| 1. |
- Kehoe, Laura, et al.
(författare)
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Make EU trade with Brazil sustainable
- 2019
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 364:6438, s. 341-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 2. |
- Ahmad Kiadaliri, Aliasghar, et al.
(författare)
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Assessing the external validity of algorithms to estimate EQ-5D-3L from the WOMAC
- 2016
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Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of mapping algorithms have been suggested as a solution to predict health utilities when no preference-based measure is included in the study. However, validity and predictive performance of these algorithms are highly variable and hence assessing the accuracy and validity of algorithms before use them in a new setting is of importance. The aim of the current study was to assess the predictive accuracy of three mapping algorithms to estimate the EQ-5D-3L from the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) among Swedish people with knee disorders. Two of these algorithms developed using ordinary least squares (OLS) models and one developed using mixture model. Methods: The data from 1078 subjects mean (SD) age 69.4 (7.2) years with frequent knee pain and/or knee osteoarthritis from the Malmö Osteoarthritis study in Sweden were used. The algorithms' performance was assessed using mean error, mean absolute error, and root mean squared error. Two types of prediction were estimated for mixture model: weighted average (WA), and conditional on estimated component (CEC). Results: The overall mean was overpredicted by an OLS model and underpredicted by two other algorithms (P < 0.001). All predictions but the CEC predictions of mixture model had a narrower range than the observed scores (22 to 90 %). All algorithms suffered from overprediction for severe health states and underprediction for mild health states with lesser extent for mixture model. While the mixture model outperformed OLS models at the extremes of the EQ-5D-3D distribution, it underperformed around the center of the distribution. Conclusions: While algorithm based on mixture model reflected the distribution of EQ-5D-3L data more accurately compared with OLS models, all algorithms suffered from systematic bias. This calls for caution in applying these mapping algorithms in a new setting particularly in samples with milder knee problems than original sample. Assessing the impact of the choice of these algorithms on cost-effectiveness studies through sensitivity analysis is recommended.
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| 3. |
- Ahmad Kiadaliri, Aliasghar, et al.
(författare)
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Association of knee pain and different definitions of knee osteoarthritis with health-related quality of life : A population-based cohort study in southern Sweden
- 2016
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Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: While the impact of knee pain and knee osteoarthritis (OA) on health-related quality of life (HRQoL) has been investigated in the literature, there is a lack of knowledge on the impact of different definitions of OA on HRQoL. The main aim of this study was to measure and compare the impact of knee OA and its different definitions on HRQoL in the general population. Methods: A random sample of 1300 participants from Malmö, Sweden with pain in one or both knees in the past 12 months with duration ≥4 weeks and 650 participants without were invited to clinical and radiographic knee examination. A total of 1527 individuals with a mean (SD) age 69.4 (7.2) participated and responded to both generic (EQ-5D-3L) and disease-specific (the Knee injury and Osteoarthritis Outcome Score) questionnaires. Knee pain was defined as pain during the last month during most of the days. Knee OA was defined radiographically (equivalent to Kellgren and Lawrence grade ≥2) and clinically according to the American College of Rheumatology (ACR) criteria. Results: Of participants with either knee pain or knee OA or both, 7 % reported no problem for the EQ-5D-3L attributes. The corresponding proportion among references (neither knee pain nor OA) was 42 %. The participants with knee pain and OA had all HRQoL measures lower compared to those with knee pain but no OA. The ACR clinical definition of knee OA was associated with lower HRQoL than the definition based on radiographic knee OA (adjusted difference -0.08 in UK EQ-5D-3L index score). Conclusions: Applying different definitions of knee OA result in different levels of HRQoL and this is mainly explained by the knee pain experience. These differences may lead to discrepant conclusions from cost-utility analyses.
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| 4. |
- Ahmad Kiadaliri, Aliasghar, et al.
(författare)
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Educational inequalities in falls mortality among older adults : population-based multiple cause of death data from Sweden
- 2018
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 1470-2738 .- 0143-005X. ; 72:1, s. 68-70
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Falls are the leading cause of fatal injuries among elderly adults. While socioeconomic status including education is a well-documented predictor of many individual health outcomes including mortality, little is known about socioeconomic inequalities in falls mortality among adults. This study aimed to assess educational inequalities in falls mortality among older adults in Sweden using multiple cause of death data.METHODS: All residents aged 50‒75 years in the Skåne region, Sweden, during 1998‒2013 (n=566 478) were followed until death, relocation outside Skåne or end of 2014. We identified any mention of falls on death certificates (n=1047). We defined three levels of education. We used an additive hazards model and Cox regression with age as time scale adjusted for marital status and country of birth to calculate slope and relative indices of inequality (SII/RII). We also computed the population attributable fraction of lower educational attainment. Analyses were performed separately for men and women.RESULTS: Both SII and RII revealed statistically significant educational inequalities in falls mortality among men in favour of high educated (SII (95% CI): 15.5 (9.8 to 21.3) per 100 000 person-years; RII: 2.19 (1.60 to 3.00)) but not among women. Among men, 34% (95% CI 19 to 46) of falls deaths were attributable to lower education.CONCLUSIONS: There was an inverse association between education and deaths from falls among men but not women. The results suggest that individual's education should be considered in falls reduction interventions.
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| 5. |
- Ahmad Kiadaliri, Aliasghar, et al.
(författare)
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Fall-related mortality in southern Sweden : a multiple cause of death analysis, 1998-2014
- 2019
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Ingår i: Injury Prevention. - : BMJ. - 1353-8047 .- 1475-5785. ; 25:2, s. 129-135
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate temporal trend in fall mortality among adults (aged ≥20 years) in southern Sweden using multiple cause of death data.METHODS: We examined all death certificates (DCs, n=2 01 488) in adults recorded in the Skåne region during 1998-2014. We identified all fall deaths using International Statistical Classification of Diseases (ICD)-10 codes (W00-W19) and calculated the mortality rates by age and sex. Temporal trends were evaluated using joinpoint regression and associated causes were identified by age-adjusted and sex-adjusted observed/expected ratios.RESULTS: Falls were mentioned on 1.0% and selected as underlying cause in 0.7% of all DCs, with the highest frequency among those aged ≥70 years. The majority (75.6%) of fall deaths were coded as unspecified fall (ICD-10 code: W19) followed by falling on or from stairs/steps (7.7%, ICD-10 code: W10) and other falls on the same level (6.3%, ICD-10 code: W18). The mean age at fall deaths increased from 77.5 years in 1998-2002 to 82.9 years in 2010-2014 while for other deaths it increased from 78.5 to 79.8 years over the same period. The overall mean age-standardised rate of fall mortality was 8.3 and 4.0 per 1 00 000 person-years in men and women, respectively, and increased by 1.7% per year in men and 0.8% per year in women during 1998-2014. Head injury and diseases of the circulatory system were recorded as contributing cause on 48.7% of fall deaths.CONCLUSIONS: There is an increasing trend of deaths due to falls in southern Sweden. Further investigations are required to explain this observation particularly among elderly men.
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| 6. |
- Ahmad Kiadaliri, Aliasghar, et al.
