| 1. |
- Askling, Johan, et al.
(author)
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Anti-TNF therapy in RA and risk of malignant lymphomas Relative risks and time-trends in the Swedish Biologics Register
- 2008
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In: Annals of the Rheumatic Diseases. - : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 68:5, s. 648-653
-
Journal article (peer-reviewed)abstract
- Background: Tumour necrosis factor (TNF) antagonists have proved effective as treatment against rheumatoid arthritis (RA), but the unresolved issue of whether the use of anti-TNF therapy increases the already elevated risk of lymphoma in RA remains a concern.Methods: Using the Swedish Biologics Register (ARTIS), the Swedish Cancer Register, pre-existing RA cohorts and cross-linkage with other national health and census registers, a national RA cohort (n = 67 743) was assembled and patients who started anti-TNF therapy between 1998 and July 2006 (n = 6604) were identified. A general population comparator (n = 471 024) was also assembled and the incidence of lymphomas from 1999 to 31 December 2006 was assessed and compared in these individuals.Results: Among the 6604 anti-TNF-treated RA patients, 26 malignant lymphomas were observed during 26 981 person-years of follow-up, which corresponded to a relative risk (RR) of 1.35 (95% CI 0.82 to 2.11) versus anti-TNF-naive RA patients (336 lymphomas during 365 026 person-years) and 2.72 (95% CI 1.82 to 4.08) versus the general population comparator (1568 lymphomas during 3 355 849 person-years). RA patients starting anti-TNF therapy in 1998–2001 accounted for the entire increase in lymphoma risk versus the two comparators. By contrast, RR did not vary significantly by time since start of first treatment or with the accumulated duration of treatment, nor with the type of anti-TNF agent.Conclusion: Overall and as used in routine care against RA, TNF antagonists are not associated with any major further increase in the already elevated lymphoma occurrence in RA. Changes in the selection of patients for treatment may influence the observed risk.
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| 2. |
- Askling, Johan, et al.
(author)
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Cancer risk in patients with rheumatoid arthritis treated with anti-tumor necrosis factor alpha therapies : does the risk change with the time since start of treatment?
- 2009
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In: Arthritis and Rheumatism. - : Wiley. - 0004-3591 .- 1529-0131. ; 60:11, s. 3180-3189
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Journal article (peer-reviewed)abstract
- OBJECTIVE:To determine the short-term and medium-term risks of cancer in patients receiving anti-tumor necrosis factor alpha (anti-TNFalpha) therapies that have proven effective in the treatment of chronic inflammatory conditions.METHODS:By linking together data from the Swedish Biologics Register, Swedish registers of RA, and the Swedish Cancer Register, we identified and analyzed for cancer occurrence a national cohort of 6,366 patients with RA who first started anti-TNF therapy between January 1999 and July 2006. As comparators, we used a national biologics-naive RA cohort (n = 61,160), a cohort of RA patients newly starting methotrexate (n = 5,989), a cohort of RA patients newly starting disease-modifying antirheumatic drug combination therapy (n = 1,838), and the general population of Sweden. Relative risks (RRs) were estimated using Cox regression analyses, examining overall RR as well as RR by time since the first start of anti-TNF therapy, by the duration of active anti-TNF therapy, and by the anti-TNF agent received.RESULTS:During 25,693 person-years of followup in 6,366 patients newly starting anti-TNF, 240 first cancers occurred, yielding an RR of 1.00 (95% confidence interval 0.86-1.15) versus the biologics-naive RA cohort, and similar RRs versus the other 2 RA comparators. RRs did not increase with increasing time since the start of anti-TNF therapy, nor with the cumulative duration of active anti-TNF therapy. During the first year following the first treatment start, but not thereafter, dissimilar cancer risks for adalimumab, etanercept, and infliximab were observed.CONCLUSION:During the first 6 years after the start of anti-TNF therapy in routine care, no overall elevation of cancer risk and no increase with followup time were observed.
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| 3. |
- Askling, Johan, et al.
