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1.	Brogårdh-Roth, Susanne, et al. (författare) Five years' follow-up of dental fear and anxiety, experience of dental care and oral health behaviour in Swedish preterm and full-term adolescents 2017 Ingår i: BMC Oral Health. - : BioMed Central. - 1472-6831. ; 17 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: There is rising concern about how preterm birth affects long-term health later in life. The various effects that preterm birth have on developmental outcomes, cognitive profiles and medical health may also affect levels of cooperation in the dental care situation in addition to general oral health and other oral health-related habits. Oral health is an integral part of one's general health and well-being; however, less is known about how prematurity affects oral health and other related areas such as dental care, and including dental fear and anxiety (DFA) in individuals during adolescence and adulthood. This is considered of special interest to study, as preterm children during the preschool and school period were reported to have behavioural problems during dental treatments and less than favourable oral hygiene. METHODS: A questionnaire was used of self-report design and structured into behavioural aspects relating to dental treatment, oral health-related factors, and medical health. This questionnaire at 17-19 years of age was a follow-up from 12 to 14 years of age and considered a predictor for planning future dental care for this group of patients. The 145 participating adolescents were all preterm, born between 23 and 32 weeks of gestation and 140 full-term controls, born ≥37 weeks of gestation. RESULTS: Dental fear and anxiety, oral health behaviour, and intake of sweets and sugary drinks of 17-19-year old adolescents born preterm was comparable to that of the full-term control group. Medical health problems as well as the intake of sweets and sugary drinks increased from the time of early adolescence to late adolescence in both groups. CONCLUSIONS: Preterm as well as full-term adolescents between 17 and 19 years of age are satisfied with their dental care and display low prevalence of dental fear and anxiety (DFA). The findings in this study indicate that adolescents born very preterm and extremely preterm are well prepared for transition to dental care in adult life with expectations of being able to take responsibility for their oral health. KEYWORDS: Adolescent; Born preterm; Dental care; Oral health behaviour
2.	Ekberg, Jana, 1964, et al. (författare) An in-progress, open-label, multi-centre study (SAILOR) evaluating whether a steroid-free immunosuppressive protocol, based on ATG induction and a low tacrolimus dose, reduces the incidence of new onset diabetes after transplantation. 2014 Ingår i: Transplantation research. - : Springer Science and Business Media LLC. - 2047-1440. ; 3 Tidskriftsartikel (refereegranskat)abstract Corticosteroids and calcineurin inhibitors (CNIs) are included in renal transplantation immunosuppressive protocols around the world. Well-known side effects are associated with the use of these drugs, including new onset of diabetes after transplantation (NODAT). Long-term patient survival rates are lower among patients with NODAT. The optimal immunosuppressive protocol would therefore include not using corticosteroids and minimization of CNI use.
3.	Ekberg, Kerstin, et al. (författare) Lättare psykisk ohälsa 2015 Ingår i: Återgång i arbete. Processer, bedömningar och åtgärder. - Lund : Studentlitteratur AB. ; , s. 111-127, s. 111-128 Bokkapitel (populärvet., debatt m.m.)
4.	Ekberg, O., et al. (författare) Effect of Barium Sulfate Contrast Medium on Rheology and Sensory Texture Attributes in a Model Food 2009 Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 50:2, s. 131-138 Tidskriftsartikel (refereegranskat)abstract Background: The swallowing process can be visualized using videoradiography, by mixing food with contrast medium, e.g., barium sulfate (BaSO4), making it radiopaque. The sensory properties of foods may be affected by adding this medium. Purpose: To evaluate if and to what extent sensory and rheological characteristics of mango puree were altered by adding barium sulfate to the food. Material and Methods: This study evaluated four food samples based on mango puree, with no or added barium sulfate contrast medium (0%, 12.5%, 25.0%, and 37.5%), by a radiographic method, and measured sensory texture properties and rheological characteristics. The sensory evaluation was performed by an external trained panel using quantitative descriptive analysis. The ease of swallowing the foods was also evaluated. Results: The sensory texture properties of mango puree were significantly affected by the added barium in all evaluated attributes, as was the perception of particles. Moreover, ease of swallowing was significantly higher in the sample without added contrast medium. All samples decreased in extensional viscosity with increasing extension rate, i.e., all samples were tension thinning. Shear viscosity was not as dependent on the concentration of BaSO4 as extensional viscosity. Conclusion: Addition of barium sulfate to a model food of mango puree has a major impact on perceived sensory texture attributes as well as on rheological parameters.
5.	Everhov, Åsa H, et al. (författare) Lost workdays in uterine cervical cancer survivors compared to the general population: impact of treatment and relapse. 2016 Ingår i: Journal of cancer survivorship : research and practice. - : Springer Science and Business Media LLC. - 1932-2267 .- 1932-2259. ; 10:3, s. 514-523 Tidskriftsartikel (refereegranskat)abstract The aim of the present study was to examine the risk of lost workdays due to sick leave and disability pension by treatment modality and relapse in a population-based cohort of cervical cancer survivors versus matched comparators.
6.	Fjordén, Karin, et al. (författare) Idelalisib in relapsed/refractory diffuse large B-cell lymphoma: results from a Nordic Lymphoma Group phase II trial 2022 Ingår i: British Journal of Haematology. - : WILEY. - 0007-1048 .- 1365-2141. ; 196:2, s. 437-440 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract n/a
7.	Abalo, Kossi, et al. (författare) Secondary malignancies among mantle cell lymphoma patients 2023 Ingår i: European Journal of Cancer. - : Elsevier. - 0959-8049 .- 1879-0852. ; 195 Tidskriftsartikel (refereegranskat)abstract Purpose:With modern treatments, mantle cell lymphoma (MCL) patients more frequently experience long-lasting remission resulting in a growing population of long-term survivors. Follow-up care includes identification and management of treatment-related late-effects, such as secondary malignancies (SM). We conducted a populationbased study to describe the burden of SM in MCL patients.Methods:All patients with a primary diagnosis of MCL, aged >= 18 years and diagnosed between 2000 and 2017 in Sweden were included along with up to 10 individually matched population comparators. Follow-up was from twelve months after diagnosis/matching until death, emigration, or December 2019, whichever occurred first. Rates of SM among patients and comparators were estimated using the Anderson-Gill method (accounting for repeated events) and presented as hazard ratios (HR) with 95% confidence intervals (CI) adjusted for age at diagnosis, calendar year, sex, and the number of previous events.Results:Overall, 1 452 patients and 13 992 comparators were followed for 6.6 years on average. Among patients, 230 (16%) developed at least one SM, and 264 SM were observed. Relative to comparators, patients had a higher rate of SM, HRadj= 1.6 (95%CI:1.4-1.8), and higher rates were observed across all primary treatment groups: the Nordic-MCL2 protocol, R-CHOP, R-bendamustine, ibrutinib, lenalidomide, and R-CHOP/Cytarabine. Compared to Nordic-MCL2, treatment with R-bendamustine was independently associated with an increased risk of SM, HRadj= 2.0 (95%CI:1.3-3.2). Risk groups among patients were those with a higher age at diagnosis (p < 0.001), males (p = 0.006), and having a family history of lymphoma (p = 0.009). Patients had preferably higher risk of melanoma, other neoplasms of the skin and other hematopoietic and lymphoid malignancies.Conclusions:MCL survivors have an increased risk of SM, particularly if treated with R-bendamustine. The intensive treatments needed for long-term remissions are a concern, and transition to treatment protocols with sustained efficacy but with a lower risk of SM is needed.
8.	Aggestam, Emil, 1992, et al. (författare) Optimisation of slab track design considering dynamic train–track interaction and environmental impact 2022 Ingår i: Engineering Structures. - : Elsevier BV. - 1873-7323 .- 0141-0296. ; 254 Tidskriftsartikel (refereegranskat)abstract Modern railway tracks for high-speed traffic are often built based on a slab track design. A major disadvantage of slab track compared to conventional ballasted track is that the environmental impact of the construction is higher due to the significant amount of concrete required. In this paper, the dimensions of the rectangular cross-sections and the types of concrete used in slab tracks are optimised with the objective to minimise greenhouse gas emissions, while considering the constraint that the design must pass the static dimensioning analysis described in the European standard 16432-2. The optimised track design is also analysed using a three-dimensional (3D) model of vertical dynamic vehicle–track interaction, where the rails are modelled as Rayleigh–Timoshenko beams and the concrete parts are represented by quadratic shell elements. Wheel–rail contact forces and the time-variant stress field of the concrete parts are calculated using a complex-valued modal superposition for the finite element model of the track. For the studied traffic scenario, it is concluded that the thickness of the panel can be reduced compared to the optimised design from the standard without the risk of crack initiation due to the dynamic vehicle load. In parallel, a model of reinforced concrete is developed to predict crack widths, the bending stiffness of a cracked panel section and to assess in which situations the amount of steel reinforcement can be reduced. To reduce the environmental impact even further, there is potential for an extended geometry optimisation by excluding much of the concrete between the rails.
