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  • 1.
    Crisby, Milita
    et al.
    Karolinska Institutet, Stockholm.
    Olsson, Anders
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Statin i hög dos vid ischemisk stroke minskar risken för ny stroke2008In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, no 48-49, p. 3541-3543Article in journal (Refereed)
  • 2.
    Freytag, F
    et al.
    Kreiskrankenhaus Gunzenhausen, DE-91709 Gunzenhausen, Germany St Elizabeth Hosp, Dept Cardiol, Tilburg, Netherlands Univ Hosp, Dept Internal Med, Sect Endocrinol, Linkoping, Sweden Clin Res Boehringer Ingelheim Pharma KG, Biberach, Germany Ingelheim Pharma KG, Med Data Serv, Ingelheim, Germany.
    Holwerda, NJ
    Kreiskrankenhaus Gunzenhausen, DE-91709 Gunzenhausen, Germany St Elizabeth Hosp, Dept Cardiol, Tilburg, Netherlands Univ Hosp, Dept Internal Med, Sect Endocrinol, Linkoping, Sweden Clin Res Boehringer Ingelheim Pharma KG, Biberach, Germany Ingelheim Pharma KG, Med Data Serv, Ingelheim, Germany.
    Karlberg, BE
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Meinicke, TW
    Kreiskrankenhaus Gunzenhausen, DE-91709 Gunzenhausen, Germany St Elizabeth Hosp, Dept Cardiol, Tilburg, Netherlands Univ Hosp, Dept Internal Med, Sect Endocrinol, Linkoping, Sweden Clin Res Boehringer Ingelheim Pharma KG, Biberach, Germany Ingelheim Pharma KG, Med Data Serv, Ingelheim, Germany.
    Schumacher, H
    Kreiskrankenhaus Gunzenhausen, DE-91709 Gunzenhausen, Germany St Elizabeth Hosp, Dept Cardiol, Tilburg, Netherlands Univ Hosp, Dept Internal Med, Sect Endocrinol, Linkoping, Sweden Clin Res Boehringer Ingelheim Pharma KG, Biberach, Germany Ingelheim Pharma KG, Med Data Serv, Ingelheim, Germany.
    Long-term exposure to telmisartan as monotherapy or combination therapy: Efficacy and safety2002In: Blood Pressure, ISSN 0803-7051, E-ISSN 1651-1999, Vol. 11, no 3, p. 173-181Article in journal (Refereed)
    Abstract [en]

    This multicentre, open-label extension study to four controlled trials involved 888 patients with mild-to-moderate primary hypertension. Patients received telmisartan 40-80 mg once daily with add-on hydrochlorothiazide (HCTZ, 12.5-25 mg) if necessary and/or other antihypertensives to achieve diastolic blood pressure (DBP) control (

  • 3.
    Hallberg, Inger
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hammerby, Staffan
    Linköping University, Department of Medicine and Health Sciences, Radiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping.
    Toss, Göran
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Health-related quality of life after vertebral or hip fracture: a seven-year follow-up study2009In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 10, no 135Article in journal (Refereed)
    Abstract [en]

    Background

    The negative impact of vertebral and hip low-energy fractures on health-related quality-of-life (HRQOL) has been demonstrated previously, but few prospective long-term follow-up studies have been conducted. This study aims to (i) investigate the changes and long-term impact of vertebral or hip fracture and between fracture groups on HRQOL in postmenopausal women prospectively between two and seven years after the inclusion fracture, (ii) compare HRQOL results between fracture and reference groups and (iii) study the relationship between HRQOL and physical performance, spinal deformity index and bone mineral density at seven-year follow-up.

    Methods

    Ninety-one women examined two years after a low-energy vertebral or hip fracture were invited to a new examination seven years after the diagnosis. HRQOL was examined using the SF-36 questionnaire and was compared with an age and sex-matched reference group. Physical function was assessed using tests and questionnaires. Bone mineral density was measured. Radiographs of the spine were evaluated using the visual semiquantitative technique. A longitudinal and cross-sectional design was used in this study. Statistical analyses included descriptive statistics, Student’s t-tests, ANCOVA, and partial correlation.

