| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
- Bergenfelz, Anders, et al.
(författare)
-
Serum levels of uric acid and diabetes mellitus influence survival after surgery for primary hyperparathyroidism: A prospective cohort study
- 2007
-
Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 1432-2323 .- 0364-2313. ; 31:7, s. 1393-1402
-
Tidskriftsartikel (refereegranskat)abstract
- Background Primary hyperparathyroidism (pHPT) is associated with an increased mortality attributable to cardiovascular disease (CVD), suggested to be alleviated by surgery. The exact mechanism of the beneficial influence of parathyroidectomy on survival is unknown. Furthermore, studies suggest that there is no increased mortality compared to the mortality rate in the general population during recent years. This study therefore investigated relative survival (RS), as well overall mortality associated with the clinical and biochemical variables in patients undergoing operation for sporadic pHPT. Furthermore, the influence of surgery on biochemical variables associated with pHPT was analyzed. Methods A group of 323 patients with sporadic pHPT operated between September 1989 and July 2003 were followed from surgery over a 10-year period. The median and mean follow-up time was 69 and 70 months, respectively (range: 1-120 months). Relative survival (RS) was calculated, and the impact of clinical and biochemical variables on overall death were evaluated. Results Postoperatively, serum levels of triglycerides and uric acid decreased. Glucose levels and glomerular filtration rate remained unchanged. A decreased RS was evident during the latter part of the 10 year follow-up period. In the multivariate Cox-analysis, diabetes mellitus (hazard ratio [HR] = 2.8, 95%; confidence interval [CI] 1.2-6.7), and the combination of an increased level of serum uric acid and cardiovascular disease (CVD) (HR = 8.6, 95%; CI 1.5-49.7) was associated with a higher mortality. The increased risk of death was evident for patients with persistently increased levels of uric acid postoperatively (HR = 4.8, 95%; CI = 1.4-16.01) Conclusions Patients undergoing operation for pHPT had a decreased RS during a 10-year follow-up compared to the general population. This decrease in RS is associated with diabetes mellitus and increased levels of uric acid pre-and postoperatively.
|
|
| 6. |
|
|
| 7. |
- Björk, Marie, et al.
(författare)
-
Self-efficacy corresponds to wrist function after combined plating of distal radius fractures
- 2020
-
Ingår i: Journal of Hand Therapy. - : Elsevier. - 0894-1130 .- 1545-004X. ; 33:3, s. 314-319
-
Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: A prospective cohort single-center study.INTRODUCTION: Self-efficacy (SE) refers to beliefs in ones capabilities to organize and execute the courses of action required to produce given goals. High SE is an important factor for recovery from injury/illness; people who believe in their capability will more likely reach a good outcome.PURPOSE OF THE STUDY: The aim of this study was to examine if SE has an effect to physical functioning, pain and patient-rated wrist function three months postoperatively in patients undergoing plating due to a distal radius fracture.METHODS: Sixty-seven patients undergoing plating for a distal radius fracture rated SE at the first appointment with the physiotherapist. At the three-month follow-up, the following assessments were administered: Patient-Rated Wrist Evaluation (PRWE), pain-scores, hand grip strength, and range of motion.RESULTS: The group with a high SE showed significantly better range of motion for flexion (P = .046) and supination (P = .045), hand grip strength (P = .001) and PRWE scores (P = .04). The NRS pain during activity was lower, although not significantly lower (P = .09). Using Spearman's rank correlation coefficient, there was a moderate correlation between SE and pain during activity, wrist flexion, and PRWE score.DISCUSSION: SE corresponds to wrist function after combined plating of distal radius fractures.CONCLUSION: Measurement of SE could possibly be useful to identify patients in special need of support during the postoperative rehabilitation.
|
|
| 8. |
- Björk, Marie, et al.
(författare)
-
Self-efficacy corresponds to wrist function after combined plating of distal radius fractures
- 2019
-
Ingår i: Abstract book IFSHT. - Freiburg : Intercongress GmbH. - 9783000635854
-
Konferensbidrag (refereegranskat)abstract
- Clinical issue/s: Self-efficacy (SE) refers to beliefs in ones capabilities to organize and execute the courses of action required to produce given goals. High SE is an important factor for recovery from injury/illness; people who believe in their capability willmore likely reach a good outcome. The distal radius fracture (DRF) is the most common fracture in adults constituting 18% of all fractures in an orthopedic trauma unit. To our knowledge there are no reports investigating the role of patient-reported self-efficacy in the rehabilitation of surgically treated DRFs. A tool that could identify patients in need of increased postoperative rehabilitation could potentially improve the allocation of rehabilitation resources.Clinical reasoning: The aim of this study was to examine if SE has an effect on physical functioning, pain and patient-rated wrist function three months postoperatively in patients who underwent combined plating with a volar and dorsal plate due to a distal radius fracture (DRF).innovative, analytical or new approach: Methods: This prospective study involved 67 patients. Follow-up results were available for 55 of them. The patients rated SE at the first appointment with the physiotherapist. The three months follow-up contained the outcome values: Patient-Rated Wrist Evaluation (PRWE), pain-scores, hand grip-strength and range of motion. Thestudy was approved by the regional ethical committee.Results: Three months after surgery the average wrist motion was 62-93 percent and hand grip-strength was 58 percent compared to the uninjured hand. Patients who rated high SE showed significantly better ROM for flexion and supination, handgrip-strength and PRWE-scores.Contribution to advancing HT practice: Discussion: Patients with a high SE are more likely to have a better wrist functionthree months postoperatively compared to patients with a low SE. Conclusion: SE can be a tool to assist the hand therapist in the allocation of rehabilitation resources.
|
|
| 9. |
- Ellis, Vincenzo A., et al.
