| 1. |
- Åberg, Anna, et al.
(författare)
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Helicobacter pylori adapts to chronic infection and gastric disease via ph-responsive baba-mediated adherence
- 2017
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Ingår i: Cell Host and Microbe. - : Elsevier BV. - 1931-3128 .- 1934-6069. ; 21:3, s. 376-389
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Tidskriftsartikel (refereegranskat)abstract
- The BabA adhesin mediates high-affinity binding of Helicobacter pylori to the ABO blood group antigen-glycosylated gastric mucosa. Here we show that BabA is acid responsive-binding is reduced at low pH and restored by acid neutralization. Acid responsiveness differs among strains; often correlates with different intragastric regions and evolves during chronic infection and disease progression; and depends on pH sensor sequences in BabA and on pH reversible formation of high-affinity binding BabA multimers. We propose that BabA's extraordinary reversible acid responsiveness enables tight mucosal bacterial adherence while also allowing an effective escape from epithelial cells and mucus that are shed into the acidic bactericidal lumen and that bio-selection and changes in BabA binding properties through mutation and recombination with babA-related genes are selected by differences among individuals and by changes in gastric acidity over time. These processes generate diverse H. pylori subpopulations, in which BabA's adaptive evolution contributes to H. pylori persistence and overt gastric disease.
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| 2. |
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| 3. |
- Hjelm, Katarina, et al.
(författare)
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Beliefs about health and illness in women managed for gestational diabetes in two organisations.
- 2008
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 24:2, s. 168-192
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to explore beliefs about health, illness and health care in women with gestational diabetes mellitus (GDM) managed in two different organisations based on diabetology or obstetrics.Semi-structured interviews were made in two different clinics. clinic A: a specialist diabetes clinic with regular contact with a diabetologist and antenatal care provided by a midwifeclinic B: a specialist maternity clinic providing regular contact with a midwife, a structured programme for self-monitoring of blood glucose and insulin treatment, and a 1-day diabetes class by an obstetrician, a diabetologist, a midwife and a dietician. The clinics were located at two different university hospitals in Sweden.Participants were a consecutive sample of Swedish women diagnosed with GDM; 13 managed in clinic A and 10 managed in clinic B.The findings showed that women described their perceptions of as well-being, being healthy and freedom from disease. All respondents reported a delay in the provision of information about GMD and an information gap about GDM and the management of the condition, from diagnosis until the start of treatment at the specialist clinic. Respondents from clinic A expressed fear about future development of type 2 diabetes. Women from clinic B discussed different causes of GDM, and many claimed that health-care staff informed them that GDM was a transient condition during pregnancy. Respondents from clinic A reported a conflict in their treatment of pregnancy and GDM as two different conditions.Beliefs differed and were related to the health-care model chosen.
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| 4. |
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| 5. |
- Weng, Jianping, et al.
(författare)
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Screening for MODY mutations, GAD antibodies, and type 1 diabetes--associated HLA genotypes in women with gestational diabetes mellitus.
- 2002
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Ingår i: Diabetes Care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 25:1, s. 68-71
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate whether genetic susceptibility to type 1 diabetes or maturity-onset diabetes of the young (MODY) increases susceptibility to gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: We studied mutations in MODY1-4 genes, the presence of GAD antibodies, and HLA DQB1 risk genotypes in 66 Swedish women with GDM and a family history of diabetes. An oral glucose tolerance test was repeated in 46 women at 1 year postpartum. RESULTS: There was no increase in type 1 diabetes-associated HLA-DQB1 alleles or GAD antibodies when compared with a group of type 2 diabetic patients (n = 82) or healthy control subjects (n = 86). Mutations in known MODY genes were identified in 3 of the 66 subjects (1 MODY2, 1 MODY3, and 1 MODY4). Of the 46 GDM subjects, 2 had diabetes (4%) and 17 had impaired glucose tolerance (IGT) (37%) at 1 year postpartum. Of the two subjects who developed manifest diabetes, one carried a MODY3 mutation (A203H in the hepatocyte nuclear factor-1alpha gene). There was no increase in high-risk HLA alleles or GAD antibodies in the women who had manifest diabetes or IGT at 1 year postpartum. CONCLUSIONS: MODY mutations but not autoimmunity contribute to GDM in Swedish women with a family history of diabetes and increase the risk of subsequent diabetes.