(author)
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Risk and case characteristics of tuberculosis in rheumatoid arthritis associated with tumor necrosis factor antagonists in Sweden
- 2005
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In: Arthritis and Rheumatism. - : Wiley. - 0004-3591 .- 1529-0131. ; 52:7, s. 1986-1992
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Journal article (peer-reviewed)abstract
- OBJECTIVE:Because treatment with tumor necrosis factor (TNF) antagonists may increase the risk of tuberculosis (TB), and because knowledge of the risk of TB in rheumatoid arthritis (RA) not treated with biologics is scarce and of uncertain generalizability to low-risk populations, this study sought to determine the risk of TB among Swedish patients with RA.METHODS:Using data from Swedish nationwide and population-based registers and data from an ongoing monitoring program of TNF antagonists, the relative risks of TB in patients with RA (versus the general population) and of TB associated with TNF antagonists (versus RA patients not treated with biologics) were determined by comparing the incidence of hospitalization for TB in 3 RA cohorts and 2 general population cohorts from 1999 to 2001. We also reviewed the characteristics of all reported cases of TB in RA patients treated with TNF antagonists in Sweden and calculated the incidence of TB per type of TNF antagonist between 1999 and 2004.RESULTS:During 1999-2001, RA patients who were not treated with TNF antagonists were at increased risk of TB versus the general population (relative risk 2.0, 95% confidence interval [95% CI] 1.2-3.4). RA patients treated with TNF antagonists had a 4-fold increased risk of TB (relative risk 4.0, 95% CI 1.3-12) versus RA patients not treated with TNF antagonists. The reported TB cases during 1999-2004 in RA patients exposed to TNF antagonists (9 infliximab, 4 etanercept, 2 both) were predominantly pulmonary. TB occurred up to 3 years following the start of treatment.CONCLUSION:Irrespective of whether TNF antagonists are administered, Swedish patients with RA are at increased risk of TB. During 1999-2001, TNF antagonists were associated with an increased risk of TB, up to 4-fold in magnitude. This increased risk may persist over time during treatment and is related to both infliximab and etanercept.
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| 4. |
- Askling, Johan, et al.
(author)
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Time-dependent increase in risk of hospitalisation with infection among Swedish RA patients treated with TNF antagonists
- 2007
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In: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967 .- 1468-2060. ; 66:10, s. 1339-1344
-
Journal article (peer-reviewed)abstract
- OBJECTIVES:The degree to which treatment with tumour necrosis factor (TNF) antagonists may be associated with increased risks for serious infections is unclear. An observational cohort study was performed using prospectively collected data from the Swedish Biologics Register (ARTIS) and other national Swedish registers.METHODS:First, in the ARTIS, all 4167 rheumatoid arthritis (RA) patients starting TNF antagonist treatment between 1999 and 2003 were identified. Secondly, in the Swedish Inpatient Register, all individuals hospitalised for any reason and who also carried a diagnosis of RA, between 1964 and 2003 (n = 44 946 of whom 2692 also occurred in ARTIS), were identified. Thirdly, in the Swedish Inpatient Register, all hospitalisations listing an infection between 1999 and 2003 were identified. By cross-referencing these three data sets, RRs for hospitalisation with infection associated with TNF antagonist treatment were calculated within the cohort of 44 946 RA patients, using Cox regression taking sex, age, geography, co-morbidity and use of inpatient care into account.RESULTS:Among the 4167 patients treated with TNF antagonists, 367 hospitalisations with infections occurred during 7776 person-years. Within the cohort of 44 496 RA patients, the RR for infection associated with TNF antagonists was 1.43 (95% CI 1.18 to 1.73) during the first year of treatment, 1.15 (95% CI 0.88 to 1.51) during the second year of treatment, and 0.82 (95% CI 0.62 to 1.08) for subjects remaining on their first TNF antagonist treatment after 2 years.CONCLUSION:Treatment with TNF antagonists may be associated with a small to moderate increase in risk of hospitalisation with infection, which disappears with increasing treatment duration.
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| 5. |
- Cöster, Lars, et al.
(author)
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Structure of proteoheparan sulfates from fibroblasts. Confluent and proliferating fibroblasts produce at least three types of proteoheparan sulfates with functionally different core proteins
- 1986
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In: Journal of Biological Chemistry. - 1083-351X. ; 261:26, s. 12079-12088
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Journal article (peer-reviewed)abstract
- [3H]Leucine- and [35S]sulfate-labeled proteoheparan sulfates were isolated from postconfluent or proliferating cultures of human skin fibroblasts. Cell layers were solubilized by Triton X-100, and transferrin-binding macromolecules were isolated by affinity chromatography. Proteoglycans with no affinity for transferrin were purified by using ion-exchange and gel permeation chromatography. Postconfluent cells synthesize a proteoheparan sulfate of Mr 350,000 (as determined by gel permeation chromatography) which has affinity for transferrin as well as for octyl-Sepharose. Its core protein (Mr 180,000) consists of two disulfide-bonded polypeptides of Mr 90,000. This species was not detected in cultures of proliferating cells. Proliferating and confluent cells also synthesize other forms of proteoheparan sulfates (Mr 200,000-400,000) which have no affinity for transferrin. However, most of them have affinity for octyl-Sepharose. The core protein of proteoheparan sulfates made by proliferating cells has Mr 50,000. A smaller form (Mr 250,000) of this proteoglycan was solubilized by Triton X-100, whereas a larger form (Mr 400,000) remained associated with the pericellular matrix. A third type of proteoheparan sulfate (Mr 200,000) without affinity for transferrin nor octyl-Sepharose was associated with postconfluent cell layers but not with proliferating ones. Its core protein has Mr 35,000. Heparan sulfate oligosaccharides (Mr 6,000 or higher) were found in proliferating cells but not in postconfluent ones.