(författare)
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Mortality from Musculoskeletal Disorders Including Rheumatoid Arthritis in Southern Sweden : A Multiple-cause-of-death Analysis, 1998-2014
- 2017
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Ingår i: Journal of Rheumatology. - : The Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 44:5, s. 571-579
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess mortality related to musculoskeletal (MSK) disorders and rheumatoid arthritis (RA), specifically, among adults (aged ≥ 20 yrs) in southern Sweden using the multiple-cause-of-death approach.METHODS: All death certificates (DC; n = 201,488) from 1998 to 2014 for adults in the region of Skåne were analyzed when mortality from MSK disorders and RA was listed as the underlying and nonunderlying cause of death (UCD/NUCD). Trends in age-standardized mortality rates (ASMR) were evaluated using joinpoint regression, and associated causes were identified by age- and sex-adjusted observed/expected ratios.RESULTS: MSK (RA) was mentioned on 2.8% (0.8%) of all DC and selected as UCD in 0.6% (0.2%), with higher values among women. Proportion of MSK disorder deaths from all deaths increased from 2.7% in 1998 to 3.1% in 2014, and declined from 0.9% to 0.5% for RA. The mean age at death was higher in DC with mention of MSK/RA than in DC without. The mean ASMR for MSK (RA) was 15.5 (4.3) per 100,000 person-years and declined by 1.1% (3.8%) per year during 1998-2014. When MSK/RA were UCD, pneumonia and heart failure were the main NUCD. When MSK/RA were NUCD, the leading UCD were ischemic heart disease and neoplasms. The greatest observed/expected ratios were seen for infectious diseases (including sepsis) and blood diseases.CONCLUSION: We observed significant reduction in MSK and RA mortality rates and increase in the mean age at death. Further analyses are required to investigate determinants of these improvements in MSK/RA survival and their potential effect on the Swedish healthcare systems.
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| 7. |
- Ahmad Kiadaliri, Aliasghar, et al.
(författare)
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Mortality with musculoskeletal disorders as underlying cause in Sweden 1997-2013: a time trend aggregate level study.
- 2016
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim was to assess time trend of mortality with musculoskeletal disorders (MSD) as underlying cause of death in Sweden from 1997 to 2013.METHODS: We obtained data on MSD as underlying cause of death across age and sex groups from the National Board of Health and Welfare's Cause of Death Register. Age-standardized mortality rates per million population for all MSD, its six major subgroups, and all other ICD-10 (International Classification of Disease) chapters were calculated. We computed the average annual percent change (AAPC) in the mortality rates across age/sex groups using joinpoint regression analysis by fitting a regression line to the natural logarithm of the age-standardized mortality rates and calendar year as a predictor.RESULTS: There were a total of 7 976 deaths (0.5 % of all causes deaths) with MSD as the underlying cause of death (32.5 % of these deaths caused by rheumatoid arthritis [RA]). The overall age-standardized mortality rates (95 % CI) were 16.0 (15.4 to 16.7) and 24.9 (24.1 to 25.7) per million among men and women, respectively (women/men rate ratio 1.55; 95%CI 1.47 to 1.63). On average, mortality rate declined by 2.3 % per year and only circulatory system mortality had a more favourable decline than mortality with MSD as underlying cause. Among MSD the highest decline was observed in RA (3.7 % per year) during study period. Across age groups, while there were generally stable or declining trends, spondylopathies and osteoporosis mortality among people ≥ 75 years increased by 2 and 1.5 % per year, respectively.CONCLUSION: In overall, mortality with MSD as underlying cause has declined in Sweden over last two decades, with the highest decline for RA. However, there are variations across MSD subgroups which warrants further investigations.
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| 8. |
- Ahmad Kiadaliri, Aliasghar, et al.
(författare)
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Musculoskeletal disorders as underlying cause of death in 58 countries, 1986-2011 : trend analysis of WHO mortality database
- 2017
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Due to low mortality rate of musculoskeletal disorders (MSK) less attention has been paid to MSK as underlying cause of death in the general population. The aim was to examine trend in MSK as underlying cause of death in 58 countries across globe during 1986-2011.METHODS: Data on mortality were collected from the WHO mortality database and population data were obtained from the United Nations. Annual sex-specific age-standardized mortality rates (ASMR) were calculated by means of direct standardization using the WHO world standard population. We applied joinpoint regression analysis for trend analysis. Between-country disparities were examined using between-country variance and Gini coefficient. The changes in number of MSK deaths between 1986 and 2011 were decomposed using two counterfactual scenarios.RESULTS: The number of MSK deaths increased by 67% between 1986 and 2011 mainly due to population aging. The mean ASMR changed from 17.2 and 26.6 per million in 1986 to 18.1 and 25.1 in 2011 among men and women, respectively (median: 7.3% increase in men and 9.0% reduction in women). Declines in ASMR of 25% or more were observed for men (women) in 13 (19) countries, while corresponding increases were seen for men (women) in 25 (14) countries. In both sexes, ASMR declined during 1986-1997, then increased during 1997-2001 and again declined over 2001-2011. Despite decline over time, there were substantial between-country disparities in MSK mortality and its temporal trend.CONCLUSIONS: We found substantial variations in MSK mortality and its trends between countries, regions and also between sex and age groups. Promoted awareness and better management of MSK might partly explain reduction in MSK mortality, but variations across countries warrant further investigations.
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| 9. |
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| 10. |
- Ahmad Kiadaliri, Aliasghar, et al.
(författare)
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Rheumatoid arthritis as underlying cause of death in 31 countries, 1987-2011: Trend analysis of WHO mortality database
- 2017
-
Ingår i: Arthritis & Rheumatology. - : Wiley. - 2326-5205 .- 2326-5191. ; 69:8, s. 1560-1565
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Tidskriftsartikel (refereegranskat)abstract
- Objective To examine trends in rheumatoid arthritis (RA) as an underlying cause of death (UCD) in 31 countries across the globe during 1987-2011. Methods Data on mortality and population were collected from the World Health Organization mortality database and the United Nations. Age-standardized mortality rates (ASMR) were calculated by means of direct standardization. We applied joinpoint regression analysis for trend analysis. Between-country disparities were examined using between-country variance, and Gini coefficient. Due to low numbers of deaths, we smoothed our ASMR using a three-year moving average. The changes in number of RA deaths between 1987 and 2011 were decomposed using two counterfactual scenarios. Results The absolute number of deaths with RA registered as UCD declined from 9281 (0.12% of all-cause deaths) in 1987 to 8428 in 2011 (0.09% of all-cause deaths). The mean ASMR declined from 7.1/million person-years in 1987-89 to 3.7 in 2009-11 (48.2% reduction). Reduction of 25% or more in ASMR occurred in 21 countries while a corresponding increase was observed in 3 countries. There was a persistent reduction in RA mortality and, on average, the ASMR declined by 3.0% per year. The absolute and relative between-country disparities declined over the study period.CONCLUSION: Mortality rates attributable to RA have declined globally. However, there were substantial between-country disparities in RA mortality, though the disparities decreased over time. Population aging combined with fall in RA mortality may lead to an increase in the economic burden of disease that should be taken into consideration in policy-making. This article is protected by copyright. All rights reserved.
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| 11. |
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| 12. |
- Bergkvist, Dan, et al.
(författare)
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Knee arthroscopies: who gets them, what does the radiologist report, and what does the surgeon find?
- 2016
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Ingår i: Acta Orthopaedica. - : Informa UK Limited. - 1745-3682 .- 1745-3674. ; 87:1, s. 12-16
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Several randomized controlled trials have not shown any added benefit of arthroscopy over placebo surgery or physiotherapy in middle-aged patients with knee symptoms without trauma. We studied the characteristics of the knee arthroscopies performed in southern Sweden. Patients and methods - From the orthopedic surgical records from 2007-2009 in the Skåne region of Sweden (with a population of 1.2 million), we retrieved ICD-10 diagnostic codes and selected all 4,096 arthroscopies that were diagnosed peroperatively with code M23.2 (derangement of meniscus due to old tear or injury) or code M17 (knee osteoarthritis). We extracted information on cartilage and meniscus status at arthroscopy, and we also randomly sampled 502 of these patients from the regional archive of radiology and analyzed the preoperative prevalence of radiographic or magnetic resonance imaging (MRI)-defined osteoarthritis. Results - 2,165 (53%) of the 4,096 arthroscopies had the diagnostic code M23.2 or M17. In this subgroup, 1,375 cases (64%) had typical findings consistent with degenerative meniscal tear (i.e. that correspond to a degenerative meniscal tear in at least a third of all arthroscopies). Of the randomly sampled patients, the preoperative prevalence of radiological knee osteoarthritis was 46%. Interpretation - There is a discrepancy between evidence-based medicine treatment guidelines and clinical practice regarding the amount of knee arthroscopies performed in patients with symptoms of degenerative knee disease.
