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| 10. |
- Förlin, Lars, 1950, et al.
(författare)
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Effektscreening –Biologisk effektövervakning i förorenade områdenlängs Sveriges kust2017–2018
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Undersökningarna visar att samtliga metoder inklusive undersökningar av hälsotillståndet hos fisk, fortplantning och biomarkörer hos vitmärla, lysosomal membranstabilitet hos mussla och imposex hos snäckor med få undantag visade på tydliga effekter i de åtta undersökta och förorenade områdena längs Sveriges kuster. En jämförelse mellan de olika metoderna visar, med undantag för området i Uddevalla/Byfjorden, en tydlig påverkan i resterande undersökta områdena. I Byfjorden noterades mindre stressade musslor och endast låga stadier av imposex hos snäckor medan fiskhälsan kunde konstateras vara påverkad. Utöver Byfjorden gjordes undersökningar med mer än en av metoderna även i Sundsvallsfjärden, Norrsundet, Bråviken, Ronnebyåns mynning och Landskrona. I dessa områden visar jämförelsen mellan metoderna att samtliga indikerar en tydlig påverkan. Att samtliga metoder ger utslag beror sannolikt på att alla valda undersökningsområden har en mycket komplex och ganska påtaglig föroreningsbelastning vilket innebär att det kan förväntas att de flesta organismer som lever i dessa områden kan uppvisa effekter som kan härledas till påverkan av miljöstörande ämnen. I Sverige är den nationella effektbaserade miljöövervakningen i marin miljö väsentligen inriktad på att undersöka effekter av miljögifter i referensområden. Sådana områden karakteriseras av att de ska ligga på stort avstånd från större befolkningscentra och industrier, eller till exempel inte ligga nära stora flodmynningar. Resultaten från denna studie kompletterar den ordinarie miljöövervakningen i referensområden och visar med stor tydlighet att de undersökta områdena är källor för miljöstörande ämnen till vattenmiljön. Undersökningarna visar också att det är önskvärt att kontinuerlig biologisk effektövervakning kommer igång i något eller några påverkade områden inom ramen för den nationella miljöövervakningen för att parallellt följa förändringar i miljön nära eller en bit från påtagliga, mer eller mindre kontinuerliga föroreningskällor i vårt samhälle. Detta skulle också komplettera Sveriges internationella rapportering av miljödata genom att förutom att rapportera effektdata från referensområden även kunna rapportera data från påverkade/förorenade områden.
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| 11. |
- Håversen, Liliana, 1963, et al.
(författare)
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Vimentin deficiency in macrophages induces increased oxidative stress and vascular inflammation but attenuates atherosclerosis in mice
- 2018
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to clarify the role of vimentin, an intermediate filament protein abundantly expressed in activated macrophages and foam cells, in macrophages during atherogenesis. Global gene expression, lipid uptake, ROS, and inflammation were analyzed in bone-marrow derived macrophages from vimentin-deficient (Vim(-/-)) and wild-type (Vim(-/-)) mice. Atherosclerosis was induced in Ldlr(-/-) mice transplanted with a PCSK9 gain-of-function virus. The mice were fed an atherogenic diet for 12-15 weeks. We observed impaired uptake of native LDL but increased uptake of oxLDL in Vim(-/-) macrophages. FACS analysis revealed increased surface expression of the scavenger receptor CD36 on Vim(-/-) macrophages. Vim(-/-) macrophages also displayed increased markers of oxidative stress, activity of the transcription factor NF-kappa B, secretion of proinflammatory cytokines and GLUT1-mediated glucose uptake. Vim(-/- )mice displayed decreased atherogenesis despite increased vascular inflammation and increased CD36 expression on macrophages in two mouse models of atherosclerosis. We demonstrate that vimentin has a strong suppressive effect on oxidative stress and that Vim(-/-) mice display increased vascular inflammation with increased CD36 expression on macrophages despite decreased subendothelial lipid accumulation. Thus, vimentin has a key role in regulating inflammation in macrophages during atherogenesis.
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| 12. |
- Kurien, Matthew, et al.