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| 6. |
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| 7. |
- Simard, Julia F., et al.
(author)
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Ten years with biologics : to whom do data on effectiveness and safety apply?
- 2011
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In: Rheumatology. - : Oxford University Press (OUP). - 1462-0324 .- 1462-0332. ; 50:1, s. 204-213
-
Journal article (peer-reviewed)abstract
- Methods. We identified all adult patients with RA (n = 9612), PsA (n = 1417) and other SpA (n = 1652) initiating a first biologic therapy between 1 January 1999 and 31 December 2008, registered in the Swedish Biologics Register (ARTIS), including information on demographics, disease characteristics and 1-year risk of first-line treatment discontinuation. Results. Over calendar time, measures of disease activity at start declined substantially for all indications, and diminished between first-, second- and third-line therapy starts. One-year risks of first-line therapy discontinuation increased. Switchers to anti-TNF and non-TNF biologics had different comorbidities. Despite < 50% drug retention at 5 years, most patients remained exposed to some biologic. Conclusions. The trends in baseline characteristics and drug retention underscores that any effects of biologics, including comparison between different biologics, must be interpreted in light of the characteristics of the population treated. The observed differences further call for continued vigilance to properly evaluate the safety profiles of biologic treatments as they are currently used. Exposure to multiple biologics presents a challenge for attribution of long-term effects.
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| 8. |
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| 9. |
- Argaw, Atelach Alemu, et al.
(author)
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Dictionary-based Amharic-French information retrieval
- 2005
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In: CLEF2005 Working Notes. - : CEUR-WS.
-
Conference paper (peer-reviewed)abstract
- We present four approaches to the Amharic -French bilingual track at CLEF 2005. All experiments use a dictionary based approach to translate the Amharic queries into French Bags-of-words, but while one approach uses word sense discrimination on the translated side of the queries, the other one includes all senses of a translated word in the query for searching. We used two search engines: The SICS experimental engine and Lucene, hence four runs with the two approaches. Non-content bearing words were removed both before and after the dictionary lookup. TF/IDF values supplemented by a heuristic function was used to remove the stop words from the Amharic queries and two French stopwords lists were used to remove them from the French translations. In our experiments, we found that the SICS search engine performs better than Lucene and that using the word sense discriminated keywords produce a slightly better result than the full set of non discriminated keywords.
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| 10. |
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| 11. |
- Askling, Johan, et al.
(author)
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Anti-tumour necrosis factor therapy in rheumatoid arthritis and risk of malignant lymphomas : relative risks and time trends in the Swedish Biologics Register
- 2009
-
In: Annals of the Rheumatic Diseases. - London, UK : BMJ. - 0003-4967 .- 1468-2060. ; 68:5, s. 648-653
-
Journal article (peer-reviewed)abstract
- BACKGROUND:Tumour necrosis factor (TNF) antagonists have proved effective as treatment against rheumatoid arthritis (RA), but the unresolved issue of whether the use of anti-TNF therapy increases the already elevated risk of lymphoma in RA remains a concern.METHODS:Using the Swedish Biologics Register (ARTIS), the Swedish Cancer Register, pre-existing RA cohorts and cross-linkage with other national health and census registers, a national RA cohort (n = 67,743) was assembled and patients who started anti-TNF therapy between 1998 and July 2006 (n = 6604) were identified. A general population comparator (n = 471,024) was also assembled and the incidence of lymphomas from 1999 to 31 December 2006 was assessed and compared in these individuals.RESULTS:Among the 6604 anti-TNF-treated RA patients, 26 malignant lymphomas were observed during 26,981 person-years of follow-up, which corresponded to a relative risk (RR) of 1.35 (95% CI 0.82 to 2.11) versus anti-TNF-naive RA patients (336 lymphomas during 365,026 person-years) and 2.72 (95% CI 1.82 to 4.08) versus the general population comparator (1568 lymphomas during 3,355,849 person-years). RA patients starting anti-TNF therapy in 1998-2001 accounted for the entire increase in lymphoma risk versus the two comparators. By contrast, RR did not vary significantly by time since start of first treatment or with the accumulated duration of treatment, nor with the type of anti-TNF agent.CONCLUSION:Overall and as used in routine care against RA, TNF antagonists are not associated with any major further increase in the already elevated lymphoma occurrence in RA. Changes in the selection of patients for treatment may influence the observed risk.
