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  • 101.
    Münch, Andreas
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken.
    Bohr, Johan
    Örebro University Hospital, and School of Health and Medical Sciences, Örebro University, Sweden .
    Miehlke, Stephan
    Centre for Digestive Disease, Hamburg, Germany .
    Benoni, Cecilia
    University Hospital, Malmö, Sweden .
    Olesen, Martin
    University Hospital, Malmö, Sweden .
    Ost, Ake
    Aleris Medilab, Täby, Sweden.
    Strandberg, Lars
    Region Hospital, Falun, Sweden.
    Hellström, Per M
    Uppsala University, Sweden.
    Hertervig, Erik
    University Hospital, Lund, Sweden.
    Armerding, Peter
    Gastroenterology, Private Practice, Berlin, Germany .
    Stehlik, Jiri
    Region Hospital, Usti nad Labem, Czech Repbulic.
    Lindberg, Greger
    Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Björk, Jan
    Karolinska University Hospital Solna, Stockholm, Sweden .
    Lapidus, Annika
    Ersta Hospital, Stockholm, Sweden .
    Löfberg, Robert
    Sophiahemmet, Stockholm, Sweden .
    Bonderup, Ole
    Regional Hospital, Silkeborg, Danmark .
    Avnström, Sören
    Amager Hospital, Copenhagen, Denmark .
    Rössle, Martin
    Gastroeneterology, Priva Practice, Freiburg, Germany.
    Dilger, Karin
    Dr Falk, Pharma GmBH, Freiburg, Germany.
    Mueller, Ralph
    Dr Falk, Pharma GmBH, Freiburg, Germany.
    Greinwald, Roland
    Dr Falk, Pharma GmBH, Freiburg, Germany.
    Tysk, Curt
    Örebro University Hospital, and School of Health and Medical Sciences, Örebro University, Sweden.
    Ström, Magnus
    Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Low-dose budesonide for maintenance of clinical remission in collagenous colitis: a randomised, placebo-controlled, 12-month trial2016Ingår i: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 65, nr 1, s. 47-56Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: This 1-year study aimed to assess low-dose budesonide therapy for maintenance of clinical remission in patients with collagenous colitis.

    DESIGN: A prospective, randomised, placebo-controlled study beginning with an 8-week open-label induction phase in which patients with histologically confirmed active collagenous colitis received budesonide (Budenofalk, 9 mg/day initially, tapered to 4.5 mg/day), after which 92 patients in clinical remission were randomised to budesonide (mean dose 4.5 mg/day; Budenofalk 3 mg capsules, two or one capsule on alternate days) or placebo in a 12-month double-blind phase with 6 months treatment-free follow-up. Primary endpoint was clinical remission throughout the double-blind phase.

    RESULTS: Clinical remission during open-label treatment was achieved by 84.5% (93/110 patients). The median time to remission was 10.5 days (95% CI (9.0 to 14.0 days)). The maintenance of clinical remission at 1 year was achieved by 61.4% (27/44 patients) in the budesonide group versus 16.7% (8/48 patients) receiving placebo (treatment difference 44.5% in favour of budesonide; 95% CI (26.9% to 62.7%), p<0.001). Health-related quality of life was maintained during the 12-month double-blind phase in budesonide-treated patients. During treatment-free follow-up, 82.1% (23/28 patients) formerly receiving budesonide relapsed after study drug discontinuation. Low-dose budesonide over 1 year resulted in few suspected adverse drug reactions (7/44 patients), all non-serious.

    CONCLUSIONS: Budesonide at a mean dose of 4.5 mg/day maintained clinical remission for at least 1 year in the majority of patients with collagenous colitis and preserved health-related quality of life without safety concerns. Treatment extension with low-dose budesonide beyond 1 year may be beneficial given the high relapse rate after budesonide discontinuation.

    TRIAL REGISTRATION NUMBERS: http://www.clinicaltrials.gov (NCT01278082) and http://www.clinicaltrialsregister.eu (EudraCT: 2007-001315-31).

  • 102.
    Narendra, Sudeep Chenna
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Chalise, Jaya Prakash
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Höök, Nina
    Rheumatology and Inflammation Research, Sahlgrenska University Hospital, Göteborgs Universitet, Göteborg, Sweden.
    Magnusson, Mattias
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Dendritic cells activated by double-stranded RNA induce arthritis via autocrine type I IFN signaling.2014Ingår i: Journal of Leukocyte Biology, ISSN 0741-5400, E-ISSN 1938-3673, Vol. 95, nr 4, s. 661-666Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Viral dsRNA can be found at the site of inflammation in RA patients, and intra-articular injection of dsRNA induces arthritis by activating type I IFN signaling in mice. Further, DCs, a major source of IFN-α, can be found in the synovium of RA patients. We therefore determined the occurrence of DCs in dsRNA-induced arthritis and their ability to induce arthritis. Here, we show, by immunohistochemistry, that cells expressing the pan-DC marker CD11c and the pDC marker 120G8 are present in the inflamed synovium in dsRNA-induced arthritis. Flt3L-generated and splenic DCs preactivated with dsRNA before intra-articular injection, but not mock-stimulated cells, clearly induced arthritis. Induction of arthritis was dependent on type I IFN signaling in the donor DCs, whereas IFNAR expression in the recipient was not required. Sorting of the Flt3L-DC population into cDCs (CD11c(+), PDCA-1(-)) and pDCs (CD11c(+), PDCA-1(+)) revealed that both subtypes were arthritogenic and produced type I IFN if treated with dsRNA. Taken together, these results demonstrate that viral nucleic acids can elicit arthritis by activating type I IFN signaling in DCs. Once triggered, autocrine type I IFN signaling in dsRNA-activated DCs is sufficient to propagate arthritis.