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| 6. |
- Åberg, Anders E, et al.
(författare)
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Predictive factors of developing diabetes mellitus in women with gestational diabetes.
- 2002
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 81:1, s. 11-16
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To investigate which factors during gestational diabetes pregnancies correlate with the risk of developing impaired glucose tolerance or diabetes 1 year postpartum and to compare this risk in women with gestational diabetes and women with a normal oral glucose tolerance test during pregnancy. METHODS: Of 315 women with gestational diabetes, defined as a 2-hr blood glucose value of at least 9.0 mmol/l at a 75-g oral glucose tolerance test, who delivered in Lund 1991-99, 229 (73%) performed a new test 1 year postpartum. We compared maternal and fetal factors during pregnancy with the test value at follow up. A control group of 153 women with a 2-hr test value below 7.8 mmol/l during pregnancy were invited to a new test 1 year postpartum and 60 (39%) accepted. RESULTS: At 1 year follow up, 31% of the women with gestational diabetes but only one of the 60 controls showed pathologic glucose tolerance and one had developed diabetes. The following factors in women with gestational diabetes were identified as predicting impaired glucose tolerance or diabetes at 1 year follow up: maternal age over 40 and--in a multiple regression analysis, independent of each other--a high 2-hr value at oral glucose tolerance test during pregnancy and insulin treatment during pregnancy. CONCLUSION: The risk of developing manifest diabetes after gestational diabetes may be high enough to justify a general screening or diagnostic procedure in all pregnant women to identify women with gestational diabetes and a postpartum follow up program for them. This study did not identify any particular factor during pregnancy with enough precision to predict a later progression to diabetes.
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| 7. |
- Agardh, Carl-David, et al.
(författare)
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Glucose levels and insulin secretion during a 75 g glucose challenge test in normal pregnancy
- 1996
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Ingår i: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 240:5, s. 303-309
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of the study was to evaluate glucose levels and insulin secretion early in pregnancy and at a time when gestational diabetes mellitus frequently occurs in order to define reference values for glucose tolerance during pregnancy. The results were also related to maternal factors that might identify subjects at risk of developing gestational diabetes mellitus as well as foetal factors that might be a result of impaired glucose tolerance during pregnancy. DESIGN: A prospective study. SETTING: All Caucasian women attending one antenatal out-patient care unit were offered a 75 g oral glucose tolerance test at the 17th and 32nd week of gestation. SUBJECTS: A total of 586 consecutive pregnant women were included in the study. All 586 women were examined by repeated blood glucose measurements and 298 agreed to perform oral glucose tolerance tests as well. MAIN OUTCOME MEASURES: Venous whole blood glucose values were measured in the fasting state and in samples obtained 15, 30, 45, 60, 75, 90 and 120 min after oral intake of 75 g glucose. Serum insulin and C-peptide were also measured at these times. In all subjects, a random blood glucose sample was taken at the first visit, and thereafter at the 20th, 30th and 36th week of gestation. Information was also obtained from all subjects regarding body mass index, weight gain during pregnancy, smoking habits, family history of diabetes and hypertension, hypertension during pregnancy, past obstetric history, parity, and fetal outcome. RESULTS: The glucose tolerance was significantly impaired at the 32nd week of gestation compared with the 17th week of gestation. The mean +2SD 2 h glucose value during the oral glucose tolerance test at the 32nd week of gestation was 8.0 mmol L-1. Impaired glucose tolerance was characterised by increased insulin resistance, with a significant rise in serum insulin and C-peptide concentrations and in the insulin/glucose index during the oral glucose tolerance test at the 32nd week of gestation. Maternal factors associated with an impaired glucose tolerance were a family history of diabetes mellitus, smoking, a weight gain more than 18 kg during pregnancy, and glucosuria, while a family history of hypertension and hypertension present during pregnancy were not. Foetal factors that might be a result of impaired glucose tolerance during pregnancy, e.g. macrosomia and prematurity as well as complicated deliveries such as vacuum extraction/forceps or Caesarean section, all tended to be associated with higher blood glucose values. The same pattern was seen when the Apgar score was < 7. CONCLUSIONS: The results from this study show that the present cut-off values for diagnosis of gestational diabetes mellitus should be revised. Even if some maternal factors might indicate an increased risk for impaired glucose tolerance during pregnancy, they are probably not enough to detect women with gestational diabetes mellitus. Therefore, a screening programme for gestational diabetes should be considered.
