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

Direct link
BETA
Redéen, Stefan
Publications (10 of 12) Show all publications
Redéen, S. (2017). The Trend of Tranexamic Use in Upper Gastrointestinal Bleeding Ulcers. Gastroenterology Research, 10(3), 159-165
Open this publication in new window or tab >>The Trend of Tranexamic Use in Upper Gastrointestinal Bleeding Ulcers
2017 (English)In: Gastroenterology Research, ISSN 1918-2805, E-ISSN 1918-2813, Vol. 10, no 3, p. 159-165Article in journal (Refereed) Published
Abstract [en]

Background: Bleeding ulcer is a common condition, especially among the elderly population. Tranexamic acid (TXA) has been successfully used for many bleeding conditions. Its use in patients with bleeding ulcer is inclusive yet. The aim of this study was to provide an overview of the prescription of TXA.

Methods: This retrospective cohort study was performed as a review of medical records at the Surgery Department, University Hospital in Linkoping. Patients with complete esophagogastroduodenoscopy and ulcer disease were included and divided on the basis of treatment with TXA or not. Differences between the groups were statistically analyzed.

Results: The main part of the prescription of TXA, 65%, occurred during 2010 and 2011, and 35% between 2012 and 2013 (P < 0.05). In the group treated with TXA, 84% needed blood transfusion, compared to 64% in the control group (P = 0.039). Of the patients treated with TXA, 18% were re-bleeding compared to 14% of the controls (P = 0.594). Median value for days at hospital was 5 in the tranexamic group and 3 in the control group (P = 0.005).

Conclusion: The prescription of TXA has declined between 2010 and 2013. TXA was more often prescribed to patients with more severe gastrointestinal (GI) bleeding ulcer disease. Further investigation is needed to conclude the significance of tranexamic acid in patients with GI bleeding ulcer disease.

Place, publisher, year, edition, pages
Montreal, Canada: Elmer Press Inc., 2017
Keywords
Bleeding ulcer; Esophagogastroduodenoscopy; H. pylori; Hematemesis; Melena; Tranexamic acid
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:liu:diva-146283 (URN)10.14740/gr836w (DOI)28725302 (PubMedID)
Available from: 2018-04-07 Created: 2018-04-07 Last updated: 2018-05-04Bibliographically approved
Altgärde, J., Redéen, S., Hilding, N. & Drott, P. (2014). Horse-related trauma in children and adults during a two year period. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 22(40)
Open this publication in new window or tab >>Horse-related trauma in children and adults during a two year period
2014 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 22, no 40Article in journal (Refereed) Published
Abstract [en]

Introduction: Horse riding, with almost 200,000 participants, is the eighth most popular sport in Sweden. Severe injuries can occur with horse riding accidents which is well documented. This study was undertaken to investigate if injuries associated with horse riding are common, which type of injuries occur, what mechanisms are involved and to estimate the costs to the society. Material and methods: All patients attending the emergency department at Link ping University Hospital, during the years 2003-2004, due to horse related trauma were prospectively recorded. The patients were divided into two groups according to age, 147 children and 141 adults. The medical records were retrospectively scrutinized. Results: The most common mechanism of injury was falling from the horse. Most commonly, minor sprains and soft tissue injuries were seen, but also minor head injuries and fractures, mainly located in the upper limb. In total 26 adults and 37 children were admitted. Of these 63 patients 19 were considered having a serious injury. In total, four patients needed treatment in intensive care units. The total cost in each group was 200,000 Euro/year. Conclusion: Horse riding is a sport with well known risks. Our results corresponds to the literature, however we have not observed the same incidence of serious injuries. In contrast we find these to be fairly uncommon. The injuries are mainly minor, with a small risk of long term morbidity. Over time regulations and safety equipment seem to have decreased the number of serious accidents.

Place, publisher, year, edition, pages
BioMed Central, 2014
Keywords
Accidents; Adults; Children; Costs; Fractures; Health care consumption; Horse; Trauma
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-109592 (URN)10.1186/s13049-014-0040-8 (DOI)000339573300001 ()25030979 (PubMedID)
Available from: 2014-08-21 Created: 2014-08-21 Last updated: 2017-12-05Bibliographically approved
Redéen, S., Petersson, F., Törnkrantz, E., Levander, H., Mårdh, E. & Borch, K. (2011). Reliability of diagnostic tests for Helicobacter pylori infection. Gastroenterology Research and Practice, 2011(940650)
Open this publication in new window or tab >>Reliability of diagnostic tests for Helicobacter pylori infection
Show others...
2011 (English)In: Gastroenterology Research and Practice, ISSN 1687-6121, E-ISSN 1687-630X, Vol. 2011, no 940650Article in journal (Refereed) Published
Abstract [en]

Introduction: Helicobacter pylori (H.pylori) infection is very common worldwide. A reliable diagnosis is crucial for patients with H.pylori related diseases. At follow-up it is important to confirm that eradication therapy has been successful. There is no established gold standard for the diagnosis of H.pylori infection.