(författare)
-
Explaining prevalence, diversity and host specificity in a community of avian haemosporidian parasites
- 2020
-
Ingår i: Oikos. - : Wiley. - 0030-1299 .- 1600-0706. ; 129:9, s. 1314-1329
-
Tidskriftsartikel (refereegranskat)abstract
- Many hypotheses attempt to explain parasite–host associations, but rarely are they examined together in a single community. For hosts, key traits are the proportion of infected individuals (prevalence) and the diversity of parasites infecting them. A key parasite trait is host specificity, ranging from specialists infecting one or a few closely related species to generalists infecting many species. We tested 10 hypotheses to explain host-parasite associations; five ‘host-centric’ (e.g. prevalence is related to host abundance) and five ‘parasite-centric’ (e.g. parasite abundance is related to host specificity). We analyzed a community of 67 locally transmitted avian haemosporidian parasite lineages (genera Plasmodium, Haemoproteus or Leucocytozoon), sampled from 2726 birds (64 species) in southern Sweden. Among host-centric hypotheses, Haemoproteus and Leucocytozoon prevalence and Haemoproteus diversity were related to host habitat preferences, whereas there were no relationships with host abundance or body mass. Haemoproteus and Leucocytozoon prevalences were more similar among closely related than among distantly related host species. Haemoproteus prevalence and diversity were lower in host species with few close relatives (‘evolutionarily distinct’ hosts). Among parasite-centric hypotheses, most lineages, even relative generalists, infected closely related host species more often than expected by chance. However, the host species of Haemoproteus and Leucocytozoon lineages overlapped less among lineages than expected by chance. Specialists did not reach higher prevalences than generalists on single host species. However, the abundance of Haemoproteus lineages was related to host specificity with generalists more common than specialists; this was driven by three closely related generalists. Host specificity of parasites was unrelated to the abundance or evolutionarily distinctiveness of their hosts. Parasite communities are likely structured by many factors and cannot be explained by hypotheses focusing solely on hosts or parasites. However, we found consistent effects of host phylogenetic relationships, plausibly a result of evolutionarily conserved host immune systems limiting parasite distributions.
|
|
| 10. |
- Hallén, Magnus, et al.
(författare)
-
Laparoscopic extraperitoneal inguinal hernia repair versus open mesh repair: long-term follow-up of a randomized controlled trial.
- 2008
-
Ingår i: Surgery. - : Elsevier BV. - 1532-7361 .- 0039-6060. ; 143:3, s. 313-317
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We have conducted a randomized controlled trial of totally extraperitoneal hernia repair (TEP) versus tension-free open repair (Lichtenstein repair); we have presented the results previously up to 1 year after the operation. The aim of this study was to compare patient outcome in both groups at a median follow-up of 7.3 years after operation. METHODS: Of 168 patients included in a prospective, randomized controlled trial designed to compare TEP with an open tension-free technique, 154 patients (92%) answered a questionnaire and 147 patients (88%) were followed up at an outpatient clinic after a minimum of 6 years after operation. RESULTS: Overall, 89% of patients in the TEP group and 95% of patients in the open group reported complete long-term recovery (P = .23). Permanent impaired inguinal sensibility was more common in the open group (P = .004), whereas the proportion of patients with reported testicular pain was higher in the TEP group (P = .003). Three recurrences were found in the TEP group, and 4 recurrences were found in the open group (P = .99). Four patients in the TEP group underwent operations for complications related to the hernia repair (small bowel obstruction, umbilical hernia, testicular pain, and neuralgia). CONCLUSION: Overall, both groups showed good long-term results with low rates of recurrences. However, the TEP group was associated with a higher proportion of patients with long-term testicular pain, whereas impaired inguinal sensibility was more common in the open group.
|
|
| 11. |
- Hallén, Magnus, et al.
(författare)
-
Male infertility after mesh hernia repair : a prospective study
- 2011
-
Ingår i: Surgery. - : Elsevier. - 0039-6060 .- 1532-7361. ; 149:2, s. 179-184
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Several animal studies have raised concern about the risk for obstructive azoospermia owing to vasal fibrosis caused by the use of alloplastic mesh prosthesis in inguinal hernia repair. The aim of this study was to determine the prevalence of male infertility after bilateral mesh repair.METHODS: In a prospective study, a questionnaire inquiring about involuntary childlessness, investigation for infertility and number of children was sent by mail to a group of 376 men aged 18-55 years, who had undergone bilateral mesh repair, identified in the Swedish Hernia Register (SHR). Questionnaires were also sent to 2 control groups, 1 consisting of 186 men from the SHR who had undergone bilateral repair without mesh, and 1 consisting of 383 men identified in the general population. The control group from the SHR was matched 2:1 for age and years elapsed since operation. The control group from the general population was matched 1:1 for age and marital status.RESULTS: The overall response rate was 525 of 945 (56%). Method of approach (anterior or posterior), type of mesh, and testicular status at the time of the repair had no significant impact on the answers to the questions. Nor did subgroup analysis of the men CONCLUSION: The results of this prospective study in men do not support the hypothesis that bilateral inguinal hernia repair with alloplastic mesh prosthesis causes male infertility at a significantly greater rate than those operated without mesh.
|
|
| 12. |
- Hallén, Magnus, et al.
(författare)
-
Mesh hernia repair and male infertility : a retrospective register study
- 2012
-
Ingår i: Surgery. - : Mosby Inc.. - 0039-6060 .- 1532-7361. ; 151:1, s. 94-98
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous studies have suggested that the use of mesh in groin hernia repair may be associated with an increased risk for male infertility as a result of inflammatory obliteration of structures in the spermatic cord. In a recent study, we could not find an increased incidence of involuntary childlessness. The aim of this study was to evaluate this issue further.METHODS: Men born between 1950 and 1989, with a hernia repair registered in the Swedish Hernia Register between 1992 and 2007 were cross-linked with all men in the same age group with the diagnosis of male infertility according to the Swedish National Patient Register. The cumulative and expected incidences of infertility were analyzed. Separate multivariate logistic analyses, adjusted for age and years elapsed since the first repair, were performed for men with unilateral and bilateral repair, respectively.RESULTS: Overall, 34,267 men were identified with a history of at least 1 inguinal hernia repair. A total of 233 (0.7%) of these had been given the diagnosis of male infertility after their first operation. We did not find any differences between expected and observed cumulative incidences of infertility in men operated with hernia repair. Men with bilateral hernia repair had a slightly increased risk for infertility when mesh was used on either side. However, the cumulative incidence was less than 1%.CONCLUSION: Inguinal hernia repair with mesh is not associated with an increased incidence of, or clinically important risk for, male infertility.
|
|
| 13. |
- Hallén, Magnus, et al.
