1. |
- Andreou, Dimitrios, et al.
(author)
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Polymorphisms in genes implicated in dopamine, serotonin and noradrenalin metabolism suggest association with cerebrospinal fluid monoamine metabolite concentrations in psychosis
- 2014
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In: Behavioral and Brain Functions. - : Springer Science and Business Media LLC. - 1744-9081. ; 10, s. 26-
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Journal article (peer-reviewed)abstract
- BACKGROUND: Homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA) and 3-methoxy-4-hydroxyphenylglycol (MHPG) are the major monoamine metabolites in the central nervous system (CNS). Their cerebrospinal fluid (CSF) concentrations, reflecting the monoamine turnover rates in CNS, are partially under genetic influence and have been associated with schizophrenia. We have hypothesized that CSF monoamine metabolite concentrations represent intermediate steps between single nucleotide polymorphisms (SNPs) in genes implicated in monoaminergic pathways and psychosis.METHODS: We have searched for association between 119 SNPs in genes implicated in monoaminergic pathways [tryptophan hydroxylase 1 (TPH1), TPH2, tyrosine hydroxylase (TH), DOPA decarboxylase (DDC), dopamine beta-hydroxylase (DBH), catechol-O-methyltransferase (COMT), monoamine oxidase A (MAOA) and MAOB] and monoamine metabolite concentrations in CSF in 74 patients with psychotic disorder.RESULTS: There were 42 nominally significant associations between SNPs and CSF monoamine metabolite concentrations, which exceeded the expected number (20) of nominal associations given the total number of tests performed. The strongest association (p = 0.0004) was found between MAOB rs5905512, a SNP previously reported to be associated with schizophrenia in men, and MHPG concentrations in men with psychotic disorder. Further analyses in 111 healthy individuals revealed that 41 of the 42 nominal associations were restricted to patients with psychosis and were absent in healthy controls.CONCLUSIONS: The present study suggests that altered monoamine turnover rates in CNS reflect intermediate steps in the associations between SNPs and psychosis.
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2. |
- Comasco, Erika, 1982-, et al.
(author)
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Genetic and Functional Study of L-Type Amino Acid Transporter 1 in Schizophrenia
- 2017
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In: Neuropsychobiology. - Basel : S. Karger. - 0302-282X .- 1423-0224. ; 74:2, s. 96-103
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Journal article (peer-reviewed)abstract
- Schizophrenia involves neural catecholaminergic dysregulation. Tyrosine is the precursor of catecholamines, and its major transporter, according to studies on fibroblasts, in the brain is the L-type amino acid transporter 1 (LAT1). The present study assessed haplotype tag single-nucleotide polymorphisms (SNPs) of the SLC7A5/LAT1 gene in 315 patients with psychosis within the schizophrenia spectrum and 233 healthy controls to investigate genetic vulnerability to the disorder as well as genetic relationships to homovanillic acid (HVA) and 3-methoxy-4-hydroxyphenylglycol (MHPG), the major catecholamine metabolites in the cerebrospinal fluid (CSF). Moreover, the involvement of the different isoforms of the system L in tyrosine uptake and LAT1 tyrosine kinetics were studied in fibroblast cell lines of 10 patients with schizophrenia and 10 healthy controls. The results provide suggestive evidence of individual vulnerability to schizophrenia related to the LAT1 SNP rs9936204 genotype. A number of SNPs were nominally associated with CSF HVA and MHPG concentrations but did not survive correction for multiple testing. The LAT1 isoform was confirmed as the major tyrosine transporter in patients with schizophrenia. However, the kinetic parameters (maximal transport capacity, affinity of the binding sites, and diffusion constant of tyrosine transport through the LAT1 isoform) did not differ between patients with schizophrenia and controls. The present genetic findings call for independent replication in larger samples, while the functional study seems to exclude a role of LAT1 in the aberrant transport of tyrosine in fibroblasts of patients with schizophrenia.
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3. |
- Alm, Fredrik, 1983-, et al.