9.	Andelid, Kristina, 1953, et al. (författare) Systemic cytokine signaling via IL-17 in smokers with obstructive pulmonary disease: a link to bacterial colonization? 2015 Ingår i: International Journal of Chronic Obstructive Pulmonary Disease. - : Informa UK Limited. - 1178-2005. ; 10, s. 689-702 Tidskriftsartikel (refereegranskat)abstract We examined whether systemic cytokine signaling via interleukin (IL)-17 and growth-related oncogene-alpha (GRO-alpha) is impaired in smokers with obstructive pulmonary disease including chronic bronchitis (OPD-CB). We also examined how this systemic cytokine signaling relates to bacterial colonization in the airways of the smokers with OPD-CB. Currently smoking OPD-CB patients (n=60, corresponding to Global initiative for chronic Obstructive Lung Disease [ GOLD] stage I-IV) underwent recurrent blood and sputum sampling over 60 weeks, during stable conditions and at exacerbations. We characterized cytokine protein concentrations in blood and bacterial growth in sputum. Asymptomatic smokers (n=10) and never-smokers (n=10) were included as control groups. During stable clinical conditions, the protein concentrations of IL-17 and GRO-alpha were markedly lower among OPD-CB patients compared with never-smoker controls, whereas the asymptomatic smoker controls displayed intermediate concentrations. Notably, among OPD-CB patients, colonization by opportunistic pathogens was associated with markedly lower IL-17 and GRO-alpha, compared with colonization by common respiratory pathogens or oropharyngeal flora. During exacerbations in the OPD-CB patients, GRO-alpha and neutrophil concentrations were increased, whereas protein concentrations and messenger RNA for IL-17 were not detectable in a reproducible manner. In smokers with OPD-CB, systemic cytokine signaling via IL-17 and GRO-alpha is impaired and this alteration may be linked to colonization by opportunistic pathogens in the airways. Given the potential pathogenic and therapeutic implications, these findings deserve to be validated in new and larger patient cohorts.
10.	Aneheim, Emma, 1982, et al. (författare) Partitioning and Transmutation Annual Report 2007 2008 Rapport (övrigt vetenskapligt/konstnärligt)
11.	Antonson, Hans, et al. (författare) Kulturhistoriska värden i ett förändrat klimat. Hot, risker och hanteringkopplat till vägar och banor 2021 Rapport (refereegranskat)abstract Klimatförändringar utgör en bred palett av risker för kulturmiljö och landskap,inklusive de kulturhistoriska lämningar som har en nära eller direkt kopplingtill transportinfrastruktur. I detta projekt tittade vi på ett antal av dessa riskeri syfte att hjälpa Trafikverket att utveckla tjänster för bättre förutsägelse ochhantering av riskerna i anslutning till vägar och banor. Forskningen inleddesgenom en översikt av befintliga offentliga publikationer om klimatförändringenshot, risker, metoder, anpassningsåtgärder och kulturmiljö. Detta följdesav en undersökning av upplevelsen av dessa frågor bland offentligt anställdaexperter som medverkar i planeringen. Geografiska informationssystem (GIS)användes för att identifiera kulturhistoriska lämningar som är klimatologisktriskutsatta sig i riskzonen för tre undersökningsområden, följt av fältbesökför att bedöma tillförlitligheten i GIS-resultaten. Analysen visade att en enkelGIS-analys kan vara till hjälp för att identifiera riskutsatta platser, men ocksåatt fältarbete kan medverka till att identifiera ytterligare risker men också problemmed noggrannheten i underliggande datamaterial. Projektet tillhandahållerockså grundläggande statistik om i vilken utsträckning olika typer avkulturhistoriska lämningar på nationell nivå riskerar att hotas enligt nuvarandeklimatförändringsmodeller. Projektet genomförde också fallstudier av 1) vägsaltetsrisker för milstolpar och andra arkeologiska företeelser i anslutning tillvägar, och 2) de historiska kartornas potential att användas för att identifierariskutsatta områden vid framtida klimatförändringar. Slutligen diskuteras konsekvensernaav dessa resultat för prioriteringar av klimatanpassningsaktivitetersamt presenterar förslag på metoder och modeller för att identifiera transportinfrastrukturenskulturmiljöer som är hotas av klimatförändringar.
12.	Bixo, Marie, et al. (författare) Treatment of premenstrual dysphoric disorder with the GABA(A) receptor modulating steroid antagonist Sepranolone (UC1010)-A randomized controlled trial 2017 Ingår i: Psychoneuroendocrinology. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0306-4530 .- 1873-3360. ; 80, s. 46-55 Tidskriftsartikel (refereegranskat)abstract Context: Allopregnanolone is a metabolite from progesterone and a positive modulator of the GABA(A) receptor. This endogenous steroid may induce negative mood in sensitive women when present in serum levels comparable to the premenstrual phase. Its endogenous isomer, isoallopregnanolone, has been shown to antagonize allopregnanolone effects in experimental animal and human models.Objective: The objective was to test whether inhibition of allopregnanolone by treatment with the GABA(A) modulating steroid antagonist (GAMSA) Sepranolone (UC1010) during the premenstrual phase could reduce symptoms of the premenstrual dysphoric disorder (PMDD). The pharmacokinetic parameters of UC1010 when given as a subcutaneous injection were measured in healthy women prior to the study in women with PMDD.Design: This was an explorative randomized, double-blind, placebo-controlled study.Setting: Swedish multicentre study with 10 centers.Participants: Participants were 26 healthy women in a pharmacokinetic phase I study part, and 126 women with PMDD in a phase II study part. Diagnosis followed the criteria for PMDD in DSM-5 using Daily Record of Severity of Problems (DRSP) and Endicott's algorithm.Intervention: Subjects were randomized to treatment with UC1010 (10 or 16 mg) subcutaneously every second day during the luteal phase or placebo during one menstrual cycle.Outcome measures: The primary outcome measure was the sum of all 21 items in DRSP (Total DRSP score). Secondary outcomes were Negative mood score i.e. the ratings of the 4 key symptoms in PMDD (anger/irritability, depression, anxiety and lability) and impairment (impact on daily life).Results: 26 healthy women completed the pharmacokinetic phase I study and the dosing in the following trial was adjusted according to the results. 106 of the 126 women completed the phase II study. Within this group, a significant treatment effect with UC1010 compared to placebo was obtained for the Total DRSP score (p = 0.041) and borderline significance (p = 0.051) for the sum of Negative mood score. Nineteen participants however showed symptoms during the follicular phase that might be signs of an underlying other conditions, and 27 participants had not received the medication as intended during the symptomatic phase. Hence, to secure that the significant result described above was not due to chance, a post hoc sub-group analysis was performed, including only women with pure PMDD who completed the trial as intended (n =60). In this group UC1010 reduced Total DRSP scores by 75% compared with 47% following placebo; the effect size 0.7 (p = 0.006), and for sum of Negative mood score (p=0.003) and impairment (p =0.010) with the effect size 0.6. No severe adverse events were reported during the treatment and safety parameters (vital signs and blood chemistry) remained normal during the study.Conclusions: This explorative study indicates promising results for UC1010 as a potential treatment for PMDD. The effect size was comparable to that of SSRIs and drospirenone containing oral contraceptives. UC1010 was well tolerated and deemed safe.
13.	Brännström, Mats, 1958, et al. (författare) Live birth after robotic-assisted live donor uterus transplantation. 2020 Ingår i: Acta obstetricia et gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 99:9, s. 1222-1229 Tidskriftsartikel (refereegranskat)abstract The proof-of-concept of uterus transplantation, as a treatment for absolute uterine factor infertility, came with the first live birth after uterus transplantation, which took place in Sweden in 2014. This was after a live donor procedure, with laparotomy in both donor and recipient. In our second, ongoing trial we introduced a robotic-assisted laparoscopic surgery of the donor to develop minimal invasive surgery for this procedure. Here, we report the surgery and pregnancy behind the first live birth from that trial.In the present study, within a prospective observational study, a 62-year-old mother was the uterus donor and her 33-year-old daughter with uterine absence as part of the Mayer-Rokitansky-Küster-Hauser syndrome, was the recipient. Donor surgery was mainly done by robotic-assisted laparoscopy, involving dissections of the utero-vaginal fossa, arteries and ureters. The last part of surgery was by laparotomy. Recipient laparotomy included vascular anastomoses to the external iliac vessels. Data relating to in vitro fertilization, surgery, follow up, obstetrics and postnatal growth are presented.Three in vitro fertilization cycles prior to transplantation gave 12 cryopreserved embryos. The surgical time of the donor in the robot was 360minutes, according to protocol. The durations for robotic surgery for dissections of the utero-vaginal fossa, arteries and ureters were 30, 160 and 84minutes, respectively. The remainder of donor surgery was by laparotomy. Recipient surgery included preparations of the vaginal vault, three end-to-side anastomoses (one arterial, two venous) on each side to the external iliacs and fixation of the uterus. Ten months after transplantation, one blastocyst was transferred and resulted in pregnancy, which proceeded uneventfully until elective cesarean section in week 36+1 . A healthy boy (Apgar 9-10-10) was delivered. Follow up of child has been uneventful for 12months.This is the first report of a live birth after use of robotic-assisted laparoscopy in uterus transplantation and is thereby a proof-of-concept of use of minimal invasive surgery in this new type of transplantation.
