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| 2. |
- Hedberg, P., et al.
(author)
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Mitral annulus motion as a predictor of mortality in a community-based sample of 75-year-old men and women
- 2006
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In: Journal of the American Society of Echocardiography. - : Elsevier BV. - 0894-7317 .- 1097-6795. ; 19:1, s. 88-94
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Journal article (peer-reviewed)abstract
- Mitral annulus motion (MAM) is a predictor of mortality in selected patient groups, but its prognostic value in less selected populations is not known. In a community-based random sample of 75-year-old men and women (n = 408), left ventricular function was measured as: (1) maximum amplitude of MAM; and (2) wall-motion index. During a median follow-up of 7.2 years, 83 persons died (26 from cardiac causes). Left ventricular function as measured by MAM predicted the risk of all-cause and cardiac mortality independently of other potential risk factors in this community-based sample. Regarding cardiac mortality, the predictive ability of MAM was also independent of left ventricular systolic function measured as wall-motion index. MAM may prove to be a valuable complement to other echocardiographic methods in the assessment of prognosis in less selected populations.
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| 9. |
- Andersson, Lars-Göran, et al.
(author)
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Thallium-201 Myocardial Imaging at Rest in Male Orienteers and Other Endurance Athletes
- 2001
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In: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 106:1, s. 59-66
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Journal article (peer-reviewed)abstract
- During the period 1979 to 1992, 16 sudden unexpected cardiac deaths were known to have occurred in young Swedish orienteers. Autopsy indicated myocarditis to be the most frequent finding, most often combined with extensive myocardial fibrosis. The aim of the present investigation was to explore whether young male orienteers show a higher frequency than other young elite endurance athletes (controls) in the occurrence of Thallium-201 myocardial perfusion defects at rest, suggestive of fibrosis evoked by myocarditis. Thallium-201 perfusion abnormalities at rest were more frequently found in the controls than in the orienteers (26% vs. 12%, p=0.03). Uneven Tl-201 perfusion was associated with left ventricular mass (r=0.32, r=0.24, p<0.01, p=0.02) and body weight (r=0.30, r=0.31, p<0.01, p=0.03) in orienteers and controls, respectively. Echocardiographic left ventricular wall motion abnormalities were found in 11 athletes (9 orienteers and 2 controls) but only two displayed an abnormal Thallium-201 perfusion scan at rest. Perfusion abnormalities at rest did not occur more frequently in the orienteers but were commonly found in both groups of apparently healthy athletes making it futile to discern abnormals from normals. Thallium-201 perfusion aberrations were not associated with left ventricular wall motion abnormalities obtained by echocardiography.
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| 10. |
- Arnardóttir, R. H., et al.
(author)
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No increase in walking distance on repeated tests in COPD patients with exercise-induced hypoxaemia
- 2007
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In: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 9:4, s. 161-168
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Journal article (peer-reviewed)abstract
- The aim of the study was to investigate the effect of retesting on the 12-min walking distance (12MWD) in patients with moderate or severe chronic obstructive pulmonary disease (COPD), with and without exercise-induced hypoxaemia (EIH) and to evaluate whether baseline characteristics derived before walking influence on variation of repeated tests. Fifty-seven COPD patients, mean age 66 (range 47 84) years, performed three 12-min walk tests within 1 week. Before and after each test, oxygen saturation (pulse oximetry, SpO 2), heart rate, breathing frequency, peak expiratory flow, and subjective ratings of exertion and dyspnoea were measured. EIH was defined as a fall in SpO 2 below 90% at the first walk test. The 12MWD did not increase on repeated testing in the EIH group. In the non-EIH group, the 12MWD increased by 12% (p<0.001) from test 1 to test 2 and by 4% (p<0.001) from test 2 to test 3. No day-to-day variation was observed in pre-walking characteristics. At least one training test is needed in non-EIH patients with COPD, as their effort and performance on the 12-min walk test increases on retesting (learning effects). In patients with EIH, the term "training test" is not relevant, as their walking distance did not homogeneously increase on repeated testing.
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| 11. |
- Bondesson, E., et al.