    Results

    Sixty-seven women participated. In the 42 women (mean age 75.8, SD 4.7) with vertebral fracture as inclusion fracture, bodily pain had deteriorated between two and seven years and might be explained by new fracture. Remaining pronounced reduction of HRQOL was seen in all domains except general health and mental health at seven-year follow-up in women with vertebral fractures compared to the reference group (p<0.05). All 25 women (mean age 75.0, SD 4.7) with hip fracture as inclusion fracture had no significant changes in HRQOL between two and seven years and did not differ from the reference group regarding HRQOL after seven years. The vertebral group had significantly lower values for bodily pain, vitality, role-emotional function and mental health compared to the hip group. HRQOL showed a positive relationship between physical activity, static balance and handgrip strength.

    Conclusions

    The long-term reduction of HRQOL in women with vertebral fracture emerged clearly in this study. The relationships between HRQOL and physical performance in women with vertebral and hip fracture raise questions for more research.

  • 4.
    Hallberg, Inger
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Toss, Göran
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    A striving for independence: a qualitative study of women living with vertebral fractureManuscript (preprint) (Other academic)
    Abstract [en]

    Background: Quantitative studies using generic and disease-specific health-related quality of life (HRQOL) questionnaires have shown that osteoporosis-related vertebral fractures have a significant negative effect on HRQOL, but there are only few studies that address what it means to live with vertebral fracture from a deeper experiential perspective. How HRQOL and daily life are affected several years after vertebral fracture and how women cope with this are more unclear. This study aimed to describe how HRQOL and daily life had been affected in women with vertebral fracture several years after diagnosis.

    Methods: The study design was qualitative. Semi-structured interviews were conducted with ten Swedish women during 2008. Data were analysed using qualitative inductive content analysis.

    Results: The findings of this study revealed three themes related to the influence on HRQOL and daily life: A threatened independence, i.e. back pain, anxiety, negative impact on self-image and consequences in daily life; Strategies for maintaining independence, i.e. coping, self-care and support; and The importance of maintaining independence, i.e. the ability to perform everyday activities, social interaction and having something meaningful to do. As a result of how their HRQOL and daily life have been affected by their vertebral fractures, the women in this study are striving for independence or maintaining their independence by trying to manage the different types of symptoms and consequences in different ways.

    Conclusion: HRQOL and daily life were strongly affected in a negative way by the impact of the vertebral fracture. One possible effective intervention for the future may be to support women in using self-management strategies so that they can be in charge of their situation and positively influence their HRQOL and daily life to achieve independence, but further evaluation is still needed. Information from this study may provide a foundation for guidelines for health care professionals to offer empathic and supportive care to women living with prevalent vertebral fracture.

  • 5.
    Jacobsson, Leif S.
    et al.
    Linköping University, Department of Medical and Health Sciences, Pharmacology. Linköping University, Faculty of Health Sciences.
    Persson, Karin
    Linköping University, Department of Medical and Health Sciences, Pharmacology. Linköping University, Faculty of Health Sciences.
    Aberg, Gunnar
    Linköping University, Department of Medical and Health Sciences, Pharmacology. Linköping University, Faculty of Health Sciences.
    Andersson, Rolf G. G.
    Linköping University, Department of Medical and Health Sciences, Pharmacology. Linköping University, Faculty of Health Sciences.
    Karlberg, Bengt E.
    Linköping University, Department of Medicine and Care, Internal Medicine. Linköping University, Faculty of Health Sciences.
    Olsson, Anders G.
    Linköping University, Department of Medicine and Care, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Antiatherosclerotic Effects of the Angiotensin-Converting Enzyme Inhibitors Captopril and Fosinopril in Hypercholesterolemic Minipigs1994In: Journal of Cardiovascular Pharmacology, ISSN 0160-2446, E-ISSN 1533-4023, Vol. 24, no 4, p. 670-677Article in journal (Refereed)
    Abstract [en]