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| 8. |
- Agardh, Elisabet, et al.
(författare)
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Fetal growth is not associated with early onset of severe retinopathy in type 1 diabetes mellitus
- 2000
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Ingår i: Diabetes Research and Clinical Practice. - 1872-8227. ; 48:1, s. 61-65
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Tidskriftsartikel (refereegranskat)abstract
- Reduced fetal growth has been suggested as a possible risk factor for diabetic nephropathy. The aim of the present study was to examine whether there could be an association also with rapidly progressing severe retinopathy in younger type 1 diabetic patients. Maternal pregnancy, as well as birth parameters of 27 type 1 diabetic patients with severe retinopathy diagnosis at a median age of 25 years, were studied retrospectively. The control group consisted of 22 type 1 diabetic patients with mild background retinopathy and with similar age, age at onset, and duration of diabetes. Mothers of the subjects with severe retinopathy had a higher body mass index (P = 0.03) but similar age, blood pressure levels, and weight gain during pregnancy as those of the control group. All but four babies, two in each group, were born after 37 completed gestational weeks. There were no differences regarding birth weight or of relative birth weight corrected for gestational length. Head circumference, birth length, and placenta weight were similar. The results indicate that fetal growth is not a factor of major importance for the development of severe retinopathy in younger type 1 diabetic patients.
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| 9. |
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| 10. |
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| 11. |
- Dahlén, Lisa, et al.
(författare)
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Inconsistent pathways of household waste
- 2009
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Ingår i: Waste Management. - : Elsevier BV. - 0956-053X .- 1879-2456. ; 29:6, s. 1798-1806
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to provide policy-makers and waste management planners with information about how recycling programs affect the quantities of specific materials recycled and disposed of. Two questions were addressed: which factors influence household waste generation and pathways? and how reliable are official waste data? Household waste flows were studied in 35 Swedish municipalities, and a wide variation in the amount of waste per capita was observed. When evaluating the effect of different waste collection policies, it was found to be important to identify site-specific factors influencing waste generation. Eleven municipal variables were investigated in an attempt to explain the variation. The amount of household waste per resident was higher in populous municipalities and when net commuting was positive. Property-close collection of dry recyclables led to increased delivery of sorted metal, plastic and paper packaging. No difference was seen in the amount of separated recyclables per capita when weight-based billing for the collection of residual waste was applied, but the amount of residual waste was lower. Sixteen sources of error in official waste statistics were identified and the results of the study emphasize the importance of reliable waste generation and composition data to underpin waste management policies.
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| 12. |
- Gislén, Lars, et al.
(författare)
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Use of the drop volume of amniotic fluid in estimating the risk for respiratory distress syndrome in the newborn infant
- 1986
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Ingår i: American Journal of Obstetrics and Gynecology. - : Elsevier BV. - 1097-6868 .- 0002-9378. ; 154:1, s. 68-74
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Tidskriftsartikel (refereegranskat)abstract
- The present study describes the testing and function of the drop-volume method in the analysis of fetal lung maturity with use of amniotic fluid. Elevated surface tension resulting from a lack of surface-active phospholipids (surfactant) is the primary etiologic defect in the development of respiratory distress syndrome. The drop-volume method quantifies the surface tension of amniotic fluid with use of the fact that the volume of a falling drop of liquid is proportional to the quantity of surfactant in the solution. The drop-volume method requires only 2 minutes and 2 ml of amniotic fluid and predicts fetal lung maturity with an accuracy equal to or greater than that of other tests currently in use.
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| 13. |
- Kvorning, N, et al.
