| 1. |
- von Kobyletzki, Laura B., 1971-, et al.
(författare)
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Insulin Pump Therapy and Adverse Skin Reactions With Focus on Allergic Contact Dermatitis in Individuals Living With Diabetes Mellitus : A Systematic Review and Clinical-Based Update
- 2024
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Ingår i: Journal of Diabetes Science and Technology. - : Diabetes Technology Society. - 1932-2968.
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: The use of insulin pumps (continuous subcutaneous insulin infusion [CSII]) in individuals living with type 1 diabetes (T1D) improves disease control. However, adverse skin reactions may hamper compliance. We aimed to assess the relationship of insulin pumps, particularly that of infusion set therapy, used in children and adults with T1D and dermatitis including allergic contact dermatitis (ACD).METHODS: A systematic search of PubMed, and EMBASE, of full-text studies reporting dermatitis in persons with diabetes using a CSII was conducted from 2020 to 2023. The Newcastle-Ottawa Scale was used to assess study quality. The inventory performed at the Department of Occupational and Environmental Dermatology, Malmö, Sweden (YMDA) was also performed highlighting the diagnostic process.RESULTS: Among the 391 screened abstracts, 21 studies fulfilled the inclusion criteria. Seven studies included data on children only, four studies were on adults, and nine studies reported data on both children and adults. Participants were exposed to a broad range of pumps. Dermatitis was rarely specified. Up to 60% of those referred to a university hospital due to skin reactions possibly related to insulin pumps had an ACD.CONCLUSIONS: The review and our findings indicate that there is not sufficient focus on contact allergy in the primary toxicological evaluations of substances used also for insulin pump therapy products and that possible adverse skin reactions are not correctly followed up in the clinical setting.
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| 2. |
- Howells, Laura, et al.
(författare)
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RECAP OF ATOPIC ECZEMA (RECAP) : ASSESSING ECZEMA CONTROL FROM THE PATIENT AND PARENT PERSPECTIVE
- 2021
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Ingår i: Acta Dermato-Venereologica. - : Medical journals Sweden AB. - 0001-5555 .- 1651-2057. ; 101:Suppl. 221, s. 29-29
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: The Harmonising Outcome Measures for Eczema (HOME) initiative recommend long-term control of eczema is measured in all clinical trials over 3 months in duration, but prior to this work, no instrument had been identified as suitable for inclusion in the core outcome set.Objective: To develop a ques-tionnaire to capture ‘eczema control’ from a patient/caregiver’s perspective.Methods: A mixed-methods approach was used to develop and refine a conceptual framework, generate, refine and select items and initial testing of the items. Questionnaire con-tent was generated and refined via a focus group, expert panel meetings, cognitive interviews and an online survey with people with eczema/caregivers. Impact analysis and multivariable li-near regression were used for item selection. The distribution of scores and construct validity were assessed.Results: Fourteen expert panel members (including patients, caregivers, healthcare professionals and methodologists) co-produced the instrument; with input from people with eczema/caregivers via a focus group (n = 6), cognitive interviews (n = 13) and an online survey (n = 330). Recap of atopic eczema (RECAP) is a seven-item questionnaire with a self-reported and caregiver-reported version. Initial testing suggested no floor or ceiling effects and good construct validity. Positive correlation with the Patient-Oriented Eczema Measure (POEM) was confirmed (r(258)=0.83, p < 0.001).Conclusions: RECAP is appropriate and feasible for measuring eczema control in clinical trials. Testing of measurement properties and translation to other languages is ongoing. RECAP has been recommended for inclusion in the HOME core outcome set for clinical trials and the HOME clinical practice set.
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| 3. |
- Thyssen, Jacob P., et al.
(författare)
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Clinical management of atopic dermatitis in adults : Mapping of expert opinion in 4 nordic countries using a modified delphi process
- 2020
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 100:1
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Tidskriftsartikel (refereegranskat)abstract
- Similarities and differences in the everyday clinical management of moderate-to-severe atopic dermatitis in Nordic countries are unknown. Using a modified Delphi approach, 15 dermatologists from Denmark, Finland, Norway and Sweden completed face-to-face and online questionnaires and participated in summary discussions to map expert opinion on the clinical management of moderate-to-severe atopic dermatitis in these Nordic countries. Through discussions, 6 adult patient profiles, reflecting common disease presentations of atopic dermatitis, were identified. Using these case profiles, diagnostic work-up, treatment goals, patient education and treatment approaches were discussed. Patient education was identified as essential for effective management. A treatment sequence of moderate-to-potent topical glucocorticosteroids and emollients, followed by systemic treatment, was recommended, allowing 3 months to ascertain systemic treatment response before switching, if necessary. Consensus was not reached on systemic treatment choice, reflecting differences in clinical practice and reimbursement between countries. Practical, case-based clinical recommendations were developed for optimal patient care.
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| 4. |
- Thyssen, Jacob P., et al.
(författare)
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Management of ocular manifestations of atopic dermatitis : A consensus meeting using a modified delphi process
- 2020
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 100:16
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Tidskriftsartikel (refereegranskat)abstract
- There is a need for unified guidance on the management of ocular manifestations of atopic dermatitis and ocular manifestations associated with dupilumab in the Nordic region (Denmark, Finland, Norway and Sweden). This initiative gathered Nordic dermatologists and ophthalmologists to identify consensus in this area using a modified Delphi process. The initiative was led by a Nordic expert panel who developed a questionnaire that was circulated to a wider group. The results informed an agenda consisting of 24 statements to be voted on using a 5-point Likert scale at a meeting in Copenhagen on 24 April 2019. A facilitator moderated discussion and revised statements according to expert feedback for a second vote when required to reach consensus. Consensus was reached for 23 statements regarding the diagnosis, treatment and referral of these patients, which we hope will improve patient management in the Nordic region.
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| 5. |
- Alsterholm, Mikael, 1977, et al.
(författare)
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Establishment and utility of SwedAD : a nationwide Swedish registry for patients with atopic dermatitis receiving systemic pharmacotherapy
- 2023
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 103
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Tidskriftsartikel (refereegranskat)abstract
- SwedAD, a Swedish nationwide registry for patients with atopic dermatitis receiving systemic pharmacotherapy, was launched on 1 September 2019. We describe here the establishment of a user-friendly registry to the benefit of patients with atopic dermatitis. By 5 November 2022, 38 clinics had recorded 931 treatment episodes in 850 patients with an approximate national coverage rate of 40%. Characteristics at enrolment included median Eczema Area and Severity Index (EASI) 10.2 (interquartile range 4.0, 19.4), Patient-Oriented Eczema Measure (POEM) 18.0 (10.0, 24.0), Dermatology Life Quality Index (DLQI) 11.0 (5.0, 19.0) and Peak Itch Numerical Rating Scale-11 (NRS-11) 6.0 (3.0, 8.0). At 3 months, median EASI was 3.2 (1.0, 7.3) and POEM, DLQI, and NRS-11 were improved. Regional coverage varied, reflecting the distribution of dermatologists, the ratio of public to private healthcare, and difficulties in recruiting certain clinics. This study highlights the importance of a nationwide registry when managing systemic pharmacotherapy of atopic dermatitis.