(författare)
-
Risk factors for reoperation due to chronic groin postherniorrhaphy pain
- 2015
-
Ingår i: Hernia. - : Springer. - 1265-4906 .- 1248-9204. ; 19:6, s. 863-869
-
Tidskriftsartikel (refereegranskat)abstract
- Chronic groin postherniorrhaphy pain (CGPP) is common and sometimes so severe that surgical treatment is necessary. The aim of this study was to identify risk factors for being reoperated due to CGPP. All 195,707 repairs registered in the Swedish Hernia Register between 1999 and 2011 were included in the study. Out of these, 28,947 repairs were excluded since they were registered as procedures on the same patient after a previous repair. Age, gender, hernia anatomy (indirect reference), method of repair (anterior sutured repair reference) and postoperative complications were included in a multivariate Cox analysis with reoperation due to CGPP as endpoint. Of the patients included in the study cohort, 218 (0.13 %) later underwent reoperation due to CGPP, including 31 (14 %) women. Median age at the primary repair was 61.5 years. Risk factors for being reoperated were age < median [hazard ratio (HR) 3.03, 95 % confidence interval (CI) 2.22-4.12], female gender (HR 2.13, CI 1.41-3.21), direct hernia (HR 1.35, CI 1.003-1.81), other hernia (HR 6.03, CI 3.08-11.79), Lichtenstein repair (HR 2.22, CI 1.16-4.25), plug repair (HR 3.93, CI 1.96-7.89), other repair (HR 2.58, CI 1.08-6.19), bilateral repair (HR 2.58, CI 1.43-4.66) and postoperative complication (HR 4.40, CI 3.25-5.96). Risk factors for being reoperated due to CGPP in this cohort included low age, female gender, a direct hernia, a previous Lichtenstein or plug repair, bilateral repair and postoperative complications. Further research on how to avoid CGPP and explore the effectiveness of surgery for CGPP is necessary.
|
|
| 14. |
- Hallgrimsson, Palli, et al.
(författare)
-
Use of the harmonic scalpel versus conventional haemostatic techniques in patients with Grave disease undergoing total thyroidectomy: a prospective randomised controlled trial.
- 2008
-
Ingår i: Langenbeck's Archives of Surgery. - : Springer Science and Business Media LLC. - 1435-2451 .- 1435-2443. ; 393, s. 675-680
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Thyrotoxicosis is often considered to be the most difficult thyroid operation because of the high vascularisation and the risk of bleeding. The conventional haemostatic technique in thyroidectomy today include knot tying and electrocoagulation. The introduction of the harmonic scalpel (HS) has led to further research if the use of the HS has any benefits in thyroid surgery. To our knowledge, no previous study has evaluated the HS dissection technique in a homogenous group of patients with Graves' disease undergoing total thyroidectomy. MATERIALS AND METHODS: Fifty-one patients (39 women and 12 men) with the pre-operative diagnosis of Graves' disease treated at two endocrine centers were randomised to total thyroidectomy with the use of the HS or with conventional haemostatic techniques. RESULTS: Twenty-seven patients were randomised to the harmonic group and 24 to the conventional group. The operating time was shorter in the HS group (median, 121 min; range, 84-213 min) compared to the conventional group (median, 172 min; range, 66-268 min; p = 0.011). CONCLUSION: The use of the HS was associated with a significant reduction in operating time compared to the use of the conventional haemostatic techniques in patients with Graves' disease undergoing total thyroidectomy.
|
|
| 15. |
- Hansson, L-A, et al.
(författare)
-
A synthesis of animal movement across scales
- 2014
-
Ingår i: Animal Movement Across Scales. - : Oxford University Press. - 9780199677184 ; , s. 259-267
-
Bokkapitel (refereegranskat)abstract
- This chapter aims at synthesizing the knowledge presented in the chapters of the book’s three sections by addressing evolutionary compromises, dispersal, gene flow, and assisted movements. How climate change and other environmental changes at different scales may affect animal movement, migration, and dispersal in the future are also summarized here. Moreover, how the different senses are utilized for navigation and orientation and how these may lead to different movement and migration patterns are also discussed. Finally, how the recent technical revolution has affected animal movement research is addressed and the view on future perspectives of animal movement research is also provided.
|
|
| 16. |
- Hessman, Ola, et al.
(författare)
-
Randomized clinical trial comparing open with video-assisted minimally invasive parathyroid surgery for primary hyperparathyroidism
- 2010
-
Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 97:2, s. 177-184
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous studies of video-assisted techniques for parathyroidectomy in patients with primary hyperparathyroidism have found similar or better results compared with bilateral neck exploration. The aim of the present study was to compare open minimally invasive parathyroidectomy with the video-assisted technique for primary hyperparathyroidism in a multicentre randomized trial. METHODS: Some 143 patients were randomized to open (n = 75) or video-assisted (n = 68) parathyroidectomy after positive sestamibi scintigraphy. There were no differences in preoperative data. The open operation was performed through a 15-mm incision. The video-assisted techniques used were minimally invasive video-assisted parathyroidectomy (MIVAP) or video-assisted parathyroidectomy using the lateral approach (VAPLA). Data were collected prospectively including postoperative pain scoring. RESULTS: The procedure was significantly quicker for the open compared to the video assisted operations: mean(s.d.) 60(35) versus 84(47) min (P = 0.001). Both groups of patients had similar conversion rates and the same outcome, with comparable incision lengths, low scores for postoperative neck discomfort, high cosmetic satisfaction and low complication rates. CONCLUSION: Open minimally invasive parathyroidectomy for primary hyperparathyroidism was quicker than either video-assisted technique.
|
|
| 17. |
- Hidestål, Joakim, et al.
(författare)
-
Hypersensitivity to noradrenaline in human omental vein but not artery isolated from a patient with idiopathic orthostatic hypotension.
- 2002
-
Ingår i: Autonomic Neuroscience: Basic & Clinical. - 1872-7484. ; 97:1, s. 55-58
-
Tidskriftsartikel (refereegranskat)abstract
- We investigated the smooth muscle contraction in response to noradrenaline (NA), endothelin-1 (ET) and 5-hydroxytryptamine (5-HT) in the omental artery and vein segments from a 67-year-old woman with idiopathic orthostatic hypotension. The blood vessels were obtained during the abdominal surgery and investigated in vitro. Noradrenaline, endothelin-1 and 5-hydroxytryptamine all induced a contraction in the artery and vein segments. Compared to the literature, the sensitivity to noradrenaline was 10 times higher than expected in the vein. In the artery, the sensitivity to noradrenaline and in both the artery and vein, the sensitivity to endothelin-1 and 5-hydroxytryptamine was similar to that reported in the literature. These results suggest that the patient had developed an isolated hypersensitivity to noradrenaline in the veins, probably due to an impairment of the sympathetic activity.
|
|
| 18. |
- Lindblom, Pia, et al.
