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Theodorsson, Elvar, ProfessorORCID iD iconorcid.org/0000-0003-0756-7723
Publications (10 of 199) Show all publications
Lööv, A., Högberg, C., Lilja, M., Theodorsson, E., Hellström, P., Metsini, A. & Olsson, L. (2022). Diagnostic accuracy for colorectal cancer of a quantitative faecal immunochemical test in symptomatic primary care patients: a study protocol. Diagnostic and Prognostic Research, 6(1), Article ID 16.
Open this publication in new window or tab >>Diagnostic accuracy for colorectal cancer of a quantitative faecal immunochemical test in symptomatic primary care patients: a study protocol
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2022 (English)In: Diagnostic and Prognostic Research, E-ISSN 2397-7523, Vol. 6, no 1, article id 16Article in journal (Refereed) Published
Abstract [en]

Background: There is increasing evidence supporting the use of faecal immunochemical tests (FIT) in patients reporting symptoms associated with colorectal cancer (CRC), but most studies until now have focused on selected subjects already referred for investigation. We therefore set out to determine the accuracy and predictive values of FIT in a primary care population.

Method: A prospective, multicentre, single-gated comparative diagnostic study on quantitative FIT in patients aged 40 years and above presenting in primary care with symptoms associated with CRC will be conducted. Patients representing the whole spectrum of severity of such symptoms met with in primary care will be eligible and identified by GPs. Participants will answer a short form on symptoms during the last month. They will provide two faecal samples from two separate days. Analyses will be performed within 5 days (QuikRead go®, Aidian Oy). The analytical working range is 10-200 μg Hb/g faeces. Reference test will be linked to the Swedish Colorectal Cancer Registry up to 2 years after inclusion. Accuracy, area under ROC curves, and predictive values will be calculated for one FIT compared to the highest value of two FIT and at cutoff < 10, 10-14.9, 15-19.9 and ≥ 20 μg Hb/g faeces. Subgroup analyses will be conducted for patients with anaemia and those reporting rectal bleeding. A model-based cost-effectiveness analysis based on the clinical accuracy study will be performed. Based on previous literature, we hypothesized that the sensitivity of the highest value of two FIT at cutoff 10 μg Hb/g faeces will be 95% (95% CI + / - 15%). The prevalence of CRC in the study population was estimated to be 2%, and the rate of non-responders to be 1/6. In all, 3000 patients will be invited at 30 primary care centres.

Discussion: This study will generate important clinical real-life structured data on accuracy and predictive values of FIT in the most critical population for work-up of CRC, i.e. patients presenting with at times ambiguous symptoms in primary care. It will help establish the role of FIT in this large group.

Place, publisher, year, edition, pages
Springer, 2022
Keywords
Colorectal cancer; Diagnostic accuracy study; Primary care; Quantitative faecal immunochemical test; Sensitivity
National Category
Cancer and Oncology General Practice
Identifiers
urn:nbn:se:liu:diva-191943 (URN)10.1186/s41512-022-00129-7 (DOI)
Funder
Swedish Cancer SocietyÖrebro UniversityNyckelfonden
Available from: 2023-02-27 Created: 2023-02-27 Last updated: 2023-03-20Bibliographically approved
Martinez-Serrano, C., Marteinsdottir, I., Josefsson, A., Sydsjö, G., Theodorsson, E. & Rodriguez-Martinez, H. (2022). Prenatal stress, anxiety and depression alter transcripts, proteins and pathways associated with immune responses at the maternal-fetal interface. Biology of Reproduction, 106(3), 449-462
Open this publication in new window or tab >>Prenatal stress, anxiety and depression alter transcripts, proteins and pathways associated with immune responses at the maternal-fetal interface
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2022 (English)In: Biology of Reproduction, ISSN 0006-3363, E-ISSN 1529-7268, Vol. 106, no 3, p. 449-462Article in journal (Refereed) Published
Abstract [en]

