| 1. |
- Himmelmann, Kate, 1959, et al.
(författare)
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The changing panorama of cerebral palsy in Sweden. IX. Prevalence and origin in the birth-year period 1995-1998
- 2005
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Ingår i: Acta Paediatr. - 0803-5253. ; 94:3, s. 287-94
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This is the ninth report from the western-Swedish study of the prevalence and origin of cerebral palsy. METHODS: A population-based study covering the 88 371 live births in the area in 1995-1998. Birth characteristics, neuroimaging findings and risk factors in children with cerebral palsy were recorded, prevalence was calculated, and aetiology was analysed. RESULTS: The study comprised 170 children with cerebral palsy, i.e. a prevalence of 1.92 per 1000 live births. Excluding eight post-neonatally derived cases, the gestational age-specific prevalences were 77 per 1000 for children born before 28 wk of gestation, 40 for children born at 28-31 wk, 7 for children born at 32-36 wk and 1.1 for children born after 36 wk of gestation. Spastic hemiplegia, diplegia and tetraplegia accounted for 38%, 35% and 6%, respectively, dyskinetic cerebral palsy for 15%, and ataxia for 6%. For the first time, hemiplegia was now most common, due to the decline in preterm diplegia. There was a further increase in full-term dyskinetic cerebral palsy. The origin of cerebral palsy in children born at term was considered to be prenatal in 38%, peri/neonatal in 35% and unclassifiable in 27%, while in children born preterm it was 17%, 49% and 33%, respectively. CONCLUSION: The decreasing trend from the period 1991-1994 continued, both in children born at term and especially in those born preterm. However, the increase in dyskinetic cerebral palsy in children born at term was a matter of concern. In this group, a perinatal hypoxic ischaemic encephalopathy had been present in 71%.
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| 2. |
- Andersson, Eva, 1955, et al.
(författare)
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Incidence of asthma among workers exposed to sulfur dioxide and other irritant gases
- 2006
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 27:4
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to investigate whether repeated peak exposure (gassings) to sulphur dioxide (SO2) and other irritant gases increases the risk of new-onset asthma. A questionnaire was sent to 4,112 sulphite workers, of whom 1,919 completed the questionnaire and 396 completed the short-form questionnaire, which was sent out as a last reminder. A sample of 130 nonrespondents completed a telephone interview using the short-form questionnaire. The incidence of adult-onset, physician-diagnosed asthma during employment duration was analysed in relation to exposure to SO2 and gassings giving rise to respiratory symptoms. Incidence rates, as well as incidence rate ratios with 95% confidence interval (CI), were calculated. Further Cox regression models were used allowing assessment of hazard ratios (HR) stratified for sex and adjusted for atopy, smoking habits and age. The incidence rate for asthma among sulphite mill workers reporting gassings of SO2 was 6.2 out of 1,000 person-yrs, compared with 1.9 out of 1,000 person-yrs among subjects unexposed to SO2 and any gassings (HR (95% CI) 4.0 (2.1-7.7)). Among males reporting gassings to SO2, the HR (95% CI) for asthma was 5.8 (2.6-13) compared with unexposed males. In conclusion, repeated peak exposure to sulphur dioxide increased the incidence of asthma during work in sulphite pulp mills, which supports the hypothesis of irritant-induced asthma.
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| 3. |
- Beckung, Eva, 1950, et al.
(författare)
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Probability of Walking in Children With Cerebral Palsy in Europe.
- 2007
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Ingår i: Pediatrics. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES. The purpose of this work was to describe walking ability in children with cerebral palsy from the Surveillance of Cerebral Palsy in Europe common database through 21 years and to examine the association between walking ability and predicting factors. PATIENTS AND METHODS. Anonymous data on 10042 children with cerebral palsy born between 1976 and 1996 were gathered from 14 European centers; 9012 patients were eligible for the analyses. RESULTS. Unaided walking as the primary way of walking at 5 years of age was reported for 54%, walking with assistive devices was reported for 16%, and no walking ability was reported for 30%. The proportion of children who were unable to walk was rather stable over time in all of the centers, with a mean proportion of 28%. Walking ability related significantly to cerebral palsy types, that is, spastic unilateral, spastic bilateral, dyskinetic, and ataxic cerebral palsy, as well as to IQ level, active epilepsy, and severe visual and hearing impairment. Severe cerebral palsy, defined as both the inability to walk and an IQ of <50, was present in 20% of the subjects. Logistic regression revealed that intellectual capacity was the variable most associated with walking ability in all 4 of the cerebral palsy types. The presence of a severe intellectual impairment increased the risk of being unable to walk 56 times if the child had unilateral spastic cerebral palsy type and 9 times if the child had bilateral spastic cerebral palsy type. CONCLUSIONS. The collaboration Surveillance of Cerebral Palsy in Europe provides a powerful means of monitoring trends in cerebral palsy and its functional consequences. The proportion of nonwalking in children with cerebral palsy seems to be rather stable over years and across centers despite the changes that have occurred in neonatal care across Europe. As is well known and also shown in this study, walking ability varied strongly with cerebral palsy type. Additional impairments, as well as the presence of epilepsy, correlated significantly with walking ability and, thus, the walking ability can be an indicator of total disability load. PMID: 18070932 [PubMed - as supplied by publisher]
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| 4. |
- Beckung, Eva, 1950, et al.
(författare)
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Probability of walking in children with cerebral palsy in Europe.
