| 1. |
- Asplund, Monika, et al.
(författare)
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Prurigo nodularis - vid svårare symtom kan pregabalin övervägas.
- 2015
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Ingår i: Läkartidningen. - 0023-7205. ; 112
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Prurigo nodularis is a pruritic condition characterized by skin noduli. Different treatment options have been used with limited success. Pregabalin is a drug licensed for treatment of neuropathic pain in adults. As prurigo nodularis involves suffering for the patients and is difficult to treat, the aim of this case report is to report the effect of pregabalin treatment in seven patients with prurigo nodularis, treated in the dermatology clinic in Malmö, Sweden. Four patients experienced good effect of pregabalin, though two patients had a transient effect. Side effects of pregabalin have been reported. This case report indicates that pregabalin is a treatment option for therapy-resistant prurigo nodularis; even though one must be aware of that the effect may not be permanent and that there are side effects. The aim must be to use the drug for a limited time, taking the patient to a remission state, where the vicious itch-scratch cycle can be inhibited.
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| 2. |
- Calling, Susanna
(författare)
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Från evidensbaserad medicin till kliniskt kunskapsstöd
- 2017
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Ingår i: Nationellt kliniskt kunskapsstöd primärvård i Region Skåne och Södra sjukvårdsregionen 2017.
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Bokkapitel (populärvet., debatt m.m.)abstract
- Allmänmedicin är ett brett område som spänner över många sjukdomstillstånd, med fokus på patientcentrering. Inom många områden sker en snabb kunskapsutveckling och rekommendationer för utrednings- och behandlingsstrategier uppdateras hela tiden. För en allmänläkare kan det vara svårt att hålla sig uppdaterad och tidsbrist begränsar möjligheterna att leta kunskap i det dagliga kliniska arbetet. Digitalisering och ökande tillgång till information via internet gör att patienter är alltmer pålästa och förberedda. Detta ger dock inte bara adekvat kunskap utan även information som ligger långt från vetenskap och beprövad erfarenhet. Även medarbetaren inom sjukvården riskerar att ta till sig information som inte är faktagranskad. För att kunna förklara för patienten vilken information som är pålitlig, är det av stort värde att kunna hänvisa till information som är kvalitetssäkrad utifrån evidens.
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| 3. |
- Calling, Susanna, et al.
(författare)
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Impact of neighborhood resources on cardiovascular disease : A nationwide six-year follow-up
- 2016
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Living in a socially deprived neighborhood is associated with lifestyle risk factors, e.g., smoking, physical inactivity and unhealthy diet, as well as an increased risk of cardiovascular disease, i.e., coronary heart disease and stroke. The aim was to study whether the odds of cardiovascular disease vary with the neighbourhood availability of potentially health-damaging and health-promoting resources. Methods: A nationwide sample of 2 040 826 men and 2 153 426 women aged 35-80 years were followed for six years for first hospitalization of coronary heart disease or stroke. Neighborhood availability of health-damaging resources (i.e., fast-food restaurants and bars/pubs) and health-promoting resources (i.e., health care facilities and physical activity facilities) were determined by use of geographic information systems (GIS). Results: We found small or modestly increased odds ratios (ORs) for both coronary heart disease and stroke, related to the availability of both health-damaging and health-promoting resources. For example, in women, the unadjusted OR (95 % confidence interval) for stroke in relation to availability of fast-food restaurants was 1.18 (1.15-1.21). Similar patterns were observed in men, with an OR = 1.08 (1.05-1.10). However, the associations became weaker or disappeared after adjustment for neighborhood-level deprivation and individual-level age and income. Conclusions: This six year follow-up study shows that neighborhood availability of potentially health-damaging as well as health-promoting resources may make a small contribution to the risk of coronary heart disease and stroke. However, most of these associations were attenuated or disappeared after adjustment for neighborhood-level deprivation and individual-level age and income. Future studies are needed to further examine factors in the causal pathway between neighborhood deprivation and cardiovascular disease.
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| 4. |
- Calling, Susanna, et al.
