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Publikationer (10 of 27) Visa alla publikationer
Wiggins, S., Abrandt Dahlgren, M., Ekstedt, M., Hammar Chiriac, E., Larsson Torstensdotter, G. & Törnqvist, T. (2018). Being a professional, or just being a student? A discursive analysis of video-recorded interprofessional learning tutorials in a medical faculty. In: : . Paper presented at NU2018, 9-11 oktober 2018, Västerås, Sweden. Västerås
Öppna denna publikation i ny flik eller fönster >>Being a professional, or just being a student? A discursive analysis of video-recorded interprofessional learning tutorials in a medical faculty
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2018 (Engelska)Konferensbidrag, Enbart muntlig presentation (Övrigt vetenskapligt)
Ort, förlag, år, upplaga, sidor
Västerås: , 2018
Nationell ämneskategori
Utbildningsvetenskap
Identifikatorer
urn:nbn:se:liu:diva-152174 (URN)
Konferens
NU2018, 9-11 oktober 2018, Västerås, Sweden
Tillgänglig från: 2018-10-19 Skapad: 2018-10-19 Senast uppdaterad: 2018-10-31
Wiggins, S., Abrandt Dahlgren, M., Ekstedt, M., Hammar Chiriac, E., Larsson Torstensdotter, G. & Törnqvist, T. (2018). On doing ‘being a student amongst other kinds of students’: Managing academic identities in an interprofessional tutorial group. In: : . Paper presented at 5th International Conference on Conversation Analysis (ICCA),15 July 2018, Loughborough University, UK.
Öppna denna publikation i ny flik eller fönster >>On doing ‘being a student amongst other kinds of students’: Managing academic identities in an interprofessional tutorial group
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2018 (Engelska)Konferensbidrag, Enbart muntlig presentation (Övrigt vetenskapligt)
Nationell ämneskategori
Psykologi Pedagogik
Identifikatorer
urn:nbn:se:liu:diva-152177 (URN)
Konferens
5th International Conference on Conversation Analysis (ICCA),15 July 2018, Loughborough University, UK
Tillgänglig från: 2018-10-19 Skapad: 2018-10-19 Senast uppdaterad: 2018-10-31
Dulai, P. S., Singh, S., Patel, J., Soni, M., Prokop, L. J., Younossi, Z., . . . Loomba, R. (2017). Increased risk of mortality by fibrosis stage in non-alcoholic fatty liver disease: Systematic Review and Meta-analysis.. Hepatology, 65(5), 1557-1565
Öppna denna publikation i ny flik eller fönster >>Increased risk of mortality by fibrosis stage in non-alcoholic fatty liver disease: Systematic Review and Meta-analysis.
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2017 (Engelska)Ingår i: Hepatology, ISSN 0270-9139, E-ISSN 1527-3350, Vol. 65, nr 5, s. 1557-1565Artikel, forskningsöversikt (Refereegranskat) Published
Abstract [en]

BACKGROUND: Liver fibrosis is the most important predictor of mortality in nonalcoholic fatty liver disease (NAFLD). Quantitative risk of mortality by fibrosis stage has not been systematically evaluated. We aimed to quantify the fibrosis stage-specific risk of all-cause and liver-related mortality in NAFLD.

METHODS: Through a systematic review and meta-analysis, we identified 5 adult NAFLD cohort studies reporting fibrosis stage specific mortality (0-4). Using fibrosis stage 0 as a reference population, fibrosis stage-specific mortality rate ratios (MRR) with 95% confidence intervals (CI), for all-cause and liver-related mortality, were estimated. The study is reported according to the PRISMA statement.

RESULTS: 1,495 NAFLD patients with 17,452 patient years of follow-up were included. Compared to NAFLD patients with no fibrosis (stage 0), NAFLD patients with fibrosis were at an increased risk for all-cause mortality and this risk increased with increase in the stage of fibrosis: stage 1, MRR, 1.58 (95% CI 1.19-2.11); stage 2, MRR, 2.52 (95% CI 1.85-3.42); stage 3, MRR, 3.48 (95% CI 2.51-4.83), and stage 4, MRR, 6.40 (95% CI 4.11-9.95). The results were more pronounced as the risk of liver-related mortality increased exponentially with increase in the stage of fibrosis: stage 1, MRR, 1.41 (95% CI 0.17-11.95); stage 2, MRR, 9.57 (95% CI 1.67-54.93); stage 3, MRR, 16.69 (95% CI 2.92-95.36); and stage 4, MRR, 42.30 (95% CI 3.51-510.34).