(author)
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Adherence to Swedish Guidelines for Pain Treatment in Tonsil Surgery in Pediatric Patients
- 2016
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Conference paper (peer-reviewed)abstract
- Objective: As shown by data from the National Tonsil Surgery Register in Sweden, tonsil surgery often causes severe pain that lasts for many days. The register data demonstrate the necessity for better evidence-based pain treatment guidelines for tonsil surgery. The guidelines, introduced in 2013, consist of both pharmacological and non-pharmacological recommendations. In the guidelines, a multimodal analgesic approach and combination of analgesics are recommended to provide effective pain treatment with limited side effects. Two national multi-professional education days on pain, pharmacology and the guidelines were offered. Web-based information about pharmacological treatment (www.tonsililloperation.se) was designed for patients and next-of-kin. The current aims were to describe adherence to the Swedish guidelines for pain treatment in tonsil surgery in pediatric patients < 18 yearsMethod: An inter-professional questionnaire was developed, including questions linked to the relevant guidelines. The questions came from a national mapping before the guidelines were designed. The items were discussed by an expert group, and content validity was evaluated using the content validity index.ENT-and anesthesia physicians and nurses from all 50 ENT clinics in Sweden were enrolled.Results: Most clinics had received the guidelines, but there was a discrepancy between the professions. More than half had perused the literature review performed before the guidelines were designed, and attended themulti-professional education day. Pre- and perioperative treatment usually included paracetamol, clonidine and betamethasone. A multimodal pain approach after discharge from hospital (tonsillectomy and tonsillotomy) was used, combining paracetamol with cox-inhibitors. Most clinics used paracetamol, with a higher dose for the first 3 days (healthy children and acceptable nutrition), and a reduced dose from day 4.In case of inadequate analgesia after tonsillectomy, oral clonidine or opioids were used. Several clinics followed the recommendation to use clonidine as first choice and secondly an opioid. No respondents prescribed codeine compared to 80% at the mapping before the guidelines were designed. The guidelines were experienced as clear, safe and sufficient. The web-based information was used by most of the clinics to improve quality of care and provide facilitating tools for patients, relatives and caregivers.Conclusion: Swedish guidelines for tonsil surgery provide practical evidence-based pain treatment recommendations. To achieve a change, multi-professional education is necessary. This needs to be repeated for a wider spread.Future research should include evaluation through pain diaries and questionnaires to next-of-kin and children. There should be matching of data from the quality registers at each clinic, with pain variables such as unplanned health care contacts due to pain, number of days with analgesics, and return to normal diet
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5. |
- Edström, Krister, et al.
(author)
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Modelling and Simulation of a Switched Power Converter
- 1996
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Reports (other academic/artistic)abstract
- In our earlier work dealing with switched systems we have focused on the conceptual and formal side of the modelling process. In this paper we go one step further and illustrate the practical generation of simulation code from a switched bond graph. The principles are illustrated by means of an industrial switched power converter used to control the power of electric rotary machines. We describe an implementation of the formal Mode Transition System (MTS) presented earlier. The format proposed is referred to as Mode Transition File (MTF) format. We present an algorithm to generate the mode transition file from a switched bond graph. Finally we illustrate how this file format can be converted to code for the well known DASSRT solver.
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6. |
- El-Hajj, Victor Gabriel, et al.
(author)
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The negative impact of treatment delays on the long-term neurological outcomes of spinal dural arteriovenous fistulas : a longitudinal cohort study
- 2024
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In: Neurosurgical Focus. - : American Association of Neurological Surgeons. - 1092-0684. ; 56:3
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Dural arteriovenous fistulas are rare vascular malformations that affect the brain and spinal cord. Spinal dural arteriovenous fistulas (sdAVFs) are the most frequently encountered vascular malformation affecting the spinal cord. The object of this study was to evaluate the impact of treatment delays on the long-term neurological outcomes of either open surgical or interventional treatment of sdAVFs.METHODS: In this retrospective, population-based cohort study, the authors examined consecutive patients with diagnosed sdAVFs at a tertiary care center between 2005 and 2020. Patients were assessed using the Aminoff-Logue disability scale (ALS) at various time points including symptom onset, primary care visit, first specialist outpatient visit, as well as both short and long-term follow-ups. The postoperative long-term ALS gait and bladder grades constituted the primary outcomes of the study.RESULTS: Among the 34 patients included in the study, the median age was 65 years, and there was a male predominance (71%). Most lesions were in the lumbar region (47%). Significant worsening in ALS gait and bladder grades was observed preoperatively, followed by postoperative improvements (p < 0.05). There was no difference in outcomes between surgical and endovascular treatments. Older age (OR 1.10, 95% CI 1.03-1.17, p = 0.007), worse preoperative ALS gait grades (OR 5.12, 95% CI 2.18-12.4, p < 0.001), and longer time from first specialist outpatient visit to first treatment (OR 1.00, 95% CI 1.00-1.01, p = 0.040) were independently associated with worse long-term gait outcomes. Only the preoperative ALS bladder score was a predictor of worse long-term bladder function (OR 92.7, 95% CI 28.0-306.7, p < 0.001).CONCLUSIONS: Both surgical and endovascular treatments for sdAVFs led to significant neurological improvements. However, treatment delays were associated with less favorable long-term outcomes. Prompt diagnosis and early intervention prior to symptom progression may enhance recovery and help to preserve neurological function.
