| 1. |
- Torngren, Kristina, et al.
(författare)
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Association of coronary calcium score with endothelial dysfunction and arterial stiffness
- 2020
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Ingår i: Atherosclerosis. - : Elsevier BV. - 0021-9150. ; 313, s. 70-75
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: The aim of the study was to determine potential associations between endothelial dysfunction and arterial stiffness, measured by peripheral arterial tonometry, and coronary artery calcium score (CACS) assessed by computed tomography (CT). Methods and results: The BIG3 study is a prospective longitudinal, non-interventional, pulmonary-cardiovascular cohort study exploring the three major smoking-induced diseases: cardiovascular disease, chronic obstructive pulmonary disease, and lung cancer, in a 45–75 aged cohort (mean 62 years), enriched in smokers. Computed tomography of the chest with assessment of CACS was performed in a selected subset of the participants (n = 2080). Peripheral arterial tonometry (EndoPAT) was used to assess endothelial function and arterial stiffness measured as reactive hyperaemia index (RHI) and augmentation index (AI), respectively. We observed significant associations of CACS, endothelial dysfunction, and arterial stiffness with several risk factors for coronary heart disease including age, sex, BMI, diabetes mellitus, and blood pressure. There was significant association of CACS, classified into three levels of severity, with RHI and AI (p = 0.0005 and p = 0.0009, respectively). For groups of increasing CACS (0, 1–400 and > 400 Agatston score), RHI decreased from median 1.89 (1.58–2.39), and 1.93 (1.62–2.41) to 1.77 (1.51–2.10). AI increased from median 14.3 (5.7–25.2), and 16.4 (8.1–27.6) to 18.0 (9.1–29.2). RHI, but not AI, remained significantly associated with CACS after risk factors adjustment. Conclusions: In this large study of coronary artery calcium and vascular function, we found an association between CACS and both endothelial dysfunction and arterial stiffness, indicating that they may reflect similar mechanisms for development of cardiovascular disease.
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| 2. |
- Wollmer, Per, et al.
(författare)
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Within-session reproducibility of forced oscillometry
- 2021
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Ingår i: Clinical Physiology and Functional Imaging. - : Wiley. - 1475-0961 .- 1475-097X. ; 41:5, s. 401-407
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The forced oscillation technique (FOT) provides detailed information about the mechanics of the respiratory system, while requiring minimal co-operation by the patient. FOT may be abnormal in subjects with normal spirometry and appears to be more closely related to airway symptoms. It is, therefore, attractive in epidemiological studies, where a large number of different examinations are made in each subjects in a short period of time. Current technical standards recommend the mean of three consecutive measurements to be used, but there is limited information regarding within-session variability of FOT measurements.OBJECTIVE: The purpose of this study was to examine the within-session variability in FOT measurements in a large, population-based sample.METHODS: We performed three consecutive FOT measurements in 700 subjects using the impulse oscillometry system. The first measurement was compared to the mean of three measurements for resistance at 5 and 20 Hz (R5 and R20, respectively), R5-R20, reactance at 5 Hz (X5) and resonant frequency (fres ).RESULTS: The differences between the first and the mean of three measurements (median, interquartile range) were minimal, for example 0.002, -0.008 to 0.014 kPa L-1 s for R5 and -0.001, -0.008 to 0.005 kPa L-1 s for X5. Findings were numerically similar for men and women as well as for subjects with and without airflow obstruction at spirometry.CONCLUSIONS: We conclude that, whereas in clinical situations, three FOT measurements are to be preferred, a single measurement may suffice in epidemiological studies.
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| 3. |
- Bjork, Jonas, et al.