(författare)
-
Decreased levels of ionized calcium one year after hemithyroidectomy: importance of reduced thyroid hormones
- 2001
-
Ingår i: Hormone Research. - : S. Karger AG. - 0301-0163. ; 55:2, s. 81-87
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previously we have found reduced levels of total serum calcium and 1,25(OH)2D3 despite an unaltered stimulated parathyroid hormone (PTH) secretion 1 year after hemithyroidectomy. The present study was undertaken to elucidate the possible relationship between calcium homeostasis, thyroid hormones and bone resorption in a group of 45 consecutive patients subjected to hemithyroidectomy because of a solitary nodule. All patients had free T4 and T3 levels within normal range preoperatively. METHODS: Thyroid hormones, bone mineral and biochemical variables known to reflect calcium homeostasis were studied. Patients were divided into three separate groups depending on their pre- and postoperative thyroid hormone status. RESULTS: One year postoperatively, serum levels of free T4 were decreased and that of thyrotropin (TSH) increased in the entire group of patients. The concentration of ionized calcium was reduced from 1.25 +/- 0.05 to 1.22 +/- 0.04 (p < 0.001) despite an unaltered PTH value (2.8 +/- 1.0 vs. 3.1 +/- 1.5, p = 0.50). A significant reduction in C-terminal telopeptide type 1 collagen (1CTP) indicated decreased bone resorption 1 year after surgery (p < 0.05). Subgroup analysis showed that a reduction in ionized calcium was seen only among patients with a postoperative decrease in free T4. Patients with subclinical hyperthyroidism preoperatively presented the lowest postoperative levels of ionized calcium, significantly reduced levels of 1CTP and increased levels of phosphate and creatinine. Multiple linear regression analysis showed that age (p < 0.05) and postoperatively changed serum levels of TSH (p < 0.05), creatinine (p < 0.05), phosphate (p < 0.001) and FT4 (p < 0.01) were independently associated with altered levels of ionized calcium. CONCLUSION: We conclude that the reduction in ionized calcium 1 year after hemithyroidectomy was not due to PTH deficiency. Instead our results suggest that the reduced effects of thyroid hormones on bone and kidney function is essential.
|
|
| 19. |
- Lindblom, Pia, et al.
(författare)
-
Hemithyroidectomy: Long-term effects on parathyroid function-preliminary report
- 2001
-
Ingår i: World Journal of Surgery. - 1432-2323. ; 25:9, s. 1155-1159
-
Tidskriftsartikel (refereegranskat)abstract
- Early hypocalcemia after thyroid surgery has frequently been reported, whereas data regarding long-term effects on calcium homeostasis are scarce. We have previously studied patients after hemithyroidectomy with an oral calcium load test and found normal parathyroid hormone (PTH) suppression. However, the 1,25-dihydroxyvitamin D concentration was decreased and the phosphate concentration increased, implying parathyroid insufficiency. We therefore proceeded to investigate PTH secretion and suppression in 10 euthyroid patients subjected to hemithyroidectomy due to benign thyroid disease before and at 1 year after surgery. In addition, biochemical variables known to influence calcium homeostasis were analyzed. Basal, maximal, and total PTH secretion were unaltered 1 year postoperatively. However, maximal PTH secretion was reached at a lower serum level of ionized calcium, and there was a tendency toward increased parathyroid sensitivity to ionized calcium. Furthermore, compared to preoperatively, total serum calcium, 1,25-dihydroxyvitamin D, and free thyroxine (T-4) concentrations were decreased at follow-up. Total serum calcium and 1,25-dihydoxyvitamin D concentrations were decreased 1 year after hemithyroidectomy. These changes were not due to parathyroid insufficiency. Instead, our results imply increased parathyroid sensitivity to calcium and possibly reduced peripheral sensitivity to PTH.
|
|
| 20. |
- Lindblom, Pia, et al.
(författare)
-
Low parathyroid hormone levels after thyroid surgery: a feasible predictor of hypocalcemia.
- 2002
-
Ingår i: Surgery. - : Elsevier BV. - 1532-7361 .- 0039-6060. ; 131:5, s. 515-520
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Selecting patients with a low risk of hypocalcemia is mandatory if patients are to be discharged on the first day after bilateral thyroidectomy. This study investigated the predictive value of intraoperative parathyroid hormone (PTH). METHODS: Thirty-eight patients underwent total or near-total thyroidectomy. Patients with or without biochemical and symptomatic hypocalcemia were compared regarding intraoperative PTH levels and previously suggested risk factors. The accuracy of intraoperative PTH to predict patients at risk for postoperative hypocalcemia was compared with a calcium concentration of less than 2.00 mmol/L (8.0 mg/dL) on the first postoperative day. RESULTS: PTH levels after resection of the second lobe, age, and number of parathyroid glands identified intraoperatively were independently associated with the reduction in serum calcium concentration measured at nadir on the first or second postoperative day. PTH levels after resection of the second lobe were lower among patients who developed biochemical (P <.001) and symptomatic hypocalcemia (P <.01) compared with those who did not. Low levels of intraoperative PTH identified the 3 patients who required intravenous calcium during the first 24 postoperative hours. An intraoperative PTH level below reference range and a calcium concentration of less than 2.00 mmol/L measured 1 day postoperatively both predicted biochemical hypocalcemia with a similar sensitivity (90% vs 90%) and specificity (75% vs 82%). Intraoperative PTH was slightly better than a serum calcium concentration of less than 2.00 mmol/L on postoperative day 1 to predict symptomatic hypocalcemia, with a sensitivity of 71% vs 52% and a specificity of 81% vs 76%, respectively. CONCLUSIONS: Parathyroid gland insufficiency is the main determinant of transient hypocalcemia after bilateral thyroid surgery. Low intraoperative PTH levels during thyroid surgery are therefore a feasible predictor of postoperative hypocalcemia.
|
|
| 21. |
- Lindblom, Pia, et al.