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| 12. |
- Askling, J, et al.
(author)
-
Haematopoietic malignancies in rheumatoid arthritis : lymphoma risk and characteristics after exposure to tumour necrosis factor antagonists
- 2005
-
In: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967 .- 1468-2060. ; 64:10, s. 1414-1420
-
Journal article (peer-reviewed)abstract
- BACKGROUND:Patients with rheumatoid arthritis (RA) are at increased risk of malignant lymphomas, and maybe also of leukaemia and multiple myeloma. The effect of tumour necrosis factor (TNF) antagonists on lymphoma risk and characteristics is unclear.OBJECTIVE:To assess expected rates and relative risks of haematopoietic malignancies, especially those associated with TNF antagonists, in large population based cohorts of patients with RA.METHODS:A population based cohort study was performed of patients with RA (one prevalent cohort (n = 53,067), one incident cohort (n = 3703), and one TNF antagonist treated cohort 1999 through 2003 (n = 4160)), who were linked with the Swedish Cancer Register. Additionally, the lymphoma specimens for the 12 lymphomas occurring in patients with RA exposed to TNF antagonists in Sweden 1999 through 2004 were reviewed.RESULTS:Study of almost 500 observed haematopoietic malignancies showed that prevalent and incident patients with RA were at increased risk of lymphoma (SIR = 1.9 and 2.0, respectively) and leukaemia (SIR = 2.1 and 2.2, respectively) but not of myeloma. Patients with RA treated with TNF antagonists had a tripled lymphoma risk (SIR = 2.9) compared with the general population. After adjustment for sex, age, and disease duration, the lymphoma risk after exposure to TNF antagonists was no higher than in the other RA cohorts. Lymphomas associated with TNF antagonists had characteristics similar to those of other RA lymphomas.CONCLUSION:Overall, patients with RA are at equally increased risks for lymphomas and leukaemias. Patients with RA treated with TNF antagonists did not have higher lymphoma risks than other patients with RA. Prolonged observation is needed to determine the long term effects of TNF antagonists on lymphoma risk.
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| 13. |
- Askling, J, et al.
(author)
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Risks of solid cancers in patients with rheumatoid arthritis and after treatment with tumour necrosis factor antagonists
- 2005
-
In: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967 .- 1468-2060. ; 64:10, s. 1421-1426
-
Journal article (peer-reviewed)abstract
- BACKGROUND:Existing studies of solid cancers in rheumatoid arthritis (RA) reflect cancer morbidity up until the early 1990s in prevalent cohorts admitted to hospital during the 1980s.OBJECTIVE:To depict the cancer pattern of contemporary patients with RA, from updated risk data from prevalent and incident RA populations. To understand the risk of solid cancer after tumour necrosis factor (TNF) treatment by obtaining cancer data from cohorts treated in routine care rather than trials.METHODS:A population based study of three RA cohorts (one prevalent, admitted to hospital 1990-2003 (n = 53,067), one incident, diagnosed 1995-2003 (n = 3703), and one treated with TNF antagonists 1999-2003 (n = 4160)), which were linked with Swedish nationwide cancer and census registers and followed up for cancer occurrence through 2003.RESULTS:With 3379 observed cancers, the prevalent RA cohort was at marginally increased overall risk of solid cancer, with 20-50% increased risks for smoke related cancers and +70% increased risk for non-melanoma skin cancer, but decreased risk for breast (-20%) and colorectal cancer (-25%). With 138 cancers, the incident RA cohort displayed a similar cancer pattern apart from non-decreased risks for colorectal cancer. TNF antagonist treated patients displayed solid cancer (n = 67) risks largely similar to those of other patients with RA.CONCLUSION:The cancer pattern in patients treated with TNF antagonists mirrors those of other contemporary as well as historic RA cohorts. The consistent increase in smoking associated cancers in patients with RA emphasises the potential for smoking cessation as a cancer preventive measure in RA.
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| 14. |
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| 15. |
- Cöster, Lars, 1945-, et al.