(författare)
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Acupuncture relieves pelvic and low-back pain in late pregnancy
- 2004
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 83:3, s. 246-250
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Tidskriftsartikel (refereegranskat)abstract
- Background The study was designed to evaluate the analgesic effect and possible adverse effects of acupuncture for pelvic and low-back pain during the last trimester of pregnancy. Methods Following individual informed consent, 72 pregnant women reporting pelvic or low-back pain were randomized during pregnancy weeks 24-37 to an acupuncture group (n = 37) or to a control group (n = 35) at three maternity wards in southern Sweden. Traditional acupuncture points and local tender points (TP) were chosen according to individual pain patterns and stimulated once or twice a week until delivery or complete recovery in acupuncture patients. Control patients were given no sham stimulation. Throughout the study period each patient made weekly visual analog scale (VAS) evaluations of maximal and minimal pain intensity as well as three-point assessments of pain intensity during various activities. Results During the study period, VAS scorings of pain intensity decreased over time in 60% of patients in the acupuncture group and in 14% of those in the control group (p < 0.01). At the end of the study period, 43% of the acupuncture patients were less bothered than initially by pain during activity compared with 9% of control patients (p < 0.01). No serious adverse effects of acupuncture were found in the patients, and there were no adverse effects at all in the infants. Conclusion Acupuncture relieves low-back and pelvic pain without serious adverse effects in late pregnancy.
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| 14. |
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| 15. |
- Källén, Bengt, et al.
(författare)
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Relationship between vitamin use, smoking, and nausea and vomiting of pregnancy.
- 2003
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 82:10, s. 916-920
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Tidskriftsartikel (refereegranskat)abstract
- Background. Nausea and vomiting in pregnancy (NVP) is a common complaint but risk factors for NVP are not well characterized. Methods. Occurrence of NVP was studied by questionnaires given to pregnant women at their first visit to the antenatal care unit and were returned around gestational week 28. Results. Analysis of 3675 completed questionnaires was made. Nausea and vomiting in pregnancy was reported by 79% of the women, approximately half of which had been vomiting. Various therapies (drugs, acupuncture, acupressure) were tried by 18% of the women with NVP, of which the majority used drugs, most notably antihistamines (specifically meclozine). Hospitalization occurred in 1% of all women. Nausea and vomiting in pregnancy caused 28% of all sick-leaves during the first 28 weeks of pregnancy. Low maternal age and parity 1+ independently increased the risk for NVP. Smoking before pregnancy and using vitamins in early pregnancy were associated with a decreased risk for NVP. Women working outside the home had a lower rate of NVP than housewives and women out of work. Conclusions. Nausea and vomiting in pregnancy is a common complaint with a significant impact on leave of absence from work. The study identifies a number of factors that are related to the occurrence of NVP and that may give hints on the etiology of the condition.
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| 16. |
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| 17. |
- Lorentzon, Siri, et al.
(författare)
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The diagnosis of bacteriuria during pregnancy
- 1990
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 8:2, s. 81-83
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Tidskriftsartikel (refereegranskat)abstract
- Three diagnostic tests, Nitur, Urobact, and Uricult, were evaluated in the detection of bacteriuria in 865 pregnant women. As reference method agar culture was performed. Heavy growth (greater than 10(5) CFU/ml) of urinary tract bacteria was considered a true positive result and demonstrated in 58 (6.7%) of the women, 14 of whom had gram-negative rods. The sensitivity of the nitrite test was extremely low (0.13). The test gave negative results in eight of 17 specimens yielding heavy growth of Escherichia coli or Proteus mirabilis. Although the Urobact test was highly sensitive as regards gram-negative infection, it had an unacceptably low (0.27) predictive value in positive tests. The sensitivity of the Uricult test was low (0.35) in this study. The predictive value (0.50) of a positive test result may be acceptable, since just over half of the false positive results were explainable by moderate growth of urinary tract pathogens (10(4)-10(5) CFU/ml). It is argued that semi-quantitative urine culture may be preferable to the rapid diagnostic methods studied for the screening of bacteriuria in pregnant women.
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| 18. |
- Lövestam Adrian, Monica, et al.
