| 1. |
- Alsterholm, Mikael, 1977, et al.
(författare)
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Establishment and utility of SwedAD : a nationwide Swedish registry for patients with atopic dermatitis receiving systemic pharmacotherapy
- 2023
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 103
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Tidskriftsartikel (refereegranskat)abstract
- SwedAD, a Swedish nationwide registry for patients with atopic dermatitis receiving systemic pharmacotherapy, was launched on 1 September 2019. We describe here the establishment of a user-friendly registry to the benefit of patients with atopic dermatitis. By 5 November 2022, 38 clinics had recorded 931 treatment episodes in 850 patients with an approximate national coverage rate of 40%. Characteristics at enrolment included median Eczema Area and Severity Index (EASI) 10.2 (interquartile range 4.0, 19.4), Patient-Oriented Eczema Measure (POEM) 18.0 (10.0, 24.0), Dermatology Life Quality Index (DLQI) 11.0 (5.0, 19.0) and Peak Itch Numerical Rating Scale-11 (NRS-11) 6.0 (3.0, 8.0). At 3 months, median EASI was 3.2 (1.0, 7.3) and POEM, DLQI, and NRS-11 were improved. Regional coverage varied, reflecting the distribution of dermatologists, the ratio of public to private healthcare, and difficulties in recruiting certain clinics. This study highlights the importance of a nationwide registry when managing systemic pharmacotherapy of atopic dermatitis.
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| 2. |
- Gu, Xiaolian, et al.
(författare)
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Epigenetic regulation of OAS2 shows disease-specific DNA methylation profiles at individual CpG sites
- 2016
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Epigenetic modifications are essential regulators of biological processes. Decreased DNA methylation of OAS2 (2'-5'-Oligoadenylate Synthetase 2), encoding an antiviral protein, has been seen in psoriasis. To provide further insight into the epigenetic regulation of OAS2, we performed pyrosequencing to detect OAS2 DNA methylation status at 11 promoter and first exon located CpG sites in psoriasis (n = 12) and two common subtypes of squamous cell carcinoma (SCC) of the head and neck: tongue (n = 12) and tonsillar (n = 11). Compared to corresponding controls, a general hypomethylation was seen in psoriasis. In tongue and tonsillar SCC, hypomethylation was found at only two CpG sites, the same two sites that were least demethylated in psoriasis. Despite differences in the specific residues targeted for methylation/demethylation, OAS2 expression was upregulated in all conditions and correlations between methylation and expression were seen in psoriasis and tongue SCC. Distinctive methylation status at four successively located CpG sites within a genomic area of 63 bp reveals a delicately integrated epigenetic program and indicates that detailed analysis of individual CpGs provides additional information into the mechanisms of epigenetic regulation in specific disease states. Methylation analyses as clinical biomarkers need to be tailored according to disease-specific sites.
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| 3. |
- Nylander, Lena, et al.
(författare)
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Insatser och behandling vid autismspektrumtillstånd
- 2013
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Ingår i: In: G. Thernlund (red.), ADHD och autismspektrum i ett livsperspektiv. En klinisk introduktion till utvecklingsrelaterade kognitivafunktionsproblem.. - Lund : Studentlitteratur.
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 4. |
- Adler, Mats, et al.
(författare)
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Diagnosdiskussion
- 2016
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Ingår i: Tidskriften för Svensk Psykiatri. - 1653-8579. ; 2016:1, s. 77-78
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Senaste halvåret har en arbetsgrupp på Svenska Psykiatriska Föreningens uppdrag arbetat med problem som finns runt psykiatriska diagnoser. En viktig del av arbetet har varit att ta fram ett diskussionsunderlag främst riktat till dem som i sitt arbete sätter psykiatriska diagnoser. Detta underlag syftar till att problematisera, inte till att polemisera. Självklart har vi i gruppen uppfattningar, men vi har inte alltid samma uppfattningar inom detta område. En sak är vi dock helt överens om – psykiatrisk diagnostik är svårt! samt att det idag finns uppenbara problem.
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| 5. |
- Adler, Mats, et al.
(författare)
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Psykiatrisk diagnostik är svårt.
- 2015
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Ingår i: Tidskriften för Svensk Psykiatri. - 1653-8579. ; 2015:4, s. 36-37
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Alonso, Lorena, et al.
(författare)
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TIGER : The gene expression regulatory variation landscape of human pancreatic islets
- 2021
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Ingår i: Cell Reports. - : Elsevier BV. - 2211-1247. ; 37:2
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Tidskriftsartikel (refereegranskat)abstract
- Genome-wide association studies (GWASs) identified hundreds of signals associated with type 2 diabetes (T2D). To gain insight into their underlying molecular mechanisms, we have created the translational human pancreatic islet genotype tissue-expression resource (TIGER), aggregating >500 human islet genomic datasets from five cohorts in the Horizon 2020 consortium T2DSystems. We impute genotypes using four reference panels and meta-analyze cohorts to improve the coverage of expression quantitative trait loci (eQTL) and develop a method to combine allele-specific expression across samples (cASE). We identify >1 million islet eQTLs, 53 of which colocalize with T2D signals. Among them, a low-frequency allele that reduces T2D risk by half increases CCND2 expression. We identify eight cASE colocalizations, among which we found a T2D-associated SLC30A8 variant. We make all data available through the TIGER portal (http://tiger.bsc.es), which represents a comprehensive human islet genomic data resource to elucidate how genetic variation affects islet function and translates into therapeutic insight and precision medicine for T2D.
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| 7. |
- Andersen, Lisa M. J., et al.
(författare)
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The Swedish Version of the Ritvo Autism and Asperger Diagnostic Scale: Revised (RAADS-R) : A Validation Study of a Rating Scale for Adults
- 2011
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Ingår i: Journal of autism and developmental disorders. - New, York, USA : Springer. - 0162-3257 .- 1573-3432. ; 41:12, s. 1635-1645
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Tidskriftsartikel (refereegranskat)abstract
- There is a paucity of diagnostic instruments for adults with autism spectrum disorder (ASD). This study evaluates the psychometric properties of the Swedish version of the Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R), an 80-item self-rating scale designed to assist clinicians diagnosing ASD in adults. It was administered to 75 adults with ASD and 197 comparison cases. Also, a subset completed the Autism Spectrum Quotient (AQ). Three out of four subscales had high internal consistency. Sensitivity was 91% and specificity was 93%. The ASD subjects had significantly higher mean scores on all subscales. ASD females had higher scores than ASD males on the sensory motor subscale, a dimension not included in the AQ. RAADS-R showed promising test re-test reliability.
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| 8. |
- Axmon, Anna, et al.
(författare)
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Psychiatric care utilization among older people with intellectual disability in comparison with the general population: a register study
- 2016
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Ingår i: Bmc Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: People with intellectual disability have been found to have higher prevalence of psychiatric disorders than the general population. However, they do not seem to have a corresponding increase in psychiatric care utilization. The aim of the present study was to investigate psychiatric care utilization among older people with intellectual disability. Methods: We used a cohort of people with intellectual disability, 55+ years in 2012 (n = 7936), and an equally sized age and sex matched reference cohort from the general population. Psychiatric care utilization was measured using registrations in the Swedish National Patient register during 2002-2012, where each registration corresponds to a psychiatric care occasion. Results: About 20 % of those with intellectual disability had at least one registration during the study period, compared to some 6 % in the general population sample. In the whole cohort as well as stratified by sex, people with intellectual disability were 3-4 times more likely than those in the general population sample to have had at least one registration during the study period. The effect was, however, only consistent in age groups comprising people younger than 65 years. Among people with intellectual disability, men were more likely than women to have had at least one registration, and people living in special housing (group home or service home) during the entire study period were less likely than those who only lived in special housing for parts of the study or not at all. People with intellectual disability had longer stays per inpatient registration compared with the general population sample. When stratifying on sex, the effect was found only among men, although there were no sex differences within the cohort of people with intellectual disability. Among people with intellectual disability, living in special housing during the entire study period was associated with shorter stays per inpatient registration. Conclusions: Although people with intellectual disability had higher psychiatric care utilization than the general population during the 11 year study period, it does not correspond to the high prevalence of psychiatric disorders in this population. Future research is required to establish if the level of care utilization is appropriate among older people with intellectual disability.
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| 9. |
- Backman, Ellen, 1981-, et al.