  • 103.
    Nestor, Colm E
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Dadfa, Elham
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Ernerudh, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Gustafsson, Mika
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Björkander, Jan Fredrik
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Benson, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Zhang, Huan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Sublingual immunotherapy alters expression of IL-4 and its soluble and membrane-bound receptors2014Ingår i: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 69, nr 11, s. 1564-1566Artikel i tidskrift (Refereegranskat)
    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.

  • 104.
    Nikamo, Pernilla
    et al.
    Karolinska Institutet, Karolinska University Hospital, Stockholm.
    Cheuk, Stanley
    Karolinska Institutet, Karolinska University Hospital, Stockholm.
    Lysell, Josefin
    Karolinska Institutet, Karolinska University Hospital, Stockholm.
    Enerbäck, Charlotta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    Bergh, Kerstin
    Karolinska Institutet, Karolinska University Hospital, Stockholm.
    Xu Landén, Ning
    Karolinska Institutet, Karolinska University Hospital, Stockholm.
    Eidsmo, Liv
    Karolinska Institutet, Karolinska University Hospital, Stockholm.
    Ståhle, Mona
    Karolinska Institutet, Karolinska University Hospital, Stockholm.
    Genetic variants of the IL22 promoter associate to onset of psoriasis before puberty and increased IL-22 production in T cells.2014Ingår i: Journal of Investigative Dermatology, ISSN 0022-202X, E-ISSN 1523-1747, Vol. 134, nr 6, s. 1535-1541Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Most psoriasis susceptibility genes were identified in cohorts of mixed clinical phenotypes and the exploration of genes in clinical subtypes is scarce. IL-22 has an established role in host defense and in psoriasis skin pathology, reflecting the delicate balance between control of infection and immunopathology. In a case-control study, we compared the genetic association to IL22 in psoriasis onset in patients between 0-9 (n=207), 10-20 (n=394), and 21-40 (n=468) years with healthy controls (n=1,529). Logistic regression analysis revealed association to regulatory elements in the IL22 promoter confined to onset of psoriasis before puberty (odds ratio=1.45, P<0.0007). The associated variants contain putative binding sites for AhR, a potent inducer of IL-22 expression. In a luciferase assay, transcriptional activity of a high-risk gene variant resulted in 80% higher promoter activity (P=0.012) compared with a low-risk variant. Ex vivo stimulated T cells from peripheral blood were analyzed with flow cytometry. Children with psoriasis carrying a high-risk variant produced 1.7 times more IL-22 compared with low-risk variants (P=0.042). Our combined genetic and functional data support the notion that a genetic IL22 variant that promotes epithelial barrier defense is preferentially enriched in and may precipitate the onset of psoriasis at an early age.

  • 105.
    Nilsson, Lennart
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US.
    Von Segebaden, Kerstin
    Blennow, Margareta
    Linde, Annika
    Uhnoo, Ingrid
    [Whooping cough is a risk to infants. The disease is circulating among adolescents and adults].2013Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 110, nr 37, s. 1599-1602Artikel i tidskrift (Refereegranskat)
  • 106.
    Nordberg, Marika
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet.
    Forsberg, Pia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Infektionskliniken i Östergötland.
    Berglund, Johan
    Blekinge Institute of Technology, Karlskrona, Sweden.
    Bjöersdorff, Anneli
    Djursjukhusgruppen, Danderyd, Sweden.
    Ernerudh, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Garpmo, Ulf
    Kalmar County Hospital, Sweden.
    Haglund, Mats
    Kalmar County Hospital, Sweden.
    Nilsson, Kenneth
    Uppsala University, Sweden.
    Eliasson, Ingvar
    Nora Älvsborg County Hospital, Trollhättan, Sweden.
    Aetiology of Tick-Borne Infections in an Adult Swedish Population—Are Co-Infections with Multiple Agents Common?2014Ingår i: Open Journal of Clinical Diagnostics, ISSN 2162-5816, E-ISSN 2162-5824, Vol. 4, nr 1, s. 31-40Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In Scandinavia, tick-borne infections affecting humans include Lyme borreliosis (LB), tick-borne encephalitis (TBE) and human granulocytic anaplasmosis (HGA). Each of these infections can present with unspecific symptoms. In this prospective clinical study, we recruited patients based on two independent inclusion criteria; 1) patients with unspecific symptoms, i.e. fever (≥38.0℃) or a history of feverishness and/or any combination of headache, myalgia or arthralgia and 2) patients with erythema migrans (EM), following an observed tick bite or tick exposure within one month prior to onset of symptoms. A total of 206 patients fulfilled the study. Among these, we could identify 186 cases of LB (174 with EM), 18 confirmed and two probable cases of HGA and two cases of TBE. Thirteen of the HGA cases presented without fever. Furthermore, 22 of the EM patients had a sub-clinical co-infection with Anaplasma phagocytophilum, based on serology. Both TBE cases had co-infections, one with Borrelia burgdorferi and one with Anaplasma phagocytophilum. We conclude that it is important to consider several causative agents and possible co-infections in the clinical management of infectious diseases where ticks may be suspected as vectors.