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| 6. |
- Beckman, Linda, 1980-, et al.
(författare)
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Associations between neurodevelopmental disorders and factors related to school, health, and social interaction in schoolchildren : Results from a Swedish population-based survey
- 2016
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Ingår i: Disability and Health Journal. - : Elsevier. - 1936-6574 .- 1876-7583. ; 9:4, s. 663-672
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Tidskriftsartikel (refereegranskat)abstract
- Background: Children and adolescents with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) are more likely to be surrounded by different risk factors. In order to work preventively with decreasing ADHD and ASD symptoms, there is a need of more knowledge concerning risk factors. Objective: This study aimed to investigate school, health, lifestyle and social interactions association with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) among schoolchildren aged 6-17 years. Methods: Data for 18,416 children and adolescents aged 6-17 years in the county of Varmland, Sweden, from the school year 2012/2013 and 2013/2014 were obtained from the Student Health Database, which includes information on health examinations by school nurses and self-reported information of mental and physical health, social relations, physical activity, and school conditions. Results: Of all participants, 2.4% reported only ADHD and 1.6% reported only ASD. The results confirmed that ADHD or ASD was significantly associated with worse school experiences, lower socioeconomic status, less physical activity, more substance use, weaker social network and more impairments than those without ADHD or ASD. Conclusions: Knowledge of risk or protective factors during school years is needed to develop interventions to reduce symptoms of neurodevelopmental disorders in children and adolescents.
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| 7. |
- Beckman, Linda, 1980-, et al.
(författare)
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Cyber bullying among children with neurodevelopmental disorders : A systematic review
- 2019
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Ingår i: Scandinavian Journal of Psychology. - : Blackwell Publishing Ltd. - 0036-5564 .- 1467-9450. ; 61:1, s. 54-67
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Tidskriftsartikel (refereegranskat)abstract
- Children and young adults with neurodevelopmental disorders (ND) are at increased risk of bullying compared to typically developing peers. It is still unclear to what extent they are involved in cyber bullying. This systematic review aimed at studying the prevalence of cyber bullying as perpetrators, victims, or both (“bully-victims”) among students with ND in a school setting and in need of special education. The Web of Science, Scopus, ERIC, PsycINFO, PubMED, and Cochrane databases were searched including a manual search of reference lists, until February 24, 2018. Eight studies conducted in Europe, North America, the Middle East, and Australia were included reporting a prevalence of cyber-victimization among students with ND of 0%–41%, a prevalence of cyber-perpetration of 0%–16.7%, and a prevalence of bully-victims of 6.7%. Three out of five studies using control groups showed that students with ND might be more involved in cyber bullying overall compared to typically developing students. Students in segregated school settings report slightly higher prevalence rates of cyber bullying compared to students with ND in inclusive school settings, especially among girls. When comparing prevalence rates among studies using the same definition, we found similar prevalence rates. There was a tendency towards students with ND being more involved in cyber bullying compared to typically developing students, but this needs to be confirmed in future studies that should include control groups with typically developing students as well as validated and standardized measurements of cyber bullying and ND diagnoses. © 2019 Scandinavian Psychological Associations and John Wiley & Sons Ltd
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| 8. |
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| 9. |
- Beckman, Linda, 1980-, et al.
(författare)
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Economic Costs of Antidepressant Use: A Population-Based Study in Sweden
- 2019
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Ingår i: Journal of Mental Health Policy and Economics. - Italy. - 1091-4358 .- 1099-176X. ; 22:4, s. 125-130
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prescription of antidepressant drugs (ADs) has increased in recent decades, with rising costs for patients as well as for the health care system. There is sparse evidence of which factors explain the high economic costs and financial burden for the general population. Aims of the study: The aim was to assess individual-level determinants of out-of-pocket and total health care costs of AD use in the Swedish general population. Methods: We randomly sampled 400,000 individuals aged 18+ from Statistics Sweden's population register from 2010 to 2013. Two-part regression models were used for our two primary outcome variables: (i) total health care costs for AD use per year and individual, and (ii) total out-of-pocket costs of AD use per year and individual. Results: Women, the unemployed, unmarried people and residents of big cities have both higher use of ADs and higher associated total health care and out-of-pocket costs. Today, ADs are relatively inexpensive and average cost differences among all groups are therefore minor. The elderly have higher use of ADs, but are more commonly low-volume users and do not have higher total health care or out-of-pocket costs. Discussion and limitations: Groups with relatively low socioeconomic status are at risk of higher costs for antidepressant use. However, given the Swedish system of drug subsidies, differences in financial burden for individuals are minor. The limitations of this study included that we lacked data on diagnosis and could therefore not categorize the reasons for AD consumption. Furthermore, our results may not be generalized to other countries with a lower AD prevalence then Sweden's, since our estimates are dependent on the point prevalence of antidepressant use in the population. Implications for health care provision and use: Groups with higher AD consumption and economic costs may suffer from more severe depression owing to more risk factors and less social support in their surroundings, and may be in greater need of additional treatment and support than other groups. Implications for health policies and further research: Our results offer insight at an aggregate level, and more information on the underlying causes of higher costs is needed to discern the policy implications.
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| 10. |
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| 11. |
- Beckman, Linda, Docent, 1980-, et al.
(författare)
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Relationship between Eczema and Self-reported Difficulties Keeping up with School Education : A Cross-sectional Study
- 2023
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden. - 0001-5555 .- 1651-2057. ; 103
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Tidskriftsartikel (refereegranskat)abstract
- Eczema is a common chronic disease that affects both children and adults, and may have an adverse impact on school performance, as it is characteristically pruri-tic, and hence may lead to poor concentration and ina-dequate sleep. The aim of this study was to elucidate the relationship between eczema and self-reported difficulties keeping up with school education. The study was based on cross-sectional questionnaire data collec-ted in schools among all 9th graders (15–16 years old) within a Swedish county. Logistic regression analyses were used to assess the association between having eczema and self-reported difficulties keeping up with school education. A total of 2,620 pupils participated (50.1% female). An increased odds ratio (OR) of self-reported difficulties keeping up with school education was found in adolescents with eczema compared with those without eczema after adjustment for sex and family residence (OR 2.13, 95% confidence interval (95% CI) 1.32–3.44), and with additional adjustment for sleeping problems, attention-deficit hyperactivity disorder, allergy, rhinitis, asthma, and alcohol con-sumption (adjusted OR 1.78, CI 1.05–3.00). Eczema may be a relevant risk factor for difficulty keeping up with school education in adolescents. However, studies that can assess temporality, based in different settings with objective reports of both eczema and self-reported difficulties at school, are needed to con-firm these findings.
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| 12. |
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| 13. |
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| 14. |
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| 15. |
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| 16. |
- Bosma, A. L., et al.