(författare)
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Metoder för att stimulera språk och kommunikation hos barn, ungdomar och vuxna inom habiliteringen
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Språkliga och kommunikativa begränsningar är vanligt förekommande vid ett flertal av de diagnoser och tillstånd som återfinns hos personer inom habiliteringsverksamheter i Sverige och förutsätter en tvärprofessionell och långvarig insats. Syftet med föreliggande arbete är att systematiskt beskriva bästa tillgängliga evidens avseende interventioner fokuserade på språklig och kommunikativ förmåga för personer med medfödda funktionsnedsättningar från sex års ålder och uppåt inom habiliteringsverksamhet. Arbetet kan ses som en fortsättning på EBH-rapporten ”Tidiga kommunikations- och språkinsatser till förskolebarn”.Internationellt publicerade interventionsstudier från de senaste 15 åren med fokus på språkliga och kommunikativa förmågor vid typiskt förekommande diagnoser inom habiliteringsverksamhet granskades och sammanfattades. Initialt inkluderades endast översiktsartiklar och metaanalyser, men då dessa till största delen hade fokus på autism och/eller Alternativ och Kompletterande Kommunikation (AKK) utökades sökningen till att även inkludera ett antal primärstudier med annat fokus. Rapporten omfattar 67 studier.Resultatet visar att ”stark rekommendation att använda” (enligt GRADE) endast förekommer i begränsad utsträckning, och när det förekommer är det vid insatser relaterade till autism och/eller AKK. ”Stark rekommendation att inte använda” finns vid insatser relaterade till akupunktur/akupressur och faciliterad kommunikation. Det kan konstateras att det finns en stor brist på studier avseende vuxna personer respektive intellektuell funktionsnedsättning.Detta arbete tillför ytterligare kunskap till området för evidensbaserade insatser vid svårigheter när det gäller kommunikation och språk, och visar att evidens i strikt bemärkelse är svår att erhålla bland annat beroende på de små och heterogena patientgrupperna och, som en konsekvens av detta, en brist på stora randomiserade studier.
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| 10. |
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| 11. |
- Bejerot, Susanne, 1955-, et al.
(författare)
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Low prevalence of smoking in patients with autism spectrum disorders
- 2003
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Ingår i: Psychiatry Research. - Claire, Ireland : Elsevier. - 0165-1781 .- 1872-7123. ; 119:1-2, s. 177-182
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Tidskriftsartikel (refereegranskat)abstract
- Psychiatric patients are significantly more often smokers than the general population, the only known exception being obsessive-compulsive disorder (OCD) and catatonic schizophrenia. We have investigated nicotine use in subjects with autism spectrum disorders (ASD). Ninety-five subjects (25 females and 70 males) consecutively diagnosed with any ASD and of normal intelligence were included in the study. Only 12.6% were smokers, compared with 19% in the general population and 47% in a control group of 161 outpatients diagnosed with schizophrenia or a schizophreniform disorder. The results suggest that smoking is rare among subjects with ASD, while the opposite was shown for schizophrenia. If replicated, this finding could suggest biological differences between non-catatonic schizophrenia and ASD, and support the theory of a biological link between ASD and a subtype of OCD, and between ASD and catatonic schizophrenia.
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| 12. |
- Benedict, Christian, et al.
(författare)
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Impaired Insulin Sensitivity as Indexed by the HOMA Score Is Associated With Deficits in Verbal Fluency and Temporal Lobe Gray Matter Volume in the Elderly
- 2012
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 35:3, s. 488-494
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVEImpaired insulin sensitivity is linked to cognitive deficits and reduced brain size. However, it is not yet known whether insulin sensitivity involves regional changes in gray matter volume. Against this background, we examined the association between insulin sensitivity, cognitive performance, and regional gray matter volume in 285 cognitively healthy elderly men and women aged 75 years from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study.RESEARCH DESIGN AND METHODSInsulin sensitivity was calculated from fasting serum insulin and plasma glucose determinations using the homeostasis model assessment of insulin resistance (HOMA-IR) method. Cognitive performance was examined by a categorical verbal fluency. Participants also underwent a magnetic resonance imaging (MRI) brain scan. Multivariate analysis using linear regression was conducted, controlling for potential confounders (sex, education, serum LDL cholesterol, mean arterial blood pressure, and abdominal visceral fat volume).RESULTSThe HOMA-IR was negatively correlated with verbal fluency performance, brain size (S1), and temporal lobe gray matter volume in regions known to be involved in speech production (Brodmann areas 21 and 22, respectively). No such effects were observed when examining diabetic (n = 55) and cognitively impaired (n = 27) elderly subjects as separate analyses.CONCLUSIONSThese cross-sectional findings suggest that both pharmacologic and lifestyle interventions improving insulin signaling may promote brain health in late life but must be confirmed in patient studies.
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| 13. |
- Björne, Petra, et al.
(författare)
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Passing laws is not enough to change staff practice: The case of legally mandated "incident" reporting in Sweden
- 2021
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Ingår i: Journal of Intellectual & Developmental Disability. - : Informa UK Limited. - 1366-8250 .- 1469-9532.
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Tidskriftsartikel (refereegranskat)abstract
- Background It is mandatory for staff in Swedish community services for people with intellectual disabilities to report incidents of error or malpractice. Aim The aim is to study if incident reports contribute to developing quality in services for people with intellectual disabilities who present with challenging behaviours. Method 159 reports on incidents from group homes and daily activities services were accessed and analysed using narrative thematic analysis. Results Most reports concerned altercations between service users. Analysis focused mainly on the immediate incident and attributes of service users. Amendments were not (obviously) aligned with causes, and neither sufficiently addressed structural shortcomings. Restrictive measures were described, but changes in practices were not mentioned. Reports including Self-injurious behaviour (SIB) were conspicuously absent. Conclusion Reports are handled in a seemingly perfunctory manner, without any development. Quality development relying on staff reports and front-line managers' investigations requires support based on values rather than on the legal framework.
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| 14. |
- Björne, Petra, et al.
(författare)
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The Use of Restrictive Measures in Community Services for People With Intellectual Disabilities in Sweden
- 2022
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Ingår i: Journal of Policy and Practice in Intellectual Disabilities. - : Wiley. - 1741-1122 .- 1741-1130. ; 19:2, s. 193-201
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Tidskriftsartikel (refereegranskat)abstract
- Background Community services for Swedish people with intellectual disability (ID) are intended to support self-determination and integrity. Legislation does not allow the use of restrictive or coercive measures. Aim The aim of this study is to identify the extent of, rationale for, and strategies staff believe would reduce the use of restrictive measures in group homes and daily activities services for people with ID. Method A survey was sent to all staff in group homes and daily activities in one large Swedish municipality. The survey comprised four Likert style questions and one free text question, addressing the type of and reasons for restrictive measures, and how much staff value their replacement. A total of 250 surveys were completed. Results A third of staff reported that some restrictive measures were used daily or weekly, primarily to protect and support service users. Adequate numbers of staff, better service design, and training were considered necessary for change. Conclusion Staff report structural reasons, such as staffing, resources time, lack of training, and supervision for using restrictive measures. Staff see reducing the use of restrictive measures as requiring structural changes with engagement from the whole organization.
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| 15. |
- Boldrup, Linda, et al.
(författare)
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Evidence that circulating proteins are more promising than miRNAs for identification of patients with squamous cell carcinoma of the tongue
- 2017
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Ingår i: Oncotarget. - : IMPACT JOURNALS LLC. - 1949-2553. ; 8:61, s. 103437-103448
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Tidskriftsartikel (refereegranskat)abstract
- Despite intense research, squamous cell carcinoma of the tongue remains a devastating disease with a five-year survival of around 60%. Late detection and recurrence are the main causes for poor survival. The identification of circulating factors for early diagnosis and/or prognosis of cancer is a rapidly evolving field of interest, with the hope of finding stable and reliable markers of clinical significance. The aim of this study was to evaluate circulating miRNAs and proteins as potential factors for distinguishing patients with tongue squamous cell carcinoma from healthy controls. Array-based profiling of 372 miRNAs in plasma samples showed broad variations between different patients and did not show any evidence for their use in diagnosis of tongue cancer. Although one miRNA, miR-150, was significantly down-regulated in plasma from patients compared to controls. Surprisingly, the corresponding tumor tissue showed an up-regulation of miR-150. Among circulating proteins, 23 were identified as potential markers of squamous cell carcinoma of the tongue. These findings imply that circulating proteins are a more promising source of biomarkers for tongue squamous cell carcinomas than circulating miRNAs. The data also highlight that circulating markers are not always directly associated with tumor cell properties.
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| 16. |
- Boldrup, Linda, et al.
