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Björkander, Jan Fredrik
Alternative names
Publications (8 of 8) Show all publications
Petersson, C., Björkander, J. F. & Fust, R. (2018). Discovering aspects of health-experiences of a web-based health diary among adults with primary immunodeficiency. Nursing Open, 5(4), 642-648
Open this publication in new window or tab >>Discovering aspects of health-experiences of a web-based health diary among adults with primary immunodeficiency
2018 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 4, p. 642-648Article in journal (Refereed) Published
Abstract [en]

Advances in technology generate new opportunities to develop e-health tools to help individuals in self-management by assessing symptoms of illness and its relation to treatments. Self-management is central when living with primary immunodeficiency diseases. The aim was to explore the experiences of people living with primary immunodeficiency, who used a pilot version of the web-based health diary.

Keywords
e-health; immunodeficiency; nurses; nursing; qualitative; self-management
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-155987 (URN)10.1002/nop2.182 (DOI)30338110 (PubMedID)
Available from: 2019-04-01 Created: 2019-04-01 Last updated: 2019-10-10
Nordenfelt, P., Nilsson, M., Lindfors, A., Wahlgren, C.-F. & Björkander, J. F. (2017). Health-related quality of life in relation to disease activity in adults with hereditary angioedema in Sweden. Allergy and Asthma Proceedings, 38(6), 447-455
Open this publication in new window or tab >>Health-related quality of life in relation to disease activity in adults with hereditary angioedema in Sweden
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2017 (English)In: Allergy and Asthma Proceedings, ISSN 1088-5412, E-ISSN 1539-6304, Vol. 38, no 6, p. 447-455Article in journal (Refereed) Published
Abstract [en]

Background: Health-related quality of life (HR-QoL) is impaired in patients with hereditary angioedema (HAE) but has not yet been satisfactorily described.

Objective: To study HR-QoL in patients with HAE by combining different HR-QoL instruments with disease activity assessment. Methods: All adults in the Swedish HAE registry were invited to take part in this questionnaire study, which used the generic HR-QoL instruments, EuroQol 5 Dimensions 5 Level (EQ-5D-5L) and the RAND Corporation Short Form 36 (RAND-36), the disease-specific Angioedema Quality of Life instrument (AE-QoL), the recently introduced Angioedema Activity Score (AAS) form, and questionnaires on sick leave and prophylactic medication.

Results: Sixty-four of 133 adults (26 men, 38 women) between 18 and 91 years old responded. The most affected HR-QoL dimensions in the EQ-5D-5L were pain/discomfort and anxiety/depression; in the RAND-36, energy/fatigue, general health, pain; and, in the AE-QoL, fears/shame and fatigue/mood. Women had lower HR-QoL in the RAND-36 for general health and energy/fatigue (p < 0.05). Patients who reported any AAS of >0 had significantly impaired HR-QoL. There were significant associations (p < 0.05) between the AAS and EQ-5D-5L, between the AAS and all dimensions of the RAND-36 except physical function, and between the AAS and AE-QoL in all dimensions. Nine of 36 patients who reported sick leave during the previous 4 weeks had significantly impaired HR-QoL in all the instruments (p < 0.05). There was no significant difference in HR-QoL in the patients with and the patients without prophylactic medication, except for the nutrition dimension of the AE-QoL (p < 0.05).

Conclusion: Comprehensive information is obtained by combining different HR-QoL instruments. Pain, anxiety/depression, and fatigue/mood are important aspects of HAE but the AE-QoL disregards pain. HR-QoL was not significantly affected by prophylaxis. Increased disease activity was associated with impaired HR-QoL, which justifies more active disease management.