(author)
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Comorbidity between pain and mental illness - Evidence of a bidirectional relationship
- 2018
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In: European Journal of Pain. - : Wiley. - 1090-3801. ; 22:7, s. 1304-1311
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Journal article (peer-reviewed)abstract
- Background: Pain from various locations in the body and mental illness are common and the comorbidity between the two is well-known although the temporal relationship remains to be determined. Our aim was to follow patients over time to study if pain (here dorsalgia/abdominal pain) or fibromyalgia lead to an increased risk of developing mental illness (here depression/anxiety) and/or the reverse, that is whether patients with mental illness have an increased risk to develop pain or fibromyalgia, compared to the rest of the population. Methods: This prospective cohort study used the Skåne Healthcare Register, covering all care in the region of Skåne, southern Sweden (population ~1.3 million). The cohort included healthcare consultations in primary care, outpatient specialized care and inpatient care between 2007 and 2016 for all patients without prior registered diagnosis of mental illness or pain, aged 18 or older (n = 504,365). Results: The incidence rate ratio (IRR) for developing mental illness after pain was 2.18 (95% CI = 2.14-2.22) compared to without pain. IRR for developing pain after mental illness was 2.02 (95% CI = 1.98-2.06) compared to without mental illness. Corresponding IRR for developing mental illness after fibromyalgia was 4.05 (95% CI = 3.58-4.59) and for developing fibromyalgia after mental illness 5.54 (95% CI = 4.99-6.16). Conclusions: This study shows a bidirectional influence of similar magnitude of pain and mental illness, respectively. In monitoring patients with pain or mental illness, a focus on both conditions is thus important to develop appropriate, targeted interventions and may increase the likelihood of improved outcomes. Significance: We followed a population-based cohort over a period of 10 years, including incident cases of both exposure and outcome and found a bidirectional relationship between pain and mental illness. Clinicians need to pay attention on both conditions, in patients seeking care due to mental illness or pain.
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| 12. |
- Enochsson, L, et al.
(author)
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Laparoscopic vs open appendectomy in overweight patients
- 2001
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In: Surgical Endoscopy. - : Springer Science and Business Media LLC. - 0930-2794 .- 1432-2218. ; 15:4, s. 387-392
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Journal article (peer-reviewed)abstract
- Background: Laparoscopic appendectomy (LA) has been associated with a faster recovery and less postoperative pain than the open technique. However, few data are available on the clinical outcome of LA in overweight patients. Methods: A group of 106 patients with a body mass index (BMI) > 26.4, representing the upper quintile of 500 prospectively randomized patients, were included in the study. They were randomized to undergo either laparoscopic or open appendectomy (OA). Operating and anesthesia times, postoperative pain, complications, hospital stay, functional index (1 week postoperatively), sick leave, and time to full recovery were documented. Results: In OA, the operating time for overweight patients was significantly longer than that for patients in the normal weight range (40 vs 35 min, p < 0.05). In LA, there was no difference in operating time between the normal and overweight patients. Overweight patients who underwent LA had longer operating and anesthesia times than their OA counterparts (55 vs 40 min, p < 0.001, and 125 vs 100 min, p < 0.001, respectively). Postoperative pain was significantly greater in overweight patients who underwent OA than in those treated with the laparoscopic technique. Postoperative pain was also significantly greater in overweight patients subjected to OA than in patients of normal weight after 4 weeks, the clinical significance may, however, be of less importance since the values are low (0.26 vs 0.09, p < 0.05). There were no significant differences between the two operating techniques in terms of complications. Hospital stay was longer for overweight patients than for normal-weight patients undergoing OA (3.0 vs 2.0, p < 0.01). The functional index did not differ between any group of patients. Sick leave was longer for overweight patients who underwent OA than for normal-weight patients treated with the same technique (17 vs 13 days, p < 0.01). In the laparoscopic group, however, there were no differences between the overweight and normal-weight patients. Time to full recovery was greater in overweight patients subjected to OA than in the overweight patients in the LA group (22 vs 15 days, p < 0.001). Conclusion: In this study, overweight patients who were submitted to LA had less postoperative pain and a faster postoperative recovery than overweight patients who had OA. LA also abolished some of the negative effects that overweight had on operating time, hospital stay, and sick leave with the open technique. However, anesthesia and operating times were significantly longer in LA for both overweight patients and those with a normal BMI.