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7. |
- El-Hajj, Victor Gabriel, et al.
(author)
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The negative impact of treatment delays on the long-term neurological outcomes of spinal dural arteriovenous fistulas : a longitudinal cohort study
- 2024
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In: Neurosurgical Focus. - : American Association of Neurological Surgeons. - 1092-0684. ; 56:3
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Journal article (peer-reviewed)abstract
- OBJECTIVE Dural arteriovenous fistulas are rare vascular malformations that affect the brain and spinal cord. Spinal dural arteriovenous fistulas (sdAVFs) are the most frequently encountered vascular malformation affecting the spinal cord. The object of this study was to evaluate the impact of treatment delays on the long-term neurological outcomes of either open surgical or interventional treatment of sdAVFs.METHODS In this retrospective, population-based cohort study, the authors examined consecutive patients with diagnosed sdAVFs at a tertiary care center between 2005 and 2020. Patients were assessed using the Aminoff-Logue disability scale (ALS) at various time points including symptom onset, primary care visit, first specialist outpatient visit, as well as both short and long-term follow-ups. The postoperative long-term ALS gait and bladder grades constituted the primary outcomes of the study.RESULTS Among the 34 patients included in the study, the median age was 65 years, and there was a male predominance (71%). Most lesions were in the lumbar region (47%). Significant worsening in ALS gait and bladder grades was observed preoperatively, followed by postoperative improvements (p < 0.05). There was no difference in outcomes between surgical and endovascular treatments. Older age (OR 1.10, 95% CI 1.03-1.17, p = 0.007), worse preoperative ALS gait grades (OR 5.12, 95% CI 2.18-12.4, p < 0.001), and longer time from first specialist outpatient visit to first treatment (OR 1.00, 95% CI 1.00-1.01, p = 0.040) were independently associated with worse long-term gait outcomes. Only the preoperative ALS bladder score was a predictor of worse long-term bladder function (OR 92.7, 95% CI 28.0-306.7, p < 0.001).CONCLUSIONS Both surgical and endovascular treatments for sdAVFs led to significant neurological improvements. However, treatment delays were associated with less favorable long-term outcomes. Prompt diagnosis and early intervention prior to symptom progression may enhance recovery and help to preserve neurological function.
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8. |
- Ericsson, Elisabeth, 1959-, et al.
(author)
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Kvalitetsregistret för tonsilloperation
- 2014
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In: Nationellt kvalitetsregister Öron- Näs och Halssjukvård - Årsrapport 2013. - : Västra Götalandsregionen. ; , s. 34-97
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Book chapter (other academic/artistic)
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10. |
- Ericsson, Elisabeth, et al.
(author)
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Nationella riktlinjer för farmakologisk behandling av smärta och illamående i samband med tonsillotomi och tonsillektomi på barn och ungdomar (<18 år)
- 2013
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In: Svensk ÖNH-tidskrift. - Stockholm : Scandinavian University Press. - 1400-0121. ; 30:3, s. 1-5
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Journal article (peer-reviewed)abstract
- Riktlinjerna är framtagna av referensgruppen för Tonsilloperation. Syftet med dessa riktlinjer är att optimera det perioperativa omhändertagandet (premedicinering - peroperativt - postoperativt smärtomhändertagande) i samband med tonsilloperationer på barn och ungdomar. Bakgrund och referenser till riktlinjerna finns i ett separat dokument.Riktlinjerna gäller för friska barn. Finns det riskfaktorer som ex grav sömnapné, kraftig övervikt, komplicerande sjukdomstillstånd eller organpåverkan behöver den farmakologiska behandlingen anpassas efter situationen.Tonsillkirurgi medför svår och långvarig smärta samt hög frekvens av illamående. Smärtan är ofta värst dag 3 till 5 efter tonsillektomi. Tonsillotomi ger generellt upphov till mindre smärta än tonsillektomi. För att uppnå effekt behöver den farmakologiska smärtbehandlingen påbörjas redan vid premedicineringen och fortlöpa under själva anestesin/ingreppet. En multimodal behandling ska eftersträvas och målsättningen är att uppnå en för individen acceptabel smärtnivå i det postoperativa skedet och i hemmet.Den farmakologiska behandlingen ska kombineras med preoperativ information om ingreppet till patienten och vårdnadshavare. En lugn och trygg situation före anestesistart ökar chanserna för ett lugnt postoperativt förlopp.