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| 13. |
- Burguillos Garcia, Miguel, et al.
(författare)
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Microglia-Secreted Galectin-3 Acts as a Toll-like Receptor 4 Ligand and Contributes to Microglial Activation.
- 2015
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Ingår i: Cell Reports. - : Elsevier BV. - 2211-1247. ; 10:9, s. 1626-1638
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Tidskriftsartikel (refereegranskat)abstract
- Inflammatory response induced by microglia plays a critical role in the demise of neuronal populations in neuroinflammatory diseases. Although the role of toll-like receptor 4 (TLR4) in microglia's inflammatory response is fully acknowledged, little is known about endogenous ligands that trigger TLR4 activation. Here, we report that galectin-3 (Gal3) released by microglia acts as an endogenous paracrine TLR4 ligand. Gal3-TLR4 interaction was further confirmed in a murine neuroinflammatory model (intranigral lipopolysaccharide [LPS] injection) and in human stroke subjects. Depletion of Gal3 exerted neuroprotective and anti-inflammatory effects following global brain ischemia and in the neuroinflammatory LPS model. These results suggest that Gal3-dependent-TLR4 activation could contribute to sustained microglia activation, prolonging the inflammatory response in the brain.
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| 14. |
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| 15. |
- Emery, Carolyn A, et al.
(författare)
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Establishing outcome measures in early knee osteoarthritis
- 2019
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Ingår i: Nature Reviews Rheumatology. - : Springer Science and Business Media LLC. - 1759-4804 .- 1759-4790. ; 15:7, s. 438-448
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Forskningsöversikt (refereegranskat)abstract
- The classification and monitoring of individuals with early knee osteoarthritis (OA) are important considerations for the design and evaluation of therapeutic interventions and require the identification of appropriate outcome measures. Potential outcome domains to assess for early OA include patient-reported outcomes (such as pain, function and quality of life), features of clinical examination (such as joint line tenderness and crepitus), objective measures of physical function, levels of physical activity, features of imaging modalities (such as of magnetic resonance imaging) and biochemical markers in body fluid. Patient characteristics such as adiposity and biomechanics of the knee could also have relevance to the assessment of early OA. Importantly, research is needed to enable the selection of outcome measures that are feasible, reliable and validated in individuals at risk of knee OA or with early knee OA. In this Perspectives article, potential outcome measures for early symptomatic knee OA are discussed, including those measures that could be of use in clinical practice and/or the research setting.
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| 16. |
- Englund, Axel
(författare)
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’L’invisible et l’inaudible’ : aspects de la performativité chez Celan et Leibowitz
- 2015
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Ingår i: Paul Celan, la poésie, la musique. - Paris : Editions Hermann. - 9782705690410 ; , s. 377-391
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- As a written poem is read aloud or performed in a musical setting, how might the transition from a visible to an audible materiality alter its meaning and its way of generating meaning? What impact does this change have on the relation between semantics and sound structure? How might the particular vocalization of the speaking or singing individual affect the interpretations of the text? The present paper approaches such questions through two late poems by Paul Celan. The po- ems are followed from their written existence on the page through a recorded reading by the author and, finally, into a musical setting by René Leibowitz. Not only do these texts explicitly thematize their own suspension between writtenness and orality, but they also enact the sensory disappearance and threatening collapse of their own language. Spoken and sung, moreover, the poems are subjected to the risks of misrepresentation and misinterpretation inherent in any performance, with concrete and crucial effects on their meaning as a result.
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| 17. |
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| 18. |
- Englund, Martin, et al.
(författare)
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Comorbidities in patients with antineutrophil cytoplasmic antibody-associated vasculitis versus the general population
- 2016
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Ingår i: Journal of Rheumatology. - : The Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 43:8, s. 1553-1558
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To evaluate the consultation rates of selected comorbidities in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) compared with the general population in southern Sweden. Methods. We used data from a population-based cohort of patients with AAV diagnosed between 1998 and 2010 in Southern Sweden (701,000 inhabitants). For each patient we identified 4 reference subjects randomly sampled from the general population and matched for year of birth, sex, area of residence, and index year. Using the population-based Skåne Healthcare Register, we identified relevant diagnostic codes, registered between 1998 and 2011, for selected comorbidities assigned after the date of diagnosis of AAV or the index date for the reference subjects. We calculated rate ratios for comorbidities (AAV:reference subjects). Results. There were 186 patients with AAV (95 women, mean age 64.5 yrs) and 744 reference persons included in the analysis. The highest rate ratios (AAV:reference) were obtained for osteoporosis (4.6, 95% CI 3.0-7.0), followed by venous thromboembolism (4.0, 95% CI 1.9-8.3), thyroid diseases (2.1, 95% CI 1.3-3.3), and diabetes mellitus (2.0, 95% CI 1.3-2.9). For ischemic heart disease, the rate ratio of 1.5 (95% CI 1.0-2.3) did not reach statistical significance. No statistically significant differences were found for cerebrovascular accidents. Conclusion. AAV is associated with increased consultation rates of several comorbidities including osteoporosis and thromboembolic and endocrine disorders. Comorbid conditions should be taken into consideration when planning and providing care for patients with AAV.
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| 19. |
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| 20. |
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| 21. |
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| 22. |
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| 23. |
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| 24. |
- Englund, Martin
(författare)
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Trevlighetens hegemoni
- 2019. - 1
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Ingår i: Normkritisk pedagogik. - Lund : Studentlitteratur AB. - 9789144118086 ; , s. 265-284
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 25. |
- Englund, Oskar, 1982, et al.
(författare)
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Oil palm for biodiesel in Brazil — risks and opportunities
- 2015
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Ingår i: Environmental Research Letters. - : IOP Publishing. - 1748-9318 .- 1748-9326. ; 10:4, s. 044002-
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Tidskriftsartikel (refereegranskat)abstract
- Although mainly used for other purposes, and historically mainly established at the expense of tropical forests, oil palm can be the most land efficient feedstock for biodiesel. Large parts of Brazil are suitable for oil palm cultivation and a series of policy initiatives have recently been launched to promote oil palm production. These initiatives are however highly debated both in the parliament and in academia. Here we present results of a high resolution modelling study of opportunities and risks associated with oil palm production for biodiesel in Brazil, under different energy, policy, and infrastructure scenarios. Oil palm was found to be profitable on extensive areas, including areas under native vegetation where establishment would cause large land use change (LUC) emissions. However, some 40–60 Mha could support profitable biodiesel production corresponding to approximately 10% of the global diesel demand, without causing direct LUC emissions or impinging on protected areas. Pricing of LUC emissions could make oil palm production unprofitable on most lands where conversion would impact on native ecosystems and carbon stocks, if the carbon price is at the level $125/tC, or higher.
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| 26. |
- Folkesson, Elin, et al.