(författare)
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Longitudinal trends in self-reported anxiety. Effects of age and birth cohort during 25 years
- 2017
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Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Anxiety has been suggested to increase among young individuals, but previous studies on longitudinal trends are inconclusive. The aim of this study was to analyze longitudinally, the changes over time of prevalence of self-reported anxiety in the Swedish population between 1980/1981 and 2004/2005, in different birth cohorts and age groups. Methods: A random sample of non-institutionalized persons aged 16-71years was interviewed every eighth year. Self-reported anxiety was assessed using the question" Do you suffer from nervousness, uneasiness, or anxiety?" (no; yes, mild; yes, severe). Mixed models with random intercepts were used to estimate changes in rates of anxiety (mild or severe) within different age groups and birth cohorts and in males and females separately. In addition to three time-related variables - year of interview, age at the time of the interview, and year of birth -the following explanatory variables were included: education, urbanization, marital status, smoking, leisure time physical activity and body mass index. Results: Overall prevalence of self-reported anxiety increased from 8.0 to 12.4% in males and from 17.8% to 23.6% in females, during the 25-year follow-up period. The increasing trend was found in all age groups except in the oldest age groups, and the highest increase was found in young adults 16-23years, with more than a three-fold increase in females, and a 2.5-fold increase in males, after adjustments for covariates. Conclusions: Between 1980/81 and 2004/05, there was an increasing prevalence of self-reported anxiety in all age groups except in the oldest, which indicates increased suffering for a large part of the population, and probably an increased burden on the health care system. Clinical efforts should focus particularly on young females (16-23years), where the increase was particularly large; almost one third experienced anxiety at the end of the 25-year follow-up.
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| 5. |
- Calling, Susanna, et al.
(författare)
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Socioeconomic status and alcohol use disorders across the lifespan : A co-relative control study
- 2019
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:10, s. 0224127-0224127
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Alcohol use disorders (AUD) is well known to aggregate in families and is associated with socioeconomic status (SES). The objective was to study the effect of education, income and neighborhood SES in adulthood on AUD, and to explore whether the potential associations were confounded by shared familial factors, by using a co-relative control design. METHODS: Data on AUD was drawn from the Swedish inpatient and outpatient care registers; prescription drug register; and crime data. Through national population registers we collected information on income, education and neighborhood SES at age 25, 30, 35 and 40 years in all individuals born in Sweden between 1950 and 1980. Each sex-specific stratum consisted of approximately 750,000-1,200,000 individuals, who were followed for AUD for a mean follow-up time ranging between 10 and 15 years until the end of 2013. Cox proportional hazards models were used to investigate the risk of AUD as a function of income, education and neighborhood SES in the general population and in pairs of first cousins and full siblings within the same sex, who differed in their exposure to the SES measure. RESULTS: Higher educational level, higher income and higher neighborhood SES were all associated with a reduced risk for AUD for both males and females in all ages. The potentially protective effect remained but was attenuated when comparing pairs of first cousins and full siblings. CONCLUSIONS: High educational level and income in adulthood, as well as high neighborhood socioeconomic status, may represent protective factors against alcohol use disorders, even when shared familial factors, e.g. childhood socioeconomic status and genetic factors, have been taken into account.
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| 6. |
- Calling, Susanna, et al.
(författare)
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The ratio of total cholesterol to high density lipoprotein cholesterol and myocardial infarction in Women's health in the Lund area (WHILA) : a 17-year follow-up cohort study
- 2019
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Identifying variables predictive of acute myocardial infarction (AMI) in women is important. The use of the ratio of total cholesterol-to-high density lipoprotein cholesterol (TC/HDL-C) is often overlooked. The aim was to study TC/HDL-C in relation to later AMI, in a large sample of women, adjusted for age, educational status, smoking, waist-hip ratio, blood pressure, and neighbourhood socioeconomic status. The hypothesis was that increasing TC/HDL-C is associated with an increased risk of later AMI.METHODS: From December 1995 to February 2000, 6147 women aged 50-59 years from the Womens' Health in Lund area (WHILA) study in southern Sweden underwent a physical examination, laboratory tests and filled in a questionnaire. The women were followed through national registers for incidence of AMI during a mean follow up of 17 years.RESULTS: An increasing TC/HDL-C showed a strong relationship with AMI, with the lowest hazard ratio (HR = 1) in women with a ratio of ≤3.5. The HR for AMI was 1.14 (95% CI: 0.73-1.78) for those with a ratio between 3.5 and 4.0; in those with a ratio between 4.0 and 5.0 the HR for AMI was 1.46 (95% CI: 1.00-2.13) and in those with a ratio > 5.0 the HR was 1.89 (95% CI 1.26-2.82), after adjusting for potential confounding factors.CONCLUSIONS: TC/HDL-C ratio is a powerful predictor of AMI in middle-aged women. The results indicate that this variable should be used in clinical practice and is important for early identification of individuals at risk of AMI.
