| 1. |
- Brodin, N., et al.
(författare)
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Coaching patients with early rheumatoid arthritis to healthy physical activity : A multicenter, randomized, controlled study
- 2008
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Ingår i: Arthritis and Rheumatism. - Hoboken, NJ : Wiley. - 0004-3591 .- 1529-0131. ; 59:3, s. 325-331
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate the effect of a 1-year coaching program for healthy physical activity on perceived health status, body function, and activity limitation in patients with early rheumatoid arthritis. Methods. A total of 228 patients (169 women, 59 men, mean age 55 years, mean time since diagnosis 21 months) were randomized to 2 groups after assessments with the EuroQol visual analog scale (VAS), Grippit, Timed-Stands Test, Escola Paulista de Medicina Range of Motion scale, walking in a figure-of-8, a visual analog scale for pain, the Health Assessment Questionnaire disability index, a self-reported physical activity questionnaire, and the Disease Activity Score in 28 joints. All patients were regularly seen by rheumatologists and underwent rehabilitation as prescribed. Those in the intervention group were further individually coached by a physical therapist to reach or maintain healthy physical activity (=30 minutes, moderately intensive activity, most days of the week). Results. The retention rates after 1 year were 82% in the intervention group and 85% in the control group. The percentages of individuals in the intervention and control groups fulfilling the requirements for healthy physical activity were similar before (47% versus 51%, P > 0.05) and after (54% versus 44%, P > 0.05) the intervention. Analyses of outcome variables indicated improvements in the intervention group over the control group in the EuroQol VAS (P = 0.025) and muscle strength (Timed-Stands Test, P = 0.000) (Grippit, P = 0.003), but not in any other variables assessed. Conclusion. A 1-year coaching program for healthy physical activity resulted in improved perceived health status and muscle strength, but the mechanisms remain unclear, as self-reported physical activity at healthy level did not change. © 2008, American College of Rheumatology.
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| 2. |
- Haglund, B, et al.
(författare)
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Is moist snuff use associated with excess risk of IHD or stroke? A longitudinal follow-up of snuff users in Sweden
- 2007
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 35:6, s. 618-622
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Tidskriftsartikel (refereegranskat)abstract
- Background: The potential risks of Swedish moist snuff (snus) are debated and studies have shown diverging results. Aims: The aim of this study is to investigate whether there is any excess risk of ischaemic heart disease (IHD) and stroke from snuff use. Methods: The Swedish Survey of Living Conditions from 1988—89 was record-linked to the Swedish Cause of Death Register and the Swedish Hospital Discharge Register to investigate excess mortality and hospitalization from IHD and stroke. A Poisson regression model was used and incidence rate ratios (IRRs) for snuff and smoking were calculated controlling for age, physical activity, self-reported health, number of longstanding illnesses, residential area, and socioeconomic position. Results: Among snuff users there were no excess risks of mortality or hospitalization from IHD (IRR 0.8; 0.5—1.2,) or stroke (IRR 1.1; 0.7—1.8), but, as expected, clear excess risks were found for smokers (IRR 1.7; 1.4—2.1 for IHD, and IRR 1.4; 1.0—1.9 for stroke). Conclusions: This study has not shown any excess risk among users of snuff for IHD or stroke. If there is a risk associated with snuff it is evidently much lower than those associated with smoking.
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| 3. |
- Jonasson, J M, et al.
(författare)
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Insulin glargine use and short-term incidence of malignancies-a population-based follow-up study in Sweden.
