| 1. |
- Andersson, Mattias, et al.
(author)
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Editor's Choice – Structured Computed Tomography Analysis can Identify the Majority of Patients at Risk of Post-Endovascular Aortic Repair Rupture
- 2022
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In: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 64, s. 166-174
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Journal article (peer-reviewed)abstract
- Objective: The main objective was to report mechanisms and precursors for post-endovascular aneurysm repair (EVAR) rupture. The second was to apply a structured protocol to explore whether these factors were identifiable on follow up computed tomography (CT) prior to rupture. The third objective was to study the incidence, treatment, and outcome of post-EVAR rupture. Methods: This was a multicentre, retrospective study of patients treated with standard EVAR at five Swedish hospitals from 2008 to 2018. Patients were identified from the Swedvasc registry. Medical records were reviewed up to 2020. Index EVAR and follow up data were recorded. The primary endpoint was post-EVAR rupture. CT at follow up and at post-EVAR rupture were studied, using a structured protocol, to determine rupture mechanisms and identifiable precursors. Results: In 1 805 patients treated by EVAR, 45 post-EVAR ruptures occurred in 43 patients. The cumulative incidence was 2.5% over a mean follow up of 5.2 years. The incidence rate was 4.5/1 000 person years. Median time to post-EVAR rupture was 4.1 years. A further six cases of post-EVAR rupture in five patients found outside the main cohort were included in the analysis of rupture mechanisms only. The rupture mechanism was type IA in 20 of 51 cases (39%), IB in 20 of 51 (39%) and IIIA/B in 11 of 51 (22%). One of these had type IA + IB combined. One patient had an aortoduodenal fistula without another mechanism being identified. Precursors had been noted on CT follow up prior to post-EVAR rupture in 16 of 51 (31%). Retrospectively, using the structured protocol, precursors could be identified in 43 of 51 (84%). In 17 of 27 (63%) cases missed on follow up but retrospectively identifiable, the mechanisms were type IB/III. Overall, the 30 day mortality rate after post-EVAR rupture was 47% (n = 24/51) and the post-operative mortality rate was 21% (n = 7/33). Conclusions: Most precursors of post-EVAR rupture are underdiagnosed but identifiable before rupture using a structured follow up CT protocol. Precursors of type IB and III failures caused the majority of post-EVAR ruptures.
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| 2. |
- Andersson, Roy, et al.
(author)
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Internationalisering av samverkan (INSA) : Slutrapport
- 2021
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Reports (pop. science, debate, etc.)abstract
- Internationaliseringen av den svenska akademin har kommit olika långt vid olika lärosäten och inom olika ämnesområden. Det är dock uppenbart att Sveriges lärosäten aktivt kommer att behöva ytterligare internationalisera sin verksamhet för att kunna påverka ännu mer lokalt, regionalt, nationellt och internationellt. Internationellt samarbete finns givetvis sedan länge inom utbildning och/eller forskning, men sällan sammanhållen med samverkan med näringsliv och offentlig verksamhet. Allt fler lärosäten funderar nu på hur man strategiskt ska koppla ihop internationalisering med lärosätets ambition för samverkan. Högskolornas nästa utmaning är att bygga kompletta internationella kunskapsmiljöer där samverkan kommer att behövas i lika stor grad som på den nationella arenan.
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| 3. |
- Andreasen, Charlotte, et al.