(författare)
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Gene expression changes in tumor free tongue tissue adjacent to tongue squamous cell carcinoma
- 2017
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Ingår i: Oncotarget. - : Impact Journals, LLC. - 1949-2553. ; 8:12, s. 19389-19402
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Tidskriftsartikel (refereegranskat)abstract
- Due to the high frequency of loco-regional recurrences, which could be explained by changes in the field surrounding the tumor, patients with squamous cell carcinoma of head and neck show poor survival. Here we identified a total of 554 genes as dysregulated in clinically tumor free tongue tissue in patients with tongue tumors when compared to healthy control tongue tissue. Among the top dysregulated genes when comparing control and tumor free tissue were those involved in apoptosis (CIDEC, MUC1, ZBTB16, PRNP, ECT2), immune response (IFI27) and differentiation (KRT36). Data suggest that these are important findings which can aid in earlier diagnosis of tumor development, a relapse or a novel squamous cell carcinoma of the tongue, in the absence of histological signs of a tumor.
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| 17. |
- Boldrup, Linda, et al.
(författare)
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Levels of MUC1 in tumours and serum of patients with different sub-types of squamous cell carcinoma of the head and neck
- 2020
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Ingår i: Oncology Letters. - : Spandidos Publications. - 1792-1074 .- 1792-1082. ; 20:2, s. 1709-1718
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Tidskriftsartikel (refereegranskat)abstract
- Mucin 1 (MUC1) is a membrane-bound and secreted glycoprotein that has a protective role in surface epithelia. We recently demonstrated that MUC1 mRNA expression was upregulated in tumour-free tongue tissues adjacent to squamous cell carcinoma of the oral tongue (SCCOT) compared with that in the tumour tissues. The present study investigated MUC1 protein in SCCOT tissue and serum from patients with squamous cell carcinoma of the head and neck (SCCHN) at different sub-sites. The results from immunohistochemistry demonstrated that all SCCOT tissues expressed MUC1; however, the protein levels were not correlated with MUC1 mRNA levels in the same tumours. Furthermore, serum MUC1 level was lower in patients with SCCOT, tonsil SCC and gingival SCC compared with that in healthy subjects; however, the difference was only significant for patients with SCCOT (P=0.0421). No correlation was seen between MUC1 level in tumour tissues and MUCI level in serum from the same patients. The absence of correlation between MUC1 protein and mRNA levels in SCCOT tissues emphasized the importance of validating genomic data in clinical samples. Although significant MUC1 downregulation was observed in the serum of patients with SCCOT, there was a large variation within the groups, suggesting that MUC1 may not be used as a biomarker for these types of tumors.
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| 18. |
- Brooks, Samantha J, et al.
(författare)
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Late-life obesity is associated with smaller global and regional gray matter volumes : a voxel-based morphometric study
- 2013
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Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 37:2, s. 230-236
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Obesity adversely affects frontal lobe brain structure and function. Here we sought to show that people who are obese versus those who are of normal weight over a 5-year period have differential global and regional brain volumes.DESIGN: Using voxel-based morphometry, contrasts were done between those who were recorded as being either obese or of normal weight over two time points in the 5 years prior to the brain scan. In a post-hoc preliminary analysis, we compared scores for obese and normal weight people who completed the trail-making task.SUBJECTS: A total of 292 subjects were examined following exclusions (for example, owing to dementia, stroke and cortical infarcts) from the Prospective Investigation of the Vasculature in Uppsala Seniors cohort with a body mass index of normal weight (<25 kg m−2) or obese (30 kg m−2).RESULTS: People who were obese had significantly smaller total brain volumes and specifically, significantly reduced total gray matter (GM) volume (GMV) (with no difference in white matter or cerebrospinal fluid). Initial exploratory whole brain uncorrected analysis revealed that people who were obese had significantly smaller GMV in the bilateral supplementary motor area, bilateral dorsolateral prefrontal cortex (DLPFC), left inferior frontal gyrus and left postcentral gyrus. Secondary more stringent corrected analyses revealed a surviving cluster of GMV difference in the left DLPFC. Finally, post-hoc contrasts of scores on the trail-making task, which is linked to DLPFC function, revealed that obese people were significantly slower than those of normal weight.CONCLUSION: These findings suggest that in comparison with normal weight, people who are obese have smaller GMV, particularly in the left DLPFC. Our results may provide evidence for a potential working memory mechanism for the cognitive suppression of appetite that may lower the risk of developing obesity in later life.
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| 19. |
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| 20. |
- Carlhäll, Carljohan, 1973-, et al.
(författare)
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Atrioventricular plane displacement correlates closely to circulatory dimensions but not to ejection fraction in normal young subjects
- 2001
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Ingår i: Clinical Physiology. - : Wiley. - 0144-5979 .- 1365-2281. ; 21:5, s. 621-628
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Tidskriftsartikel (refereegranskat)abstract
- Aims Mitral atrioventricular plane displacement (AVPD) provides information about left ventricular systolic function. M-mode of systolic annulus amplitude or tissue Doppler imaging of systolic annulus velocity are the current methods of evaluating AVPD. A correlation to ejection fraction (EF) has been demonstrated in patients with coronary artery disease and left ventricular dysfunction. Our aim was (i) to investigate the mitral AVPD of normal subjects with different physical work capacities and (ii) to further evaluate AVPD as an index of left ventricular systolic function.Methods and results Twenty-eight healthy men mean age 28 years (20–39) were included: endurance trained (ET) (n=10), strength trained (ST) (n=9) and untrained (UT) (n=9). The systolic AVPD was recorded at four sites, septal, lateral, anterior and posterior, using M-mode. Left ventricular volumes were calculated according to Simpson’s rule. Systolic AVPD was higher in endurance trained, 16·9 ± 1·5 mm, as compared with both strength trained, 13 ± 1·6 (P<0·001) and untrained, 14 ± 1·6 (P<0·001). Left ventricular systolic AVPD correlated strongly with end-diastolic volume (r=0·82), stroke volume (r=0·80) and maximal oxygen consumption per body weight (r=0·72). The correlation between AVPD and EF was poor (r=0·22).Conclusion In the subjects studied, with a range of normal cardiac dimensions, AVPD correlated to stroke volume, end-diastolic volume and maximal oxygen consumption per body weight, but not to EF. On theoretical grounds, it also seems reasonable that a dimension like AVPD is related to other cardiac dimensions and volumes, rather than to a fraction, like EF. AVPD is one parameter that is useful for evaluation of left ventricular systolic function but is not interchangeable with other measurements such as EF.
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| 21. |
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| 22. |
- Fernell, Elisabeth, 1948, et al.
(författare)
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ADHD bör uppmärksammas mer - tidiga insatser spar lidande.
- 2014
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Ingår i: Läkartidningen. - 0023-7205. ; 111
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Tidskriftsartikel (refereegranskat)abstract
- ADHD is a common neurodevelopmental/neuropsychiatric disorder affecting about 5 percent of children. About 2-3 percent meet diagnostic criteria in adulthood as well. The core symptoms include inattention with or without hyperactivity/restlessness and impulsivity. The main cognitive deficit involves executive functions, probably related to a weak reward system. Symptoms will affect daily functioning at home, among friends and at school/work. In girls and women particularly, a correct diagnosis of ADHD is often late, or is not at all appropriately considered. Co-existing disorders are common; dyslexia, developmental coordination disorder, emotional lability, conduct disorder, autistic symptoms, obsessive compulsive disorder, depression, bipolar disorder, Tourette syndrome, eating disorder, sleeping disorder, and substance abuse. Extensive research in ADHD has increased knowledge in genetics, neurobiology, neuropsychology, intervention, and treatment. Despite this, many individuals with ADHD are not offered a correct assessment, and accordingly, not given appropriate support and treatment.
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| 23. |
- Forsberg, Lena, 1983-
(författare)
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Cardiac Function and Aortic Valve Intervention : Echocardiographic Studies of Myocardial Recovery in Patients with Severe Aortic Valve Disease
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In patients with severe aortic valve disease, aortic valve intervention is performed when the risk for mortality or morbidity with conservative management is significantly increased. Left ventricular (LV) longitudinal motion decreases before conventional echocardiographic measures such as ejection fraction, are influenced in patients with severe aortic valve disease. This thesis is devoted to the assessment of cardiac function, including ventricular longitudinal motion, by echocardiography before and after aortic valve intervention in patients with chronic severe aortic regurgitation (AR) or severe aortic stenosis (AS).Patients with chronic AR (n=29) were studied preoperatively, and 6 months and 4 years postoperatively by echocardiography, including tissue Doppler imaging, at rest and during exercise. LV longitudinal function (atrioventricular plane displacement, AVPD, and peak systolic velocity, PSV) decreased postoperatively, and patients with low PSV continued to show reduced longitudinal function 6 months after surgery. Preoperative exercise echocardiographic variables showed a strong correlation to late LV function variables, while preoperative variables obtained at rest were not useful for prediction. Exercise echocardiography and longitudinal LV function could therefore be useful complements in the timing of aortic valve surgery for AR.Patients with chronic AR (n=29) were studied preoperatively, and 6 months and 4 years postoperatively by echocardiography, including tissue Doppler imaging, at rest and during exercise. LV longitudinal function (atrioventricular plane displacement, AVPD, and peak systolic velocity, PSV) decreased postoperatively, and patients with low PSV continued to show reduced longitudinal function 6 months after surgery. Preoperative exercise echocardiographic variables showed a strong correlation to late LV function variables, while preoperative variables obtained at rest were not useful for prediction. Exercise echocardiography and longitudinal LV function could therefore be useful complements in the timing of aortic valve surgery for AR.