  • 107. Nordenskjöld, U
    et al.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Arbetsterapi vid reumatisk sjukdom 2011Ingår i: Reumatologi / [ed] Lars Klareskog, Tore Saxne, Yvonne Enman, 2011, 2, s. 423-Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 108.
    Nordmark, Gunnel
    et al.
    Uppsala University, Sweden .
    Wang, Chuan
    Uppsala University, Sweden .
    Vasaitis, Lilian
    Uppsala University, Sweden .
    Eriksson, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Reumatologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Theander, Elke
    Lund University, Sweden .
    Kvarnström, Marika
    Karolinska Institutet, Stockholm, Sweden.
    Forsblad-d'Elia, Helena
    University of Gothenburg, Sweden .
    Jazebi, Helmi
    Karolinska Institutet, Stockholm, Sweden.
    Sjöwall, Christoffer
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Reksten, Tove Ragna
    University of Bergen, Norway .
    Brun, Johan G.
    Haukeland University Hospital, Bergen, Norway.
    Jonsson, Malin V.
    University of Bergen, Norway .
    Johnsen, Svein J.
    Stavanger University Hospital, Norway .
    Wahren-Herlenius, Marie
    Karolinska Institutet, Stockholm, Sweden.
    Omdal, Roald
    Stavanger University Hospital, Norway .
    Jonsson, Roland
    University of Bergen, Norway.
    Bowman, Simon
    University Hospital Birmingham, UK.
    Ng, Wan-Fai
    Newcastle University, UK.
    Eloranta, Maija-Leena
    Uppsala University, Sweden .
    Syvänen, Ann-Christine
    Uppsala University, Sweden .
    Association of Genes in the NF-κB Pathway with Antibody-Positive Primary Sjögren's Syndrome2013Ingår i: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 78, nr 5, s. 447-454Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Primary Sjogrens syndrome (SS) is a systemic autoimmune inflammatory disease characterized by focal lymphocytic infiltrates in the lachrymal and salivary glands and autoantibodies against the SSA/Ro and SSB/La antigens. Experimental studies have shown an activation of NF-B in primary SS. NF-B activation results in inflammation and autoimmunity and is regulated by inhibitory and activating proteins. Genetic studies have shown an association between multiple autoimmune diseases and TNFAIP3 (A20) and TNIP1 (ABIN1), both repressors of NF-B and of IKBKE (IKK epsilon), which is an NF-B activator. The aim of this study was to analyse single nucleotide polymorphisms (SNPs) in the IKBKE, NFKB1, TNIP1 and TNFAIP3 genes for association with primary SS. A total of 12 SNPs were genotyped in 1105 patients from Scandinavia (Sweden and Norway, n=684) and the UK (n=421) and 4460 controls (Scandinavia, n=1662, UK, n=2798). When patients were stratified for the presence of anti-SSA and/or anti-SSB antibodies (n=868), case-control meta-analysis found an association between antibody-positive primary SS and two SNPs in TNIP1 (P=3.4x10(-5), OR=1.33, 95%CI: 1.16-1.52 for rs3792783 and P=1.3x10(-3), OR=1.21, 95%CI: 1.08-1.36 for rs7708392). A TNIP1 risk haplotype was associated with antibody-positive primary SS (P=5.7x10(-3), OR=1.47, 95%CI: 1.12-1.92). There were no significant associations with IKBKE, NFKB1 or TNFAIP3 in the meta-analysis of the Scandinavian and UK cohorts. We conclude that polymorphisms in TNIP1 are associated with antibody-positive primary SS.

  • 109.
    Noren, Elisabeth
    et al.
    Karolinska Institute, Sweden; Regional Jonköping County, Sweden.
    Verma, Deepti
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet.
    Söderkvist, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Diagnostikcentrum, Klinisk patologi och klinisk genetik.
    Weisselberg, Tilman
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken.
    Söderman, Jan
    Regional Jönköping County, Sweden.
    Lotfi, Kourosh
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Almer, Sven
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Single Nucleotide Polymorphisms in MORC4, CD14, and TLR4 Are Related to Outcome of Allogeneic Stem Cell Transplantation2016Ingår i: Annals of Transplantation, ISSN 1425-9524, E-ISSN 2329-0358, Vol. 21, s. 56-67Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Non-HLA genes may contribute to the prognosis after hematopoietic stem cell transplantation. We investigated associations between single nucleotide polymorphisms in regions of MORC4, CD14, TLR4, NOD2, SLC22A4, SLC22A5, CARD8, NLRP3, and CLDN2 and the outcomes of patients undergoing allogeneic stem cell transplantation. Material/Methods: Single nucleotide polymorphisms in selected regions were determined and analyzed for putative associations with overall mortality and acute graft-versus-host disease. Significant associations were further explored by logistic regression, controlling for additional variables. Results: A significant association was identified between overall mortality among recipients and a nonsynonymous coding variant of MORC4 (rs6622126) in the recipient genetic makeup (P=0.029). Since MORC4 is located on the X-chromosome, the results were also analyzed separately for males and females. The association between overall mortality for recipients and the risk allele (rs6622126; A) was confirmed for males with respect to genetic makeup of recipients (P=0.012), donor genetic makeup (P=0.004), and the combined allele composition of the donor and recipient (P=0.001). A significant association was also identified between overall mortality and the recipient risk allele of CD14 (rs2569190; P=0.031), TLR4 (rs4986790; P=0.043), and NOD2 (carriage of at least 1 mutant allele of rs2066844, rs2066845, or rs2066847; P=0.048). Among the investigated genes, only the CD14 (rs2569190) recipient risk allele was significantly associated with acute graft-versus-host disease (P=0.023). Logistic regression models confirmed these findings, except for NOD2, and also identified a significant contribution by age at stem cell transplantation (MORC4, CD14, TLR4), diagnosis (CD14, TLR4), and prophylaxis (MORC4). Conclusions: Genetic variation in MORC4, CD14, and TLR4 may affect the outcome of allogeneic stem cell transplantation.

