liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
BETA
Grodzinsky, Ewa
Alternative names
Publications (10 of 63) Show all publications
Rendek, Z., Falk, M., Grodzinsky, E., Wahlin, K., Kechagias, S., Svernlöv, R. & Hjortswang, H. (2016). Effect of oral diclofenac intake on faecal calprotectin. Scandinavian Journal of Gastroenterology, 51(1), 28-32.
Open this publication in new window or tab >>Effect of oral diclofenac intake on faecal calprotectin
Show others...
2016 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 51, no 1, p. 28-32Article in journal (Refereed) Published
Abstract [en]

Background. NSAIDs are a known source of increased faecal calprotectin (FC) levels. Currently, there is a lack of knowledge about how long it takes for an increased FC level to return to normal after NSAID intake. Objective. The aim was to investigate how oral diclofenac intake affects FC levels and assess how long it takes for an increased FC level to return to normal after oral diclofenac intake. Material and methods. Thirty healthy volunteers received diclofenac 50 mg three times daily for 14 days. Participants provided a stool sample on Days 0, 2, 4, 7, 14 during intake and Days 17, 21, 28 after discontinuation. FC levels were then followed at 7-day intervals until normalization. Results. During diclofenac intake, eight participants (27%) had FC levels exceeding the upper limit of normal (median, 76 mu g/g; range, 60-958 mu g/g), corresponding to 8.3% of measurements. FC was not constantly increased and became normal in most participants during diclofenac intake. FC levels were on average significantly higher during intake (M = 9.5, interquartile range (IQR) = 13.4) than on baseline (M = 7.5, IQR = 0.0), p = 0.003. After discontinuation, two participants had increased FC on Days 17 and 21, respectively. No significant differences in FC levels were found between baseline and measurements after discontinuation. Two weeks after discontinuation, all participants had normal FC levels. Conclusions. Short-term oral diclofenac intake is associated with increased FC levels. However, the likelihood of an increased test result is low. Our results suggest that 2 weeks of diclofenac withdrawal is sufficient to get an uninfluenced FC test result.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2016
Keyword
intestinal inflammation; proton pump inhibitors; NSAIDs; non-steroidal anti-inflammatory agents; diclofenac; calprotectin
National Category
Physiology Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-127586 (URN)10.3109/00365521.2015.1066421 (DOI)000373621900005 ()26200803 (PubMedID)
Note

Funding Agencies|County Council of Ostergotland, Sweden

Available from: 2016-05-03 Created: 2016-05-03 Last updated: 2018-01-10
Grodzinsky, E. & Sund-Levander, M. (2015). Assessment of Fever: Physiology, Immunology and Measurement in Clinical Practice (1ed.). Gleerups Utbildning AB.
Open this publication in new window or tab >>Assessment of Fever: Physiology, Immunology and Measurement in Clinical Practice
2015 (English)Book (Other academic)
Abstract [en]

When we say that someone has a fever, what do we really mean? Most people only take their temperature when they have a fever, and with good reason: fever is part of a larger response in the body.

Assessment of Fever, a problem-based learning (PBL) textbook, uses inter-professional discussions of scenarios from clinical practice to examine the question of body temperature. The authors start by examining the historical perspective and go on to consider technical measurement accuracy and thermoregulation from a physiological and immunological perspective. They address evaluations of body temperature and inflammatory activity in various conditions. They end by discussing how evidence-based knowledge can inform clinical practice, looking at different scenarios in the shape of case histories and realistic situations from clinical practice. These clinical scenarios are pertinent both in an inter-professional perspective in clinical practice and in the advanced education of health-care professionals, research scientists, and technicians. Each chapter concludes with a number of reflections and additional questions that the reader will be able to answer using the material presented in the book.

