| 1. |
- Dehlin, Mats, 1968, et al.
(författare)
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Lifestyle factors and comorbidities in gout patients compared to the general population in Western Sweden: results from a questionnaire study.
- 2022
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Ingår i: Scandinavian journal of rheumatology. - : Informa UK Limited. - 1502-7732 .- 0300-9742. ; 51:5, s. 390-393
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to identify lifestyle factors associated with gout in patients with prevalent gout compared to the general population.Adult patients with gout identified in primary and secondary care in Western Sweden between 2015 and 2017 were sent a questionnaire asking about demographics, lifestyle, and comorbidities. Five age- and gender-matched controls were identified in a random sample of 52348 individuals aged 16-84years who participated in the National Public Health survey in Sweden, year 2015. Logistic regression models were used to compare cases and controls with regard to lifestyle factors and comorbidities.Of the 1589 invited gout patients, 868 (55%) responded. After matching for age and gender, 728 were included in the analysis (82.4% male; mean±sd age 69.3±10.5 years for men and 71.8±9.9 years for women with gout). Male and female gout patients were significantly more likely to be overweight or obese (men 79% vs 66%; women 78.5% vs 65.3%), to have binge-drinking behaviour (men 29.9% vs 11%; women 13.7% vs 2.9%), and to be ex-smokers, compared to controls. Moreover, male gout patients reported lower levels of physical activity, while diabetes and hypertension were more common in both genders with gout than in controls.In this questionnaire study, gout patients reported significantly more obesity and binge-drinking behaviour and less physical activity than controls. This suggests that there are great unmet needs for the management of lifestyle factors, particularly regarding overweight/obesity and binge drinking, in patients with gout.
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| 2. |
- Lennerstrand, Johan, et al.
(författare)
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Hur har omikron uppstått och varför sprider den sig så snabbt? : Fyra hypoteser om variantens ursprung och tänkbara mekanismer bakom den snabba spridningen presenteras [How did Omicron evolve and why does this SARS-CoV-2 variant spread so fast?]
- 2022
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Ingår i: Läkartidningen. - : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 119
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Forskningsöversikt (refereegranskat)abstract
- Omicron has more than twenty new mutations in the S1 domain of the spike gene as compared to the other previously known variants of SARS-CoV-2. Many of these new mutations, especially those located in the receptor binding domain, are likely to improve binding to the ACE2 receptor and to avoid binding to antibodies induced by a previous infection or by vaccination. Today there are several different hypotheses about the origin of Omicron, for example that it would have arisen in an immunosuppressed individual. Alternatively, a SARS-CoV-2 variant could have infected an unknown animal, and re-infection of humans would then have occurred. Furthermore, Omicron may have picked up a piece of a human common cold coronavirus. The hitherto available data suggest that the rapid spread of Omicron is a combination of properties of the virus replication ability in addition to its ability to avoid pre-existing immune responses.
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| 3. |
- Reyes, Yaoska
(författare)
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Norovirus and rotavirus susceptibility : studies from a Nicaraguan birth cohort
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Norovirus and rotavirus are major causes of pediatric acute gastroenteritis (AGE). It is estimated that norovirus is responsible for ~20% of all diarrheal diseases in children worldwide and causes approximately 200,000 deaths each year, mostly in young children and the elderly. Despite this vast disease burden, there is no licensed vaccine available. The introduction of universal infant rotavirus vaccination has led to marked reductions in diarrhea incidence and diarrhea-associated mortality in children. However, rotavirus continues to cause a high disease burden, particularly in low- and middle-income countries (LMIC), associated with an estimated 128,500 deaths in young children. Susceptibility to both norovirus and rotavirus AGE is strongly associated with the secretor phenotype (expression of specific glycans in mucosa and secretions). This, along with the Lewis phenotype and ABO group form the differential expression of histo-blood group antigens (HBGAs) in the mucosa. These HBGAs can act as putative receptors or attachment factors facilitating infection of these viruses. The overall aim of this thesis was to address outstanding questions regarding susceptibility and immunity to norovirus and rotavirus infections in children. These questions are of relevance for understanding the effects of a future norovirus vaccine and factors influencing vaccine protection. Our questions were addressed by investigating norovirus and rotavirus disease burden, molecular epidemiology, and the role of HBGAs in susceptibility in children enrolled in a rotavirus-vaccinated birth cohort in Nicaragua. We further estimated the breadth and duration of immune response and protection after the first norovirus AGE episode. Our results showed that the incidence of rotavirus and norovirus was 9.3 and 21.9 per 100 child-years, respectively. Several different norovirus genotypes were observed (n=13), the most common being GII.4 (42%), GI.3 (18%), GII.12 (9%) and GII.17 (9%). Genotype GII.4 was not only the most common genotype but also infected children earlier in life and caused more severe AGE episodes compared to other genotypes. In contrast, the distribution of rotavirus genotypes was limited and dominated by animal-derived strains and the absence of the wild-type G1P[8] genotype, which is the component of the Rotarix vaccine used in Nicaragua. Secretor children had the highest risk of norovirus AGE, with the predominant and clinically more severe GII.4 genotype only observed in secretors. Secretor children also had the highest risk for rotavirus AGE after vaccination. This is of particular interest since previous studies have observed that non-secretors have a less immune response after vaccination of the live oral rotavirus vaccines. Hence, the mediation of protection against rotavirus AGE for these children is likely due to genetic resistance to wild-type infections and not by vaccine-induced immune protection. Using surrogate neutralization assays, we observed that the antibody-mediated immune response after the first AGE episode of norovirus GII.4 persisted for about 19 months, thus suggesting a relatively long-term protection. We further found that the immune response against GII.4 was genotype-specific in a significant proportion (60%) of children. The multitypic response exhibited in some children could be due to asymptomatic infections with two or more genotypes over the studied period. Using statistical models, we found that one episode of norovirus GI and norovirus GII conferred approximately 33% and 80% reduced hazard against future genogroup-specific episodes in the first 3 years of life, respectively. In summary, the results presented in this thesis suggest that a pediatric norovirus vaccine including norovirus GII.4, and given early in life, would significantly reduce the high burden of diarrheal disease in young children, particularly for secretors.
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| 4. |
- Sharma, Sumit, 1978-, et al.
(författare)
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Human Norovirus and Sapovirus
- 2021. - 2
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Ingår i: Encyclopedia of Virology. - : Academic Press. - 9780128145166 ; , s. 483-492
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- The Caliciviridae family includes human norovirus and sapovirus. These are a diverse set of viruses causing acute gastroenteritis (AGE) in people of all ages, with norovirus being responsible for approximately 20% of all AGE worldwide and sapovirus 3%–17% of AGE in children, respectively. Susceptibility to norovirus is associated with human genetics, with approximately one-fifth of the population being resistant to the predominant GII.4 genotype. A human enteroid model has recently been successfully established to address questions regarding pathogenesis and virus–host interactions. While no specific antivirals are available, norovirus vaccine candidates are in clinical trials.
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| 5. |
- Svensson, Elin, et al.
(författare)
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Dual energy CT findings in gout with rapid kilovoltage-switching source with gemstone scintillator detector
- 2020
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Ingår i: BMC Rheumatology. - : SPRINGERNATURE. - 2520-1026. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundA definite diagnosis of gout requires demonstration of monosodium urate crystals in synovial fluid or in tophi, which in clinical practice today seldom is done. Dual energy CT (DECT) has repeatedly been shown to be able to detect monosodium urate crystals in tissues, hence being an alternative method to synovial fluid microscopy. The vast majority of these studies were performed with CT scanners with two X-ray tubes. In the present study we aim to investigate if and at what locations DECT with rapid kilovoltage-switching source with gemstone scintillator detector (GSI) can identify MSU crystals in patients with clinically diagnosed gout. We also performed a reliability study between two independent readings.MethodsPatients with new or established gout who had been examined with DECT GSI scanning of the feet at Sahlgrenska University Hospital, Molndal between 2015 and 2018 were identified. Their medical records were sought for gout disease characteristics using a structured protocol. Urate deposits in MTP1, MTP 2-5, ankle/midfoot joints and tendons were scored semiquantatively in both feet and presence of artifacts in nail and skin as well as beam hardening and noise were recorded. Two radiologists performed two combined readings and scoring of the images, thus consensus was reached over the scoring at each occasion (Espeland et al., BMC Med Imaging. 2013;13:4). The two readings were compared with kappa statistics.ResultsDECT GSI could identify urate deposits in the feet of all 55 participants with gout. Deposits were identified in the MTP-joints of all subjects but were also present in ankle/midfoot joints and tendons in 96 and 75% respectively. Deposition of urate was predicted by longer disease duration (Spearman's Rho 0.64, p <.0001) and presence of tophi (p =0.0005). Artifacts were common and mostly found in the nails (73%), a minority displayed skin artifacts (31%) while beam hardening and noise was rare. The agreement between the two readings was good (=0.66, 95% CI=0.61-0.71).ConclusionThe validity of DECT GSI in gout is supported by the identification of urate in all patients with clinical gout and the good correlations with clinical characteristics. The occurrence of artifacts was relatively low with expected locations.
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