  • 110.
    ODoherty, Jim
    et al.
    St Thomas Hospital, England .
    Henricson, Joakim
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Kirurgi. Linköpings universitet, Hälsouniversitetet.
    Falk, Magnus
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Anderson, Chris
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    Correcting for possible tissue distortion between provocation and assessment in skin testing: The divergent beam UVB photo-test2013Ingår i: Skin research and technology, ISSN 0909-752X, E-ISSN 1600-0846, Vol. 19, nr 4, s. 368-374Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundIn tissue viability imaging (TiVi), an assessment method for skin erythema, correct orientation of skin position from provocation to assessment optimizes data interpretation. Image processing algorithms could compensate for the effects of skin translation, torsion and rotation realigning assessment images to the position of the skin at provocation. less thanbrgreater than less thanbrgreater thanMethodsA reference image of a divergent, UVB phototest was acquired, as well as test images at varying levels of translation, rotation and torsion. Using 12 skin markers, an algorithm was applied to restore the distorted test images to the reference image. less thanbrgreater than less thanbrgreater thanResultsThe algorithm corrected torsion and rotation up to approximately 35 degrees. The radius of the erythemal reaction and average value of the input image closely matched that of the reference images true value. less thanbrgreater than less thanbrgreater thanConclusionThe image de-warping procedure improves the robustness of the response image evaluation in a clinical research setting and opens the possibility of the correction of possibly flawed images performed away from the laboratory setting by the subject/patient themselves. This opportunity may increase the use of photo-testing and, by extension, other late response skin testing where the necessity of a return assessment visit is a disincentive to performance of the test.

  • 111.
    Orwelius, Lotti
    et al.
    Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och intensivvårdskliniken US. Linköpings universitet, Institutionen för klinisk och experimentell medicin.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Kristenson, Margareta
    Linköpings universitet, Institutionen för medicin och hälsa, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och intensivvårdskliniken US.
    Health-related quality of life scores after intensive care are almost equal to those of the normal population: a multicenter observational study2013Ingår i: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 17, nr 5, s. R236-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION:

    Health-related quality of life (HRQoL) in patients treated in intensive care has been reported to be lower compared with age- and sex-adjusted control groups. Our aim was to test whether stratifying for coexisting conditions would reduce observed differences in HRQoL between patients treated in the ICU and a control group from the normal population. We also wanted to characterize the ICU patients with the lowest HRQoL within these strata.

    METHODS:

    We did a cross-sectional comparison of scores of the short-form health survey (SF-36) questionnaire in a multicenter study of patients treated in the ICU (n = 780) and those from a local public health survey (n = 6,093). Analyses were in both groups adjusted for age and sex, and data stratified for coexisting conditions. Within each stratum, patients with low scores (below -2 SD of the control group) were identified and characterized.

    RESULTS:

    After adjustment, there were minor and insignificant differences in mean SF-36 scores between patients and controls. Eight (n = 18) and 22% (n = 51) of the patients had low scores (-2 SD of the control group) in the physical and mental dimensions of SF-36, respectively. Patients with low scores were usually male, single, on sick leave before admission to critical care, and survived a shorter time after being in ICU.

    CONCLUSIONS:

    After adjusting for age, sex, and coexisting conditions, mean HRQoL scores were almost equal in patients and controls. Up to 22% (n = 51) of the patients had, however, a poor quality of life as compared with the controls (-2 SD). This group, which more often consisted of single men, individuals who were on sick leave before admission to the ICU, had an increased mortality after ICU. This group should be a target for future support.

  • 112.
    Panzer, S
    et al.
    Medical University of Vienna, Austria .
    Engelbrecht, S
    Alfred Hospital, Australia .
    Cole-Sinclair, M F
    St Vincents Hospital, Australia .
    Wood, E M
    Monash University, Australia .
    Wendel, S
    Hospital Sirio Libanes, Brazil .
    Biagini, S
    Hospital Sirio Libanes, Brazil .
    Zhu, Z
    Institute National Transfus Sanguine, France .
    Lefrere, J-J
    Institute National Transfus Sanguine, France .
    Andreu, G
    Institute National Transfus Sanguine, France .
    Zunino, T
    Institute National Transfus Sanguine, France .
    Cabaud, J-J
    Institute National Transfus Sanguine, France .
    Rouger, P
    Institute National Transfus Sanguine, France .
    Garraud, O
    University of Lyon, France .
    Janetzko, K
    Heidelberg University, Germany .
    Mueller-Steinhardt, M
    Heidelberg University, Germany .
    van der Burg, P
    Sanquin Bloedvoorziening, Netherlands .
    Brand, A
    Leiden University, Netherlands .
    Agarwal, P
    SGPGIMS, India .
    Triyono, T
    University of Gadjah Mada, Indonesia .
    Gharehbaghian, A
    Shahid Beheshti University of Medical Science, Iran .
    Manny, N
    Hadassah Hebrew University of Medical Centre, Israel .
    Zelig, O
    Hadassah Hebrew University of Medical Centre, Israel .
    Takeshita, A
    Hamamatsu University of School Med, Japan .
    Yonemura, Y
    Kumamoto University Hospital, Japan .
    Fujihara, H
    Hamamatsu University, Japan .
    Nollet, K E
    Fukushima Medical University, Japan .
    Ohto, H
    Fukushima Medical University, Japan .
    Han, K-S
    Seoul National University, South Korea .
    Nadarajan, V S
    University of Malaya, Malaysia .
    Berlin, Gösta
    Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin.
    Sandler, S G.
    Georgetown University, DC USA .
    Strauss, R G
    University of Iowa Hospital and Clin, IA USA .
    Reesink, H W
    University of Amsterdam, Netherlands .
    Education in transfusion medicine for medical students and doctors2013Ingår i: Vox Sanguinis, ISSN 0042-9007, E-ISSN 1423-0410, Vol. 104, nr 3, s. 250-272Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    n/a