(författare)
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Mapping exercise and status update of eight established registries within the TREatment of ATopic eczema (TREAT) Registry Taskforce
- 2023
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Blackwell Publishing. - 0926-9959 .- 1468-3083. ; 37:1, s. 123-136
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: the TREatment of ATopic eczema (TREAT) Registry Taskforce is a collaborative international network of registries collecting data of atopic eczema (AE) patients receiving systemic and phototherapy with the common goal to provide long-term real-world data on the effectiveness, safety and cost-effectiveness of therapies. A core dataset, consisting of domains and domain items with corresponding measurement instruments, has been developed to harmonize data collection.OBJECTIVES: we aimed to give an overview of the status and characteristics of the eight established TREAT registries, and to perform a mapping exercise to examine the degree of overlap and pooling ability between the national registry datasets. This will allow us to determine which research questions can be answered in the future by pooling data.METHODS: all eight registries were asked to share their dataset and information on the current status and characteristics. The overlap between the core dataset and each registry dataset was identified (according to the domains, domain items and measurement instruments of the TREAT core dataset).RESULTS AND CONCLUSIONS: a total of 4,702 participants have been recruited in the 8 registries as of 1st of May 2022. Of the 69 core dataset domain items, data pooling was possible for 69 domain item outcomes in TREAT NL (the Netherlands), 61 items in A-STAR (UK and Ireland), 38 items in TREATgermany (Germany), 36 items in FIRST (France), 33 items in AtopyReg (Italy), 29 items in Biobadatop (Spain), 28 items in SCRATCH (Denmark) and 20 items in SwedAD (Sweden). Pooled analyses across all registries can be performed on multiple important domain items, covering the main aims of analyzing data on the (cost-)effectiveness and safety of AE therapies. These results will facilitate future comparative or joint analyses.
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| 17. |
- Bylund, Simon, et al.
(författare)
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Prevalence and incidence of atopic dermatitis-a systematic review
- 2020
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Ingår i: Acta Dermato-Venereologica. - 1651-2057. ; 100, s. 320-329
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Forskningsöversikt (refereegranskat)abstract
- The primary objective of this study was to systematically review and analyse epidemiological studies of the prevalence and incidence of atopic dermatitis (AD) during childhood and adulthood, focusing on data from the 21st century. A systematic search of PubMed, EMBASE and Google (manual search) was performed in June 2019, followed by data abstraction and study quality assessment (Newcastle–Ottawa Scale). Cross-sectional and longitudinal epidemiological studies of individuals with AD (doctor-diagnosed or standardized definition) were included. Of 7,207 references reviewed, 378 moderate/good-quality studies were included: 352 on prevalence of AD and 26 on incidence of AD. In the 21st century, the 1-year prevalence of doctor-diagnosed AD ranged from 1.2% in Asia to 17.1% in Europe in adults, and 0.96% to 22.6% in children in Asia. The 1-year incidence ranged from 10.2 (95% confidence interval (95% CI) 9.9–10.6) in Italy to 95.6 (95% CI 93.4–97.9) per 1,000 person-years in children in Scotland. There were few recent studies on incidence of AD in the 21st century and no studies on adults only; most studies were conducted in Europe and the USA. Epidemiological studies on childhood and adulthood AD in different continents are still needed, especially on the incidence of AD during adulthood.
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| 18. |
- Chalmers, J. R., et al.
(författare)
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Report from the fifth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)
- 2018
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Ingår i: British Journal of Dermatology. - : John Wiley & Sons. - 0007-0963 .- 1365-2133. ; 178:5, s. E332-E341
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Tidskriftsartikel (refereegranskat)abstract
- This is the report from the fifth meeting of the Harmonising Outcome Measures for Eczema initiative (HOME V). The meeting was held on 12-14 June 2017 in Nantes, France, with 81 participants. The main aims of the meeting were (i) to achieve consensus over the definition of the core domain of long-term control and how to measure it and (ii) to prioritize future areas of research for the measurement of the core domain of quality of life (QoL) in children. Moderated whole-group and small-group consensus discussions were informed by presentations of qualitative studies, systematic reviews and validation studies. Small-group allocations were performed a priori to ensure that each group included different stakeholders from a variety of geographical regions. Anonymous whole-group voting was carried out using handheld electronic voting pads according to pre-defined consensus rules. It was agreed by consensus that the long-term control domain should include signs, symptoms, quality of life and a patient global instrument. The group agreed that itch intensity should be measured when assessing long-term control of eczema in addition to the frequency of itch captured by the symptoms domain. There was no recommendation of an instrument for the core outcome domain of quality of life in children, but existing instruments were assessed for face validity and feasibility, and future work that will facilitate the recommendation of an instrument was agreed upon.
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| 19. |
- Chalmers, J. R., et al.
(författare)
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Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)
- 2016
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 0007-0963 .- 1365-2133. ; 175:1, s. 69-79
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Tidskriftsartikel (refereegranskat)abstract
- This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmo, Sweden on 23-24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and quality of life for the HOME core outcome set for atopic eczema (AE). Following presentations, which included data from systematic reviews, consensus discussions were held in a mixture of whole group and small group discussions. Small groups were allocated a priori to ensure representation of different stakeholders and countries. Decisions were voted on using electronic keypads. For the patient-reported symptoms, the group agreed by vote that itch, sleep loss, dryness, redness/inflamed skin and irritated skin were all considered essential aspects of AE symptoms. Many instruments for capturing patient-reported symptoms were discussed [ including the Patient-Oriented SCOring Atopic Dermatitis index, Patient-Oriented Eczema Measure (POEM), Self-Administered Eczema Area and Severity Index, Itch Severity Scale, Atopic Dermatitis Quickscore and the Nottingham Eczema Severity Score] and, by consensus, POEM was selected as the preferred instrument to measure patient-reported symptoms. Further work is needed to determine the reliability and measurement error of POEM. Further work is also required to establish the importance of pain/soreness and the importance of collecting information regarding the intensity of symptoms in addition to their frequency. Much of the discussion on quality of life concerned the Dermatology Life Quality Index and Quality of Life Index for Atopic Dermatitis; however, consensus on a preferred instrument for measuring this domain could not be reached. In summary, POEM is recommended as the HOME core outcome instrument for measuring AE symptoms.
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| 20. |
- Chalmers, J. R., et al.
(författare)
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Report from the third international consensus meeting to harmonise core outcome measures for atopic eczema/dermatitis clinical trials (HOME)
- 2014
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 171:6, s. 1318-1325
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Tidskriftsartikel (refereegranskat)abstract
- This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6-7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial: clinical signs, patient-reported symptoms, long-term control and quality of life. Formal presentations and nominal group techniques were used at this working meeting, attended by 56 voting participants (31 of whom were dermatologists). Significant progress was made on the domain of clinical signs. Without reference to any named scales, it was agreed that the intensity and extent of erythema, excoriation, oedema/papulation and lichenification should be included in the core outcome measure for the scale to have content validity. The group then discussed a systematic review of all scales measuring the clinical signs of eczema and their measurement properties, followed by a consensus vote on which scale to recommend for inclusion in the core outcome set. Research into the remaining three domains was presented, followed by discussions. The symptoms group and quality of life groups need to systematically identify all available tools and rate the quality of the tools. A definition of long-term control is needed before progress can be made towards recommending a core outcome measure.
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| 21. |
- Friman, Göran, et al.
(författare)
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Samband munhälsa och allmän hälsa
- 2019
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Ingår i: Hälsan i Värmland. - : Karlstads universitet och Landstinget i Värmland.
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 22. |
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| 23. |
- Howells, L., et al.