(författare)
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Pre-eclampsia is a potent risk factor for deterioration of retinopathy during pregnancy in Type 1 diabetic patients
- 1997
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Ingår i: Diabetic Medicine. - 1464-5491. ; 14:12, s. 1059-1065
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to examine the influence of pregnancy on deterioration of retinopathy in patients with Type 1 diabetes mellitus. Sixty-five pregnant Type 1 diabetic women attending the University Hospital in Lund were studied retrospectively. The degree of retinopathy, and levels of HbA1c and blood pressure 12 months before, during, and 6 months after pregnancy were compared of those of 56 non-pregnant Type 1 diabetic women matched for age and duration of diabetes. For all patients, sight-threatening deterioration of retinopathy did not differ between the pregnancy group (9/65) and the control group (6/56). Over time, pregnant patients had lower HbA1c levels than controls (p < 0.001). Pregnant patients with sight-threatening deterioration of retinopathy had higher HbA1c levels than those without (p = 0.028 and the decrement in HbA1c between the 6-14th and the 20th week of gestation was more pronounced (p = 0.006). In those patients who developed pre-eclampsia during pregnancy, deterioration of retinopathy ocurred more frequently compared to those without pre-eclampsia (4/8 vs 5/65; p = 0.005). In conclusion, sight-threatening deterioration of retinopathy was not more common during pregnancy in IDDM patients than among age- and duration-matched control patients. In pregnant patients, deterioration of retinopathy was associated with the pregestational degree of metabolic control as well as with a rapidly improved glycaemic control acheived during pregnancy. Among those in whom deterioration occurred during pregnancy, pre-eclampsia was a potent risk factor.
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| 19. |
- MacIntyre, Sally, et al.
(författare)
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Buoyancy flux, turbulence, and the gas transfer coefficient in a stratified lake
- 2010
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Ingår i: Geophysical Research Letters. - 0094-8276 .- 1944-8007. ; 37:L24604
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Tidskriftsartikel (refereegranskat)abstract
- Gas fluxes from lakes and other stratified water bodies, computed using conservative values of the gas transfer coefficient k600, have been shown to be a significant component of the carbon cycle. We present a mechanistic analysis of the dominant physical processes modifying k600 in a stratified lake and resulting new models of k600 whose use will enable improved computation of carbon fluxes. Using eddy covariance results, we demonstrate that i) higher values of k600 occur during low to moderate winds with surface cooling than with surface heating; ii) under overnight low wind conditions k600 depends on buoyancy flux β rather than wind speed; iii) the meteorological conditions at the time of measurement and the inertia within the lake determine k600; and iv) eddy covariance estimates of k600 compare well with predictions of k600 using a surface renewal model based on wind speed and β.
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| 20. |
- Nilsson, Charlotta, et al.
(författare)
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Presence of GAD-antibodies during gestational diabetes predicts type 1 diabetes.
- 2007
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Ingår i: Diabetes Care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 30:8, s. 1968-1971
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE - we sought to study the frequency of P-cell-specific autoantibody markers in women with gestational diabetes mellitus (GDM) and to follow these women to estimate the risk of later development of type I diabetes. RESEARCH DESIGN AND METHODS - Of 385 pregnant women with GDM during 1995-2005 in the district of Lund, 24 (6%) women were found positive for at least one of the following: islet cell antibody (ICA), GAD antibody (GADA), or tyrosine phosphatase antibody(IA-2A). The women were followed and autoantibodies reanalyzed. Those who had not developed diabetes did an oral glucose tolerance test. The frequencies of known risk factors; for GD were compared in women with GDM with and without pancreatic autoantibodies. RESULTS - Among the autoantibody-positive women, 50% had developed type I diabetes compared with none among the GDM control subjects (P = 0. 00 1), 2 1 % had impaired fasting glucose or impaired glucose tolerance compared with 12.5% among control subjects (P = 0.3), and none had developed type 2 diabetes compared with 12.5% among control subjects (P 0.1). CONCLUSIONS - Autoantibody screening in pregnant women with GDM and follow-up after delivery should be considered for early recognition of type I diabetes.
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| 21. |
- Panezai, Jeneen, et al.