LIMITATIONS: Inability to adjust for co-morbid conditions or demographics known to impact fibrosis progression in NAFLD, and the inclusion of patients with simple steatosis and NASH without fibrosis in the reference comparison group.

CONCLUSION: The risk of liver-related mortality increases exponentially with increase in fibrosis stage. These data have important implications in assessing utility of each stage and benefits of regression of fibrosis from one stage to another. This article is protected by copyright. All rights reserved.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2017
Nationell ämneskategori
Gastroenterologi
Identifikatorer
urn:nbn:se:liu:diva-134875 (URN)10.1002/hep.29085 (DOI)000399459800011 ()28130788 (PubMedID)
Anmärkning

Funding agencies: American Gastroenterological Association Foundation [K23-DK090303, R01-DK106419-01]; National Institute of Diabetes and Digestive and Kidney Diseases [5T32DK007202]; National Institute of Environmental Health Sciences of the National Institutes of Health 

Tillgänglig från: 2017-02-28 Skapad: 2017-02-28 Senast uppdaterad: 2018-04-18
Nasr, P., Hilliges, A., Thorelius, L., Kechagias, S. & Ekstedt, M. (2016). Contrast-enhanced ultrasonography could be a non-invasive method for differentiating none or mild from severe fibrosis in patients with biopsy proven non-alcoholic fatty liver disease. Scandinavian Journal of Gastroenterology, 51(9), 1126-1132
Öppna denna publikation i ny flik eller fönster >>Contrast-enhanced ultrasonography could be a non-invasive method for differentiating none or mild from severe fibrosis in patients with biopsy proven non-alcoholic fatty liver disease
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2016 (Engelska)Ingår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 51, nr 9, s. 1126-1132Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: The gold standard for diagnosing fibrosis stage in non-alcoholic fatty liver disease (NAFLD) is liver biopsy. The aim of this study was to determine whether contrast-enhanced ultrasonography (CEUS) with transit time measurements could be a non-invasive alternative for differentiating none or mild from severe fibrosis in NAFLD patients. Various serum markers and clinical variables were also evaluated.

MATERIALS AND METHODS: Fifty-eight patients with NAFLD underwent CEUS prior to liver biopsy. All patients were also evaluated according to the Göteborg University Cirrhosis Index (GUCI), the AST-Platelet Ratio Index (APRI), the NAFLD fibrosis score, and the FIB-4 and BARD score.

RESULTS: The hepatic vein arrival time (HV) was shorter in patients with severe fibrosis (25.9 ± 4.8 vs 29.5 ± 4.7 s, p = 0.023), and the difference between the hepatic and portal vein (ΔHV-PV) was shorter (2.3 ± 2.8 vs 6.4 ± 2.8 s, p < 0.0001) while the difference in arrival time between the portal vein and hepatic artery (ΔPV-HA) arrival time was significantly longer (6.0 ± 2.2 vs 3.6 ± 1.6 s, p < 0.0001). The area under receiver operating characteristics curve values for HV, ΔHV-PV and ΔPV-HA to separate none or mild from severe fibrosis was 0.71, 0.83 and 0.84, respectively. The corresponding figures for GUCI, APRI, NAFLD fibrosis score, FIB-4 and BARD score were 0.93, 0.92, 0.86, 0.90 and 0.77, respectively.

CONCLUSIONS: CEUS and non-invasive scoring systems could exclude severe fibrosis in NAFLD patients.