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- Eriksson, Carl, 1981-, et al.
(author)
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Long-term effectiveness of vedolizumab in inflammatory bowel disease : a national study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)
- 2017
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In: Scandinavian Journal of Gastroenterology. - : Taylor & Francis. - 0036-5521 .- 1502-7708. ; 52:6-7, s. 722-729
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Journal article (peer-reviewed)abstract
- Objectives: Clinical trials have demonstrated the efficacy of vedolizumab in inflammatory bowel disease (IBD). However, these findings may not reflect the clinical practice. Therefore, we aimed to describe a vedolizumab-treated patient population and assess long-term effectiveness.Materials and methods: Patients initiating vedolizumab between 1 June 2014 and 30 May 2015 were identified through the Swedish National Quality Registry for IBD. Prospectively collected data on treatment and disease activity were extracted. Clinical remission was defined as Patient Harvey Bradshaw index<5 in Crohn's disease (CD) and Patient Simple Clinical Colitis Activity index<3 in ulcerative colitis (UC).Results: Two-hundred forty-six patients (147CD, 92 UC and 7 IBD-Unclassified) were included. On study entry, 86% had failed TNF-antagonist and 48% of the CD patients had undergone1 surgical resection. After a median follow-up of 17 (IQR: 14-20) months, 142 (58%) patients remained on vedolizumab. In total, 54% of the CD- and 64% of the UC patients were in clinical remission at the end of follow-up, with the clinical activity decreasing (p<.0001 in both groups). Faecal-calprotectin decreased in CD (p<.0001) and in UC (p=.001), whereas CRP decreased in CD (p=.002) but not in UC (p=.11). Previous anti-TNF exposure (adjusted HR: 4.03; 95% CI: 0.96-16.75) and elevated CRP at baseline (adjusted HR: 2.22; 95% CI: 1.10-4.35) seemed to be associated with discontinuation because of lack of response. Female sex was associated with termination because of intolerance (adjusted HR: 2.75; 95% CI: 1.16-6.48).Conclusion: Vedolizumab-treated patients represent a treatment-refractory group. A long-term effect can be achieved, even beyond 1 year of treatment.
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14. |
- Eriksson, Carl, 1981-, et al.
(author)
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Real-world effectiveness of vedolizumab in inflammatory bowel disease : week 52 results from the Swedish prospective multicentre SVEAH study
- 2021
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In: Therapeutic Advances in Gastroenterology. - : Sage Publications. - 1756-283X .- 1756-2848. ; 14
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Journal article (peer-reviewed)abstract
- Background: Prospectively and systematically collected real-world data on vedolizumab are scarce. We aimed to assess the long-term clinical effectiveness of vedolizumab in inflammatory bowel disease (IBD).Methods: This study was a prospective, observational, multicentre study. Overall, 286 patients with active IBD were included (Crohn's disease, n = 169; ulcerative colitis, n = 117). The primary outcomes were clinical response at week 12 and clinical remission at week 52, based on the Harvey Bradshaw Index and the partial Mayo Clinic score. Secondary outcomes included clinical remission at week 12, clinical response at week 52, corticosteroid-free clinical remission at week 52, changes in biochemical measures, and health-related quality of life (HRQoL).Results: At baseline, 88% of the patients were exposed to anti-TNF and 41% of the patients with Crohn's disease had undergone ⩾1 surgical resection. At week 12, clinical response was 27% and remission 47% in Crohn's disease; corresponding figures in ulcerative colitis were 52% and 34%. Clinical response, remission and corticosteroid-free remission at week 52 were 22%, 41% and 40% in Crohn's disease and 49%, 47% and 46% in ulcerative colitis, respectively. A statistically significant decrease in median faecal-calprotectin and C-reactive protein was observed at 12 and 52 weeks in patients with Crohn's disease and ulcerative colitis. The HRQoL measures Short Health Scale and EuroQol 5-Dimensions improved in both Crohn's disease and ulcerative colitis patients (p < 0.001). Clinical disease activity at baseline was inversely associated with clinical remission at week 52.Conclusion: Vedolizumab proved effective for the treatment of refractory IBD in clinical practice.