    We evaluated the two angiotensin-converting enzyme (ACE) inhibitors captopril and fosinopril with regard to possible antiatherosclerotic effects in minipigs. Experimental hypercholesterolemia and atherosclerosis was produced in 33 minipigs of the Gottingen strain by an egg yolk/cholesterol-enriched diet for 1 year. One group (n = 11) was fed the atherogenic diet alone and served as a control. A second group (n = 11) received captopril (80 mg/kg/day) added to the atherogenic diet, and a third group (n = 11) was treated in the same manner but with fosinopril (8 mg/kglday). The drug treatments produced significant reduction in serum ACE activity associated with a reactive increase in plasma renin activity (PRA), but had only minor effects on plasma lipids and lipoproteins. At the end of the treatment period, all animals were killed and examined for degree of atherosclerosis. The percentage of atherosclerotic area in the abdominal aorta was significantly lower in both drug-treated groups as compared with controls. Furthermore, accumulation of cholesterol in the thoracic and abdominal aorta was inhibited by drug treatment. Finally, the percentage of intimal thickening in abdominal aorta was significantly reduced in the drug-treated groups. In conclusion, the ACE inhibitors captopril and fosinopril inhibited development of atherosclerosis in hypercholesterolemic minipigs.

  • 6.
    Karppi, J.
    et al.
    Research Institute of Public Health, University of Kuopio, P.O. Box 1627, FI-70211 Kuopio, Finland.
    Rissanen, T.H.
    Research Institute of Public Health, University of Kuopio, P.O. Box 1627, FI-70211 Kuopio, Finland, Department of Public Health and Clinical Nutrition, University of Kuopio, P.O. Box 1627, FI-70211 Kuopio, Finland.
    Nyyssonen, K.
    Nyyssönen, K., Research Institute of Public Health, University of Kuopio, P.O. Box 1627, FI-70211 Kuopio, Finland, Research Institute of Public Health, University of Kuopio, P.O. Box 1627, FI-70210 Kuopio, Finland.
    Kaikkonen, J.
    Oy Jurilab Ltd., Microkatu 1, FI-70210 Kuopio, Finland.
    Olsson, Anders G.
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Voutilainen, S.
    Research Institute of Public Health, University of Kuopio, P.O. Box 1627, FI-70211 Kuopio, Finland.
    Salonen, J.T.
    Research Institute of Public Health, University of Kuopio, P.O. Box 1627, FI-70211 Kuopio, Finland, Oy Jurilab Ltd., Microkatu 1, FI-70210 Kuopio, Finland.
    Effects of astaxanthin supplementation on lipid peroxidation2007In: International Journal for Vitamin and Nutrition Research, ISSN 0300-9831, E-ISSN 1664-2821, Vol. 77, no 1Article in journal (Refereed)
    Abstract [en]

    Astaxanthin, the main carotenoid pigment in aquatic animals, has greater antioxidant activity in vitro (protecting against lipid peroxidation) and a more polar configuration than other carotenoids. We investigated the effect of three-month astaxanthin supplementation on lipid peroxidation in healthy non-smoking Finnish men, aged 19-33 years by using a randomized double-blind study design. Also absorption of astaxanthin from capsules into bloodstream and its safety were evaluated. The intervention group received two 4-mg astaxanthin (Astaxin®) capsules daily, and the control group two identical-looking placebo capsules. Astaxanthin supplementation elevated plasma astaxanthin levels to 0.032 µmol/L (p < 0.001 for the change compared with the placebo group). We observed that levels of plasma 12- and 15-hydroxy fatty acids were reduced statistically significantly in the astaxanthin group (p = 0.048 and p = 0.047 respectively) during supplementation, but not in the placebo group and the change of 15-hydroxy fatty acid was almost significantly greater (p = 0.056) in the astaxanthin group, as compared with the placebo group. The present study suggests that intestinal absorption of astaxanthin delivered as capsules is adequate, and well tolerated. Supplementation with astaxanthin may decrease in vivo oxidation of fatty acids in healthy men. © Hogrefe & Huber Publishers.