Ort, förlag, år, upplaga, sidor
Taylor & Francis, 2016
Nyckelord
Contrast-enhanced ultrasonography, fibrosis, fibrosis scores, non-alcoholic fatty liver disease
Nationell ämneskategori
Gastroenterologi
Identifikatorer
urn:nbn:se:liu:diva-129954 (URN)10.3109/00365521.2016.1172336 (DOI)000381406800018 ()27161854 (PubMedID)
Anmärkning

Funding agencies: Research Council of Southeast Sweden [F2004-303]; ALF Grants, Region Ostergotland

Tillgänglig från: 2016-07-02 Skapad: 2016-07-02 Senast uppdaterad: 2017-11-28Bibliografiskt granskad
Hagström, H., Nasr, P., Bottai, M., Ekstedt, M., Kechagias, S., Hultcrantz, R. & Stål, P. (2016). Elevated serum ferritin is associated with increased mortality in non-alcoholic fatty liver disease after 16 years of follow-up. Liver international (Print), 36(11), 1688-1695
Öppna denna publikation i ny flik eller fönster >>Elevated serum ferritin is associated with increased mortality in non-alcoholic fatty liver disease after 16 years of follow-up
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2016 (Engelska)Ingår i: Liver international (Print), ISSN 1478-3223, E-ISSN 1478-3231, Vol. 36, nr 11, s. 1688-1695Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND AND AIMS: High levels of ferritin in patients with non-alcoholic fatty liver disease (NAFLD) are associated with significant fibrosis and higher NAFLD activity score (NAS). It is unclear if this association has an impact on mortality. We investigated if high levels of ferritin, with or without iron overload, were associated with an increased mortality in NAFLD.

METHODS: We included 222 patients between 1979 and 2009 with biopsy-proven NAFLD and available serum ferritin concentrations. The cohort was divided into "high" (n = 89) and "normal" (n = 133) ferritin values, using a cut-point of 350 μg/L in males, and 150 μg/L in females, and stratified upon iron overload status. Data on mortality was obtained from a national, population based register. Poisson regression was used to estimate hazard ratios for mortality. The estimates were adjusted for age at biopsy, sex, smoking, BMI, diabetes, hypertension, cardiovascular disease and fibrosis stage at the time of biopsy.

RESULTS: The median follow-up time was 15.6 years (range: 0.5-34.2). Patients with high ferritin had more advanced fibrosis and higher NAS than patients with normal ferritin (p < 0.05). Fifteen years after diagnosis, and after adjusting for confounders, the high-ferritin group showed an increasingly higher mortality that was statistically significant (Hazard ratio = 1.10 per year, 95% Confidence interval 1.01-1.21, p < 0.05). There was no difference in mortality between patients with different iron overload patterns.

CONCLUSIONS: High levels of ferritin are associated with a long-term increased risk of death. This article is protected by copyright. All rights reserved.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2016
Nyckelord
ferritin;fibrosis, long-term outcome, mortality, NAFLD activity score, non-alcoholic fatty liver disease
Nationell ämneskategori
Gastroenterologi
Identifikatorer
urn:nbn:se:liu:diva-129955 (URN)10.1111/liv.13144 (DOI)000385863400016 ()27064133 (PubMedID)
Anmärkning

Funding agencies:Stockholm County Council (ALF projects from the Swedish Society of Medicine [20140329, 20150403]; Ruth and Richard Julins Foundation; Medical Research Council of Southeast Sweden [311151]; ALF grants, Region Ostergotland, Sweden

