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  • 1.
    Borendal Wodlin, Ninnie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Intraoperative Cervical Treatment Does Not Affect the Prevalence of Vaginal Bleeding 1 Year Postoperatively After Subtotal Hysterectomy: A Register Study From the Swedish National Register for Gynecological Surgery2018Inngår i: Obstetrical and Gynecological Survey, ISSN 0029-7828, E-ISSN 1533-9866, Vol. 73, nr 2, s. 88-89Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A subtotal hysterectomy implies retaining the cervix. Women who undergo this procedure are more likely to present with persistent vaginal bleeding (PVB) after surgery. To prevent subsequent vaginal bleeding, intraoperative cervical treatment (electrosurgical cauterization or resection) has been recommended. However, there is insufficient evidence demonstrating the efficacy of this treatment. The aims of this retrospective register study were to (1) establish the prevalence of PVB 1 year after subtotal hysterectomy, (2) analyze the effect of intraoperative cervical treatment during the subtotal hysterectomy on the occurrence of PVB, and (3) assess the impact of PVB on the patients self-reported assessment of her medical condition and satisfaction with the hysterectomy 1 year after surgery. Data were obtained fromthe SwedishNational Register for Gynecological Surgery for a cohort of women who underwent subtotal hysterectomy for benign conditions between January 2004 and June 2016. Preoperative and perioperative forms were collected to obtain demographic and clinical data. The 1-year inquiry form was used to collect data on occurrence of PVB, rating of medical condition, and satisfaction with surgical results. Multivariate logistic regression analyses were used to assess outcome measures. The prevalence of PVB following subtotal hysterectomy was 18.6%. Intraoperative treatment of the cervix at the time of the subtotal hysterectomy did not affect the frequency of PVB; the adjusted odds ratio (aOR) was 1.48, with a 95% confidence interval (CI) of 0.93 to 2.37. Althoughmore than 90% of women were satisfied or very satisfied with the surgical results, those experiencing bleeding episodes 1 year after the subtotal hysterectomy were significantly less content with the result of the surgery (aOR, 0.42; 95% CI, 0.26-0.67). There was no difference in self-perception of the medical condition 1 year after the surgery between women with and without PVB; the aOR was 1.16 with a 95% CI of 0.33 to 4.12. These data show that nearly 2 in 10 women may expect PVB following subtotal hysterectomy and that intraoperative cervical treatment does not affect the prevalence of bleeding. Although more than 90% of patients are satisfied with the results of surgery, women with PVB are less content. When choosing hysterectomy technique, information on the risk of PVB may be important. Subtotal hysterectomy may not be an option for women not willing to accept this risk.

  • 2.
    Isaksson, S
    et al.
    Uppsala University.
    Skoog Svanberg, A
    Uppsala University.
    Sydsjö, Gunilla
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Thurin-Kjellberg, A
    Sahlgrens Academy.
    Karlström, P O
    Uppsala University.
    Solensten, N G
    Umeå University Hospital.
    Lampic, C
    Karolinska Institute.
    Editorial Material: Two Decades After Legislation on Identifiable Donors in Sweden: Are Recipient Couples Ready to be Open About Using Gamete Donation? EDITORIAL COMMENT in OBSTETRICAL and GYNECOLOGICAL SURVEY, vol 66, issue 7, pp 423-4242011Inngår i: Obstetrical and Gynecological Survey, ISSN 0029-7828, E-ISSN 1533-9866, Vol. 66, nr 7, s. 423-424Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    n/a

  • 3.
    Kjölhede, Preben
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Halili, Shefqet
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Löfgren, Mats
    Department of Clinical Science, Obstetrics and Gynecology, Umeå University Hospital, Umeå, Sweden.
    The Influence of Preoperative Vaginal Cleansing on Postoperative Infectious Morbidity in Abdominal Total Hysterectomy for Benign Indications: A Study From the Swedish National Register for Gynecological Surgery2009Inngår i: Obstetrical and Gynecological Survey, ISSN 0029-7828, E-ISSN 1533-9866, Vol. 64, nr 7, s. 453-455Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    n/a