Material and Methods: A sample of 304 volunteers from the general population was screened for H.pylori infection with serology, 13C-urea breath test (UBT), rapid urease test (RUT) on fresh biopsy, culture from biopsy and histological examination. Each method was tested against the other methods (except serology) taken together as gold standard.

Result: The sensitivity was 0.99 for serology 0.92 for UBT, 0.96 for RUT, 0.99 for culture and 0.95 for histological examination. Corresponding specificities were 0.82, 0.94, 0.93, 0.90 and 0.92, respectively. The accuracy was 0.86 for serology, 0.94 for UBT, 0.94 for RUT, 0.93 for culture and 0.93 for histology. There was a strong correlation between the results of UBT and histological scores for H.pylori colonization as well as between the results of UBT and the scores of RUT.

Conclusion: There were only minor differences in accuracy between three invasive tests for H.pylori infection in this population. RUT may be recommended as first choice since a result is obtained within hours. The accuracy of UBT was comparable to the invasive tests and it is recommended for situations when endoscopy is not needed.

Place, publisher, year, edition, pages
Hindawi, 2011
Keywords
Accuracy, diagnosis, diagnostic test, gold standard, H. pylori, sinsitivity, specificity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-56574 (URN)10.1155/2011/940650 (DOI)000295641000001 ()
Note
Funding agencies|Swedish Cancer Society||Research Council in the South East of Sweden (FORSS)||Available from: 2010-05-25 Created: 2010-05-25 Last updated: 2017-12-12
Redéen, S. (2010). Chronic Gastritis: Diagnosis, natural history and consequences. (Doctoral dissertation). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Chronic Gastritis: Diagnosis, natural history and consequences
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background & alms: The main cause of chronic gastritis is Helicobacter pylori (H. pylori). Clinical manifestations of chronic gastritis are ulcer disease, gastric cancer and mucosa-associated lymphoma tissue (MALT) lymphoma in the stomach. It is uncertain whether gastritis can be diagnosed macroscopically at endoscopy. H. pylori infection may be diagnosed by several different methods, the accuracy of which needs to be explored. Some individuals with H. pylori related chronic gastritis will develop atrophy of the gastric mucosa. This condition is the main risk factor for cancer development and may also be associated with vitamin B12 deficiency leading to hyperhomocysteinaemia. The natural history of chronic gastritis in terms of development of atrophy and ulcer disease in the adult general population is largely unknown.

Material & methods: A sample of 50 I volunteers from the general population in the municipality of Linköping was examined with esophago-gastro-duodenoscopy (EGD) with biopsy. Blood samples were collected in the fasting state and the subjects answered a questionnaire about lifestyle factors, medications and disease history. In-hospital diagnoses and causes of death during follow-up of the population were extracted from local and national patient files. Re-examination was done in 314 subjects after a median follow-up interval of 8.4 years. Five diagnostic tests (serology UBT, RUT, culture and microscopic examination) for H. pylori infection were used at re-examination.

Results: The best values of sensitivity and specificity were for visible vessels in relation to microscopic presence of severe atrophy in the gastric corpus mucosa (80% and 87%, respectively). There was a positive relation of S-homocysteine to male gender, age, S-cystatin C (renal function), methylenetetrahydrofolate reductase 677TT genotype and atrophic gastritis. Logistic regression analysis showed an association of S-homocysteine higher than 14.5 Ilmol/L to cardiovascular diseases (OR 2.05), but not to dementia overall.

The incidence ofulcer was 0.45 per 100 person years and was associated with weekly NSAID use, weekly alcohol consumption (OR 19.4) and smoking (OR 31.0), but not with H. pylori status. Among subjects with chronic gastritis, the incidence of atrophy of the corpus mucosa was 1.4 per 100 person years. Considering diagnostic test for H. pylori infection the accuracy was 0.86 for serology, 0.94 for UBT, 0.94 for RUT, 0.93 for culture, and 0.93 for histological examination. There was a strong correlation between the results of UBT and the histological scores of H. pylori colonisation as well as between the results of UBT and scores of RUT.

