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- Bergström, Göran, 1964, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 2. |
- Bergström, Göran, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - : Wolters Kluwer. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 3. |
- Adrian-Kalchhauser, I., et al.
(författare)
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The round goby genome provides insights into mechanisms that may facilitate biological invasions
- 2020
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Ingår i: BMC Biology. - : Springer Science and Business Media LLC. - 1741-7007. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The invasive benthic round goby (Neogobius melanostomus) is the most successful temperate invasive fish and has spread in aquatic ecosystems on both sides of the Atlantic. Invasive species constitute powerful in situ experimental systems to study fast adaptation and directional selection on short ecological timescales and present promising case studies to understand factors involved the impressive ability of some species to colonize novel environments. We seize the unique opportunity presented by the round goby invasion to study genomic substrates potentially involved in colonization success. Results We report a highly contiguous long-read-based genome and analyze gene families that we hypothesize to relate to the ability of these fish to deal with novel environments. The analyses provide novel insights from the large evolutionary scale to the small species-specific scale. We describe expansions in specific cytochrome P450 enzymes, a remarkably diverse innate immune system, an ancient duplication in red light vision accompanied by red skin fluorescence, evolutionary patterns of epigenetic regulators, and the presence of osmoregulatory genes that may have contributed to the round goby's capacity to invade cold and salty waters. A recurring theme across all analyzed gene families is gene expansions. Conclusions The expanded innate immune system of round goby may potentially contribute to its ability to colonize novel areas. Since other gene families also feature copy number expansions in the round goby, and since other Gobiidae also feature fascinating environmental adaptations and are excellent colonizers, further long-read genome approaches across the goby family may reveal whether gene copy number expansions are more generally related to the ability to conquer new habitats in Gobiidae or in fish.
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| 4. |
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| 5. |
- Blomberg, Karin, 1970-, et al.
(författare)
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Physical touch in nursing and nursing education – an integrative review
- 2020
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Physical touch is a basic need of all people, regardless of age or life situation. It can provide security, well-being and belonging. But negative perceived physical touch can generate emotions such as fear, vulnerability and perceived as violations. As a consequent of the #metoo movement in the fall of 2017, it’s a risk that physical contact and especially physical touch are avoided by professions where it’s central. For example, in the context of education, studies show that sports teachers in many countries have become more cautious and avoid having physical contact with students due not to being misinterpreted as negative touch (Fletcher, 2013; Öhman, 2016; Piper, Garratt & Taylor, 2013). In healthcare, caregivers who use physical touch in their work with disabled and elderly people have also become insecure and worried that they may be misunderstood (Bergstrand, 2018). A review shows that healthcare professionals see physical touch as part of the work but want to be the initiator of the contact, not that it should be initiated by the patients (Kelly et al. 2018).The use of physical touch in healthcare is also affected by the need to avoid contamination and widespread of infections agents, a question with extra relevance in the light of the Covid-19 pandemic.There is currently a lack of knowledge about how physical touch is experienced and used. As a first step is to increase the knowledge and understanding of how physical touch is experienced and used in healthcare by mapping studies explored physical touch both in daily care but also from the perspective of nursing students. With increased knowledge, a basis for developing interventions/teaching modules can be generated.
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| 6. |
- Brorson, Lars-Olov, et al.
(författare)
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Fifty years’ follow up of childhood epilepsy - medical and psycho-social outcomes
- 2020
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Konferensbidrag (refereegranskat)abstract
- Purpose: To describe the long-term prognosis of childhood epilepsy in general, with special emphasis on seizure remission, relapse, medication, associated neurological impairment, mortality rate, cause of death, the experience of a childhood diagnosis of epilepsy and its consequences for the experiences of daily life.Methods: A prospective longitudinal study on a population-based total cohort of 195 children with epilepsy in 1962-1964. Data were collected from medical records, questionnaires and additional interviews were conducted. Results: Follow-up data from 94% of the initial cohort showed the best long-term prognosis for seizure freedom for children with no intellectual or neurological impairment. These children had later seizure onset, shorter total duration of epilepsy and, they were more often medication free. Generalized, rather than focal, epilepsy had a better outcome. Ninety per cent, with onset during the inclusion period 1962-1964, were seizure-free after 50 years. No one in this group died in SUDEP. The standardized mortality ratio (SMR) was 2. 61. Death at young age was due to neurological impairment or epilepsy-related conditions whereas later deaths often followed non–epilepsy-related conditions. Few persons reported that the childhood diagnosis of epilepsy had affected their choice of education, work or leisure activities. However, 20% reported that the diagnosis had caused problems in school or at work and had restricted their activities of daily living. Almost all reported no anxiety (82%) and no depression (90%). The interviews revealed a good balance between ‘Controlling and managing the situation’ and ‘Not being restricted by the condition’.Conclusion: This 50-year, long-term, follow-up of a cohort of persons with childhood epilepsy in general demonstrates a better outcome for seizure freedom, relapses and minor consequences for education, work and leisure activities than earlier reported. Most of the participants had developed strategies to manage their situation.