Place, publisher, year, edition, pages
Gleerups Utbildning AB, 2015. p. 162 Edition: 1
National Category
Public Health, Global Health, Social Medicine and Epidemiology Health Sciences
Identifiers
urn:nbn:se:liu:diva-118351 (URN)978-91-406-8696-1 (ISBN)
Available from: 2015-05-27 Created: 2015-05-27 Last updated: 2015-08-31Bibliographically approved
Grodzinsky, E., Walter, S., Viktorsson, L., Carlsson, A.-K., Jones, M. P. & Olsen Faresjö, A. (2015). More negative self-esteem and inferior coping strategies among patients diagnosed with IBS compared with patients without IBS - a case-control study in primary care. BMC Family Practice, 16(6).
Open this publication in new window or tab >>More negative self-esteem and inferior coping strategies among patients diagnosed with IBS compared with patients without IBS - a case-control study in primary care
Show others...
2015 (English)In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 16, no 6Article in journal (Refereed) Published
Abstract [en]

Background

Irritable Bowel Syndrome (IBS) is a chronic, relapsing gastrointestinal disorder,that affects approximately 10% of the general population and the majority are diagnosed  in primary care. IBS has been reported to be associated with altered psychological and cognitive functioning such as mood disturbances, somatization, catastrophizing or altered visceral interoception by negative emotions and stress. The aim was to  investigate the psychosocial constructs of self-esteem and sense of coherence among IBS patients compared to non-IBS patients in primary care.     

Methods

A case–control study in primary care setting among IBS patients meeting the ROME III         criteria (n = 140) compared to controls i.e. non-IBS patients (n = 213) without any         present or previous gastrointestinal complaints. The data were collected through self-reportedquestionnaires of psychosocial factors.     

Results

IBS-patients reported significantly more negative self-esteem (p < 0.001), lower scores         for positive self-esteem (p < 0.001), and lower sense of coherence (p < 0.001) than the controls. The IBS-cases were also less likely to report ‘good’ health status (p < 0.001) and less likely to report a positive belief in the future (p < 0.001). After controlling for relevant confounding factors in multiple regressions, the elevation  in negative self-esteem among IBS patients remained statistically significant (p =0.02), as did the lower scores for sense of coherence among IBS cases (p = 0.04).     

Conclusions

The more frequently reported negative self-esteem and inferior coping strategies among         IBS patients found in this study suggest the possibility that psychological therapies         might be helpful for these patients. However these data do not indicate the causal         direction of the observed associations. More research is therefore warranted to determine whether these psychosocial constructs are more frequent in IBS patients.

Place, publisher, year, edition, pages
BioMed Central, 2015
Keyword
Primary care; IBS; Self-esteem; Coping; Psychosocial factors
National Category
Gastroenterology and Hepatology Psychology
Identifiers
urn:nbn:se:liu:diva-114578 (URN)10.1186/s12875-015-0225-x (DOI)000349125500001 ()25626450 (PubMedID)
Note

Funding Agencies|FORSS (Research fund in South of Sweden)

Available from: 2015-02-27 Created: 2015-02-26 Last updated: 2017-12-04
Tingström, P., Milberg, A., Rodhe, N., Ernerudh, J., Grodzinsky, E. & Sund-Levander, M. (2015). Nursing assistants: "He seems to be ill" - a reason for nurses to take action: validation of the Early Detection Scale of Infection (EDIS). BMC Geriatrics, 15(122).
Open this publication in new window or tab >>Nursing assistants: "He seems to be ill" - a reason for nurses to take action: validation of the Early Detection Scale of Infection (EDIS)
Show others...
2015 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, no 122Article in journal (Refereed) Published
Abstract [en]

