| 1. |
- Bergström, Göran, 1964, et al.
(författare)
-
Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
-
Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
|
|
| 2. |
|
|
| 3. |
- Johnson, Mats, 1956, et al.
(författare)
-
Open-label trial of atomoxetine hydrochloride in adults with ADHD.
- 2010
-
Ingår i: Journal of Attention Disorders. - : SAGE Publications. - 1087-0547 .- 1557-1246. ; 13:5, s. 539-545
-
Tidskriftsartikel (refereegranskat)abstract
- Background: While atomoxetine is an established treatment for attention-deficit/hyperactivity disorder in children, few studies have examined its efficacy for adults. Methods: Open-label trial of atomoxetine in 20 individuals with ADHD, aged 19-47 years, for 10 weeks, and a total of one year for responders. Results: Ten patients met primary efficacy criteria at 10 weeks. Only one patient completed the whole study. Six patients discontinued before 10 weeks and thirteen at 10 weeks or later, mainly because of side-effects (aggression, depressed mood, raised liver enzymes, thyroid hormones, diastolic blood pressure), decreasing efficacy or non-compliance. Conclusion: Fifty percent responded to treatment, but only one patient (5%) felt sufficient improvement to continue for one year. Dosage may have been too low, and baseline impairment too high, for atomoxetine to have sufficient effect on ADHD symptoms in our group of adults. The majority had few side-effects, but several terminated treatment because of adverse effects.
|
|
| 4. |
- Mårtensson, Ulrika, et al.
(författare)
-
Experiences before and after nasogastric and gastrostomy tube insertion with emphasis on mealtimes: a case study of an adolescent with cerebral palsy
- 2021
-
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 16:1
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Adolescents with cerebral palsy may need a feeding tube due to feeding challenges, since nutritional intake and mealtimes may be negatively affected. The purpose of the study was to describe and better understand how one adolescent with cerebral palsy and her parents experienced mealtimes before and after a nasogastric and gastrostomy tube insertion and how the use of these feeding tubes was experienced in daily life. Methods: Individual interviews were performed with one adolescent and each of her parents. In total, six interviews were conducted on two separate occasions. The qualitative approach known as Interpretive Description was used during the analysis. Results: Four thematic patterns were identified within the data: (i) struggling with nutritional intake, (ii) the paradox of using an aid, (iii) being different, and (iv) challenges of public mealtimes. Conclusions: The results showed that four themes influenced daily mealtimes in adolescents with cerebral palsy and a gastrostomy tube. Nutritional intake and mealtimes may be difficult, which is why using a gastrostomy tube can be a relief. However, the gastrostomy tube can also pose a challenge and a paradox. Time of change and acceptance seems necessary in order to meet these challenges.
|
|
| 5. |
- Cederlund, Mats, 1962, et al.
(författare)
-
Asperger syndrome and autism: a comparative longitudinal follow-up study more than 5 years after original diagnosis.
- 2008
-
Ingår i: Journal of Autism and Developmental Disorders. - : Springer Science and Business Media LLC. - 0162-3257 .- 1573-3432. ; 38:1, s. 72-85
-
Tidskriftsartikel (refereegranskat)abstract
- Prospective follow-up study of 70 males with Asperger syndrome (AS), and 70 males with autism more than 5 years after original diagnosis. Instruments used at follow-up included overall clinical assessment, the Diagnostic Interview for Social and Communication Disorders, Wechsler Intelligence Scales, Vineland Adaptive Behavior Scales, and Global Assessment of Functioning Scale. Specific outcome criteria were used. Outcome in AS was good in 27% of cases. However, 26% had a very restricted life, with no occupation/activity and no friends. Outcome in the autism group was significantly worse. Males with AS had worse outcomes than expected given normal to high IQ. However, outcome was considerably better than for the comparison group of individuals with autism.
|
|
| 6. |
- Cederlund, Mats, 1962, et al.
(författare)
-
Asperger syndrome in adolescent and young adult males. Interview, self- and parent assessment of social, emotional, and cognitive problems.