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| 13. |
- Enochsson, L, et al.
(author)
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The Fenyo-Lindberg scoring system for appendicitis increases positive predictive value in fertile women - A prospective study in 455 patients randomized to either laparoscopic or open appendectomy
- 2004
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In: Surgical Endoscopy. - : Springer Science and Business Media LLC. - 0930-2794 .- 1432-2218. ; 18:10, s. 1509-1513
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Journal article (peer-reviewed)abstract
- Background: Suspected appendicitis is one of the most common indications for acute laparotomy or laparoscopy. The negative laparotomy and laparoscopy rates are high, often in the range of 15-30%, and especially high in some groups of patients such as women of child-bearing age and young patients. Different scoring systems have been introduced in order to improve diagnostic accuracy. The aim of the present study was to analyse the outcome of the Fenyo-Lindberg scoring system in a prospectively randomized multicenter trial and to analyze how well the score performed in stratified subgroups. Methods: The variables of the Fenyo-Lindberg scoring system were collected in a prospective study comparing laparoscopic and open surgery in suspected appendicitis and with four participating centers. None of the hospitals had used the scoring system previously. Since surgeons were unfamiliar with the score, they could not use it as a diagnostic aid. When comparing the score with the clinical outcome, retrospectively, the investigators interpreting the score were blinded regarding the surgical outcome. Results: Positive predictive value (PPV) of the Fenyo-Lindberg score was higher than that of the surgeon's clinical diagnosis in the patient cohort [0.90 vs 0.79 (p < 0.001)]. The score demonstrated an improvement of PPV in women [0.83 vs 0.70 (p < 0.01)]. PPV was increased in women between 15 and 50 years of age. In women aged 15-30 years and 31-50 years PPV increased from 0.69 to 0.82 and 0.68 to 0.86, respectively (p < 0.01). Both the sensitivity (0.77) and the specificity (0.69) of the score were, however, low. Conclusion: The Fenyo-Lindberg score is an inexpensive clinical tool that may improve the diagnostic accuracy for acute appendicitis in women of childbearing age, which is a group of patients where the diagnostic accuracy usually is low and where the arsenal of diagnostic tools such Lis Computed tomography is limited because of radiation. The low specificity of the score in women of childbearing age must, however, be kept in mind.
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| 14. |
- Evren, Elza, et al.
(author)
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Distinct developmental pathways from blood monocytes generate human lung macrophage diversity
- 2021
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In: Immunity. - : Elsevier. - 1074-7613 .- 1097-4180. ; 51, s. 35-35
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Journal article (peer-reviewed)abstract
- The study of human macrophages and their ontogeny is an important unresolved issue. Here, we use a humanized mouse model expressing human cytokines to dissect the development of lung macrophages from human hematopoiesis in vivo. Human CD34+ hematopoietic stem and progenitor cells (HSPCs) generated three macrophage populations, occupying separate anatomical niches in the lung. Intravascular cell labeling, cell transplantation, and fate-mapping studies established that classical CD14+ blood monocytes derived from HSPCs migrated into lung tissue and gave rise to human interstitial and alveolar macrophages. In contrast, non-classical CD16+ blood monocytes preferentially generated macrophages resident in the lung vasculature (pulmonary intravascular macrophages). Finally, single-cell RNA sequencing defined intermediate differentiation stages in human lung macrophage development from blood monocytes. This study identifies distinct developmental pathways from circulating monocytes to lung macrophages and reveals how cellular origin contributes to human macrophage identity, diversity, and localization in vivo.
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| 15. |
- Harpa Arnardóttir, R., et al.