- 2008
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 1098-4275 .- 0031-4005. ; 121:1
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The purpose of this work was to describe walking ability in children with cerebral palsy from the Surveillance of Cerebral Palsy in Europe common database through 21 years and to examine the association between walking ability and predicting factors. PATIENTS AND METHODS: Anonymous data on 10042 children with cerebral palsy born between 1976 and 1996 were gathered from 14 European centers; 9012 patients were eligible for the analyses. RESULTS: Unaided walking as the primary way of walking at 5 years of age was reported for 54%, walking with assistive devices was reported for 16%, and no walking ability was reported for 30%. The proportion of children who were unable to walk was rather stable over time in all of the centers, with a mean proportion of 28%. Walking ability related significantly to cerebral palsy types, that is, spastic unilateral, spastic bilateral, dyskinetic, and ataxic cerebral palsy, as well as to IQ level, active epilepsy, and severe visual and hearing impairment. Severe cerebral palsy, defined as both the inability to walk and an IQ of <50, was present in 20% of the subjects. Logistic regression revealed that intellectual capacity was the variable most associated with walking ability in all 4 of the cerebral palsy types. The presence of a severe intellectual impairment increased the risk of being unable to walk 56 times if the child had unilateral spastic cerebral palsy type and 9 times if the child had bilateral spastic cerebral palsy type. CONCLUSIONS: The collaboration Surveillance of Cerebral Palsy in Europe provides a powerful means of monitoring trends in cerebral palsy and its functional consequences. The proportion of nonwalking in children with cerebral palsy seems to be rather stable over years and across centers despite the changes that have occurred in neonatal care across Europe. As is well known and also shown in this study, walking ability varied strongly with cerebral palsy type. Additional impairments, as well as the presence of epilepsy, correlated significantly with walking ability and, thus, the walking ability can be an indicator of total disability load.
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| 5. |
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| 6. |
- Benzein, Eva, et al.
(författare)
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Familj och sociala relationer.
- 2009
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Ingår i: Omvårdnadens grunder. - Lund : Studentlitteratur AB. - 9789144049069 ; , s. 65-84
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 7. |
- Benzein, Eva Gunilla, et al.
(författare)
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'Being appropriately unusual' : a challenge for nurses in health-promoting conversations with families.
- 2008
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Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 15:2, s. 106-115
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Tidskriftsartikel (refereegranskat)abstract
- This study describes the theoretical assumptions and the application for health-promoting conversations, as a communication tool for nurses when talking to patients and their families. The conversations can be used on a promotional, preventive and healing level when working with family-focused nursing. They are based on a multiverse, salutogenetic, relational and reflecting approach, and acknowledge each person's experience as equally valid, and focus on families' resources, and the relationship between the family and its environment. By posing reflective questions, reflection is made possible for both the family and the nurses. Family members are invited to tell their story, and they can listen to and learn from each other. Nurses are challenged to build a co-creating partnership with families in order to acknowledge them as experts on how to lead their lives and to use their own expert knowledge in order to facilitate new meanings to surface. In this way, family health can be enhanced.
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| 8. |
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| 9. |
- Björkholm, Magnus, et al.
(författare)
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Central nervous system occurrence in elderly patients with aggressive lymphoma and a long-term follow-up
- 2007
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Ingår i: Annals of Oncology. - : Elsevier BV. - 0923-7534 .- 1569-8041. ; 18:6, s. 1085-1089
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Secondary central nervous system (CNS) involvement by aggressive lymphoma is a well-known and dreadful clinical complication. The incidence and risk factors for CNS manifestation were studied in a large cohort of elderly (>60 years) patients with aggressive lymphoma. PATIENTS AND METHODS: In all, 444 previously untreated patients were randomized to receive 3-weekly combination chemotherapy with cyclophosphamide, doxorubicin, vincristine and prednisone or cyclophosphamide, mitoxantrone, vincristine and prednisone (CNOP) (doxorubicin substituted by mitoxantrone) chemotherapy with or without filgrastim. Prophylactic intrathecal methotrexate was given to patients with lymphoma involvement of bone marrow, testis and CNS near sites. RESULTS: In all 29 of 444 (6.5%) developed CNS disease after a median observation time of 115 months. CNS was the only site of progression/relapse in 13 patients while part of a systemic disease manifestation in 16 patients. In univariate risk factor analysis, CNS occurrence was associated with extranodal involvement of testis (P = 0.002), advanced clinical stage (P = 0.005) and increased age-adjusted International Prognostic Index score (aaIPI; P = 0.035). In multivariate analysis, initial involvement of testis remained significant and clinical stage was of borderline significance. The median survival time was 2 months after presentation of CNS disease. CONCLUSION: A significant proportion of elderly patients with advanced aggressive lymphoma will develop CNS disease. CNS occurrence is related to testis involvement, advanced clinical stage and high aaIPI and the prognosis is dismal.
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| 10. |
- Caragounis, Eva Corina, et al.
