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- Carlsson, G, et al.
(författare)
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Periodontal disease in patients from the original Kostmann family with severe congenital neutropenia
- 2006
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Ingår i: Journal of Periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 77:4, s. 744-751
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Tidskriftsartikel (refereegranskat)abstract
- Patients with Kostmann syndrome (severe congenital neutropenia [SCN]) typically normalize their absolute neutrophil count (ANC) upon granulocyte colony-stimulating factor (G-CSF) therapy. However, although they no longer experience life-threatening bacterial infections, they frequently still have recurrent gingivitis and even severe periodontitis, often starting in early childhood. METHODS: We studied the periodontal disease in the four surviving patients belonging to the family originally described by Kostmann. Their odontological records, x-rays, color photos, bacterial cultures, serum antibodies to oral bacteria, and histopathological examinations were reviewed. The data were also correlated to previous investigations on their antibacterial peptides and molecular biology. RESULTS: Three patients had periodontal disease, despite normal ANC and professional dental care, and had neutrophils deficient in antibacterial peptides. One of these patients also had a heterozygous mutation in the neutrophil elastase gene, had severe periodontal disease and overgrowth of the periodontal pathogen Actinobacillus actinomycetemcomitans in the dental flora, and 15 permanent teeth had been extracted by the age of 27. One bone marrow-transplanted patient had no periodontal disease. CONCLUSIONS: Normalized ANC levels are not sufficient to maintain normal oral health in SCN patients, and because neutrophils are important for first-line defense and innate immunity, the deficiency of the antibacterial peptide LL-37 probably explains their chronic periodontal disease. Professional dental care is still important for SCN patients, despite treatment with G-CSF and normal ANC levels. Whether antibacterial peptides play a role in the pathogenesis of periodontitis in other patients remains to be elucidated.
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- Juliusson, Gunnar, et al.
(författare)
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Attitude towards remission induction for elderly patients with acute myeloid leukemia influences survival.
- 2006
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Ingår i: Leukemia. - : Springer Science and Business Media LLC. - 1476-5551 .- 0887-6924. ; 20:1, s. 42-47
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Tidskriftsartikel (refereegranskat)abstract
- Combination chemotherapy may induce remission from acute myeloid leukemia (AML), but validated criteria for treatment of elderly are lacking. The remission intention ( RI) rate for elderly patients, as reported to the Swedish Leukemia Registry, was known to be different when comparing the six health care regions, but the consequences of different management are unknown. The Leukemia Registry, containing 1672 AML patients diagnosed between 1997 and 2001, with 98% coverage and a median follow-up of 4 years, was completed with data from the compulsory cancer and population registries. Among 506 treated and untreated patients aged 70-79 years with AML (non-APL), there was a direct correlation between the RI rate in each health region ( range 36-76%) and the two-year overall survival, with no censored observations (6-21%) ( v 2 for trend = 11.3, P < 0.001; r(2) = 0.86, P < 0.02, nonparametric). A 1-month landmark analysis showed significantly better survival in regions with higher RI rates ( P = 0.003). Differences could not be explained by demographics, and was found in both de novo and secondary leukemias. The 5-year survival of the overall population aged 70-79 years was similar between the regions. Survival of 70-79-year-old AML patients is better in regions where more elderly patients are judged eligible for remission induction.
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- Larsson, Maria U., et al.
(författare)
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Phonemic fluency deficits in asymptomatic gene carriers for Huntington's disease
- 2008
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Ingår i: Neuropsychology. - : American Psychological Association (APA). - 0894-4105 .- 1931-1559. ; 22:5, s. 596-605
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to investigate verbal fluency in preclinical Huntington's disease (HD). Phonemic and semantic fluency and the rate of word production over time were assessed for 29 asymptomatic gene carriers and 34 noncarriers of HD. The relationship between fluency tasks and other cognitive domains was investigated. Compared to noncarriers, carriers produced fewer words and produced them more slowly in the phonemic fluency task but not in the semantic fluency task. When the carrier group was divided on the basis of Predicted-Years-To-Onset (PYTO), only carriers with <12 PYTO performed worse than noncarriers on both fluency tasks. Correlational analyses revealed that phonemic fluency was associated with cognitive speed and working memory, while semantic fluency was linked with crystallized abilities. The difference between carriers and noncarriers in phonemic fluency and a difference between the two carrier groups (<12 PYTO and ≥12 PYTO) in semantic fluency, but not in phonemic fluency, suggest that frontostriatal deficits may precede temporal involvement in preclinical HD.