Place, publisher, year, edition, pages
OceanSide Publications, 2017
Keywords
AAS; AE-QoL; C1-inhibitor deficiency; EQ-5D-5L; HAE; HR-QoL; RAND-36; Sweden; disease activity; prophylaxis; sex differences; sick leave; the Svensson method
National Category
Neurology Public Health, Global Health, Social Medicine and Epidemiology Geriatrics
Identifiers
urn:nbn:se:liu:diva-142205 (URN)10.2500/aap.2017.38.4087 (DOI)000415839200009 ()28855002 (PubMedID)
Note

Funding agencies: Karolinska Institutet; Stockholm County Council, Stockholm; Futurum; Jonkoping County Council, Jonkoping; Linkoping University, Linkoping, Sweden; CSL Behring; Shire; Galderma; Novartis

Available from: 2017-10-23 Created: 2017-10-23 Last updated: 2018-03-28Bibliographically approved
Nordenfelt, P., Nilsson, M., Björkander, J. F., Mallbris, L., Lindfors, A. & Wahlgren, C.-F. (2016). Hereditary Angioedema in Swedish Adults: Report From the National Cohort. Acta Dermato-Venereologica, 96(4), 540-545
Open this publication in new window or tab >>Hereditary Angioedema in Swedish Adults: Report From the National Cohort
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2016 (English)In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 96, no 4, p. 540-545Article in journal (Refereed) Published
Abstract [en]

Hereditary angioedema (HAE) is rare, disabling and sometimes life-threatening. The aim of this study is to describe its prevalence, symptomatology and treatment in Sweden. A total of 146 patients were identified; 110 adults and 36 children with HAE type I (n = 136) or II (n = 10), giving a minimum HAE prevalence of 1.54/100,000. All patients received a written questionnaire followed by a structured telephone interview. This report focuses on the 102 adults who responded. Females reported 19 attacks in the previous year vs. 9 for males (p &lt; 0.01), and females reported 10 days of sick leave vs. 4 days for males (p &lt; 0.05). For all treated acute attacks, plasma-derived Cl-inhibitor concentrate (pdClINH) (used in 27% of patients) had a good effect. For maintenance treatment, 43% used attenuated androgens and 8% used pdClINH, which reduced their attack rate by more than 50%. In conclusion, the minimum HAE prevalence in Sweden was 1.54/100,000. HAE affected females more severely. Attenuated androgens and pdClINH had a good effect on preventing attacks.

Place, publisher, year, edition, pages
ACTA DERMATO-VENEREOLOGICA, 2016
Keywords
Clinhibitor deficiency; census; clinical manifestations; epidemiology; hereditary angioedema; prevalence; Sweden
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-128976 (URN)10.2340/00015555-2274 (DOI)000375741300022 ()26540175 (PubMedID)
Note

Funding Agencies|Futurum the Academy for Healthcare; Jonkoping County Council; Linkoping University; Karolinska Institutet

Available from: 2016-06-09 Created: 2016-06-07 Last updated: 2018-03-19
Nygren, A., Nordenfelt, P., Lindfors, A., Mallbris, L., Björkander, J. F. & Wahlgren, C.-F. (2016). Swedish children with hereditary angioedema report good overall health and quality of life despite symptoms. Acta Paediatrica, 105(5), 529-534
Open this publication in new window or tab >>Swedish children with hereditary angioedema report good overall health and quality of life despite symptoms
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2016 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 5, p. 529-534Article in journal (Refereed) Published
Abstract [en]

AimFew studies have been published on children with hereditary angioedema (HAE), an autosomal dominant disease caused by mutations on chromosome 11. This study explored various aspects of the disease in the Swedish paediatric population. MethodsA retrospective questionnaire was sent to all 36 Swedish children known to have HAE, and a physician carried out follow-up telephone interviews. ResultsMost of the questionnaires were completed by the parents of 31 (86%) children with HAE, with or without their input, at a median age of nine years (range 1-17), and the physician also interviewed 29. HAE symptoms were experienced by 23 children, including abdominal attacks (96%), skin swelling (78%) and swelling in the mouth and/or upper airways (52%). Psychological stress was the most common trigger for abdominal attacks and trauma and sports triggered skin swelling. The majority (n = 19) had access to complement-1 esterase inhibitor concentrate at home. Current health and quality of life were generally rated as good, independent of whether the child had experienced HAE symptoms or not. ConclusionMost children with HAE had experienced abdominal attacks and skin swelling, but their overall health and quality of life were generally perceived to be good.