Background: Signs and symptoms of infection in frail elderly are atypical, causing delay in diagnosis and treatment. To improve communication between healthcare staff of signs and symptoms of infection we developed an instrument, using qualitative data from observations by nursing assistants when they suspected infection. The aim of this study was to assess the validity of nursing assistants observations by developing and testing the instrument for early detection of infection in elderly nursing home residents. Methods: The early detection of infection (EDIS) instrument was based on data from focus interviews with nursing assistants. Over one year the nursing assistants used EDIS to document episodes of suspected early signs and symptoms of infection in 204 nursing home residents. Two physicians classified documented episodes as "no infection", "possible infection", and "infection". The content validity of the 13 items of the EDIS was established to explore the relationships between the items. The construct validity was used to explore the relationship between the items and the presence or absence of infection. The predictive value of the developed model was evaluated by the percentage of correct classifications of the observed cases. Generalized linear model (ordinal multinomial distribution and logit link) was used. Results: Of the 388 events of suspected infection, 20 % were assessed as no infection, 31 % as possible infection and 49 % as infection. Content validity analysis showed that 12/13 of the items correlated significantly with at least one other statement. The range in number of significant inter-correlations was from 0 ("pain") to 8 ("general signs and symptoms of illness"). The construct validity showed that the items "temperature", "respiratory symptoms" and "general signs and symptoms of illness" were significantly related to "infection", and these were also selected in the model-building. These items predicted correct alternative responses in 61 % of the cases. Conclusion: The validation of EDIS suggests that the observation of "general signs and symptoms of illness", made by nursing assistants should be taken seriously in detecting early infection in frail elderly. Also, the statement "He/She is not as usual" should lead to follow-up.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2015
Keyword
Nursing home residents; Clinical assessment; Instrument validation; Instrument construction
National Category
Clinical Medicine Sociology
Identifiers
urn:nbn:se:liu:diva-122527 (URN)10.1186/s12877-015-0114-0 (DOI)000362866800002 ()26459627 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden; Futurum/The Academy for Health and Care, Jonkoping County, Sweden

Available from: 2015-11-09 Created: 2015-11-06 Last updated: 2017-12-01
Sund-Levander, M. & Grodzinsky, E. (2015). The Challenge of Infections in Frail Elderly: The Story of Mr. Nilsson. Clinical Medical Reviews and Case Reports, 2(4).
Open this publication in new window or tab >>The Challenge of Infections in Frail Elderly: The Story of Mr. Nilsson
2015 (English)In: Clinical Medical Reviews and Case Reports, ISSN 2378-3656, Vol. 2, no 4Article in journal (Refereed) Published
Abstract [en]

Signs and symptoms of infection in Nursing Home Residents (NHR) are often atypical with a lack of specific ones, causing a delay in diagnosis and treatment. The complexity of detecting infections in NHR can be explained by difficulties in understanding and interpreting non-specific signs and symptoms and co-existing chronic diseases that blur the clinical picture. The case of Mr. Nilsson illustrates the process from the first signs and symptoms of infection to diagnosis in an elderly person with severe cognitive decline and physical impairment. What we can learn from this case is to reflect on changed behavior from habitual status and/or non-specific symptoms as possible suspected infection, and to consider a rise from individual baseline temperature, so called DiffTemp™, instead of traditional decided cut-off values for fever.

Keyword
Assessment, Fever, Infection, Interleukin, Nursing home resident
National Category
Geriatrics
Identifiers
urn:nbn:se:liu:diva-123975 (URN)
Available from: 2016-01-15 Created: 2016-01-15 Last updated: 2016-04-24Bibliographically approved
Bragde, H., Jansson, U., Fredrikson, M., Grodzinsky, E. & Soederman, J. (2014). Potential blood-based markers of celiac disease. BMC Gastroenterology, 14(176).
Open this publication in new window or tab >>Potential blood-based markers of celiac disease
Show others...
2014 (English)In: BMC Gastroenterology, ISSN 1471-230X, E-ISSN 1471-230X, Vol. 14, no 176Article in journal (Refereed) Published
Abstract [en]