(författare)
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Comparison of HIV-1 pol and env sequences of blood, CSF, brain and spleen isolates collected ante-mortem and post-mortem
- 2008
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Ingår i: Acta Neurol Scand. - : Hindawi Limited. - 1600-0404. ; 117:2, s. 108-16
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: HIV-1 infects the central nervous system (CNS) early in the course of infection. However, it is not known to what extent the virus evolves independently within the CNS and whether the HIV-RNA in cerebrospinal fluid (CSF) reflects the viral population replicating within the brain parenchyma or the systemic infection. The aim of this study was to investigate HIV-1 evolution in the CNS and the origin of HIV-1 in CSF. MATERIALS AND METHODS: Longitudinally derived paired blood and CSF samples and post-mortem samples from CSF, brain and spleen were collected over a period of up to 63 months from three HIV-1 infected men receiving antiretroviral treatment and presenting with symptoms of AIDS dementia complex (ADC). RESULTS: Phylogenetic analyses of HIV-1 V3, reverse transcriptase (RT) and protease sequences from patient isolates suggest compartmentalization with distinct viral strains in blood, CSF and brain. We found a different pattern of RT and accessory protease mutations in the systemic infection compared to the CNS. CONCLUSIONS: We conclude that HIV-1 may to some extent evolve independently in the CNS and the viral population in CSF mainly reflects the infection in the brain parenchyma in patients with ADC. This is of importance in understanding HIV pathogenesis and can have implications on treatment of HIV-1 patients.
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| 11. |
- Carlsson, Malin, et al.
(författare)
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Behaviour in children with cerebral palsy with and without epilepsy.
- 2008
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Ingår i: Developmental medicine and child neurology. - : Wiley. - 0012-1622 .- 1469-8749. ; 50:10, s. 784-9
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe behavioural problems in children with cerebral palsy (CP) with and without epilepsy. The children were sampled from the Western Sweden CP register and were part of a European Union project. The Strength and Difficulties Questionnaire and questions on epilepsy were answered by one parent of each child. Medical records were reviewed. Parents of 83 children (44 males, 39 females) age range participated: 30 at Gross Motor Function Classification System levels I and II, and 53 at levels III to V; 60 had spastic age range 8 to 12 years (bilateral 42, unilateral 18) and 23 dyskinetic CP; 34 children had active epilepsy. The proportion of children with normal behaviour on the total difficulties score (TDS) of the Strength and Difficulties Questionnaire was significantly lower than normative data (57% vs 80%, p<0.001). Parents of 21 children (25%) considered their child's behaviour to be abnormal. Children with CP and epilepsy had a significantly higher median TDS (p=0.03) than seizure-free children. In children with aided or no walking ability, the TDS was significantly higher in those with epilepsy (p=0.04). Parents of 32 children (39%) considered their children's behaviour to have an impact on themselves and others. We conclude that behavioural problems are common in children with CP, and even more when epilepsy is present. Parents identify these problems, and professionals need to address them.
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| 12. |
- Cederlund, Mats, 1962, et al.
(författare)
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Asperger syndrome and autism: a comparative longitudinal follow-up study more than 5 years after original diagnosis.
- 2008
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Ingår i: Journal of Autism and Developmental Disorders. - : Springer Science and Business Media LLC. - 0162-3257 .- 1573-3432. ; 38:1, s. 72-85
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Tidskriftsartikel (refereegranskat)abstract
- Prospective follow-up study of 70 males with Asperger syndrome (AS), and 70 males with autism more than 5 years after original diagnosis. Instruments used at follow-up included overall clinical assessment, the Diagnostic Interview for Social and Communication Disorders, Wechsler Intelligence Scales, Vineland Adaptive Behavior Scales, and Global Assessment of Functioning Scale. Specific outcome criteria were used. Outcome in AS was good in 27% of cases. However, 26% had a very restricted life, with no occupation/activity and no friends. Outcome in the autism group was significantly worse. Males with AS had worse outcomes than expected given normal to high IQ. However, outcome was considerably better than for the comparison group of individuals with autism.
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| 13. |
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| 14. |
- Ehrenborg, Christian, et al.
(författare)
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First known case of Bartonella quintana endocarditis in Sweden
- 2009
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 41:1, s. 73-75
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Tidskriftsartikel (refereegranskat)abstract
- In this report, we present the first known case of Bartonella endocarditis in Sweden. IgG antibody titres to Bartonella spp. were elevated but blood cultures remained negative. Sequencing of a gltA fragment from DNA extracted from heart valve tissue specimens revealed sequence homology with B. quintana.
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| 15. |
- Frossard, Laurent, et al.
(författare)
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Load-relief of walking AIDS on osseointegrated fixation: instrument for evidence-based practice.
- 2009
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Ingår i: IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society. - 1558-0210. ; 17:1, s. 9-14
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Tidskriftsartikel (refereegranskat)abstract
- Clinicians are currently in demand of tools enabling individual assessment during their daily practice of load-relief of walking aids. The first aim of this article is to describe a portable kinetic system that could be used to measure directly the true load applied on the residuum during assisted walking. The second aim is to present the information that can be derived from the raw loading data. The third aim is to provide an example for a participant. One active transfemoral amputee fitted with an osseointegrated fixation was asked to walk in straight level line with no aid, one stick, one and two elbow crutches on a 20 m walkway. The load-relief was measured using a six-channel transducer and recorded using a data logger. The overall loading was decreased by 2% using one stick, 5% using one crutch and by 10% using two crutches. This study presents a method that can be used by clinicians facing the challenge of prescribing and assessing walking aids to restore the locomotion of lower limb amputees in the framework of an evidence-based practice.
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| 16. |
- Frossard, L., et al.