  • 113.
    Perneros, Gerd
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Tropp, Hans
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Sandqvist, Jan
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Evaluation of occupational performance and pain intensity: before and after back surgery and rehabilitation2014Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, nr 1, s. 69-81Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The study had a descriptive, longitudinal design and evaluated occupational performance and pain intensity in daily occupations for patients with low back pain (LBP), assessed preoperatively, and at six and 12 months after surgery and rehabilitation. Methods: Patients were assessed by surgeons and occupational therapists (OTs) to determine whether surgery was required. The OTs used the Assessment of Pain and Occupational Performance (POP) instrument. The POP measures 36 occupations in two dimensions: occupational performance and pain intensity. Patients with specific LBP (n = 97) were included. Results: Preoperatively, 23 occupations showed lower performance and "severe pain". At six months, 27 occupations were performed "without restriction" (p = n.s. -less than 0.001) and without pain or with "mild pain" (p less than 0.001). A comparison of preoperative values with those at 12 months showed that 35 occupations were significantly changed on both scales, and 31 occupations were performed "without restriction" (p less than 0.01-less than 0.001) and "without pain" (p less than 0.001). Conclusions: The results indicate significant improvements between baseline, six months, and 12 months. Moreover, when occupational performance and pain intensity were separately identified, it was shown that patients had regained their performance at an ordinary level without pain. This underlines the added value of differentiating between disability and pain.

  • 114.
    Persson, Bodil
    et al.
    Skåne University Hospital, Sweden.
    Vrethem, Magnus
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Murgia, Nicola
    University of Perugia, Italy.
    Lindh, Jonas
    Ryhov County Hospital, Sweden.
    Hällsten, Anna-Lena
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Yrkes- och miljömedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Arbets- och miljömedicin.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Tondel, Martin
    Uppsala University, Sweden.
    Urinary 2,5-hexanedione excretion in cryptogenic polyneuropathy compared to the general Swedish population2013Ingår i: Journal of Occupational Medicine and Toxicology, ISSN 1745-6673, E-ISSN 1745-6673, Vol. 8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    2,5-hexanedione (2,5-HD) is the main neurotoxic metabolite of methyl-n-butyl ketone (MBK) and n-hexane, and known to cause polyneuropathy. The aim of our study was to compare the urinary levels of 2,5-HD between cases with cryptogenic polyneuropathy and the general Swedish population, and to elucidate the role of certain external factors.

    Methods

    Morning urine samples were collected from 114 cases with cryptogenic polyneuropathy (77 men and 37 women) and 227 referents (110 men and 117 women) randomly selected from the population registry. None had any current occupational exposure to n-hexane or MBK. The urine samples were analysed by a gas chromatographic method based on acidic hydrolysis.

    Results

    Cases had statistically higher urinary levels of 2,5-HD (0.48 mg/L) than the general population (0.41 mg/L) and men higher excretion than women (0.48 mg/L and 0.38 mg/L, respectively). There was no difference in 2,5-HD levels between current smokers and non-smokers. Occupational exposure to xylene, alcohol consumption and ever exposed to general anaesthesia were associated with lower excretion in men while for occupational exposure to nitrous oxide in women higher excretion was seen. Higher excretion of 2,5 HD was inversely related to increasing age.

    Conclusions

    Significantly higher levels of urinary 2,5-HD were seen in men and cryptogenic polyneuropathy cases seemingly unexposed to n-hexane. Hypothetically, this might be due to either differences in metabolic patterns or some concealed exposure. The difference in means between cases and the general population is small and can therefore not allow any firm conclusions of the causality, however.

  • 115.
    Pihl Lesnovska, Katarina
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Börjeson, Sussanne
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US.
    Hjortswang, Henrik
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken.
    Hollman Frisman, Gunilla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    What do patients need to know? Living with inflammatory bowel disease2014Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, nr 11-12, s. 1718-1725Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore the need for knowledge as expressed by patients diagnosed with inflammatory bowel disease.

    BACKGROUND: Inflammatory bowel disease has a major impact on physical and emotional well-being, placing considerable demands on patients' management of daily activities. Although inflammatory bowel disease patients' level of knowledge about their disease has been previously studied, it is necessary to learn more about their self-expressed needs.

    DESIGN: The study was designed to explore patients' need for knowledge; therefore, an inductive method was chosen.

    METHODS: Thirty patients with inflammatory bowel disease were interviewed. Content analysis was used to describe their need for knowledge.

    RESULTS: The analysis generated three categories and eight subcategories: (1) knowledge related to the course of the disease (subcategories: understanding causal relationships between symptoms and the disease, complications related to the disease and understanding treatment), (2) knowledge related to managing everyday life (subcategories: behaviour that enhances well-being and managing social life) and (3) difficulty understanding and assimilating information (subcategories: shifting knowledge needs, help to understand information and reasons for wanting or not wanting knowledge).

    CONCLUSION: Knowledge needs were related to what to expect when living with inflammatory bowel disease in order to manage everyday life. There was a great variation in the need for knowledge, which was greatest immediately following diagnosis and during relapse.

    RELEVANCE TO CLINICAL PRACTICE: It is important for healthcare providers to ascertain the patients' individual knowledge needs and together with them formulate an individual care plan that gives the patient the necessary knowledge to manage their health and social life.

