| 1. |
- Högberg, Cecilia, et al.
(författare)
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Qualitative faecal immunochemical tests (FITs) for diagnosing colorectal cancer in patients with histories of rectal bleeding in primary care : a cohort study
- 2020
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Ingår i: International Journal of Colorectal Disease. - : Springer. - 0179-1958 .- 1432-1262. ; 35, s. 2035-2040
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Tidskriftsartikel (refereegranskat)abstract
- Background Rectal bleeding is considered an alarm symptom for colorectal cancer (CRC) but it is common and mostly caused by benign conditions. Qualitative faecal immunochemical tests (FITs) for occult blood have been used as diagnostic aids for many years in Sweden when CRC is suspected. The study aimed to evaluate the usefulness of FITs requested by primary care physicians for patients with and without histories of rectal bleeding, in the diagnosis of CRC. Methods Results of all FITs requested in primary care for symptomatic patients in the orebro region during 2015 were retrieved. Data on each patient's history of rectal bleeding was gathered from electronic health records. Patients diagnosed with CRC within 2 years were identified from the Swedish Cancer Register. The analysis focused on three-sample FITs, the customary FIT in Sweden. Results A total of 4232 patients provided three-sample FITs. Information about the presence/absence of rectal bleeding was available for 2027 patients, of which 59 were diagnosed with CRC. For 606 patients with the presence of rectal bleeding, the FIT showed sensitivity 96.2%, specificity 60.2%, positive predictive value 9.8% (95% CI 6.1-13.4) and negative predictive value 99.7% (95% CI 99.2-100) for CRC. For 1421 patients without rectal bleeding, the corresponding figures were 100%, 73.6%, 8.3% (95% CI 5.6-10.9) and 100% (95% CI 99.6-100). Conclusion The diagnostic performance of a qualitative three-sample FIT provided by symptomatic patients in primary care was similar for those with and without a history of rectal bleeding. FITs seem useful for prioritising patients also with rectal bleeding for further investigation.
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| 2. |
- Lexne, Erik, et al.
(författare)
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Psychiatric symptoms among patients with acute abdominal pain Patients with organic dyspepsia report more psychiatric symptoms and rate poorer general health compared to patients with other specific abdominal diagnoses and non-specific abdominal pain at an emergency ward
- 2020
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Ingår i: Scandinavian Journal of Gastroenterology. - : Taylor & Francis Group. - 0036-5521 .- 1502-7708. ; 55:7, s. 769-776
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Tidskriftsartikel (refereegranskat)abstract
- Background:Abdominal pain is a common cause of visits to emergency facilities. It is related to psychiatric disorders in primary care, but it is unclear if this also holds in emergency departments. Objective:Is to explore potential differences between diagnostic groups in patients with acute abdominal pain in an emergency ward regarding concurrent somatic-and psychiatric symptoms, 'Length of stay' (LOS) and perceived health. Method:The patients (N = 137) were divided into three groups; organic dyspepsia, specific abdominal diagnoses, and non-specific abdominal pain. The Prime-MD results for extra gastrointestinal symptoms (outside the gastrointestinal tract), psychiatric symptoms, frequency of symptoms, self-reported health, and LOS within the month before admittance were compared between the diagnostic groups. Results: There was a significant positive correlation between the number of physical extra gastrointestinal and psychiatric symptoms (p < .001), especially regarding anxiety (p < .001) and depression (p = .002). Patients with organic dyspepsia reported significantly more total (p = .016), extragastrointestinal (p = .026) (chest pain;p = .017, dizziness;p = .004, palpitations;p = .005, insomnia;p = .005 and worries;p = .001), and summarized anxiety and depression symptoms (p = .001-0.002) besides poorer general health (p < .001) compared to other abdominal conditions. Also, organic dyspepsia patients needed longer hospital stay than the non-specific abdominal group (p = .002) but similar to the specific abdominal disorders group. Conclusion:Organic dyspepsia is accompanied by more co-occurring physical, anxiety and depression symptoms as well as poorer perceived health than other abdominal pain conditions and comparably increased LOS. This suggests that psychiatric consultations might be beneficial for diagnosing and treating psychiatric comorbidity in emergency care.
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| 3. |
- Nygren, David, et al.