14.	Bäckström, Torbjörn, et al. (författare) A randomized, double-blind study on efficacy and safety of sepranolone in premenstrual dysphoric disorder 2021 Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530 .- 1873-3360. ; 133 Tidskriftsartikel (refereegranskat)abstract Women with premenstrual dysphoric disorder (PMDD) experience mood symptoms related to the increase in progesterone and the neuroactive steroid allopregnanolone. Our hypothesis is that allopregnanolone is the symptom provoking factor. The rationale for the present study was to treat PMDD patients with the GABAA receptor modulating steroid antagonist, sepranolone (isoallopregnanolone). Patients (n = 206) with PMDD from 12 European centers were randomized in a parallel double-blind study and treated with placebo, sepranolone 10 mg and 16 mg. Patients administered sepranolone subcutaneously every 48 h during the 14 premenstrual days of three consecutive menstrual cycles. After obtaining informed consent, the PMDD diagnosis was confirmed according to DSM-5 and verified with two menstrual cycles of daily symptom ratings using the Daily Record of Severity of Problems (DRSP) scale in an eDiary. Inclusion and exclusion criteria stipulated that the women should be essentially healthy, not pregnant, have no ongoing psychiatric disorder or take interfering medications, and have regular menstrual cycles. The study's primary endpoint was the Total symptom score (Sum21, the score for all 21 symptom questions in the DRSP). In the prespecified statistical analysis the average score of the 5 worst premenstrual days in treatment cycles 2 and 3 were subtracted from the corresponding average score in the two diagnostic cycles. The treatment effects were tested using analysis of variance in a hierarchal order starting with the combined active sepranolone treatments vs. placebo. The prespecified analysis of Sum21 showed a large treatment effect of all three treatments but no statistically significant difference to placebo. However, the ratings of distress showed a significant treatment effect of sepranolone compared to placebo (p = 0.037) and the ratings of impairment showed a trend to greater treatment effect of sepranolone compared to placebo. Many women with PMDD had symptoms during a longer period than the late luteal phase. It has previously been shown that 9 premenstrual days may be more representative for comparison of PMDD symptom periods than the 5 worst premenstrual days. A post hoc analysis was undertaken in the per protocol population investigating the treatment effect during 9 premenstrual days in the third treatment cycle. The Sum21 results of this analysis showed that the sepranolone 10 mg was significantly better than placebo (p = 0.008). Similar significant treatment effects were found for the impairment and distress scores. A significantly larger number of individuals experienced no or minimal symptoms (Sum21 <42 points) with the 10 mg sepranolone treatment compared to placebo (p = 0.020). The results indicate that there is an attenuating effect by sepranolone on symptoms, impairment, and distress in women with PMDD especially by the 10 mg dosage. Sepranolone was well tolerated, and no safety concerns were identified.
15.	Bäckström, Torbjörn, et al. (författare) Isoallopregnanolone inhibits estrus cycle-dependent aggressive behavior 2023 Ingår i: Biomolecules. - : MDPI. - 2218-273X. ; 13:6 Tidskriftsartikel (refereegranskat)abstract Among female rats, some individuals show estrus cycle-dependent irritability/aggressive behaviors, and these individual rats may be used as a model for premenstrual dysphoric disorder (PMDD). We wanted to investigate if these behaviors are related to the estrus cycle phase containing moderately increased levels of positive GABA-A receptor-modulating steroids (steroid-PAM), especially allopregnanolone (ALLO), and if the adverse behavior can be antagonized. The electrophysiology studies in this paper show that isoallopregnanolone (ISO) is a GABA-A-modulating steroid antagonist (GAMSA), meaning that ISO can antagonize the agonistic effects of positive GABA-A receptor-modulating steroids in both α1β2γ2L and α4β3δ GABA-A receptor subtypes. In this study, we also investigated whether ISO could antagonize the estrus cycle-dependent aggressive behaviors in female Wistar rats using a resident–intruder test. Our results confirmed previous reports of estrus cycle-dependent behaviors in that 42% of the tested rats showed higher levels of irritability/aggression at diestrus compared to those at estrus. Furthermore, we found that, during the treatment with ISO, the aggressive behavior at diestrus was alleviated to a level comparable to that of estrus. We noticed an 89% reduction in the increase in aggressive behavior at diestrus compared to that at estrus. Vehicle treatment in the same animals showed a minimal effect on the diestrus-related aggressive behavior. In conclusion, we showed that ISO can antagonize Steroid-PAM both in α1β2γ2L and α4β3δ GABA-A receptor subtypes and inhibit estrus cycle-dependent aggressive behavior.
16.	Chen, Lingjing, et al. (författare) Work Loss Duration and Predictors Following Rectal Cancer Treatment among Patients with and without Prediagnostic Work Loss 2016 Ingår i: Cancer Epidemiology, Biomarkers and Prevention. - 1055-9965 .- 1538-7755. ; 25:6, s. 987-994 Tidskriftsartikel (refereegranskat)abstract Background: The number of working-age rectal cancer survivors is increasing due to early detection and improved treatment. However, work loss duration and predictors among them have not been studied thoroughly. Methods: We identified 3,438 patients with stage I-III rectal cancer, 18 to 61 years of age in the Swedish Colorectal Cancer Register 1996-2009. Information on work loss due to sick leave or disability pension was collected from 2 years before diagnosis to 5 years after (until December 31st, 2013). Incidence rate ratios (IRR) of work loss were estimated in a negative binominal model by clinical characteristics for the 1st and 2nd-5th years after diagnosis. Patients were stratified by prediagnostic work loss. Results: Patients without prediagnostic work loss (74%) experienced median 147 days (25th and 75th percentile: 55 and 281) of work loss during the 1st year after diagnosis. Work loss rates (2nd-5th years) were significantly increased among relapse-free patients diagnosed in stage III [IRR = 1.92; 95% confidence interval (CI), 1.52-2.43], operated with abdominoperineal resection (IRR = 1.26; 95% CI, 1.03-1.56), and treated with neoadjuvant (chemo) radiotherapy (IRR = 1.46; 95% CI, 1.06-2.02). Patients with prediagnostic work loss (26%) experienced median 336 days (25th and 75th percentile: 183 and 365) of work loss during the 1st year, and rates did not vary clinically till 5 years. Conclusion: Without prediagnostic work loss, disease-and treatment-related factors could help identify rectal cancer patients in need of early interventions to facilitate return to work. Impact: Clinical awareness around prediagnostic and postdiagnostic work loss and individualized cancer rehabilitation programs should be emphasized among cancer survivors.
17.	Dahl, Sara, et al. (författare) Can sense of coherence be a predictor for treatment outcome in patients with TMD-pain? 2011 Ingår i: Svenska tandläkaresällskapets 47:e odontologisk riksstämma 2011. - : Svenska tandläkaresällskapet. ; , s. 110-110 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Aims. To investigate whether SOC (sense of coherence) changed after twelve months of treatment of TMD-pain, and if any such change could be correlated with treatment outcome. Another objective was to examine whether SOC was correlated with grade of depression and somatisation. Materials and Methods. 73 patients participated in the double-blind randomized controlled trial. The TMD-treatment was active for at least ten weeks and consisted of either a resilient or a non-occluding control appliance. Patients were diagnosed according to RDC/TMD and completed the SOC-29 at baseline and after twelve months. Treatment outcome was evaluated as a reduction of pain registered as characteristic pain intensity. No difference was found between the resilient appliance and the control appliance in reducing pain at the 12-months follow-up. Therefore the material was pooled together. Results. Of the 73 participating TMD-pain patients, a total of 44 patients filled in the SOC-29 at both baseline and after twelve months, and 42 of them also stated values for depression and somatisation. There was no correlation between high SOC and treatment outcome. No differences were found in the mean value of SOC for patients younger and older than 30 respectively 40 years. Significant correlations were found between mean differences of SOC and grade of depression, and between mean differences of grade of depression and somatisation. Conclusion. Our results showed that SOC was not a predictor for treatment outcome in TMD-pain patients previously treated with an appliance. SOC seems to be correlated to grade of depression.
18.	Ekberg, Joakim, et al. (författare) Cell phone-supported cognitive behavioural therapy for anxiety disorders : a protocol for effectiveness studies in frontline settings. 2011 Ingår i: BMC Medical Research Methodology. - : BMC. - 1471-2288. ; 11, s. 3- Tidskriftsartikel (refereegranskat)abstract The resulting protocol (NCT01205191 at clinicaltrials.gov) for use in frontline clinical practice in which effectiveness, adherence, and the role of the therapists are analyzed, provides evidence for what are truly valuable cell phone-supported CBT treatments and guidance for the broader introduction of CBT in health services.