  • 7.
    Kjeldsen, SE
    et al.
    Univ Oslo, Ullevaal Hosp, Dept Cardiol, N-0407 Oslo, Norway Univ Michigan, Div Hypertens, Ann Arbor, MI 48109 USA Sahlgrens Univ Hosp, Dept Clin Pharmacol, S-41345 Gothenburg, Sweden Varna Med Ctr, Moss, Norway Haukeland Univ Hosp, Dept Cardiol, N-5021 Bergen, Norway Univ Uppsala Hosp, Dept Geriatr, S-75185 Uppsala, Sweden Lund Univ, Dept Stat, S-22363 Lund, Sweden Univ Umea Hosp, Dept Publ Hlth & Clin Med, S-90185 Umea, Sweden Karolinska Univ Hosp, Dept Med, Stockholm, Sweden Ostra Univ Hosp, Dept Med, Gothenburg, Sweden Linkoping Univ Hosp, Dept Endocrinol, S-58185 Linkoping, Sweden.
    Hedner, T
    Univ Oslo, Ullevaal Hosp, Dept Cardiol, N-0407 Oslo, Norway Univ Michigan, Div Hypertens, Ann Arbor, MI 48109 USA Sahlgrens Univ Hosp, Dept Clin Pharmacol, S-41345 Gothenburg, Sweden Varna Med Ctr, Moss, Norway Haukeland Univ Hosp, Dept Cardiol, N-5021 Bergen, Norway Univ Uppsala Hosp, Dept Geriatr, S-75185 Uppsala, Sweden Lund Univ, Dept Stat, S-22363 Lund, Sweden Univ Umea Hosp, Dept Publ Hlth & Clin Med, S-90185 Umea, Sweden Karolinska Univ Hosp, Dept Med, Stockholm, Sweden Ostra Univ Hosp, Dept Med, Gothenburg, Sweden Linkoping Univ Hosp, Dept Endocrinol, S-58185 Linkoping, Sweden.
    Syvertsen, JO
    Univ Oslo, Ullevaal Hosp, Dept Cardiol, N-0407 Oslo, Norway Univ Michigan, Div Hypertens, Ann Arbor, MI 48109 USA Sahlgrens Univ Hosp, Dept Clin Pharmacol, S-41345 Gothenburg, Sweden Varna Med Ctr, Moss, Norway Haukeland Univ Hosp, Dept Cardiol, N-5021 Bergen, Norway Univ Uppsala Hosp, Dept Geriatr, S-75185 Uppsala, Sweden Lund Univ, Dept Stat, S-22363 Lund, Sweden Univ Umea Hosp, Dept Publ Hlth & Clin Med, S-90185 Umea, Sweden Karolinska Univ Hosp, Dept Med, Stockholm, Sweden Ostra Univ Hosp, Dept Med, Gothenburg, Sweden Linkoping Univ Hosp, Dept Endocrinol, S-58185 Linkoping, Sweden.
    Lund-Johansen, P
    Univ Oslo, Ullevaal Hosp, Dept Cardiol, N-0407 Oslo, Norway Univ Michigan, Div Hypertens, Ann Arbor, MI 48109 USA Sahlgrens Univ Hosp, Dept Clin Pharmacol, S-41345 Gothenburg, Sweden Varna Med Ctr, Moss, Norway Haukeland Univ Hosp, Dept Cardiol, N-5021 Bergen, Norway Univ Uppsala Hosp, Dept Geriatr, S-75185 Uppsala, Sweden Lund Univ, Dept Stat, S-22363 Lund, Sweden Univ Umea Hosp, Dept Publ Hlth & Clin Med, S-90185 Umea, Sweden Karolinska Univ Hosp, Dept Med, Stockholm, Sweden Ostra Univ Hosp, Dept Med, Gothenburg, Sweden Linkoping Univ Hosp, Dept Endocrinol, S-58185 Linkoping, Sweden.
    Hansson, L
    Lanke, J
    Univ Oslo, Ullevaal Hosp, Dept Cardiol, N-0407 Oslo, Norway Univ Michigan, Div Hypertens, Ann Arbor, MI 48109 USA Sahlgrens Univ Hosp, Dept Clin Pharmacol, S-41345 Gothenburg, Sweden Varna Med Ctr, Moss, Norway Haukeland Univ Hosp, Dept Cardiol, N-5021 Bergen, Norway Univ Uppsala Hosp, Dept Geriatr, S-75185 Uppsala, Sweden Lund Univ, Dept Stat, S-22363 Lund, Sweden Univ Umea Hosp, Dept Publ Hlth & Clin Med, S-90185 Umea, Sweden Karolinska Univ Hosp, Dept Med, Stockholm, Sweden Ostra Univ Hosp, Dept Med, Gothenburg, Sweden Linkoping Univ Hosp, Dept Endocrinol, S-58185 Linkoping, Sweden.
    Lindholm, LH
    Univ Oslo, Ullevaal Hosp, Dept Cardiol, N-0407 Oslo, Norway Univ Michigan, Div Hypertens, Ann Arbor, MI 48109 USA Sahlgrens Univ Hosp, Dept Clin Pharmacol, S-41345 Gothenburg, Sweden Varna Med Ctr, Moss, Norway Haukeland Univ Hosp, Dept Cardiol, N-5021 Bergen, Norway Univ Uppsala Hosp, Dept Geriatr, S-75185 Uppsala, Sweden Lund Univ, Dept Stat, S-22363 Lund, Sweden Univ Umea Hosp, Dept Publ Hlth & Clin Med, S-90185 Umea, Sweden Karolinska Univ Hosp, Dept Med, Stockholm, Sweden Ostra Univ Hosp, Dept Med, Gothenburg, Sweden Linkoping Univ Hosp, Dept Endocrinol, S-58185 Linkoping, Sweden.
    de Faire, U
    Univ Oslo, Ullevaal Hosp, Dept Cardiol, N-0407 Oslo, Norway Univ Michigan, Div Hypertens, Ann Arbor, MI 48109 USA Sahlgrens Univ Hosp, Dept Clin Pharmacol, S-41345 Gothenburg, Sweden Varna Med Ctr, Moss, Norway Haukeland Univ Hosp, Dept Cardiol, N-5021 Bergen, Norway Univ Uppsala Hosp, Dept Geriatr, S-75185 Uppsala, Sweden Lund Univ, Dept Stat, S-22363 Lund, Sweden Univ Umea Hosp, Dept Publ Hlth & Clin Med, S-90185 Umea, Sweden Karolinska Univ Hosp, Dept Med, Stockholm, Sweden Ostra Univ Hosp, Dept Med, Gothenburg, Sweden Linkoping Univ Hosp, Dept Endocrinol, S-58185 Linkoping, Sweden.
    Dahlof, B
    Univ Oslo, Ullevaal Hosp, Dept Cardiol, N-0407 Oslo, Norway Univ Michigan, Div Hypertens, Ann Arbor, MI 48109 USA Sahlgrens Univ Hosp, Dept Clin Pharmacol, S-41345 Gothenburg, Sweden Varna Med Ctr, Moss, Norway Haukeland Univ Hosp, Dept Cardiol, N-5021 Bergen, Norway Univ Uppsala Hosp, Dept Geriatr, S-75185 Uppsala, Sweden Lund Univ, Dept Stat, S-22363 Lund, Sweden Univ Umea Hosp, Dept Publ Hlth & Clin Med, S-90185 Umea, Sweden Karolinska Univ Hosp, Dept Med, Stockholm, Sweden Ostra Univ Hosp, Dept Med, Gothenburg, Sweden Linkoping Univ Hosp, Dept Endocrinol, S-58185 Linkoping, Sweden.
    Karlberg, BE
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Influence of age, sex and blood pressure on the principal endpoints of the Nordic Diltiazem (NORDIL) Study2002In: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 20, no 6, p. 1231-1237Article in journal (Refereed)
    Abstract [en]