(författare)
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Persistent mucosal damage and the risk of epilepsy in people with celiac disease
- 2018
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Ingår i: European Journal of Neurology. - : John Wiley & Sons. - 1351-5101 .- 1468-1331. ; 25:3, s. 592-e38
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Celiac disease (CD) is associated with an increased risk of developing epilepsy, a risk that persists after CD diagnosis. A significant proportion of CD patients have persistent villous atrophy (VA) on follow-up biopsy. This study's objective was to determine whether persistent VA on follow-up biopsy affects long-term epilepsy risk and epilepsy-related hospital emergency admissions.METHODS: Nationwide Cohort Study. We identified all people in Sweden with histological evidence of CD who underwent a follow-up small intestinal biopsy (1969-2008). We compared those with persistent VA to those who showed histological improvement, assessing the development of epilepsy and related emergency hospital admissions (defined according to relevant ICD codes in the Swedish Patient Register). Cox regression analysis was used to assess outcome measures.RESULTS: Of 7590 people with CD who had a follow-up biopsy, VA was present in 43%. The presence of persistent VA was significantly associated with a reduced risk of developing newly-diagnosed epilepsy (hazard ratio [HR] 0.61; 95% confidence interval [CI] 0.38-0.98). On stratified analysis this effect was primarily amongst males (HR 0.35; 95 CI 0.15-0.80). Among the 58 CD patients with a prior diagnosis of epilepsy, those with persistent VA were less likely to visit an emergency department with epilepsy (HR 0.37; 95%CI 0.09-1.09).CONCLUSIONS: In a population-based study of CD individuals, persisting VA on follow up biopsy was associated with reduced future risk of developing epilepsy but did not influence emergency epilepsy-related hospital admissions. Mechanisms as to why persistent VA confers this benefit requires further exploration. This article is protected by copyright. All rights reserved.
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| 13. |
- Laszkowska, Monika, et al.
(författare)
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Nationwide population-based cohort study of celiac disease and risk of Ehlers-Danlos syndrome and joint hypermobility syndrome
- 2016
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Ingår i: Digestive and Liver Disease. - : Elsevier. - 1590-8658 .- 1878-3562. ; 48:9, s. 1030-1034
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with celiac disease (CD) often have articular complaints, and small prior studies suggest an association with Ehlers-Danlos syndrome (EDS)/joint hypermobility syndrome (JHS). Aims: This study examines the risks of EDS/JHS in patients with CD. Methods: This cohort study compared all individuals in Sweden diagnosed with CD based on small intestinal biopsy between 1969-2008 (n = 28,631) to 139,832 matched reference individuals, and to a second reference group undergoing biopsy without having CD (n = 16,104). Rates of EDS/JHS were determined based on diagnostic codes in the Swedish Patient Register. Hazard ratios (HRs) for EDS/JHS were estimated through Cox regression. Results: There are 45 and 148 cases of EDS/JHS in patients with CD and reference individuals, respectively. This corresponds to a 49% increased risk of EDS/JHS in CD (95% CI = 1.07-2.07). The HR for EDS was 2.43 (95% CI = 1.20-4.91) and for JHS 1.34 (95% CI = 0.93-1.95). Compared to reference individuals undergoing intestinal biopsy, CD was not a risk factor for EDS/JHS. A stronger association was seen in patients initially diagnosed with EDS/JHS and subsequently diagnosed with CD (odds ratio = 2.29; 95% CI = 1.21-4.34). Conclusions: Individuals with CD have higher risk of EDS/JHS than the general population, which may be due to surveillance bias or factors intrinsic to celiac development. (C) 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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| 15. |
- Sundelin, Heléne E. K., et al.
(författare)
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Autism and epilepsy : A population-based nationwide cohort study
- 2016
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Ingår i: Neurology. - Philadelphia, USA : Lippincott Williams & Wilkins. - 0028-3878 .- 1526-632X. ; 87:2, s. 192-197
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the risk of autism spectrum disorder (ASD) in individuals with epilepsy and in their first-degree relatives to determine shared etiology.Methods: Through the Swedish Patient Register, we identified 85,201 individuals with epilepsy, as well as all their siblings (n = 80,511) and offspring (n = 98,534). Each individual with epilepsy was compared with 5 controls, matched for age, sex, calendar period, and county, while siblings and offspring were compared with siblings and offspring of controls. We excluded siblings and offspring with epilepsy. Using Cox regression, we calculated hazard ratios (HRs) for future diagnosis of ASD. Logistic regression was applied to calculate odds ratios (ORs) for prior diagnosis of ASD.Results: During follow-up, 1,381 (1.6%) individuals with epilepsy and 700 (0.2%) controls were diagnosed with ASD. Individuals with epilepsy were therefore at increased risk of future ASD (HR 10.49, 95% confidence interval [CI] 9.55-11.53), with the highest risk seen in individuals diagnosed with epilepsy in childhood. Both siblings (HR 1.62, 95% CI 1.43-1.83) and offspring (HR 1.64, 95% CI 1.46-1.84) of epilepsy patients were at increased risk of ASD. The risk in the offspring was particularly high in mothers with epilepsy (HR 1.91; 95% CI 1.63-2.23). Epilepsy was also associated with a prior diagnosis of ASD (OR 4.56, 95% CI 4.02-5.18).Conclusions: Individuals with epilepsy are at increased risk of ASD, especially if epilepsy appears in childhood. Further, ASD is more common in the siblings and offspring of individuals with epilepsy, suggesting shared etiology.