- 2010
-
Ingår i: Research in Developmental Disabilities. - : Elsevier BV. - 0891-4222. ; 31:2, s. 287-298
-
Tidskriftsartikel (refereegranskat)abstract
- Descriptive and comparative follow-up studies of young adult males with Asperger syndrome (AS) diagnosed in childhood, using both interview, self- and parent assessment instruments for the study of aspects of emotional well-being, social functioning, and cognitive-practical skills have not been performed in the past. One-hundred males with AS diagnosed in childhood were approached for the assessment using the Asperger Syndrome Diagnostic Interview (ASDI), (personal and parent interview), the Leiter-R-Questionnaires, the Beck Depression Inventory (BDI), and the Dysexecutive Questionnaire (DEX). About 75% of the targeted group participated. The ASDI results came out significantly different at personal vs parent interviews in several key domains. In contrast, the Leiter-R-Questionnaires, showed no significant differences across the individuals with AS and their parents in the scoring of cognitive/social and emotional/adaptive skills. The BDI proved to be an adequate screening instrument for depression in that it correctly identified the vast majority of cases with clinical depression in the AS group. The DEX results suggested an executive function deficit problem profile in males with AS as severe as that reported in groups of individuals with traumatic brain injury and schizophrenia. Interviews (personal and collateral), and self-rating and parent-rating questionnaires all have a role in the comprehensive diagnostic process in AS and other autism spectrum disorders, and could be used as adjuncts when evaluating whether or not individuals meeting diagnostic symptom criteria for the condition have sufficient problems in daily life to warrant a clinical diagnosis of AS.
|
|
| 7. |
- Cederlund, Mats, 1962
(författare)
-
Boys with Asperger Syndrome grown up. A longitudinal follow-up study of 100 cases more than 5 years after original diagnosis
- 2007
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction and aims: In 1981, the diagnostic label of Asperger Syndrome (AS), was coined after the Austrian paediatrician Hans Asperger, by the English psychiatrist Lorna Wing, who reintroduced his 1944 work about ?die autistischen Psychopathen im Kindesalter?, so as to have a concept for relatively high functioning individuals with problems in the ?autism spectrum?. Little is known about the risk factors and outcome of AS and whether or not they are different from those of autism. The present study were to examine (1) a large number of background and associated factors in AS; (2) how aims of the different kinds of background factors influence IQ, neuropsychological skills, and psychomotor development in males with AS; (3) the outcome of AS in males, and compare it to that of a similarly aged group of males with autism; and (4) to what extent males with AS acknowledge problems related to their diagnosis, and agree with their parents on these matters. Subjects and methods: Medical records of 100 clinical cases of males with AS diagnosed at least five years prior to the present study were searched for information concerning background and associated factors. Sub-grouping in accordance with operationalised ?pathogenetic? factors was attempted, and the influence of subgroup on psychomotor development, IQ, and degree of autism spectrum problems was investigated. These 100 males (and their parents) were approached for inclusion in a follow-up study. Seventy-six of the families participated in this in-depth study. The individuals with AS were evaluated at neuropsychiatric examinations, neuropsychological testing, and by interview schedules and questionnaires, some of which were used with their parents as well. Those 70 males with AS whose parents/carers had been given the Diagnostic Interview for Social and Communication disorders were compared with 70 males with autism of similar age. Specific outcome criteria were used taking into consideration, employment, education/vocational training, independent living, and peer relations. Results and Discussion: Mean age at original diagnosis was 11.3 years. In 28 cases there was a strong suspicion of autism spectrum problems in close relatives, 12 of whom had been formally diagnosed with autism or AS. Some pre- and perinatal risk factors were much more common than in the general population. No definite clue as to ?pathogenesis? could be established in 13%. Intellectual ability was average, and more than half the group had a verbal over performance IQ difference of 15 points or more at original diagnosis, consistent with so called Non-Verbal Learning Disability (NVLD). However, at follow-up fewer than 20% had indications of NVLD. For the AS cases followed up diagnosis and overall IQ were stable over time. However, 12% no longer met criteria for an autism spectrum disorder. Overall outcome was good in 27% of cases, but 26% had a very restricted life, with no occupation/activity and no friends. Outcome in the autism group was significantly worse, possibly due to the much lower IQ in this group. The males with AS had a good understanding of their own problems in some areas, but disagreed with their parents regarding some core AS symptoms. In spite of the much better outcome than in the autism group, prognosis in clinical cases of AS appears to be restricted as compared with individuals at the same IQ-level in the general population. However, given the lack of a general population comparator group, no generalized conclusions can be drawn in this respect.