(författare)
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Defining and measuring 'eczema control' : an international qualitative study to explore the views of those living with and treating atopic eczema
- 2019
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : John Wiley & Sons. - 0926-9959 .- 1468-3083. ; 33:6, s. 1124-1132
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Tidskriftsartikel (refereegranskat)abstract
- Background Atopic eczema (also known as eczema) is a chronic, inflammatory skin condition that often afflicts patients' health and well-being. The Harmonising Outcome Measures for Eczema (HOME) initiative recommends that 'long-term control of eczema' is measured in all clinical trials 3 months or longer in duration. However, little has been published on what eczema control means to those living with or treating atopic eczema. Objectives To (i) develop understanding of what eczema control means to patients, carers and clinicians and (ii) explore the feasibility and acceptability of different ways of measuring eczema control in the long term. Methods Online focus groups explored patients/carers experiences in the UK, the United States, the Netherlands, France, Sweden and Japan, and an international online survey gathered views of clinicians. The framework method was used to analyse the focus groups, and thematic analysis was used to analyse survey data. All findings were integrated into a theoretical framework to create overarching themes that cut across these diverse groups. Results Eight focus groups with patients (16 years+) and eight groups with carers of children took place (N = 97). Sixty-two people took part in the survey. Eczema control was described as a multifaceted construct involving changes in disease activity, the treatment and management of the condition and psychological, social and physical functioning. Patient/carer measurement allows personal accounts and frequent measurement, whilst clinician measurement was deemed less subjective. The burden on patients/carers and issues for analysing and interpreting data should be considered. Conclusions This study formed the basis of judging the content validity and feasibility of measurement instruments/methods to assess control of eczema in clinical trials. This online approach to an international qualitative study is an example of how core outcome set developers with limited resources can engage with multiple stakeholder groups on an international basis to inform consensus meeting discussions.
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| 24. |
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| 25. |
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| 26. |
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| 27. |
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| 28. |
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| 29. |
- Jamil, Wasim, et al.
(författare)
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Incidence Rate of Hand Eczema in Different Occupations : A Systematic Review and Meta-analysis
- 2022
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Ingår i: Acta Dermato-Venereologica. - : Taylor & Francis. - 0001-5555 .- 1651-2057. ; 102
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Forskningsöversikt (refereegranskat)abstract
- Hand eczema is a chronic disease that results in economic and psychosocial burdens. The aim of this study was to systematically review and assess the magnitude of the association between exposure related to occupations and the incidence rate of hand eczema. A systematic search in PubMed, EMBASE, CINAHL and Cochrane databases, from inception to September 2017, of full-text observational studies reporting incident cases of hand eczema during employment, and a supplementary search in PubMed to September 2020, were conducted. Among 2,417 screened abstracts, 15 studies fulfilled the inclusion criteria. Incidence rates were reported per 100 person-years. Based on the Newcastle-Ottawa Scale, 9 studies were good quality, 2 fair quality, and 4 poor quality. Hairdressers had a high incidence of hand eczema of 21.4 (95% confidence interval [CI] 15.3-27.4), as did nurses, 16.9 (95% CI 11.2-22.7), and metal workers, 12.4 (95% CI 3.5-21.3). Hairdressers were predominantly women, and metal worker were predominantly men. Office occupations had an incidence rate of hand eczema of 4.9 (95% CI 1.2-9.6). The high risk of hand eczema for hairdressers, nurses, and metal workers, should be considered by healthcare policymakers. Even occupations with low irritant profile, such as office workers, were at risk of developing hand eczema, and more occupations should be investigated regarding the related risk of developing hand eczema.
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| 30. |
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| 31. |
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| 32. |
- Leitenberger, Sabra, et al.
(författare)
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Validation of a Parent-Reported Diagnostic Instrument in a U.S. Referral Population : The Childhood Eczema Questionnaire
- 2017
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Ingår i: Pediatric Dermatology. - : Wiley. - 0736-8046. ; 34:4, s. 398-401
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Tidskriftsartikel (refereegranskat)abstract
- Background/Objectives: There is a paucity of validated tools for diagnosing atopic dermatitis (AD) in very young children that do not rely on clinical evaluation. The Childhood Eczema Questionnaire (CEQ)-a diagnostic tool for AD in children younger than 2 years that a caretaker can complete-was recently validated in Sweden. The objective of this study was to validate the tool in a U.S. population. As a substudy, we added an additional question that was independently assessed. Methods: Children younger than 2 years old were recruited from a dermatology clinic. Their caretakers completed a questionnaire containing the original tool's three questions as well as a fourth question that increased the time frame measured from 1 week to 6 months. Questionnaires with all "yes" answers were considered positive and were compared with a dermatologist diagnosis of AD. Results: A total of 283 subjects were recruited. The first three questions (the original CEQ) predicted a positive diagnosis of AD with a sensitivity of 0.72 (95% confidence interval [CI] 0.58, 0.82) and a specificity of 0.93 (95% CI 0.87, 0.95). In a separate analysis we included the first two questions and the fourth question and found that the sensitivity increased to 0.82 (95% CI 0.69, 0.90) with a specificity of 0.89 (95% CI 0.83, 0.93). Conclusion: This study validates a novel parental questionnaire for the diagnosis of AD in children younger than 2 years in a U.S. clinic population.
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| 33. |
- Löfvander, Monica, et al.
(författare)
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Chronic Severe Sleep Problems among Non-Nordic Immigrants : Data from a Population Postal Survey in Mid-Sweden
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:21
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Tidskriftsartikel (refereegranskat)abstract
- Sweden has a large population of both recent and established immigrants with high prevalence of risk factors for ill health. Here, we aimed to explore the prevalence of chronic severe sleep problems (CSSP) among non-Nordic-born persons, and to evaluate the risk for CSSP when fully adjusted for covariates. Our additional hypothesis was that lengthier time since immigration would reduce the risk for CSSP. We used data from a large-population postal survey covering life and health issues among inhabitants in mid-Sweden. Relationship between different countries of birth and CSSP was assessed in logistic analyses for more severe and longstanding pain, sex, employment, mental disability, gastrointestinal problems, and length of stay (short, middle time, and up to ten years of stay). Persons of non-Nordic birth reported significantly more often CSSP, regardless of short or long-term stay. Our findings indicate that non-Nordic birth, regardless of residence time and covariates, was an independent and significant predictor for CSSP. The findings may contribute to increasing awareness in healthcare personnel to recognize chronic sleep problems among immigrant patients. Thus, our study might contribute to developing strategies to enhance health for minorities.
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| 34. |
- Mischo, Meike, et al.
(författare)
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Similar appearance, different mechanisms : xerosis in HIV, atopic dermatitis and ageing
- 2014
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Ingår i: Experimental dermatology. - : Wiley. - 0906-6705 .- 1600-0625. ; 23:6, s. 446-448
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Tidskriftsartikel (refereegranskat)abstract
- Xerosis is one of the most common dermatologic disorders occurring in the elderly and in patients with atopic dermatitis (AD) and human immunodeficiency virus (HIV) infection. Xerosis has been linked to an impaired skin barrier function of the stratum corneum. Using Raman microspectroscopy, we concentrated on deeper skin layers, viable epidermis and dermis of 47 volunteers and associated molecular alterations to the evolution of xerosis and the skin barrier, for example, lipid, water and antioxidant content. A decrease in lipids within the viable epidermis is found for elderly and HIV-patients. Lipid and water values of AD patients and their healthy reference group are similar. Decreases in lipids and simultaneous increases in water are found in the dermis for HIV and AD patients in comparison to their healthy reference groups. Excessive levels of epidermal carotenoids, mainly lycopene, in HIV-patients were found potentially leading to adverse effects such as premature skin ageing.