(författare)
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Differential protein expression in human knee articular cartilage and medial meniscus using two different proteomic methods : A pilot analysis
- 2018
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Proteomics is an emerging field in the study of joint disease. Our two aims with this pilot analysis were to compare healthy human knee articular cartilage with meniscus, two tissues both known to become affected in the osteoarthritic disease process, and to compare two mass spectrometry (MS)-based methods: data-dependent acquisition (DDA) and data-independent acquisition (DIA). Methods: Healthy knee articular cartilage taken from the medial tibial condyle and medial meniscus samples taken from the body region were obtained from three adult forensic medicine cases. Proteins were extracted from tissue pieces and prepared for MS analysis. Each sample was subjected to liquid chromatography (LC)-MS/MS analysis using an Orbitrap mass spectrometer, and run in both DDA and DIA mode. Linear mixed effects models were used for statistical analysis. Results: A total of 653 proteins were identified in the DDA analysis, of which the majority was present in both tissue types. Only proteins with quantitation information in both tissues (n = 90) were selected for more detailed analysis, of which the majority did not statistically significantly differ in abundance between the two tissue types, in either of the MS analyses. However, 21 proteins were statistically significantly different (p < 0.05) between meniscus and cartilage in the DIA analysis. Out of these, 11 proteins were also significantly different in the DDA analysis. Aggrecan core protein was the most abundant protein in articular cartilage and significantly differed between the two tissues in both methods. The corresponding protein in meniscus was serum albumin. Dermatopontin exhibited the highest meniscus vs articular cartilage ratio among the statistically significant proteins. The DIA method led to narrower confidence intervals for the abundance differences between the two tissue types than DDA. Conclusions: Although articular cartilage and meniscus had similar proteomic composition, we detected several differences by MS. Between the two analyses, DIA yielded more precise estimates and more statistically significant different proteins than DDA, and had no missing values, which makes it preferable for future LC-MS/MS analyses.
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| 27. |
- Freitas, Flavio L M, et al.
(författare)
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Biodiversity values of Brazilian native vegetation – How much is protected by the Forest Act?
- 2018
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Konferensbidrag (refereegranskat)abstract
- Human-induced land use change (LUC) is the most important driver of biodiversity loss. In Brazil, this process is particularly concerning considering that here are the most extensive tracts of tropical forest and other rare habitat types which host unique biodiversity. The preservation of much of this area is highly dependent on the implementation of the Forest Act, the central legal framework regulating the conservation of native vegetation on private land in Brazil. Recent studies provide a modelling framework for assessing the impacts of the Forest Act on the protection of native vegetation and associated carbon stocks for the entire Brazilian territory. However, there is not sufficient knowledge on the efficiency of this legislation in protecting areas of high and unique biodiversity in Brazil.This study aims to apply the existing land use governance assessment (LUGA) model to quantify the extent to which the Forest Act protects biodiversity. For this purpose, we construct indicators at fine-scale levels to capture the multiple dimensions of biodiversity (species richness, genetic, and functional diversity) and how these are related to the native vegetation. Using state-of-the-art databases of species distribution data, GIS-based modeling frameworks are developed and adapted to identify values of native vegetation related to the preservation of biodiversity in general, and endangered species in particular, and ecological connectivity. The results are evaluated for Brazilian regions where the LUC pressure is recognized to be most significant. The final model output consists of geoexplicit indicators at a high resolution, which informs about the degree of biodiversity protection provided by the Forest Act. The information provided by this project can support decision-making related to the selection of areas of high importance for biodiversity protection at local and regional levels. Further, it can potentially contribute to efficient use of resources and improved effectiveness of incentive mechanisms in promoting conservation of unprotected native vegetation of high biodiversity value.
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| 28. |
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| 29. |
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| 30. |
- Friberger Pajalic, Katarina, et al.
(författare)
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Update on the risks of complications after knee arthroscopy
- 2018
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Knee arthroscopy is one of the most common surgical procedures worldwide and the number of arthroscopies has substantially increased in the last 30 years. Thus, our aim was to provide updated estimates on the risk of complications and compare it with the background risk in the general population. Methods: We identified patients aged 15-84 years with knee arthroscopy in the years 2005-2016 in southern Sweden. We calculated the risk of pyogenic arthritis, venous thromboembolism, and other typical complications within 30 days. As a reference cohort we included the regional population in the corresponding age interval. We estimated the relative and absolute risks of complications compared to the reference cohort using logistic regression adjusted for age, sex, and level of education. We also estimated the proportion of complications in the population explained by knee arthroscopy (population attributable fraction). Results: We identified 18,735 knee arthroscopy patients (mean age 39 years) and 1,171,084 reference subjects (mean age 46 years). The absolute risk of one or more complications was 1.1% after knee arthroscopy and 0.16% in references. The odds ratio of any complication after knee arthroscopy vs. the reference cohort was 9.4 (95% confidence interval [CI] 8.1, 10.9) with an absolute risk difference of 1.4% (1.1, 1.6%). The relative risk (95% CI) for pyogenic arthritis was 115 (75, 174), venous thromboembolism 6.8 (5.1, 9.1), and other complications 7.7 (6.3, 9.5). The population attributable fraction for pyogenic arthritis was 5%. Conclusions: The absolute risks of complications associated with knee arthroscopy remain small at about 1%. Still, 5% of all pyogenic knee arthritis cases in adults are attributable to knee arthroscopy, thus risks with knee arthroscopy should be carefully considered in the choice of treatment.
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| 31. |
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| 32. |
- Hameed, Mohaned, et al.
(författare)
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Prevalence and incidence of non-gout crystal arthropathy in southern Sweden
- 2019
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Ingår i: Arthritis research & therapy. - : Springer Science and Business Media LLC. - 1478-6354 .- 1478-6362. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To estimate the prevalence and incidence of non-gout crystal arthropathy in relation to socioeconomic factors in southern Sweden. Methods: All patients (age >= 18 years) with at least one visit to a physician with the diagnosis of interest in the Skane region (population of 1.3 million) in 1998-2014 were identified. Non-gout crystal arthropathy (ICD-10 codes M11.0-M11.9) was subclassified in four different groups: calcium pyrophosphate crystal deposition related arthropathy (CPPD), unspecified non-gout arthropathies, chondrocalcinosis, and hydroxyapatite crystal deposition disease. The crude and age-adjusted point prevalence on December 31, 2014, and the cumulative incidence during 2014 were calculated for all non-gout crystal arthropathies, CPPD, and other unspecified non-gout arthropathies overall and in relation to occupation, income, and level of education. Results: The crude 2014 point prevalence (95% CI) and 2014 cumulative incidence (95% CI) of all non-gout crystal arthropathies were 0.23% (0.23-0.24) and 21.5 (19-25) cases/100,000 persons. Mean age (range) among all prevalent cases in 2014 was 71 (20-102) years and 56% were males. The point prevalence and cumulative incidence of CPPD were 0.09% (0.08-0.09) and 8 (7-10)/100,000 persons, respectively. The corresponding data for unspecified non-gout crystal deposition disease was 0.16% (0.16-0.17) and 15.6 (13-18)/100,000 persons, respectively. The prevalence and incidence of CPPD and unspecified non-gout crystal arthropathies were slightly higher in men and increased with age irrespective of gender. Unspecified non-gout crystal arthropathy but not CPPD was less prevalent in persons with >= 15 years of education, whereas there were no clear associations with occupation and income. Conclusion: The prevalence of all diagnosed non-gout crystal arthropathies was 0.23%, thus considerably less prevalent than gout in southern Sweden. CPPD and other unspecified non-gout crystal arthropathies are the predominant diagnoses, increasing with age and in men. With the exception for unspecified non-gout crystal arthropathies being inversely correlated to a higher level of education, no convincing association with the socioeconomic factors was found.
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| 33. |
- Haugen, Ida K, et al.