  • 4.
    Ladenson, Paul W
    et al.
    Johns Hopkins University.
    Kristensen, Jens D
    Karo Bio AB.
    Ridgway, E Chester
    University of Colorado.
    Olsson, Anders G
    Linköpings universitet, Institutionen för medicin och hälsa, Internmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Carlsson, Bo
    Klein, Irwin
    Baxter, John D
    Angelin, Bo
    Karolinska Institutet.
    Use of the Thyroid Hormone Analogue Eprotirome in Statin-Treated Dyslipidemia2010Inngår i: Obstetrical and Gynecological Survey, ISSN 0029-7828, E-ISSN 1533-9866, Vol. 65, nr 8, s. 512-513Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Statins effectively reduce levels of serum cholesterol and lower the risk of cardiovascular disease, but have limited effectiveness if stringent goals for serum low-density lipoprotein (LDL) cholesterol levels are not met or adverse effects develop, requiring a dose reduction or drug discontinuation. Previous studies have shown that thyroid hormone and some of its metabolites reduce levels of serum LDL cholesterol and have potentially favorable actions on other lipoproteins. The studies were discontinued because of reports of adverse effects on heart and bone, and possible deaths. In a recent report, eprotirome, a thyromimetic compound with minimal uptake in nonhepatic-tissues, was shown to reduce levels of serum total and LDL cholesterol and apolipoprotein B without apparent side effects in patients not receiving statin therapy. This randomized, placebo-controlled, double-blind, multicenter trial investigated the safety and efficacy of eprotirome in lowering the level of serum LDL cholesterol in patients with hypercholesterolemia who already were receiving simvastatin or atorvastatin. The aim of the study was to determine whether adding eprotirome to statin therapy would provide additional lipid-lowering actions without producing adverse extrahepatic thyromimetic effects. Patients were randomly assigned to receive daily oral doses of 25, 50, or 100 mcg of eprotirome or a placebo for 12 weeks. The primary study outcome was changes in serum LDL cholesterol. The potential adverse thyromimetic effects on the heart, bone, and pituitary were examined. Treatment of patients for 12 weeks already receiving statins with either placebo or eprotirome at a dose of 25, 50, or 100 mu g reduced the mean level of serum LDL cholesterol from 141 mg per deciliter (3.6 mmol per liter) at baseline to 127, 113, 99, and 94 mg per deciliter (3.3, 2.9, 2.6, and 2.4 mmol per liter), respectively; this represented a mean reduction from baseline of 7%, 22%, 28%, and 32%, respectively. Similar reductions were found in the secondary study outcomes, which included serum levels of apolipoprotein B, triglycerides, and Lp(a) lipoprotein. No evidence of adverse effects of eprotirome on the heart, bone, or pituitary was noted. Although reductions in serum levels of thyroxine occurred in some patients who received eprotirome, there were no changes in levels of thyrotropin or triiodothyronine. These findings demonstrate that the addition of eprotirome to statin therapy produces substantial further reductions in serum LDL cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B. The drug appears to have an excellent safety profile.

  • 5.
    Moen, V.
    et al.
    Countty Hospital, Kalmar.
    Brudin, Lars
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Rundgren, M.
    n/a.
    Irestedt, L.
    n/a.
    Hyponatremia Complicating Labor-Rare or Unrecognised? A Prospective Observational Study EDITORIAL COMMENT: in OBSTETRICAL & GYNECOLOGICAL SURVEY, vol 64, issue 7, pp 431-4322009Inngår i: Obstetrical and Gynecological Survey, ISSN 0029-7828, E-ISSN 1533-9866, Vol. 64, nr 7, s. 431-432Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    n/a