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| 35. |
- Ortsäter, Gustaf, et al.
(författare)
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Societal economic burden and determinants of costs for atopic dermatitis
- 2022
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Ingår i: JEADV Clinical Practice. - : John Wiley & Sons. - 2768-6566. ; 1:4, s. 326-343
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Tidskriftsartikel (refereegranskat)abstract
- Background: Atopic dermatitis (AD) is a common inflammatory skin disease while the economic burden of AD by severity is not adequately understood.Objective: To estimate the societal economic burden and to identify cost determinants of AD.Methods: In this population-based, controlled cohort study in Sweden, patients with AD were identified through diagnosis codes in primary or secondary care or by dispensed medications using administrative healthcare registers. A reference cohort without AD was randomly selected from the general population. Healthcare costs (primary/secondary care visits and dispensed medication) and indirect costs (care for sick children and long-term sick leave for adults) were calculated annually. AD patients were stratified by age (paediatric [age < 12], adolescent [12 ≤ age < 18] or adult [age ≥ 18]), and severity (mild-to-moderate [M2M] or severe AD) and matched to the reference cohort.Results: Compared with controls, the annual mean per-patient direct healthcare costs in the first year following diagnosis were €941 and €1259 higher in paediatric patients with M2M and severe AD, respectively. In the first year following diagnosis, the mean indirect cost for care of sick children was €69 and €78 higher per patient in M2M and severe AD, respectively. In adolescents with M2M and severe AD, direct healthcare costs were €816 and €1260 higher, respectively. In adults, healthcare costs were €1583 and €2963 higher in patients with M2M and severe AD, respectively and indirect costs were €148 and €263 higher compared with controls. Management of comorbid medical conditions was an important driver of incremental healthcare costs. Total incremental societal economic burden for AD was €351 and €96 million higher in patients with M2M and severe AD, respectively, compared to controls.Conclusion: AD is associated with a significant societal economic burden primarily driven by the cost burden of M2M AD due to the high prevalence of this population. Regardless of severity level, management of non-AD comorbidities is a major driver of total costs.
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| 36. |
- Ortsäter, Gustaf, et al.
(författare)
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Validation of Patient Identification Algorithms for Atopic Dermatitis Using Healthcare Databases
- 2022
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Ingår i: Dermatology and Therapy. - : Adis. - 2193-8210 .- 2190-9172. ; 12, s. 545-559
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The use of real-world data offers a possibility to perform large-scale epidemiological studies in actual clinical settings. Despite their many advantages, administrative databases were not designed to be used in research, and the validation of diagnoses and treatments in administrative databases is needed. The primary objective of this study was to validate an existing algorithm based on dispensed prescriptions and diagnoses of skin conditions to identify pediatric patients with atopic dermatitis (AD), using a diagnosis of AD in primary care as a gold standard.Methods: Retrospective observational data were collected from nation-wide secondary care and pharmacy-dispensed medication databases and two regional primary care databases in Sweden. An existing algorithm and a Modified algorithm, using skin-specific diagnoses from secondary care and/or pharmacy-dispensed prescriptions to identify patients with AD, were assessed. To verify the presence of AD, diagnoses from primary care were used in the base case and complemented with diagnoses from secondary care in a sensitivity analysis.Results: The sensitivity (30.0%) and positive predictive value (PPV) (40.7%) of the existing algorithm were low in the pediatric patient population when using primary care data only but increased when secondary care visits were also included in the Modified algorithm (sensitivity, 62.1%; PPV, 66.3%). The specificity of the two algorithms was high in both the base case and sensitivity analysis (95.1% and 94.1%). In the adult population, sensitivity and PPV were 20.4% and 8.7%, respectively, and increased to 48.3% and 16.9% when secondary care visits were also included in the Modified algorithm.Conclusion: The Modified algorithm can be used to identify pediatric AD populations using primary and secondary administrative data with acceptable sensitivity and specificity, but further modifications are needed to accurately identify adult patients with AD.
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| 37. |
- Sadeghi, Sara, et al.
(författare)
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A SYSTEMATIC REVIEW OF ELECTRONIC HEALTH TOOLS FOR ATOPIC DERMATITIS
- 2022
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Ingår i: Acta Dermato-Venereologica. - : Medical journals Sweden AB. - 0001-5555 .- 1651-2057. ; 102:Suppl. 223, s. 54-54
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Atopic dermatitis (AD) education empowers patients and their caregivers with knowledge and is critical to successful management. AD education is often delivered by health care providers to individual patients/families or to groups but barriers to access leave some AD sufferers without this critical component of AD management. Electronic health (e-Health) tools for AD could bridge this gap. 1. Identify current e-Health tools for AD; 2. For each e-Health tool, summarize and assess: a. Objective/purpose, b. Informational content, c. Effect on knowledge about AD, d. Validity, and e. Delivery and feasibility. A systematic review has been performed to evaluate all available E-health tools for children with AD, parents of the children with AD, adults with AD, and health care professionals working in the related fields using Medline, EMBASE, Cochrane, CINAHL, PsycINFO, and Google Scholar. Data collection elements include e-Health tool features (platform, purpose, content, delivery) and target audience factors (AD disease course, type and duration of treatment, severity, quality of life impact). We will assess the validity, feasibility, and effect on knowledge about AD for each tool. Results will be stratified by the target audience. Data analysis is ongoing and will be presented. By identifying gaps that exist in the content of currently available e-Health tools, future work can address the identified unmet needs.
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| 38. |
- Schmitt, Jochen, et al.
(författare)
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Assessment of clinical signs of atopic dermatitis: A systematic review and recommendation
- 2013
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Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier BV. - 1097-6825 .- 0091-6749. ; 132:6, s. 1337-1347
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Forskningsöversikt (refereegranskat)abstract
- Background: Clinical signs are a core outcome domain for atopic dermatitis (AD) trials. The current lack of standardization of outcome measures in AD trials hampers evidence-based communication. Objective: We sought to provide evidence-based recommendations for the measurement of clinical signs in AD trials and to inform the Harmonising Outcome Measures for Atopic Dermatitis Initiative. Methods: We conducted a systematic review on measurement properties of outcome measurements for clinical signs of AD. We systematically searched MEDLINE and Embase (until October 1, 2012) for validation studies on instruments measuring the clinical signs of AD. Grading of the truth, discrimination, and feasibility of scales; methodological study quality; and recommendations were based on predefined criteria. Results: Sixteen eligible instruments were identified, of which 2 were best validated. The Eczema Area and Severity Index has adequate validity, responsiveness, internal consistency, intraobserver reliability, and intermediate interobserver reliability but unclear interpretability and feasibility. The Severity Scoring of Atopic Dermatitis Index (SCORAD) has adequate validity, responsiveness, interobserver reliability, and interpretability and unclear intraobserver reliability. Only the objective SCORAD (ie, the clinical signs domain of the SCORAD) is internally consistent. The Six Area, Six Sign Atopic Dermatitis Index severity score and Three Item Severity Score fulfill some quality criteria, but the performance in other required measurement properties is unclear. The Patient-oriented Eczema Measure is reliable and responsive but has inadequate content validity to assess clinical signs of AD. The remaining 11 scales have either (almost) not been validated or performed inadequately. Conclusions: The Eczema Area and Severity Index and SCORAD are the best instruments to assess the clinical signs of AD. The other 14 instruments identified are (currently) not recommended because of unclear or inadequate measurement properties.