Tillgänglig från: 2016-07-02 Skapad: 2016-07-02 Senast uppdaterad: 2017-11-28Bibliografiskt granskad
Ekstedt, M., Hagström, H., Nasr, P., Fredrikson, M., Stal, P., Kechagias, S. & Hultcrantz, R. (2016). Nonalcoholic Fatty Liver Disease Activity Score and Mortality: Imperfect But Not Insignificant REPLY [Letter to the editor]. Hepatology, 64(1), 310-311
Öppna denna publikation i ny flik eller fönster >>Nonalcoholic Fatty Liver Disease Activity Score and Mortality: Imperfect But Not Insignificant REPLY
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2016 (Engelska)Ingår i: Hepatology, ISSN 0270-9139, E-ISSN 1527-3350, Vol. 64, nr 1, s. 310-311Artikel i tidskrift, Letter (Refereegranskat) Published
Ort, förlag, år, upplaga, sidor
Wiley-Blackwell, 2016
Nationell ämneskategori
Gastroenterologi
Identifikatorer
urn:nbn:se:liu:diva-124403 (URN)10.1002/hep.28314 (DOI)000379233400041 ()26517017 (PubMedID)
Tillgänglig från: 2016-01-28 Skapad: 2016-01-28 Senast uppdaterad: 2017-11-30
Johansson, J., Sahin, C., Pestoff, R., Ignatova, S., Forsberg, P., Edsjö, A., . . . Stenmark Askmalm, M. (2015). A Novel SMAD4 Mutation Causing Severe Juvenile Polyposis Syndrome with Protein Losing Enteropathy, Immunodeficiency, and Hereditary Haemorrhagic Telangiectasia.. Case Reports in Gastrointestinal Medicine, 2015, 1-5, Article ID 140616.
Öppna denna publikation i ny flik eller fönster >>A Novel SMAD4 Mutation Causing Severe Juvenile Polyposis Syndrome with Protein Losing Enteropathy, Immunodeficiency, and Hereditary Haemorrhagic Telangiectasia.
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2015 (Engelska)Ingår i: Case Reports in Gastrointestinal Medicine, ISSN 2090-6528, E-ISSN 2090-6536, Vol. 2015, s. 1-5, artikel-id 140616Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Juvenile polyposis syndrome (JPS) is a rare genetic disorder characterized by juvenile polyps of the gastrointestinal tract. We present a new pathogenic mutation of the SMAD4 gene and illustrate the need for a multidisciplinary health care approach to facilitate the correct diagnosis. The patient, a 47-year-old Caucasian woman, was diagnosed with anaemia at the age of 12. During the following 30 years, she developed numerous gastrointestinal polyps. The patient underwent several operations, and suffered chronic abdominal pain, malnutrition, and multiple infections. Screening of the SMAD4 gene revealed a novel, disease-causing mutation. In 2012, the patient suffered hypoalbuminemia and a large polyp in the small bowel was found. Gamma globulin was given but the patient responded with fever and influenza-like symptoms and refused more treatment. The patient underwent surgery in 2014 and made an uneventful recovery. At follow-up two months later albumin was 38 g/L and IgG was 6.9 g/L. Accurate diagnosis is essential for medical care. For patients with complex symptomatology, often with rare diseases, this is best provided by multidisciplinary teams including representatives from clinical genetics. Patients with a SMAD4 mutation should be followed up both for JPS and haemorrhagic hereditary telangiectasia and may develop protein loosing enteropathy and immunodeficiency.