  • 116.
    Pihl, Mikael
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Verma, Deepti
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Söderkvist, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Hälsouniversitetet.
    Ludvgisson, Johnny
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Casas, Rosaura
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Polymorphisms in NALP3 inflammasome components NLRP3 and CARD8 affect C-peptide secretion in type 1 diabetes2013Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Interleukin-1β has long been known to have potential roles in type 1 diabetes (T1D) pathogenesis. Production of active Iinterleukin-1β is dependent on the action of a caspase activating protein complex called NALP3 inflammasome. The NALP3 inflammasome is composed of NALP3/Cryopyrin, ASC and CARD8. Polymorphisms in the NLRP3 and CARD8 genes have been linked to several autoinflammatory diseases. The NALP3 inflammasome is crucial for adjuvanticity of aluminium hydroxide, which is used as adjuvant in clinical trials of glutamic acid decarboxylase (GAD)-alum in T1D. Our aim was to investigate the effect of common polymorphisms of NLRP3 on T1D susceptibility as well as on GAD-alum treatment efficacy. The single nucleotide polymorphisms NLRP3 Q705K, CARD8 C10X and an SNP downstream of the NLRP3 gene, rs10733113, were genotyped using a Taqman genotyping assay. The A allele of CARD8 C10X was associated with a lower stimulated insulin secretion 3 months after diagnosis in males. Patients with at least one G allele at rs10733113 were more likely to produce auto-antibodies against two or more of the islet antigens GAD, Insulin or IA-2. None of the genotyped SNPs had any significant influence on efficacy of GAD-alum treatment, but individuals with at least one rs10733113 G allele treated with placebo had lower residual insulin secretion than those with the AA genotype at 9, 15 and 21 months after start of treatment.

  • 117.
    Rafat, Mehrdad
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Filosofiska fakulteten.
    Hackett, Joanne
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Fagerholm, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neurovetenskap. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Ögonkliniken US/LiM.
    Griffith, May
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Hälsouniversitetet.
    Artificial Cornea2011Ingår i: Ocular Periphery and Disorders / [ed] Darlene A. Dartt, Peter Bex, Patricia D'Amore, Reza Dana, Linda Mcloon, Jerry Niederkorn, Elsevier, 2011, s. 311-317Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [en]

    This selection of articles from the Encyclopedia of the Eye is the first single-volume overview presenting articles on the function, biology, physiology, and pathology of the structures of the ocular periphery, as well as the related disorders and their treatment. The peripheral structures are implicated in a number of important diseases, including optic neuritis, thyroid eye disease, and strabismus. The volume offers a basic science background of these topics rather than a strictly clinical focus.

    *The first single volume to integrate comparative studies into a comprehensive resource on the neuroscience of the ocular periphery

    *Chapters are carefully selected from the Encyclopedia of the Eye by the world's leading vision researchers

    *The best researchers in the field provide their conclusions in the context of the latest experimental results

  • 118.
    Raffetseder, Johanna
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet.
    Pienaar, Elsje
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet.
    Blomgran, Robert
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet.
    Eklund, Daniel
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Brodin Patcha, Veronika
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Andersson, Henrik
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet.
    Welin, Amanda
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet.
    Lerm, Maria
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet.
    Replication Rates of Mycobacterium tuberculosis in Human Macrophages Do Not Correlate with Mycobacterial Antibiotic Susceptibility2014Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, nr 11, s. e112426-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The standard treatment of tuberculosis (TB) takes six to nine months to complete and this lengthy therapy contributes to the emergence of drug-resistant TB. TB is caused by Mycobacterium tuberculosis (Mtb) and the ability of this bacterium to switch to a dormant phenotype has been suggested to be responsible for the slow clearance during treatment. A recent study showed that the replication rate of a non-virulent mycobacterium, Mycobacterium smegmatis, did not correlate with antibiotic susceptibility. However, the question whether this observation also holds true for Mtb remains unanswered. Here, in order to mimic physiological conditions of TB infection, we established a protocol based on long-term infection of primary human macrophages, featuring Mtb replicating at different rates inside the cells. During conditions that restricted Mtb replication, the bacterial phenotype was associated with reduced acid-fastness. However, these phenotypically altered bacteria were as sensitive to isoniazid, pyrazinamide and ethambutol as intracellularly replicating Mtb. In support of the recent findings with M. smegmatis, we conclude that replication rates of Mtb do not correlate with antibiotic tolerance.

  • 119.
    Rasmusson, Lars
    et al.
    Department Oral and Maxillofacial Surgery, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,.
    Abtahi, Jahan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Medicinska fakulteten. Östergötlands Läns Landsting, Sinnescentrum, Käkkliniken US.
    Bisphosphonate associated osteonecrosis of the jaw: an update on pathophysiology, risk factors, and treatment.2014Ingår i: International Journal of Dentistry, ISSN 1687-8728, E-ISSN 1687-8736, artikel-id 71035Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Osteonecrosis of the jaw in patients treated with bisphosphonates is a relatively rare but well known complication at maxillofacial units around the world. It has been speculated that the medication, especially long-term i.v. bisphosphonate treatment, could cause sterile necrosis of the jaws. The aim of this narrative review of the literature was to elaborate on the pathological mechanisms behind the condition and also to gather an update on incidence, risk factors, and treatment of bisphosphonate associated osteonecrosis of the jaw. In total, ninety-one articles were reviewed. All were published in internationally recognized journals with referee systems. We can conclude that necrotic lesions in the jaw seem to be following upon exposure of bone, for example, after tooth extractions, while other interventions like implant placement do not increase the risk of osteonecrosis. Since exposure to the bacterial environment in the oral cavity seems essential for the development of necrotic lesions, we believe that the condition is in fact chronic osteomyelitis and should be treated accordingly.