During pregnancy, the immune system is modified to allow developmental tolerance of the semi-allogeneic fetus and placenta to term. Pregnant women suffering from stress, anxiety, and depression show dysfunctions of their immune system that may be responsible for fetal and/or newborn disorders, provided that placental gene regulation is compromised. The present study explored the effects of maternal chronic self-perceived stress, anxiety, and depression during pregnancy on the expression of immune-related genes and pathways in term placenta. Pregnancies were clinically monitored with the Beck Anxiety Inventory (BAI) and Edinburgh Postnatal Depression Scale (EPDS). A cutoff threshold for BAI/EPDS of 10 divided patients into two groups: Index group (&gt;10, n = 11) and a Control group (&lt;10, n = 11), whose placentae were sampled at delivery. The placental samples were subjected to RNA-Sequencing, demonstrating that stress, anxiety, and depression during pregnancy induced a major downregulation of placental transcripts related to immune processes such as T-cell regulation, interleukin and cytokine signaling, or innate immune responses. Expression differences of main immune-related genes, such as CD46, CD15, CD8 alpha & beta ILR7 alpha, and CCR4 among others, were found in the Index group (P &lt; 0.05). Moreover, the key immune-like pathway involved in humoral and cellular immunity named "Primary immunodeficiency" was significantly downregulated in the Index group compared with Controls. Our results show that mechanisms ruling immune system functions are compromised at the maternal-fetal interface following self-perceived depressive symptoms and anxiety during pregnancy. These findings may help unveil mechanisms ruling the impact of maternal psychiatric symptoms and lead to new prevention/intervention strategies in complicated pregnancies. Summary Sentence Mechanisms ruling immune system functions are compromised at the maternal-fetal interface following self-perceived depressive symptoms and anxiety during pregnancy.

Place, publisher, year, edition, pages
Oxford University Press, 2022
Keywords
antenatal stress; immune system; term-placentae; RNA-Seq; human
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-183253 (URN)10.1093/biolre/ioab232 (DOI)000756755300001 ()34935902 (PubMedID)
Available from: 2022-03-04 Created: 2022-03-04 Last updated: 2023-12-28Bibliographically approved
Sjödahl, R., Davidson, T., Aldman, Å., Lennmarken, C., Kammerlind, A.-S., Gustavsson, E. & Theodorsson, E. (2022). Robotassisterad bäcken- och njurkirurgi – en utvärdering. Läkartidningen, 119, Article ID 21172.
Open this publication in new window or tab >>Robotassisterad bäcken- och njurkirurgi – en utvärdering
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2022 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 119, article id 21172Article, review/survey (Refereed) Published
Abstract [en]

Current studies indicate that robotic-assisted surgery is not inferior to laparoscopic or open surgery regarding oncologic or functional outcomes. An exception may be uterine cervix cancer, where the survival after minimal invasive surgery might not be as good as after open surgery. There is less bleeding and need for blood transfusion after robotic-assisted surgery, and postoperative complications are similar to open or laparoscopic surgery. Robotic-assisted surgery offers ergonomic advantages compared to laparoscopic surgery. The effect of the surgical learning curve is not sufficiently studied. Presently robotic-assisted surgery is not cost-effective due to high costs of investments. The operation is more time consuming than laparoscopic or open surgery with risks of delaying and cancellation of other operations.

Abstract [sv]

Onkologiskt och funktionellt resultat vid robotassisterad kirurgi skiljer sig inte från laparoskopisk eller öppen kirurgi. Ett undantag kan vara sämre överlevnad vid cervixcancer.

Robotassisterad kirurgi är inte kostnadseffektiv i dagsläget på grund av investeringskostnaderna.

Robotassisterad kirurgi erbjuder ergonomiska fördelar och ger ingen ökning av postoperativa komplikationer. Operationstiderna är längre, men möjligen är blödning och transfusionsbehov mindre och vårdtiden kortare.

Inlärningseffekterna är ofullständigt undersökta.

Det finns etiska skäl att vara observant på undanträngningseffekter till följd av ökad användning av robotkirurgi.