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| 24. |
- Forsberg, Lena M, et al.
(författare)
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Differences in recovery of left and right ventricular function following aortic valve interventions : a longitudinal echocardiographic study in patients undergoing surgical, transapical or transfemoral aortic valve implantation
- 2013
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Ingår i: Catheterization and cardiovascular interventions. - : Wiley. - 1522-1946 .- 1522-726X. ; 82:6, s. 1004-1014
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesTo evaluate longitudinal left and right ventricular function (LVF and RVF) after transcatheter aortic valve implantation (TAVI) as compared to surgical aortic valve replacement (SAVR) and LVF and RVF after TAVI by the transfemoral (TF) or transapical (TA) approach.BackgroundKnowledge about differences in recovery of LVF and RVF after TAVI and SAVR is scarce.MethodsSixty patients (age 81 ± 7 years, logistic EuroSCORE 16 ± 10%), undergoing TAVI (TF: n = 35 and TA: n = 25), were examined by echocardiography including atrioventricular plane displacement (AVPD) and peak systolic velocities (PSV) by tissue Doppler at basal RV free wall, LV lateral wall and septum preprocedurally, 7 weeks and 6 months postprocedurally. Twenty-seven SAVR patients were matched to 27 TAVI patients by age, gender and LVF.ResultsEarly postintervention, TAVI patients had improved longitudinal LVF. However, when analyzed separately, only TF, but not TA patients, had improved LV lateral and septal AVPD and PSV (all P ≤ 0.01). All TAVI patients, as well as the TF and TA group had unchanged longitudinal LVF between the early and late follow-ups (all P > 0.05). The SAVR group had higher septal LVF than the matched TAVI group preprocedurally, while postoperatively this difference was diminished. Longitudinal RVF was better in the TF group than in the TA group pre- and postprocedurally. Although the SAVR group had superior longitudinal RVF preoperatively, this was inferior to TAVI postoperatively.Conclusions Postprocedural longitudinal LVF and RVF in patients undergoing TF-TAVI, TA-TAVI, or SAVR differ considerably. Preservation of longitudinal RVF after TAVI might influence the selection of aortic valve intervention in the future.
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| 25. |
- Forsberg, Lena M, et al.
(författare)
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Exercise echocardiography predicts postoperative left ventricular remodeling in aortic regurgitation
- 2014
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Ingår i: SCANDINAVIAN CARDIOVASCULAR JOURNAL. - : Informa Healthcare. - 1401-7431 .- 1651-2006. ; 48:1, s. 4-12
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Tidskriftsartikel (refereegranskat)abstract
- Objective. We aimed to investigate if preoperative left ventricular (LV) function assessed by exercise echocardiography could predict late postoperative LV function in aortic regurgitation (AR) patients and to evaluate how LV long-axis function is affected late after aortic valve surgery. Design. A total of 21 male chronic AR patients, aged 49 (12) years, accepted for surgery were examined preoperatively, 6 months-, and 4 years postoperatively, at rest and during exercise. Besides conventional echocardiographic parameters, the atrioventricular plane displacement (AVPD) by M-mode and peak systolic velocity (s) in the basal LV by color tissue Doppler were measured. Results. Preoperatively EFrest and EFexercise, were 55(7)% and 54(9)%, respectively, and Delta EF 0(8)%. LV dimensions and volumes indexed to BSA had decreased at the 6-month follow-up and were stable at late follow-up. s(rest), s(exercise), AVPD(rest), and AVPD(exercise) were unchanged at both the postoperative examinations (all P >= 0.05). Preoperative EFexercise and AVPD(exercise) showed inverse correlation to late postoperative indexed LV enddiastolic volume (r = -0.68, p < 0.004 and r = -0.86, P < 0.001) and indexed LV endsystolic volume (r = -0.68, P = 0.004 and r = -0.81, P < 0.001), while there was no correlation to preoperative EFrest and AVPD(rest) (all r < 0.2). Conclusions. Preoperative exercise echocardiography can detect AR patients with suboptimal LV remodeling late postoperatively.
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| 26. |
- Forsberg, Lena M, et al.
(författare)
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Left and right ventricular function in aortic stenosis patients 8 weeks post-transcatheter aortic valve implantation or surgical aortic valve replacement
- 2011
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Ingår i: European Journal of Echocardiography. - : Oxford University Press (OUP). - 1525-2167 .- 1532-2114. ; 12:8, s. 603-611
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Tidskriftsartikel (refereegranskat)abstract
- Aims Knowledge of longitudinal left and right ventricular (LV and RV) function after transcatheter aortic valve implantation (TAVI) is scarce. We hypothesized that the longitudinal systolic biventricular function in aortic stenosis (AS) patients is affected differently by TAVI and surgical aortic valve replacement (SAVR). less thanbrgreater than less thanbrgreater thanMethods and results Thirty-three AS patients (all-TAVI group, age 81 +/- 9 years, 18 female), with EuroSCORE 18 +/- 9%, were accepted for TAVI. Seventeen of these patients were matched (by gender, age, and LV function) to 17 patients undergoing SAVR. Conventional echocardiographic parameters, systolic atrioventricular plane displacement (AVPD) at standard sites and peak systolic velocity (PSV) by pulsed tissue Doppler at basal RV free wall, LV lateral wall, and septum were studied before and 8 weeks after the procedure. Procedural success was 100%, and 30-day mortality 9%. In all TAVI patients, AVPD(lateral), PSV(lateral), AVPD(septal), and PSV(septal) increased (P andlt; 0.001, 0.003, 0.006 and 0.002). When studying the matched patients postoperatively, both the SAVR and TAVI patients had increased PSV(lateral) and AVPD(lateral) (SAVR: P = 0.03 and P = 0.04, TAVI: P = 0.04 and P = 0.01). The PSV(RV) increased in the all-TAVI group (P = 0.007), while the AVPD(RV) was unchanged. SAVR patients had decreased AVPD(RV) (P = 0.001) and PSV(RV) (P = 0.004), while the matched TAVI patients had unchanged RV function parameters. less thanbrgreater than less thanbrgreater thanConclusion An improvement in regional longitudinal LV function in the septal and lateral wall could be seen after TAVI. Among the matched patients, both the TAVI and SAVR patients seemed to improve LV function in the lateral wall. RV systolic function increased in TAVI patients, but was impaired in the matched SAVR group at the 8-week follow-up.
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| 27. |
- Fusar-Poli, Laura, et al.
(författare)
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Psychometric properties of the Autism Spectrum Disorder in Adults Screening Questionnaire (ASDASQ) in a sample of Italian psychiatric outpatients
- 2020
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Ingår i: Research in Autism Spectrum Disorders. - : Elsevier BV. - 1750-9467. ; 78
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Tidskriftsartikel (refereegranskat)abstract
- Background: The present study aimed to examine the reliability and validity of the Italian version of the Autism Spectrum Disorder in Adults Screening Questionnaire (ASDASQ), a screening tool for autism spectrum disorder (ASD) among psychiatric outpatients. Methods: We recruited 340 subjects via an outpatient psychiatric service in Italy. Forty-eight had a diagnosis of ASD, confirmed after a comprehensive clinical assessment and the administration of the Autism Diagnostic Observation Schedule-2 (ADOS-2). The remaining 292 participants had other diagnoses, confirmed after a careful psychiatric evaluation and the administration of the Structured Clinical Interview for DSM-5 (SCID-5). The ASDASQ was administered to contact clinicians of each subject. Results: The ASDASQ showed outstanding accuracy (AUC = 0.96) in discriminating between ASD and non-ASD patients, with good sensitivity (0.85) and specificity (0.92). Agreement with clinical diagnosis was substantial (k = 0.68). Internal consistency of the tool was good (Cronbach's alpha = 0.82), while intra- (ICC = 0.97) and inter-rater reliability (ICC = 0.92) were excellent. We found also a moderate correlation between ASDASQ and ADOS-2 scores in the ASD sample (r = 0.56). Conclusion: Our findings suggest that the ASDASQ, in the Italian adaptation, may be considered a quick, simple, and effective tool to screen for ASD among psychiatric outpatients. Further studies are needed to evaluate its utility in other clinical settings.