19.	Ekberg, Jan, 1942-, et al. (författare) Mental Health, employment and gender. Cross-sectional evidence in a sample of refugees from Bosnia-Herzegovina living in two Swedish regions 2006 Ingår i: Social Science and Medicine. - Oxford : Pergamon-Elsevier LTD, Oxford. - 0277-9536 .- 1873-5347. ; 62:7, s. 1697-1709 Tidskriftsartikel (refereegranskat)
20.	Ekberg, Karin, et al. (författare) C-Peptide replacement therapy and sensory nerve function in type 1 diabetic neuropathy 2007 Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 30:1, s. 71-76 Tidskriftsartikel (refereegranskat)abstract OBJECTIVE - C-peptide replacement in animals results in amelioration of diabetes-induced functional and structural abnormalities in peripheral nerves. The present study was undertaken to examine whether C-peptide administration to patients with type 1 diabetes and peripheral neuropathy improves sensory nerve function. RESEARCH DESIGN AND METHODS - This was an exploratory, double-blinded, randomized, and placebo-controlled study with three study groups that was carried out at five centers in Sweden. C-peptide was given as a replacement dose (1.5 mg/day, divided into four subcutaneous doses) or a dose three times higher (4.5 mg/day) during 6 months. Neurological examination and neurophysiological measurements were performed before and after 6 months of treatment with C-peptide or placebo. RESULTS - The age of the 139 patients who completed the protocol was 44.2 ± 0.6 (mean ± SE) years and their duration of diabetes was 30.6 ± 0.8 years. Clinical neurological impairment (NIA) (score >7 points) of the lower extremities was present in 86% of the patients at baseline. Sensory nerve conduction velocity (SCV) was 2.6 ± 0.08 SD below body height-corrected normal values at baseline and improved similarly within the two C-peptide groups (P < 0.007). The number of patients responding with a SCV peak potential improvement >1.0 m/s was greater in C-peptide-treated patients than in those receiving placebo (P < 0.03). In the least severely affected patients (SCV < 2.5 SD below normal at baseline, n = 70) SCV improved by 1.0 m/s (P < 0.014 vs. placebo). NIA score and vibration perception both improved within the C-peptide-treated groups (P < 0.011 and P < 0.002). A1C levels (7.6 ± 0.1% at baseline) decreased slightly but similarly in C-peptide- and placebo-treated patients during the study. CONCLUSIONS - C-peptide treatment for 6 months improves sensory nerve function in early-stage type 1 diabetic neuropathy.
21.	Ekberg, Karin (författare) Quantitation of gluconeogenesis in humans 1998 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Several methods have been introduced for estimating gluconeogenesis, but none provides a direct measurement without assumptions that condition the accuracy of the estimate. The aim of this work has been to develop a new method for quantitative studies of gluconeogenesis, applicable in humans. We postulated that by using (U-13C3) glyceroland application of mass isotopomer distribution analysis (MIDA) to the enrichments of 13C incorporated into blood glucose the contribution of gluconeogenesis to wholebody glucose production could be determined. However, when applied in healthy subjects fasted for 60 h, the estimated contribution was only 50-60% when close to 100% of the glucose production was expected to derive from gluconeogenesis. The values obtained were incompatible with glucose being formed from a single pool of triose phosphate in the liver, which was a condition for the validity of the method. Thus, we concluded that the MIDA technique based on administration of 13C-labeled glycerol does not provide a valid quantitation of gluconeogenesis in vivo. Gluconeogenesis can be estimated a few hours after ingestion of a dose of deuterated water that can be safely administered to humans (body water is enriched to 0.5%). The method is based on the incorporation of deuterium into the hydrogen bound to carbon 5 of glucose (C-5) formed by gluconeogenesis and to carbon 2 (C-2) of all newly formed glucose molecules (i.e formed after the ingestion of deuterated water). The contribution of gluconeogenesis to whole body glucose production thus equals the ratio of enrichments at C-5 to C-2. Simultaneously, glucose production can be estimated by isotope dilution technique using (6,6-2H2) glucose infusion. Together, the methods provide a quantitative measurement of gluconeogenesis. The applicability of the techniques rests on the conversion of the tracer hydrogens and their carbon into formaldehyde and its further polymerization to hexamethylenetetramine (HMT). Thereby, an accurate assessment of the enrichments is facilitated although body water has only been enriched to 0.5%. Moreover, the glucose rate of appearance can be determined without influence from the ingested deuterated water. Applied in healthy subjects in the overnight fasted state, approximately equal proportions of glucose production derived from gluconeogenesis and glycogenolysis. During continued fasting the contribution from gluconeogenesis increased gradually (54% at 14 h and 62% at 22 h), but in absolute terms it stayed constant between 14h and 22 h of fasting (5.5 µmol/kg/min). Thus, the fall in glucose production observed between 14 and 22 h of fasting, from 10.2 to 8.6 lµmol/kg/min, could be attributed to a decrease in the rate of glycogenolysis After 42 h of fasting almost all glucose produced (94%) derived from gluconeogenesls. In the overnight fasted state, gluconeogenesis, as reported above, may be equated with hepatic gluconeogenesis. This was evident from the application of catheterization technique in healthy subjects together with labeled glucose infusion for estimation across both splanchnic and renal tissues: in the 12 h fasted state, hepatic glucose production (the sum of net splanchnic output and glucose uptake to the splanchnic bed) accounted for 100% of whole body glucose production as measured by the isotope dilution technique. No net renal production of glucose and no or only a minimal fractional extraction of labeled glucose were found. In the 60 h fasted state, hepatic glucose production accounted for 80% of whole body glucose production. No renal extraction of glucose but a significant net renal glucose production were found. Thus the renal contribution to glucose production may represent 10-25% after 60 h of fasting.
22.	Ekberg, Olle, et al. (författare) Effect of barium sulfate contrast medium on rheology and sensory texture attributes in a model food 2009 Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 50:2, s. 131-138 Tidskriftsartikel (refereegranskat)abstract Background: The swallowing process can be visualized using videoradiography, by mixing food with contrast medium, e.g., barium sulfate (BaSO4), making it radiopaque. The sensory properties of foods may be affected by adding this medium. Purpose: To evaluate if and to what extent sensory and rheological characteristics of mango puree were altered by adding barium sulfate to the food. Material and Methods: This study evaluated four food samples based on mango puree, with no or added barium sulfate contrast medium (0%, 12.5%, 25.0%, and 37.5%), by a radiographic method, and measured sensory texture properties and rheological characteristics. The sensory evaluation was performed by an external trained panel using quantitative descriptive analysis. The ease of swallowing the foods was also evaluated. Results: The sensory texture properties of mango puree were significantly affected by the added barium in all evaluated attributes, as was the perception of particles. Moreover, ease of swallowing was significantly higher in the sample without added contrast medium. All samples decreased in extensional viscosity with increasing extension rate, i.e., all samples were tension thinning. Shear viscosity was not as dependent on the concentration of BaSO4 as extensional viscosity. Conclusion: Addition of barium sulfate to a model food of mango puree has a major impact on perceived sensory texture attributes as well as on rheological parameters. © 2009 Informa UK Ltd.
23.	Ekberg, Olle, et al. (författare) Flow properties of oral contrast medium formulations depend on the temperature 2010 Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 51:4, s. 363-367 Tidskriftsartikel (refereegranskat)abstract Background: During the therapeutic videofluoroscopic examination of swallowing, gradation of bolus volume, texture, and viscosity can be implemented to determine the optimal bolus characteristics in that particular patient. When a thickened liquid is given to a dysphagic patient it is served at room temperature. However, in these patients with a delayed oral and/or pharyngeal stage of swallow, the bolus is held for a long time in the oral cavity. The temperature of the thickened liquid thereby increases. Purpose: To study the rheological exploration (variation of viscosity with temperature) of thickened food used for radiologic swallowing examinations in patients with oral and pharyngeal dysfunction, in particular in mixtures of barium sulfate suspensions and in iodine solutions. Material and Methods: Deep-frozen mango purée was thawed at room temperature. It was then mixed with barium sulfate contrast medium to a density of 25% w/w. Resorce® Thicken Up was mixed at room temperature at two concentrations: 4.3% w/w (4.5 g thickener + 100 g distilled water) and 6.0% w/w (4.5 g thickener + 70 g distilled water). The thickener consisted of modified corn starch. Resorce® Thicken Up was also mixed at room temperature with two concentrations of an iodine contrast material, iohexol (Omnipaque®, 350 mg I/ml). The two concentrations were: 4.3% w/w (4.5 g thickener + 100 g iohexol) and 6% w/w (6 g thickener + 100 g iohexol). Measurements were carried out from 20°C to 37°C using a Stresstech HR rheometer. The rheometer was equipped with a concentric cylinder measuring system (inner cylinder 15 mm). Results: The samples containing thickener in water as well as in iohexol showed a dependence on thickener concentration and temperature. The mango purée with barium sulfate displayed very small temperature dependence. The thickener solutions in iohexol had significantly higher viscosity compared with the other thickener solutions and the mango purée. The relative decrease shows that mango purée, the 6% thickener solution in water, and solutions with iohexol exhibited similar relative viscosity change at different temperatures. Conclusion: Our conclusion is therefore that it is important always to make the solution with high precision. It is also of importance to observe how long the patient keeps the bolus in the mouth. This might vary and actually it may not be possible to influence this factor. When different types of thickeners are compared, it is important to take into account the temperature at which the thickener is observed.