- 2009
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 52:9, s. 1745-54
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Tidskriftsartikel (refereegranskat)abstract
- AIMS/HYPOTHESIS: In the light of a report suggesting that insulin glargine may increase cancer occurrence, the EASD asked us to perform this study. METHODS: We followed 114,841 individuals who had a prescription dispensed for insulin between 1 July and 31 December 2005. From 1 January 2006 to 31 December 2007, we noted the occurrence of malignancies. Seven different nationwide registers were used to obtain information on insulin exposure, outcome and possible confounders; these were linked using the unique personal identity number assigned to every Swedish resident. RESULTS: After adjustment for age and, when appropriate, sex, users of insulin glargine alone (no other types of insulin), compared with users of types of insulin other than insulin glargine, had an RR of 1.99 (95% CI 1.31-3.03) for breast cancer, 0.93 (95% CI 0.61-1.40) for gastrointestinal cancer, 1.27 (95% CI 0.89-1.82) for prostate cancer and 1.07 (95% CI 0.91-1.27) for any type of malignancy. Adjustment for age, smoking, BMI, age at onset of diabetes, age at birth of first child, cardiovascular disease and oestrogen use gave an RR for breast cancer of 1.97 (95% CI 1.29-3.00). The 95% CIs crossed 1.0 for the RR calculated in all analyses of users of insulin glargine in combination with other types of insulin. CONCLUSIONS/INTERPRETATION: In Sweden, during 2006 and 2007, women using insulin glargine alone (no other types of insulin) had an increased incidence rate of breast cancer as compared with women using types of insulin other than insulin glargine. This result may be due to a random fluctuation; the possibilities for examining validity are limited, and no statistically significant results were obtained for any other individual cancer site or for the outcome 'all malignancies'. No definitive conclusions regarding a possible causal relationship between insulin glargine use and the occurrence of malignancies can be drawn from the results of this study.
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| 4. |
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| 5. |
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| 6. |
- Bartonek, A., et al.
(författare)
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The influence of spasticity in the lower limb muscles on gait pattern in children with sacral to mid-lumbar myelomeningocele : a gait analysis study
- 2005
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Ingår i: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 22:1, s. 10-25
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Tidskriftsartikel (refereegranskat)abstract
- Gait analysis and recording of standing position were performed in 38 ambulatory children with myelomeningocele. Thirty-four were independent ambulators and four required a walking aid. All subjects were assigned one of four muscle function groups based on muscle strength. They were also divided into subgroups based on the distinction between flaccid and spastic paresis in the lower limb joints. A comparison was made between the gait pattern of the children with spasticity and that of the children with flaccid paresis in each muscle function group. Spasticity in only the ankle joint muscles influenced the subject's gait and standing position compared to the subgroups with a flaccid paresis. Even larger deviations in gait and standing position were observed when spasticity occurred in muscles at the knee and hip joints. When setting ambulatory goals the presence of additional neurological symptoms such as spasticity and inadequate balance should be taken into consideration.
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| 7. |
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| 8. |
- Broström, Eva, et al.
(författare)
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Trunk and center of mass movements during gait in children with juvenile idiopathic arthritis
- 2007
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Ingår i: Human Movement Science. - : Elsevier BV. - 0167-9457 .- 1872-7646. ; 26:2, s. 296-305
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Tidskriftsartikel (refereegranskat)abstract
- Motion of the body center of mass (CoM) can often indicate the overall effect of the strategy of forward progression used. In the present study, focus is placed on trunk movements in the sagittal, coronal, and transverse/rotation plane, as well as placement of the CoM, during gait in children with juvenile idiopathic arthritis (JIA). Seventeen children with JIA, all with polyarticular lower extremity involvement were examined before and approximately two weeks after treatment with intra-articular cortico-steroid injections. Movement was recorded with a 6-camera 3D motion analysis system in both the children with JIA and in 21 healthy controls. Trunk and center of mass movements were compared between JIA and controls, and effects of intra-articular cortico-steroid treatment were evaluated. Children with JIA were more posteriorly tilted in the trunk, contrary to the common clinical impression, and had their CoM placed more posterior and off-centred, which may have been a result of pain. With such knowledge, it might be possible to better understand the effects of their pain and involvement, and ultimately to plan a treatment strategy for improving their gait patterns.
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| 9. |
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| 11. |
- Duffy, M. J., et al.
(författare)
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Tumour markers in colorectal cancer : European Group on Tumour Markers (EGTM) guidelines for clinical use
- 2007
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Ingår i: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 43:9, s. 1348-1360
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this article is to present updated guidelines for the use of serum, tissue and faecal markers in colorectal cancer (CRC). Lack of specificity and sensitivity preclude the use of all existing serum markers for the early detection of CRC. For patients with stage Il or stage III CRC who may be candidates for either liver resection or systemic treatment should recurrence develop, CEA should be measured every 2-3 months for at least 3 years after diagnosis. insufficient evidence exists to recommend routine use of tissue factors such as thymidylate synthase, microsatellite instability (MSI), p53, K-ras and deleted in colon cancer (DCC) for either determining prognosis or predicting response to therapy in patients with CRC. Microsatellite instability, however, may be used as a pre-screen for patients with suspected hereditary non-polyposis colorectal cancer. Faecal occult blood testing but not faecal DNA markers may be used to screen asymptomatic subjects 50 years or older for early CRC.