  • 6.
    Persson, P.
    et al.
    University of Uppsala Hospital.
    Brynhildsen, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Kjölhede, Preben
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Short-Term Recovery After Subtotal and Total Abdominal Hysterectomy-A Randomized Clinical Trial2010Inngår i: Obstetrical and Gynecological Survey, ISSN 0029-7828, E-ISSN 1533-9866, Vol. 65, nr 6, s. 370-371Artikkel i tidsskrift (Annet vitenskapelig)
  • 7.
    Serenius, Fredrik
    et al.
    Uppsala University, Sweden and Umeå University, Sweden .
    Kallen, Karin
    Lund University, Sweden .
    Blennow, Mats
    Karolinska Institute, Sweden .
    Ewald, Uwe
    Uppsala University, Sweden .
    Fellman, Vineta
    Lund University, Sweden .
    Holmström, Gerd
    Uppsala University, Sweden .
    Lindberg, Eva
    Örebro University, Sweden .
    Lundqvist, Pia
    Lund University, Sweden .
    Marsal, Karel
    Lund University, Sweden .
    Norman, Mikael
    Karolinska Institute, Sweden .
    Olhager, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Stigson, Lennart
    Gothenburg University, Sweden .
    Stjernqvist, Karin
    Lund University, Sweden .
    Vollmer, Brigitte
    Karolinska Institute, Sweden .
    Strömberg, Bo
    Uppsala University, Sweden .
    Neurodevelopmental Outcome in Extremely Preterm Infants at 2.5 Years After Active Perinatal Care in Sweden2013Inngår i: Obstetrical and Gynecological Survey, ISSN 0029-7828, E-ISSN 1533-9866, Vol. 68, nr 12, s. 781-783Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

     A proactive approach to the care of extremely preterm infants has increased survival and lowered the gestational age of viability, but these improvements may be associated with later neurodevelopmental disability. EXPRESS is a national population-based prospective study of all infants born alive or stillborn at less than 27 weeks’ gestation between 2004 and 2007 in Sweden. This prospective follow-up study was undertaken to assess neurologic and developmental outcome of the EXPRESS cohort at 2.5 years corrected age compared with a matched control group born at term.

    Of 707 live-born infants, 497 (70%) survived to corrected age 2.5 years; the final cohort included 491 children. Each preterm child was matched with 2 control subjects at 2.5 years chronological age. Cognitive, language, and motor development were assessed with the Bayley Scales of Infant and Toddler Development (Bayley III). Cerebral palsy (CP), visual and hearing disability, and a composite outcome of overall disabilities were assessed. The overall outcome was characterized as no, mild, moderate, and severe disability.

    Of 415 infants assessed with clinical examinations, 399, 393, and 382, respectively, completed the Bayley III cognitive, language, and motor scales; 366 control children were assessed with Bayley III. The mean composite cognitive, language, and motor scores for children in the preterm and control groups were 94 ± 12 and 104 ± 11, respectively (P < 0.001), 98 ± 17 and 109 ± 12 (P < 0.001), respectively, and 94 ± 16 and 107 ± 14 (P < 0.001), respectively. Normal cognitive development or mild cognitive disability was found in 354 preterm children (88.8%) and 364 control children (99.5%). Moderate or severe cognitive disability was present in 20 preterm children (5.0%) and 1 control child (0.3%) (P < 0.001) and in 25 (6.3%) and 1 (0.3%), respectively (P < 0.001). Normal language development or mild language disability was found in 330 children (83.9%) in the preterm group and with 351 (97.5%) in the control group (all group comparisons, P < 0.001). Normal motor development or mild motor disability occurred in 324 (84.8%) and 348 (98.6%) of children in the preterm and control groups, respectively. Moderate or severe mental developmental delay was seen in 88 and 10 children (20% and 2.8%), respectively (P < 0.001).

    In the preterm group, Bayley III cognitive, language, and motor scores increased with advancing gestational age at birth by 2.5 points (99% confidence interval [CI], 1.0–4.0) per week (P < 0.001), by 3.6 points (99% CI, 1.6–5.6) per week (P < 0.001), and by 2.5 points (99% CI, 0.5–4.5) per week scores (P = 0.001), respectively. Cerebral palsy was present in 32 preterm children (7.0%; 99% CI, 3.9–10.1%). Of 456 preterm children, 42.1% were classified as normal, 30.7% as having mild disabilities, and 27.2% as having moderate or severe disabilities (vs 78.1%, 18.6%, 3.3% of control subjects, respectively; P < 0.001 for all comparisons). The proportion of children with mild or no disabilities increased from 40% at 22 weeks to 83% at 26 weeks (P < 0.001 for trend). Moderate or severe disabilities decreased from 60% at 22 weeks to 17% at 26 weeks (P < 0.001 for trend).

    The impact of prematurity on neurodevelopmental outcome indicates that further improvements in neonatal care are necessary. Although preterm children had poorer neurodevelopmental outcomes than those born at term, 73% had no or mild disability, and neurodevelopmental outcome improved with each week of gestational age. These results are relevant for clinicians counseling couples facing extremely preterm birth of their infant

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