(författare)
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Monitoring of the load regime applied on the osseointegrated fixation of a trans-femoral amputee: a tool for evidence-based practice
- 2008
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Ingår i: Prosthetics and Orthotics International. - 1746-1553. ; 32:1, s. 68-78
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to provide a description of the continuous recording of the true load regime experienced during daily living by the abutment of a trans-femoral amputee fitted with an osseointegrated fixation. The specific objectives: (i) To present an apparatus and a procedure allowing recording of the load regime, and (ii) an example of the raw data and six performance indicators of the usage of the prosthesis obtained with this method. A subject was monitored for a period of 5 hours as he went about his daily activities. The load regime was directly measured and recorded using a commercial transducer and data logger. The overall load profile presented alternative periods of variable length of inactivity (64%) and activity (36%), respectively. The maximum load applied on the mediolateral, anteroposterior and the long axes represented 21%, 21% and 120% of the body weight, respectively. The anteroposterior, mediolateral and long components of the impulse were 395 kN.s, 359 kN.s and 2,323 kN.s, respectively. The amputee generated a total of 2312 gait cycles of the prosthetic leg, giving an approximate overall cadence of 8 stride/min. Preliminary outcomes indicated that the proposed method was an improvement on the current techniques as it provided the true loading and actual usage of the prosthesis during daily living. This study is a stepping stone in the development of future affordable, on-board and user-friendly load recording systems that can be used in evidence-based practice.
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| 17. |
- Grimby-Ekman, Anna, 1967, et al.
(författare)
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Analyzing musculoskeletal neck pain, measured as present pain and periods of pain, with three different regression models: a cohort study
- 2009
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Ingår i: BMC Musculoskelet Disord. - : Springer Science and Business Media LLC. - 1471-2474. ; 10:73
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In the literature there are discussions on the choice of outcome and the need for more longitudinal studies of musculoskeletal disorders. The general aim of this longitudinal study was to analyze musculoskeletal neck pain, in a group of young adults. Specific aims were to determine whether psychosocial factors, computer use, high work/study demands, and lifestyle are long-term or short-term factors for musculoskeletal neck pain, and whether these factors are important for developing or ongoing musculoskeletal neck pain. METHODS: Three regression models were used to analyze the different outcomes. Pain at present was analyzed with a marginal logistic model, for number of years with pain a Poisson regression model was used and for developing and ongoing pain a logistic model was used. Presented results are odds ratios and proportion ratios (logistic models) and rate ratios (Poisson model). The material consisted of web-based questionnaires answered by 1204 Swedish university students from a prospective cohort recruited in 2002. RESULTS: Perceived stress was a risk factor for pain at present (PR = 1.6), for developing pain (PR = 1.7) and for number of years with pain (RR = 1.3). High work/study demands was associated with pain at present (PR = 1.6); and with number of years with pain when the demands negatively affect home life (RR = 1.3). Computer use pattern (number of times/week with a computer session > or = 4 h, without break) was a risk factor for developing pain (PR = 1.7), but also associated with pain at present (PR = 1.4) and number of years with pain (RR = 1.2). Among life style factors smoking (PR = 1.8) was found to be associated to pain at present. The difference between men and women in prevalence of musculoskeletal pain was confirmed in this study. It was smallest for the outcome ongoing pain (PR = 1.4) compared to pain at present (PR = 2.4) and developing pain (PR = 2.5). CONCLUSION: By using different regression models different aspects of neck pain pattern could be addressed and the risk factors impact on pain pattern was identified. Short-term risk factors were perceived stress, high work/study demands and computer use pattern (break pattern). Those were also long-term risk factors. For developing pain perceived stress and computer use pattern were risk factors.
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| 18. |
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| 19. |
- Hagberg, Kerstin, 1957, et al.
(författare)
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Physiological cost index (PCI) and walking performance in individuals with transfemoral prostheses compared to healthy controls
- 2007
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Ingår i: Disabil Rehabil. - : Informa UK Limited. - 0963-8288. ; 29:8, s. 643-9
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Uncomplicated methods for evaluation of prosthetic walking performance for individuals with lower limb amputations are valuable. The Physiological Cost Index (PCI), the comfortable walking speed (CWS) and self-reported walking distances are three examples of such measures. The aim was to obtain values for these measures for individuals walking with transfemoral prostheses and to compare the results with healthy controls. METHOD: Individuals with an established transfemoral amputation for reasons other than vascular disease (TFA-group, n = 41, 30 male/11 female, mean age 49, SD 11.5) were compared to age-and gender matched healthy controls (Healthy group, n = 22). PCI was assessed walking in CWS for 5 min and self-reported distances accomplished outdoors was assessed with the Walking Habit Score (0 - 100). RESULTS: Mean PCI was 0.55 (SD 0.19) in the TFA-group and 0.31 (SD 0.09) in the Healthy group (p < 0.001). The CWS was 62 (SD 12.6) and 90 (SD 12.8) m/min and the Walking Habit Score 48 (SD 19) and 74 (SD 16) score-points respectively (p < 0.001). CONCLUSIONS: By using uncomplicated and inexpensive methods, this study shows that walking with transfemoral prostheses is done with considerably increased energy cost, slower CWS and that limited walking distances outdoors are performed compared to healthy controls.
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| 20. |
- Hagberg, Kerstin, 1957, et al.