(author)
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Two different training programmes for patients with COPD : A randomised study with 1-year follow-up
- 2006
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In: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 100:1, s. 130-139
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Journal article (peer-reviewed)abstract
- Purpose: To compare the effects on exercise capacity and health related quality of life (HRQoL) of two exercise programmes; one programme including endurance training and one including only resistance training and callisthenics. A second purpose was to find out whether the severity of chronic obstructive pulmonary disease (COPD) affected the training response and whether the interventions had a long-term effect. Methods: Sixty-three patients were stratified according to severity of COPD and randomised to two training groups. Group A had a mixed programme including endurance training. Group B had resistance training and callisthenics. All trained twice weekly for 8 weeks. A symptom-limited ergometer test, 12-min walking test, dynamic spirometry, blood gas analysis at rest and HRQoL were measured before and after the training period. Follow-up tests were conducted at 6 and 12 months after training. Results: Forty-two patients fulfilled the trial. In group A (n = 20) peak exercise capacity increased by 7 W (P<0.001) and 12-min walking distance (12MWD) by 50 m (P<0.01), whereas group B (n = 22) did not change in any of these variables. HRQoL did not change significantly in either group. Training response was similar in patients with moderate and severe disease. One year post-training 12MWD had returned to pre-training level in group A, and below pre-training level in group B (P<0.05). Conclusions: Exercise capacity in patients with severe and moderate COPD improved by intensive endurance training, two sessions a week for 8 weeks. The improvement was however small and HRQoL did not improve. Severity of illness did not affect response to training. The results indicated that the effects of a short endurance training intervention slowed down decline in baseline functional exercise capacity for 1 year.
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| 16. |
- Jonason, T., et al.
(author)
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Menopause is associated with the stiffness of the common carotid artery in 50-year-old women
- 1998
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In: Clinical Physiology. - : Wiley. - 0144-5979 .- 1365-2281. ; 18:2, s. 149-155
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Journal article (peer-reviewed)abstract
- To determine if menopause has an effect on the elasticity of the arteries, the stiffness index of the common carotid artery was studied in 84 premenopausal and 139 post-menopausal women. The study group was age-homogeneous, all women being 50 years of age. There were no significant differences between pre- and post-menopausal women regarding atherosclerosis, when measured as the number of subjects with plaques or intimal-medial thickness. The diameter of the common carotid artery was significantly larger in post-menopausal women. The diameter was correlated to measurements of body size which did not, however, differ between the two groups. The mean stiffness indexes were 4.99 +/- 1.02 and 5.38 +/- 1.21 in the pre- and post-menopausal groups respectively (P < 0.05). In a multivariate analysis, menopause (P < 0.05), and also serum insulin levels (P < 0.01) and smoking (P < 0.05) were found to have independent significant associations to the stiffness index. In conclusion, menopause is associated with reduced elasticity of the carotid arteries in 50-year-old women.
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| 22. |
- Michaëlsson, Karl, 1959-, et al.
(author)
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Effect of prefracture versus postfracture dietary assessment on hip fracture risk estimates
- 1996
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In: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 25:2, s. 403-10
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Journal article (peer-reviewed)abstract
- BACKGROUND. Dietary factors are presumed to have influence on bone mass and hence fracture susceptibility. Most information in this respect is based on retrospective assessment of previous dietary habits. In a population-based case-control study nested within a cohort, we collected dietary information both before and after a first hip fracture. Thus it was possible to study reported changes in dietary habits, intentional as well as unintentional, among hip fracture patients after a first hip fracture and to compare postfracture with prefracture dietary information. METHODS. More than 65 000 women born 1914-1948 in two counties in central Sweden completed a food frequency questionnaire regarding their usual current dietary habits, before attending a mammographic screening between the years 1987 and 1990. Subsequently 123 of them sustained a first hip fracture and were defined as cases in the present study. For every case, one control, individually matched by age and county of residence, was selected from the cohort. A second identical food frequency questionnaire was mailed to both cases and controls on average 2 years after the hip fracture event. In total 98 case/control pairs could be included in the analysis. The association between diet and hip fracture was evaluated and the results from the two dietary assessments were contrasted. Women who themselves claimed that they had not changed their diet in recent years were analysed separately. RESULTS. The hip fracture cases, compared with the controls, had reduced their reported dietary intake of dairy products after the fracture. Apparently this was not intentional since this effect was more pronounced among those cases who claimed that their diet was unchanged. The changes were most apparent among the younger cases with a more recent hip fracture and with a body mass index above the median. Half of the cases, more than twice the frequency in controls, who were initially classified as having high intake of dairy products were classified as having low intake (<800 mg calcium/day) after the hip fracture. This also lowered, in fact reversed, the relative risk estimates of hip fracture both for intake of dairy products and calcium. Crude odds ratios of highest quartile of intake versus lowest, changed from 3.0 to 0.6 for dairy products and from 2.6 to 0.9 for calcium. No other foods or nutrients displayed such notable differences between the two surveys. CONCLUSION. We conclude that the use of current and retrospective dietary information after a hip fracture can lead to a differential misclassification in dietary studies and to biased estimates of hip fracture risk as compared with prospectively collected dietary information.