Background: Blood-based diagnostics has the potential to simplify the process of diagnosing celiac disease (CD). Although high levels of autoantibodies against tissue transglutaminase (anti-TG2) are strongly indicative of active CD, several other scenarios involve a need for additional blood-based CD markers. Methods: We investigated the levels of messenger RNA (mRNA) in whole blood (n = 49) and protein in plasma (n = 22) from cases with active CD (n = 20), with confirmed CD and normalized histology (n = 15), and without a CD diagnosis (n = 14). Group differences were analyzed using Kruskal-Wallis one-way analysis of variance by ranks. We also investigated correlations between levels of potential markers, histopathology according to the modified Marsh scale, and CD risk gradient based on HLA type, using Spearman rank correlation. The relation between HLA-DQ2 gene dose effect and the expression levels of selected blood-based markers was investigated using the Mann-Whitney U test. Finally, the diagnostic performance of anti-TG2, potential blood-based CD markers, and logistic regression models of combined markers was evaluated using receiver operating characteristic (ROC) curve analysis. Results: CXCL11 protein levels and TNFRSF9 and TNFSF13B mRNA levels were identified as potential CD markers. These are all affected by or involved in the regulation of the NF-kappa B complex. CXCL11 protein levels and IL21 and IL15 mRNA levels were correlated with histopathology according to the modified Marsh scale, as were the established CD markers. HLA genotype risk and HLA-DQ2 gene dose effect did not show any significant relations with either the potential CD markers or the established CD markers. ROC curve analysis revealed a slight, non-significant increase in the area under the curve for the combined use of anti-TG2 and different constellations of potential blood-based CD markers compared to anti-TG2 alone. Conclusions: The CD markers identified in this study further emphasize the significance of components related to NF-kappa B regulation in relation to CD. However, the relevance of CXCL11, TNFSF13B, TNFRSF9, and other NF-kappa B interacting proteins recognized by pathway analysis, needs to be further investigated in relation to diagnosis and monitoring of CD.

Place, publisher, year, edition, pages
BioMed Central, 2014
Keyword
Celiac disease; Molecular diagnostics; Blood-based biological markers
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-112037 (URN)10.1186/1471-230X-14-176 (DOI)000342782900001 ()25298177 (PubMedID)
Note

Funding Agencies|Futurum - the Academy for Healthcare; Jonkoping County Council; Medical Research Council of Southeast Sweden

Available from: 2014-11-17 Created: 2014-11-13 Last updated: 2017-12-05
Sund-Levander, M. & Grodzinsky, E. (2013). Assessment of body temperature measurement options. British Journal of Nursing, 22(16), 942-950.
Open this publication in new window or tab >>Assessment of body temperature measurement options
2013 (English)In: British Journal of Nursing, ISSN 0966-0461, E-ISSN 2052-2819, Vol. 22, no 16, p. 942-950Article in journal (Refereed) Published
Abstract [en]

Assessment of body temperature is important for decisions in nursing care, medical diagnosis, treatment and the need of laboratory tests. The definition of normal body temperature as 37°C was established in the middle of the 19th century. Since then the technical design and the accuracy of thermometers has been much improved. Knowledge of physical influence on the individual body temperature, such as thermoregulation and hormones, are still not taken into consideration in body temperature assessment. It is time for a change; the unadjusted mode should be used, without adjusting to another site and the same site of measurement should be used as far as possible. Peripheral sites, such as the axillary and the forehead site, are not recommended as an assessment of core body temperature in adults. Frail elderly individuals might have a low normal body temperature and therefore be at risk of being assessed as non-febrile. As the ear site is close to the hypothalamus and quickly responds to changes in the set point temperature, it is a preferable and recommendable site for measurement of body temperature.