Conclusions: The occurrence of chronic gastritis or H. pylori infection is not evaluable macroscopically at gastroscopy, except for the absence of rugae or visible vessels in the gastric corpus mucosa. Serum Hcy concentrations are dependent on gender, age, the levels of vitamin B12 and folate, renal function, the occurrence of atrophic gastritis and the MTHFR 677 TT genotype. Elevated S-Hcy is a risk factor for cardiovascular disease. The incidence of atrophy of the corpus mucosa is 1.4 per 100 person years for chronic gastritis overall. Chronic gastritis with or without H. pylori infection is a variable process in which milder degrees of atrophy of the corpus mucosa may appear or disappear. In contrast, moderate-to-severe atrophy of the corpus mucosa rarely regresses. Age and the degree of chronic inflammation in the gastric corpus mucosa are major risk factors for the development of atrophy. The incidence of ulcer was 0.45 per 100 person years. There are only minor differences in accuracy between the three invasive tests for H. pylori infection. The UBT is recommended for situations where endoscopy is not required. RUT may be recommended as the first non-invasive method of choice in the diagnosis of H. pylori infection.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2010. p. 72
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1174
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-56575 (URN)978-91-7393-426-8 (ISBN)
Public defence
2010-06-11, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2010-05-25 Created: 2010-05-25 Last updated: 2012-05-09Bibliographically approved
Redéen, S., Ryberg, A., Petersson, F., Eriksson, O., Nägga, K. & Borch, K. (2010). Homocysteine Levels in Chronic Gastritis and Other Conditions: Relations to Incident Cardiovascular Disease and Dementia. DIGESTIVE DISEASES AND SCIENCES, 55(2), 351-358
Open this publication in new window or tab >>Homocysteine Levels in Chronic Gastritis and Other Conditions: Relations to Incident Cardiovascular Disease and Dementia
Show others...
2010 (English)In: DIGESTIVE DISEASES AND SCIENCES, ISSN 0163-2116, Vol. 55, no 2, p. 351-358Article in journal (Refereed) Published
Abstract [en]

Background Homocysteine levels in circulation are determined by several factors and hyperhomocysteinemia is reportedly associated with cardiovascular diseases and dementia. The aim of this study is to determine the relation of chronic gastritis and other conditions to homocysteine levels and their relation to incident cardiovascular diseases and dementia. Methods An adult population-based cohort (N = 488) was screened for H. pylori infection, gastro-duodenitis ( endoscopic biopsies), disease history, and lifestyle factors. Blood samples were analyzed for pepsinogen I and II ( gastric function), vitamin B12, folate, homocysteine, and cystatin C ( renal function). The methylenetetrahydrofolate reductase C677T polymorphism reportedly associated with hyperhomocysteinemia was analyzed by pyrosequencing. Incident cardiovascular diseases and dementia were monitored during a median follow-up interval of 10 years. Results At baseline, there was a positive relation of S-homocysteine to male gender, age, S-cystatin C, methylenetetrahydrofolate reductase 677TT genotype and atrophic gastritis. During follow-up, cardiovascular diseases occurred in 101/438 and dementia in 25/488 participants, respectively. Logistic regression analysis ( adjusting for gender, age at baseline, follow-up interval, BMI, smoking, alcohol consumption, NSAID use, P-cholesterol, and P-triglycerides) showed an association of S-homocysteine higher than 14.5 mu mol/l to cardiovascular diseases (OR 2.05 [95% c.i. 1.14-3.70]), but not to dementia overall. Conclusions Gender, age, vitamin B12, folate, renal function, atrophic gastritis and the methylenetetrahydrofolate 677TT genotype were significant determinants of homocysteine levels, which were positively related to incident cardiovascular diseases.

Keywords
Atrophic gastritis, Cardiovascular disease, Cohort, Cystatin C, Dementia, Folate, Gastritis, Homocysteine, H. pylori, Pepsinogen, Vitamin B12
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-53694 (URN)10.1007/s10620-009-0761-0 (DOI)
Available from: 2010-02-01 Created: 2010-02-01 Last updated: 2019-06-27
Redéen, S., Petersson, F., Kechagias, S., Mårdh, E. & Borch, K. (2010). Natural history of chronic gastritis in a population-based cohort. SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 45(5), 540-549
Open this publication in new window or tab >>Natural history of chronic gastritis in a population-based cohort
Show others...
2010 (English)In: SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, ISSN 0036-5521, Vol. 45, no 5, p. 540-549Article in journal (Refereed) Published
Abstract [en]