  • 120.
    Reksten, Tove Ragna
    et al.
    University of Bergen, Norway / Uppsala University, Sweden .
    Johnsen, Svein Joar Auglænd
    Stavanger University Hospital, Norway.
    Jonsson, Malin Viktoria
    University of Bergen, Norway .
    Omdal, Roald
    Stavanger University Hospital, Norway.
    Brun, Johan G
    University of Bergen, Norway .
    Theander, Elke
    Skåne University Hospital, Lund University, Malmö, Sweden .
    Eriksson, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Wahren-Herlenius, Marie
    Karolinska Institutet, Stockholm, Sweden .
    Jonsson, Roland
    University of Bergen, Norway / Haukeland University Hospital, Bergen, Norway .
    Nordmark, Gunnel
    Uppsala University, Sweden.
    Genetic associations to germinal centre formation in primary Sjogren's syndrome2014Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 73, nr 6, s. 1253-1258Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Primary Sjögren's syndrome (pSS) is an autoimmune rheumatic disease mainly characterised by focal mononuclear cell infiltration in the salivary and lacrimal glands, and by the symptoms xerostomia and keratoconjunctivitis sicca. Germinal centre-like structures (GC) are found in the minor salivary glands of approximately 25% of patients. In this study, we aimed to assess genetic variations in pSS patients with GC-like formations (GC+) compared with patients without such formations (GC−).                                

    Methods Minor salivary gland biopsies from Swedish and Norwegian pSS patients (n=320) were evaluated for GC-like formations, identifying 76 GC+ and 244 GC− patients. A panel of 1536 single-nucleotide polymorphisms (SNPs) in 107 genes was genotyped. Minor allele frequencies in GC+ and GC− patients were compared using Fisher's exact test, and associations were considered significant when p<4.7×10−4 and suggestive when p<0.01.                                

    Results In this case-only analysis, we identified two SNPs in CCL11 (eotaxin) associated with GC-like structures (p<4.7×10−4, OR 0.45 and 0.41, respectively). A haplotype of the two minor alleles was associated with GC status with p=2.6×10−4, OR 0.40. Suggestive associations (p<0.01) were found in SNPs in the B cell activation and/or GC-formation related genes AICDA, BANK1 and BCL2. Furthermore, SNPs in IL17A, ICA1, PKN1 and SNPs in the NF-κB pathway genes CARD8, IKBKE and TANK were found suggestively associated with GC-like structures.                                

    Conclusions Our findings suggest that genetic variations may explain why ectopic GC-like structures are present in some pSS patients, and support the hypothesis that GC+ and GC− patients represent distinct disease phenotypes.

  • 121.
    Rydén, Anna
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Ludvigsson, Johnny
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Faresjo, Maria
    Jonköping University, Sweden Ryhov County Hospital, Sweden .
    General immune dampening is associated with disturbed metabolism at diagnosis of type 1 diabetes2014Ingår i: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 75, nr 1, s. 45-50Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Type 1 diabetes (T1D) is a serious diagnosis with the prospect of grave short- and long-term complications and even death if poorly managed. An attempt has been made to describe how clinical and immunological deviations might influence each other close to the diagnosis of T1D. METHODS: Sixty-nine newly diagnosed T1D children were studied together with a reference group of 30 healthy children. Cytokines (interleukin (IL)-6, IL-10, IL-13, IL-17, interferon-gamma, and tumor necrosis factor-alpha) were detected in in vitro culture by multiplex fluorochrome technique. Information of clinical status of the patients such as BMI, weight loss, pubertal stage, duration of symptoms, previous and/or ongoing infections, insulin requirement, and ketoacidosis were gathered together with the analysis of C-peptide and glycosylated hemoglobin (HbA1c). RESULTS: In general, low cytokine secretion was found at diagnosis of T1D. However, high C-peptide, short duration of symptoms, or an infection prior to diagnosis was associated with increased immune activity including proinflammatory, Th2-associated, and Tr1-associated cytokines. In contrast, ketoacidosis and later pubertal stage at onset of disease were more related to a Th1-prone response. CONCLUSION: There is a general immune dampening at diagnosis of T1D, which appears to be related to the metabolic state close to diagnosis.

  • 122.
    Sandberg, Olof
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Eliasson, Pernilla T
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin.
    Andersson, Therese
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Agholme, Fredrik
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Ortopedi och idrottsmedicin. Linköpings universitet, Hälsouniversitetet.
    Aspenberg, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Ortopedi och idrottsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Etanercept does not impair healing in rat models of tendon or metaphyseal bone injury2012Ingår i: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 83, nr 3, s. 305-310Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and purpose Should blockade of TNF-alpha be avoided after orthopedic surgery? Healing of injuries in soft tissues and bone starts with a brief inflammatory phase. Modulation of inflammatory signaling might therefore interfere with healing. For example, Cox inhibitors impair healing in animal models of tendon, ligament, and bone injury, as well as in fracture patients. TNF-alpha is expressed locally at increased levels during early healing of these tissues. We therefore investigated whether blocking of TNF-alpha with etanercept influences the healing process in established rat models of injury of tendons and metaphyseal bone. less thanbrgreater than less thanbrgreater thanMethods Rats were injected with etanercept, 3.5 mg/kg 3 times a week. Healing of transected Achilles tendons and bone healing around screws implanted in the tibial metaphysis were estimated by mechanical testing. Tendons were allowed to heal either with or without mechanical loading. Ectopic bone induction following intramuscular BMP-2 implants has previously been shown to be stimulated by etanercept in rodents. This was now tested as a positive control. less thanbrgreater than less thanbrgreater thanResults Tendon peak force after 10 days was not significantly influenced by etanercept. Changes exceeding 29% could be excluded with 95% confidence. Likewise, screw pull-out force was not significantly influenced. More than 25% decrease or 18% increase could be excluded with 95% confidence. However, etanercept treatment increased the amount of bone induced by intramuscular BMP-2 implants, as estimated by blind histological scoring. less thanbrgreater than less thanbrgreater thanInterpretation Etanercept does not appear to impair tendon or metaphyseal bone healing to any substantial degree.