Place, publisher, year, edition, pages
London: MA Healthcare Ltd, 2013
Keyword
Axillary, Ear, Oral, Rectal, Evidence-based, Measurement
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-98138 (URN)24037397 (PubMedID)
Available from: 2013-09-30 Created: 2013-09-30 Last updated: 2017-12-06Bibliographically approved
Hallgren, I.-M., Grodzinsky, E. & Törnvall, E. (2013). “Measuring makes aware” Implementation of the Diabetes Registry for Quality Improvement in Primary Health . In: Abstracts. Paper presented at The Nordic Conference on Implementation of Evidence-Based Practice, Linköping 5-6 feb 2013 (pp. 26-27). Linköping.
Open this publication in new window or tab >>“Measuring makes aware” Implementation of the Diabetes Registry for Quality Improvement in Primary Health
2013 (English)In: Abstracts, Linköping, 2013, p. 26-27Conference paper, Oral presentation with published abstract (Refereed)
Place, publisher, year, edition, pages
Linköping: , 2013
Keyword
Quality register, diabetes, implementation, primary helath care
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-90643 (URN)
Conference
The Nordic Conference on Implementation of Evidence-Based Practice, Linköping 5-6 feb 2013
Available from: 2013-04-03 Created: 2013-04-03 Last updated: 2013-04-24Bibliographically approved
Olsen Faresjö, Å., Grodzinsky, E., Hallert, C. & Timpka, T. (2013). Patients with irritable bowel syndrome are more burdened by co-morbidity and worry about serious diseases than healthy controls- eight years follow-up of IBS patients in primary care. BMC Public Health, 13(832).
Open this publication in new window or tab >>Patients with irritable bowel syndrome are more burdened by co-morbidity and worry about serious diseases than healthy controls- eight years follow-up of IBS patients in primary care
2013 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, no 832Article in journal (Refereed) Published
Abstract [en]

Background

Irritable Bowel Syndrome (IBS) is a hidden public health disease that affects up to 20% of the general population. Although co-morbidity can affect diagnose setting and treatment of the disease, there are few studies concerning diagnosed and registered co-morbidity for IBS patients in primary care. The aim of this study was to analyse co-morbidity among IBS-patients compared to age- and sex-matched controls from the general population using data from a county-wide computerized medical record system.

Methods

IBS cases were recruited from three Swedish primary health care centres during a five-years period and controls from the same corresponding geographical areas. Co-morbidity data for IBS-patients and morbidity data for controls were derived from a population-based Health Care Register (HCR) covering all diagnoses in primary as well as hospital care in the region. Odds Ratios with 95% confidence intervals for morbidity in gastro-intestinal and non-gastrointestinal diagnoses for cases with irritable bowel syndrome compared to controls were calculated separately for each gender and diagnosis.

Results

We identified more co-morbidity among IBS patients of both sexes, compared to matched controls in the general population. Patients with IBS were particularly more worried about having a serious disease than their control group. The risk among male IBS-cases to get this latter diagnose was three times higher compared to the male controls.

Conclusions

In this population based case–control study, the analysis of diagnoses from the HCR revealed a broad spectrum of common co-morbidity and significantly more physician-recorded diagnoses among IBS-patients in comparisons to the control group.

Place, publisher, year, edition, pages
London: BioMed Central, 2013
Keyword
Functional gastrointestinal disorder; Co-morbidity; Case–control; Public health problem; Disease worry; Gender
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:liu:diva-98161 (URN)10.1186/1471-2458-13-832 (DOI)000324462000001 ()
Available from: 2013-09-30 Created: 2013-09-30 Last updated: 2017-12-06Bibliographically approved
Nilsson, S., Andersson, P. O., Borgquist, L., Grodzinsky, E., Janzon, M., Kvick, M., . . . Karlsson, J.-E. (2013). Point-of-Care Troponin T Testing in the Management of Patients with Chest Pain in the Swedish Primary Care. International Journal of Family Medicine, 2013.
Open this publication in new window or tab >>Point-of-Care Troponin T Testing in the Management of Patients with Chest Pain in the Swedish Primary Care
Show others...
2013 (English)In: International Journal of Family Medicine, ISSN 2090-2042, E-ISSN 2090-2050, Vol. 2013Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-97557 (URN)10.1155/2013/532093 (DOI)
Available from: 2013-09-16 Created: 2013-09-16 Last updated: 2017-12-22
Organisations

Search in DiVA

Show all publications