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- Herbertsson, Lina, et al.
(author)
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Bees increase seed set of wild plants while the proportion of arable land has a variable effect on pollination in European agricultural landscapes
- 2021
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In: Plant Ecology and Evolution. - : Societe Royale de Botanique de Belgique. - 2032-3913 .- 2032-3921. ; 154:3, s. 341-350
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Journal article (peer-reviewed)abstract
- Background and aims: Agricultural intensification and loss of farmland heterogeneity have contributed to population declines of wild bees and other pollinators, which may have caused subsequent declines in insect-pollinated wild plants.Material and methods: Using data from 37 studies on 22 pollinator-dependent wild plant species across Europe, we investigated whether flower visitation and seed set of insect-pollinated plants decline with an increasing proportion of arable land within 1 km.Key results: Seed set increased with increasing flower visitation by bees, most of which were wild bees, but not with increasing flower visitation by other insects. Increasing proportion of arable land had a strongly variable effect on seed set and flower visitation by bees across studies.Conclusion:Factors such as landscape configuration, local habitat quality, and temporally changing resource availability (e.g. due to mass-flowering crops or honey bee hives) could have modified the effect of arable land on pollination. While our results highlight that the persistence of wild bees is crucial to maintain plant diversity, we also show that pollen limitation due to declining bee populations in homogenized agricultural landscapes is not a universal driver causing parallel losses of bees and insect-pollinated plants.
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18. |
- Hessén-Söderman, Anne-Charlotte, et al.
(author)
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Post-tonsillectomy haemorrhage rates are related to technique for dissection and for haemostasis : an analysis of 15734 patients in the National Tonsil Surgery Register in Sweden
- 2015
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In: Clinical Otolaryngology. - : Wiley. - 1749-4478 .- 1365-2273. ; 40:3, s. 248-254
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Journal article (peer-reviewed)abstract
- Objectives: To analyse post-tonsillectomy haemorrhage(PTH) rates related to technique for dissection and haemostasis.Study Design: Register study from the National TonsilSurgery Register in Sweden (NTSRS).Methods: All patients, subjected to tonsillectomy (TE)without adenoidectomy from 1 March 2009 to 26 April 2013,were included in the study. The surgeon reports data abouttechnique and early PTH, while late PTH is reported by thepatient in a questionnaire 30 days after surgery.Results: 15734 patients with complete data concerningtechnique for dissec tion and for haemostasis were identifiedin the NTSRS. Techniques used were cold steel dissectionwith uni- or bipolar diathermy haemostasis (65.3%),diathermy scissors (15.7%), coblation (9.1%), cold steeldissection with cold haemostasis (7.4%) and ultrascision(2.5%). Early and late PTH were reported in 3.2% and 9.4% of the cases, respectively, and return to theatre (RTT) in2.7%. The rat es for PTH and RTT related to technique wereanalysed. Compared with cold dissection+ cold haemostasis,late PTH rate was 2.8 times higher after cold dissection + hothaemostasis, 3.2 times higher after coblation, 4.3 timeshigher after diathermy scissors and 5.6 times higher afterultrascision. The risk for RTT was higher for all hottechniques except for coblation, while ultrascision resultedin a lower risk for early PTH.Conclusions: All hot techniques resulted in a higher risk forlate PTH compared with cold steel dissection +coldhaemostasis. The risk for RTT was higher for all hottechniques except for coblation, while ultrascision resultedin a lower risk for early PTH. An early PTH was associatedwith an increased risk for late PTH.
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- Odhagen, Erik, et al.