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| 39. |
- Schmitt, J., et al.
(författare)
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Efficacy and tolerability of proactive treatment with topical corticosteroids and calcineurin inhibitors for atopic eczema: systematic review and meta-analysis of randomized controlled trials
- 2011
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 164:2, s. 415-428
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Tidskriftsartikel (refereegranskat)abstract
- P>Background Long-term low-level topical anti-inflammatory therapy has been suggested as a new paradigm in the treatment of atopic eczema (AE). Objectives To determine the efficacy and tolerability of topical corticosteroids and calcineurin inhibitors for flare prevention in AE. Methods Systematic review of randomized controlled trials reporting efficacy of topical corticosteroids and/or topical calcineurin inhibitors for flare prevention in AE. Identification of relevant articles by systematic electronic searches (Cochrane Library, Medline) supplemented by hand search. Primary efficacy endpoint: proportion of participants experiencing at least one flare during proactive anti-inflammatory treatment. Relative risks (RRs) and corresponding 95% confidence intervals (CIs) were calculated and pooled by pharmaceutical agent using random-effects meta-analysis. Sensitivity analysis included meta-regression to explore the influence of study-specific covariates. Results Nine articles reporting on eight vehicle-controlled trials were included. Three, four and one trial(s) evaluated proactive therapy with topical tacrolimus, fluticasone propionate and methylprednisolone aceponate, respectively. Each agent under study was more efficacious to prevent flares than vehicle. Meta-analysis suggested that topical fluticasone propionate (RR 0 center dot 46, 95% CI 0 center dot 38-0 center dot 55) may be more efficacious to prevent disease flares than topical tacrolimus (RR 0 center dot 78, 95% CI 0 center dot 60-1 center dot 00). Meta-regression indicated robustness of these findings. Proactive anti-inflammatory therapy was generally well tolerated. The trials identified, however, do not allow firm conclusions about long-term safety. Conclusions Vehicle-controlled trials indicate efficacy of proactive treatment with tacrolimus, fluticasone propionate and methylprednisolone aceponate to prevent AE flares. Indirect evidence from vehicle-controlled trials suggests that twice weekly application of the potent topical corticosteroid fluticasone propionate may be more efficacious to prevent AE flares than tacrolimus ointment. Head to head trials should be conducted to confirm these results. Future studies are also needed to evaluate the long-term safety of proactive treatment of AE.
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| 40. |
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| 41. |
- Sigurdardottir, Gunnthorunn, et al.
(författare)
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Cross-Cultural Validation of the RECAP of Atopic Eczema Question-naire in a Swedish Population
- 2024
-
Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden. - 0001-5555 .- 1651-2057. ; 104
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Tidskriftsartikel (refereegranskat)abstract
- A Swedish translation of the patient-reported outcome measure for assessing long-term control of atopic dermatitis, Recap of atopic eczema (RECAP), has not been validated. Cross-cultural translation and multi-centre validation of the translated RECAP questionnaire were therefore performed. Disease severity was assessed using the validated Investigator Global Assessment Scale for atopic dermatitis (vIGA-ADTM). The Swedish RECAP was completed by 208 individuals aged 16 years or older with a median age of 36 years (interquartile range [IQR] 27-48). The participants considered the questionnaire suitable for assessing eczema control. The median RECAP score (range 0-28) was 12 (IQR 5-19). The mean and median vIGA-ADTM scores (range 0-4) were 2 (standard deviation [SD] 2) and 3 (IQR 2-4), respectively. A correlation between RECAP and the vIGA-ADTM was observed (p < 0.001). There was no significant change in scores for participants who answered the questionnaire twice within 14 days. Over time, improved or worsened eczema, as evaluat-ed by vIGA-ADTM, affected RECAP scores significantly (p < 0.001). The study suggests that RECAP can assess AD control in a Swedish clinical setting and shows -acceptable reliability.
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| 42. |
- Sigurdardottir, Gunnthorunn, et al.
(författare)
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Cross-Cultural Validation of the RECAP of Atopic Eczema Question-naire in a Swedish Population
- 2024
-
Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden. - 1651-2057 .- 0001-5555. ; 104
-
Tidskriftsartikel (refereegranskat)abstract
- A Swedish translation of the patient-reported outcome measure for assessing long-term control of atopic dermatitis, Recap of atopic eczema (RECAP), has not been validated. Cross-cultural translation and multi-centre validation of the translated RECAP questionnaire were therefore performed. Disease severity was assessed using the validated Investigator Global Assessment Scale for atopic dermatitis (vIGA-ADTM). The Swedish RECAP was completed by 208 individuals aged 16 years or older with a median age of 36 years (interquartile range [IQR] 27-48). The participants considered the questionnaire suitable for assessing eczema control. The median RECAP score (range 0-28) was 12 (IQR 5-19). The mean and median vIGA-ADTM scores (range 0-4) were 2 (standard deviation [SD] 2) and 3 (IQR 2-4), respectively. A correlation between RECAP and the vIGA-ADTM was observed (p<0.001). There was no significant change in scores for participants who answered the questionnaire twice within 14 days. Over time, improved or worsened eczema, as evaluat-ed by vIGA-ADTM, affected RECAP scores significantly (p<0.001). The study suggests that RECAP can assess AD control in a Swedish clinical setting and shows -acceptable reliability.
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| 43. |
- Smirnova, Jevgenija, 1988-, et al.