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| 24. |
- Ringqvist, L., et al.
(author)
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Poorly humified peat as an adsorbent for metals in wastewater
- 2002
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In: Water Research. - 0043-1354 .- 1879-2448. ; 36:9, s. 2394-2404
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Journal article (peer-reviewed)abstract
- Metal adsorption and surface charge determinations were performed previously on well-characterised Sphagnum and Carex peat samples. The aim of this investigation was to determine metal adsorption from complex wastewaters onto these peat samples and compare it to the adsorption onto peat granules, clinoptilolite, glauconite and a flue dust from steel production. A sulphide mine leachate, a landfill leachate and a laundry wastewater were chosen, giving a variation in pH, ionic strength, total organic carbon and concentrations of metals. Metal adsorption was determined in batch and column experiments. The wastewater composition was of great importance for metal removal efficiency, mainly due to the difference in dominating metal species. In the sulphide mine leachate, containing free metal ions, a high metal adsorption was observed onto both peat and inorganic adsorbents. In the landfill leachate the metals formed carbonate and organic complexes and a low metal removal was achieved. Contrary to the leachates, the laundry wastewater contained suspended particles. The high amount of metals removed, 80% of the Cu and 30-60% of the Zn concentration, was probably withdrawn bound to the particle fraction. The highest removal of metal ions was obtained in the sulphide mine leachate with Carex peat, removing 97-99% of the Zn and 85-100% of the Cu content. The Sphagnum peat sample removed 37-77% of the Zn and 80-100% of the Cu content. The differences found between Sphagnum and Carex peat were attributed to the original chemistry of the plant material and the habitat conditions at the time of peat formation. Generally, the combination of glauconite or clinoptilolite with the peat samples in column experiments gave a minor improvement in metal removal.
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| 25. |
- Sundstedt, M., et al.
(author)
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Left ventricular volumes during exercise in endurance athletes assessed by contrast echocardiography
- 2004
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In: Acta Physiologica Scandinavica. - 0001-6772 .- 1365-201X. ; 182:1, s. 45-51
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Journal article (peer-reviewed)abstract
- Aim: The objective was to assess left ventricular (LV) volumes at rest and during upright submaximal exercise in endurance athletes to see whether changes in heart volume could explain the large predicted increase in cardiac output in endurance athletes. Method: Contrast echocardiography was used to assess changes in LV volumes during upright bicycle exercise in 24 healthy male endurance athletes. Maximal oxygen uptake and oxygen pulse were measured by using cardiopulmonary exercise testing. Results: From rest to exercise at a heart rate of 160 beats min(-1) end-diastolic volume increased by 18% (P < 0.001) and end-systolic volume decreased by 21% (P = 0.002). Stroke volume showed an almost linear increase during exercise (45% increase, P < 0.001). The increase in end-diastolic volume contributed to 73% of the increase in stroke volume. No significant differences were observed between stroke volume calculated from LV volumes with contrast echocardiography and stroke volume calculated from oxygen pulse at heart rates of 130 and 160 beats min(-1). Using the linear regression equation between oxygen uptake and cardiac output assessed by echocardiography during exercise (r = 0.87, P = 0.002), cardiac output at maximal exercise was estimated at 33 +/- 3 L min(-1), with an estimated increase in stroke volume by 69% from rest to maximal exercise. Conclusion: By using contrast echocardiography, a large increase in stroke volume in endurance athletes could be explained by an almost linear increase in end-diastolic volume and an initial small decrease in end-systolic volume during incremental upright exercise.
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