(author)
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Readmission Rates Due to Post-Tonsillectomy Haemorrhage in Sweden: SIGNIFICANT DIFFERENCES BETWEEN SURGICAL CENTRES : Significant Differences Between Surgical Centres
- 2016
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Conference paper (peer-reviewed)abstract
- Objectives: Post-surgical haemorrhage is the major complication of tonsil surgery. Post-tonsillectomy haemorrhage often results in readmission to hospital, sometimes demands return to theatre and can be a life-threatening occurrence. There are large differences in previously reported rates of post-tonsillectomy haemorrhage. The aim of this study is to determine readmission rates due to post-tonsillectomy haemorrhage in Sweden 2012-2014.Method: This is a population-based cohort study based on matched data from two healthcare registries in Sweden; the Swedish National Patient Register (NPR) and the National Tonsil Surgery Register in Sweden (NTSRS). All patients who underwent tonsillectomy, with or without simultaneous adenoidectomy, on benign indications from 2012 to 2014 were included in the study. The unique Personal Identity numbers were used to follow patients over time in NPR and identify readmission due to haemorrhage within 30 days from surgery. In NTSRS, readmission was reported by the patient in a questionnaire 30 days after surgery.Results: By matching the two registries a total of 22 800 unique patients were identified and included in the study. A total of 1726 patients (7.6%) were readmitted to hospital due to post-surgical haemorrhage. Tonsil surgery was conducted at 56 different surgical centres. Readmission rates due to post-tonsillectomy haemorrhage ranged from 0% to 22.4% at different surgical centres. 11 of 56 surgical centres had significant lower readmission rates compared to the average in Sweden. 12 of 56 surgical centres had significant higher readmission rates than the average.Conclusions: The rate of hospital readmissions due to post-surgical haemorrhage following tonsillectomy in Sweden 2012-2014 was 7.6%. There were significant differences in readmission rates between different surgical centres. This suggests that quality improvement interventions should be explored in units with high readmission rates to decrease post-tonsillectomy morbidity.
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24. |
- Odhagen, Erik, 1977, et al.
(author)
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Reducing post-tonsillectomy haemorrhage rates through a quality improvement project using a Swedish National quality register : a case study
- 2018
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In: European Archives of Oto-Rhino-Laryngology. - : Springer. - 0937-4477 .- 1434-4726. ; 275:6, s. 1631-1639
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Journal article (peer-reviewed)abstract
- PurposeTonsillectomy (TE) is one of the most frequently performed ENT surgical procedures. Post-tonsillectomy haemorrhage (PTH) is a potentially life-threatening complication of TE. The National Tonsil Surgery Register in Sweden (NTSRS) has revealed wide variations in PTH rates among Swedish ENT centres. In 2013, the steering committee of the NTSRS, therefore, initiated a quality improvement project (QIP) to decrease the PTH incidence. The aim of the present study was to describe and evaluate the multicentre QIP initiated to decrease PTH rates.MethodsSix ENT centres, all with PTH rates above the Swedish average, participated in the 7-month quality improvement project. Each centre developed improvement plans describing the intended changes in clinical practice. The project’s primary outcome variable was the PTH rate. Process indicators, such as surgical technique, were also documented. Data from the QIP centres were compared with a control group of 15 surgical centres in Sweden with similarly high PTH rates. Data from both groups for the 12 months prior to the start of the QIP were compared with data for the 12 months after the QIP.ResultsThe QIP centres reduced the PTH rate from 12.7 to 7.1% from pre-QIP to follow-up; in the control group, the PTH rate remained unchanged. The QIP centres also exhibited positive changes in related key process indicators, i.e., increasing the use of cold techniques for dissection and haemostasis.ConclusionsThe rates of PTH can be reduced with a QIP. A national quality register can be used not only to identify areas for improvement but also to evaluate the impact of subsequent improvement efforts and thereby guide professional development and enhance patient outcomes.
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25. |
- Odhagen, Erik, 1977, et al.
