a tachistoscope and the patient's perceptual distortions are registered. Patients with borderline personality disorder (BPD) were compared with patients with other personality disorders, patients with schizophrenic disorders and healthy controls. Specific perceptual distortions were identified among patients with BPD. Some individual DMT signs correlated with some deviant behaviors as identified by the DIB. The findings supported the psychodynamic validity of the concept of borderline personality disorder. It is concluded that DMT is a promising research instrument that provides an empirical approach to crucial psychodynamic phenomena.
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| 31. |
- Sundbom, Marcus, et al.
(författare)
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Alteration in human defensin-5 expression following gastric bypass surgery
- 2007
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Ingår i: Journal of Clinical Pathology. - : BMJ. - 0021-9746 .- 1472-4146. ; 60:9, s. 1029-1034
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Tidskriftsartikel (refereegranskat)abstract
- Background: Roux-en-Y gastric bypass surgery provides a novel human model to investigate small bowel mucosal innate immunity, in which there is loss of gastric acid-mediated protection against orally-acquired microorganisms. Aim: To study changes in jejunal mucosal immunoreactivity of human defensin (HD)-5,an antimicrobial peptide normally produced by Paneth cells. Methods: Mucosal samples were obtained from 18 female patients ( 24 - 54 years), from the same segment of jejunum during and after gastric bypass surgery. Samples were used for bacterial culture and immunohistochemistry using anti-HD-5 antibody. The number of immunoreactive cells per crypt and villus were determined and expressed as mean (SD). Results: No bacteria were cultured from any of the perioperative jejunal samples but colonies of bacteria normally present in the pharynx were identified during culture of all postoperative jejunal biopsy specimens (1-> 100 colonies). Paneth cell numbers per crypt were unchanged after gastric bypass ( 4.16 (0.71) vs 4.24 (0.78)). However, following surgery, there was an increase in HD-5-positive intermediate cells per crypt (0.25 (0.41) vs 1.12 (0.66), p < 0.01), HD-5 staining enterocytes per crypt ( 0.03 ( 0.09) vs 1.38 ( 1.10), p < 0.01), HD-5 staining material in the crypt lumen (crypt lumens: 5.0% ( 10.9%) vs 68.1% ( 27.9%), p < 0.01) and HD-5 immunoreactivity coating the luminal surface of villus enterocytes ( villi sampled: 15.0% ( 31.0%) vs 67.5% ( 42.0%), p < 0.01). Conclusions: Bacteria normally resident in the pharynx were present in the proximal jejunal mucosa following Roux-en-Y gastric bypass surgery. After gastric bypass, there was increased secretion of HD-5 and an increase in HD-5 expressing intermediate cells and enterocytes in the crypt. The increase in HD-5 expression in the jejunal mucosa following gastric bypass surgery is likely to be secondary to exposure to orally-acquired microorganisms.
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- Tabar, Laszlo, et al.
(författare)
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Early detection of breast cancer rectifies inequality of breast cancer outcomes
- 2021
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Ingår i: Journal of Medical Screening. - : Sage Publications. - 0969-1413 .- 1475-5793. ; 28:1, s. 34-38
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To explain apparent differences among mammography screening services in Sweden using individual data on participation in screening and with breast cancer-specific survival as an outcome.Methods: We analysed breast cancer survival data from the Swedish Cancer Register on breast cancer cases from nine Swedish counties diagnosed in women eligible for screening. Data were available on 38,278 breast cancers diagnosed and 4312 breast cancer deaths. Survival to death from breast cancer was estimated using the Kaplan-Meier estimate, for all cases in each county, and separately for cases of women participating and not participating in their last invitation to screening. Formal statistical comparisons of survival were made using proportional hazards regression.Results: All counties showed a reduction in the hazard of breast cancer death with participation in screening, but the reductions for individual counties varied substantially, ranging from 51% (95% confidence interval 46-55%) to 81% (95% confidence interval 74-85%). Survival rates in nonparticipating women ranged from 53% (95% confidence interval 40-65%) to 74% (95% confidence interval 72-77%), while the corresponding survival in women participating in screening varied from 80% (95% confidence interval 77-84%) to 86% (95% confidence interval 83-88%), a considerably narrower range.Conclusions: Differences among counties in the effect of screening on breast cancer outcomes were mainly due to variation in survival in women not participating in screening. Screening conferred similarly high survival rates in all counties. This indicates that the performance of screening services was similar across counties and that detection and treatment of breast cancer in early-stage reduces inequalities in breast cancer outcome.
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