|
|
| 8. |
- Cederlund, Mats, 1962
(författare)
-
Microcephaly in preschool children with Autism Spectrum Disorder
- 2021
-
Ingår i: Research in Autism Spectrum Disorders. - : Elsevier BV. - 1750-9467. ; 88
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The present study presents results of head circumference (HC) measurements in a group of children being part of a larger group of children referred for neuropsychiatric assessment to a neuropsychiatric assessment team in Sweden. Methods: Of the 126 children included in the present study HC was possible to measure in 114 individuals. However, two of these children were not diagnosed since they did not conclude the study, leaving 112 children for further assessment. In addition, birth data was recovered either from the digital birth sheet used in Sweden for the registration of birth data, or in a few cases from the Child Care Centers or medical journals if the child had been admitted to hospital care after birth. Results: Of the 112 individuals, only one individual, a boy, diagnosed with ICD-10 Autism, had a HC above the 97.5th percentile at birth. At the physical assessment included in the study one individual, a boy (not the same boy as mentioned above) was found to have a HC above the 97.5th percentile. Hence, 1.2 % of the boys in this study with an ICD-10 ASD diagnosis were macrocephalic. In contrast, 6.7 % of the boys, and 8% of the girls, who received an ICD-10 ASD diagnosis had a HC below the 2.5th percentile and were considered microcephalic at the assessment. Conclusions: The results from this study could not confirm previous research arguing macrocephaly to be considerably more common in ASD than in the general population. However, in contrast, the results from this study indicated that microcephaly could be more common in children with ICD-10 ASD, for both sexes, than in the general population. Since none of the children had been microcephalic at birth the results indicate a relative decrease in HC over time in these individuals.
|
|
| 9. |
- Cederlund, Mats, 1962, et al.
(författare)
-
One hundred males with Asperger syndrome: a clinical study of background and associated factors.
- 2004
-
Ingår i: Developmental medicine and child neurology. - 0012-1622. ; 46:10, s. 652-60
-
Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to investigate the background and associated factors in a representative group of young males with Asperger syndrome (AS) presenting at a specialized autism clinic. One hundred males aged 5 years 6 months to 24 years 6 months, with a mean age of 11 years 4 months (SD 3y 10mo), who had a clinical diagnosis of AS were included in the study. An in-depth review of their medical records and neuropsychological test data was performed. There was a high rate (51%) of non-verbal learning disability (defined as Verbal IQ more than 15 points higher than Performance IQ), but otherwise there was little or no support for the notion of right-hemisphere brain dysfunction being at the core of the syndrome. There was a very high rate of close relatives with autism spectrum problems, but also high rates of prenatal and perinatal problems, including prematurity and postmaturity. In comparison with general population data, those with AS very often had a combination of genetic and prenatal and perinatal risk factors. Non-verbal learning disability test results applied in about half the group. There was a subgroup of individuals with AS who had macrocephalus. However, there was no support for an association of AS with low body mass index.
|
|
| 10. |
- Cederlund, Mats, 1962, et al.
(författare)
-
Pre-schoolchildren with autism spectrum disorders are rarely macrocephalic: A population study.
- 2014
-
Ingår i: Research in developmental disabilities. - : Elsevier BV. - 1873-3379 .- 0891-4222. ; 35:5, s. 992-998
-
Tidskriftsartikel (refereegranskat)abstract
- Numerous clinical studies over the past decades have concluded that there is an association between autism spectrum disorders (ASD) and large head size. Lately, some studies have reported conflicting results. The present study was conducted with a view to assess the presence of macrocephaly in a community-representative group of pre-school children with ASD. The prevalence of ASD in this general population was 0.8%. Thirty-three children (5 girls, 28 boys) recruited after general population screening for ASD, and diagnosed with ASD (two-thirds not globally delayed) were assessed as regards growth parameters; height, weight, and head circumference (HC), at birth and at comprehensive medical-psychiatric diagnostic examinations at a mean age of 3 years. Macrocephaly in the present study was defined as HC above the 97th percentile, and ≥2 SD above recorded length/height. Only one of the 33 children (3%) had macrocephaly which is similar to the general population prevalence. Another 9% had a big but proportional head. None of the children were microcephalic. In this community-based study we found no evidence to support a strong link between a large head size and ASD. Conclusions must be guarded because of the relatively small number of ASD cases included.
|
|