Objective. To describe and explore the natural history of Helicobacter pylori infection and chronic gastritis in terms of gastric mucosal atrophy and ulcer development over time in a population-based cohort. Material and methods. A population-based cohort of 314 volunteers was re-screened (median follow-up interval of 8.4 years) with gastroduodenoscopy with biopsy, assessment of H. pylori status, analysis of pepsinogens, and monitoring of a nonsteroidal anti-inflammatory drug (NSAID) use and alcohol and smoking habits. Results. The incidence of duodenal or prepyloric ulcer was 0.45 per 100 person years and was associated with weekly NSAID use (odds ratios, OR 27.8), weekly alcohol consumption (OR 19.4) and smoking (OR 31.0), but not with H. pylori status. De novo infection with H. pylori was not observed, and the infection had disappeared in 11 of 113 subjects. Among subjects with chronic gastritis, the incidence of atrophy of the corpus mucosa was 1.4 per 100 person years. Atrophy development was related to age (OR 1.23) and to the severity of chronic inflammation in the corpus mucosa at baseline (OR 8.98). Substituting atrophy for subnormal S-pepsinogen I/S-pepsingen II gave similar results. Conclusions. In this cohort, the minimum incidence of ulcer was 0.45 per 100 person years. Smoking, alcohol, and NSAIDs, but not H. pylori infection were significant risk factors. The incidence of atrophy of the corpus mucosa was 1.4 per 100 person years with a positive relation to age and to the degree of chronic inflammation at baseline. Atrophy was stationary in advanced stages.

Place, publisher, year, edition, pages
Taylor and Francis, 2010
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-56293 (URN)10.3109/00365521003624151 (DOI)000276897600005 ()
Note
This is an electronic version of an article published in: Stefan Redéen, Fredrik Petersson, Stergios Kechagias, Erik Mårdh and Kurt Borch, Natural history of chronic gastritis in a population-based cohort, 2010, SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, (45), 5, 540-549. SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY is available online at informaworldTM: http://dx.doi.org/10.3109/00365521003624151 Copyright: Taylor and Francis http://www.tandf.co.uk/journals/default.asp Available from: 2010-05-07 Created: 2010-05-07 Last updated: 2010-05-29
Berg, A., Redéen, S., Sjöstrand, S.-E. & Ericson, A.-C. (2007). Effect of nitric oxide on histamine-induced cytological transformations in parietal cells in isolated human gastric glands. Digestive Diseases and Sciences, 52(1), 126-136
Open this publication in new window or tab >>Effect of nitric oxide on histamine-induced cytological transformations in parietal cells in isolated human gastric glands
2007 (English)In: Digestive Diseases and Sciences, ISSN 0163-2116, E-ISSN 1573-2568, Vol. 52, no 1, p. 126-136Article in journal (Refereed) Published
Abstract [en]

Previous studies have shown that nitric oxide (NO) inhibits histamine-induced gastric acid secretion in isolated human gastric glands. NO synthase has been found to be present in the human oxyntic mucosa and has been suggested to serve as a paracrine regulator of gastric acid secretion. Histamine stimulation of parietal cells induces cytoskeletal rearrangements, recruitment of H +/K +-ATPase-rich tubulovesicles to the apical membrane and expansion of intracellular canaliculi. The aim of the present study was thus to investigate (i) the effect of an NO donor on histamine-induced cytological transformations and (ii) the influence of increased [Ca 2+] i on NO-induced morphological changes in human parietal cells. Human gastric glands were isolated and subjected to the NO donor SNAP prior to histamine administration. [Ca 2+] i was increased by photolysis of the caged Ca 2+ compound NP-EGTA. The distribution of F-actin, ezrin, and H +/K +-ATPase was assessed by confocal microscopy. Ultrastructural analysis was performed using transmission electron microscopy. SNAP did not influence the histamine-induced translocation of F-actin, ezrin, and H +/K +-ATPase but prevented an increase in the canalicular size. Elevation of [Ca 2+] i in resting cells was found to mimic histamine-induced intraparietal cell transformations; however, NO-induced parietal cell morphology was unaffected by a rise in [Ca 2+] i. These results indicate that NO inhibits secretion of fluid into the canalicular lumen without affecting membrane recruitment and that this effect is Ca 2+-insensitive. © 2006 Springer Science+Business Media, Inc.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-40472 (URN)10.1007/s10620-006-9439-z (DOI)53339 (Local ID)53339 (Archive number)53339 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13Bibliographically approved
Redéen, S., Engström, H., Erikson, S., Haldestam, I., Leinsköld, T. & Johansson, K.-E. (2005). Abdominell tuberkulos - en nygammal diagnostisk utmaning. Läkartidningen, 102(30-31), 2151-2153
Open this publication in new window or tab >>Abdominell tuberkulos - en nygammal diagnostisk utmaning
Show others...
2005 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, no 30-31, p. 2151-2153Article in journal (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-33243 (URN)19242 (Local ID)19242 (Archive number)19242 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
Berg, A., Redéen, S., Grenegård, M., Ericson, A.-C. & Sjöstrand, S.-E. (2005). Nitric oxide inhibits gastric acid secretion by increasing intraparietal cell levels of cGMP in isolated human gastric glands. American Journal of Physiology - Gastrointestinal and Liver Physiology, 289(6), G1061-G1066
Open this publication in new window or tab >>Nitric oxide inhibits gastric acid secretion by increasing intraparietal cell levels of cGMP in isolated human gastric glands
Show others...
2005 (English)In: American Journal of Physiology - Gastrointestinal and Liver Physiology, ISSN 0193-1857, E-ISSN 1522-1547, Vol. 289, no 6, p. G1061-G1066Article in journal (Refereed) Published
Abstract [en]