24.	Ekberg, Sofie, et al. (författare) Does the menstrual cycle influence aerobic capacity in endurance-trained women? 2023 Ingår i: Research Quarterly for Exercise and Sport. - : Routledge. - 0270-1367 .- 2168-3824. Tidskriftsartikel (refereegranskat)abstract Purpose: The aim was to study if aerobic capacity varies during different phases of the menstrual cycle (MC) in endurance-trained female athletes.Methods: Ten endurance-trained eumenorrheic women performed a submaximal test followed by an incremental test until exhaustion three times during one MC, early follicular phase (EFP), late follicular phase (LFP), and midluteal phase (MLP). During the submaximal test, the respiratory exchange ratio (RER) and utilization of fat and carbohydrates were analyzed; and, during the incremental test, VO2 peak, maximal heart rate, utilization of fat and carbohydrates, and RER were analyzed. Lactate levels were analyzed at rest, during the submaximal test, and after the incremental test. The anaerobic threshold was determined at RER = 1.Results: No significant differences (p <.05) between the MC phases were seen in a maximal heart rate or VO2peak. Similarly, VO2, heart rate, RER, fatty acid oxidation, and carbohydrate oxidation at 70, 80, 90, and 100% of VO2peak did not differ significantly between MC phases. There were no significant differences between these phases in resting lactate before the test or during the submaximal tests, though there was a significant difference in lactate concentration 3 minutes after the incremental test between the EFP and the LFP (p =.043).Conclusion: This study did not display variations in physiological parameters between EFP, LFP, and MLP, indicating similar aerobic capacity despite hormonal variations. This knowledge may be useful when planning for competition in aerobic events.
25.	Ekberg, Sara, et al. (författare) Impact of the COVID-19 pandemic on lymphoma incidence and short-term survival - a Swedish Lymphoma Register Study 2024 Ingår i: Acta Oncologica. - : Medical Journals Sweden. - 0284-186X .- 1651-226X. ; 63, s. 164-168 Tidskriftsartikel (refereegranskat)abstract Background & purpose: The COVID-19 pandemic posed a large challenge for healthcare systems across the world. Comprehensive data on the impact of the COVID-19 pandemic on incidence and mortality in lymphoma are lacking.Patients/methods: Using data from the Swedish lymphoma register, we compare incidence and 1-year survival of lymphoma patients in Sweden before (2017-2019) and during the pandemic (2020 and 2021).Results: Fewer patients were diagnosed with lymphomas during March-June 2020, but the annual incidence rates for 2020 and 2021 were similar to those of 2017-2019. A larger proportion of patients presented with stage IV disease during 2021. There were no differences in other base-line characteristics nor application of active treatment in pre-pandemic and pandemic years. One-year overall survival was not inferior among lymphoma patients during the pandemic years compared to pre-pandemic years i.e., 2017-2019.Interpretation: The COVID-19 pandemic had limited impact on the incidence and mortality of lymphoma in Sweden.
26.	Ekberg, Sara, et al. (författare) Late effects in patients with mantle cell lymphoma treated with or without autologous stem cell transplantation 2023 Ingår i: Blood Advances. - : Elsevier. - 2473-9529 .- 2473-9537. ; 7:5, s. 866-874 Tidskriftsartikel (refereegranskat)abstract Studies on late effects in patients with mantle cell lymphoma (MCL) are becoming increasingly important as survival is improving, and novel targeted drugs are being introduced. However, knowledge about late effects is limited. The aim of this population-based study was to describe the magnitude and panorama of late effects among patients treated with or without high-dose chemotherapy with autologous stem cell transplantation (HD-ASCT). The study cohort included all patients with MCL, recorded in the Swedish Lymphoma Register, aged 18 to 69 years, diagnosed between 2000 and 2014 (N = 620; treated with HD-ASCT, n = 247) and 1:10 matched healthy comparators. Patients and comparators were followed up via the National Patient Register and Cause of Death Register, from 12 months after diagnosis or matching to December 2017. Incidence rate ratios of the numbers of outpatient visits, hospitalizations, and bed days were estimated using negative binomial regression models. In relation to the matched comparators, the rate of specialist and hospital visits was significantly higher among patients with MCL. Patients with MCL had especially high relative risks of infectious, respiratory, and blood disorders. Within this observation period, no difference in the rate of these complications, including secondary neoplasms, was observed between patients treated with and without HD-ASCT. Most of the patients died from their lymphoma and not from another cause or treatment complication. Taken together, our results imply that most of the posttreatment health care needs are related to the lymphoma disease itself, thus, indicating the need for more efficient treatment options.
27.	Ekberg, Sara, et al. (författare) Patient trajectories after diagnosis of diffuse large B-cell lymphoma—a multistate modelling approach to estimate the chance of lasting remission 2022 Ingår i: British Journal of Cancer. - : Springer Science and Business Media LLC. - 0007-0920 .- 1532-1827. ; 127:9, s. 1642-1649 Tidskriftsartikel (refereegranskat)abstract Background: Achieving lasting remission for at least 2 years is a good indicator for favourable prognosis long term after Diffuse large B-cell lymphoma (DLBCL). The aim of this study was to provide real-world probabilities, useful in risk communication and clinical decision-making, of the chance for lasting remissions by clinical characteristics. Methods: DLBCL patients in remission after primary treatment recorded in the Swedish Lymphoma register 2007–2014 (n = 2941) were followed for relapse and death using multistate models to study patient trajectories. Flexible parametric models were used to estimate transition rates. Results: At 2 years, 80.7% (95% CI: 79.0–82.2) of the patients were predicted to remain in remission and 13.2% (95% CI: 11.9–14.6) to have relapsed. The relapse risk peaked at 7 months, and the annual decline of patients in remission stabilised after 2 years. The majority of patients in the second remission transitioned into a new relapse. The probability of a lasting remission was reduced by 20.4% units for patients with IPI 4–5 compared to patients with IPI 0–1, and time in remission was shortened by 3.5 months. Conclusion: The long-term prognosis was overall favourable with 80% achieving durable first remissions. However, prognosis varied by clinical subgroups and relapsing patients seldom achieved durable second remissions.
28.	Ekberg, Sara, et al. (författare) Trends in the prevalence, incidence and survival of non-Hodgkin lymphoma subtypes during the 21st century - a Swedish lymphoma register study 2020 Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 189:6, s. 1083-1092 Tidskriftsartikel (refereegranskat)abstract Non-Hodgkin lymphoma (NHL) prognosis has improved in recent years, yet the number of patients living with the diagnosis, i.e. the prevalence, has seldom been reported. The prevalence provides a measure of the burden of disease, useful for healthcare planning and to optimise resource allocation. We provide a systematic presentation of temporal trends in absolute numbers of prevalent patients by NHL subtypes, linking them to trends in incidence, survival and mortality. Patients diagnosed 2000-2016 were identified in the national Swedish lymphoma register. Incidence and mortality rates, relative survival and prevalence were estimated for NHL overall and for major clinical and morphological subtypes. Poisson regression was used to test for temporal trends. Increasing incidence and improved survival have led to a 47% increase in the five-year prevalence of NHL overall in 2016 compared to 2004. An increasing prevalence was observed for all investigated subtypes during the study period, but most notably for diffuse large B cell lymphomas among aggressive subtypes (66%), and marginal zone lymphomas among indolent subtypes (135%). This dramatic increase in NHL prevalence underscores the need to develop and evaluate alternative follow-up schemes to use resources efficiently and still ensure optimal care of lymphoma survivors.
29.	Festin, Karin, et al. (författare) Choice of measure matters: A study of the relationship between socioeconomic status and psychosocial resources in a middle-aged normal population 2017 Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 12:8 Tidskriftsartikel (refereegranskat)abstract Psychosocial resources may serve as an important link to explain socioeconomic differences in health. Earlier studies have demonstrated that education, income and occupational status cannot be used interchangeably as indicators of a hypothetical latent social dimension. In the same manner, it is important to disentangle the effect of measuring different constructs of psychosocial resources. The aim of this study was therefore to analyse if associations between socioeconomic status (SES) and psychosocial resources differ depending on the measures used. A cross-sectional population-based study of a random sample (n = 1007) of middle-aged individuals (45-69 years old, 50% women) in Sweden was performed using questionnaire and register data. SES was measured as education, occupation, household income and self-rated economy. Psychosocial resources were measured as social integration, social support, mastery, self-esteem, sense of coherence (SOC) and trust. Logistic regression models were applied to analyse the relationships controlling for the effects of possible confounders. The measures of SES were low or moderately correlated to each other as were the measures of psychosocial resources. After controlling for age, sex, country of birth and employment status, household income and self-rated economy were associated with all six psychosocial resources; occupation was associated with three (social integration, self-esteem and trust) and education with two (social integration and self-esteem). Social integration and self-esteem showed a significant and graded relationship with all SES measures; trust was associated with all SES measures except education, whereas SOC and mastery were only associated with household income and self-rated economy. After controlling for other SES measures, no associations with psychosocial resources remained for education or occupation. In conclusion, associations between SES and psychosocial resources did differ depending on the measures used. The findings illustrate the importance of the choice of measure when investigating SES as well as psychosocial resources.