(author)
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Chronic widespread musculoskeletal pain - A comparison of those who meet criteria for fibromyalgia and those who do not
- 2008
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In: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 12:5, s. 600-610
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Journal article (peer-reviewed)abstract
- Fibromyalgia is currently classified as chronic widespread pain with widespread allodynia to pressure pain. There are few data describing pain characteristics, quality of life, consequences for daily living, and psychosocial status in patients who meet the classification criteria for fibromyalgia proposed by the American College of Rheumatology compared with patients with chronic widespread pain but not widespread allodynia. This study used a randomly selected sample from the general population. A postal questionnaire and a pain mannequin were sent to 9952 people. The response rate was 76.7%. The pain drawings showed that 345 people had widespread pain, that is, they noted pain in all four extremities and axially. Clinical examination, which included a manual tender point examination, was performed in 125 subjects. These people answered commonly used questionnaires on pain, quality of life, coping strategies, depression, and anxiety. Compared with chronic widespread pain without widespread allodynia, fibromyalgia was associated with more severe symptoms/consequences for daily life and higher pain severity. Similar coping strategies were found. Chronic widespread pain without widespread allodynia to pressure pain was found in 4.5% in the population and fibromyalgia in 2.5%. © 2007 European Federation of Chapters of the International Association for the Study of Pain.
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| 16. |
- CöSter, Maria C., et al.
(author)
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Minimally important change, measurement error, and responsiveness for the Self-Reported Foot and Ankle Score
- 2017
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In: Acta Orthopaedica. - Abingdon : TAYLOR & FRANCIS LTD. - 1745-3674 .- 1745-3682. ; 88:3, s. 300-304
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Journal article (peer-reviewed)abstract
- Background and purpose - Patient-reported outcome measures (PROMs) are increasingly used to evaluate results in orthopedic surgery. To enhance good responsiveness with a PROM, the minimally important change (MIC) should be established. MIC reflects the smallest measured change in score that is perceived as being relevant by the patients. We assessed MIC for the Self-reported Foot and Ankle Score (SEFAS) used in Swedish national registries. Patients and methods - Patients with forefoot disorders (n = 83) or hindfoot/ankle disorders (n = 80) completed the SEFAS before surgery and 6 months after surgery. At 6 months also, a patient global assessment (PGA) scaleas external criterionwas completed. Measurement error was expressed as the standard error of a single determination. MIC was calculated by (1) median change scores in improved patients on the PGA scale, and (2) the best cutoff point (BCP) and area under the curve (AUC) using analysis of receiver operating characteristic curves (ROCs). Results - The change in mean summary score was the same, 9 (SD 9), in patients with forefoot disorders and in patients with hindfoot/ankle disorders. MIC for SEFAS in the total sample was 5 score points (IQR: 2-8) and the measurement error was 2.4. BCP was 5 and AUC was 0.8 (95% CI: 0.7-0.9). Interpretation - As previously shown, SEFAS has good responsiveness. The score change in SEFAS 6 months after surgery should exceed 5 score points in both forefoot patients and hindfoot/ankle patients to be considered as being clinically relevant.
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| 17. |
- Cöster, Maria, et al.
(author)
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Comparison of the Self-Reported Foot and Ankle Score (SEFAS) and the American Orthopedic Foot and Ankle Society Score (AOFAS)
- 2014
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In: Foot & ankle international. - Thousand Oaks, CA : SAGE Publications (UK and US): 12 month Embargo. - 1071-1007 .- 1944-7876. ; 35:10, s. 1031-1036
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Journal article (peer-reviewed)abstract
- Background: The Self-reported Foot and Ankle Score (SEFAS) is a patient-reported outcome measure, while the American Orthopedic Foot and Ankle Society Score (AOFAS) is a clinician-based score, both used for evaluation of foot and ankle disorders. The purpose of this study was to compare the psychometric properties of these 2 scoring systems. Methods: A total of 95 patients with great toe disorders and 111 patients with ankle or hindfoot disorders completed the 2 scores before and after surgery. We evaluated time to complete the scores in seconds, correlations between scores with Spearmans correlation coefficient (r(s)), floor and ceiling effects by proportion of individuals who reached the minimum or maximum values, test-retest reliability and interobserver reliability by intraclass correlation coefficient (ICC), internal consistency by Cronbachs coefficient alpha (CA), and responsiveness by effect size (ES). Data are provided as correlation coefficients, means, and standard deviations. Results: SEFAS was completed 3 times faster than AOFAS. The scores correlated with an r(s) of .49 for great toe disorders and .67 for ankle/hindfoot disorders (both P less than .001). None of the scores had any floor or ceiling effect. SEFAS test-retest ICC values measured 1 week apart were .89 for great toe and .92 for ankle/hindfoot disorders, while the corresponding ICC values for AOFAS were .57 and .75. AOFAS interobserver reliability ICC values were .70 for great toe and .81 for ankle/hindfoot disorders. SEFAS CA values were .85 for great toe and .86 for ankle/hindfoot disorders, while the corresponding CA values for AOFAS were .15 and .42. SEFAS ES values were 1.15 for great toe and 1.39 for ankle/hindfoot disorders, while the corresponding ES values for AOFAS were 1.05 and 1.73. Conclusion: As SEFAS showed similar or better outcome in our tests and was completed 3 times faster than AOFAS, we recommend SEFAS for evaluation of patients with foot and ankle disorders.