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| 28. |
- Gu, Xiaolian, 1976-, et al.
(författare)
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Copy number variation : A prognostic marker for young patients with squamous cell carcinoma of the oral tongue
- 2019
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Ingår i: Journal of Oral Pathology & Medicine. - : John Wiley & Sons. - 0904-2512 .- 1600-0714. ; 48:1, s. 24-30
-
Tidskriftsartikel (refereegranskat)abstract
- Background The incidence of squamous cell carcinoma of the oral tongue (SCCOT) is increasing in people under age 40. There is an urgent need to identify prognostic markers that help identify young SCCOT patients with poor prognosis in order to select these for individualized treatment. Materials and methods To identify genetic markers that can serve as prognostic markers for young SCCOT patients, we first investigated four young (<= 40 years) and five elderly patients (>= 50 years) using global RNA sequencing and whole-exome sequencing. Next, we combined our data with data on SCCOT from the cancer genome atlas (TCGA), giving a total of 16 young and 104 elderly, to explore the correlations between genomic variations and clinical outcomes. Results In agreement with previous studies, we found that SCCOT from young and elderly patients was transcriptomically and also genomically similar with no significant differences regarding cancer driver genes, germline predisposition genes, or the burden of somatic single nucleotide variations (SNVs). However, a disparate copy number variation (CNV) was found in young patients with distinct clinical outcome. Combined with data from TCGA, we found that the overall survival was significantly better in young patients with low-CNV (n = 5) compared to high-CNV (n = 11) burden (P = 0.044). Conclusions Copy number variation burden is a useful single prognostic marker for SCCOT from young, but not elderly, patients. CNV burden thus holds promise to form an important contribution when selecting suitable treatment protocols for young patients with SCCOT.
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| 29. |
- Gu, Xiaolian, 1976-, et al.
(författare)
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High immune cytolytic activity in tumor-free tongue tissue confers better prognosis in patients with squamous cell carcinoma of the oral tongue
- 2019
-
Ingår i: The journal of pathology. Clinical research. - : John Wiley & Sons. - 2056-4538. ; 5:4, s. 240-247
-
Tidskriftsartikel (refereegranskat)abstract
- Immune cells and cytolytic activity within the tumor microenvironment are being intensively studied. Through transcriptome profiling, immune cell enumeration using the xCell tool and cytolytic activity quantification according to granzyme A (GZMA) and perforin (PRF1) mRNA levels, we investigated immunoreactivity in tumor and/or tumor‐free tongue tissue samples from 31 patients with squamous cell carcinoma of the oral tongue and 14 healthy individuals (control tongue tissues). We found significantly altered immune cell compositions (p < 0.001) and elevated cytolytic activity (p < 0.001) in tumor compared to tumor‐free samples, and altered infiltration of a subset of immune cells (e.g. CD8+ T cells, p < 0.01) as well as increased cytolytic activity (p < 0.001) in tumor‐free compared to control samples. Controlling for patient age at diagnosis and tumor stage, Cox regression analysis showed that high cytolytic activity in tumor‐free samples associated with improved disease‐free survival (hazard ratio= 4.20, 95% CI = 1.09–16.20, p = 0.037). However, the degree of cytolytic activity in tumor samples did not provide prognostic information. Taken together, our results show the presence of cancer‐related immune responses in clinically tumor‐free tongue in patients with squamous cell carcinoma of the oral tongue. Measuring cytolytic activity in tumor‐free tongue samples contralateral to tumor might thus be an effective approach to predict clinical outcome.
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| 30. |
- Hagström, Emil, et al.
(författare)
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Plasma parathyroid hormone is associated with vascular dementia and cerebral hyperintensities in two community-based cohorts
- 2014
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 99:11, s. 4181-4189
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Tidskriftsartikel (refereegranskat)abstract
- Context: In diseases with increased PTH such as hyperparathyroidism and chronic renal failure, dementia is common. Little is known of PTH and dementia in the community.Objective: We sought to investigate relations between PTH, clinical dementia and cerebral micro-vascular disease. Setting and Design: The Uppsala Longitudinal Study Of Adult Men (ULSAM) was prospective, baseline, 1991-1995; followup, 15.8 years. The Prospective Investigation Of The Vasculature In Uppsala Seniors (PIVUS) was cross-sectional, baseline, 2001. Both settings were community based.Participants and Main Outcome Measure: In the ULSAM study of 998 men (age 71) the association between PTH and dementia was investigated. In the PIVUS study of 406 men and women (age 70) the relation between PTH and magnetic resonance imaging signs of cerebral small vascular disease was investigated.Results: During followup, 56 individuals were diagnosed with vascular, 91 with Alzheimer's, and 59 with other dementias. In Cox-regression analyses, higher PTH was associated with vascular dementia (hazard ratio per 1 SD increase of PTH, 1.41; P < .01), but not with other dementias. The top tertile of PTH accounted for 18.5% of the population-attributable risk for vascular dementia, exceeding all other risk factors. In linear regression analysis in PIVUS, PTH was associated with increasing white matter hyperintensities (WMHI), reflecting increasing burden of cerebral small vessel disease (1 SD PTH increase, 0.31 higher category of WMHI; P = .016). All models were adjusted for vascular risk factors and mineral metabolism.Conclusions: In two community-based samples, PTH predicted clinically diagnosed and neuroimaging indices of vascular dementia and cerebral small vessel disease. Our data suggest a role for PTH in the development of vascular dementia.
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| 31. |
- Helin Forsberg,, Lena, et al.
(författare)
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Preoperative Longitudinal Left Ventricular Function by Tissue Doppler Echocardiography at Rest and During Exercise Is Valuable in Timing of Aortic Valve Surgery in Male Aortic Regurgitation Patients
- 2010
-
Ingår i: Journal of the American Society of Echocardiography. - : Elsevier Science B.V. Amsterdam. - 0894-7317 .- 1097-6795. ; 23:4, s. 387-395
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to evaluate if left ventricular (LV) systolic function by tissue Doppler echocardiography at rest and during exercise preoperatively could predict postoperative LV function and thereby be useful in the timing of aortic valve surgery in patients with severe aortic regurgitation. Methods: In 29 patients (median age, 59 years; interquartile range, 39-64 years), echocardiography, tissue Doppler echocardiography, and radionuclide ventriculography were performed preoperatively and postoperatively at rest and during supine bicycle exercise. Results: Preoperative ejection fraction (EF) was 62%. Patients formed two groups, with basal LV peak systolic velocity (PSV) 5.9 cm/s preoperatively as the cutoff value between low and high PSV. Preoperatively, patients with low PSV had lower PSV during exercise (Pandlt;.005), EF during exercise (Pandlt;.05), and atrioventricular plane displacement (AVPD) at rest (Pandlt;.005) and during exercise (P andlt;.05) than those with high PSV. Postoperatively, patients with low PSV had smaller AVPD at rest (P andlt;.05), AVPD during exercise (Pandlt;.01), and PSV during exercise (Pandlt;.01). Conclusion: In patients with chronic aortic regurgitation with EFs and LV dimensions not fulfilling criteria for surgery according to guidelines, preoperative PSV and AVPD at rest and during exercise detected postoperative LV dysfunction.
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| 32. |
- Holm, Lena, et al.
(författare)
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Duodenal alkaline secretion in rabbits : influence of artificial ventilation.