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| 7. |
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| 8. |
- Chaplin, John, et al.
(författare)
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Translation and cross-cultural adaptation of ten pediatric PROMIS (R) item banks into Swedish
- 2020
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Ingår i: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 29:Suppl. 1, s. S175-S176
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aims: We describe the first large-scale translation and cross-cultural adaptation into Swedish of ten pediatric PROMIS item banks: Anger (9-items), Anxiety (15-items), Depressive symptoms (14-items) ,Cognitive function (43-items), Family relationships (47-items), Fatigue (25-items), Pain interference (20-items), Peer relationships (15-items), Physical activity (10-items), Positive affect (38-items) and Profile-25.Methods: ISPOR recommendations were followed. There view was carried out in multi-professional small groups of twelve health-related quality-of-life researchers, pediatric clinicians and linguists from different geographical regions in a two-day workshop. Cross-cultural comparisons were made to identify problems and to produce a consensus-derived version, which was then back translated, evaluated, and revised where necessary. Prior translations and review of version 1 of the item-banks were utilized (4 item-banks). There viewed item-banks were presented in four sessions of cognitive debriefings over 2 years with twenty-two young people (8-18 years) in three dialectically different regions of Sweden before finalization.Results: One hundred and seventy-five items were translated. All item banks had translation issues to be resolved. Sixty-six items (38%) needed resolution at the cognitive debriefing stage, the majority of issues were in the area of unclear definitions in the English items (35 items), followed by language and cultural differences (16 issues) and age appropriate language (14 items). The cultural issues identified were 1) identifying suitable word alternative to match the English where Swedish lacked the volume of words to choose from; 2) adjectival agreement on intensity levels of the concept to be translated; 3) culturally specific idiomatic phrases; 4) use of linguistically specific homonyms in English that did not match Swedish word usage; 5) cultural differences in describing members of the family unit and the family unit itself.Conclusion: The Swedish translations of ten PROMIS Pediatric item banks and Profile-25 were rigorously translated using internationally standardized methods. Close consideration of the translations, and multiple translations helped to ensure conceptual equivalence and comprehensibility. The banks are culturally adapted and appropriate for the age range 8 to 18 years. They can be used for clinical trials and routine pediatric health care.
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| 10. |
- Ekström, Magnus, et al.
(författare)
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Exertional breathlessness related to medical conditions in middle-aged people: the population-based SCAPIS study of more than 25,000 men and women.
- 2024
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Ingår i: Respiratory research. - : BioMed Central (BMC). - 1465-993X .- 1465-9921. ; 25:1
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Tidskriftsartikel (refereegranskat)abstract
- Breathlessness is common in the population and can be related to a range of medical conditions. We aimed to evaluate the burden of breathlessness related to different medical conditions in a middle-aged population.Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study of adults aged 50-64years. Breathlessness (modified Medical Research Council [mMRC]≥2) was evaluated in relation to self-reported symptoms, stress, depression; physician-diagnosed conditions; measured body mass index (BMI), spirometry, venous haemoglobin concentration, coronary artery calcification and stenosis [computer tomography (CT) angiography], and pulmonary emphysema (high-resolution CT). For each condition, the prevalence and breathlessness population attributable fraction (PAF) were calculated, overall and by sex, smoking history, and presence/absence of self-reported cardiorespiratory disease.We included 25,948 people aged 57.5±[SD] 4.4; 51% women; 37% former and 12% current smokers; 43% overweight (BMI 25.0-29.9), 21% obese (BMI≥30); 25% with respiratory disease, 14% depression, 9% cardiac disease, and 3% anemia. Breathlessness was present in 3.7%. Medical conditions most strongly related to the breathlessness prevalence were (PAF 95%CI): overweight and obesity (59.6-66.0%), stress (31.6-76.8%), respiratory disease (20.1-37.1%), depression (17.1-26.6%), cardiac disease (6.3-12.7%), anemia (0.8-3.3%), and peripheral arterial disease (0.3-0.8%). Stress was the main factor in women and current smokers.Breathlessness mainly relates to overweight/obesity and stress and to a lesser extent to comorbidities like respiratory, depressive, and cardiac disorders among middle-aged people in a high-income setting-supporting the importance of lifestyle interventions to reduce the burden of breathlessness in the population.
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