(författare)
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Associations of self-reported atopic dermatitis with comorbid conditions in adults : a population-based cross-sectional study
- 2020
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Ingår i: BMC Dermatology. - : BioMed Central (BMC). - 1471-5945. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The objective of this study was to investigate the relationships between atopic dermatitis (AD) and other common chronic health conditions in adults.Methods: A cross-sectional survey was sent to a randomly selected population sample of 78,004 adults in Sweden. The questionnaires included measures of self-reported physical and mental health. Binary and multinomial logistic regression were used to examine the associations of AD with common chronic health conditions and psychological wellbeing.Results: AD was self-reported by 4,175 respondents, representing almost 14% of the study population of 34,313 adults. Our results showed positive associations between AD and chronic health disorders, including conditions of the oral cavity: chronic obstructive pulmonary disease (adjusted odds ratio [aOR] = 1.58, 95% confidence interval [CI]: 1.30 to 1.92), asthma (aOR = 2.13, 95% CI: 1.91 to 2.38), mild recurrent gastrointestinal symptoms (adjusted relative risk ratio [aRRR] = 1.78, 95% CI: 1.64 to 1.92), high blood pressure (aOR = 1.16, 95% CI: 1.06 to 1.26), obesity (aOR = 1.34, 95% CI: 1.23 to 1.47), mild joint pain (aRRR = 1.47, 95% CI: 1.35 to 1.61), mild headache or migraine (aRRR = 1.50, 95% CI: 1.38 to 1.64), caries (aOR = 1.25, 95% CI: 1.04 to 1.49), bleeding gums (aOR = 1.69, 95% CI: 1.38 to 2.08), periodontitis (aOR = 1.42, 95% CI: 1.13 to 1.77), sensitive teeth (aOR = 1.57, 95% CI: 1.35 to 1.82), and dry mouth (aOR = 1.52, 95% CI: 1.33 to 1.74). Adjustment for asthma and depression attenuated the magnitude of the associations between AD and the study outcomes. AD was also associated with poorer general psychological wellbeing.Conclusions: Adults reporting AD may be at increased risk of chronic disorders and decreased psychological wellbeing. Physicians should recognize that individuals with severe AD and those with comorbid asthma or depression may be especially vulnerable.
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| 44. |
- Smith, Kelsi A., et al.
(författare)
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Atopic dermatitis and cognitive function : a sibling comparison study among males in Sweden
- 2024
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Ingår i: British Journal of Dermatology. - : Wiley-Blackwell Publishing Inc.. - 0007-0963 .- 1365-2133. ; 190:4, s. 592-593
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Tidskriftsartikel (refereegranskat)abstract
- A previous study indicated that atopic dermatitis (AD) was associated with better cognitive function in males during late adolescence. This association was examined among 2 021 369 males who had a medical examination and cognitive function testing during a military conscription assessment in late adolescence in Sweden. Sibling-comparison analysis to tackle confounding indicated that AD is associated with poorer cognitive function, suggesting AD in childhood is detrimental for the development of cognitive function.
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| 45. |
- Sterner, Therese, et al.
(författare)
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IgE sensitization in a cohort of adolescents in southern Sweden and its relation to allergic symptoms
- 2019
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Ingår i: Clinical and Molecular Allergy. - : Springer Science and Business Media LLC. - 1476-7961. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is a strong and consistent association between IgE sensitization and allergy, wheeze, eczema and food hypersensitivity. These conditions are also found in non-sensitized humans, and sensitization is found among individuals without allergy-related diseases. The aim of this study was to analyse the sensitization profile in a representative sample of the population, and to relate patterns of allergens and allergen components to allergic symptoms. Methods: A population of 195 adolescents took part in this clinical study, which included a self-reported questionnaire and in vitro IgE testing. Results: Sensitization to airborne allergens was significantly more common than sensitization to food allergens, 43% vs. 14%, respectively. IgE response was significantly higher in airborne allergens among adolescents with rhinitis (p < 0.001) and eczema (p < 0.01). Among 53 children with allergic symptoms according to the questionnaire, 60% were sensitized. Sensitization to food allergens was found among those with rhinitis, but only to PR-10 proteins. None of the participants had IgE to seed storage proteins. Conclusion: The adolescents in this study, taken from a normal Swedish population, were mainly sensitized to grass pollen and rarely to specific food allergens. The major grass pollen allergen Phl p 1 was the main sensitizer, followed by Cyn d 1 and Phl p 2. Sixty-one percent reporting any allergic symptom were sensitized, and the allergen components associated with wheeze and rhinoconjunctivitis were Fel d 4, Der f 2 and Can f 5.
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| 46. |
- Sterner, Therese, et al.
(författare)
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Physical Activity and Health Related Quality of Life in Relation to Allergic Disease among Adolescents: : Results from a Crosssectional Study
- 2021
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Ingår i: Journal of Pulmonary Medicine. ; 5:1
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The overall aim of was to investigate the impact of self-reportedallergic disease on physical activity (PA) and health-related quality oflife (HRQoL) among adolescents.Methods: A cross-sectional analysis of 1 181 adolescents aged 13-14years (251 with current allergic disease), participating in the baselineinvestigation of the Southern Sweden allergy cohort, including a surveywith questions on wheeze, rhinoconjunctivitis, eczema, PA and HRQoL.Results: Boys were more physically active than girls (mean total PAscore 6.47 vs. 5.98, possible range 3-9). There were no noticeabledifferences in PA among adolescents with and without allergic disease(p ≥ 0.3 in all comparisons). Clear differences in HRQoL wereobserved depending on current or previous symptoms. In particular,adolescents with both current asthma and rhinoconjunctivitis scoredlower HRQoL than the others.Conclusions: Our results support the importance of havinghealth care measures directed towards promoting PA amongadolescents with allergic disease as part of their treatment.The noticeable impaired HRQoL during pollen season in relationto self-reported symptoms Observed in the present study warrantsfurther attention by health care.Keywords: Adolescent health; Allergy; Asthma; Physical activity;Health-related quality of lifeAbbreviations: The International Study of Asthma and Allergies inChildhood (ISAAC); The international Physical Activity Questionnaire(IPAQ); Health Related Quality of Life (HRQoL); Pediatric AllergicDisease Quality of Life Questio
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| 47. |
- Theodosiou, Grigorios, et al.
(författare)
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Burden of Atopic Dermatitis in Swedish Adults : A Population-based Study
- 2019
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Ingår i: Acta Dermato-Venereologica. - : Society for Publication of Acta Dermato-Venereologica. - 0001-5555 .- 1651-2057. ; 99:11, s. 964-970
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Tidskriftsartikel (refereegranskat)abstract
- The burden of atopic dermatitis (AD) was assessed. A population-based, cross-sectional questionnaire study was performed among 34,313 Swedish adults in 2017. The prevalence of AD was 14%. Adults with mild AD had an increased relative risk ratio (RRR) of severe depression (aRRR 1.78, 95% confidence interval (95% CI) 1.50-2.12) and anxiety (aRRR 1.97, 95% CI 1.69-2.30), which was higher for severe AD (aRRR 6.22 95% CI 4.60-8.42, aRRR 5.62 95% CI 4.10-7.71, respectively). Persons with severe AD were less likely to have a university degree (aRRR 0.55, 95% CI 0.34-0.90) and more likely to have a lower annual income (238,000-324,000 SEK: aRRR 0.51, 95% CI 0.39-0.77; 325,000 SEK or more 0.36; 0.25-0.58) compared with individuals without AD. These results suggest that AD implies an increased prevalence of comorbid mental conditions and an adverse impact on academic achievement and work. These adverse associations increase substantially for patients with severe AD and comorbid asthma.
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| 48. |
- Theodosiou, Grigorios, et al.