- 1990
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Ingår i: Acta Physiologica Scandinavica. - 0001-6772 .- 1365-201X. ; 138:4, s. 471-8
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Tidskriftsartikel (refereegranskat)abstract
- The effect of artificial ventilation on duodenal alkaline secretion and blood flow was studied in sodium pentobarbital-anaesthetized rabbits. A duodenal segment (approximately 3 cm) was cannulated in situ and continuously perfused with isotonic saline, and the bicarbonate secretion was titrated by pH-stat. Compared with the spontaneous breathing state, artificial ventilation improved the respiratory status of the animal, increasing Po2 and decreasing both Pco2 and plasma bicarbonate. Duodenal blood flow as measured with laser-Doppler flowmetry was not altered but the alkaline secretion was reduced. Pretreatment with the alpha 2-adrenoceptor antagonist yohimbine (0.5 mg kg-1 i.v., followed by 0.5 mg kg-1 h-1 i.v.) or the ganglionic blocker hexamethonium (10 mg kg-1 i.v.) did not affect the decline in duodenal alkaline secretion in response to artificial ventilation. Nor did these pretreatments affect the changes in plasma bicarbonate and Pco2 or significantly alter the blood flow. Increasing Pco2 in the respirator air increased the plasma Pco2 and bicarbonate concentration as well as the duodenal bicarbonate secretion. Pretreatment with the carbonic anhydrase inhibitor acetazolamide (80 mg kg-1 i.v.) reduced the bicarbonate secretion, and artificial ventilation induced a further reduction. Increasing Pco2 in the respirator in the animals pretreated with acetazolamide did not affect the bicarbonate secretion. Duodenal alkaline secretion was thus always reduced on artificial ventilation. The mechanism for this reduction does not seem to involve the sympathetic nervous system or the blood flow, but appears to be the consequence of alterations in the plasma concentration of bicarbonate and the plasma Pco2.
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| 33. |
- Jonsson, Lena, et al.
(författare)
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Livsmedelskvalitet
- 2014. - 2:1
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Bok (övrigt vetenskapligt/konstnärligt)
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| 34. |
- Jonsson, Lena, et al.
(författare)
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Livsmedelsvetenskap
- 2007. - 1
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- En lärobok som tekniskt och kemiskt förklarar varför man ska tillaga på ett visst sätt. Råvaor belyses från sitt ursprung, via kemisk sammansättning till vad som händer under tillagning. Dessutom belyses närings- och miljöaspekter på respektive råvara.
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| 35. |
- Landgren, Valdemar, 1988, et al.
(författare)
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Inability to start or complete upper secondary school strongly predicts unemployment and psychosocial and psychiatric adversities - A register-based follow-up study from southwestern Sweden
- 2024
-
Ingår i: ACTA PAEDIATRICA. - 0803-5253 .- 1651-2227.
-
Tidskriftsartikel (refereegranskat)abstract
- AimTo study academic, social and psychiatric outcomes among adults in the general population in southwestern Sweden. Groups of individuals born in 1998 and ineligible, eligible but not completed, and eligible and completed upper secondary school were followed in 2020.MethodsData were retrieved from Statistics Sweden, the Swedish National Agency for Education, the Longitudinal Integrated Database for Health Insurance and Labour Market Studies, the Swedish National Crime Register and the National Patient Register. The four adverse outcomes neither engaging in post-secondary studies nor having a regular salary, needing social benefits, having any criminal conviction, and having a psychiatric disorder at age >= 16 were examined.ResultsOf the final sample of 2706 individuals who had attended 9th grade of compulsory school in 2014, 273 (10%) were ineligible for upper secondary school. Of eligible individuals, 82 (3%) never started, 282 (10%) did not complete and 2065 (77%) completed upper secondary school. Compared with completers, the odds ratios for adverse outcomes were markedly increased for all other groups up to 22 years old.ConclusionInability to start or complete upper secondary school strongly predicted unemployment and psychosocial and psychiatric adversities. School authorities should consider offering vocational programmes post compulsory school without grade restrictions.
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| 36. |
- Lindström, Lena, 1958-, et al.
(författare)
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Left ventricular involvement in arrhythmogenic right ventricular cardiomyopathy : A scintigraphic and echocardiographic study
- 2005
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Ingår i: Clinical Physiology and Functional Imaging. - 1475-0961 .- 1475-097X. ; 25:3, s. 171-177
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Tidskriftsartikel (refereegranskat)abstract
- Background: Left ventricular involvement in arrhythmogenic right ventricular cardiomyopathy (ARVC) is a common finding in autopsy studies. In clinical studies using myocardial scintigraphy, MRI and echocardiography, contradictory results have been reported. In this study, we therefore investigated a group of 15 patients with ARVC using thallium-201 (Tl) single-photon emission tomography (SPECT) and echocardiography including assessment of mitral annular motion with M-mode and pulsed tissue Doppler.Methods: Exercise and rest Tl-201 SPECT were performed in 15 patients with ARVC. The time from diagnosis of the disease varied from less than 1–16 years. All patients fulfilled the established diagnostic criteria for ARVC. An echocardiographic examination, including assessment of left and right ventricular motion and measurements of the mitral annulus motion with M-mode and pulsed tissue Doppler was performed in the patients and in 25 normal subjects.Results: Tl-201 uptake defects in the left ventricular myocardium were present in all except one patient (93%). The uptake defects were predominantly located to the anteroseptal and basal posterior segments. Wall motion abnormalities were seen in the same segments, and in addition to this, in the septal area. In line with this, the total amplitude and the peak systolic velocity of mitral annular motion at the septal point were significantly decreased in the patients compared with the control group.Conclusions: Our data show that left ventricular involvement is common in ARVC. Tl-201 SPECT and echocardiographic abnormalities were seen not only in patients with long-lasting symptoms but also in asymptomatic patients and in those with short duration of symptoms.
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| 37. |
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| 38. |
- Maret, Eva, et al.
(författare)
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Computer-assisted determination of left ventricular endocardial borders reduces variability in the echocardiographic assessment of ejection fraction
- 2008
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Ingår i: Cardiovascular Ultrasound. - : Springer Science and Business Media LLC. - 1476-7120. ; 6:55
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Tidskriftsartikel (refereegranskat)abstract
- Background: Left ventricular size and function are important prognostic factors in heart disease. Their measurement is the most frequent reason for sending patients to the echo lab. These measurements have important implications for therapy but are sensitive to the skill of the operator. Earlier automated echo-based methods have not become widely used. The aim of our study was to evaluate an automatic echocardiographic method (with manual correction if needed) for determining left ventricular ejection fraction (LVEF) based on an active appearance model of the left ventricle (syngo (R) AutoEF, Siemens Medical Solutions). Comparisons were made with manual planimetry (manual Simpson), visual assessment and automatically determined LVEF from quantitative myocardial gated single photon emission computed tomography (SPECT). Methods: 60 consecutive patients referred for myocardial perfusion imaging (MPI) were included in the study. Two-dimensional echocardiography was performed within one hour of MPI at rest. Image quality did not constitute an exclusion criterion. Analysis was performed by five experienced observers and by two novices. Results: LVEF (%), end-diastolic and end-systolic volume/BSA (ml/m(2)) were for uncorrected AutoEF 54 +/- 10, 51 +/- 16, 24 +/- 13, for corrected AutoEF 53 +/- 10, 53 +/- 18, 26 +/- 14, for manual Simpson 51 +/- 11, 56 +/- 20, 28 +/- 15, and for MPI 52 +/- 12, 67 +/- 26, 35 +/- 23. The required time for analysis was significantly different for all four echocardiographic methods and was for uncorrected AutoEF 79 +/- 5 s, for corrected AutoEF 159 +/- 46 s, for manual Simpson 177 +/- 66 s, and for visual assessment 33 +/- 14 s. Compared with the expert manual Simpson, limits of agreement for novice corrected AutoEF was lower than for novice manual Simpson (0.8 +/- 10.5 vs. -3.2 +/- 11.4 LVEF percentage points). Calculated for experts and with LVEF (%) categorized into < 30, 30-44, 45-54 and >= 55, kappa measure of agreement was moderate (0.44-0.53) for all method comparisons (uncorrected AutoEF not evaluated). Conclusion: Corrected AutoEF reduces the variation in measurements compared with manual planimetry, without increasing the time required. The method seems especially suited for unexperienced readers.
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| 39. |
- Mortazavi, Susanne E., et al.
(författare)
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Acquisition of complement fixing antibodies targeting Plasmodium falciparum merozoites in infants and their mothers in Uganda
- 2023
-
Ingår i: Frontiers in Immunology. - 1664-3224. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Antibody-mediated complement fixation has previously been associated with protection against malaria in naturally acquired immunity. However, the process of early-life development of complement-fixing antibodies in infants, both in comparison to their respective mothers and to other immune parameters, remains less clear. Results: We measured complement-fixing antibodies in newborns and their mothers in a malaria endemic area over 5 years follow-up and found that infants’ complement-fixing antibody levels were highest at birth, decreased until six months, then increased progressively until they were similar to birth at five years. Infants with high levels at birth experienced a faster decay of complement-fixing antibodies but showed similar levels to the low response group of newborns thereafter. No difference was observed in antibody levels between infant cord blood and mothers at delivery. The same result was found when categorized into high and low response groups, indicating placental transfer of antibodies. Complement-fixing antibodies were positively correlated with total schizont-specific IgG and IgM levels in mothers and infants at several time points. At nine months, complement-fixing antibodies were negatively correlated with total B cell frequency and osteopontin concentrations in the infants, while positively correlated with atypical memory B cells and P. falciparum-positive atypical memory B cells. Conclusion: This study indicates that complement-fixing antibodies against P. falciparum merozoites are produced in the mothers and placentally-transferred, and they are acquired in infants over time during the first years of life. Understanding early life immune responses is crucial for developing a functional, long lasting malaria vaccine.