30.	Frisk, Gabriella, et al. (författare) No association between low-dose aspirin use and breast cancer outcomes overall : a Swedish population-based study 2018 Ingår i: Breast Cancer Research. - : BioMed Central. - 1465-5411 .- 1465-542X. ; 20 Tidskriftsartikel (refereegranskat)abstract Background: Results from previous studies indicate that use of low-dose aspirin may improve breast cancer prognosis. We evaluated aspirin use and breast cancer outcomes in relation to clinical characteristics as well as dose and duration of aspirin use.Methods: We used information from the Regional Breast Cancer Quality-of-Care Registries in three Swedish regions to identify 21,414 women diagnosed with a first stage I-III breast cancer between 1 April 2006 and 31 December 2012. The cohort was further linked to nationwide registers to retrieve information about dispensing low-dose aspirin before and after breast cancer diagnosis, comorbidity and causes of death. In a separate analysis, we investigated time to breast cancer death among 621 women with stage IV disease at diagnosis. Associations were evaluated using a multivariable Cox proportional hazards model.Results: Among women with stage I-III breast cancer, 2660 (12.4%) used low-dose aspirin shortly before breast cancer diagnosis and 4091 (19.1%) were users during follow-up. Women were followed for a median of 3.8years after diagnosis. There was no association between aspirin use and breast cancer-specific death in multivariable analyses (use before diagnosis: hazard ratio (HR) 0.93, 95% confidence interval (CI) 0.77-1.12; use after diagnosis: HR 1.00, 95% CI 0.74-1.37). Similarly, aspirin use was not associated with risk of first recurrence/metastases in a subgroup of stage I-III breast cancer patients (HR 0.97, 95% CI 0.86-1.10). However, in analyses stratified by stage, an inverse association between low-dose aspirin use after diagnosis and breast cancer death was found for women with stage I tumors (HR 0.53, 95% CI 0.29-0.96). Among women with stage IV disease at diagnosis, aspirin use was not associated with time to breast cancer death (HR 0.91, 95% CI 0.67-1.23).Conclusion: In this large population-based cohort study there was no evidence that low-dose aspirin use before or after breast cancer diagnosis is associated with a reduced risk of adverse outcomes overall in breast cancer. However, a potential benefit was noted among women with stage I tumors, warranting further investigation.
31.	Glimelius, Ingrid, 1975-, et al. (författare) Increased healthcare use up to 10 years among relapse-free Hodgkin lymphoma survivors in the era of intensified chemotherapy and limited radiotherapy 2017 Ingår i: American Journal of Hematology. - : WILEY. - 0361-8609 .- 1096-8652. ; 92:3, s. 251-258 Tidskriftsartikel (refereegranskat)abstract With today's excellent cure rates for Hodgkin lymphoma (HL), the number of long-term survivors is increasing. This study aims to provide a global assessment of late adverse effects for workingage HL survivors treated with contemporary protocols (combination chemotherapy and limited radiotherapy). From Swedish nationwide registers we identified 1017 HL survivors diagnosed in 2000-2009, aged 18-60 years (median 32) and surviving at least one year post-diagnosis, and 4031 age-,sex-, and calendar-year-matched population comparators. Incidence rate ratios (IRR) and 95% confidence intervals (95% CI) for outpatient visits and inpatient bed-days after the first year up to 14 years post-diagnosis (through 2013) were estimated across treatment subgroups, considering relapse-free time and using negative binomial regression. Scheduled outpatient visits for HL were excluded. The rate of outpatient visits was nearly double (IRR = 1.8, 95% CI: 1.6-2.0) that among comparators and higher rates persisted up to 10 years post-diagnosis. The rate of inpatient bed-days among relapse-free survivors was more than three-fold (IRR = 3.6, 95% CI: 2.74.7) that of comparators and the increase persisted up to four years post-diagnosis. Patients requiring 6-8 chemotherapy courses had higher rates of outpatient visits (IRR = 1.4, 95% CI: 1.11.7) and bed-days (IRR-4.7, 95% CI: 2.9-7.8) than patients treated with 2-4 courses+radiotherapy. Previously seldom reported reasons for the excess healthcare use included chest pain, keratitis, asthma, diabetes mellitus, and depression. Contemporary treatment, chemotherapy in particular, was associated with excess healthcare use among HL survivors during the first decade postdiagnosis. The reasons for healthcare visits reflected a wide range of disorders, indicating the need of broad individualized care in addition to specific screening programs.
32.	Glimelius, Ingrid, 1975-, et al. (författare) Stable use of radiotherapy in lymphoma patients over time : A comprehensive national overview of radiotherapy use in Sweden with focus on older patients 2024 Ingår i: Clinical and Translational Radiation Oncology. - : Elsevier. - 2405-6308. ; 46 Tidskriftsartikel (refereegranskat)abstract Background and purposeThe role of radiotherapy (RT) in lymphoma is constantly refined with the advent of novel treatments. However, RT is still an effective treatment and tolerability is high. Therefore, we aimed to describe the use of RT in primary treatment of lymphoma over calendar time, with a specific focus on older patients (age ≥ 70 years) with non-Hodgkin lymphoma (NHL) subtypes.Materials & MethodsAll adult patients diagnosed with lymphoma from 2007 to 2018 in Sweden were included and followed for survival until end of 2020. Patient characteristics and relative survival (RS) were described for patients with NHL by subtype and RT use.ResultsIn the cohort of lymphoma patients aged ≥ 70 years (n = 12,698) 11 % received RT as part of primary treatment. No decline in use of RT over calendar period was seen. Use of RT as monotherapy was associated with stage I-II disease and older age among patients with stage III-IV disease. Patients with indolent lymphomas aged ≥ 70 years who were selected for treatment with RT as monotherapy with a dose of ≥ 20 Gy had 2-year RS rate of 100 % which remained similar at five years. For patients with DLBCL, RT as monotherapy with a dose of ≥ 20 Gy was mostly administered to patients aged ≥ 85 years with a 2-year RS rate of 68 %.ConclusionThe use of RT in first-line lymphoma treatment was stable over calendar time. RT monotherapy is associated with encouraging outcomes among patients with NHL aged ≥ 70 years who were selected to receive this.
33.	Halje, Karin, et al. (författare) Towards mHealth Systems for Support of Psychotherapeutic Practice : A Qualitative Study of Researcher-Clinician Collaboration in System Design and Evaluation. 2016 Ingår i: International Journal of Telemedicine and Applications. - : Hindawi Publishing Corporation. - 1687-6415 .- 1687-6423. ; 2016 Tidskriftsartikel (refereegranskat)abstract We examined clinicians' and researchers' experiences from participation in collaborative research on the introduction of Internet and mobile information systems (mHealth systems) in psychotherapeutic routines. The study used grounded theory methodology and was set in a collaboration that aimed to develop and evaluate mHealth support of psychotherapy provided to young people. Soundness of the central objects developed in the design phase (the collaboration contract, the trial protocol, and the system technology) was a necessary foundation for successful collaborative mHealth research; neglect of unanticipated organizational influences during the trial phase was a factor in collaboration failure. The experiences gained in this study can be used in settings where collaborative research on mHealth systems in mental health is planned.
34.	Harrysson, Sara, et al. (författare) Outcomes for patients with secondary CNS involvement in relapsed/refractory diffuse large B-cell lymphoma and estimation of eligibility for CAR T-cell therapy 2024 Ingår i: LEUKEMIA & LYMPHOMA. - 1042-8194 .- 1029-2403. ; 65:4, s. 534-537 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
35.	Jerkeman, Mats, et al. (författare) Nationwide Assessment of Patient Trajectories in Mantle Cell Lymphoma : The Swedish MCLcomplete Project 2023 Ingår i: HemaSphere. - : Ovid Technologies (Wolters Kluwer Health). - 2572-9241. ; 7:8 Tidskriftsartikel (refereegranskat)abstract Mantle cell lymphoma (MCL) is a B-cell malignancy currently considered incurable. Although some patients obtain prolonged remission after first-line chemoimmunotherapy, many will need several treatment lines. Here, we present a nationwide assessment of treatment strategies, time to progression and survival in MCL. All patients diagnosed with MCL 2006-2018 were identified in the Swedish Lymphoma Register. Information on all lines of therapy was extracted from the medical records. Overall and progression-free survival (OS and PFS) were assessed through August 2021. In total, 1367 patients were included (median age, 71 years) and median follow-up was 6.8 years. Two hundred and one (15%) were managed initially with watch-and-wait, but 1235 (90%) eventually received treatment. The most frequently used first-line regimens were rituximab-bendamustine (BR) (n = 368; 30%) and Nordic MCL2 (n = 342; 28%). During follow-up, 630 patients (46%) experienced relapse/progression and 546 (40%) received second-line treatment. The most frequently used second-line regimen was BR (n = 185; 34%) but otherwise a wide variety of second-line treatments were used. Further, 382 and 228 patients experienced a second or third relapse/progression, respectively. Median PFS after first (PFS-1), second (PFS-2), third (PFS-3), and fourth (PFS-4) treatment lines was 29.4, 8.9, 4.3, and 2.7 months. Patients with early progression, defined as a PFS-1 <24 months, had an inferior median OS of 13 versus 37 months in patients with later relapse. For patients treated with frontline BR, however, time to relapse had no impact on later outcome. By use of nationwide population-based data, we provide important benchmarks for future studies of all treatment lines in MCL.