(författare)
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The prevalence, incidence, and progression of hand osteoarthritis in relation to body mass index, smoking, and alcohol consumption
- 2017
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Ingår i: Journal of Rheumatology. - : The Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 44:9, s. 1402-1409
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To estimate the extent that overweight/obesity, smoking, and alcohol are associated with prevalence and longitudinal changes of radiographic hand osteoarthritis (OA). Methods. Participants from the Osteoarthritis Initiative (n = 1232) were included, of whom 994 had 4-year followup data. In analyses on incident hand OA, only persons without hand OA at baseline were included (n = 406). Our exposure variables were overweight/obesity [body mass index (BMI), waist circumference], smoking (current/former, smoking pack-yrs), and alcohol consumption (drinks/week). Using linear and logistic regression analyses, we analyzed possible associations between baseline exposure variables and radiographic hand OA severity, erosive hand OA, incidence of hand OA, and radiographic changes. Analyses were adjusted for age, sex, and education. Results. Neither overweight nor obesity were associated with hand OA. Current smoking was associated with less hand OA in cross-sectional analyses, whereas longitudinal analyses suggested higher odds of incident hand OA in current smokers (OR 2.20, 95% CI 1.02-4.77). Moderate alcohol consumption was associated with higher Kellgren-Lawrence sum score at baseline (1-3 drinks: 1.55, 95% CI 0.43-2.67) and increasing sum score during 4-year followup (4-7 drinks: 0.33, 95% CI 0.01-0.64). Moderate alcohol consumption (1-7 drinks/week) was associated with 2-fold higher odds of erosive hand OA, which was statistically significant. Additional adjustment for BMI gave similar strengths of associations. Conclusion. Overweight/obesity were not associated with hand OA. Contrasting results were observed for smoking and hand OA, suggesting lack of association. Moderate alcohol consumption was associated with hand OA severity, radiographic changes, and erosive hand OA, warranting further investigation.
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| 34. |
- Hubertsson, Jenny, et al.
(författare)
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Understanding Occupation, Sick Leave, and Disability Pension Due to Knee and Hip Osteoarthritis From a Sex Perspective
- 2017
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Ingår i: Arthritis Care and Research. - : Wiley. - 2151-464X. ; 69:2, s. 226-233
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the association between occupation and risk for sick leave or disability pension due to knee or hip osteoarthritis (OA) from a sex perspective. Methods: We conducted a population-based study including residents ages 40–70 years in the Skåne region, Sweden (2007) and working in the included job sectors (n = 165,179). We retrieved data on cause-specific sick leave and disability pension (2007–2012) and linked to individual information on occupation and education (2007). Occupations were classified into job sectors. We calculated sex-specific, age-adjusted odds ratios (ORs) of sick leave and disability pension due to OA in traditionally female-dominated job sectors (health care, child care, and cleaning) and traditionally male-dominated job sectors (construction, farming, metal work, or transportation) compared to business and administration. Results: Of all eligible subjects, 2,445 had sick leave or disability pension due to knee or hip OA. Adjusted for age, the risk of sick leave due to knee OA was increased for women working in health care, with an OR of 3.3 (95% confidence interval [95% CI] 2.6–4.2), child care OR 2.9 (95% CI 2.2–3.8), and cleaning OR 3.0 (95% CI 2.2–4.1), as was the risk for disability pension. The risk was increased also for persons working in occupations with higher educational requirements. The risk was similarly increased in male-dominated sectors. In female-dominated job sectors the risk of sick leave and disability pension due to knee OA, but not hip OA, was higher than that for other musculoskeletal diseases. Conclusion: Traditionally female-dominated occupational sectors are associated with an increased risk of sick leave and disability pension due to knee OA.
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| 35. |
- Jarraya, Mohamed, et al.
(författare)
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Meniscus morphology : Does tear type matter? A narrative review with focus on relevance for osteoarthritis research
- 2017
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Ingår i: Seminars in Arthritis and Rheumatism. - : Elsevier BV. - 0049-0172. ; 46:5, s. 552-561
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To give a narrative overview of meniscal tears with a radiologic emphasis on the morphologic type, technical considerations, and on the relevance of the type of meniscal tear in the context of osteoarthritis (OA) research. Design: Total 20 years of the PubMed database were searched for epidemiological, radiological, arthroscopic and biomechanical reports, and review articles focusing on meniscal tears in middle-aged and older individuals, in the setting of OA. Case reports, publications on meniscal tears in young active individuals, and publications not in English were excluded. Results: Meniscal intra-substance signal abnormalities are associated with an increased risk of a degenerative meniscal tear in the same segment. Posterior radial tears of the medial meniscus appear to be a highly relevant event in OA of the knee, with associated cartilage loss and meniscal extrusion. Radial tears are more commonly missed on MRI than other types, and should be carefully looked for on coronal and axial images. While medial meniscus posterior root tears are of "radial" morphology, there is growing interest in looking at them as a separate entity, mainly because they require a different therapeutic approach. Conclusion: There is a lack of data on the relevance of different morphologic types of meniscal tears to the natural history of knee OA, both cross-sectionally and-especially-longitudinally. Further epidemiologic studies should focus on specific meniscal tears based on their morphology to better understand their relevance in the genesis and progression of knee OA.
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| 36. |
- Jerrhag, Daniel, et al.
(författare)
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Epidemiology and time trends of distal forearm fractures in adults - a study of 11.2 million person-years in Sweden
- 2017
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: A distal forearm fracture is a very common injury causing both suffering and substantial health care costs. The incidence of this fracture type seemed to increase worldwide until the middle 1980’s, but thereafter most reports have shown stable or decreasing rates. As few large studies have been presented lately we aimed to describe recent epidemiology and time trends of distal forearm fractures in adults. We paid special attention to fractures in working ages as they present challenges in terms of treatment and costs for sick-leave, and have not previously been thoroughly investigated. Methods: By use of population data from Statistics Sweden and official in- and out-patient register data of men and women (≥17 years) in Sweden (Skåne region), we ascertained distal forearm fractures and estimated age- and sex-specific rates and time-trends from year 1999 to 2010 (11.2 million person-years (py)). Results: The total incidence rate was 278 per 100,000 py (31,233 fractures) with 23% higher annual numbers 2010 compared with 1999. An increase in the annual age standardized incidence was found in men, +0.7% per annum (95% confidence interval (CI) 0.1, 1.4), and women, +0.9% (95% CI 0.5, 1.3), driven mainly by an increasing incidence in working ages (17-64 years). Also, expected demographic changes including a 25% population increase may result in 38% more fractures until 2050, compared to 2017. Conclusions: The incidence of distal forearm fractures in adults in southern Sweden is increasing, mainly driven by an increase in working ages. In combination with expected demographic changes these findings may present substantial challenges for the future.
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| 37. |
- Jerrhag, Daniel, et al.
(författare)
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Increasing wrist fracture rates in children may have major implications for future adult fracture burden.
- 2016
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Ingår i: Acta Orthopaedica. - : Informa UK Limited. - 1745-3682 .- 1745-3674. ; :Feb 24, s. 1-5
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Childhood fractures are associated with lower peak bone mass (a determinant of osteoporosis in old age) and higher adult fracture risk. By examining time trends in childhood fracture epidemiology, it may be possible to estimate the vector of fragility fracture risk in the future. Patients and methods - By using official inpatient and outpatient data from the county of Skåne in Sweden, 1999-2010, we ascertained distal forearm fractures in children aged ≤ 16 years and estimated overall and age- and sex-specific rates and time trends (over 2.8 million patient years) and compared the results to earlier estimations in the same region from 1950 onwards. Results - During the period 1999-2010, the distal forearm fracture rate was 634 per 10(5) patient years (750 in boys and 512 in girls). This was 50% higher than in the 1950s with a different age-rate distribution (p < 0.001) that was most evident during puberty. Also, within the period 1999-2010, there were increasing fracture rates per 10(5) and year (boys +2.0% (95% CI: 1.5-2.6), girls +2.4% (95% CI: 1.7-3.1)). Interpretation - The distal forearm fracture rate in children is currently 50% higher than in the 1950s, and it still appears to be increasing. If this higher fracture risk follows the children into old age, numbers of fragility fractures may increase sharply-as an upturn in life expectancy has also been predicted. The origin of the increase remains unknown, but it may be associated with a more sedentary lifestyle or with changes in risk behavior.