(author)
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Incidence of Ischemic Stroke in Individuals with and without Aortic Valve Stenosis : A Danish Retrospective Cohort Study
- 2020
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In: Stroke. - 0039-2499. ; 51:1, s. 1364-1371
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Journal article (peer-reviewed)abstract
- Background and Purpose - Aortic valve stenosis may lead to atrial and ventricular remodeling, predisposes to atrial fibrillation, and may also be an independent risk factor of ischemic stroke. However, information on stroke rates among persons with aortic valve stenosis are sparse. We aimed to determine the incidence rates and relative risks of ischemic stroke in individuals with diagnosed aortic valve stenosis compared with age- and sex-matched controls. Methods - All patients with incident aortic valve stenosis aged >18 years (n=79 310) and age- and sex-matched controls were identified using the Danish nationwide registries (1997-2017). Incidence rates per 1000 person-years (PY) and multivariable adjusted hazard ratios with 95% CIs were reported. Results - In total, 873 373 individuals (median age 77 years, 51.5% men, 9.1% with aortic valve stenosis) were included. Ischemic stroke occurred in 70 205 (8.0%) individuals during 4 880 862 PY of follow-up. Incidence rates of ischemic stroke were 13.3/1000 PY among the controls compared with 30.4/1000 PY in patients with aortic valve stenosis, corresponding to a hazard ratio of 1.31 (95% CI, 1.28-1.34). In all age-groups, the incidence rates and relative risks were significantly increased in patients with aortic valve stenosis compared with controls, but the relative risk was greater for younger individuals (eg, age group, 18-45 years: hazard ratio, 5.94 [95% CI, 4.10-8.36]). In patients with aortic valve stenosis above 65 years of age, the risk of ischemic stroke was markedly lower after aortic valve replacement (30.3 versus 19.6/1000 PY before and after valve replacement). Among people with atrial fibrillation the incidence rate of ischemic stroke was 1.5 times higher when aortic valve stenosis was present (33.0/1000 PY versus 49.9/1000 PY). Conclusions - People with aortic valve stenosis have a significantly increased risk of ischemic stroke compared with age- and sex-matched controls. Future studies are warranted to explore whether antithrombotic therapy may be beneficial in some individuals.
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| 5. |
- Andersson, Anneli, 1992-, et al.
(author)
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Depression and anxiety disorders during the postpartum period in women diagnosed with attention deficit hyperactivity disorder
- 2023
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In: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 325, s. 817-823
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Journal article (peer-reviewed)abstract
- Background: Attention deficit hyperactivity disorder (ADHD) is associated with an increased risk of poor mental health. However, the understanding of ADHD-related burden and impairments in women during the postpartum period is limited. The aim with the present study was to examine the risk of depression and anxiety disorders during the postpartum period among women with and without an ADHD diagnosis.Methods: We used register-based data to identify women who gave birth to their first and/or second child between 2005 and 2013 in Sweden (n = 773,047), of which 0.5 % (n = 3515) had a diagnosis of ADHD prior to pregnancy. Diagnoses of depression and anxiety disorders up to one year after delivery were collected from the national patient register.Results: A total of 16.76 % of the women with an ADHD diagnosis were also diagnosed with depression disorders in the postpartum period, prevalence ratio (PR) 5.09 (95 % confidence interval (CI), 4.68-5.54). A total of 24.92 % of the women with an ADHD diagnosis were also diagnosed with anxiety disorders in the postpartum period, PR 5.41 (5.06-5.78). Stratified results revealed that having a diagnosis of ADHD increased the risk for both depression and anxiety disorders postpartum, beyond other well-known risk factors.Limitations: There is a potential risk of surveillance bias as women diagnosed with ADHD are more likely to have repeated visits to psychiatric care and might have an enhanced likelihood of also being diagnosed with depression and anxiety disorders postpartum, compared to women without ADHD.Conclusions: ADHD is an important risk factor for both depression and anxiety disorders postpartum. Therefore, ADHD needs to be considered in the maternal care, regardless of sociodemographic factors and the presence of other psychiatric disorders.
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| 6. |
- Andersson, Anders-Petter, et al.
(author)
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What do we create in a responsible workshop in 2030?
- 2023
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In: Proceedings of the international conference on engineering and product design education, E&PD 2023. - : The Design Society. - 9781912254194 ; , s. 559-564
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Conference paper (peer-reviewed)abstract
- What should design students learn, not to lose hope, but be able to design in the current dire climate, energy and health situation? What can we design and still stay on track with the Sustainable Development Goals (SDG) in 2030? What can we design in the long run, not worsening critical human and non-human systems? In the paper we question "good intentions" and business-as-usual approaches, to challenges facing many of our most existential systems. We suggest changes to the Design field's understanding of the SDG's. Further, we suggest focusing on several solutions at the same time, in local communities, with collaboration with others and design educations. The paper argues that a holistic and systemic view is required that rather focuses on root-problems, than the symptoms these problems cause. Based on a multidisciplinary selection of scientific literature, the paper shows how acclaimed systemic approaches often harm the health of both human and non-human systems. In addition, the paper argues that these acclaimed systemic approaches tend to suggest "solutions" that stand in the way of more realistic solutions emerging from supportive and social environments. One of the insights from the literature, is how individuals by reconnecting to community- and practice-based activities strengthen hope of better futures. In the paper we argue how designers and design educations, can act multidisciplinary, with others, to become agents towards the kind of holistically, community-based, and radical changes required to heal all broken systems. We suggest how designers can situate themselves in the responsible workshop of 2030.