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| 40. |
- Nilsson, M., et al.
(författare)
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Arguments for a Phenomenologically Informed Clinical Approach to Autism Spectrum Disorder
- 2019
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Ingår i: Psychopathology. - : S. Karger AG. - 0254-4962 .- 1423-033X. ; 52, s. 153-160
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this paper is to provide arguments for a phenomenologically informed clinical approach to autism spectrum disorder (ASD), including a plea for clinical attention to the self in ASD. Methods: Central concepts of continental phenomenology, phenomenological psychopathology, and the phenomenological interview are presented, with an emphasis on the potential unifying qualities of an approach which includes the exploration of subjective and intersubjective experience. These phenomenological concepts and methods are contrasted with the current conceptualization of ASD, where the first-person perspective is not in focus. Results: Contemporary phenomenological papers on ASD address key concepts like intersubjectivity, intercorporeality, and intentionality. However, insights from this theoretical field have not been followed up in clinical research and practice. Consequently, there is (to our knowledge) still a lack of phenomenologically informed clinical explorations of experience of self, others, and the world in ASD. Conclusion: A phenomenologically informed focus on the form and structure of subjective experience, including a focus on self-experience in ASD, can lead to new and important insights in relation to clinical differentiation between ASD and schizophrenia spectrum disorder. © 2019 S. Karger AG, Basel.
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| 41. |
- Nilsson, Maria, et al.
(författare)
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Self-Disorders in Asperger Syndrome Compared to Schizotypal Disorder : A Clinical Study
- 2020
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Ingår i: Schizophrenia Bulletin. - : Oxford University Press (OUP). - 1745-1701 .- 0586-7614. ; 46:1, s. 121-129
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: There are historical and theoretical indications of a difference in subjective experience between autism spectrum disorder (ASD) and the schizophrenia spectrum. However, this difference has not been empirically explored. Therefore, to explore potential differences in subjective experience between the 2 spectra, we examined the presence/absence of self-disorders in Asperger syndrome/autism spectrum disorder (As/ASD) compared to schizotypal disorder (Sd). Self-disorders represent changes in basic self-awareness which have been found to accumulate within the schizophrenia spectrum. METHODS: All participants were recruited from clinical units and interviewed with a focus on the exploration of presence/absence of self-disorders, with the Examination of Anomalous Self-Experience (EASE) scale, and a general assessment of present psychopathology, with Schedules for Clinical Assessment in Neuropsychiatry (SCAN). RESULTS: A total of 51 participants (As/ASD, n = 22; Sd, n = 29) were included in the statistical analyses. When controlling for age, gender, years of education, mental problems before the age of 16, and special needs school attendance, there was a clear difference in presence/absence of self-disorders between the 2 groups, with significantly higher levels in the Sd group. Further, there was an overlap in SCAN-rated symptoms between the 2 groups. CONCLUSION: Our results indicate a significant difference between As/ASD and Sd at the level of the basic self, which, in turn, indicates that an exploration of anomalous self-experience is a valuable supplement in the clinical differentiation between As/ASD and Sd.
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| 42. |
- Nilsson, M., et al.
(författare)
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Well-Being and Self-Disorders in Schizotypal Disorder and Asperger Syndrome/Autism Spectrum Disorder
- 2020
-
Ingår i: Journal of Nervous and Mental Disease. - : Ovid Technologies (Wolters Kluwer Health). - 0022-3018 .- 1539-736X. ; 208:5, s. 418-423
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Tidskriftsartikel (refereegranskat)abstract
- We explored subjective well-being in two groups of young adult participants diagnosed with either schizotypal disorder (Sd) (n = 29) or Asperger syndrome/autism spectrum disorder (As/ASD) (n = 22). Well-being was impaired in both groups and was lower in the Sd group than in the As/ASD group. Furthermore, there was a negative correlation between well-being and the presence of self-disorders. The negative effect of self-disorders on well-being was still significant when adjusted for diagnosis, age and gender, and level of function. The present findings point toward clinically important disorder-specific differences in the nature of impaired well-being between the Sd group and the As/ASD group, as there seems to be a self-disorder-driven additional contribution to impaired subjective well-being within the schizophrenia spectrum. These findings further nuance the understanding of fundamental and clinically important qualitative differences between the schizophrenia spectrum and the autism spectrum.
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| 43. |
- Nylander, Lena, et al.
(författare)
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ADHD in adult psychiatry. Minimum rates and clinical presentation in general psychiatry outpatients.
- 2009
-
Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 63:1, s. 64-71
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Tidskriftsartikel (refereegranskat)abstract
- The objective of the study was to determine the prevalence and comorbidity of persisting attention-deficit hyperactivity disorder (ADHD) in adult psychiatric outpatients. Consecutive patients, first visits excluded, at a general psychiatric outpatient clinic were offered a screening for childhood ADHD with the Wender Utah Rating Scale (WURS). One hundred and forty-one patients out of 398 (35%) completed and returned the scale. Patients above or near cut-off for ADHD (n=57) were offered an extensive clinical evaluation with psychiatric as well as neuropsychological examination. The attrition was analysed regarding age, sex and clinical diagnoses. Out of the screened sample, 40% had scores indicating possible childhood ADHD. These 57 patients were invited to the clinical part of the study, but 10 declined assessment, leaving 47 (37 women and 10 men) who were actually examined. Thirty of these (21 women and nine men) met diagnostic criteria for ADHD at the time of examination. Among the patients with ADHD, affective disorders were the most common psychiatric diagnoses. The rate of alcohol and/or substance abuse, as noted in the medical records, was also high in the ADHD group. In the WURS-screened group, 22% (30 patients assessed as part of this study and one person with ADHD previously clinically diagnosed) were shown to have persisting ADHD. Therefore, it is clearly relevant for psychiatrists working in general adult psychiatry to have ADHD in mind as a diagnostic option, either as the patient's main problem or as a functional impairment predisposing for other psychiatric disorders.
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| 44. |
- Nylander, Lena, et al.
(författare)
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Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in adult psychiatry. A 20-year register study.
- 2013
-
Ingår i: Nordic journal of psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 67:5, s. 344-350
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Tidskriftsartikel (refereegranskat)abstract
- Nylander L, Holmqvist M, Gustafson L, Gillberg C. Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in adult psychiatry. A 20-year register study. Nord J Psychiatry 2012;Early Online:1-7 Objective: Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are increasingly recognized in adults. This study aimed to assess trends in diagnostic practice, diagnostic delay and comorbidity regarding ADHD and ASD in adult psychiatric patients. Methods: Individuals with diagnosed ADHD or ASD were identified in an adult psychiatry register comprising 56,462 patients. Results: ADHD was diagnosed in up to 2.7% and ASD in 1.3% of the patients. Most cases were diagnosed within 2 years of first contact with adult psychiatry, but some patients were treated for 10 years or more before being diagnosed with ADHD or ASD. Seventy per cent of ADHD and 56% of ASD patients were treated as outpatients only. Other psychiatric diagnoses were registered in about 60%. Affective disorders were common in patients with ADHD. Psychoses and intellectual disability were more common in ASD patients. Psychoactive substance use-related disorders were considerably more common in those with ADHD. Concomitant ADHD and ASD were seldom diagnosed in this clinical material. Conclusion: ADHD and ASD were probably much underdiagnosed in the studied group of psychiatric patients. Other psychiatric diagnoses were common, but not ADHD with concomitant ASD.