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| 38. |
- Johnsen, Marianne Bakke, et al.
(författare)
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The association between smoking and knee osteoarthritis in a cohort of Danish patients undergoing knee arthroscopy
- 2019
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: It has been suggested that smoking is associated with reduced risk of knee osteoarthritis (OA). However, supplementary studies are needed to further investigate any such potential association. Thus, our aim was to examine the relationship between smoking and early or more established knee OA in a cohort of relatively young patients with meniscal tears. Methods: This cross-sectional study included 620 participants from the Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing knee arthroscopy for a meniscal tear (mean age 49.2 (18.0-76.8) years). Recruitment of patients was performed between February 1, 2013, and January 31, 2015, at four different hospitals in Denmark. We defined early or more established knee OA as the combination of patient-reported frequent knee pain, degenerative meniscal tissue and presence of cartilage defects assessed by the operating surgeons. The relationship between smoking status and knee OA was examined by risk ratio (RR) with a 95% confidence interval (CI), estimated from logistic regression adjusted for age, sex, BMI, education, work status and level of physical activity. Results: The prevalence of early or more established knee OA was 37.7% in current smokers and 45.0% in non-smokers. We found no statistically significant association between current smoking and knee OA (adjusted RR 1.09, 95% CI 0.91-1.30). Conclusions: This study found no relationship between current smoking and early or more established knee OA in a cohort of patients undergoing arthroscopic meniscal surgery. Thus, the inverse association between smoking and knee OA that has been suggested by previous studies was not confirmed.
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| 39. |
- Jonsson, Magnus H., et al.
(författare)
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Plasma lactate at admission does not predict mortality and complications in hip fracture patients : a prospective observational study
- 2018
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Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation. - : Informa UK Limited. - 0036-5513 .- 1502-7686. ; 78:6, s. 508-514
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Tidskriftsartikel (refereegranskat)abstract
- Hip fractures in elderly carry a high mortality. Our objective was to test the hypothesis that plasma lactate concentration at hospital admission can be used to identify patients with a high risk for poor outcome. Hip fracture patients admitted to a university hospital in Sweden from January 2011 to August 2014 in whom a venous lactate was obtained at admission were included in this prospective observational study. Primary outcome measure was 30-d mortality and secondary outcome measure was a composite outcome of 30-d mortality and postoperative complications. Lactate concentration was evaluated as a continuous predictor using logistic regression, crude and adjusted for age, gender and American Society of Anesthesiology Physical Status (ASA PS) score. Discrimination was evaluated using receiver operating characteristics (ROC) analysis. Totally, 690 patients were included. Median age was 84 years (interquartile range [IQR] 77–90). At 30-d follow-up, mortality was 7.2%, and 45% of the patients had suffered the composite outcome. Median lactate level was 1.3 mmol/L (IQR 1.0–1.8 mmol/L). The odds ratio (OR) by each 1.0 mmol/L increase in the lactate concentration for 30-d mortality was 1.13 (95% CI 0.77–1.68) while for the composite outcome it was 1.06 (95% CI 0.85–1.3). Similar results were obtained after adjustment for age, sex and ASA PS classification for both outcomes. Area under the ROC curve for lactate as a predictor of 30-d mortality was 0.51 (95% CI 0.45–0.57). In our cohort, plasma lactate at admission does not appear to be a useful biomarker to identify high-risk patients after hip fracture.
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| 40. |
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| 41. |
- Jørgensen, Tanja Schjødt, et al.
(författare)
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EQ-5D utility, response and drug survival in rheumatoid arthritis patients on biologic monotherapy : A prospective observational study of patients registered in the south Swedish SSATG registry
- 2017
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 12:2
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Biologic agents have dramatically changed treatment of rheumatoid arthritis (RA). To date only scarce head-To-head data exist especially when the biological therapies are given as monotherapy without concomitant disease modifying drugs (DMARDs). Thus the objective of the current study is to evaluate treatment response of all available biological therapies with special focus on utility (EQ-5D-3L) and drug survival of biologic DMARDs (bDMARDs) prescribed as monotherapy in RA patients in southern Sweden. Materials and methods All RA patients registered in a regional database as initiating bDMARD as monotherapy, i.e. without concomitant conventional synthetic DMARDs (csDMARDs), from 1st of January 2006 through 31st of December 2012, were included. Patients were followed from initiation of the first dose of bDMARD monotherapy treatment until withdrawal from treatment, loss of follow-up or 31st of December 2012. Descriptive statistics for utility (EQ-5D-3L), effectiveness, and drug survival of bDMARD monotherapy were calculated. Results During the study period, a total of 554 patients were registered in SSATG as initiating bDMARD monotherapy. Most of the patients were women (81%), with a mean age of 57 years. The average disease duration was more than 12 years, and on average the patients had previously been treated with approximately four different csDMARDs. Fifty-five percent of the patients were initiating their first bDMARD, 26% their second, and 19% their third or more. At baseline the average EQ-5D-3L was 0.34. Most patients had moderate to high disease activity, with a mean DAS28 of 5.0, and were substantially disabled, with an average HAQ score of 1.4. At 6 months follow-up, the EQ-5D-3L in patients still on the biologic drug had increased by mean 0.23 (SD 0.4) with no differences between type of bDMARD (p = 0.49). The mean change in EQ-5D-3L ranged from 0.11 (rituximab and infliximab) to 0.42 (tocilizumab). Although the changes were numerically different, no distinct pattern favored any particular bDMARD for EQ-5D-3L (p = 0.49) or other clinical outcomes. Overall, DAS28 defined remission and low disease activity were achieved in 20% and 43% of patients, respectively. Drug survival rates were statistically significantly different between bDMARDs (p = 0.01), with the highest rates observed for rituximab, followed by etanercept. After failing first course of anti-TNF, patients switching to another mode of action had significantly higher drug survival than those switching to a second course of anti-TNF therapy (p = 0.02). Conclusions Utility (EQ-5D-3L) increased after 6 months of all bDMARD treatments in monotherapy, indicating improvement of patients' quality of life. After failure of anti-TNF treatment in monotherapy, switching to another mode of action may be associated with better drug survival than starting a second TNF-inhibitor.
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| 42. |
- Kapetanovic, Meliha C., et al.
(författare)
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Prevalence and incidence of gout in southern Sweden from the socioeconomic perspective
- 2016
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Ingår i: RMD Open. - : BMJ. - 2056-5933. ; 2:2
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To estimate the prevalence and cumulative incidence of gout in southern Sweden with respect to socioeconomic status. Methods Among residents of Skåne region in the year 2013 (total population 1.3 million), adult persons (age 18 years +) who between 1998 and 2013 received a diagnosis of gout (International Classification of Disease 10th Edition (ICD-10) code M10) by any physician were identified using the Skåne Healthcare Register. We calculated the point prevalence by end of 2013 and annual cumulative incidence in 2013 standardised to the whole Skåne population according to sex, individual information on occupation (white collar/blue collar), income (low/middle/high) and level of education (primary school/high school/university). Results The crude 2013 point prevalence of gout and 2013 cumulative incidence (95% CI) were 1.69% (1.66% to 1.71%) and 24 cases per 10 000 persons (23-25), respectively. Compared to women, men had higher point prevalence (2.44% (2.40% to 2.49%) vs 0.96% (0.93% to 0.98%)) and higher annual cumulative incidence (33 cases per 10 000 (32-35)) versus 15 (14-16)). These figures increased with higher age but decreased with higher level of education, being the lowest in individuals with a university degree. Persons with middle income had highest point prevalence and cumulative incidence of gout, while those with white collar occupations had the lowest. Conclusions Gout is the most common inflammatory arthritis in southern Sweden with a prevalence of 1/41.7% in the adult population. There is a socioeconomic gradient with more gout present in the lower level of education and with more manual labour. © 2016 Published by the BMJ Publishing Group Limited.