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| 7. |
- Calling, Susanna, et al.
(författare)
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Women's Health in the Lund Area (WHILA) study. Health problems and acute myocardial infarction in women – A 17-year follow-up study
- 2018
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Ingår i: Maturitas. - : Elsevier BV. - 0378-5122. ; 115, s. 45-50
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The literature has highlighted the importance of identifying symptoms predictive of acute myocardial infarction (AMI) in women, in addition to traditional cardiovascular risk factors. The objective was to study subjective health problems, in relation to later AMI, in a large sample of women, adjusted for age, educational status, smoking, waist/hip ratio, blood pressure, total cholesterol/HDL ratio, diabetes and neighbourhood socioeconomic status. Study design: From December 1995 to February 2000 a cohort of 6711 women aged 50–59 years in southern Sweden underwent a physical examination and answered a questionnaire that had 18 items on health problems such as stress symptoms, tiredness and pain. Main outcome measures: Incidence of AMI during a mean follow-up of 17 years, drawn from national registers. Results: The number of health problems showed a J-shaped relationship with AMI, with the lowest hazard ratio (HR) in women with a median of 4 health problems. The HR for AMI in women with 0 health problems was 1.58 (95% CI: 0.95–2.63) and in those with 13 problems HR 1.65 (95% CI 1.16–2.36), after adjusting for potential confounding factors. Conclusions: The presence of several health problems, including pain and stress symptoms, is associated with an increased risk of later AMI in middle-aged women. Awareness among clinicians of predictive risk factors for AMI is important for the early identification of individuals at higher risk.
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| 8. |
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| 9. |
- Memarian, Ensieh, et al.
(författare)
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Country of origin and bariatric surgery in Sweden during 2001-2010.
- 2015
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Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier BV. - 1550-7289. ; 11:6, s. 1332-1341
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of obesity, as well as use of bariatric surgery, has increased worldwide. The aim of the present study was to investigate the potential differences in the use of bariatric surgery among Swedes and immigrants in Sweden and whether the hypothesized differences remain after adjustment for socioeconomic factors.
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| 10. |
- Memarian, Ensieh, et al.
(författare)
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Socioeconomic factors, body mass index and bariatric surgery : A Swedish nationwide cohort study 11 Medical and Health Sciences 1117 Public Health and Health Services 11 Medical and Health Sciences 1103 Clinical Sciences
- 2019
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bariatric surgery is considered to be the most effective method of weight loss today. The aim of the present Swedish study, which was performed in a country that has universal health care, was to investigate if there is an association between socioeconomic factors and bariatric surgery by taking body mass index (BMI) into account. Methods: In this prospective cohort study, BMI data were collected for the period 1985-2010 from the Military Service Conscription Register (for men) and from the Medical Birth Register in the first trimester (for women). The follow-up period started in 2005 and continued until 2012. Age-standardized cumulative incidence rates (CR) of bariatric surgery were compared between different BMI groups by considering individual variables. We analyzed the association between the individual variables and bariatric surgery using Cox proportional hazard models. Results: In the study population of 814,703 women and 787,027 men, a total of 7433 women and 1961 men underwent bariatric surgery. In women, the hazard ratios (HRs) for bariatric surgery were higher for low and middle income and educational levels, compared to high income and educational levels. In men, the highest HR for bariatric surgery was found among those with a high income. The HRs when comparing the different socioeconomic groups in those with BMI > 40 kg/m 2 showed no significant results, except for middle education in women. Conclusion: Differences in bariatric surgery between socioeconomic groups were found, favoring those with a low socioeconomic status. However, very few socioeconomic differences were found amongst those who had a BMI > 40 kg/m 2 . This indicates that the Swedish healthcare system seems to have achieved equal access to health care for bariatric surgery.
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