(författare)
-
Peripheral effects of PTH are not altered after thyroid surgery in euthyroid patients
- 2001
-
Ingår i: Hormone Research. - : S. Karger AG. - 0301-0163. ; 56:3-4, s. 105-109
-
Tidskriftsartikel (refereegranskat)abstract
- Background. We have previously found decreased serum levels of both ionized calcium and 1,25(OH)(2)D and an increase in serum phosphate levels at 1 year after hemithyroidectomy. However, basal and stimulated parathyroid hormone (PTH) secretions were not altered. To investigate whether the observed biochemical changes after unilateral thyroid surgery may be due to a relative end-organ resistance to PTH, we studied the peripheral effects of infused hPTH-(1-34) in 6 patients preoperatively and 3 months after hemithyroidectomy. Methods: Serum levels of TSH, FT4 and FT3 were measured pre- and postoperatively. hPTH-(1-34) was infused at 0.9 IU/kg/h during 6 h. Blood samples for analysis of ionized calcium, intact PTH, phosphate, 25(OH)D, 1,25(OH)(2)D and urinary samples for calcium, phosphate and nephrogenous(n)-cAMP analysis were taken at baseline, when the infusion was discontinued after 6 h and at 24 h. Results: Three months after hemithyroidectomy, serum levels of FT3 were decreased and TSH levels increased. Pre- and postoperative hPTH-(1-34) infusions induced increased serum levels of ionized calcium, 1,25(OH)2D, increased urinary excretion of phosphate and elevated n-cAMP levels. The changes in the studied biochemical variables during the hPTH-(1-34) infusions did not differ between the two study occasions. Conclusion: By using a 6-hour hPTH-(1-34) infusion protocol, we have shown that the peripheral PTH effect is not altered by a slight reduction in thyroid hormone levels at 3 months after hemithyroidectomy.
|
|
| 22. |
- Molander, Sverker, 1957, et al.
(författare)
-
Calculating the Swedish economy‐wide emissions of additives from plastic materials
- 2012
-
Ingår i: 33rd Annual Meeting SETAC North America.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- "Plastics" are very diverse, multipurpose and ubiquitous materials found in very many types of products like shoes, cars, bags and containers. Plastic materials have these many uses due to the possibility of modifying the polymer matrices constituting the bulk material in very many ways with a large number of additives; compounds that are more or less permanently attached in the matrix. Some of these additives have properties with high importance for the final functionality of the product. Flame retardants is a well know example of an additive making otherwise combustible plastic materials (often textile fibres) much less apt for taking fire. There are however a very large number of substances which have got less attention.Our modeling approach aims at a quantification of emissions from a large set of materials occuring in a typical developed country - Sweden. The approach is "bottom-up" in the sense that it is not based on a back-calculation of measured emitted substances. It is rather a combination of a diffusive mass-transfer emission model with models providing information on aggregated product surface areas and material composition of these areas. This combination of the physico-chemical modeling of substance release from a surface under a specific set of environmental conditions, which also rely on substance and material characteristics, and the substance and material flow models, based on trade statistics, longevity data and product properties, is a unique emission model giving the possibility to feed in results to environmental fate modelling and environmental analysis.Results show that textiles, and the huge number of substances occuring in them, are of particular interest due to the fact that this product category constitutes the largest surface area. Due to wear and washing textiles are also fragmented, giving very small fibers and fragments contributing to a further increased surface area that increase the emission rate from the fibre materials in textiles. The result indicate that a number of substances, beside known environmental pollutant, are emitted from textiles.
|
|
| 23. |
|
|
| 24. |
- Måsbäck, Anna, et al.
(författare)
-
Clinical and histopathological features of malignant melanoma in germline CDKN2A mutation families
- 2002
-
Ingår i: Melanoma Research. - 0960-8931. ; 12:6, s. 549-557
-
Tidskriftsartikel (refereegranskat)abstract
- Primary cutaneous malignant melanomas (CMMs) from 26 individuals belonging to nine families with an identified CDKN2A mutation were clinically and histopathologically compared with 78 matched CMM controls and with a population-based series of CMMs (n=667). All tumours were histopathologically re-examined. CDKN2A-associated cases were significantly less invasive compared with the matched controls, with an adjusted odds ratio (adjOR) of 2.9 and a 95% confidence interval (CI) of 1.0-8.1 (P=0.04). According to the odds ratio (OR) values, CDKN2A-associated cases seemed to have tumours more often located on the head and neck (adjOR 2.9, 95% CI 0.6-13.7), with less inflammation (adjOR 0.7, 95% CI 0.3-1.8) and regression (adjOR 0.6, 95% CI 0.2-1.8) but more frequent histological ulceration (adjOR 1.9, 95% CI 0.6-5.8). In comparison with the population-based material, CDKN2A-associated cases were significantly younger at diagnosis (crude OR 3.5, 95% CI 1.6-7.5, divided at 50 years) and had less regressive reaction in their tumours (crude OR 0.355 95% CI 0.2-0.8). No significant differences were seen for tumour thickness between the different groups. On multivariate analysis, the overall survival was significantly worse for thicker tumours and older age (P=0.04 for both). To our knowledge this is the first description of the histopathological features of CMMs from families with mutations in the CDKN2A gene.
|
|
| 25. |
- Måsbäck, Anna, et al.
