| 1. |
- Dahlqvist, Per, et al.
(författare)
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Testicular enlargement in a patient with a FSH-secreting pituitary adenoma
- 2010
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Ingår i: Endocrine. - : Springer Science and Business Media LLC. - 1355-008X .- 1559-0100. ; 37:2, s. 289-293
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Tidskriftsartikel (refereegranskat)abstract
- Clinically non-functional pituitary adenomas are often derived from gonadotropin producing cells. However, gonadotropinomas causing elevated serum levels of follicle-stimulating hormone (FSH) and clinical signs of FSH hypersecretion are very rarely described. Our patient, a 56-year-old man, was referred to our clinic with signs of hypogonadism. Magnetic resonance imaging (MRI) and biochemical examinations showed a large pituitary adenoma and excessive levels of serum FSH. Clinical examination and ultrasound measurement revealed bilaterally enlarged testes. After pituitary surgery, serum FSH levels normalized and there was a decrease in testicular volume. This case suggests that supraphysiological levels of FSH from a gonadotropinoma can cause a clinically observable effect, i.e. testicular enlargement. This is in line with experimental studies showing biological effect of FSH from pituitary adenomas and previous occasional reports of ovarian hyperstimulation and testicular enlargement in patients with FSH-secreting gonadotropinomas.
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| 2. |
- Fall, Tove, et al.
(författare)
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The Role of Adiposity in Cardiometabolic Traits : A Mendelian Randomization Analysis
- 2013
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Ingår i: PLoS Medicine. - : Public Library of Science (PLoS). - 1549-1277 .- 1549-1676. ; 10:6, s. e1001474-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The association between adiposity and cardiometabolic traits is well known from epidemiological studies. Whilst the causal relationship is clear for some of these traits, for others it is not. We aimed to determine whether adiposity is causally related to various cardiometabolic traits using the Mendelian randomization approach. Methods and Findings: We used the adiposity-associated variant rs9939609 at the FTO locus as an instrumental variable (IV) for body mass index (BMI) in a Mendelian randomization design. Thirty-six population-based studies of individuals of European descent contributed to the analyses. Age-and sex-adjusted regression models were fitted to test for association between (i) rs9939609 and BMI (n = 198,502), (ii) rs9939609 and 24 traits, and (iii) BMI and 24 traits. The causal effect of BMI on the outcome measures was quantified by IV estimators. The estimators were compared to the BMI-trait associations derived from the same individuals. In the IV analysis, we demonstrated novel evidence for a causal relationship between adiposity and incident heart failure (hazard ratio, 1.19 per BMI-unit increase; 95% CI, 1.03-1.39) and replicated earlier reports of a causal association with type 2 diabetes, metabolic syndrome, dyslipidemia, and hypertension (odds ratio for IV estimator, 1.1-1.4; all p<0.05). For quantitative traits, our results provide novel evidence for a causal effect of adiposity on the liver enzymes alanine aminotransferase and gamma-glutamyl transferase and confirm previous reports of a causal effect of adiposity on systolic and diastolic blood pressure, fasting insulin, 2-h post-load glucose from the oral glucose tolerance test, C-reactive protein, triglycerides, and high-density lipoprotein cholesterol levels (all p<0.05). The estimated causal effects were in agreement with traditional observational measures in all instances except for type 2 diabetes, where the causal estimate was larger than the observational estimate (p = 0.001). Conclusions: We provide novel evidence for a causal relationship between adiposity and heart failure as well as between adiposity and increased liver enzymes.
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| 3. |
- Gao, He, et al.
(författare)
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Evidence of a Causal Relationship Between Adiponectin Levels and Insulin Sensitivity : A Mendelian Randomization Study
- 2013
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Ingår i: Diabetes. - : American Diabetes Association. - 0012-1797 .- 1939-327X. ; 62:4, s. 1338-1344
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Tidskriftsartikel (refereegranskat)abstract
- The adipocyte-secreted protein adiponectin is associated with insulin sensitivity in observational studies. We aimed to evaluate whether this relationship is causal using a Mendelian randomization approach. In a sample of Swedish men aged 71 years (n = 942) from the Uppsala Longitudinal Study of Adult Men (ULSAM), insulin sensitivity (M/I ratio) was measured by the euglycemic insulin clamp. We used three genetic variants in the ADIPOQ locus as instrumental variables (IVs) to estimate the potential causal effect of adiponectin on insulin sensitivity and compared these with results from conventional linear regression. The three ADIPOQ variants, rs17300539, rs3774261, and rs6444175, were strongly associated with serum adiponectin levels (all P ≤ 5.3 × 10−9) and were also significantly associated with M/I ratio in the expected direction (all P ≤ 0.022). IV analysis confirmed that genetically determined adiponectin increased insulin sensitivity (β = 0.47–0.81, all P ≤ 0.014) comparable with observational estimates (β = 0.50, all Pdifference ≥ 0.136). Adjustment for BMI and waist circumference partly explained the association of both genetically determined and observed adiponectin levels with insulin sensitivity. The observed association between higher adiponectin levels and increased insulin sensitivity is likely to represent a causal relationship partly mediated by reduced adiposity.