We have previously identified cells containing the enzyme nitric oxide (NO) synthase (NOS) in the human gastric mucosa. Moreover, we have demonstrated that endogenous and exogenous NO has been shown to decrease histamine-stimulated acid secretion in isolated human gastric glands. The present investigation aimed to further determine whether this action of NO was mediated by the activation of guanylyl cyclase (GC) and subsequent production of cGMP. Isolated gastric glands were obtained after enzymatic digestion of biopsies taken from the oxyntic mucosa of healthy volunteers. Acid secretion was assessed by measuring [14C]aminopyrine accumulation, and the concentration of cGMP was determined by radioimmunoassay. In addition, immunohistochemistry was used to examine the localization of cGMP in mucosal preparations after stimulation with the NO donor S-nitroso-N-acetylpenicillamine (SNAP). SNAP (0.1 mM) was shown to decrease acid secretion stimulated by histamine (50 μM); this effect was accompanied by an increase in cGMP production, which was histologically localized to parietal cells. The membrane-permeable cGMP analog dibuturyl-cGMP (db-cGMP; 0.1–1 mM) dose dependently inhibited acid secretion. Additionally, the effect of SNAP was prevented by preincubating the glands with the GC inhibitor 4H-8-bromo-1,2,4-oxadiazolo[3,4-d]benz[b][1,4]oxazin-1-one (10 μM). We therefore suggest that NO in the human gastric mucosa is of physiological importance in regulating acid secretion. Furthermore, the results show that NO-induced inhibition of gastric acid secretion is a cGMP-dependent mechanism in the parietal cell involving the activation of GC.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-31485 (URN)10.1152/ajpgi.00230.2005 (DOI)17277 (Local ID)17277 (Archive number)17277 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
Berg, A., Redéen, S., Ericson, A.-C. & Sjöstrand, S.-E. (2004). Nitric oxide-an endogenous inhibitor of gastric acid secretion in isolated human gastric glands. BMC Gastroenterology, 4(16)
Open this publication in new window or tab >>Nitric oxide-an endogenous inhibitor of gastric acid secretion in isolated human gastric glands
2004 (English)In: BMC Gastroenterology, ISSN 1471-230X, E-ISSN 1471-230X, Vol. 4, no 16Article in journal (Refereed) Published
Abstract [en]

Background

Endothelial nitric oxide synthase (eNOS) has previously been detected in the glandular part of the human gastric mucosa. Furthermore, nitric oxide (NO) has been shown to influence gastric secretion in various animal models. The present study was conducted to investigate the influence of exogenously and endogenously derived NO on histamine- and cAMP-stimulated gastric acid secretion in isolated human oxyntic glands.

Methods

Oxyntic glands were isolated from human gastric biopsies and were subsequently pre-treated with NO donors and nitric oxide synthase inhibitors and then exposed to histamine or dibutyryl-cAMP (db-cAMP). The secretory response of the glands was determined as accumulation of [14C]aminopyrine.

Results

The histamine- or db-cAMP-induced acid secretion was attenuated by L-arginine, a known source of endogenous NO, and also by the NO-donors sodium nitroprusside (SNP) and S-nitroso-N-acetyl-penicillamine (SNAP). Pre-treatment with either of the NOS inhibitors NG-nitro-L-arginine methyl ester (L-NAME) or NG-nitro-L-arginine (L-NNA) enhanced the secretory response.

Conclusion

Our results show that NO inhibits gastric acid secretion in isolated human gastric glands, and that there is endogenous formation of NO within the glandular epithelium in the vicinity of the parietal cells.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-22394 (URN)10.1186/1471-230X-4-16 (DOI)1604 (Local ID)1604 (Archive number)1604 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13Bibliographically approved
Organisations

Search in DiVA

Show all publications