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| 12. |
- Gutierrez, Elena M, 1973-, et al.
(författare)
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Kinetics of compensatory gait in persons with myelomeningocele
- 2005
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Ingår i: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 21:1, s. 12-23
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the kinetic strategy and compensatory mechanisms during self-ambulatory gait in children with lumbo-sacral myelomeningocele. Thirty-one children with mid-lumbar to low-sacral myelomeningocele who walked without aids and 21 control children were evaluated by three-dimensional gait analysis. Joint moments in all planes at the hip and knee and sagittal moments at the ankle, as well as joint power and work done at all three joints, were analyzed. Joint moment capacity lost due to plantarflexor and dorsiflexor weakness was provided instead by orthotic support, but other joints were loaded more to compensate for the weakness at the ankles and restricted ankle motion. Subjects with total plantarflexor and dorsiflexor paresis and strength in the hip abductors had more knee extensor loading due to plantarflexor weakness and dorsiflexion angle of the orthotic, ankle joint. The subjects with orthoses also generated more power at the hip to supplement the power generation lost to plantarflexor weakness and fixed ankles. The most determinant muscle whose paresis changes gait kinetics was the hip abductor. Hip abductor weakness resulted in a characteristic pattern where the hips displayed an eccentric adduction moment, mediating energy transfer into the lower limbs, and the hips replaced the knees as power absorbers in early stance. Joint moment, power and work analyses complement a kinematic analysis to provide a complete picture of how children who have muscle paresis recruit stronger muscle groups to compensate for weaker ones.
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| 13. |
- Gössling, Stefan, et al.
(författare)
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Swedish air travellers and voluntary carbon offsets : towards the Co-creation of Environmental Value?
- 2009
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Ingår i: Current Issues in Tourism. - : Routledge. - 1368-3500 .- 1747-7603. ; 12:1, s. 1-19
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Tidskriftsartikel (refereegranskat)abstract
- There is now a broad consensus that aviation is a significant contributor to global warming. One question that thus arises is whether voluntary carbon-offsetting schemes can make a significant contribution to mitigating the contribution of aviation to climate change. These schemes have seen considerable growth in recent years, even though the overall amount of emissions offset remains negligible: tour operators and airlines offering voluntary carbon offsets report that customers show limited interested in these schemes. In the light of this, the article seeks to discuss the implications of voluntary carbon-offsetting schemes as a means of compensating emissions from aviation, and goes on to assess air travellers' knowledge of and attitudes to these schemes. Structural problems that have to be overcome to create broader interest in voluntary carbon offsetting are discussed in the context of co-creation of environmental value at the level of economic transactions between individual passengers (consumers) and airlines (producers), based on a survey of Swedish air travellers.
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| 14. |
- Haglund, L, et al.
(författare)
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Proteomic analysis of the LPS-induced stress response in rat chondrocytes reveals induction of innate immune response components in articular cartilage
- 2008
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Ingår i: Matrix Biology. - : Elsevier BV. - 1569-1802 .- 0945-053X. ; 27:2, s. 107-118
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Tidskriftsartikel (refereegranskat)abstract
- Activation of toll-like receptors (TLR) in articular chondrocytes has been reported to increase the catabolic compartment, leading to matrix degradation, while the main consequence of TLR activation in monocytic cells is the expression and secretion of components of the innate immune response, particularly that of inflammatory cytokines. The objective of the work reported here was to obtain a more complete picture of the response repertoire of articular chondrocytes to TLR activation. Mass spectrometry was used to analyse the secretome of stimulated and unstimulated cells. Characterization of TLR expression in rat articular chondrocytes by RT/PCR indicated that TLR4 was the major receptor form. Exposure of these cells to lipopolysaccharide (LPS), the well-characterized TLR4 ligand, induced production not only of the matrix metalloproteinases MMP3 and 13, but also of components traditionally associated with the innate immune response, such as the complement components C1r, C3 and complement factor B, long pentraxin-3 and osteoglycin. Neither TNF-alpha nor IL-1 was detectable in culture media following exposure to LPS. One of the most prominently-induced proteins was the chitinase-like protein, Chi3L1, linking its expression to the innate immune response repertoire of articular chondrocytes. In intact femoral heads, LPS induced expression of Chi3L1 in chondrocytes close to the articular surface, suggesting that only these cells mount a stress response to LPS. Thus articular chondrocytes have a capacity to respond to TLR activation, which results in the expression of matrix metalloproteases as well as subsets of components of the innate immune response without significant increases in the production of inflammatory cytokines. This could influence the erosive processes leading to cartilage degeneration as well as the repair of damaged matrix.