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| 4. |
- Gao, H., et al.
(författare)
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Serum selenium in relation to measures of glucose metabolism and incidence of Type 2 diabetes in an older Swedish population
- 2014
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 31:7, s. 787-793
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Tidskriftsartikel (refereegranskat)abstract
- Aims The relation between selenium status and risk of Type2 diabetes is controversial. We aimed to evaluate associations of serum selenium, a marker of dietary selenium, with measures of glucose metabolism and risk of diabetes. Methods We used data from a population-based, longitudinal cohort of 1925 Swedish men who were 50years old and did not have diabetes at baseline in the 1970s. At baseline, an intravenous glucose tolerance test was performed and, at a follow-up examination after 20years, an oral glucose tolerance test and a hyperinsulinaemic euglycaemic clamp for the assessment of insulin sensitivity were conducted. Results At baseline, the mean (standard deviation) selenium concentration was 75.6 (14.3) g/l. During 20years of follow-up, 88 incident cases of diabetes occurred in 1024 participants with follow-up data. Baseline serum selenium levels were not associated with risk of diabetes (odds ratio1.06; 95%CI 0.83-1.38). Higher selenium levels were associated with lower early insulin response (standardized -0.08; 95%CI -0.14 to -0.03) at baseline after adjusting for potential confounders, but not with any other measures of -cell function or insulin sensitivity at baseline or follow-up. The association with early insulin response was non-significant after taking multiple testing into account. Conclusions Our results do not support a role of dietary selenium in the development of disturbances in glucose metabolism or diabetes in older individuals.
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| 5. |
- Holmer, Helene, et al.
(författare)
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Psychosocial health and levels of employment in 851 hypopituitary Swedish patients on long-term GH therapy
- 2013
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Ingår i: Psychoneuroendocrinology. - : Elsevier. - 0306-4530 .- 1873-3360. ; 38:6, s. 842-852
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Tidskriftsartikel (refereegranskat)abstract
- Context: The psychosocial health and working capacity in hypopituitary patients receiving long-term growth hormone (GH) therapy are unknown. less thanbrgreater than less thanbrgreater thanObjective: Psychosocial health and levels of employment were compared between GH deficient (GHD) patients on long-term replacement and the general population. less thanbrgreater than less thanbrgreater thanDesign and participants: In a Swedish nationwide study, 851 GHD patients [101 childhood onset (CO) and 750 adult onset (AO)] and 2622 population controls answered a questionnaire regarding current living, employment and educational level, alcohol consumption and smoking habits. The median time on GH therapy for both men and women with CO GHD was 9 years and for AO GHD 6 years, respectively. less thanbrgreater than less thanbrgreater thanResults: As compared to the controls, the GHD patients were less often working full time, more often on sick leave/disability pension, and to a larger extent alcohol abstainers and never smokers (all; P andlt; 0.05). Predominantly CO GHD women and men, but to some extent also AO GHD women and men, lived less frequently with a partner and more often with their parents. Particularly AO GHD craniopharyngioma women used more antidepressants, while AO GHD men with a craniopharyngioma used more analgesics. less thanbrgreater than less thanbrgreater thanConclusions: A working capacity to the level of the general population was not achieved among hypopituitary patients, although receiving long-term GH therapy. Patients were less likely to use alcohol and tobacco. The CO GHD population lived a less independent life.
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| 6. |
- Hong, Bongghi, et al.
(författare)
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Evaluating regional variation of net anthropogenic nitrogen and phosphorus inputs (NANI/NAPI), major drivers, nutrient retention pattern and management implications in the multinational areas of Baltic Sea basin
- 2012
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Ingår i: Ecological Modelling. - : Elsevier BV. - 0304-3800 .- 1872-7026. ; 227, s. 117-135
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Tidskriftsartikel (refereegranskat)abstract
- The NANI/NAPI (net anthropogenic nitrogen/phosphorus input) Calculator Toolbox described in this paper is designed to address the consequences to Baltic Sea nutrient loads of the significant variation in agronomic practices and dietary preferences among European countries whose watersheds comprise the Baltic Sea basin. A primary objective of this work is to develop regional parameters and datasets for this budgeting tool. A previous version of the toolbox was applied to the entire contiguous United States to calculate NANI and its components (atmospheric N deposition, fertilizer N application, agricultural N fixation and N in net food and feed imports). Here, it is modified for application to the Baltic Sea catchments, where coastal watersheds from several countries are draining to international waters. A similar accounting approach is taken for calculating NAPI, which includes fertilizer P application, P in net food and feed imports and non-food use of P by human. Regional variation of NANI/NAPI parameters (agricultural fixation rates, human intake rates and livestock intake and excretion rates) are estimated, and their impact on the regional nutrient budget and the riverine nutrient flux is evaluated. There is a distinct north-to-south gradient in NANI and NAPI across the Baltic Sea catchments, and regional nutrient inputs are strongly related to riverine nutrient fluxes. Analysis of regional nutrient retention pattern indicates that, for some countries, compliance to the Baltic Sea Action Plan would imply enormous changes in the agricultural sector.