36.	Johansson Blight, Karin, et al. (författare) Medical and licit drug use in an urban/rural study population with a refugee background, 7-8 years into resettlement 2008 Ingår i: GMS Psycho-Social-Medicine. - 1860-5214. ; 5, s. 1-11 Tidskriftsartikel (refereegranskat)
37.	Johansson Blight, Karin, et al. (författare) Medical and licit drug use in an urban/rural study population with refugee background, 7-8 years into resettlement 2008 Ingår i: GMS Psycho-Social-Medicine. - 1860-5214. ; 5 Tidskriftsartikel (refereegranskat)abstract Objective: Research into medical and licit drug use in resettled refugee populations is scarce, despite the fact that mental health status often has been found to be poorer than in general populations. Hence the aim of this study was to estimate the prevalence of self-rated use of medicine and licit drugs among adults who came to Sweden from Bosnia-Herzegovina (1993/94) and who in 2001 were living in either an urban (low employment context) or a rural (high employment context) region (n=4185).Methods: Prevalence was estimated from a cross-sectional questionnaire distributed to a representative sample (n=650) in 2001 (63.5% response rate).Results: The study population estimates of usage of sedatives (26.5%), sleeping tablets (26.2%) and antidepressants (22.3%) did not differ by gender but did so by region, with a higher urban prevalence. The consumption of alcohol (5.1%) and cigarettes (41.0%) did not differ by region but men reported higher alcohol consumption than women.Conclusion: The high consumption of medicine (compared with general populations) raises the question of treatment efficiency and the need for public health attention and evaluation many years after resettlement. Factors to consider for further research with analytic prerequisites concern indications that regional differences may be influenced, not only by urban employment being lower but also by urban/rural differences in prescription rates and/or access to health care; moreover, there might have been a selection to the urban region of older people, with a more vulnerable family situation, and/or poorer mental health. Finally, the overall alcohol (low) and cigarettes (high) consumption in the study population followed prevalence patterns found in Bosnia-Herzegovina rather than in Sweden.
38.	Karlfeldt Fedje, Karin, 1977, et al. (författare) Initial studies of the recovery of Cu from MSWI fly ash leachates using solvent extraction 2012 Ingår i: Waste Management and Research. - 1096-3669 .- 0734-242X. ; 30:10, s. 1072-1080 Tidskriftsartikel (refereegranskat)abstract Large volumes of ash from combustion of municipal solid waste are produced and most of it is landfilled. As this type of ash contains significant amounts of metal compounds the landfilling strategy is not optimal when considered from a resource conservation perspective. A better situation would be created if metals were recovered from the ash. In the present study leaching and solvent extraction was applied for release and separation of copper from municipal solid waste combustion fly ashes. The results showed promising results with Cu yields of 50-95%. The yield was heavily dependent on the efficiency of the initial leaching of Cu from the ash.
39.	Karlfeldt Fedje, Karin, 1977, et al. (författare) Removal of hazardous metals from MSW fly ash-An evaluation of ash leaching methods 2010 Ingår i: Journal of Hazardous Materials. - : Elsevier BV. - 1873-3336 .- 0304-3894. ; 173:1-3, s. 310-317 Tidskriftsartikel (refereegranskat)abstract Incineration is a commonly applied management method for municipal solid waste (MSW). However, significant amounts of potentially hazardous metal species are present in the resulting ash, and these may be leached into the environment. A common idea for cleaning the ash is to use enhanced leaching with strong mineral acids. However, due to the alkalinity of the ash, large amounts of acid are needed and this is a drawback. Therefore, this work was undertaken in order to investigate some alternative leaching media (EDTA, ammonium nitrate, ammonium chloride and a number of organic acids) and to compare them with the usual mineral acids and water. All leaching methods gave a significant increase in ash specific surface area due to removal of soluble bulk (matrix) compounds, such as CaCO3 and alkali metal chlorides. The use of mineral acids and EDTA mobilised many elements, especially Cu, Zn and Pb, whereas the organic acids generally were not very effective as leaching agents for metals. Leaching using NH4NO3 was especially effective for the release of Cu. The results show that washing of MSW filter ash with alternative leaching agents is a possible way to remove hazardous metals from MSW fly ash.
40.	Leijon, Matti E., 1970-, et al. (författare) Factors associated with patients self-reported adherence to prescribed physical activity in routine primary health care 2010 Ingår i: BMC Family Practice. - London, UK : BioMed Central. - 1471-2296. ; 11:38 Tidskriftsartikel (refereegranskat)abstract Background: Written prescriptions of physical activity, so‐called physical activity referral (PAR) schemes, have increased in popularity in recent years. Such schemes have mostly been evaluated in terms of efficacy. This study reports on a Swedish PAR scheme implemented in routine primary health care (PHC) measuring patients’ self‐reported adherence to physical activity prescriptions. The aim of this study was to evaluate adherence to physical activity prescriptions issued in everyday PHC at 3 and 12 months and to analyse the different characteristics associated with adherence to these prescriptions.Methods: Prospective prescription data were obtained for 37 of the 42 PHC centres in Östergötland County, Sweden, during 2004. The study population consisted of 3300 patients issued PARs by ordinary PHC staff members. Odds ratios were calculated to identify the factors associated with adherence.Results: The average adherence rate was 56% at 3 months and 50% at 12 months. In the descriptive analyses, higher adherence was associated with increased age, higher activity level at baseline, home‐based activities, prescriptions issued by professional groups other than physicians, and among patients issued PARs due to diabetes, high blood pressure and “other PAR reasons”. In the multiple logistic regression models, higher adherence was associated with higher activity level at baseline, and to prescriptions including home‐based activities, both at 3 and 12 months.Conclusions: Prescriptions from ordinary staff in routine PHC yielded adherence in 50% of the patients in this routine care PAR scheme follow‐up. Patients’ activity level at baseline (being at least somewhat physically inactive) and being issued homebased activities were associated with higher adherence at both 3 and 12 months.
41.	Nilsson, Karin, et al. (författare) Physicians' experiences of challenges in working conditions related to the provision of care during the initial response to the COVID-19 pandemic in Sweden 2022 Ingår i: International Journal of Health Governance. - : Emerald Group Publishing Limited. - 2059-4631. ; 27:3, s. 254-267 Tidskriftsartikel (refereegranskat)abstract Purpose: This aim of this study was to explore how hospital-based physicians in Sweden experienced the challenges in working conditions related to the provision of care during the initial response to the COVID-19 pandemic in 2020 when hospitals transitioned to pandemic care. Design/methodology/approach: The study has a qualitative design. Twenty-five hospital-based physicians were interviewed about their experiences from working in a hospital while healthcare organisations initially responded to COVID-19 pandemic in 2020. A thematic analysis was used to analyse the empirical material. Findings: The analysis resulted in four themes: involuntary self-management, a self-restrictive bureaucracy, passive occupational safety and health (OSH) management, and information overload. These themes reflect how the physicians perceived their work situation during the pandemic and how they tried to maintain quality care for their patients. Practical implications: The study gives valuable insights for formulating preparedness in regard to crisis management plans that can secure the provision of care for future emergencies in the healthcare services. Originality/value: This paper shows that a crisis management plans in the healthcare services should include decision structures and management, measures of risk assessment and OSH management, and the maintenance of personnel wellbeing. A prepared healthcare management can preserve quality care delivery while under crisis.
42.	Norberg Brorsson, Birgitta, et al. (författare) Uppsatshandledning och skrivutveckling i högre utbildning : Om det självständiga arbetet och skrivande i alla ämnen 2012. - 1 Bok (övrigt vetenskapligt/konstnärligt)
43.	Nord, Carina, et al. (författare) Sick leave and disability pension among Swedish testicular cancer survivors according to clinical stage and treatment 2015 Ingår i: Acta Oncologica. - 1651-226X .- 0284-186X. ; 54:10, s. 1770-1780 Tidskriftsartikel (refereegranskat)abstract Purpose. To investigate if testicular cancer survivors (TCSs) have a higher incidence of work loss compared with the population, accounting for stage, treatment and relapse.Material and methods. A cohort of 2146 Swedish TCSs diagnosed 1995-2007 (seminoma n = 926, non-seminoma n = 1220) was identified in the SWENOTECA (Swedish-Norwegian Testicular Cancer Group) register, and matched 1:4 to population comparators. Prospectively recorded work loss data (both before and after diagnosis) were obtained from national registers through September 2013. Adjusted relative risks (RR) and 95% confidence intervals (CI) of sick leave and/or disability pension were calculated annually and overall with Poisson- and Cox regression, censoring at relapse. The mean number of annual work days lost was also estimated.Results. TCSs were at a modestly increased annual risk of work loss up to the third year of follow-up (RR3rd year 1.25, 95% CI 1.08, 1.43), attributed to a more pronounced risk among extensively treated patients (4 chemotherapy courses: RR3rd year 1.60, 95% CI 1.19, 2.15; > 4 courses: RR3rd year 3.70, 95% CI 2.25, 6.11). Patients on surveillance or limited treatment (radiotherapy, 1-3 chemotherapy courses) did not have an increased risk of work loss beyond the first year. TCSs receiving > 4 chemotherapy courses had higher mean number of annual days of work loss up to the 10th year post-diagnosis, and a five-fold risk of disability pension (RR 5.16, 95% CI 2.00, 10.3).Conclusion. Extensively treated TCSs, but not those on surveillance or limited treatment, are at increased risk of work loss long-term, not explained by relapse. These patients may benefit from early rehabilitation initiatives.