    Background The aim of the Nordic Diltiazem (NORDIL) Study was to compare patients with essential hypertension receiving calcium-antagonist-based treatment with diltiazem and similar patients receiving conventional diuretic/beta-blocker-based treatment, with respect to cardiovascular morbidity and mortality. Objective To assess the influence of age, sex, severity of hypertension and heart rate on treatment effects, in a sub-analysis. Methods The NORDIL study was prospective, randomized, open and endpoint-blinded. It enrolled, at health centres in Norway and Sweden, 10881 patients aged 50-74 years who had diastolic blood pressure (DBP) of 100 mmHg or more. Systolic blood pressure (SBP) and DBP were decreased by 20.3/18.7 mmHg in the diltiazem group and by 23.3/18.7 mmHg in the diuretic/beta-blocker group - a significant difference in SBP (P < 0.001). Results The incidence of the primary endpoint - a composite of cardiovascular death, cerebral stroke and myocardial infarction - was similar for the two treatments. Fatal and non-fatal stroke occurred in 159 patients in the diltiazem group and in 196 patients in the conventional treatment group [relative risk MR) 0.80, 95% confidence interval (CO 0.65 to 0.99, P = 0.0401, whereas there was a non-significant inverse tendency with respect to all myocardial infarction. Three Were significantly fewer cerebral strokes ip atiepts receiving diltiazem in the subgroups with baseline SBP > 170 mmHg (n = 5420, RR 0.75,95% CI 0.58 to 0.98, P = 0.032), DBP 105 mmHg (n = 5881, RR 0.74,95% Cl 0.57 to 0.97, P = 0.030) and pulse pressure greater than or equal to 66 mmHg (n = 5461, RR 0.76, 95% Cl 0.58 to 0.99, P = 0.041), and more myocardial infarctions in those with heart rate less than 74 beats/min (n = 5303, RR 1.13, 95% Cl 1.01 to 1.87, P = 0.040). However, the tendencies for fewer strokes and greater incidence of myocardial infarction were present across subgroups when results were analysed for age, sex, severity of hypertension and heart rate, and treatment-subgroup interaction analyses were not statistically significant. Conclusions Compared with a conventional diuretic/beta-blocker-based anti hypertensive regimen, there were additional 25% reductions in stroke in the diltiazem-treated patients with blood pressure or pulse pressure greater than the medians, and an increase in myocardial infarction in those with heart rate less than the median. Such findings may be attributable to chance, but the consistency of, in particular, the stroke findings may also suggest an ability of diltiazem, beyond conventional treatment, to prevent cerebral stroke in hypertensive patients with the greatest cardiovascular risk. (C) 2002 Lippincott Williams Wilkins.