Nationell ämneskategori
Gastroenterologi
Identifikatorer
urn:nbn:se:liu:diva-115933 (URN)10.1155/2015/140616 (DOI)25705527 (PubMedID)
Tillgänglig från: 2015-03-24 Skapad: 2015-03-24 Senast uppdaterad: 2017-12-04
Lindh Falk, A., Dahlberg, J., Ekstedt, M., Heslyk, A., Whiss, P. & Abrandt Dahlgren, M. (2015). Creating spaces for interprofessional learning: Strategic revision of a common IPL curriculum in undergraduate programs. In: Andre Vyt, Majda Pahor, Tiina Tervaskanto-Maentausta (Ed.), Interprofessional Education in Europe: Policy and Practice: (pp. 49-66). Antwerpen: Garant Publishers Limited
Öppna denna publikation i ny flik eller fönster >>Creating spaces for interprofessional learning: Strategic revision of a common IPL curriculum in undergraduate programs
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2015 (Engelska)Ingår i: Interprofessional Education in Europe: Policy and Practice / [ed] Andre Vyt, Majda Pahor, Tiina Tervaskanto-Maentausta, Antwerpen: Garant Publishers Limited , 2015, s. 49-66Kapitel i bok, del av antologi (Refereegranskat)
Ort, förlag, år, upplaga, sidor
Antwerpen: Garant Publishers Limited, 2015
Nationell ämneskategori
Sociologi (exklusive socialt arbete, socialpsykologi och socialantropologi)
Identifikatorer
urn:nbn:se:liu:diva-125288 (URN)9789044133349 (ISBN)
Tillgänglig från: 2016-02-19 Skapad: 2016-02-19 Senast uppdaterad: 2016-11-21Bibliografiskt granskad
Ekstedt, M., Hagström, H., Nasr, P., Fredrikson, M., Stål, P., Kechagias, S. & Hultcrantz, R. (2015). Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology, 61(5), 1547-1554
Öppna denna publikation i ny flik eller fönster >>Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up
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2015 (Engelska)Ingår i: Hepatology, ISSN 0270-9139, E-ISSN 1527-3350, Vol. 61, nr 5, s. 1547-1554Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background and rationale for the study: Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in the Western world, strongly associated with insulin resistance and the metabolic syndrome. Nonalcoholic steatohepatitis, i.e. fatty liver accompanied by necroinflammatory changes, is mostly defined by the NAFLD activity score (NAS). The aim of the current study was to determine disease-specific mortality in NAFLD, and evaluate the NAS and fibrosis stage as prognostic markers for overall and disease-specific mortality. Methods: In a cohort study, data from 229 well-characterized patients with biopsy-proven NAFLD were collected. Mean follow-up was 26.4 (± 5.6, range 6-33) years. A reference population was obtained from the National Registry of Population, and information on time and cause of death were obtained from the Registry of Causes of Death. Main results: NAFLD patients had an increased mortality compared with the reference population (HR 1.29, CI 1.04-1.59, p=0.020), with increased risk of cardiovascular disease (HR 1.55, CI 1.11-2.15, p=0.01), hepatocellular carcinoma (HR 6.55, CI 2.14-20.03, p=0.001), infectious disease (HR 2.71, CI 1.02-7.26, p=0.046), and cirrhosis (HR 3.2, CI 1.05-9.81, p=0.041). Overall mortality was not increased in patients with NAS 5-8 and fibrosis stage 0-2 (HR 1.41, CI 0.97-2.06, p=0.07), whereas patients with fibrosis stage 3-4, irrespective of NAS, had increased mortality (HR 3.3, CI 2.27-4.76, p<0.001). Conclusions: NAFLD patients have increased risk of death, with a high risk of death from cardiovascular disease and liver-related disease. The NAS was not able to predict overall mortality, whereas fibrosis stage predicted both overall and disease-specific mortality.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2015
Nyckelord
NAFLD activity score; cohort study; fatty liver; liver fibrosis; mortality
Nationell ämneskategori
Gastroenterologi
Identifikatorer
urn:nbn:se:liu:diva-112707 (URN)10.1002/hep.27368 (DOI)000353233500015 ()25125077 (PubMedID)
Tillgänglig från: 2014-12-08 Skapad: 2014-12-08 Senast uppdaterad: 2017-12-05
Johansson, J., Björnsson, B., Ignatova, S., Sandström, P. & Ekstedt, M. (2015). Littoral cell angioma in a patient with Crohn's disease.. Case Reports in Gastrointestinal Medicine, 2015, 1-4, Article ID 474969.
Öppna denna publikation i ny flik eller fönster >>Littoral cell angioma in a patient with Crohn's disease.
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2015 (Engelska)Ingår i: Case Reports in Gastrointestinal Medicine, ISSN 2090-6528, E-ISSN 2090-6536, Vol. 2015, s. 1-4, artikel-id 474969Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Littoral cell angioma is a rare vascular tumor of the spleen. The pathogenesis is unknown but the lesion is associated with several malignancies and immunological disorders. The diagnosis requires histopathological examination. The malignant potential of this lesion is unknown, which is why splenectomy is recommend for all cases. Symptomatic cases generally suffer from hypersplenism and pyrexia. A previously healthy 20-year-old female was diagnosed with colonic Crohn's disease; as part of the work-up a magnetic resonance enterography was performed which showed multiple signal changes of the spleen. The patient reported chronic abdominal pain in the left upper quadrant, malaise, and fever. The unknown splenic lesions prompted a laparoscopic splenectomy; pathology revealed a littoral cell angioma. The abdominal pain and malaise remitted but the fever persisted one year despite adequate treatment of the patient's Crohn's disease. Littoral cell angioma is associated with immune-dysregulation including Crohn's disease with several reported cases. Signs and symptoms of hypersplenism and splenic lesions on imaging should raise suspicion of littoral cell angioma in patients with Crohn's disease. Magnetic resonance enterography to assess disease severity in Crohn's disease may provide an opportunity to study the prevalence and natural history of this rare splenic tumor.

Nationell ämneskategori
Cancer och onkologi
Identifikatorer
urn:nbn:se:liu:diva-115929 (URN)10.1155/2015/474969 (DOI)25705528 (PubMedID)
Tillgänglig från: 2015-03-24 Skapad: 2015-03-24 Senast uppdaterad: 2017-12-04
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-5590-8601

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