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| 7. |
- Hong, Bongghi, et al.
(författare)
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NANI/NAPI Calculator Toolbox Version 2.0 Documentation : Net Anthropogenic Nutrient Inputs in Baltic Sea Catchments
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The main objective of this work was to develop regional settings of the NANI budgeting tool that will address the significant variation in agricultural practices and resulting nutrient accountings among European countries. NANI (Net Anthropogenic Nitrogen Inputs), first introduced by Howarth et al. (1996), estimate the human‐induced nitrogen inputs to a watershed and have been shown to be a good predictor of riverine nitrogen export at a large scale, multi‐year average basis. NANI have been calculated as the sum of four major components: atmospheric N deposition, fertilizer N application, agricultural N fixation, and net food and feed imports, which in turn are composed of crop and animal N production (negative fluxes removing N from watersheds) and animal and human N consumption (positive fluxes adding N to watersheds). Assuming approximate steady-state behavior, riverine N export is a fixed proportion of net nitrogen inputs.Similar calculations can be made for phosphorus (P) inputs, though because atmospheric deposition of P is usually considered negligible and there is no analog in P for atmospheric fixation, the calculation of Net Anthropogenic Phosphorus Inputs (NAPI) reduces to accounting for P fertilizer and P in net food/feed terms. While this document is primarily concerned with calculating NANI, we also describe the data sources and assumptions used to make the parallel calculations of NAPI.Version 2.0 of the Toolbox described in this document is an improvement of version 1.0 developed for US watersheds (http://www.eeb.cornell.edu/biogeo/nanc/nani/nani.htm; Hong et al. 2011). Version 1.0 allows the user to calculate NANI in any area within the contiguous United States (e.g., watershed, county, etc.) from nationally available databases downloadable from the Internet. The toolbox consists of a set of tools that:(1) calculate the proportions of various regions (political or gridded) in which data are collected that fall into areas of interest such as watersheds (“NANI‐GIS tools”),(2) extract and organize relevant data downloaded from web‐based datasets to be used by the accounting tools (“NANI‐extraction tools”), and(3) calculate NANI, their components, and other relevant items such as animal excretion (“NANI-.‐accounting tools”).While attempting to apply version 1.0 of the toolbox to Baltic Sea catchments, we found that the calculation of NANI in Baltic Sea catchments is more challenging than in US watersheds, mainly for two reasons:• Watersheds span international boundaries. Significant variation in agricultural practices and resulting nutrient accountings among European countries exist. For example, a substantial gradient in agricultural practices is expected among the former EU countries, new EU member states with transitional economies, and Belarus and Russia.• Gaps and uncertainties in the available data are much greater than those in the US. In general, the problem of missing information is more severe for the transitional countries, Belarus, and Russia, requiring numerous assumptions and guesswork to be made to deal with the insufficient data issue.Version 2.0 of the Toolbox describe in this document has several modules and improvements added to version 1.0 (which assumes spatially uniform agricultural practices, i.e., fixed values for all the NANI parameters, supported by the availability of well‐established and standardized datasets) to address the above difficulties. These improvements include:• Allowing spatial variation of NANI parameters (in this example, country‐specific NANI parameters) (Sections 4, 5.1, and 5.2)• Distribution of regional data (e.g., country-level crop production) into smaller spatial units (e.g., grid cells containing crop area information) (Section 5.3)• Making post‐calculation adjustments and refinements by accepting auxiliary datasets and manual calculations from the user (Section 3) In the following sections we describe the calculation of NANI and their components in the Baltic Sea catchments, with details of data availability, input preparation, and step-by‐step procedure of the use of various tools, and provide some preliminary results. In addition, Appendix 1 described parameter values used to create NAPI estimates following an accounting methodology in parallel to that for NANI.
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| 8. |
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| 9. |
- Lind, Mikael, et al.