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| 18. |
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| 19. |
- Cöster, Rickard, 1973-
(author)
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Algorithms and Representations for Personalised Information Access
- 2005
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Doctoral thesis (other academic/artistic)abstract
- Personalised information access systems use historical feedback data, such as implicit and explicit ratings for textual documents and other items, to better locate the right or relevant information for individual users.Three topics in personalised information access are addressed: learning from relevance feedback and document categorisation by the use of concept-based text representations, the need for scalable and accurate algorithms for collaborative filtering, and the integration of textual and collaborative information access.Two concept-based representations are investigated that both map a sparse high-dimensional term space to a dense concept space. For learning from relevance feedback, it is found that the representation combined with the proposed learning algorithm can improve the results of novel queries, when queries are more elaborate than a few terms. For document categorisation, the representation is found useful as a complement to a traditional word-based one.For collaborative filtering, two algorithms are proposed: the first for the case where there are a large number of users and items, and the second for use in a mobile device. It is demonstrated that memory-based collaborative filtering can be more efficiently implemented using inverted files, with equal or better accuracy, and that there is little reason to use the traditional in-memory vector approach when the data is sparse. An empirical evaluation of the algorithm for collaborative filtering on mobile devices show that it can generate accurate predictions at a high speed using a small amount of resources.For integration, a system architecture is proposed where various combinations of content-based and collaborative filtering can be implemented. The architecture is general in the sense that it provides an abstract representation of documents and user profiles, and provides a mechanism for incorporating new retrieval and filtering algorithms at any time.In conclusion this thesis demonstrates that information access systems can be personalised using scalable and accurate algorithms and representations for the increased benefit of the user.
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| 20. |
- Djukanovic, Ingrid, et al.
(author)
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Health-related quality of life in patients before and after planned orthopedic surgery : a prospective follow-up study
- 2011
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In: International Journal of Orthopaedic and Trauma Nursing. - : Elsevier. - 1878-1241 .- 1878-1292. ; 15:4, s. 185-195
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Journal article (peer-reviewed)abstract
- BackgroundThere are increasing demands on health care for both results and quality. Treatment outcome from the patient’s perspective is essential but not often demanded. The aim of the study was to assess Health Related Quality of Life (HRQoL) prior to and one year after an elective orthopedic intervention.MethodsHRQoL was evaluated by the 5-dimensional scale of the EuroQoL (EQ5D) with two additional scales, EQVAS and PainVAS in 676 consecutive patients undergoing 120 different elective orthopedic interventions. Descriptive statistics were used.ResultsResults showed patients treated for arthrosis with total hip and knee replacement had the greatest improvement in HRQoL. Patients that underwent spinal, upper arm and arthroscopic knee surgery showed considerable improvement. All patients experienced pain relief one year after surgery. Changes in the three effect variables EQ5D, EQVAS and PainVAS correlated significantly with each other.ConclusionsThe study provides an overview of patient assessment of HRQoL before and after some of the most common elective orthopedic interventions. Knowledge obtained from patient groups should help improve and individualize care both from a nursing and surgical perspective.
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| 21. |
- Ekström, Alva, 1938-
(author)
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Inget är skapat utanför : Teologi och kontext i Anders Frostensons författarskap
- 2006
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Doctoral thesis (other academic/artistic)abstract
- To the general public, Anders Frostenson clergyman and poet, is primarily known for his many contributions to the Swedish hymn treasure. He was born on 23 April 1906. The present thesis examines and defines the theology embodied in his works, especially in his hymns, showing that Frostenson occupies a central and unique position in the Swedish 20th Century Christian tradition.The study charts Frostenson´s life and work from poetry to hymn, and draws attention to the growth of a long-standing, significant authorship, that has served to make the Christian gospel accessible, relevant, and down-to-earth.Much has happened in the last century. The 1900s have been characterised by enormous changes, social, cultural and public, involving both individuals and nations. Matters of opinion and aims, union and dissension, have in a special way been put at the centre of things. This is also reflected in Anders Frostenson´s work.Frostenson´s autorship can be understood in terms of four concepts, which reflect the epiphanic mode of his works: the Word, the Testament, the Confirmation, and the Inheritance. These concepts can to a great extent be chronologically ordered, and taken together they function as the cornerstones on which Frostenson´s theology is built. The relationship between the four cornerstones and different periods is defined against the background of Frostenson´s existential situation and the socio-cultural context.The theological analysis shows how central Christian themes and the Christian philosophy of life are shaped in the meeting of tradition and actuality. Frostenson conveys the idea that God reveals himself in the here and now. Human suffering is God´s injunction to the world to act with love in daily service. The sense of belonging and continuity makes life meaningful and excludes no one from the earthly and heavenly “endless home”. In true Lutheran spirit Frostenson places his creative will and words in the service of God.The 1986 Hymnal is the cultural treasure through which Frostenson chiefly brought Word and Tradition into the everyday world. The cultural concept has been expanded with his help, through, among other things, spiritual song, where trust and tradition are obviously linked together with contemporary Christian culture.In 1935, Anders Frostenson wrote ´Let my life also be a working day, in Your vast Kingdom!` On 4 February 2006, that long day´s work finally came to a close.