(författare)
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COVID-19 vaccine effectiveness against severe disease from the Omicron BA.1 and BA.2 subvariants: surveillance results from southern Sweden, December 2021 to March 2022
- 2022
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- We compared vaccine effectiveness (VE) against severe COVID-19 during calendar periods from December 2021 to March 2022 when Omicron BA.1 and BA.2, respectively, were the dominating virus variants in Scania county, Sweden. We used continuous density case-control sampling matched for sex and age, and with further adjustment for differences in comorbidities and prior infection. VE remained relatively stable after the transition from BA.1 to BA.2 among people with at least three doses but decreased markedly among those with only two doses. Protection from prior infection was also lower after the transition to BA.2. These findings suggest that booster vaccination is needed to maintain sufficient protection against severe COVID-19.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis study was supported by Swedish Research Council (VR; grant numbers 2019-00198 and 2021-04665), Sweden's Innovation Agency (Vinnova; grant number 2021-02648) and by internal grants for thematic collaboration initiatives at Lund University held by JB and MI. FK is supported by grants from the Swedish Research Council and Governmental Funds for Clinical Research (ALF), and CB is supported by Swedish Research Council for Health, Working life and Welfare (Forte; grant number 2020-00962). The funders played no role in the design of the study, data collection or analysis, decision to publish, or preparation of the manuscript.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:Ethical approval was obtained from the Swedish Ethical Review Authority (2021-00059).I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesAggregated surveillance data from the present study are publicly available.https://sodrasjukvardsregionen.se/kliniskastudier/covid-vacciner-skyddseffekt/
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| 4. |
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| 5. |
- Björk, Jonas, et al.
(författare)
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Effectiveness of the BNT162b2 vaccine in preventing COVID-19 in the working age population – first results from a cohort study in Southern Sweden
- 2021
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background Vaccine effectiveness against COVID-19 needs to be assessed in diverse real-world population settings.Methods A cohort study of 805 741 residents in Skåne county, Southern Sweden, aged 18-64 years, of whom 26 587 received at least one dose of the BNT162b2 vaccine. Incidence rates of COVID-19 were estimated in sex- and age-adjusted analysis and stratified in two-week periods with substantial community spread of the disease.Results The estimated vaccine effectiveness in preventing infection ≥7 days after second dose was 86% (95% CI 72-94%) but only 42% (95% CI 14-63%) ≥14 days after a single dose. No difference in vaccine effectiveness was observed between females and males. Having a prior positive test was associated with 91% (95% CI 85 to 94%) effectiveness against new infection among the unvaccinated.Conclusion A satisfactory effectiveness of BNT162b2 after the second dose was suggested, but with possibly substantially lower effect before the second dose.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis study was supported by an internal grant for thematic collaboration initiatives at Lund University held by JB, and by Swedish Research Council (VR; grant number 2019-00198). FK is supported by grants from the Swedish Research Council and Governmental Funds for Clinical Research (ALF). The funders played no role in the design of the study, data collection or analysis, decision to publish, or preparation of the manuscript.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:Ethical approval was obtained from the Swedish Ethical Review Authority (2021-00059). As the study is register-based, individual participant consent was not necessary.All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesThe dataset used in the present study is hosted by Scania county council, Sweden. Legal and ethical restrictions prevent public sharing of the dataset. Data can be made available for collaborations upon request to interested researchers but would generally require a new ethical permission.
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| 6. |
- Björk, Jonas, et al.
(författare)
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High level of protection against COVID-19 after two doses of BNT162b2 vaccine in the working age population–first results from a cohort study in Southern Sweden
- 2022
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Ingår i: Infectious Diseases. - : Informa UK Limited. - 2374-4235 .- 2374-4243. ; 54:2, s. 128-133
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Tidskriftsartikel (refereegranskat)abstract
- Background: Vaccine effectiveness against COVID-19 needs to be assessed in diverse real-world population settings. Methods: A cohort study of 805,741 residents in Skåne county, Southern Sweden, aged 18–64 years, of whom 26,587 received at least one dose of the BNT162b2 vaccine. Incidence rates of COVID-19 were estimated in sex- and age-adjusted analysis and stratified in two-week periods with substantial community spread of the disease. Results: The estimated vaccine effectiveness in preventing infection ≥7 days after second dose was 86% (95% CI 72–94%) but only 42% (95% CI 14–63%) ≥14 days after a single dose. No difference in vaccine effectiveness was observed between females and males. Having a prior positive test was associated with 91% (95% CI 85–94%) effectiveness against new infection among the unvaccinated. Conclusion: A satisfactory effectiveness of BNT162b2 after the second dose was suggested, but with possibly substantially lower effect before the second dose.
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| 7. |
- Björk, Jonas, et al.
(författare)
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Surveillance of COVID-19 vaccine effectiveness : A real-time case-control study in southern Sweden
- 2022
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 150
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Tidskriftsartikel (refereegranskat)abstract
- The extensive register infrastructure available for coronavirus disease 2019 surveillance in Scania county, Sweden, makes it possible to classify individual cases with respect to hospitalisation and disease severity, stratify on time since last dose and demographic factors, account for prior infection and extract data for population controls automatically. In the present study, we developed a case-control sampling design to surveil vaccine effectiveness (VE) in this ethnically and socioeconomically diverse population with more than 1.3 million inhabitants. The first surveillance results show that estimated VE against hospitalisation and severe disease 0-3 months after the last dose remained stable during the study period, but waned markedly 6 months after the last dose in persons aged 65 years or over.