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| 43. |
- Kapetanovic, Meliha C., et al.
(författare)
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The risk of clinically diagnosed gout by serum urate levels : Results from 30 years follow-up of the Malmö preventive project cohort in southern Sweden
- 2018
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Ingår i: Arthritis Research and Therapy. - : Springer Science and Business Media LLC. - 1478-6354 .- 1478-6362. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hyperuricemia (HU) is in the causal pathway for developing clinical gout. There are few population-based assessments of the absolute and relative risk of clinically diagnosed incident gout in subjects with HU. We aimed to explore the long-term risk of developing incident gout among asymptomatic adults with different levels of serum urate (SU). Methods: Malmö Preventive Project was a population-based screening program for cardiovascular risk factors, alcohol abuse, and breast cancer in Malmö, Sweden. The study population was screened between 1974 and 1992. At baseline, subjects were assessed with a questionnaire, physical examination, and laboratory tests. Follow-up ended at first gout diagnosis, death, moving from area, or December 31, 2014. Incident gout (using ICD10 codes) was diagnosed based on national registers for specialized inpatient and outpatient care, and from 1998 onward in the Skåne Healthcare Register including primary healthcare. Incidence rates, absolute risk, hazard ratios (HRs) and potentially associated factors were analyzed by baseline SU levels, i.e. normal levels (≤ 360 μmol/L); 361-405 (levels below tissue solubility of SU), and > 405 (HU), overall, and by sex. Results: Overall, 1275 individuals [3.8%; 1014 men (4.5%) and 261 women (2.4%)] of the 33,346 study participants (mean age: 45.7 (SD: 7.4), 67% men), developed incident gout during follow-up (mean 28.2 years). Of those with HU, 14.7% of men and 19.5% of women developed gout. Compared to subjects in the lowest SU category, the age-adjusted HR in men increased from 2.7 to 6.4, and in women from 4.4 to 13.1 with increasing baseline SU category, and with a statistically significant interaction of sex (p < 0.001). Body mass index, estimated glomerular filtration rate (negative), triglycerides, alcohol risk behavior (only in men), and comorbidities such as hypertension, cardiovascular disease, and diabetes were strongly associated with SU at baseline in both sexes. Conclusions: The absolute risk for developing clinically diagnosed gout over 30 years in middle-aged subjects was 3.8%, and increased progressively in both men and women in relation to baseline SU. This risk increase was significantly higher in women than in men, whereas the associations between baseline risk markers and SU levels were similar in both sexes.
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| 44. |
- Kiadaliri, Aliasghar A, et al.
(författare)
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Educational inequalities in mortality associated with rheumatoid arthritis and other musculoskeletal disorders in Sweden
- 2019
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Musculoskeletal (MSK) disorders are less likely to be reported as an underlying cause of death (UCD) and since cause of death studies are generally limited to the UCD, little is known about socioeconomic inequalities in MSK disorders as cause of death in the general population. Using multiple-cause-of-death data, we aimed to quantify and compare educational inequalities in musculoskeletal (MSK) disorders- with non-MSK disorders-related mortality.METHODS: All residents aged 30-99 years in the Skåne region, Sweden, during 1998-2013 (n = 999,148) were followed until their 100th birthday, death, relocation outside Skåne, or end of 2014. We identified any mention of rheumatoid arthritis (RA) or other MSK disorders on death certificates using multiple-cause-of-death data. We retrieved and linked individual-level data from Statistics Sweden on highest level of education. We used Cox regression and additive hazards models with age as time-scale adjusted for sex, marital status, and country of birth to calculate slope and relative indices of inequality (SII/RII).RESULTS: During a mean follow-up of 12.2 years, there were 1407 (0.8% of all deaths) and 3725 (2.1% of all deaths) death certificates with mention of RA and other MSK disorders, respectively, and 171,798 death certificates without any mention of a MSK disorder. Age-standardized RA mortality rate was 2.2 (95% confidence interval [CI]: 2.0-2.8) times greater in people with 0-9 years of education compared with those with > 12 years of education. Corresponding figure for other MSK disorders was 1.5 (95% CI: 1.4-1.6). Both RIIs and SIIs revealed statistically significant educational inequalities in RA/other MSK disorders mortality favouring high-educated people. The RIIs of MSK disorders-related deaths were generally greater than non-MSK disorders-related deaths.CONCLUSION: We found substantial educational inequality in mortality from MSK disorders. Further research is needed to investigate underlying pathways driving these inequalities.
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| 45. |
- Kiadaliri, Aliasghar A, et al.
(författare)
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Fracture-related mortality in southern Sweden : A multiple cause of death analysis, 1998-2014
- 2018
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Ingår i: Injury. - : Elsevier BV. - 1879-0267 .- 0020-1383. ; 49:2, s. 236-242
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To assess fracture-related mortality among adults (aged ≥20years) in southern Sweden using multiple causes of death approach.METHODS: All death certificates (n=201 488) in adults recorded in the region of Skåne from 1998 to 2014 were examined. We identified fracture-related deaths and computed mortality rates by sex, age group, and fracture site. Temporal trends were evaluated using joinpoint regression and associated causes were identified by age- and sex-adjusted observed/expected ratios.RESULTS: Fractures were mentioned on 6 226 (3.1%) death certificates, with majority of these occurred among women (60%) and those aged≥80years (77%). While hip was the most common site overall (61% of all fracture-related deaths), skull was the most common site in people <60years (60% of all fracture-related deaths). Proportion of death certificates mentioning fracture was stable in women but increased by 0.4% (95% CI: 0.1 to 0.6) in men between 1998-2002 and 2010-2014. The mean age at death was higher in death certificates mentioning fracture than those without and this gap widened over time. The mean age-standardized fracture-related mortality rate was 18.8 (14.0) per 100 000 person-year in men (women) and declined by 1.5% (1.3%) per year during 1998-2014. Injuries (84.6%) and cardiovascular disorders (64.6%) were the most common comorbidities on death certificates mentioning fracture.CONCLUSIONS: Fracture is a contributing cause of death in more than 3% of all deaths in southern Sweden with hip in lead among older and skull fracture among younger people. There was a slight increase in proportion of deaths associated with fracture in men but not women during the study period.
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| 46. |
- Kiadaliri, Aliasghar A, et al.
(författare)
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High and rising burden of hip and knee osteoarthritis in the Nordic region, 1990-2015
- 2018
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 89:2, s. 177-183
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Osteoarthritis (OA) imposes a substantial burden on individuals and societies. We report on the burden of knee and hip OA in the Nordic region. Patients and methods - We used the findings from the 2015 Global Burden of Diseases Study to explore prevalence, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) of OA in the 6 Nordic countries during 1990-2015 (population of about 27 million in 2015). Results - During 1990-2015, the number of prevalent OA cases increased by 43% to 1,507,587 (95% uncertainty interval [UI] 1,454,338-1,564,778) in the region. OA accounted for 1.3% (UI 1.0-1.7) of YLDs in 1990, increasing to 1.6% (UI 1.2-2.0) in 2015. Of 315 causes studied, OA was the 15th leading cause of YLDs, causing 52,661 (UI 34,056-77,499) YLDs in 2015; of these 23% were attributable to high body mass index. The highest relative importance of OA was reported for women aged 65-74 years (8th leading cause of YLDs in 2015). Among the top 30 leading causes of YLDs in the region, OA had the 5th greatest relative increase in total YLDs during 1990-2015. From 1990 to 2015, increase in age-standardized YLDs from OA in the region was slightly lower than increase at the global level (7.5% vs. 10.5%). OA was, however, responsible for a higher proportional burden of DALYs in the region compared with the global level. Interpretation - The OA burden is high and rising in the Nordic region. With population growth, aging, and the obesity epidemic, a substantial rise in the burden of OA is expected and should be addressed in health policies.