Place, publisher, year, edition, pages
Stockholm, Sweden: Sveriges läkarförbund, 2022
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:liu:diva-192046 (URN)35471726 (PubMedID)
Available from: 2023-02-28 Created: 2023-02-28 Last updated: 2023-05-02Bibliographically approved
Carlstedt, A., Bringman, S., Egberth, M., Emanuelsson, P., Olsson, A., Petersson, U., . . . Theodorsson, E. (2021). Management of Diastasis of the Rectus Abdominis Muscles: Recommendations for Swedish National Guidelines. Scandinavian Journal of Surgery, 110(3), 452-459
Open this publication in new window or tab >>Management of Diastasis of the Rectus Abdominis Muscles: Recommendations for Swedish National Guidelines
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2021 (English)In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 110, no 3, p. 452-459Article in journal (Refereed) Published
Abstract [en]

Background: Diastasis of the rectus abdominis muscle is a common condition. There are no generally accepted criteria for diagnosis or treatment of diastasis of the rectus abdominis muscle, which causes uncertainty for the patient and healthcare providers alike. Methods: The consensus document was created by a group of Swedish surgeons and based on a structured literature review and practical experience. Results: The proposed criteria for diagnosis and treatment of diastasis of the rectus abdominis muscle are as follows: (1) Diastasis diagnosed at clinical examination using a caliper or ruler for measurement. Diagnostic imaging by ultrasound or other imaging modality, should be performed when concurrent umbilical or epigastric hernia or other cause of the patients symptoms cannot be excluded. (2) Physiotherapy is the firsthand treatment for diastasis of the rectus abdominis muscle. Surgery should only be considered in diastasis of the rectus abdominis muscle patients with functional impairment, and not until the patient has undergone a standardized 6-month abdominal core training program. (3) The largest width of the diastasis should be at least 5 cm before surgical treatment is considered. In case of pronounced abdominal bulging or concomitant ventral hernia, surgery may be considered in patients with a smaller diastasis. (4) When surgery is undertaken, at least 2 years should have elapsed since last childbirth and future pregnancy should not be planned. (5) Plication of the linea alba is the firsthand surgical technique. Other techniques may be used but have not been found superior. Discussion: The level of evidence behind these statements varies, but they are intended to lay down a standard strategy for treatment of diastasis of the rectus abdominis muscle and to enable uniformity of management.

Place, publisher, year, edition, pages
Sage Publications, 2021
Keywords
Diastasis of the rectus abdominis muscles; guidelines; linea alba; pregnancy; physiotherapy; mesh
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-171054 (URN)10.1177/1457496920961000 (DOI)000574873800001 ()32988320 (PubMedID)
Available from: 2020-11-01 Created: 2020-11-01 Last updated: 2022-05-26
Kallner, A. & Theodorsson, E. (2020). An experimental study of methods for the analysis of variance components in the inference of laboratory information. Scandinavian Journal of Clinical and Laboratory Investigation, 80(1), 73-80
Open this publication in new window or tab >>An experimental study of methods for the analysis of variance components in the inference of laboratory information
2020 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 80, no 1, p. 73-80Article in journal (Refereed) Published
Abstract [en]

Measurement uncertainty (MU) can be estimated and calculated by different procedures, representing different aspects and intended use. It is appropriate to distinguish between uncertainty determined under repeatability and reproducibility conditions, and to distinguish causes of variation using analysis of variance components. The intra-laboratory MU is frequently determined by repeated measurements of control material(s) of one or several concentrations during a prolonged period of time. We demonstrate, based on experimental results, how such results can be used to identify the repeatability, pure reproducibility and intra-laboratory variance as the sum of the two. Native patient material was used to establish repeatability using the Dahlberg formula for random differences between measurements and an expanded Dahlberg formula if a non-random difference, e.g. bias, was expected. Repeatability and reproducibility have different clinical relevance in intensive care compared to monitoring treatment of chronic diseases, comparison with reference intervals or screening.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2020
Keywords
Dahlberg error; repeatability; reproducibility; measurement uncertainty; variance components; analytical sensitivity
National Category
Clinical Laboratory Medicine
Identifiers
urn:nbn:se:liu:diva-162940 (URN)10.1080/00365513.2019.1700426 (DOI)000502501100001 ()31841049 (PubMedID)
Note

Funding Agencies|Karolinska university laboratory; County council of Ostergotland