  • 8.
    Olsson, Anders
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Nationella riktlinjer för hjärtsjukvård 2008:  Lägesbeskrivning eller instrument för förändring?2008In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, p. 17-18Article in journal (Refereed)
  • 9.
    Olsson, Anders
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    NICE lipid modification guideline:both absolute and obsolete!2008In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 94, no 10, p. 1256-1257Article in journal (Other academic)
    Abstract [en]

    Guidelines for the prevention of cardiovascular disease (CVD)are greatly time-dependent owing to the rapid increase in knowledgein this important research area. However, at each point in timethe knowledge base behind all guidelines on CVD prevention—forexample, blood lipid modification, is common, internationaland easily available to all clinical scientists and opinionleaders engaged in the formulation of these guidelines. Nevertheless,they differ markedly between continents, countries and regions.There are several reasons for this: from factual differencesin risk factor distribution between different populations tolocal customs and traditions and individual influences fromscientists and clinicians involved in the authorship of theguidelines. Recently a new guideline for lipid modificationby the National Institute for Health and Clinical Excellencein the United Kingdom was issued

  • 10.
    Schoultz, Ida
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Surgery . Linköping University, Faculty of Health Sciences.
    Carlsson, Anders
    Linköping University, Department of Clinical and Experimental Medicine, Surgery . Linköping University, Faculty of Health Sciences.
    Gullberg, Elisabet
    Linköping University, Department of Clinical and Experimental Medicine, Surgery . Linköping University, Faculty of Health Sciences.
    Almer, Sven
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Ström, Magnus
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Lerm, Maria
    Linköping University, Department of Clinical and Experimental Medicine, Medical Microbiology . Linköping University, Faculty of Health Sciences.
    McKay, Derek M.
    Department of Physiology and Biophysics, University of Calgary, Calgary, Canada.
    Rhodes, Jonathan M.
    Department of Medicine, Henry Wellcome Laboratory of Molecular and Cellular Gastroenterology, University of Liverpool, Liverpool, United Kingdom.
    Söderholm, Johan D.
    Linköping University, Department of Clinical and Experimental Medicine, Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Infliximab reduces bacterial uptake in mucosal biopsies of Crohn’s colitis viamicrotubule-dependent pathwayManuscript (preprint) (Other academic)
    Abstract [en]

    Background: A defective intestinal barrier, shown by increased paracellular permeability is an importantpathogenic factor in Crohn’s disease (CD). TNFα is a key mediator in the regulation of the intestinal barrierfunction. Treatment with antibodies directed against TNFα, such as infliximab, has been established as animportant part of the therapeutic arsenal in severe Crohn’s disease, but the mechanisms of action have yet tobe elucidated. Part of infliximab’s effect has been suggested to be reduced apoptosis of epithelial cells andthereby reduced paracellular permeability. Our aim was to study how infliximab affects uptake of adherent E.coli across the colonic mucosa in CD.