Place, publisher, year, edition, pages
WILEY-BLACKWELL, 2016
Keywords
Children; Complement-1 esterase inhibitor defects; Epidemiology; Hereditary angioedema; Symptoms
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-127743 (URN)10.1111/apa.13345 (DOI)000373921200028 ()26821285 (PubMedID)
Note

Funding Agencies|Futurum - the Academy for Health and Care; Region Jonkoping County; Linkoping University; Karolinska Institutet

Available from: 2016-05-12 Created: 2016-05-12 Last updated: 2017-11-30
Wågström, P., Bengnér, M., Dahle, C., Nilsdotter-Augustinsson, Å., Neumark, T., Brudin, L. & Björkander, J. (2015). Does the frequency of respiratory tract infections help to identify humoral immunodeficiencies in a primary health-care cohort?. Scandinavian Journal of Infectious Diseases, 47(1), 13-19
Open this publication in new window or tab >>Does the frequency of respiratory tract infections help to identify humoral immunodeficiencies in a primary health-care cohort?
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2015 (English)In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 47, no 1, p. 13-19Article in journal (Refereed) Published
Abstract [en]

Background: Primary immune deficiency (PID) due to humoral defects is associated with recurrent respiratory tract infections (RTIs). Reliable clinical warning signs of PID would facilitate early diagnosis and thereby reduce long-term complications. The aim of the present study was to evaluate the accuracy of the warning sign, 'four or more antibiotic-treated RTIs annually for 3 or more consecutive years,' for detecting PID among adults in a primary health-care setting. Methods: Fifty-three cases with 'four or more antibiotic-treated RTIs annually for 3 or more consecutive years' were selected from a Swedish primary health-care registry of RTIs. In addition, 66 age- and sex-matched controls were selected having a maximum of one antibiotic-treated RTI during the period covered by the study. Levels of immunoglobulin (Ig) IgG, IgA, IgM, IgG subclasses, and IgG antibodies against Haemophilus influenzae and Streptococcus pneumoniae as well as the inflammatory markers, C-reactive protein, interleukin (IL)-6 and IL-8 were determined. Results: IgG subclass deficiencies (IgGsd) were found in 5/53 (9.4%) of the cases and in 7/66 (10.6%) controls. The most frequent deficiency was IgG3sd and this was found in three participants in the case group and seven in the control group. The mean level of IgG3 was lower in the control group (p = 0.02). The mean level of IL-8 was lower in the case group (p = 0.02). Conclusion: The results show that physicians working in primary health care cannot solely rely on the frequency of antibiotic-treated RTIs as a warning sign for the detection of common humoral immune deficiencies.

Place, publisher, year, edition, pages
Informa Healthcare, 2015
Keywords
Clinical warning sign; immunoglobulin deficiency; primary health care; respiratory tract infections
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-112726 (URN)10.3109/00365548.2014.956330 (DOI)000350052400003 ()25378084 (PubMedID)
Available from: 2014-12-10 Created: 2014-12-10 Last updated: 2017-12-05
Nestor, C. E., Dadfa, E., Ernerudh, J., Gustafsson, M., Björkander, J. F., Benson, M. & Zhang, H. (2014). Sublingual immunotherapy alters expression of IL-4 and its soluble and membrane-bound receptors. Allergy. European Journal of Allergy and Clinical Immunology, 69(11), 1564-1566
Open this publication in new window or tab >>Sublingual immunotherapy alters expression of IL-4 and its soluble and membrane-bound receptors
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2014 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 69, no 11, p. 1564-1566Article in journal (Refereed) Published
Abstract [en]