(författare)
-
Cutaneous malignant melanoma in South Sweden 1965, 1975, and 1985. A histopathologic review
- 1994
-
Ingår i: Cancer. - 0008-543X. ; 73:6, s. 1625-1630
-
Tidskriftsartikel (refereegranskat)abstract
- Background. There is an increase in the incidence of cutaneous malignant melanoma (CMM) among white people throughout the world. In Sweden, a fivefold increase has been recorded since 1960, but the mortality is rising at a much lower rate. Tumor thickness is the single most important prognostic factor for primary melanoma. This study aimed to clarify whether the thickness of the tumor in invasive CMM decreased during the period 1965–1985. Methods. This population‐based study identified 574 cases of CMM, both invasive and noninvasive, in the South Swedish Health Care Region in 1965, 1975, and 1985. Twenty‐six cases were excluded because the collection or evaluation of the material was not possible. The remaining 548 cases were reviewed histopathologically, and a diagnosis of invasive CMM was rejected in 71 cases. Eventually, 467 cases of invasive melanoma remained in our study (70 in 1965, 124 in 1975, and 273 in 1985). The level of invasion, tumor thickness, regression, ulceration, presence of inflammatory cells, benign naevus cells, and the site of presentation were studied. Results. The study found neither a significant decrease of tumor thickness of invasive CMM nor changes in the level of invasion or proportion of ulcerated melanoma. A significantly higher proportion of melanoma tumors containing benign naevus cells was seen throughout the years (P < 0.05). Women had significantly fewer inflammatory cells in their tumors than did men (P < 0.01). As expected, the anatomical site of presentation showed a significant sex‐related difference, with more tumors on the legs of female patients and more on the trunk of male patients (P < 0.001). Conclusions. There is a divergence between the rapidly increasing incidence and the slower increase in mortality of CMM. This cannot be explained by a removal of the melanoma at a thinner thickness. Differences between the sexes according to the tumor site and the increasing rate of CMM containing benign naevus cells could implicate changes in the tumor biology. Public education in Sweden concerning ultraviolet radiation and the connection with melanoma is fairly new and might not have any influence on this time period. Additional investigation is needed to clarify this matter.
|
|
| 26. |
- Måsbäck, Anna, et al.
(författare)
-
Prognostic factors in invasive cutaneous malignant melanoma: a population-based study and review
- 2001
-
Ingår i: Melanoma Research. - 0960-8931. ; 11:5, s. 435-445
-
Tidskriftsartikel (refereegranskat)abstract
- A population-based study from Sweden identified 711 patients with cutaneous malignant melanoma diagnosed in 1965, 1975, 1985 and 1989. Prognostic factors were evaluated and a review of the literature was performed. On univariate analysis, thick tumours (> 0.8 mm) (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.6-2.1), increasing Clark level (OR 1.8, 95% CI 1.6-2.0), ulceration (OR 1.8, 95% CI 1.6-2.0), nodular melanoma (OR 1.5, 95% CI 1.3-1.6) and increasing age (continuous variable, P < 0.0001) were associated with a shorter survival. Location on extremities (OR 0.8, 95% CI 0.7-0.9), inflammation (OR 0.8, 95% CI 0.7-0.9) and female gender (OR 0.8, 95% CI 0.8-0.9) were associated with improved survival. On multivariate analysis, thick tumours (> 0.8 mm) (OR 1.5, 95% CI 1.2-1.7) and ulceration (OR 1.4, 95% CI 1.2-1.6) were independently related to a poor prognosis, while location on extremities (OR 0.8, 95% CI 0.7-0.9), inflammation (OR 0.8, 95% CI 0.7-0.9) and female gender (OR 0.8, 95% CI 0.8-1.0) were associated with improved survival. No difference in mean tumour thickness was seen over time, but there was a significant increase in the percentage of thin melanomas (< 0.8 mm) in 1985 (P = 0.01) and 1989 (P = 0.002) compared with 1965. The incidence of melanomas with inflammation increased significantly (P = 0.04), as did age at diagnosis (P = 0.005).
|
|
| 27. |
|
|
| 28. |
- Nordenstrom, E, et al.
(författare)
-
Multifactorial risk profile for bone fractures in primary hyperparathyroidism
- 2002
-
Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 1432-2323 .- 0364-2313. ; 26:12, s. 1463-1467
-
Tidskriftsartikel (refereegranskat)abstract
- Primary hyperparathyroidism (pHPT) is associated with an increased fracture risk, and decreased bone density thus has been considered an indication for surgery. However, many pHPT patients have a multifactorial risk profile for osteoporosis and bone fractures. The aim of the present study was to evaluate variables associated with fracture risk within the group of pHPT patients. A series of 203 consecutive patients operated for pHPT were investigated with bone mineral content and biochemical and clinical risk factors for bone fracture. Seventeen patients (8%) had a history of at least one bone fracture up to 5 years before pHPT surgery. Twenty-six patients (13%) had a history of at least one fracture during the 10-year period prior to surgery. In the univariate analyses corticosteroid treatment, serum levels of alkaline phosphatase, 25-hydroxyvitamin D-3, type I collagen telopeptide, and bone mineral content were found to be associated with a history of bone fractures up to 10 years before surgery. Additionally, age and menopausal status were of importance for fractures during the 10-year-period, whereas a history of cardiovascular disease was important for fractures during the 5-year-period prior to surgery. Multivariate analyses showed that serum level of PTH was independently associated with bone fractures during the 5-year period prior to pHPT surgery and further that serum level of 25-hydroxyvitainin D-3 was associated with fractures up to 10 years before surgery. In conclusion, serum levels of 25-hydroxyvitamin D-3 and PTH were independently associated with a history of bone fractures in pHPT. These variables should be considered when evaluating patients for parathyroid surgery.
|
|
| 29. |
- Nordenström, Erik, et al.
(författare)
-
Effect on bone density of postoperative calcium and vitamin-D supplementation in patients with primary hyperparathyroidism: A retrospective study.
- 2009
-
Ingår i: Langenbeck's Archives of Surgery. - : Springer Science and Business Media LLC. - 1435-2451 .- 1435-2443. ; Jun 11, s. 461-467
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Primary hyperparathyroidism (pHPT) is associated with decreased bone density and increased fracture risk. A significant number of pHPT patients have low calcium intake and suffer from vitamin deficiency. Thus, we adopted a policy of postoperative supplements with calcium and vitamin D after parathyroid surgery. In this study, we investigated if this policy enhanced the postoperative increase in bone density. PATIENTS/METHODS: Forty-two consecutive patients (83% female) were studied. The first 21 patients received no supplements, whereas the following 21 patients received 1,000 g calcium and 800 IU hydroxy D: -vitamin daily (Ca-D group) for 1 year postoperatively. The patients were monitored with bone density and biochemistry pre- and at 1 year postoperatively. RESULTS: Preoperatively, the patients without vitamin D supplementation (non-Ca-D group) did neither differ in biochemistry, clinical features, nor in bone density from patients in Ca-D group. Postoperatively, there was a tendency that patients in Ca-D group increased their bone density, at all sites measured, in a greater extent than patients that did not receive calcium and vitamin D supplementation. CONCLUSION: In conclusion, based on our results, it is difficult to give a recommendation of vitamin D supplementation in routine use following surgery for primary hyperparathyroidism. Based on the present data, a calculation of sample size for a future randomized controlled trial is presented.
|
|
| 30. |
|
|
| 31. |
|
|
| 32. |
|
|
| 33. |
|
|
| 34. |
- Rydberg, Tomas, 1962, et al.