(författare)
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Prevalence of Itch in German Schoolchildren : A Population-based Study
- 2022
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Ingår i: Acta Dermato-Venereologica. - : Taylor & Francis. - 0001-5555 .- 1651-2057. ; 102
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Tidskriftsartikel (refereegranskat)abstract
- Itch is a common symptom, but there is limited evidence on the prevalence of itch in children. The aim of this study was to assess the prevalence of itch in schoolchildren. A questionnaire was developed by experts in the field and based on a literature search. The questionnaire was applied in a pilot study of 25 consecutively selected paediatric patients and their parents. It confirmed the high content validity of the questionnaire, and the questionnaire was comparable to hospital records regarding chronic itch (n = 19, mean consistency 89.47%). The questionnaire was distributed among German schoolchildren in 9/12 randomly selected primary schools in Kiel, Germany. Of 1,722 invited students, 443 schoolchildren aged 6-10 years participated, and 26.2% (n = 116) reported itch. The prevalence of acute itch was 20.0% (n = 87), and 14.7% (n = 65) reported chronic itch. Reduced sleep and mood were often related to chronic itch. This study demonstrated that itch is a common symptom in German schoolchildren.
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| 49. |
- Thyssen, Jacob P., et al.
(författare)
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Comorbidity burden in adult atopic dermatitis : a population-based study
- 2024
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Ingår i: JEADV Clinical Practice. - : John Wiley & Sons. - 2768-6566. ; 3:1, s. 128-141
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Tidskriftsartikel (refereegranskat)abstract
- Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that has been shown to be associated with allergic comorbidities. However, studies examining comorbidities in patients with AD are incomplete, which may contribute to suboptimal care.Objectives: The objective was to compare the risk of developing different allergic and nonallergic comorbidities among adult patients with AD to that of a matched reference cohort in Sweden.Methods: This was a nationwide population-based cohort study using longitudinal data from primary and specialist care registers. AD patients were identified by confirmed diagnosis in primary or specialist care. A non-AD reference cohort was randomly drawn from the general population and matched 1:1 with the AD patients on age, gender, and geographical region. The risk of developing the following conditions was evaluated: asthma, food hypersensitivity, allergic rhinitis, neurological disorders, psychiatric disorders, infections, immunological & inflammatory disorders, type 1 diabetes (T1D), type 2 diabetes (T2D), endocrine & metabolic disorders, skeletal disorders, ocular disorders, cardiovascular diseases, and malignancies.Results: This study included 107,774 AD patients [mild-to-moderate (n = 92,413) and severe (n = 15,361)] and an equally-sized reference cohort. AD patients displayed a higher risk of developing comorbid conditions for all investigated categories, except for T1D, compared with the reference cohort. The highest risk compared with the reference cohort was observed for allergic comorbidities followed by immunological & inflammatory disorders (hazard ratio: 2.15) and infections (hazard ratio: 2.01). Patients with AD also had higher risk of developing multiple comorbidities (2 or more). The risk of comorbidity onset increased alongside AD severity and patients with active AD were associated with increased risk of comorbidity onset compared with patients in remission.Conclusions: AD patients are at an increased risk of developing many comorbidities that extend beyond allergic conditions. This study highlights the need for interdisciplinary follow-up of comorbidities in the management of AD patients to reduce overall patient burden.
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| 50. |
- Thyssen, Jacob P., et al.
(författare)
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Effect of abrocitinib vs. dupilumab on skin pain : an analysis of the phase 3 JADE COMPARE and JADE DARE trials
- 2023
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Ingår i: British Journal of Dermatology. - : Oxford University Press. - 0007-0963 .- 1365-2133. ; 188:Suppl. 3
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Skin pain is a common and bothersome symptom of atopic dermatitis (AD) that is associated with a substantial burden. To assess the efficacy of abrocitinib vs. dupilumab on skin pain in patients with moderate-to-severe AD. Data from patients aged ≥18 years who received oral abrocitinib 200 mg once daily (QD) or subcutaneous dupilumab 300 mg once every 2 weeks in combination with topical therapy in the phase 3 trials JADE COMPARE (NCT03720470) and JADE DARE (NCT04345367) were analysed. Data from patients who received abrocitinib 100 mg QD or placebo in the JADE COMPARE trial were also included in this analysis. Patients rated their skin pain using the Skin Pain Numerical Rating Scale (NRS) item of the Pruritus and Symptoms Assessment for Atopic Dermatitis (PSAAD) instrument [‘How painful was your skin over the past 24 h?’ on a scale from 0 (not painful) to 10 (extremely painful) ] in JADE COMPARE or the Skin Pain Numerical Rating Scale [SP-NRS, which queried patients for the severity of their ‘worst skin pain’ in the past 24 h on a scale from 0 (no skin pain) to 10 (worst skin pain imaginable)] in JADE DARE. Least squares mean (LSM) changes from baseline and proportions of patients who achieved a ≥4-point improvement from baseline in PSAAD skin pain score or SP-NRS were assessed through Week 16 (JADE COMPARE) or Week 26 (JADE DARE). The JADE COMPARE analysis (Skin Pain NRS item of the PSAAD) was performed post hoc, whereas the JADE DARE analysis (SP-NRS) was prespecified. At Week 2 of JADE COMPARE, LSM change from baseline in PSAAD skin pain score was greater with abrocitinib 200 mg [−2.8 (95% CI, −3.1, −2.5)] than with abrocitinib 100 mg [−2.1 (−2.3, −1.8)], dupilumab [−2.0 (−2.3, −1.8)], or placebo [−1.3 (−1.6, −0,9)]; improvements were sustained through Week 16 of treatment with abrocitinib 200 mg [−4.1 (−4.4, −3.8)], abrocitinib 100 mg [−3.3 (−3.6, −3.0)] and dupilumab [−4.0 (−4.2, −3.7)] compared with placebo [−1.8 (−2.2, −1.4)]. In JADE DARE, LSM change from baseline in SP-NRS was significantly greater with abrocitinib 200 mg vs. dupilumab at Week 2 [−3.7 (−3.9, −3.4) vs. −2.6 (−2.8, −2.3); P < 0.0001] and week 12 [−4.5 (−4.7, −4.2) vs. −4.0 (−4.3, −3.8); P = 0.0116]; no significant differences were observed between the treatment arms at Week 16 [−4.4 (−4.7, −4.2) vs. −4.2 (−4.4, −4.0); P = 0.16], Week 20 [−4.8 (−5.0, −4.5) vs. −4.5 (−4.7 vs. −4.2); P = 0.06] or Week 26 [−4.5 (−4.8, −4.3)] vs. −4.3 (−4.6, −4.1); P = 0.27]. The proportions of patients who achieved a ≥4-point improvement in PSAAD skin pain score at week 2 of JADE COMPARE were greater with abrocitinib 200 mg (43%) than with abrocitinib 100 mg (23%), dupilumab (24%) or placebo (14%). At Week 16, these proportions increased to 76% (abrocitinib 200 mg), 57% (abrocitinib 100 mg) and 70% (dupilumab) compared with placebo (29%). In JADE DARE, the proportions of patients who achieved a ≥4-point improvement in SP-NRS were significantly greater with abrocitinib 200 mg vs. dupilumab at Week 2 (58% vs. 36%; P < 0.0001) and Week 12 (71% vs. 61%; P = 0.0098) but not at subsequent timepoints. Similar to previous findings on the effect of abrocitinib on itch, these results suggest that abrocitinib 200 mg provides greater early skin pain relief in patients with moderate-to-severe AD compared with dupilumab, but the difference between the treatments diminishes with time. At earlier time points, skin pain improvement with abrocitinib 100 mg was similar to that with dupilumab.
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