(författare)
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Periodontal Disease Augments Cardiovascular Disease Risk Biomarkers in Rheumatoid Arthritis
- 2022
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Ingår i: Biomedicines. - : MDPI. - 2227-9059. ; 10:3
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Periodontal disease (PD) and rheumatoid arthritis (RA) are known chronic conditions with sustained inflammation leading to osteolysis. Cardiovascular diseases (CVD) are frequent comorbidities that may arise from sustained inflammation associated with both PD and RA. In order to determine CVD risk, alterations at the molecular level need to be identified. The objective of this study, therefore, was to assess the relationship of CVD associated biomarkers in RA patients and how it is influenced by PD.METHODS: The study consisted of patient (26 RA with PD, 21 RA without PD, 51 patients with PD only) and systemically and periodontally healthy control (n = 20) groups. Periodontal parameters bleeding on probing, probing pocket depth, and marginal bone loss were determined to characterize the patient groups. Proteomic analysis of 92 CVD-related protein biomarkers was performed using a multiplex proximity extension assay. Biomarkers were clustered using the search tool for retrieval of interacting genes (STRING) to determine protein-protein interaction (PPI) networks.RESULTS: RA patients with PD had higher detection levels for 47% of the measured markers (ANGPT1, BOC, CCL17, CCL3, CD4, CD84, CTRC, FGF-21, FGF-23, GLO1, HAOX1, HB-EGF, hOSCAR, HSP 27, IL16, IL-17D, IL18, IL-27, IL6, LEP, LPL, MERTK, MMP12, MMP7, NEMO, PAPPA, PAR-1, PARP-1, PD-L2, PGF, PIgR, PRELP, RAGE, SCF, SLAMF7, SRC, THBS2, THPO, TNFRSF13B, TRAIL-R2, VEGFD, VSIG2, and XCL1) as compared to RA without PD. Furthermore, a strong biological network was identified amongst these proteins (clustering coefficient = 0.52, PPI enrichment p-value < 0.0001). Coefficients for protein clusters involved in CVD (0.59), metabolic (0.53), and skeletal (0.51) diseases were strongest in the PD group.CONCLUSION: Periodontal disease augments CVD-related biomarkers in RA through shared pathological clusters, concurrently enhancing metabolic and skeletal disease protein interactions, independent of autoimmune status.
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| 22. |
- Samsioe, Göran, et al.
(författare)
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Changes in lipid and lipoprotein profile in postmenopausal women receiving low-dose combinations of 17 beta-estradiol and norethisterone acetate
- 2002
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Ingår i: Menopause. - 1530-0374. ; 9:5, s. 335-342
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the modification of lipid and lipoprotein by use of low doses of continuous-combined formulations of 17beta-estradiol (E-2) and norethisterone acetate (NETA) in healthy postmenopausal women. Design: The study was designed as a double-blind, randomized, placebo-controlled trial. A total of 120 healthy postmenopausal women were randomized to one of three treatment arms: (1) placebo group (n = 40); (2) E-2/NETA 0.25-mg group-subjects receiving oral continuous-combined E-2 1 mg and NETA 0.25 mg (n = 40); (3) E2/NETA 0.5-mg group-women who were treated with E-2 1 mg and NETA 0.5 mg (n = 40). The duration of study was 12 months. Plasma levels of total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very low-density lipoprotein (VLDL) cholesterol, triglycerides, lipoprotein(a), apolipoprotein A and apolipoprotein B were determined on four occasions (i.e., baseline, 3-, 6-, and 12-month visits). Results: There were no differences in the baseline characteristics among the three groups. A total of 102 women completed the study, resulting in a compliance rate of 85%. There was a significant reduction of total cholesterol, LDL cholesterol, and lipoprotein(a) in both combined groups when compared with placebo. The level of apolipoprotein B declined significantly only in the E-2/NETA 0.25-mg group. Decrements were observed within 3 months of treatment and maintained thereafter. No significant changes were found in triglycerides, VLDL cholesterol, HDL cholesterol, apolipoprotein A, and LDL/HDL ratio. Between the two active combined groups, no statistically significant differences were noted. Conclusion: Favorable changes in lipids and lipoproteins were associated with the low dose of E-2/NETA combinations. These effects may contribute to the reduction or prevention of atherogenesis in postmenopausal women.
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| 23. |
- Vikström, Linnea, et al.