(författare)
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Low Prevalence of Mild Alpha-1-Antitrypsin Deficiency in Hospitalized COVID-19-Patients
- 2022
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Ingår i: International Journal of General Medicine. - : Dove Medical Press Ltd. - 1178-7074. ; 15, s. 5843-5848
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Alpha- 1-antitrypsin (AAT) has been shown to inhibit SARS-CoV-2 cell entry and suggested as a therapeutic agent for COVID-19. Furthermore, epidemiological association of high prevalence of Alpha- 1-antitrypsin deficiency (AATD) and regional severity of COVID-19-impact has been hypothesized. In our study setting, the estimated prevalence rates of mild (PI*MZ, PI*SS or PI*MS) and moderate-to-severe AATD (PI*ZZ or PI*SZ) are high, 9% and 0.2%, respectively. Our primary aim was to examine the prevalence rate of AATD among hospitalized COVID-19-patients. Methods: In this prospective observational study, enrollment occurred from December 2020 to January 2021 in two COVID-19-units at Skane University Hospital, Lund, Sweden. Case definition was a patient hospitalized due to COVID-19. Patients were screened for AATD with PI-typing and if results were inconclusive, PCR for the S- and Z-genes were performed. Patients were categorized as severe or moderate COVID-19 and 30-day-mortality data were collected. The primary outcome was prevalence rate of AATD. The secondary outcome investigated association between presence of mild AATD and severe COVID-19. Results: We enrolled 61 patients with COVID-19. Two patients out of 61 (3%) had mild AATD (PI*MZ) and none had moderate-tosevere AATD. 30/61 (49%) had severe COVID-19. Both patients with mild AATD developed severe COVID-19. Yet, presence of AATD was not significantly associated with severe COVID-19 (p=0.24). Conclusion: Mild AATD (PI*MS or PI*MZ) was rare in a small cohort of hospitalized patients with COVID-19 in a study setting with a high background prevalence of AATD.
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| 4. |
- Ge, Huifang, et al.
(författare)
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Egg white peptides ameliorate dextran sulfate sodium-induced acute colitis symptoms by inhibiting the production of pro-inflammatory cytokines and modulation of gut microbiota composition
- 2021
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Ingår i: Food Chemistry. - : Elsevier. - 0308-8146 .- 1873-7072. ; 360
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Tidskriftsartikel (refereegranskat)abstract
- Egg white peptides (EWPs) can be effectively used to alleviate and treat inflammatory diseases due to their anti-oxidation, anti-inflammation, and microbiota regulation capabilities. A dextran sodium sulfate (DSS)-induced colitis model was used to clarify the regulatory effects of EWPs on colitis. Forty-three peptide sequences were identified from EWPs using LC-MS/MS. The results demonstrated that EWPs decreased the levels of pro-inflammatory cytokines and the extent of crypt damage in a dose-dependent manner. 16S rRNA gene sequencing results indicated that 200 mg/kg EWPs significantly increased the relative abundance of beneficial bacteria Lactobacillus and Candidatus Saccharimonas, and reduced the relative abundance of pathogenic bacteria Ruminiclostridium and Akkermansia. In addition, the degree of correlation between pro-inflammatory cytokines and microbiota was as follows: interleukin (IL)-1 beta > IL-8 > IL-6 > tumor necrosis factor-alpha To summarize, EWPs contributed to the alleviation of colitis symptoms and the intestinal injury through anti-inflammatory effects, repair of intestinal mucosa, and modulation of gut microbiota.
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| 5. |
- Lexne, Erik
(författare)
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Psychiatric aspects on acute abdominal pain
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Psychiatric comorbidity is estimated to occur in up to 40% of all patients with somatic disorders, and it can have an influence on patient morbidity and mortality. Approximately 20% of patients who seek care for abdominal pain receive the diagnosis nonspecific abdominal pain, and later develop chronic abdominal pain. This condition and other abdominal conditions without organic explanation are sometimes called diseases of gut-braininteraction, and psychosocial factors (personality, psychiatric conditions, etc.) have been suggested to play an important role. Organic dyspepsia (which in this thesis is limited to pepticulcer, gastritis and gastro-esophageal reflux disease, or GERD) has previously been reported to be associated with personality traits and psychiatric conditions. Despite these known associations, few studies have specifically investigated psychiatric comorbidity in patients with acute abdominal conditions.The aim of this thesis is to investigate the prevalence of psychiatric comorbidity in patients with acute abdominal pain conditions in the emergency setting and to evaluate the possible longterm psychiatric problems of these patients.Methods: Consecutive patients with who came to emergency care with acute abdominal pain conditions were divided into three diagnostic groups: acid-dependent organic dyspepsia (pepticulcer, gastritis and GERD), specific abdominal diagnoses, and non-specific abdominal pain.These groups were evaluated for personality traits, psychiatric symptoms, and self-rated health.A follow-up study explored prescription of antidepressant and anxiolytic (anti-anxiety) medications in this patients 10–15 years after the initial visit to emergency care.Results: Among the various diagnostic groups, patients with acid-dependent organic dyspepsia had significantly more anxiety-related personality traits, less mature characters, significantly more psychiatric symptoms, and poorer self-rated health. Patients with nonspecific abdominal pain also had more personality traits associated with anxiety, although to a lesser extent. Personality factors were significantly associated with poor self-rated health. The long-term follow-up showed that patients with organic dyspepsia and non-specific abdominal pain were prescribed antidepressants and anxiolytic drugs statistically more often than patients with specific abdominal diagnoses.Conclusion: Patients with abdominal pain who seek emergency care have enhanced psychiatric comorbidity, more anxiety-related personality traits, and poorer perceived health.This trend is particularly evident in patients with a diagnosis of acid-dependent organicdyspepsia, and to a lesser degree, patients with a diagnosis of non-specific abdominal pain.These factors also predict future prescription of depression and anxiety medications. These results suggest that patients who come to emergency care with acute abdominal pain could potentially benefit from psychiatric consultation.
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