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| 22. |
- Franzén, Kristofer, et al.
(author)
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Protein names and how to find them
- 2002. - 1
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In: International Journal of Medical Informatics. - : Elsevier. - 1386-5056 .- 1872-8243. ; 67, s. 49-61
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Journal article (peer-reviewed)abstract
- A prerequisite for all higher level information extraction tasks is the identification of unknown names in text. Today, when large corpora can consist of billions of words, it is of utmost importance to develop accurate techniques for the automatic detection, extraction and categorization of named entities in these corpora. Although named entity recognition might be regarded a solved problem in some domains, it still poses a significant challenge in others. In this work we focus on one of the more difficult tasks, the identification of protein names in text. This task presents several interesting difficulties because of the named entities' variant structural characteristics, their sometimes unclear status as names, the lack of common standards and fixed nomenclatures, and the specifics of the texts in the molecular biology domain in which they appear. We describe how we approached these and other difficulties in the implementation of Yapex, a system for the automatic identification of protein names in text. We also evaluate Yapex under four different notions of correctness and compare its performance to that of another publicly available system for protein name recognition.
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| 23. |
- Gerdle, Björn, 1953-, et al.
(author)
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Prevalence of widespread pain and associations with work status : A population study
- 2008
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In: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 9
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Journal article (peer-reviewed)abstract
- Background. This population study based on a representative sample from a Swedish county investigates the prevalence, duration, and determinants of widespread pain (WSP) in the population using two constructs and estimates how WSP affects work status. In addition, this study investigates the prevalence of widespread pain and its relationship to pain intensity, gender, age, income, work status, citizenship, civil status, urban residence, and health care seeking. Methods. A cross-sectional survey using a postal questionnaire was sent to a representative sample (n = 9952) of the target population (284,073 people, 18-74 years) in a county (Östergötland) in the southern Sweden. The questionnaire was mailed and followed by two postal reminders when necessary. Results. The participation rate was 76.7% (n = 7637), the non-participants were on the average younger, earned less money, and male. Women had higher prevalences of pain in 10 different predetermined anatomical regions. WSP was generally chronic (90-94%) and depending on definition of WSP the prevalence varied between 4.8-7.4% in the population. Women had significantly higher prevalence of WSP than men and the age effect appeared to be stronger in women than in men. WSP was a significant negative factor - together with age 50-64 years, low annual income, and non-Nordic citizen - for work status in the community and in the group with chronic pain. Chronic pain but not the spreading of pain was related to health care seeking in the population. Conclusion. This study confirms earlier studies that report high prevalences of widespread pain in the population and especially among females and with increasing age. Widespread pain is associated with prominent effects on work status. © 2008 Gerdle et al, licensee BioMed Central Ltd.
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- Kastbom, Alf, et al.
(author)
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Influence of FCGR3A genotype on the therapeutic response to rituximab in rheumatoid arthritis : an observational cohort study
- 2012
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In: BMJ Open. - : BMJ. - 2044-6055. ; 2:5
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Journal article (peer-reviewed)abstract
- Objectives To determine whether a polymorphism in the Fcγ receptor type IIIA (FCGR3A-F158V), influencing immunoglobulin G binding affinity, relates to the therapeutic efficacy of rituximab in rheumatoid arthritis (RA) patients.Design Observational cohort study.Setting Three university hospital rheumatology units in Sweden.Participants Patients with established RA (n=177; 145 females and 32 males) who started rituximab (Mabthera) as part of routine care.Primary outcome measures Response to rituximab therapy in relation to FCGR3A genotype, including stratification for sex.Results The frequency of responders differed significantly across FCGR3A genotypes (p=0.017 in a 3×2 contingency table). Heterozygous patients showed the highest response rate at 83%, as compared with patients carrying 158FF (68%) or 158VV (56%) (p=0.028 and 0.016, respectively). Among 158VV patients, response rates differed between male and female patients (p=0.036), but not among 158FF or 158VF patients (p=0.72 and 0.46, respectively).Conclusions Therapeutic efficacy of rituximab in RA patients is influenced by FCGR3A genotype, with the highest response rates found among heterozygous patients. This may suggest that different rituximab mechanisms of action in RA are optimally balanced in FCGR3A-158VF patients. Similar to the previously described associations with RA susceptibility and disease course, the impact of 158VV on rituximab response may be influenced by sex.