(author)
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Risk of reoperation after tonsillotomy versus tonsillectomy : a population-based cohort study
- 2016
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In: European Archives of Oto-Rhino-Laryngology. - : Springer. - 0937-4477 .- 1434-4726. ; 273, s. 3263-3268
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Journal article (peer-reviewed)abstract
- Tonsil surgery to address upper airway obstruction in children can be performed either as a tonsillectomy (TE) or as a tonsillotomy/intracapsular/partial tonsillectomy (TT). The advantage of TT is a decreased risk of postoperative morbidity. The disadvantage is the risk of tonsil regrowth with recurrence of symptoms and/or problems with future tonsil infections, which may demand a reoperation of the tonsils. The aim of this study is to compare the risk of reoperation of the tonsils following TE and TT in children with tonsil-related upper airway obstruction. This is a retrospective register-based cohort study of the Swedish National Patient Register. All children aged 1–12 years who underwent TE or TT from 2007 to 2012 for the main indication of upper airway obstruction were included in the study. The unique Personal Identity numbers were used to follow patients over time in the register and identify additional tonsil surgery. A total of 27,535 patients were included in the study, contributing 76,054 person-years of follow-up. A total of 684 patients (2.5 %) underwent a second tonsil surgery during follow-up. The incidences of reoperation were 1.94 per 1000 person-years in the TE group and 16.34 per 1000 person-years in the TT group. The risk for reoperation was seven times higher (HR 7.16) after TT compared to TE. Younger age was significantly associated with reoperation for both TE and TT and the difference in risk between TE and TT gradually decreased with time. The most common indication for reoperation after both TE and TT was ‘‘Upper airway obstruction’’.
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- Pettersson, Erik, et al.
(author)
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Surfactant/nonionic polymer interaction. a NMR diffusometry and NMR electrophoretic investigation
- 2004
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In: Langmuir. - : American Chemical Society (ACS). - 0743-7463 .- 1520-5827. ; 20:4, s. 1138-1143
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Journal article (peer-reviewed)abstract
- The interaction between the nonionic polymer poly(ethylene oxide) (PEO) of molecular weight 20 000 and surfactants of various types [sodium dodecyl sulfate (SDS), dodecyl trimethylammonium bromide, octyl beta-D-glucoside, and potassium laurate] has been investigated in an aqueous solution at 25 degreesC by H-1 NMR pulsed-gradient spin-echo self-diffusion techniques. The SDS/PEO study was further complemented by component-resolved H-1 NMR-based studies of the electrophoretic mobility of PEO and the alkyl part of SDS under the same measurement conditions. Through such combined studies, a much more complete picture of the binding and aggregation processes becomes accessible.
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- Renström, Barbro, et al.
(author)
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Self-reported health and influence on life situation 5–8 years after paediatric traumatic brain injury
- 2012
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In: Brain Injury. - : Informa Healthcare. - 0269-9052 .- 1362-301X. ; 26:12, s. 1405-1414
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Journal article (peer-reviewed)abstract
- Primary objective : During childhood, the central nervous system is in a state of rapid development which can be interrupted by a traumatic brain injury (TBI). This study aimed to describe if and how TBI during childhood influences health and life situation, 5–8 years later.Research design : A case-control retrospective design was employed for the assessment of 61 adolescents and young adults with a mild, moderate or severe TBI and 229 matched controls from a normative group (16–24 years).Methods and procedures : SF-36 (Short Form 36 health survey) and a self-reported questionnaire measuring life situation were distributed to youths suffering TBI 5–8 years ago. Forty-five youths (74%) completed the questionnaires.Main outcomes and results : Participants with a TBI stated lower self-estimated health compared with the normative group.Remaining self-reported symptoms were physical and cognitive. Negative effects of TBI influencing school results, leisure activities and thoughts about future life situation were also described.Conclusion : Young individuals experience sustained negative effects of childhood TBI on health and life situation. More research is necessary to detect, understand and properly support these youths.
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- Stalfors, Joacim, et al.
(author)
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Registerdata från tonsillregistret
- 2015
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In: Svensk ÖNH-tidskrift. - Örebro : Svensk förening för Otorhinolaryngologi, Huvud- och Halskirurgi. - 1400-0121. ; 22:3, s. 34-93
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Journal article (pop. science, debate, etc.)
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- Strömberg, Jan-Erik, et al.
(author)
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Bond Graph Supported Estimation of Discretely Changing Parameters
- 1993
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In: International Conference on Bond Graph Modeling, 1993. - 9781565550193 - 1565550196 ; , s. 47-52
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Conference paper (other academic/artistic)abstract
- A key factor in parameter estimation is the selection of model structure within which the fit to observed data is to be achieved. For linear systems, bond graphs have proven to give excellent support in this respect. However, for systems undergoing abrupt transitions between different (linear) modes of behaviour, the situation is far more complex. To handle this, we exploit the features of the ideal switching element as introduced by Strömberg, Top and Söderman. This solves the question of physical modelling as well as how to derive the supporting information. The approach is demonstrated on a non-trivial example using a multiple Kalman filter estimator.