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| 45. |
- Nylander, Lena
(författare)
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Attention-deficit/hyperactivity disorder and autism spectrum disorders in adult psychiatric patients
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Knowledge about attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) in adult psychiatry is scant. Aims: Estimate prevalence, psychiatric morbidity patterns and impact of ADHD/ASD diagnoses in general adult psychiatry services. Material and methods: Two adult psychiatric out-patient groups were screened and clinically examined for ADHD and ASD. A new screening instrument, the Autism Spectrum Disorders in Adults Screening Questionnaire (ASDASQ) was developed for ASD. The Wender Utah Rating Scale was used for retrospective screening of childhood ADHD symptoms. A new questionnaire was used in an attempt to measure the subjective impact of receiving an ADHD or ASD diagnosis in adulthood in a group of consecutively clinically evaluated adult patients and their significant others. A very large data-set of all registered psychiatric patients at one clinic over a 20-year-period was used to assess time trends in clinical diagnoses of ADHD and ASD and “comorbidities”/psychiatric service use. Results: Of screened adult psychiatric patients 1.4% had ASD and most of these were treated at a centre for chronic disorders. The rate of ASD in this centre was 3.2%. A quarter of the patients with ASD had previous diagnoses of schizophrenia. The ASDASQ showed good psychometric properties. The rate of ADHD in the screened group of general psychiatric out-patients was 21.9%. These patients had been variably diagnosed, often with affective disorder. Greater subjective impact of the diagnosis for patients with ADHD than ASD was suggested. Perceived positive post-diagnosis change was reported by patients and significant others, and as regards medication (ADHD), housing and habilitation service contact (ASD). The rate of ADHD diagnoses increased from 1990 to 2009, but only about 2.7% of the whole adult psychiatric patient group received this diagnosis. ASD diagnosis rates also went up but only to about 1.3% of all registered patients. Discussion: In adult psychiatry, many patients have ADHD or ASD, developmental disorders that underlie or are overshadowed by “psychiatric illness”. Some patients seek help for problems related to the formerly unrecognized ADHD or ASD rather than for “psychiatric disorder”. ADHD seems to be much more common than ASD, and in both disorders concomitant psychiatric illness is usually present. It is important not to rely only on self-assessment questionnaires for diagnosis. An essential part of diagnostic work-up is a detailed history taking and testing of cognitive and adaptive development/capacity, currently not standard in adult psychiatric practice. Measuring the subjective impact of ADHD or ASD diagnoses proved to be difficult. The rate of diagnosed ADHD/ASD in adult psychiatry went up over the past two decades but was, by 2010, far below the likely “real” rate. The underdiagnosis of ADHD/ASD in adult psychiatry remains a huge clinical problem. Key words: Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), adults, psychiatry, Autism Spectrum Disorder in Adults Screening Questionnaire (ASDASQ)
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| 46. |
- Nylander, Lena, et al.
(författare)
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Autism spectrum disorders and schizophrenia spectrum disorders in adults - Is there a connection? : A literature review and some suggestions for future clinical research
- 2008
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Ingår i: Clinical Neuropsychiatry. - Rom : Giovanni Fioriti Editore. - 1724-4935. ; 5:1, s. 43-54
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Forskningsöversikt (refereegranskat)abstract
- Since autism was first described, there has been an ongoing discussion concerning the connections, if any, with schizophrenia. Once thought to be the same disorder, autistic disorder and childhood schizophrenia were in the 1970s shown to be distinguishable by symptomatology and age of onset. However, as the concept of autism spectrum disorders (ASD) as well as that of schizophrenia spectrum disorders have evolved, the distinction has become less clear. To begin with the increased frequency of ASD diagnosed in adults of normal intelligence has brought up the issue of possible comorbidily of ASD and psychoses. Second, in the schizophrenia research field, it has become clear that schizophrenia is a neurodevelopmental disorder, implying that a liability may be manifested by developmental delays or abnormalities appearing in early childhood. Thus, as neurodevelopmental markers for adult schizophrenia have become better known, it seems reasonable to speculate that ASD may be among several such vulnerability factors. Finally, autistic symptoms in adults and some non-psychotic symptoms of schizophrenia are not always easily distinguishable. Cognitive impairments, deficit symptoms and motor symptoms including catatonia may be features of ASD as well as of schizophrenia. Until we have reliable biological markers for psychiatric syndromes, differential diagnosis between ASD, particularly in patients of normal intelligence, and psychoses, particularly some variants within the schizophrenia spectrum, will remain difficult. A further confounding factor is the possibility of comorbidity. More studies are needed, preferably as collaborative efforts between adult psychiatry and child and adolescent psychiatry.
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| 47. |
- Nylander, Lena
(författare)
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Friskvern og psykisk helse
- 2012
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Ingår i: Psykisk lidelse hos personer med utviklingshemning: forståelse og behandling. T.L. Bakken & M.E. Olsen (Eds).. - Olso, Norway : Universitetsforlaget AS. - 9788215013435 ; , s. 45-52
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 48. |
- Nylander, Lena, et al.
(författare)
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Historik, förekomst och orsaker.
- 2013
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Ingår i: In: G. Thernlund (red.), ADHD och autismspektrum i ett livsperspektiv. En klinisk introduktion till utvecklingsrelaterade kognitivafunktionsproblem.. - Lund : Studentlitteratur. - 9144069006
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 49. |
- Nylander, Lena, et al.
(författare)
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Intellectual developmental disorder in adult psychiatry : A 24-year register study
- 2016
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 70:7, s. 508-513
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Tidskriftsartikel (refereegranskat)abstract
- Background: Intellectual developmental disorder (IDD) may pre-dispose for mental health disorders. It is sometimes debated whether the needs of this group are adequately met in general psychiatry. However, little is known about patients with IDD in the psychiatric clinical setting—occurrence, clinical diagnoses, or service use. Aims: This study aimed to assess the number of adult patients diagnosed with IDD in a psychiatric clinic, their psychiatric diagnoses, and their use of psychiatric services. Methods: Individuals with registered IDD diagnoses were identified in a university hospital adult psychiatric clinic register comprising 67 384 patients. Results: IDD had been diagnosed in 0.6% of the patients. Psychotic disorders were the most common co-existing psychiatric diagnoses (25.5%). In 21.8% no psychiatric diagnosis other than IDD was registered. More than 50% had been inpatients; 21% had been compulsorily admitted. Patients with IDD had required a mean of five hospital beds per day. Conclusions: The percentage, 0.6%, of IDD diagnoses was lower than estimates of the prevalence of IDD in the general population. This may reflect a lower need for psychiatric care, barriers to access services, or diagnostic over-shadowing. One fifth of the patients in this study had no psychiatric diagnosis beside IDD, which may be due to diagnostic difficulties, or other problems (e.g. somatic or behavioural disorders) leading to psychiatric contact. Since patients with IDD use the equivalent of five inpatient beds every year, it is suggested that it may be worthwhile to consider specialized psychiatry with expertise in IDD, even though this group is small.
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| 50. |
- Nylander, Lena, et al.
(författare)
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Is it possible to measure the impact of a developmental disorder diagnosis received in adulthood? An attempt at follow-up and discussion of difficulties encountered in the process.
- 2010
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Ingår i: Clinical Audit. ; 2, s. 127-136
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Assessment of patients’ and their significant others’ (SOs’) views of receiving a diagnosis of a developmental disorder, namely attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or Tourette’s syndrome (TS), in adulthood. Method: One to three years after clinical examination and diagnosis, a questionnaire was sent to 225 consecutive patients. Results: One hundred twenty-one patients responded (53.7%). The number of ASD patients in contact with habilitation services and with independent living had increased, as also had the number of ADHD patients receiving medication. The patients and SO expressed satisfaction with the diagnostic process. Conclusion: ADHD or ASD diagnoses received in adulthood did not, in the patients’ opinion, have a great impact in a 1- to 3-year perspective. However, since a large number of the responding patients as well as SOs were positive to the examination as such, it is suggested that the so-called neuropsychiatric diagnostic procedure may lead to rapport and thus understanding of psychiatric patients, irrespective of diagnosis. The low number of respondents is an indication that mailed questionnaires may not be the optimal method to follow-up the impact of the developmental disorder diagnosis in these patients. There are also difficulties regarding the choice of a relevant control group and regarding measurement of patients’ opinions. Significant outcomes: According to the patients themselves, rather small changes were brought about by receiving an ADHD or ASD diagnosis in adulthood. Patients who were assigned an ADHD or ASD diagnosis were more satisfied with the diagnostic procedure and its consequences than the reference group, consisting of patients who were examined, but did not meet the criteria for an ADHD, ASD, or TS diagnosis. Patients and SOs had a positive view of the assessment procedure. Limitations: Forty-six percent of the included patients did not respond. The reference group was a diagnostically heterogeneous group of patients, most of whom had severe mental disor- ders. The availability of services may be a confounding factor, influencing the patients’ views of the present situation and the benefit of the diagnosis. There was no questionnaire given to the patients at baseline, and the mailed questionnaire had not been validated. Considering that every patient or SO answered several questions, the differences at P = 0.05 may not actually be significant if corrected for multiple comparisons.
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