    Method: Seven patients with active CD colitis were examined before and after a four week treatment withinfliximab. Control biopsies were taken from healthy volunteers (4) and patients undergoing controlexamination for colonic polyps (4), aged 36 (range 25-81), coloscopy. Biopsies were taken from macroscopicallynon-inflamed descending colon and were mounted in Ussing chambers to study barrier function. Transmucosalpassage of green fluorescent protein (GFP) incorporated E. coli HM427, an adherent bacteria isolated from thecolon of a CD patient, was studied by quantifying the translocated fluorescent bacteria using flow cytometry.

    Results: Bacterial passage across the colonic mucosa was increased in CD (2500 ± 300 arb. units) comparedwith controls (960 ± 280; p<0.05), and was reduced to 500 ± 200 units after the infliximab treatment (p<0.05).In biopsies treated with colchicine (a microtubuline inhibitor) uptake of E. coli HM427 was reduced by 2/3compared to non-treated biopsies.

    Conclusion: Patients with active Crohn’s disease showed a defect in the barrier to adherent E. coli, which waspartly mediated through a microtubule dependent uptake. The four week treatment with infliximab improvedthe intestinal barrier to these bacteria. This may constitute an important part of infliximab’s mechanisms ofaction in active colitis.

  • 11.
    Tengblad, Anders
    et al.
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Länne, Toste
    Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Engvall, Jan
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Nyström, Fredrik
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Östgren, Carl Johan
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, West County Primary Health Care.
    Sagittal abdominal diameter and waist circumference as markers of early organ damage in patients with Type 2 diabetes2011In: Journal of Clinical Metabolism & Diabetes, Vol. 2, no 1Article in journal (Refereed)
    Abstract [en]

    Aims: In a cohort of 465 patients with Type 2 diabetes aged 55-66 years the associationbetween the anthropometric measures: Waist circumference (WC) and Sagittal abdominaldiameter (SAD) versus subclinical cardiovascular organ damage by measuring Pulse wavevelocity (PWV) and Left ventricular mass index (LVMI) was studied.

    Methods: Blood pressure, weight, height and WC were measured within primary care. SADwas measured by using standardized calliper equipment. Blood samples were taken foranalysis of HbA1c and serum lipids. LVMI was measured by M-mode echocardiography.Aortic PWV was measured by applanation tonometry (Sphygmocor®) over the carotid andfemoral arteries.

    Results: There were significant correlations between aortic PWV and WC (r=0.23; p<0.01)and SAD (r=0.25; p<0.01). LVMI was also correlated to WC (r=0.26; p<0.01) and SAD(r=0.25; p<0.01). When analysed in a multiple regression model, SAD and WC were bothassociated with PWV and LVMI, independently of age, sex, systolic blood pressure, serumlipids and HbA1c.

    Conclusion: This study shows that abdominal obesity, measured either with WC or SAD, is afeasible risk assessment tool for early subclinical organ damage in patients who have alreadydeveloped Type 2 diabetes.

  • 12.
    Tikkanen, M.J.
    et al.
    Helsinki University Central Hospital, Helsinki, Finland, Department of Medicine, Division of Cardiology, Helsinki University Central Hospital, 00290 Helsinki, Finland.
    Jackson, G.
    Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
    Tammela, T.
    Tampere University Hospital, Tampere, Finland.
    Assmann, G.
    Institut für Arterioskleroseforschung, Universität Münster, Münster, Germany.
    Palomaki, A.
    Palomäki, A., Kanta-Häme Central Hospital, Hämeenlinna, Finland.
    Kupari, M.
    Helsinki University Central Hospital, Helsinki, Finland.
    Olsson, Anders
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Erectile dysfunction as a risk factor for coronary heart disease: Implications for prevention2007In: International journal of clinical practice (Esher), ISSN 1368-5031, E-ISSN 1742-1241, Vol. 61, no 2, p. 265-268Article, review/survey (Refereed)
    Abstract [en]

    There is now mounting evidence that erectile dysfunction (ED) is an early predictor of coronary heart disease (CHD). Men presenting with ED but no other cardiovascular symptoms provide an opportunity for the treating physician to test for asymptomatic CHD and to reduce CHD risk factors. © 2007 The Authors Journal compilation 2007 Blackwell Publishing Ltd.