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| 47. |
- Kiadaliri, Aliasghar A, et al.
(författare)
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Hospitalizations due to systemic connective tissue diseases: : Secular trends and regional disparities in Sweden, 1998-2016
- 2018
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Ingår i: International Journal of Rheumatic Diseases. - 1756-185X. ; 21:11, s. 1900-1906
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate secular trends and regional disparities in hospitalizations due to systemic connective tissue diseases (SCTD) in Sweden from 1998 to 2016.METHOD: We identified all hospital admissions with a principal diagnosis of SCTD (ICD-10 codes: M30-M36) from the Swedish National Patient Register. Joinpoint regression was used to assess secular trends in age-standardized hospitalization rates (ASHR) and proportions of SCTD from all and musculoskeletal disorders hospitalizations. We also assessed the secular trends in the absolute and relative regional disparities of SCTD hospitalizations.RESULTS: We identified 89 333 SCTD hospitalizations (0.3% of all hospitalizations), of these about 69% were for women and 49% of patients were aged 15-64 years. Polyarteritis nodosa and related conditions (PANRC) and systemic lupus erythematosus (SLE) were the most frequent SCTD among those aged <10 years and 10-54 years, respectively. Joinpoint regression suggested that both rates and proportions of SCTD hospitalizations declined over time. These trends persisted among sex, age and diagnosis subgroups except for PANRC in patients aged 0-19 years who observed an average annual increase of 3.4% (95% CI: 1.8, 5.1) over the study period. There were 2.4-fold (95% CI: 2.3-2.5) difference between the regions with the highest and lowest mean ASHR. There was no statistically significant secular trend in the relative regional disparities, whereas the absolute regional disparity declined over time.CONCLUSION: There were substantial decreases in the absolute and relative burden of SCTD hospitalizations reflecting possible improvements in disease management in Sweden. The rising trend in PANRC among the youngest children warrants further investigation.
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| 48. |
- Kiadaliri, Aliasghar A, et al.
(författare)
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Temporal trend and regional disparity in osteoarthritis hospitalisations in Sweden 1998-2015
- 2019
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 47:1
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This study investigated time trend and regional disparities in hospitalisations due to osteoarthritis (OA) among people aged ≥20 years in Sweden from 1998 through 2015.METHODS: National and regional data on hospital admissions with a primary diagnosis of OA were collected from the National Patient Register. The absolute and relative regional disparities were assessed using the absolute weighted mean difference from overall mean and the index of disparity. We applied joinpoint regression for temporal trend analysis of hospitalisations and the Mann-Kendall trend test for disparity measures. Changes in number of OA hospitalisations between 1998-2000 and 2013-2015 were analysed using two counterfactual scenarios.RESULTS: During 1998-2015, OA hospitalisations constituted 2.0% of all hospitalisations, with higher proportions among women (58.7%) and those aged 70-74 years (18.0%). The age-standardised rate of OA hospitalisation and its proportions from all and musculoskeletal disorders hospitalisations rose, on average, by >2.0% per year during the study period. OA hospitalisation rates rose statistically significantly in all age groups except for the youngest and oldest age groups. The proportion of hip OA from all OA hospitalisations declined, while the opposite was observed for knee OA. The relative regional disparities declined in men, and the absolute regional disparities rose among women over time. The population growth and ageing could explain only about one third of the observed increases in the absolute number of OA hospitalisations between 1998-2000 and 2013-2015.CONCLUSIONS: OA hospitalisations have increased substantially, suggesting the need to improve OA prevention and primary-care management in Sweden.
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| 49. |
- Kiadaliri, Aliasghar A, et al.
(författare)
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Temporal trends and regional disparity in rheumatoid arthritis and gout hospitalizations in Sweden, 1998-2015
- 2018
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Ingår i: Clinical Rheumatology. - : Springer Science and Business Media LLC. - 1434-9949 .- 0770-3198. ; 37:3, s. 825-830
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Tidskriftsartikel (refereegranskat)abstract
- Hospitalization is an important component of rheumatoid arthritis (RA) and gout economic burden. This study aimed to assess temporal trends and regional disparities in RA and gout hospitalizations among people aged ≥ 20 years in Sweden during 1998-2015. Data on hospital admissions with a principal diagnosis of RA or gout were collected from the National Patient Register. Age-standardized hospitalization rates (ASHRs) were calculated by means of direct standardization. The absolute and relative regional disparities were assessed. The temporal trends in ASHR and proportion of RA and gout hospitalizations from all and musculoskeletal disorders hospitalizations were analyzed using joinpoint regression. Between 1998-2000 and 2013-2015, the ASHR for RA declined by 78.9% from 109.9 to 23.2 per 100,000 Swedish adults, while it almost doubled for gout (from 10.5 to 20.8 per 100,000 Swedish adults). While in 1998-2000, RA hospitalizations were 10.3 times more frequent than gout (0.54 vs 0.05% of all hospitalizations), this ratio declined to 1.1 in 2013-2015 (0.13 vs 0.11% of all hospitalizations). The joinpoint regression revealed that, on average, the ASHR for RA declined by 10.2% (95% CI: 9.3-11.1) per year whereas for gout, it rose by 4.3% (3.2-5.4) per year during 1998-2015. While the relative regional disparities were stable, the absolute regional disparity declined for RA and increased for gout over the study period. While substantial decline in RA hospitalization is encouraging, the substantial rise in gout hospitalization is of concern, reflecting potential increase in prevalence of gout and suboptimal management of the disease.
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| 50. |
- Kiadaliri, Ali, et al.
(författare)
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Educational inequalities in all-cause and cause-specific mortality among people with gout : a register-based matched cohort study in southern Sweden
- 2019
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Ingår i: International Journal for Equity in Health. - : Springer Science and Business Media LLC. - 1475-9276. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Gout is the most common inflammatory arthritis with a rising prevalence around the globe. While educational inequalities in incidence and prevalence of gout have been reported, no previous study investigated educational inequality in mortality among people with gout. The aim of this study was to assess absolute and relative educational inequalities in all-cause and cause-specific mortality among people with gout in comparison with an age- and sex-matched cohort free of gout in southern Sweden.METHODS: We identified all residents aged ≥30 years of Skåne region with doctor-diagnosed gout (ICD-10 code M10, n = 24,877) during 1998-2013 and up to 4 randomly selected age- and sex-matched comparators free of gout (reference cohort, n = 99,504). These were followed until death, emigration, or end of 2014. We used additive hazards models and Cox regression adjusted for age, sex, marital status, and country of birth to estimate slope and relative indices of inequality (SII/RII). Three cause-of-death attribution approaches were considered for RII estimation: "underlying cause", "any mention", and "weighted multiple-cause".RESULTS: Gout patients with the lowest education had 1547 (95% CI: 1001, 2092) more deaths per 100,000 person-years compared with those with the highest education. These absolute inequalities were larger than in the reference population (1255, 95% CI: 1038, 1472). While the contribution of cardiovascular (cancer) mortality to these absolute inequalities was greater (smaller) in men with gout than those without, the opposite was seen among women. Relative inequality in all-cause mortality was smaller in gout (RII 1.29 [1.18, 1.41]) than in the reference population (1.46 [1.38, 1.53]). The weighted multiple-cause approach generally led to larger RIIs than the underlying cause approach.CONCLUSIONS: Our register-based matched cohort study showed that low level of education was associated with increased mortality among gout patients. Although the magnitude of relative inequality was smaller in people with gout compared with those without, the absolute inequalities were greater reflecting a major mortality burden among those with lower education.
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