(författare)
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Socket versus bone-anchored trans-femoral prostheses: hip range of motion and sitting comfort
- 2005
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Ingår i: Prosthet Orthot Int. - : Ovid Technologies (Wolters Kluwer Health). - 0309-3646. ; 29:2, s. 153-63
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Tidskriftsartikel (refereegranskat)abstract
- This is the first study to report on hip range of motion (ROM) among active prosthesis users, when wearing and not wearing a trans-femoral socket prosthesis and to compare with individuals rehabilitated with an osseointegrated bone-anchored prosthesis. In addition, discomfort when sitting with the prosthesis is reported in both groups. The study group all had a non-vascular amputation and were divided into those supplied with a socket prosthesis (S group) (n = 43, mean age 51 years, 74% men) or a bone-anchored prosthesis (OI group) (n = 20, mean age 46 years, 75% men). Active hip ROM was measured with a goniometer, and self-reported problems with discomfort when sitting were recorded. The hip motion decreased in all directions when wearing the socket prosthesis compared to without it (P < 0.001 for all directions), and 37% of the subjects had less than 90 degrees of hip flexion when wearing their prosthesis. Discomfort when sitting was reported among 44% (n = 19) in the S group and was more common among individuals with less than 90 degrees of hip flexion motion (P= 0.025). In the OI group, no restriction in hip motion was measured with the prosthesis, and no subject had less than 90 degrees of flexion and 5% (n = 1) reported discomfort when sitting. This study shows that a trans-femoral prosthetic socket significantly reduces the ROM of the hip and that discomfort when sitting is common among individuals wearing such prostheses. Further, the study confirms that individuals using a bone-anchored prosthesis have no restricted hip motion with the prosthesis and report very few problems with discomfort when sitting.
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| 21. |
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| 22. |
- Hagberg, Mats, et al.
(författare)
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Epidemin av belastningsskador i Sverige
- 2007
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 104:48, s. 3664-3667
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Tidskriftsartikel (refereegranskat)abstract
- Belastningsepidemin, som startade på 1980-talet, hade samband med arbetsskadeförsäkringen och rationaliseringen i industrin. Lagom och varierad fysisk aktivitet i arbetet och på fritiden behöver stimuleras ytterligare. Arbetsplatsnära forskning är viktig för utveckling av goda ergonomiska förhållanden och produktionsmetoder som leder till en hållbar arbetsförmåga. Kunskapen om arbetsrelaterade sjukdomar i rygg, leder och muskler har ökat avsevärt de senaste tio åren, men stora kunskapsluckor finns fortfarande. Resurser till randomiserade, kontrollerade studier avseende hälsofrämjande arbete bör prioriteras. Arbetsskadeförsäkring för många med ospecifika muskuloskeletala besvär skulle kanske i större utsträckning vara en arbetsförsäkring, där man garanteras arbete även om man inte kan prestera fullt ut under kortare eller längre perioder. Vi läkare måste bli bättre på att kunna undersöka patienter med symtom i rörelseorganen. Undersökningen är inte bara viktig från diagnostisk synpunkt utan är även en del av behandling, rehabilitering och säker återgång till arbete.
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| 23. |
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| 24. |
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| 25. |
- Himmelmann, Kate, 1959, et al.
(författare)
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Bilateral spastic cerebral palsy--prevalence through four decades, motor function and growth
- 2007
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Ingår i: Eur J Paediatr Neurol. - : Elsevier BV. - 1090-3798. ; 11:4, s. 215-22
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to depict changes in the prevalence and severity of bilateral spastic cerebral palsy (CP) over a 40-year period. Another objective was to characterise the group born in 1991-1998 with respect to gross motor function, spasticity and growth. Data were obtained from the CP register of western Sweden and rehabilitation records. RESULTS: After a rise to 1.27 per 1000 live births in 1983-1986, the prevalence decreased significantly, in children born both preterm and at term, to 0.69 in 1995-1998. After 1975, more children were born preterm than at term. There was a significant decrease in severe bilateral spastic CP during the same period, mainly in children born at term. In all, 46% of the children born at term and 33% of those born preterm had a severe motor impairment, i.e. no walking ability. In the 167 children born in 1991-1998, the gross motor function classification system (GMFCS) level was I in 14%, II in 34%, III in 10%, IV in 25% and V in 17%. The GMFCS level correlated with the gross motor function measure (GMFM) and the Ashworth spasticity scores, as well as with the deviation in postnatal weight and height. We conclude that the prevalence of bilateral spastic CP has decreased since the mid-1980s, parallel to a reduction in the severity of the motor impairment. Children born preterm have predominated since the mid-1970s. The severity of the motor impairment correlated with the degree of spasticity, GMFM and growth. The percentage of children who were underweight was substantial.
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| 26. |
- Himmelmann, Kate, 1959, et al.
(författare)
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Gross and fine motor function and accompanying impairments in cerebral palsy
- 2006
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Ingår i: Dev Med Child Neurol. - 0012-1622. ; 48:6, s. 417-23
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe and analyze gross and fine motor function and accompanying neurological impairments in children with cerebral palsy (CP) born between 1991 and 1998 in western Sweden. A population-based study comprised 411 children with a diagnosis of CP ascertained at 4 to 8 years of age. Gross Motor Function Classification System (GMFCS) levels were documented in 367 children (205 males, 162 females). Bimanual Fine Motor Function (BFMF) classification levels of 345 of the children and information on learning disability, epilepsy, visual and hearing impairments, and hydrocephalus from 353 children were obtained. For spastic CP, a new classification according to the Surveillance of Cerebral Palsy in Europe of uni- and bilateral spastic CP was applied. GMFCS was distributed at Level I in 32%, Level II in 29%, Level III in 8%, Level IV in 15%, and Level V in 16%. The corresponding percentages for BFMF were 30.7%, 31.6%, 12.2%, 11.9%, and 13.6% respectively. Learning disability was present in 40%, epilepsy in 33%, and severe visual impairment in 19% of the children. Motor function differed between CP types. More severe GMFCS levels correlated with larger proportions of accompanying impairments and, in children born at term, to the presence of adverse peri/neonatal events in the form of intracranial haemorrhage/stroke, cerebral infection, and hypoxic-ischaemic encephalopathy. GMFCS Level I correlated positively to increasing gestational age. We conclude that the classification of CP should be based on CP type and motor function, as the two combine to produce an indicator of total impairment load.