44.	Nordström, Karin, 1982-, et al. (författare) Rörlighet på arbetsmarknaden och återgång i arbete. Posterpresentation. 2011 Konferensbidrag (refereegranskat)
45.	Nordström, Karin, 1982-, et al. (författare) Sick leave and the impact of job-to-job mobility on future vocational situation. 2012 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
46.	Nordström, Karin, 1982-, et al. (författare) Sick leave and the impact of job-to-job mobility on the future vocational situation 2014 Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14:305 Tidskriftsartikel (refereegranskat)abstract Background: Change of job could be a strategy in vocational rehabilitation when return to the original job is not possible, but research is very limited concerning the effects of job mobility on the future vocational situation. The aim of the study was to investigate whether job-to-job mobility affects the likelihood of remaining on the labour market over time among persons who are employed and have experienced long-term sick leave.Methods: In a longitudinal register study, cohorts from three base years (1994, 1999 and 2004) were created, based on the Swedish population who were 20–60 years old, had sickness allowance insurance, and were employed in the base year and the following year (n > 3,000,000). The likelihood that individuals on long-term sick leave were employed later depending on whether or not they changed workplace during the present or next year of long-term sick leave was analyzed using logistic regression analysis. Age, sector, industry, children, marital status, education, income, rate of sick leave and earlier sick leave and earlier mobility were taken into consideration.Results: Women with more than 180 days’ sick leave who changed workplaces were more likely to have a job later compared with those who did not change jobs. For men, the association was statistically significant with 1994 and 2004 as base years, but not in the cohort from 1999.Conclusions: The present study indicates that for those on long-term sick leave that changed workplaces, the opportunities to stay on the labour market might increase. However, the study has methodological limitations and the results for men are ambiguous. We do not therefore have enough evidence for recommending job change as a strategy for vocational rehabilitation.
47.	Nordström, Karin, et al. (författare) Sick leave and the impact of job-to-job mobility on the likelihood of remaining on the labour market - a longitudinal Swedish register study 2014 Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14, s. 305- Tidskriftsartikel (refereegranskat)abstract Background: Change of job could be a strategy in vocational rehabilitation when return to the original job is not possible, but research is very limited concerning the effects of job mobility on the future vocational situation. The aim of the study was to investigate whether job-to-job mobility affects the likelihood of remaining on the labour market over time among persons who are employed and have experienced long-term sick leave. Methods: In a longitudinal register study, cohorts from three base years (1994, 1999 and 2004) were created, based on the Swedish population who were 20-60 years old, had sickness allowance insurance, and were employed in the base year and the following year (n > 3,000,000). The likelihood that individuals on long-term sick leave were employed later depending on whether or not they changed workplace during the present or next year of long-term sick leave was analyzed using logistic regression analysis. Age, sector, industry, children, marital status, education, income, rate of sick leave and earlier sick leave and earlier mobility were taken into consideration. Results: Women with more than 180 days' sick leave who changed workplaces were more likely to have a job later compared with those who did not change jobs. For men, the association was statistically significant with 1994 and 2004 as base years, but not in the cohort from 1999. Conclusions: The present study indicates that for those on long-term sick leave that changed workplaces, the opportunities to stay on the labour market might increase. However, the study has methodological limitations and the results for men are ambiguous. We do not therefore have enough evidence for recommending job change as a strategy for vocational rehabilitation.
48.	Nordström, Karin, et al. (författare) SICKNESS ABSENCE IN WORKPLACES : DOES IT REFLECT A HEALTHY HIRE EFFECT? 2016 Ingår i: International Journal of Occupational Medicine and Environmental Health. - : Nofer Institute of Occupational Medicine. - 1232-1087 .- 1896-494X. ; 29:2, s. 315-330 Tidskriftsartikel (refereegranskat)abstract Objectives: Sickness absence in workplaces may reflect working conditions. It may also reflect a healthy hire effect, i.e., that workplaces recruit individuals with experience of sickness absence differently. The purpose of the study was to determine if a history of sickness absence among recruits is associated with the average level of sickness absence in workplaces. Material and Methods: In a register-based follow-up study, Swedish workplaces with at least 5 employees in 2006 were selected (approximately 127 000 workplaces with 3.9 million employees). The workplaces were categorized according to the average workplace sickness absence in 2006 and the recruits were categorized according to the individual sickness absence in 2005. The workplaces with a high average level of sickness absence were more likely than those with a low level to hire employees with high sickness absence in the year preceding employment: men - odds ratio (OR) = 7.2, 95% confidence interval (CI): 6.6-7.8, women OR = 7.5, 95% CI: 6.9-8.1. Results: The results show that there is a greater likelihood of employing individuals with high levels of sickness absence in the workplaces with many days of the average sickness absence than in the workplaces with few days of the average sickness absence. Conclusions: The results suggest that sickness absence in workplaces may reflect a healthy hire effect.
49.	Nourbakhsh, Nima, et al. (författare) Effects of Corticosteroid Treatment on Mycophenolic Acid Exposure in Renal Transplant Patients—Results From the SAILOR Study 2021 Ingår i: Frontiers in Pharmacology. - : Frontiers Media SA. - 1663-9812. ; 12:September 2021 Tidskriftsartikel (refereegranskat)abstract Background: Mycophenolic acid (MPA) is a potent immunosuppressive agent used in solid organ transplantation. MPA exhibits large interindividual variation in dose-normalized plasma concentrations but is nevertheless usually prescribed as a fixed dose without use of therapeutic drug monitoring (TDM). Data on the effect of corticosteroid (CS) treatment on MPA concentrations during concomitant tacrolimus treatment remains sparse. Methods: Data is based on TDM of MPA area under the concentration curve (AUC) in 210 renal transplant recipients participating in the prospective, randomized, controlled, multi-center trial (SAILOR) where a steroid-free immunosuppressive regimen with mycophenolate mofetil (MMF) and low-dose tacrolimus was compared with a conventional prednisolone-based treatment regimen. Multilevel mixed-effects linear regression post-hoc analyses of MPA AUC was performed. Results: Median MPA AUC at baseline (within the first 2 weeks post-transplant) in patients taking 2 g MMF daily was 53 mgh/L (interquartile range: 43–69 mgh/L, min: 24—max: 117 mg*h/L). Between-patient variation in MPA AUC was up to 5-fold on the same MMF dose. Patients in the steroid-free group had 12.5% lower (95% CI; 3.2–20.9%, p = 0.01) MPA AUC levels at baseline compared to the steroid treated group. During follow-up (14 days–2 years post-transplant) there were no significant differences in MPA AUC between the groups with MPA AUC being 4.2% lower (95% CI: −4.8%−12,5%, p = 0.35) in the steroid-free vs standard treatment group in restricted analysis after multivariate adjustment for tacrolimus trough level, body weight, time after transplantation and MMF dose. MMF dose was positively correlated with MPA AUC (p < 0.001) whereas body weight was negatively correlated with MPA AUC (p < 0.001). MPA AUC was 0.4% (95% CI: 0.2–0.6%, p < 0.001) lower per 1 kg increase in weight. Tacrolimus trough levels had no significant effect on MPA AUC. Conclusion: Immunosuppression with CS during concomitant tacrolimus treatment was shortly after transplantation associated with a significantly higher MPA exposure but the effect was small and not maintained during follow-up. Low body weight was associated with higher MPA exposure, which suggests a potential for weight adjusted MMF dosing.
50.	Nyqvist, Johanna, et al. (författare) Differences in health related quality of life in the randomised ARTSCAN study; accelerated vs. conventional radiotherapy for head and neck cancer. A five year follow up 2016 Ingår i: Radiotherapy and Oncology. - : Elsevier BV. - 0167-8140 .- 1879-0887. ; 118:2, s. 335-341 Tidskriftsartikel (refereegranskat)abstract Background and purpose: Health related quality of life (HRQoL) was assessed in the randomised, prospective ARTSCAN study comparing conventional radiotherapy (CF) with accelerated radiotherapy (AF) for head and neck cancer. Material and methods: 750 patients with squamous cell carcinoma (of any grade and stage) in the oral cavity, oro-, or hypopharynx or larynx (except T1-2, NO glottic carcinoma) without distant metastases were randomised to either conventional fractionation (2 Gy/day, 5 days/week in 49 days, total dose 68 Gy) or accelerated fractionation (1.1 + 2.0 Gy/day, 5 days/week in 35 days, total dose 68 Gy). HRQoL was assessed with EORTC QLQ-C30, QLQ-H&N35 and HADS at baseline, at end of radiotherapy (eRT) and at 3 and 6 months and 1, 2 and 5 years after start of treatment. Results: The AF group reported HRQoL was significantly lower at eRT and at 3 months for most symptoms, scales and functions. Few significant differences were noted between the groups at 6 months and 5 years. Scores related to functional oral intake never reached baseline. Conclusion: In comparison to CF, AF has a stronger adverse effect on HRQoL in the acute phase.

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