  • 13.
    Ziedén, Bo
    et al.
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences.
    Olsson, Anders
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    The role of statins in the prevention of ischemic stroke2005In: Current Atherosclerosis Reports, ISSN 1523-3804, E-ISSN 1534-6242, Vol. 7, no 5, p. 364-368Article in journal (Refereed)
    Abstract [en]

    Statin treatment has been demonstrated to diminish the risk for stroke in patients with coronary heart disease, hypercholesterolemia, normocholesterolemia, in the elderly, and among hypertensive and diabetic patients. Stroke incidence in patients on statin treatment has been reduced in all these clinical settings involving both primary and secondary prevention but not in patients with previous stroke. Two recent meta-analyses confirm this conclusion. The mechanism by which statins provide benefit against stroke is likely multifactorial, involving both the low-density lipoprotein cholesterol-lowering effect with stabilization of vulnerable plaques, and pleiotropic effects such as improvement of endothelial function, increased nitric oxide bioavailability, antioxidant properties, inhibition of inflammatory responses, immunomodulatory actions, and regulation of progenitor cells.

  • 14.
    Öst, Anita
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Danielsson, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Lidén, Martin
    Ludwig Institute for Cancer Research, Stockholm, Sweden.
    Eriksson, Ulf
    Ludwig Institute for Cancer Research, Stockholm, Sweden.
    Nyström, Fredrik H
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Strålfors, Peter
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Retinol-binding protein-4 attenuates insulin-induced phosphorylation of IRS1 and ERK1/2 in primary human adipocytes2007In: The FASEB journal : official publication of the Federation of American Societies for Experimental Biology, ISSN 1530-6860, Vol. 21, no 13, p. 3696-3704Article in journal (Refereed)
    Abstract [en]

    Reduced sensitivity to insulin in adipose, muscle, and liver tissues is a hallmark of type 2 diabetes. Animal models and patients with type 2 diabetes exhibit elevated levels of circulating retinol-binding protein (RBP4), and RBP4 can induce insulin resistance in mice. However, little is known about how RBP4 affects insulin signaling. We examined the mechanisms of action of RBP4 in primary human adipocytes. RBP4-treated adipocytes exhibited the same molecular defects in insulin signaling, via IRS1 to MAP kinase, as in adipocytes from patients with type 2 diabetes. Without affecting autophosphorylation of the insulin receptor, RBP4 blocked the insulin-stimulated phosphorylation of IRS1 at serine (307) [corresponding to serine (302) in the murine sequence] and concomitantly increased the EC50 (from 0.5 to 2 nM) for insulin stimulation of IRS1 phosphorylation at tyrosine. The phosphorylation of IRS1 at serine (312) [corresponding to serine (307) in the murine sequence] was not affected in cells from diabetic patients and was also not affected by RBP4. The EC50 for insulin stimulation of downstream phosphorylation of MAP kinase ERK1/2 was increased (from 0.2 to 0.8 nM) by RBP4. We show that ERK1/2 phosphorylation is similarly impaired in adipocytes from patients with type 2 diabetes. However, the sensitivity to insulin for downstream signaling to control of protein kinase B and glucose uptake was not affected by RBP4. When insulin-resistant adipocytes from patients with type 2 diabetes were incubated with antibodies against RBP4, insulin-induced phosphorylation of IRS1 at serine (307) was normalized and the EC50 for insulin stimulation of ERK1/2 phosphorylation was reduced. Endogenous levels of RBP4 were markedly reduced in adipocytes from obese or type 2 diabetic subjects, whereas expression levels of RBP4 mRNA were unaffected. These findings indicate that RBP4 may be released from diabetic adipocytes and act locally to inhibit phosphorylation of IRS1 at serine (307), a phosphorylation site that may integrate nutrient sensing with insulin signaling.

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