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- van Vollenhoven, R.F., et al.
(author)
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Addition of infliximab compared with addition of sulfasalazine and hydroxychloroquine to methotrexate in patients with early rheumatoid arthritis (Swefot trial) : 1-year results of a randomised trial
- 2009
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In: The Lancet. - 0140-6736 .- 1474-547X. ; 374:9688, s. 459-466
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Journal article (peer-reviewed)abstract
- Background: New treatment strategies for early rheumatoid arthritis are evolving rapidly. We aimed to compare addition of conventional disease-modifying antirheumatic drugs (sulfasalazine and hydroxychloroquine) with addition of a tumour necrosis factor antagonist (infliximab) to methotrexate in patients with early rheumatoid arthritis. Methods: We undertook a randomised trial in 15 rheumatology units in Sweden. We enrolled patients with early rheumatoid arthritis (symptom duration less than1 year) and administered methotrexate (up to 20 mg per week). After 3-4 months, those who had not achieved low disease activity but who could tolerate methotrexate were randomly allocated by computer addition of either sulfasalazine and hydroxychloroquine or infliximab. Primary outcome was achievement of a good response according to European League Against Rheumatism (EULAR) criteria at 12 months. Patients were followed up to 24 months; here, we present findings at 12 months. Analysis was by intention to treat and we used non-responder imputation. The Swefot (Swedish Pharmacotherapy) study is registered in the WHO database at the Karolinska University Hospital, number CT20080004. Findings: 487 patients were initially enrolled. Of 258 who had not achieved low disease activity with methotrexate, 130 were allocated sulfasalazine and hydroxychloroquine and 128 were assigned infliximab. 32 of 130 (25%) patients allocated sulfasalazine and hydroxychloroquine achieved the primary outcome compared with 50 of 128 (39%) assigned infliximab (risk ratio 1·59 [95% CI 1·10-2·30], p=0·0160). Adverse events were balanced fairly well between the two groups and accorded with known adverse events of the drugs used. No deaths occurred in either group. Interpretation: In patients with early rheumatoid arthritis in whom methotrexate treatment failed, addition of a tumour necrosis factor antagonist to methotrexate monotherapy is clinically superior to addition of conventional disease-modifying antirheumatic drugs. Funding: Swedish Rheumatism Association, Schering-Plough.
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| 30. |
- Westergren-Thorsson, G, et al.
(author)
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Altered dermatan sulfate proteoglycan synthesis in fibroblast cultures established from skin of patients with systemic sclerosis
- 1996
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In: Journal of Rheumatology. - 0315-162X. ; 23:8, s. 406-1398
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To study whether changes in the properties of skin from patients with systemic sclerosis (SSc) are the result of altered metabolism of dermatan sulfate proteoglycans.METHODS: Fibroblast cultures were established from skin of healthy controls, and from affected and unaffected skin of patients with SSc. Synthesized proteoglycans were labeled with 3H glucosamine and 35S sulfate. The amount of mRNA of the different dermatan sulfate proteoglycans was determined by hybridization with the corresponding cDNA probes.RESULTS: A 2-fold increase in secretion of total proteoglycans was found in cell cultures from affected and normal appearing skin from patients with SSc. The production of 2 different dermatan sulfate proteoglycans was increased. Aggrecan/versican increased 4-fold and decorin 2-fold in cultures of affected skin from patients with SSc. The mRNA for decorin increased 3-fold, while the mRNA level for versican increased only slightly. Similar but less marked changes were noted in cultures from normal appearing skin. In contrast, the biglycan mRNA level decreased and the product could only be found in very small amounts in SSc cultures.CONCLUSION: This marked alteration of dermatan sulfate proteoglycan metabolism distinguishes not only affected skin but also normal appearing SSc skin from that of controls. The altered proteoglycan production may affect organization of matrix fibers and thereby the fibrotic process observed in patients with SSc.
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