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| 8. |
- Håkansson, Anders, et al.
(författare)
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Distribution of intranasal naloxone to potential opioid overdose bystanders in Sweden : Effects on overdose mortality in a full region-wide study
- 2024
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Ingår i: BMJ Open. - 2044-6055. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Distribution of take-home naloxone is suggested to reduce opioid-related fatalities, but few studies have examined the effects on overdose deaths in the general population of an entire community. This study aimed to assess the effects on overdose deaths of a large-scale take-home naloxone programme starting in June 2018, using an observational design with a historic control period. Design From the national causes of death register, deaths diagnosed as X42 or Y12 (International Classification of Diseases, 10th revision, ICD-10) were registered as overdoses. Numbers of overdoses were calculated per 100 000 inhabitants in the general population, and controlled for data including only individuals with a prior substance use disorder in national patient registers, to focus on effects within the primary target population of the programme. The full intervention period (2019-2021) was compared with a historic control period (2013-2017). Setting Skåne county, Sweden. Participants General population. Interventions Large-scale take-home naloxone distribution to individuals at risk of overdose. Primary and secondary outcome measures Decrease in overdose deaths per 100 000 inhabitants, in total and within the population with substance use disorder diagnosis. Results Annual average number of overdose deaths decreased significantly from 3.9 to 2.8 per 100 000 inhabitants from the control period to the intervention period (a significant decrease in men, from 6.7 to 4.3, but not in women, from 1.2 to 1.3). Significant changes remained when examining only prior substance use disorder patients, and decreases in overdose deaths could not be attributed to a change in treatment needs for opioid use disorders in healthcare and social services. Conclusions The present study, involving 3 years of take-home naloxone distribution, demonstrated a decreased overdose mortality in the population, however, only in men. The findings call for further implementation of naloxone programmes, and for further studies of potential effects and barriers in women. Trial registration number NCT03570099.
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| 9. |
- Kahn, Fredrik, et al.
(författare)
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Previous SARS-CoV-2 infections and their impact on the protection from reinfection during the Omicron BA.5 wave – a nested case-control study among vaccinated adults in Sweden
- 2024
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Ingår i: IJID Regions. - 2772-7076. ; 10, s. 235-239
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We evaluated the protection afforded by SARS-CoV-2 infection-induced immunity against reinfection among working-age vaccinated individuals during a calendar period from June to December 2022 when Omicron BA.5 was the dominating subvariant in Scania County, Sweden. Methods: The study cohort (n = 71,592) mainly consisted of health care workers. We analyzed 4144 infected cases during the Omicron BA.5 dominance and 41,440 sex- and age-matched controls with conditional logistic regression. Results: The average protection against reinfection was marginal (16%, 95% confidence interval [CI] 7-23%) during the study period but substantially higher for recent infections. Recent infection (3-6 months) with Omicron BA.2 and BA.5 offered strong protection (86%, 95% CI 68-94% and 78%, 95% CI 69-84%), whereas more distant infection (6-12 months) with Omicron BA.1, BA.2, and the variants before Omicron offered marginal or no protection. Conclusions: These findings suggest that infection-induced immunity contributes to short-term population protection against infection with the subvariant BA.5 among working-age vaccinated individuals but wanes considerably with time, independent of the virus variant.
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| 10. |
- Kahn, Fredrik, et al.
(författare)
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Risk of severe COVID-19 from the Delta and Omicron variants in relation to vaccination status, sex, age and comorbidities - surveillance results from southern Sweden, July 2021 to January 2022
- 2022
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Ingår i: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin. - 1560-7917. ; 27:9
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Tidskriftsartikel (refereegranskat)abstract
- We compared the risk of severe COVID-19 during two periods 2021 and 2022 when Delta and Omicron, respectively, were the dominating virus variants in Scania county, Sweden. We adjusted for differences in sex, age, comorbidities, prior infection and vaccination. Risk of severe disease from Omicron was markedly lower among vaccinated cases. It was also lower among the unvaccinated but remained high (> 5%) for older people and middle-aged men with two or more comorbidities. Efforts to increase vaccination uptake should continue.
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