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41. |
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42. |
- Strömberg, Jan-Erik, et al.
(author)
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Combining Qualitative and Quantitative Knowledge to Generate Models of Physical Systems
- 1991
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In: Proceedings of the 12th International Joint Conference on Artificial Intelligence. - Linköping : Linköping University. ; , s. 1158-1163
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Conference paper (peer-reviewed)abstract
- All major approaches to Qualitative Reasoning rely on the existence of a model of the physical system. However, the task of finding a model is usually far from trivial. Within the area of electrical engineering, model building methods have been developed to automatically deduce models from measurements. In this paper we explicitly show how to incorporate qualitative knowledge in order to apply these methods to situations where they do not behave satisfactorily. A program has been developed and applied to a non-trivial example. The qualitative input, in terms of an incomplete bond graph, and the resulting output can be used to form a more complete bond graph. This more informative model is suitable for further reasoning.
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43. |
- Strömberg, Jan-Erik, et al.
(author)
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Conceptual Modelling of Hybrid Systems
- 1994
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In: Proceedings of the 1994 European Simulation and Modelling Conference. - Linköping : Linköping University. ; , s. 1095-1099
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Reports (other academic/artistic)
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44. |
- Strömberg, Jan-Erik, et al.
(author)
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Modelling and Simulation of a Switched Power Converter
- 1997
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In: Proceedings of the Third International Conference on Bond Graph Modeling and Simulation. - 1565551036 ; , s. 195-200
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Conference paper (peer-reviewed)abstract
- In our earlier work dealing with switched systems we have focused on the conceptual and formal side of the modelling process. In this paper we go one step further and illustrate the practical generation of simulation code from a switched bond graph. The principles are illustrated by means of an industrial switched power converter used to control the power of electric rotary machines. We describe an implementation of the formal Mode Transition System (MTS) presented earlier. The format proposed is referred to as Mode Transition File (MTF) format. We present an algorithm to generate the mode transition file from a switched bond graph. Finally we illustrate how this file format can be converted to code for the well known DASSRT solver.
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45. |
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46. |
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47. |
- Strömberg, Jan-Erik, et al.
(author)
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Variable Causality in Bond Graphs Caused by Discrete Effects
- 1993
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In: International Conference on Bond Graph Modeling, 1993. - 9781565550193 - 1565550196 ; , s. 115-119
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Conference paper (other academic/artistic)abstract
- Current approaches to the problem of switching between modes in continuous dynamic system models tend to confound modelling and computation. Here we introduce an alternative approach ensuring a clear distinction between the physical and computational levels. Our method is centered around the idea that the variability of causal directions should be accepted rather than being alleviated. Hence, we define an ideal bond graph switching element, to deal with this variability in a bond graph uniform and systematic way. We hereby maintain the abstraction level of the bond graph language as well as the possibility to perform initial model validation directly in the graph.
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48. |
- Strömberg, Jan-Erik, et al.
(author)
-
Variable Causality in Bond Graphs Caused by Discrete Effects
- 1992
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Reports (other academic/artistic)abstract
- Current approaches to the problem of switching between modes in continuous dynamic system models tend to confound modelling and computation. Here we introduce an alternative approach ensuring a clear distinction between the physical and computational levels. Our method is centered around the idea that the variability of causal directions should be accepted rather than being alleviated. Hence, we define an ideal bond graph switching element, to deal with this variability in a bond graph uniform and systematic way. We hereby maintain the abstraction level of the bond graph language as well as the possibility to perform initial model validation directly in the graph.
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49. |
- Sunnergren, Ola, et al.
(author)
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Nytta med tonsilloperation
- 2015
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In: Svensk ÖNH-tidskrift. - Örebro : Svensk förening för Otorhinolaryngologi, Huvud- och Halskirurgi. - 1400-0121. ; 22:S1, s. 30-32
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Journal article (other academic/artistic)
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50. |
- Sunnergren, Ola, et al.
(author)
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Nytta med tonsilloperation
- 2016
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In: Svensk ÖNH-tidskrift. - Stockholm, Sweden : Taylor & Francis Group. - 1400-0121. ; 23:S1, s. 24-25
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Journal article (other academic/artistic)
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