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| 27. |
- Kasteng, Frida, et al.
(författare)
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Cost-effectiveness of maintenance rituximab treatment after second line therapy in patients with follicular lymphoma in Sweden
- 2008
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 47:6, s. 1029-36
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Rituximab has significantly improved the prognosis for patients with both indolent and aggressive non-Hodgkin's lymphoma. An economic evaluation was carried out to assess the cost-effectiveness in Sweden of rituximab as maintenance therapy for patients with follicular lymphoma in remission after second line therapy. MATERIALS AND METHODS: The incremental cost and effectiveness of rituximab maintenance therapy versus observation were evaluated in a health-state transition model. Primary effect measures were quality-adjusted life-years (QALY) and life-years gained (LYG). Model state transitions were calculated based on progression-free and overall survival data from the EORTC20981 trial. The analysis was made from the perspective of the healthcare provider, including direct medical costs presented in euro, 2007 value. Effects and costs were discounted at a 3% annual rate. The stability of the base case results were tested in one-way and probabilistic sensitivity analyses. RESULTS: The evaluation assessed rituximab maintenance therapy to be associated with an incremental cost per QALY gained of euro 12,600 and an incremental cost per LYG of euro 11,200. The average discounted life expectancy for patients on rituximab maintenance was 1.0 year longer than for patients on observation (5.96 vs. 4.94 years). Rituximab maintenance was associated with an additional 0.9 QALY, and total costs per patient were euro 11,500 higher in the treatment arm, compared to observation. DISCUSSION: The results indicate that rituximab maintenance treatment after successful induction therapy for patients with relapsed/refractory follicular lymphoma in Sweden is cost-effective compared to observation.
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| 28. |
- Kimby, Eva, et al.
(författare)
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Long-term molecular remissions in patients with indolent lymphoma treated with rituximab as a single agent or in combination with interferon alpha-2a : a randomized phase II study from the Nordic Lymphoma Group
- 2008
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Ingår i: Leukemia and Lymphoma. - : Informa UK Limited. - 1042-8194 .- 1029-2403. ; 49:1, s. 102-112
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this phase II randomized trial was to evaluate the effect and safety of interferon-alpha2a (IFN) in combination with extended dosing rituximab in patients with symptomatic, advanced indolent lymphoma responding to a standard single course of rituximab. Totally 123 patients were treated with rituximab 375 mg/m2 once weekly for 4 weeks leading to 14 complete response (CR; 11%), 56 partial response (PR; 46%), and 13 minor responses (MR; 11%). Patients achieving either PR or MR were randomized to four more infusions of rituximab alone (n = 36) or in combination with five weeks of IFN (n = 33), with an overall response rate (CR + PR) of 78% and 94%, respectively. Significantly more patients in the combination arm improved their response from PR/MR to CR (P < 0.05) and more maintained their responses for > or = 24 months (72% versus 50%), respectively. Overall, 26 out of the 52 patients who achieved CR underwent minimal residual disease (MRD) evaluation. Totally 17 of these (65%) achieved MRD negativity, 14 of whom remain in CR after 4.8 years' follow-up. The addition of IFN to rituximab was generally safe, but reversible thrombocytopenia and neutropenia were noted in one and six patients, respectively, requiring a reduction in the IFN dose. Extended rituximab is effective and well tolerated and combination with IFN seems to improve both the quality and duration of the responses, providing the opportunity to achieve long-term molecular CRs and prolonged failure-free survival without chemotherapy.
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| 29. |
- Lee, W. C., et al.
(författare)
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Kinetics of transfemoral amputees with osseointegrated fixation performing common activities of daily living
- 2007
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Ingår i: Clin Biomech (Bristol, Avon). - : Elsevier BV. - 0268-0033. ; 22:6, s. 665-73
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Direct anchorage of a lower-limb prosthesis to the bone through an implanted fixation (osseointegration) has been suggested as an excellent alternative for amputees experiencing complications from use of a conventional socket-type prosthesis. However, an attempt needs to be made to optimize the mechanical design of the fixation and refine the rehabilitation program. Understanding the load applied on the fixation is a crucial step towards this goal. METHODS: The load applied on the osseointegrated fixation of nine transfemoral amputees was measured using a load transducer, when the amputees performed activities which included straight-line level walking, ascending and descending stairs and a ramp as well as walking around a circle. Force and moment patterns along each gait cycle, magnitudes and time of occurrence of the local extrema of the load, as well as impulses were analysed. FINDINGS: Managing a ramp and stairs, and walking around a circle did not produce a significant increase (P>0.05) in load compared to straight-line level walking. The patterns of the moment about the medio-lateral axis were different among the six activities which may reflect the different strategies used in controlling the prosthetic knee joint. INTERPRETATIONS: This study increases the understanding of biomechanics of bone-anchored osseointegrated prostheses. The loading data provided will be useful in designing the osseointegrated fixation to increase the fatigue life and to refine the rehabilitation protocol.