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| 15. |
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| 18. |
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| 19. |
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| 20. |
- Stålberg, Karin, et al.
(författare)
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Prenatal ultrasound exposure and children’s school performance at age 15-16; follow-up of a randomised controlled trial
- 2009
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Ingår i: Ultrasound in Obstetrics and Gynecology. - : Wiley. - 0960-7692 .- 1469-0705. ; 34:3, s. 297-303
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Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate the association between prenatal ultrasound exposure and school performance at 15-16 years of age. Methods The study population consisted of children born to women who participated in a randomized controlled trial on the second-trimester ultrasound examination in Sweden from 1985 to 1987. Information about the children's grades when graduating from primary school and information on socioeconomic factors was obtained from Swedish nationwide registers. Comparisons were made using linear and logistic regression analyses according to randomization to ultrasound, ultrasound exposure in the second trimester and ultrasound exposure at an), time during pregnancy. Boys and girls were analyzed separately. Results Of the 4756 singleton children from the randomized trial, we identified 4458 (94%) in the National School Register. There were no statistically significant differences in school performance for boys or girls according to randomization or exposure to ultrasound in the second trimester. Compared to those who were unexposed, boys exposed to ultrasound at least once at any time during fetal life bad a tendency towards lower mean school grades in general (-4.39 points; 95% CI, -9.59 to 0.81. (max possible, 320) points) and in physical education (-0.45 points; 95% CI, -0.91 to 0.01 (max possible, 20) points), but the differences did not reach significance. Conclusion In general, routine ultrasound examination in the second trimester bad no effect on overall school performance in teenagers.
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| 21. |
- Stålberg, Karin, et al.
(författare)
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Prenatal ultrasound scanning and the risk of schizophrenia and other psychoses
- 2007
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Ingår i: Epidemiology. - 1044-3983 .- 1531-5487. ; 18:5, s. 577-582
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Prenatal ultrasound exposure has been associated with increased prevalence of left-hand or mixed-hand preference, and has been suggested to affect the normal lateralization of the fetal brain. Atypical lateralization is more common in patients with schizophrenia. We evaluated possible associations of prenatal ultrasound with schizophrenia and other psychoses. METHODS: We identified a cohort of individuals born in Sweden 1973-1978. During this period, one Swedish hospital (Malmö University Hospital) performed prenatal ultrasound on a routine basis, and all individuals born at that hospital were considered exposed to ultrasound. Children born at hospitals where ultrasound was not used routinely or selectively were considered unexposed. We used Poisson regression analysis to estimate the effect of ultrasound exposure on the incidence of schizophrenia and other psychoses. RESULTS: In all, 370,945 individuals were included in the study, of whom 13,212 were exposed to ultrasound. The exposed group demonstrated a tendency toward a higher risk of schizophrenia (among men, crude incidence rate ratio = 1.58 [95% confidence interval = 0.99-2.51]; among women, 1.26 [0.62-2.55]). However, men and women born in several of the 7 tertiary level hospitals without ultrasound scanning also had higher risks of schizophrenia compared with those born in other hospitals. For other psychoses there were no differences between groups. CONCLUSIONS: No clear associations between prenatal ultrasound exposure and schizophrenia or other psychoses were found. Other factors related to place of birth might have influenced the results.
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| 22. |
- Sundqvist, Kristina, et al.