(författare)
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Vaccine-induced correlate of protection against fatal COVID-19 in older and frail adults during waves of neutralization-resistant variants of concern : an observational study
- 2023
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Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 30
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To inform future preventive measures including repeated vaccinations, we have searched for a clinically useful immune correlate of protection against fatal COVID-19 among nursing homes residents.METHODS: We performed repeated capillary blood sampling with analysis of S-binding IgG in an open cohort of nursing home residents in Sweden. We analyzed immunological and registry data from 16 September 2021 to 31 August 2022 with follow-up of deaths to 30 September 2022. The study period included implementation of the 3rd and 4th mRNA monovalent vaccine doses and Omicron virus waves.FINDINGS: A total of 3012 nursing home residents with median age 86 were enrolled. The 3rd mRNA dose elicited a 99-fold relative increase of S-binding IgG in blood and corresponding increase of neutralizing antibodies. The 4th mRNA vaccine dose boosted levels 3.8-fold. Half-life of S-binding IgG was 72 days. A total 528 residents acquired their first SARS-CoV-2 infection after the 3rd or the 4th vaccine dose and the associated 30-day mortality was 9.1%. We found no indication that levels of vaccine-induced antibodies protected against infection with Omicron VOCs. In contrast, the risk of death was inversely correlated to levels of S-directed IgG below the 20th percentile. The death risk plateaued at population average above the lower 35th percentile of S-binding IgG.INTERPRETATION: In the absence of neutralizing antibodies that protect from infection, quantification of S-binding IgG post vaccination may be useful to identify the most vulnerable for fatal COVID-19 among the oldest and frailest. This information is of importance for future strategies to protect vulnerable populations against neutralization resistant variants of concern.FUNDING: Swedish Research Council, SciLifeLab via Knut and Alice Wallenberg Foundation, VINNOVA. Swedish Healthcare Regions, and Erling Persson Foundation.
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| 24. |
- Westbom, Lena, et al.
(författare)
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Childhood malignancy and maternal diabetes or other auto-immune disease during pregnancy.
- 2002
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Ingår i: British Journal of Cancer. - 1532-1827. ; 86:7, s. 1078-1080
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Tidskriftsartikel (refereegranskat)abstract
- Among 4380 children born in 1987-1997 of women with a diagnosis of diabetes and alive at the age of one, 10 were registered in the Swedish Cancer Registry before the end of 1998. The odds ratio for having a childhood cancer after maternal diabetes, stratified for year of birth, maternal age, parity, multiple birth, and 500 g birth weight class was 2.25 (95%CI 1.22-4.15). Among 5842 children born during the period 1973-1997 whose mothers had other auto-immune diseases (SLE, rheumatoid arthritis, Crohn, ulcerous colitis, multiple sclerosis or thyroiditis), the number of observed childhood cancers (9) was close to that expected (8.5). Maternal diabetes but not other auto-immune diseases may be a risk factor for childhood cancer.
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| 25. |
- Åberg, Anders E, et al.
(författare)
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Association between maternal pre-existing or gestational diabetes and health problems in children
- 2001
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Ingår i: Acta Pædiatrica. - 1651-2227. ; 90:7, s. 746-750
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Tidskriftsartikel (refereegranskat)abstract
- There is general consensus that children of women with pre-existing diabetes mellitus (PDM) have an increased risk of malformations and neurodevelopmental problems. Whether this is also true for children of women with gestational diabetes mellitus (GDM) is a matter of debate. This study investigated inpatient hospital care up to 10 y of age of children born to GDM and PDM women as a rough estimate of child morbidity. Hospital care of children born to 82,684 GDM women, 3,874 PDM women and 1,213,957 controls was compared by linking the Swedish Medical Birth Registry with the Hospital Discharge Registry. Similar comparisons were performed in a local well-controlled group of 326 children born to GDM women in the Lund area. Children of PDM women and to a lesser degree children of GDM women had a statistically significant increase in hospitalizations, evident at least up to 10 y of age. Significantly increased risks of hospitalization were found for neurological/developmental disorders [odds ratio (OR) 2.30 and 1.36 for PDM and GDM, respectively)], malformations (OR 2.05 and 1.23), infections (OR 1.56 and 1.20) and accidents (OR 1.32 and 1.14). CONCLUSION: The high hospitalization rates of these children indicate an increased morbidity, including neurodevelopmental disorders.