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| 30. |
- Lohela, Malin, et al.
(författare)
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Does a Change in Psychosocial Work Factors Lead to a Change in Employee Health?
- 2009
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Ingår i: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 51:2, s. 195-203
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim was to identify psychosocial factors at work that promote positive changes in employee health and factors that prevent negative changes in employee health. METHOD:: This study is part of a large longitudinal study and includes 1212 employees. Data for psychosocial work factors and self rated health was collected in 2000 and 2003. A modified Poisson regression was used to find factors of relevance for positive and negative changes in health. RESULTS:: A negative change in leadership, organizational commitment and reporting job strain increased the risk for negative change in health. Improved leadership and social climate increased the chance for positive changes in health. CONCLUSION:: By improving psychosocial factors at work, it is possible to promote employee health as well as prevent employee ill-health.
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| 31. |
- Meding, B., et al.
(författare)
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Occupational skin exposure and hand eczema among dental technicians-need for improved prevention
- 2006
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Ingår i: Scand J Work Environ Health.. ; 32:3
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aims of this study were to estimate occupational skin exposure, the use of skin protection, and the incidence of hand eczema among dental technicians. METHODS: In a retrospective cohort study, dental technicians (N=2139) and randomly selected population controls (N=2288) received a postal questionnaire on occupational skin exposure, protective glove use, and hand eczema, including the year of onset. The response rate was 57% for the dental technicians and 58% for the controls. RESULTS: Altogether 80% of the dental technicians reported skin exposure to uncured (meth)acrylates (MA), and 87% had skin contact with grinding dust from MA. Thirty-nine percent used protective gloves when handling uncured MA. Twenty-two percent of the currently employed technicians reported participation in obligatory training concerning the handling of thermosetting plastics, and 58% did not know how long normally used gloves protected the skin against uncured MA. Altogether 48% of the dental technicians and 30% of the controls reported more than 10 hand washings a day (P<0.001). For the dental technicians, the incidence of hand eczema was 8.5 cases/1000 person-years during MA-exposed time. For the controls, the incidence was 3.3. The incidence rate ratio for the men was 3.6 (95% CI 2.3-5.6), and for the women it was 2.4 (95% CI 1.7-3.3). CONCLUSIONS: The work of dental technicians involves frequent and unprotected exposure to MA and frequent hand washings. Dental technicians have twice the risk of hand eczema than the general population. Efforts to improve skin protection and increase participation in obligatory training about handling thermosetting plastics are important.
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| 32. |
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| 33. |
- Nygren, Gudrun, 1957, et al.
(författare)
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The Swedish version of the Diagnostic Interview for Social and Communication Disorders (DISCO-10). Psychometric properties.
- 2009
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Ingår i: Journal of Autism and Developmental Disorders. - : Springer Science and Business Media LLC. - 0162-3257 .- 1573-3432. ; 39:5, s. 730-741
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Tidskriftsartikel (refereegranskat)abstract
- Psychometric properties of the Diagnostic Interview for Social and Communication Disorders schedule (DISCO) have only been studied in the UK. The authorised Swedish translation of the tenth version of the DISCO (DISCO-10) was used in interviews with close relatives of 91 Swedish patients referred for neuropsychiatrical assessment. Validity analysis compared DISCO-10-algorithm diagnoses with clinical diagnoses and with Autism Diagnostic Interview Revised (ADI-R) algorithm diagnoses in 57 cases. Good-excellent inter-rater reliability was demonstrated in 40 cases of children and adults. The criterion validity was excellent when compared with clinical diagnoses and an investigator-based diagnostic interview. The DISCO-10 has good psychometric properties. Advantages over the ADI-R include valuable information of the broader autism phenotype and co-existing problems for clinical practice and research.
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| 34. |
- Persson, Eva-Karin, 1956, et al.
(författare)
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Disabilities in children with hydrocephalus--a population-based study of children aged between four and twelve years
- 2006
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Ingår i: Neuropediatrics. - : Georg Thieme Verlag KG. - 0174-304X .- 1439-1899. ; 37:6, s. 330-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Children with hydrocephalus represent a heterogeneous group with various aetiologies and disability profiles. Over the years, continuous changes in medical care have occurred and updated information is important. AIM: To study disability profiles in aetiological and gestational age subgroups of children with hydrocephalus in the 1990s. METHOD: A population-based series of 114 children, 70 with infantile hydrocephalus and 44 with hydrocephalus associated with MMC. All the children were examined clinically and interviewed. RESULTS: Learning disabilities were present in 47 % of children with infantile hydrocephalus compared with 16 % of those with MMC, cerebral palsy in 27 % vs. zero and epilepsy in 34 vs. 11 %. Even after excluding children with cerebral palsy, the majority had abnormal tendon reflexes and scored below the 5th centile on a motor test. Hydrocephalus overt at birth, low gestational age, a perinatal origin, enlarged ventricles at follow-up and several shunt revisions all indicated risk factors for a poor outcome. CONCLUSIONS: In spite of major advances in management, hydrocephalus in children still has a considerable impact on outcome. Being born very preterm and with a hydrocephalus that is already overt at birth involve the highest risk of a poor outcome. Apart from major impairments, the children frequently have definite motor problems.
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| 35. |
- Persson, Eva-Karin, 1956, et al.