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| 16. |
- Sundelin, Heléne E.K. 1965-
(författare)
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Comorbidity and complications in neurological diseases
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Neurological diseases are complex and many share etiology as well as comorbidities. Epilepsy, a brain disorder characterized by an enduring predisposition to generate epileptic seizures and autism spectrum disorder (ASD), are considered to be associated, but the connection is still not fully uncovered. Cerebral palsy (CP), a lifelong, nonspecific, non-progressive disorder of posture and movement control, and Ehlers-Danlos Syndrome (EDS), a connective tissue disorder, both have many consequences for health and wellbeing throughout life.Aims: The aim of this thesis was to explore the impact of comorbidity and complications in neurological diseases and EDS. The objective was to gain information on the nature of the connection between epilepsy and ASD, if EDS, ASD and CP have consequences for pregnancy outcome, and the risk of traffic accidents in individuals with epilepsy.Materials and methods: The studies are all historical observational population- based cohort studies with prospectively collected data from national registers. The risk of ASD was analysed in 85,201 individuals with epilepsy and compared with 425,760 controls as well as for their firstdegree relatives. In a cohort of 1,248,178 singleton births, 314 births to women with EDS, 2,072 births to women with ASD, and 770 births to women with CP, pregnancy outcome was explored. The risk of traffic accidents was estimated in 29,220 individuals with epilepsy and 267,637 matched controls.Results: There is an increased risk of; ASD in individuals with epilepsy and their relatives, moderately preterm birth and pre-eclampsia in maternal ASD, of preterm birth in maternal CP and transport accidents in individuals with epilepsy. There is no increased risk of adverse pregnancy outcome in women with EDS.Conclusions: This thesis found proofs of a bidirectional association between epilepsy and ASD, that ASD and CP have consequences for pregnancy outcome and epilepsy is a risk factor for traffic accidents.
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| 17. |
- Sundelin, Heléne, et al.
(författare)
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Epilepsy, antiepileptic drugs, and serious transport accidents : A nationwide cohort study
- 2018
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Ingår i: Neurology. - : Lippincott Williams & Wilkins. - 0028-3878 .- 1526-632X. ; 90:13, s. E1111-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate the association between epilepsy and antiepileptic drugs and serious transport accidents requiring emergency care or resulting in death.Methods: We identified 29,220 individuals 18 years or older with epilepsy without cerebral palsy or intellectual disability and 267,637 matched controls using Swedish registers. This nationwide cohort was followed from 2006 to 2013 for serious transport accidents. We used Cox regression to analyze the risk of serious transport accidents between individuals with epilepsy and matched controls, and then stratified Cox regression to compare the risk during periods of medication with the risk during nonmedication period within the same individual with epilepsy. We adjusted for civil status, employment, education, living area, psychiatric disorders prior to the start of follow-up, and psychotropic medication.Results: Compared to matched controls, individuals with epilepsy were at increased risk of serious transport accidents (hazard ratio [HR] 1.37; 95% confidence interval [CI] 1.29-1.46). There were increased risks of pedestrian accidents (HR 2.24, 95% CI 1.69-2.97), bicycle accidents (HR 1.68, 95% CI 1.49-1.89) and car accidents (HR 1.31, 95% CI 1.19-1.44). However, among patients with a diagnosis of epilepsy, use of antiepileptic drugs did not influence the risk of serious transport accidents in population-level comparisons (HR 0.97; 95% CI 0.85-1.11) or within-individual comparisons (HR 0.99; 95% CI 0.69-1.42).Conclusion: Serious transportation accidents were more common in individuals with epilepsy, but this risk was independent of use of antiepileptic drugs.
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| 18. |
- Sundelin, Heléne, 1965-, et al.