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| 7. |
- Andersson, Charlotte, et al.
(author)
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Biodistribution of I-131 in mice is influenced by circadian variations
- 2020
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In: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10:1
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Journal article (peer-reviewed)abstract
- Effects of radiation and biodistribution of radionuclides are often studied in animal models. Circadian rhythm affects many biological functions and may influence the biokinetics of radionuclides and observed responses. The aim of this study was to investigate if the time during the day of I-131 injection affects the biodistribution and absorbed dose to tissues in mice. Biodistribution studies were conducted on male C57BL/6 N mice for three diurnal time-series: the animals were i.v. injected with 160 kBq I-131 at 8 am, 12 pm or 4 pm. The activity concentration in organs and tissues was measured at 1 h to 7 days after administration and absorbed dose at day 7 was determined. Comparison between the three time-series showed statistically significant differences in activity concentration in all investigated tissues and organs. Administration performed at 12 pm resulted in general in higher absorbed dose to the organs than injection performed at 8 am and 4 pm. Time of day of administration affects the biodistribution of I-131 in mice and consequently the absorbed dose to individual organs. These findings advocate that subsequent biodistribution studies and dosimetry calculations should consider time-point of administration as a variable that could influence the results.
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| 8. |
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| 9. |
- Andersson, Charlotte
(author)
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Optimisation of radionuclide therapy by reduction of normal tissue damage
- 2022
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Doctoral thesis (other academic/artistic)abstract
- Background:177Lu-octreotate is used to treat patients with neuroendocrine tumours (NETs) often resulting in prolonged life and better quality of life, but is today seldom a cure for these patients. Optimisation of 177Lu-octreotate therapy can be achieved by reducing the risk of side effects on the main dose limiting organs, kidneys and bone marrow, enabling higher administered activity. One proposed option is co-administration with the antioxidant α1-microglobulin (A1M). Aims: 1) to investigate if co-administration with A1M results in a negative (protective) effect on the tumour response to 177Lu-octreotate 2) to study the normal tissue response in mice following 177Lu-octreotate administration with or without A1M and A1M alone, 3) and to propose biomarkers for 177Lu-octreotate induced kidney damage. Methods: Biodistribution of 177Lu was investigated in mice bearing human GOT2 NET after injection of 177Lu-octreotate with or without A1M. Tumour volume and regulation of apoptosis related genes were studied on human GOT1 NET in mice after injection of 177Lu-octreotate with or without A1M and A1M alone. Effects on normal tissues were studied in mice injected with 177Lu-octreotate with or without A1M and A1M alone. Early proteomic responses were investigated in kidney tissues and bone marrow. Regulation of apoptosis related genes was investigated in kidney tissues. Late effects on kidneys were studied based on expression of proposed markers for kidney damage. Results and conclusions: No negative impact of A1M were observed on the therapeutic effects of 177Lu-octreotate in NET. A tissue-dependent early proteomic response was observed in kidney tissue, including regulation of previously observed radiation responsive proteins. No clear changes in regulation of these radiation-induced proteins was observed after co-administration of A1M. Regulation of pro- and anti-apoptotic genes was observed in kidney cortex and kidney medulla following 177Lu-octreotate exposure. Indication of an A1M initiated pro-survival response was observed in kidney medulla when 177Lu-octreotate was combined with A1M. Promising results were found for KIM-1, CDKN1A and S100A6 as biomarkers for 177Lu-octreotate induced late kidney injury, and RBP4 as an early responding urinary biomarker. No clear protective effect of A1M on late radiation induced effects on kidneys were observed.
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