(författare)
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Punctuality as performance metrics for efficient transportation systems
- 2014
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Ingår i: 21st World Congress on Intelligent Transport Systems, ITSWC 2014. - : Intelligent Transport Systems (ITS).
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Konferensbidrag (refereegranskat)abstract
- Transportation systems are ecosystems building on a high degree of co-production of value performed by multiple actors. In order to guide involved actors and ensure expected performance it becomes necessary to have an agreed performance metrics. Beside operational capacity for the transportation systems as such it is believed that punctuality as a performance metrics would be a solid base enabling different actors to take appropriate actions in planning, realizing, and evaluating their actions in relation to the expectations among involved actors (including beneficiaries) of the transportation system. In this paper, underlying mechanisms for punctuality are explored as the basis for an efficient transportation system.
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| 10. |
- Lundberg, Ulf, et al.
(författare)
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Arbetsmiljöns betydelse för ryggproblem : En systematisk litteraturöversikt
- 2014
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Rapport (refereegranskat)abstract
- The Swedish Council on Health Technology Assessment (SBU) conducted a systematic literature review of research on the association between occupational exposures and back disorders. In this review, we use back disorders as an umbrella term to include the more specific terms back trouble (a subjective experience of pain, ache or discomfort in the back), symptoms of sciatica, intervertebral disc changes and diseases of the back. The report is focused on disorders of the thoracic and lumbar spine. A wide range of occupational exposures were investigated, including: physical work load, vibration, organizational and psychosocial factors, chemical and biological factors, noise, environmental factors and contagious substances.Background: Since 2011 SBU has had a mandate from the Swedish government to systematically assess the evidence associating occupational exposures to health issues. The objective of this review was to assess the scientific basis describing the influence of occupational exposures on back disorders. Back disorders are common. Between 60 and 70 percent of the general population world-wide suffer from back pain at least once in their life. For affected individuals, back disorders are the source of both suffering and decreased functioning. The costs to society are also considerable in terms of direct health care costs, financial support to individuals with work disability, as well as costs due to loss of production.Method: A systematic review was undertaken following the PRISMA statement and standard methods used by SBU adapted to an occupational context. A literature search covering years 1980 to January 2014 was conducted in international medical and occupational data bases. The review assessed almost 8 000 abstracts. Studies that fulfilled strict inclusion criteria were assessed for relevance and quality, using pre-set protocols. Relevance and quality assessments were conducted by two experts, working in an evaluation pair. After conducting independent assessments, the two experts had to agree on a mutual relevance and quality classification. Some articles required that all exporters participated in discussion and made a collective assessment. A total of 109 studies were classified as moderate or high quality, representing more than 150 000 study participants. The strength of the scientific evidence was assessed with the GRADE system.Results: There is an association between occupational exposure and back disorders. This result is based on investigations of a large variety of work environments, mainly in Europe and North America. In most studies passing the quality criteria, researchers investigated occupational exposure and back disorders in populations consisting of both women and men with at least one year of follow up.Conclusions: People in the following groups develop more back trouble over time than those who are not subjected to the specified exposure at work:– Those who work with manual handling (e.g. lift) or in a posture where the back is bent or rotated– Those who work in a kneeling or squatting posture, or have physically demanding work tasks– Those exposed to whole body vibration– Those who experience work as mentally stressful; or those who find their work demanding, but lack decision latitude (personal control of their own working situation); or those who have insufficient opportunities for personal development– Those who work outside standard office hours.In some work environments, people have less back trouble. Those who experience high influence over work-related decisions, those who get social support at work and those with high job satisfaction develop less back trouble than others.Women and men with similar occupational exposures develop back troubles to the same extent.Those who work in forward bent postures or are exposed to whole body vibration in their work develop more symptoms of sciatica than others, while those with high job satisfaction develop less such symptoms. Those whose work entails manual handling develop more intervertebral disc changes than others.This systematic literature review has uncovered a substantial body of knowledge concerning occupational exposures and back disorders. Future research should include intervention studies, i.e. studies that scientifically test the effect of well defined interventions on back disorders over extended periods of time in authentic work situations.Project groupExperts: Karin Harms-Ringdahl (Chair), Sven Ove Hanson (Ethics), Olle Hägg, Ulf Lundberg, Svend Erik Mathiasen, Gunnevi Sundelin, Magnus Svartengren, and Hans Tropp.SBU: Charlotte Hall (Project Director), Karin Stenström (Assistant Project Director), Agneta Brolund (Information Specialist), Therese Kedebring (Project Administrator), Laura Lintamo (Investigator), Maria Skogholm (Project Administrator), Lena Wallgren (Scientific Writer)Scientific reviewers: Eva Denison, Mats Hagberg, Gunnar Nemeth, Esa-Pekka Takala.
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