Seasonal allergic rhinitis (SAR) is a disease of increasing prevalence, which results from an inappropriate T-helper cell, type 2 (Th2) response to pollen. Specific immunotherapy (SIT) involves repeated treatment with small doses of pollen and can result in complete and lasting reversal of SAR. Here, we assayed the key Th2 cytokine, IL-4, and its soluble and membrane-bound receptor in SAR patients before and after SIT. Using allergen-challenge assays, we found that SIT treatment decreased IL-4 cytokine levels, as previously reported. We also observed a significant decrease in the IL-4 membrane-bound receptor (mIL4R) at both the level of mRNA and protein. SIT treatment resulted in a significant increase in the inhibitory soluble IL-4 receptor (sIL4R). Reciprocal changes in mIL4R and sIL4R were also observed in patient serum. Altered mIL4R and sIL4R is a novel explanation for the positive effects of immunotherapy with potential basic and clinical research implications.

Place, publisher, year, edition, pages
Wiley, 2014
National Category
Clinical Medicine Basic Medicine
Identifiers
urn:nbn:se:liu:diva-109429 (URN)10.1111/all.12505 (DOI)000343851200016 ()25130266 (PubMedID)
Available from: 2014-08-18 Created: 2014-08-18 Last updated: 2018-01-11
Zhang, H., Cardell, L. O., Björkander, J., Benson, M. & Wang, H. (2013). Comprehensive Profiling of Peripheral Immune Cells and Subsets in Patients with Intermittent Allergic Rhinitis Compared to Healthy Controls and After Treatment with Glucocorticoids. Inflammation, 36(4), 821-829
Open this publication in new window or tab >>Comprehensive Profiling of Peripheral Immune Cells and Subsets in Patients with Intermittent Allergic Rhinitis Compared to Healthy Controls and After Treatment with Glucocorticoids
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2013 (English)In: Inflammation, ISSN 0360-3997, E-ISSN 1573-2576, Vol. 36, no 4, p. 821-829Article in journal (Refereed) Published
Abstract [en]

Intermittent allergic rhinitis (IAR) is a common allergic disease, which is associated with local infiltration of T cells, eosinophils, and basophils. However, changes of circulating inflammatory cells may reflect local and systemic allergic inflammation and potentially, also the response to treatment with glucocorticoids (GCs). In this study, we comprehensively profiled peripheral blood immune cells and subsets from 12 patients with IAR during the birch pollen season before and after GC treatment and nine healthy controls by flow cytometry. Orthogonal partial least squares discriminant analysis (OPLS-DA) identified that peripheral immune cells and subsets markedly separated symptomatic patients and controls. Eosinophils, basophils, and Th2 cells contributed most to the separation. However, there was no good separation between patients before and after GC treatment. Local allergic inflammation in the nasal mucosa is associated with increased circulating Th2 cells, eosinophils, and basophils. Local GC treatment has limited effects on circulating immune cells.

Place, publisher, year, edition, pages
Springer, 2013
Keywords
glucocorticoids, orthogonal partial least squares, discriminant analysis, peripheral blood, intermittent allergic rhinitis
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-91691 (URN)10.1007/s10753-013-9608-0 (DOI)000321641300005 ()23413042 (PubMedID)
Available from: 2013-04-29 Created: 2013-04-29 Last updated: 2017-12-06
Pan-Hammarström, Q., Salzer, U., Du, L., Björkander, J. F., Cunningham-Rundles, C., Nelson, D. L., . . . Hammarström, L. (2007). Reexamining the role of TACI coding variants in common variable immunodeficiency and selective IgA deficiency.. Nature Genetics, 39(4), 429-430
Open this publication in new window or tab >>Reexamining the role of TACI coding variants in common variable immunodeficiency and selective IgA deficiency.
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2007 (English)In: Nature Genetics, ISSN 1061-4036, E-ISSN 1546-1718, Vol. 39, no 4, p. 429-430Article in journal (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-38481 (URN)44607 (Local ID)44607 (Archive number)44607 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
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