(författare)
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Concentrations and Congener Patterns of PCDD/FS in Surface Sediment, Settling Particulate Matter, Water and Fish From the South Bothnian Sea, Sweden
- 2007
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Ingår i: Organohalogen Compounds. ; 69, s. 247-50
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Tidskriftsartikel (refereegranskat)abstract
- This study focused on PCDD/F contamination along the Swedish coast of the southern Bothnian Sea, a heavily polluted area of the Baltic Sea. Data from earlier studies of surface sediment, perch, viviparous blenny and herring were analyzed together with new data for settling particulate matter (SPM) and sea water. PCDD/F pollution in surface sediment and SPM in the southern Bothnian Sea were similar both in respect to pattern and levels. The highest levels were 170 000 and 33 000 pg/g TOC in sediment and SPM respectively, and the congener pattern was dominated by OCDD, OCDF and 1,2,3,4,6,7,8-HpCDF. The dissolved concentrations in water were estimated by analysis of passive samplers of low density polyethylene (LDPE) type. The water pollution pattern was extremely different and showed complete domination of 2,3,7,8-TCDF. The fish showed species specific differences in the fractions of the two dominating congeners, 2,3,7,8-TCDF and 2,3,4,7,8-PeCDF. All species did, however, show an increase in the fraction 2,3,4,7,8-PeCDF as compared to the pattern in passive water samplers.
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| 23. |
- Trindade, Mirta, et al.
(författare)
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Enzyme-Linked Immunosorbent Assay for Screening Dioxin Soil Contamination by Uncontrolled Combustion During Informal Recycling in Slums
- 2008
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Ingår i: Environmental Toxicology and Chemistry. - : John Wiley & Sons. - 0730-7268 .- 1552-8618. ; 27:11, s. 2224-2232
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Tidskriftsartikel (refereegranskat)abstract
- Uncontrolled combustion due to garbage recycling is a widespread activity among slum dwellers in distressed economy countries, and has been indicated as a major source of dioxin contamination. However, due to the high cost and complexity of gas chromatography-high resolution mass spectrometry (GC-HRMS) analysis, the magnitude of the problem remains largely unknown. This work describes a first approach towards the use of a dioxin antibody-based enzyme-linked immunosorbent assay (ELISA) as the basis for a sustainable, simple, and low cost monitoring program to assess the toxicological impact of uncontrolled combustion in slums. A panel of sixteen samples was analyzed by GC-HRMS and ELISA on split extracts. Close to 20 % of the analyzed samples showed dioxin concentrations up to almost twice the guidance level for residential soil in several countries, pointing out the need for performing a large-scale monitoring program. Despite the potential for variations in dioxin congener distribution due to the mixed nature of the incinerated material, there was a good correlation between the toxic equivalents as determined by GC-HRMS and ELISA. Furthermore, an inter-laboratory ELISA validation showed that the capacity to perform the dioxin ELISA was successfully transferred between laboratories. It was concluded that the ELISA method performed very well as a screening tool to prioritize samples for instrumental analysis, which allows cutting down costs significantly.
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| 24. |
- van der Merwe, M, et al.
(författare)
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Locked doors in acute inpatient psychiatry : a literature review
- 2009
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 16:3, s. 293-299
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Forskningsöversikt (refereegranskat)abstract
- Many acute inpatient psychiatric wards in the UK are permanently locked, although this is contrary to the current Mental Health Act Code of Practice. To conduct a literature review of empirical articles concerning locked doors in acute psychiatric inpatient wards, an extensive literature search was performed in SAGE Journals Online, EBM Reviews, British Nursing Index, CINAHL, EMBASE Psychiatry, International Bibliography of the Social Sciences, Ovid MEDLINE, PsycINFO and Google, using the search terms 'open$', 'close$', '$lock$', 'door', 'ward', 'hospital', 'psychiatr', 'mental health', 'inpatient' and 'asylum'. A total of 11 empirical papers were included in the review. Both staff and patients reported advantages (e.g. preventing illegal substances from entering the ward and preventing patients from absconding and harming themselves or others) and disadvantages (e.g. making patients feel depressed, confined and creating extra work for staff) regarding locked doors. Locked wards were associated with increased patient aggression, poorer satisfaction with treatment and more severe symptoms. The limited literature available showed the urgent need for research to determine the real effects of locked doors in inpatient psychiatry.
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| 25. |
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