Available from: 2020-01-02 Created: 2020-01-02 Last updated: 2021-04-25
Sundman, A.-S., Van Poucke, E., Svensson Holm, A.-C. B., Olsen Faresjö, Å., Theodorsson, E., Jensen, P. & Roth, L. (2020). Author Correction: Long-term stress levels are synchronized in dogs and their owners. Scientific Reports, 10(1)
Open this publication in new window or tab >>Author Correction: Long-term stress levels are synchronized in dogs and their owners
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2020 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1Article in journal (Other academic) Published
Place, publisher, year, edition, pages
Nature Publishing Group, 2020
National Category
Behavioral Sciences Biology
Identifiers
urn:nbn:se:liu:diva-174435 (URN)10.1038/s41598-020-74204-8 (DOI)000577457500001 ()33028958 (PubMedID)2-s2.0-85092523187 (Scopus ID)
Note

Correction to: Scientific Reports https://doi.org/10.1038/s41598-019-43851-x

Available from: 2021-03-21 Created: 2021-03-21 Last updated: 2023-12-28Bibliographically approved
Leijon, I., Bladh, M., Finnström, O., Gäddlin, P.-O., Hammar, M., Nelson, N., . . . Sydsjö, G. (2020). God prognos för unga vuxna med mycket låg födelsevikt [Follow-up study of very low birthweight children in Sweden at the age of 27-28]. Läkartidningen, 117
Open this publication in new window or tab >>God prognos för unga vuxna med mycket låg födelsevikt [Follow-up study of very low birthweight children in Sweden at the age of 27-28]
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2020 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 117Article in journal (Refereed) Published
Abstract [en]

Studies show that very low birthweight can be an important risk factor for mental problems, disturbed fertility and neuroendocrine dysregulation. In a regional long-term study 56 of 86 adult individuals 27 to 28 years of age with a very low birthweight were compared with normal birthweight controls. Analyses of self-reported mental health, socio-demographic factors, sex hormone levels, and hair cortisol levels showed no significant differences between the groups. However, in order to analyse subgroups with different risk factors from the newborn period or children with a variety of social background factors, larger patient groups are needed.

Place, publisher, year, edition, pages
Stockholm, Sweden: Sveriges Läkarförbund, 2020
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-174497 (URN)33259050 (PubMedID)
Note

Självskattning av mental hälsa, psykosociala förhållanden och könshormonnivåer hos unga vuxna kvinnoroch män med mycket låg födelsevikt skilde sig inte från respektive kontroller med normal födelsevikt.

Kvinnorna med mycket låg födelsevikt undersökta i tonåren hade mindre grad av utagerande beteende än kontrollerna, skillnader som var utjämnade i vuxen ålder.

Kvinnorna med mycket låg födelsevikt uppvisade högre koncentrationer av morgonkortisol i saliv än kvinnorna i kontrollgruppen. Den kliniska relevansen är osäker, då inget samband med beteendeskalorna kunde påvisas och på grund av att spridningen av kortisolnivåerna var stor.

Available from: 2021-03-22 Created: 2021-03-22 Last updated: 2024-01-10Bibliographically approved
Sauveroche, M., Henriksson, J., Theodorsson, E., Svensson Holm, A.-C. B. & Roth, L. (2020). Hair cortisol in horses (Equus caballus) in relation to management regimes, personality and breed. Journal of Veterinary Behavior, 37
Open this publication in new window or tab >>Hair cortisol in horses (Equus caballus) in relation to management regimes, personality and breed
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2020 (English)In: Journal of Veterinary Behavior, ISSN 1558-7878, Vol. 37Article in journal (Refereed) Published
Abstract [en]