(författare)
-
Emissions of additives from plastics in the societal material stock – a case study for Sweden
- 2012
-
Ingår i: Handbook of Environmental Chemistry. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 1867-979X. ; 18, s. 253-264, s. 253-264
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Estimating the size of the problems related to release, fate, exposure and effects from the human use of chemical substances in materials and consumer products is daunting. More than 100,000 chemical substances are in commercial use and a reasonable description of their existence in, and release from, plastic polymers, glues, paints, fibres, lubricants etc. comprise a big challenge. Here we report the initial results from a generic emission model that has been developed and applied to estimate emissions of a set of organic chemicals from products. The scope of the study was to estimate emissions from products containing plastic materials during their average lifetime within the geographical boundaries of Sweden. The results show that approximately 2% of the plastic additives are emitted annually. Plasticisers, flame retardants, organic pigments and stabilizers are the use categories of additives that are emitted in the largest quantities. Until now, the method has only been used to estimate emissions of additives from plastic materials, but it is believed to also be applicable to other materials.
|
|
| 35. |
- Siilin, Helene
(författare)
-
Primary Hyperparathyroidism : Prevalence and Associated Morbidity in Middle-Aged Women and Elderly Men
- 2011
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Primary hyperparathyroidism (PHPT) is a common endocrine disease, existing in both genders and in all age groups. Postmenopausal women are at particular risk of developing the disease and estrogen decline after menopause is suggested to affect the progress. Although PHPT is mild in its presentation with subtle or no subjective symptoms, it is associated with an increased risk of associated morbidity and also mortality i.e cardiovascular complications, psychiatric instability, concomitant metabolic abnormalities, obesity and decrease in bone mineral density. The current cure is surgical removal of the diseased gland/s, but other medical alternatives have been investigated. The disease is thoroughly explored in postmenopausal women but less is known about other populations groups. Since progression of the disease generally is slow, the underlying disturbance of the calcium homeostasis can be suspected to have been established a long time prior to diagnose with potential to affect associated morbidity. The general aim of this thesis is to clarify the expression of PHPT in premenopausal women and in elderly men and to explore how frequent the disease in these populations occurs. The women and men were investigated through population-based studies. Baseline data and prevalence of PHPT in premenopausal women age 40-50 years were studied (Paper I), the prevalence was 5.1% in this population and was associated with decreased bone mineral density and associated obesity. In a three years follow up of the female cohort, the effects of menopausal transition and associated morbidity was investigated (Paper II). The prevalence and expression of PHPT in men between 69 and 81 years and impact on bone mineral density, physical performance, fall and fracture prevalence was explored through data from Mr Os Sweden (Papers III and IV). In this population prevalence of PHPT was 0.73% and associated with lower bone mineral density and inferior physical performance.
|
|
| 36. |
- Thier, Mark, et al.
(författare)
-
Surgery for patients with primary hyperparathyroidism and negative sestamibi scintigraphy--a feasibility study
- 2009
-
Ingår i: Langenbeck's Archives of Surgery. - : Springer Science and Business Media LLC. - 1435-2451 .- 1435-2443. ; 394:5, s. 4-881
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We report the surgical treatment of a consecutive series of scan negative patients with the intention of unilateral parathyroid exploration with the aid of intraoperative quick PTH (qPTH).MATERIALS AND METHODS: The study included 35 consecutive sestamibi scan negative patients (27 women, eight men) with sporadic pHPT subjected to first time surgery. Median age was 70 years and median preoperative calcium level 2.8 mmol/L.RESULTS: Thirty-three patients had a histological diagnosis of a parathyroid adenoma (median weight 0.48 g [range 0.12 g-2.5 g]). Nineteen patients were explored bilaterally and 16 patients (46%) were operated unilaterally. The median operation time was 40 min in the unilateral group and 95 min in the bilateral group (p < 0.001). Three patients were treated for postoperative hypocalcemia after bilateral exploration versus none in the unilateral group (p = 0.23). With a minimum of 12 months of follow-up, 33 patients (94.3%) were cured. One case of recurrent HPT presented after bilateral exploration with visualization of four glands. One case of persistent HPT was observed after unilateral exploration. qPTH was predictive of operative failure in both patients.CONCLUSION: Forty-six percent of the patients in our study could be operated unilaterally with a total cure rate of 94%. Patients in the unilateral group had a significant shorter operation time and a lower incidence of postoperative hypocalcemia. In conclusion our investigation shows that limited parathyroid exploration can safely be performed on patients with negative sestamibi scintigraphy by the aid of qPTH.
|
|
| 37. |
- Westerdahl, Jenny, 1984, et al.
(författare)
-
Emissions of chemicals from the economy-wide stock of plastic material - a first model iteration for Sweden
- 2011
-
Ingår i: 21st Annual Meeting SETAC Europe, Milan, Italy, 2011.
-
Konferensbidrag (refereegranskat)abstract
- Estimating the size of the problem with release, fate, exposure and effects from the human use of chemical substances of materials and consumer products is dauntingMore than 100,000 chemical substances are in commercial use and a reasonable description of their existence in, and release from, plastic polymers, glues, paints, fibres, lubricants etc. comprise a big challenge.In this study, a generic emission model has been developed and applied to estimate emissions of a set of organic chemicals from products. The scope of the estimate is emissions from products containing plastic materials during their average lifetime within the geographical boundaries of Sweden. The customs Combined Nomenclature has been used to divide the products into categories for which the chemical composition, surface area, thickness and accumulated stock in society has been described and estimated using several approaches for approximation in cases where data have been lacking. For this, information from national trade statistics as well as lifecycle assessments and building product declarations was usedAnti-oxidants, flame retardants and plasticisers are among the most interesting use categories of additives that are emitted in significant quantities. Thus for anti-oxidants in plastic material in the economy-wide product stock in Sweden as an example, the emissions in the service-life were estimated to be almost 500 tons/year divided on 32 individual chemical organic substances, stemming from a stock of anti-oxidants of 84000 tons, contained in a stock of plastic material of 24 million tons.Until now, the method has only been used to estimate emissions of additives from plastic materials, but it is believed to also be applicable to other materials. However, the uncertainties in the estimations are currently large, which is partly due to model uncertainties but to a large extent also due to uncertainties in the input data.
|
|
| 38. |
- Westerdahl, Johan, et al.