(författare)
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Pregnancy outcome in joint hypermobility syndrome and Ehlers-Danlos syndrome
- 2017
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 96:1, s. 114-119
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: An increased risk of preterm birth in women with joint hypermobility syndrome or Ehlers-Danlos syndrome is suspected.MATERIAL AND METHODS: In this nationwide cohort study from 1997 through 2011, women with either joint hypermobility syndrome or Ehlers-Danlos syndrome or both disorders were identified through the Swedish Patient Register, and linked to the Medical Birth Register. Thereby, 314 singleton births to women with joint hypermobility syndrome/Ehlers-Danlos syndrome before delivery were identified. These births were compared with 1 247 864 singleton births to women without a diagnosis of joint hypermobility syndrome/Ehlers-Danlos syndrome. We used logistic regression, adjusted for maternal age, smoking, parity, and year of birth, to calculate adjusted odds ratios for adverse pregnancy outcomes.RESULTS: Maternal joint hypermobility syndrome/Ehlers-Danlos syndrome was not associated with any of our outcomes: preterm birth (adjusted odds ratio = 0.6, 95% confidence interval 0.3-1.2), preterm premature rupture of membranes (adjusted odds ratio = 0.8; 95% confidence interval 0.3-2.2), cesarean section (adjusted odds ratio = 0.9, 95% confidence interval 0.7-1.2), stillbirth (adjusted odds ratio = 1.1, 95% confidence interval 0.2-7.9), low Apgar score (adjusted odds ratio = 1.6, 95% confidence interval 0.7-3.6), small for gestational age (adjusted odds ratio = 0.9, 95% confidence interval 0.4-1.8) or large for gestational age (adjusted odds ratio = 1.2, 95% confidence interval 0.6-2.1). Examining only women with Ehlers-Danlos syndrome (n = 62), we found a higher risk of induction of labor (adjusted odds ratio = 2.6; 95% confidence interval 1.4-4.6) and amniotomy (adjusted odds ratio = 3.8; 95% confidence interval 2.0-7.1). No excess risks for adverse pregnancy outcome were seen in joint hypermobility syndrome.CONCLUSION: Women with joint hypermobility syndrome/Ehlers-Danlos syndrome do not seem to be at increased risk of adverse pregnancy outcome.
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| 19. |
- Sundelin, Heléne, et al.
(författare)
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Pregnancy outcomes in women with autism : a nationwide population-based cohort study
- 2018
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Ingår i: Clinical Epidemiology. - : DOVE Medical Press Ltd.. - 1179-1349. ; 10, s. 1817-1826
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Tidskriftsartikel (refereegranskat)abstract
- Background: The consequences of autism in pregnancy outcomes have not been explored before, although it is of crucial importance because of the frequent comorbidities and medication in this group of women.Objectives: To estimate the risk of adverse pregnancy outcomes in women diagnosed with autism.Design: Nationwide population-based cohort study.Setting: Sweden.Participants: Singleton births identified in the Swedish Medical Birth Registry, 2006-2014. A total of 2,198 births to women diagnosed with autism registered in the Swedish National Patient Registry were compared to 877,742 singleton births to women without such a diagnosis.Main outcome and measures: Preterm delivery. Secondary measures were cesarean delivery (emergency and elective), Apgar score <7 at 5 minutes, small for gestational age, large for gestational age, stillbirth, gestational diabetes, and preeclampsia. ORs were calculated through logistic regression, adjusted for maternal age at delivery, maternal country of birth, smoking, maternal body mass index, parity, calendar year of birth, and psychotropic and antiepileptic medication during pregnancy.Results: Women with autism were at increased risk of preterm birth (OR=1.30; 95% CI=1.10-1.54), especially medically indicated preterm birth (OR=1.41; 95% CI=1.08-1.82), but not with spontaneous preterm birth. Maternal autism was also associated with an increased risk of elective cesarean delivery (OR=1.44; 95% CI=1.25-1.66) and preeclampsia (OR=1.34; 95% CI=1.08-1.66), but not with emergency cesarean delivery, low Apgar score (<7), large for gestational age, gestational diabetes, and stillbirth. In women with medication during pregnancy, there was no increased risk of adverse pregnancy outcome except for induction of delivery (OR=1.33; 95% CI=1.14-1.55).Conclusion and relevance: Maternal autism is associated with preterm birth, likely due to an increased frequency of medically indicated preterm births, but also with other adverse pregnancy outcomes, suggesting a need for extra surveillance during prenatal care.
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