Hair cortisol is a promising biomarker to measure long-term stress since cortisol is incorporated into the hair shaft as it grows. However, few studies have previously assessed hair cortisol concentrations (HCC) in horses. In this study, HCC was evaluated in both mane hair from the neck and body hair from the withers in 153 horses of different breeds, from seven different stables with three different management regimes (Free-roaming horses, Riding school horses, Trotter horses). In addition, 4 hours of behavioral observations were performed at each stable, and for 43 of the horses, a personality survey was completed. Mane and withers HCC correlated moderately, but significantly (rs=0.48, p<0.001). Differences between the stables were found for both mane and withers hair (both p<0.01) and the stable with lowest HCC also showed highest occurrences of positive social and resting behaviors (both p<0.01). There were no significant differences in HCC between the management regimes even though Free-roaming horses showed less negative social behavior compared to Riding school horses (p=0.041) and Trotter horses (p=0.055). The personality traits Dominance, Anxiousness, and Excitability revealed weak to moderate correlations with mane HCC (rs=-0.34, p=0.027; rs=-0.46, p=0.002; rs=-0.31, p=0.043 respectively) which might suggest that personality could also be related to long-term stress levels in horses.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Horse; Cortisol; Behavior; Stress; Welfare; Management; Personality
National Category
Other Veterinary Science
Identifiers
urn:nbn:se:liu:diva-163937 (URN)10.1016/j.jveb.2019.12.002 (DOI)000542146600001 ()
Available from: 2020-02-27 Created: 2020-02-27 Last updated: 2021-02-19Bibliographically approved
Leijon, I., Bladh, M., Finnström, O., Gäddlin, P.-O., Nelson, N., Hammar, M., . . . Sydsjö, G. (2020). Self-reported mental health and cortisol activity at 27-28 years of age in individuals born with very low birthweight. Acta Paediatrica, 109(5), 948-958
Open this publication in new window or tab >>Self-reported mental health and cortisol activity at 27-28 years of age in individuals born with very low birthweight
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2020 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 109, no 5, p. 948-958Article in journal (Refereed) Published
Abstract [en]

Aim

To assess mental health outcomes of very low birthweight (VLBW, <1500 g) subjects to adulthood and to examine salivary cortisol and hair cortisol levels and their relation to birth characteristics and mental health.

Methods

A Swedish regional cohort of 56 VLBW subjects and 55 full‐term controls were assessed at the ages 27‐28 with adult self‐reported scales and the mean of 2 days diurnal salivary cortisol and hair cortisol. The cohorts had been assessed at 15 years of age with youth self‐reported scales.

Results

There were no differences between the groups in youth self‐reported scales and adult self‐reported scores. The 24 participating VLBW girls scored lower on youth self‐reported scales externalising and total problem scores than the control girls. In adulthood, the 21 participating VLBW women had significantly higher morning concentrations of salivary cortisol than control women, P = .014. No significant associations were found between cortisol concentrations and adult self‐reported scales internalising, externalising and total scores.

Conclusion

Self‐reported mental health in VLBW subjects was comparable with normal birthweight controls indicating a satisfying transition from adolescence to adulthood. VLBW females had higher morning salivary cortisol concentrations, suggesting a gender difference. We found no correlations between cortisol and mental health.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2020
Keywords
adults; cortisol; longitudinal; low birthweight; mental health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-162725 (URN)10.1111/apa.15093 (DOI)000500499300001 ()31732987 (PubMedID)2-s2.0-85076315484 (Scopus ID)
Note

Funding Agencies|County Council of Ostergotland; Futurum-the Academy for Health and Care, Region Jonkoping County, Sweden

Available from: 2019-12-19 Created: 2019-12-19 Last updated: 2024-01-10Bibliographically approved
Gustavsson, E., Sjödahl, R. & Theodorsson, E. (2020). The ethical dilemma ofgranulocyte transfusions. Clinical Ethics, 15(3), 156-161
Open this publication in new window or tab >>The ethical dilemma ofgranulocyte transfusions
2020 (English)In: Clinical Ethics, ISSN 1477-7509, E-ISSN 1758-101X, Vol. 15, no 3, p. 156-161Article in journal (Refereed) Published
Abstract [en]

Granulocyte transfusions have been administered to patients with life-threatening infections for more than five decades. However, to what extent this should be the case is far from established. On the one hand, the clinical effects of these transfusions are difficult to prove in clinical studies, and the donors of granulocytes may be exposed to certain risks. On the other hand, clinical experience seems to support the idea that granulocyte transfusions do play an important role for severely ill patients, and the donors are primarily motivated by altruistic reasons. In this paper, we first discuss the ethical issues that arise from the fact that there is a conflict between clinical experience and the results from the attempts to perform randomized control trials, and second, the risk/benefit assessment that has to be made between two different parties, namely the recipient and the donor of granulocyte transfusions.

Place, publisher, year, edition, pages
Sage Publications, 2020
National Category
Medical Ethics
Identifiers
urn:nbn:se:liu:diva-165995 (URN)10.1177/1477750920927162 (DOI)
Available from: 2020-06-04 Created: 2020-06-04 Last updated: 2021-04-12Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-0756-7723

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