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| 26. |
- Åberg, Anders E, et al.
(författare)
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Congenital malformations among infants whose mothers had gestational diabetes or preexisting diabetes
- 2001
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Ingår i: Early Human Development. - 1872-6232. ; 61:2, s. 85-95
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Diabetes type 1 is associated with an increased risk for infant congenital malformations. It is debated whether this is true also at gestational diabetes. AIMS: To study occurrence of congenital malformations in infants whose mothers had preexisting or gestational diabetes. STUDY DESIGN: A register study covering over 1.2 million Swedish births in 1987-1997 based on the Swedish health registries. SUBJECTS: We identified from the Medical Birth Registry 3864 infants born of women with preexisting diabetes and 8688 infants born of women with gestational diabetes. OUTCOMES MEASURES: Congenital malformations identified in the Medical Birth Registry, the Registry of Congenital Malformations, and the Hospital Discharge Registry. The rates of congenital malformations among these infants was compared with the population rates. RESULTS: At preexisting diabetes, the total malformation rate was 9.5% while the rate at gestational diabetes was similar to the population rate, 5.7%. At preexisting diabetes, certain conditions were more common than expected: orofacial clefts, cardiovascular defects, oesophageal/intestinal atresia, hypospadias, limb reduction defects, spine malformations, and polydactyly. For some of these conditions, an excess was found also for infants whose mothers had gestational diabetes. Infants with multiple malformations were in excess at preexisting diabetes but not at gestational diabetes but the specific type of malformations involved were similar in the two diabetes groups. CONCLUSIONS: It is suggested that in the group of gestational diabetes exists a subgroup with an increased risk for a diabetes embryopathy, perhaps due to preexisting but undetected diabetes type 2.
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- Åberg, Anders E
(författare)
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Gestational Diabetes, screening, diagnosis and prognosis
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Gestational diabetes (GD) is still a nonentity disease. There is no worldwide consensus how to define it or whether it is harmful to the woman or fetus. Therefore, from an ethical point of view, it is uncertain whether one should try to identify it. Since 1991, all pregnant women in Lund are offered a 75g oral glucose tolerance test (OGTT) at 27 – 28 weeks of pregnancy. In Sweden, the definition of GD is a 2-hour glucose value in capillary whole blood, at a 75g OGTT, of at least 9.0 mmol/l. In the materials from Lund, the upper 2 standard deviation limit in the distribution of 2-hour glucose values at OGTT is 8.3 mmol/l. Increased rates of Caesarean section and infant macrosomia were found even in the “sub GD” region (7.8 mmol/l – 8.9 mmol/l), suggesting that the limit of 7.8 mmol/l for impaired glucose tolerance, set by World Health Organisation, is more relevant from a clinical point of view. The Swedish Medical Birth Registry was used to identify 3,958 women with pregnancies complicated by GD in 1987–92. Their previous pregnancy outcomes were compared with those of 7,916 controls without a diagnosis of GD. A significantly increased risk of previous intrauterine death (OR 1.56) was found. Many of the GD women probably had an undetected GD in the previous pregnancy. The 8,684 children born in 1987–97 to women with GD in Sweden were significantly more often hospitalised during their first decade of life than the 1,213,957 controls but less often than the 3,874 children to women with pregestational diabetes. Congenital defects, neurological problems, accidents, and infections were the reasons for the increased hospital care rate in both groups. The increased rate of accidents may be due to neurological damage and it can be speculated that increased glucose values during pregnancy may contribute to infant brain damage. All women with GD in Lund, 1.2 % of all pregnant women, were offered another OGTT one year post partum. Then, 9.2% had diabetes mellitus (2 hour glucose value > 11.0 mmol/l) and another 21.8% had impaired glucose tolerance (7.8–11.0 mmol/l). No specific symptoms or factors were found, except the 2hour glucose value at the diagnostic OGTT, which could predict future development of diabetes. Thorough information and guidance to individuals at the risk of developing diabetes may lower their risk to develop diabetes mellitus and its complications. Today the diagnosis of diabetes mellitus type 2 is often not made until complications have occurred. Then the diabetes may have been undetected for several years.
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