(författare)
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Hydrocephalus prevalence and outcome in a population-based cohort of children born in 1989-1998
- 2005
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Ingår i: Acta Paediatr. - 0803-5253. ; 94:6, s. 726-32
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To determine the prevalence, aetiology and clinical outcome in children with surgically treated hydrocephalus. METHODS: A population-based study of all 208 liveborn children with hydrocephalus, 124 with infantile hydrocephalus and 84 with hydrocephalus associated with myelomeningocoele, born during 1989-1998 in western Sweden. Aetiological and clinical information was collected from records. RESULTS: The prevalence of hydrocephalus was 0.82 per 1000 live births, 0.49 for children with infantile hydrocephalus and 0.33 for children with myelomeningocoele. The prevalence of infantile hydrocephalus decreased during the period from 0.55 to 0.43 per 1000. In this group, the aetiology was prenatal in 55% and peri-postnatal in 44% of the children. The origin was perinatal haemorrhage in all cases born very preterm. The mortality rate was 5% for children with either infantile hydrocephalus or myelomeningocoele. Mental retardation, cerebral palsy and epilepsy were significantly more frequent in the group with infantile hydrocephalus: 46% vs 16%, 31% vs 4% and 31% vs 10%, respectively. All children with infantile hydrocephalus born very preterm had at least one of these impairments, as did 80% of those with overt hydrocephalus at birth. CONCLUSION: A slightly decreasing trend for infantile hydrocephalus was observed during the 10-y period. Children with infantile hydrocephalus had a worse outcome than those with myelomeningocoele. The need for neurosurgical revisions for two-thirds of the children indicates the need for further development of prevention and treatment strategies.
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| 36. |
- Söderström, Ing-Mari, et al.
(författare)
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Family adaptation in relation to a family member's stay in ICU
- 2009
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 25:5, s. 250-257
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe and interpret the family adaptation during the ICU hospitalisation andup to 18 months after discharge.Research methodology/design: A qualitative design was chosen.Main outcome measures: Individual and family interviews with eight families including 31 familymembers. A hermeneutical analysis was performed and paradigm cases were constructed.Results: The result is presented in three themes: striving for endurance, striving for consolationand striving to rebuild life under new conditions. The family adaptation started at the onset ofthe critical incident and continued during the ICU stay and after discharge. The family membersmetaphorically went through peaks and valleys during the whole process of adaptation.Conclusion: Adaptation is an issue for the whole family and is facilitated by being able to stayclose to the patient and receive supportive unambiguous information from the staff both duringthe ICU stay and after discharge.
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| 37. |
- Wastensson, Gunilla, 1956, et al.
(författare)
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Parkinson's disease in diphenyl-exposed workers--a causal association?
- 2006
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Ingår i: Parkinsonism & Related Disorders. - : Elsevier BV. - 1353-8020. ; 12:1, s. 29-34
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Tidskriftsartikel (refereegranskat)abstract
- We report a cluster of five cases of Parkinson's disease (PD) among paper mill workers exposed to a fungicide, diphenyl. The cause of PD is still unknown, but epidemiological studies have indicated an elevated risk of developing PD after exposure to pesticides. The five cases of PD were found in a group of 255 diphenyl-exposed workers, and the number of expected cases in the exposed group was estimated to be 0.9, resulting in a relative risk of 5.6 (95% CI 1.8-13). Exposure to diphenyl may have contributed to this PD cluster, but chance is an alternative explanation.
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| 38. |
- Wigaeus Tornqvist, Ewa, et al.
(författare)
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The influence of working conditions and individual factors on the incidence of neck and upper limb symptoms among professional computer users
- 2009
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 82:6, s. 689-702
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Tidskriftsartikel (refereegranskat)abstract
- To assess the influence of working conditions and individual factors on the incidence of neck and upper limb symptoms among professional computer users. The study is a prospective cohort study with an observation period of 10 months. A baseline questionnaire about symptoms in the neck, shoulder and arm/hand during previous month, individual factors, work content, physical and psychosocial work-related exposures was answered by 1,283 computer operators (response rate 84%). Incidence data were collected by ten monthly questionnaires regarding the occurrence of symptoms categorized into three gross body regions: neck, shoulders and arms/hands. A case, in the specific gross body region, was defined as a subject who was classified as non-symptomatic in that region at baseline or during minimum one follow-up period and later reported symptoms (a parts per thousand yen3 days). Univariable and multivariable incidence rate ratios with 95% confidence intervals for first occurrence of neck, shoulder and arm/hand cases, respectively, were calculated with Cox regression analysis. The incidence rate was 67, 41 and 47 cases per 100 person years for neck, shoulder and arm/hand symptoms, respectively. In the multivariable analyses, comfort of the computer work environment and gender were related to the incidence of symptoms in all body regions (RR = 1.5-1.9 for low comfort and 1.8-2.1 for females, respectively). Duration of mouse use predicted arm/hand symptoms (RR = 1.7 for a parts per thousand yen3 h/day) and job strain (high demands and low decision latitude) predicted neck symptoms (RR = 1.6 and 2.2 for medium and high strain, respectively). Additionally, age was related to neck and shoulder symptoms. Preventive strategies to reduce neck and upper limb symptoms among computer users should include measures to reduce mouse use, to increase the comfort of the work environment and to reduce job strain. Although the effect estimates were relatively weak to moderate, preventive measures may have a marked impact on the incidence of neck and upper limb symptoms in the general population because of the widespread use of computers in working life as well as at home.
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