(författare)
-
Measurement of intraoperative parathyroid hormone predicts long-term operative success.
- 2002
-
Ingår i: Archives of Surgery. - 0004-0010. ; 137:2, s. 186-190
-
Tidskriftsartikel (refereegranskat)abstract
- HYPOTHESIS: A decrease in the intraoperative parathyroid hormone (PTH) level predicts long-term operative success. DESIGN: A case series of consecutive patients undergoing parathyroidectomy with intraoperative PTH measurement. SETTING: A university hospital. PATIENTS AND INTERVENTION: One hundred two patients with sporadic primary hyperparathyroidism underwent parathyroidectomy according to the principles of unilateral exploration with intraoperative PTH measurement. MAIN OUTCOME MEASURES: Longitudinal effects on levels of serum calcium and PTH. RESULTS: In 94 of 98 patients who underwent primary exploration because of a solitary adenoma, intraoperative PTH decreased at least 60% 15 minutes after gland excision. The 4 cases in which PTH fell to less than 60% were classified as false negatives. Patients examined for multiglandular disease (n = 4) were correctly predicted not to have an adenoma. Twenty-two patients (22%) were unavailable for 5-year follow-up. These patients were followed up for 2 months to 48 months (median, 24 months), and none developed recurrent primary hyperparathyroidism. Of the remaining 80 patients (78%), all but 1 patient had normal or slightly decreased serum calcium levels (mean +/- SD, 9.24 +/- 0.4 mg/dL [2.31 +/- 0.10 mmol/L]) at 5-year follow-up. One patient with hypercalcemia (10.6 mg/dL [2.65 mmol/L]) was interpreted to have developed renal failure with secondary hyperparathyroidism. Thirty-four patients had elevated serum PTH levels at least once during the postoperative study period, with normal or slightly decreased calcium concentrations. The prediction of late postoperative normocalcemia by means of intraoperative PTH measurement had an overall accuracy of 95%. CONCLUSIONS: The measurement of intraoperative PTH during surgery for primary hyperparathyroidism accurately differentiates between single- and multiple-gland disease and ensures good long-term results.
|
|
| 39. |
|
|
| 40. |
|
|
| 41. |
|
|
| 42. |
- Westerdahl, Johan, et al.
(författare)
-
Unilateral versus bilateral neck exploration for primary hyperparathyroidism - Five-year follow-up of a randomized controlled trial
- 2007
-
Ingår i: Annals of Surgery. - 1528-1140. ; 246:6, s. 976-981
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare long-term patient outcome in a prospective randomized controlled trial between unilateral and bilateral neck exploration for primary hyperparathyroidism (pHPT). Summary Background Data: Minimal invasive and/or focused parathyroidectomy has challenged the traditional bilateral neck exploration for pHPT. Between 1997 and 2001, we conducted the first unselected randomized controlled trial of unilateral versus bilateral neck exploration for pHPT. The results showed that unilateral exploration is a surgical strategy with distinct advantages in the early postoperative period. However, concerns have been raised that limited parathyroid exploration could increase the risk for recurrent pHPT during long-term follow-up. Methods: Ninety-one patients with the diagnosis of pHPT were randomized to unilateral or bilateral neck exploration. Preoperative scintigraphy and intraoperative parathyroid hormone measurement guided the unilateral exploration. Gross morphology and frozen section determined the extent of parathyroid tissue resection in the bilateral group. Follow-up was performed after 6 weeks, I year, and 5 years postoperatively. Results: Seventy-one patients were available for 5-year follow-up. There were no differences in serum ionized calcium and parathyroid hormone, respectively, between patients in the unilateral and bilateral group. Overall 6 patients have been found to have persistent (n = 3) or recurrent (n = 3) pHPT; 4 patients in the unilateral group (3 of these 4 patients were bilaterally explored) and 2 patients in the bilateral group. Three of 6 failures were unexpectedly found to have multiple endocrine neoplasia mutations. One patient with solitary adenoma in the bilateral group still required vitamin D substitution 5 years after surgery. Conclusion: Unilateral neck exploration with intraoperative parathyroid hormone assessment provides the same long-term results as bilateral neck exploration, and is thus a valid strategy for the surgical treatment of pHPT.
|
|
| 43. |
- Westerdahl, Johan, et al.
(författare)
-
Urate and arteriosclerosis in primary hyperparathyroidism
- 2001
-
Ingår i: Clinical Endocrinology. - : Wiley. - 1365-2265 .- 0300-0664. ; 54:6, s. 805-811
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: An increased mortality due to cardiovascular disease has been reported in patients with primary hyperparathyroidism (pHPT). An association between urate and cardiovascular disease has been suggested. Metabolic abnormalities in pHPT may include urate. We therefore evaluated the metabolic arteriosclerotic risk profile in pHPT with special focus on the role of urate. DESIGN: Retrospective analysis of data before and 1 year after surgery for pHPT. PATIENTS: 130 consecutive patients, over the age of 44 years, who underwent surgery for pHPT. MEASUREMENTS: Biochemical variables known to reflect risk of arteriosclerotic disease (AD) and renal function tests including measurement of glomerular filtration rate (GFR) were investigated before and 1 year after surgery. RESULTS: pHPT patients with AD (n = 40) were older and had higher serum levels of urate and triglyceride, and more impaired renal function in comparison with patients without AD. PTH and calcium values did not differ. Multiple logistic regression analysis indicated that urate was an independent risk factor for AD in pHPT (P < 0.01). Three variables were shown to be positively associated with urate; male gender (P < 0.01), fasting blood glucose (P < 0.05) and serum level of triglyceride (P < 0.05). CONCLUSIONS: Urate was found to be an independent risk factor for arteriosclerotic disease in primary hyperparathyroidism. Serum level of urate could (in addition to gender) be associated with a metabolic disorder comprising increased glucose and triglyceride levels.
|
|