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- Rana, A.K.M. Masud, et al.
(författare)
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Association of bone and joint diseases with health-related quality of life among older people : a population-based cross-sectional study in rural Bangladesh
- 2009
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Ingår i: Ageing & Society. - : Cambridge University Press. - 0144-686X .- 1469-1779. ; 29:5, s. 727-743
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Tidskriftsartikel (refereegranskat)abstract
- This study examined the cross-sectional association of bone and joint diseases with health-related quality of life (HRQoL) among 850 randomly sampled people aged 60 or more years in a rural area of Bangladesh. Information about arthritis, back and joint pain was collected through self-reports and two physicians' assessments at a health centre. Health-related quality of life was measured using a multi-dimensional generic instrument designed for older people that has questions on the construct's physical, psychological, social, economic, spiritual and environmental dimensions. Bivariate analyses showed that the most negative effects of bone and joint diseases were on the physical and psychological dimensions. Hierarchical linear regression analyses revealed that joint pain, whether doctor-diagnosed or self-reported, and self-reported back pain were all associated with lower HRQoL scores and accounted for almost 20 per cent of the variation (adjusted for age, sex, education, marital status, household size, income, expenditure and occupation). The analyses further revealed that women with self-reported back pain had significantly lower psychological, environmental and overall HRQoL scores than equivalent men, while self-reported joint pain was associated with significantly lower scores only for the environmental dimension. The strong association of bone and joint diseases with HRQoL underscores the importance of regarding these illnesses as public health problems.
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- Rana, A.K.M. Masud, et al.
(författare)
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Impact of health education on health-related quality of life among elderly persons : results from a community-based intervention study in rural Bangladesh
- 2009
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Ingår i: Health Promotion International. - : Oxford University Press. - 0957-4824 .- 1460-2245. ; 24:1, s. 36-45
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Tidskriftsartikel (refereegranskat)abstract
- This study examines the change in health-related quality oflife (HRQoL) among (60 years) elderly persons as a result ofhealth education intervention. A community-based interventionstudy was performed in eight randomly selected villages (Intervention:n = 4; Control: n = 4) in rural Bangladesh. A total of 1135elderly persons was selected for this study. The analyses include839 participants (Intervention: n = 425; Control: n = 414) whoparticipated in both baseline and post-intervention surveys.Participants in the intervention area were further stratifiedinto compliant (n = 315) and non-compliant (n = 110) groupsbased on the reported compliance to the intervention activities.The intervention includes, for example, physical activity, adviceon healthy food intake and other aspects of management. To createan enabling environment, social awareness was provided by meansof information about the contribution of and challenges facedby elderly persons at home and the community, including informationabout elderly persons' health and health care. The interventionactivities were provided to the elderly persons, caregivers,household members and community people for 15 months. The HRQoLwas assessed using a multi-dimensional generic instrument designedfor elderly persons. Multivariate analyses revealed that inthe non-compliant group the probabilities of increased scoreswere less likely in overall HRQoL (OR 0.52, 95% CI 0.32–0.82).Among the Control group, increased scores were less likely inthe physical (OR 73, 95% CI 0.54–0.99), social (OR 0.37,95% CI 0.27–0.50), spiritual (OR 0.60, 95% CI 0.34–0.94),environment (OR 0.36, 95% CI 0.26–0.49) dimensions andoverall HRQoL (OR 0.44, 95% CI 0.32–0.59) (adjusted forage, sex, literacy, marital status and economic status). Thisstudy concludes that provision of community-based health educationintervention might be a potential public health initiative toenhance the HRQoL in old age.
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