  • 123.
    Sandholm, Kerstin
    et al.
    Linneaues University, Kalmar .
    Henningsson, Anna J
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet. Ryhov County Hospital Jönköping .
    Säve, Susanne
    Linneaues University, Kalmar.
    Bergström, Sven
    University of Umeå .
    Forsberg, Pia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Infektionskliniken i Östergötland.
    Jonsson, Nina
    Linneaues University, Kalmar, University Uppsala.
    Ernerudh, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Ekdahl, Kristina N
    Linneaues University, Kalmar, University Uppsala.
    Early cytokine release in response to live Borrelia burgdorferi Sensu Lato Spirochetes is largely complement independent2014Ingår i: PloS one, ISSN 1932-6203, Vol. 9, nr 9, s. e108013-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: Here we investigated the role of complement activation in phagocytosis and the release of cytokines and chemokines in response to two clinical isolates: Borrelia afzelii K78, which is resistant to complement-mediated lysis, and Borrelia garinii LU59, which is complement-sensitive.

    METHODS: Borrelia spirochetes were incubated in hirudin plasma, or hirudin-anticoagulated whole blood. Complement activation was measured as the generation of C3a and sC5b-9. Binding of the complement components C3, factor H, C4, and C4BP to the bacterial surfaces was analyzed. The importance of complement activation on phagocytosis, and on the release of cytokines and chemokines, was investigated using inhibitors acting at different levels of the complement cascade.

    RESULTS: 1) Borrelia garinii LU59 induced significantly higher complement activation than did Borrelia afzelii K78. 2) Borrelia afzelii K78 recruited higher amounts of factor H resulting in significantly lower C3 binding. 3) Both Borrelia strains were efficiently phagocytized by granulocytes and monocytes, with substantial inhibition by complement blockade at the levels of C3 and C5. 4) The release of the pro-inflammatory cytokines and chemokines IL-1β, IL-6, TNF, CCL20, and CXCL8, together with the anti-inflammatory IL-10, were increased the most (by>10-fold after exposure to Borrelia). 5) Both strains induced a similar release of cytokines and chemokines, which in contrast to the phagocytosis, was almost totally unaffected by complement blockade.

    CONCLUSIONS: Our results show that complement activation plays an important role in the process of phagocytosis but not in the subsequent cytokine release in response to live Borrelia spirochetes.

  • 124.
    Schepull, Thorsten
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Aspenberg, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Early Controlled Tension Improves the Material Properties of Healing Human Achilles Tendons After Ruptures: A Randomized Trial2013Ingår i: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 41, nr 11, s. 2550-2557Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Weightbearing in a fixed brace after acute Achilles tendon ruptures does not necessarily lead to mechanical tension in the tendon. Early motion has a positive effect on the clinical outcome, but it is not clear if this is because of effects on tendon strength or unspecific effects. The aim of this study was to examine if tensional loading leads to an improvement in the mechanical properties of the healing Achilles tendon. Hypothesis: The elastic modulus of the tendon callus is increased by early tensional loading. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Thirty-five patients with an acute Achilles tendon rupture were recruited consecutively. They underwent surgery with a single suture and received metal markers in the distal and proximal parts of the tendon. After surgery, the patients were randomized to either cast immobilization for 7 weeks or tensional loading. The latter group wore a cast for 2 weeks and then a removable foam walker boot for 5 weeks. They were instructed to remove the boot twice daily and push a special training pedal to produce a predetermined, gradually increasing tensional load on the healing tendon. At 7, 19, and 52 weeks postoperatively, the patients were investigated with roentgen stereophotogrammetric analysis under different loading conditions and computed tomography. The collected data allowed calculation of the modulus of elasticity. At 52 weeks, the clinical outcome was also examined using the Achilles tendon Total Rupture Score (ATRS) and the heel-raise index. Results: The elastic modulus at 19 and 52 weeks was higher in the tensional loading group. There was no significant difference in the ATRS or heel-raise index at 52 weeks. As in previous studies, there was a significant correlation between the modulus at 7 weeks and the heel-raise index at 52 weeks. There were no signs of tendon elongation. Conclusion: Early tensional loading improves the mechanical properties of the healing Achilles tendon.

  • 125.
    Schilcher, Jörg
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Aspenberg, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Atypical fracture of the femur in a patient using denosumab - a case report2014Ingår i: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 85, nr 1, s. 6-7Artikel i tidskrift (Övrigt vetenskapligt)
  • 126.
    Schilcher, Jörg
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Koeppen, Veronika
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Aspenberg, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Michaelsson, Karl
    Uppsala University, Sweden.
    Risk of Atypical Femoral Fracture during and after Bisphosphonate Use2014Ingår i: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 371, nr 10, s. 974-976Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 127.
    Schilcher, Jörg
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Sandberg, Olof
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Isaksson, Hanna
    Lund University, Sweden.
    Aspenberg, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Histology of 8 atypical femoral fractures2014Ingår i: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 85, nr 3, s. 280-286Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND AND PURPOSE:

    The pathophysiology behind bisphosphonate-associated atypical femoral fractures remains unclear. Histological findings at the fracture site itself may provide clues.

    PATIENTS AND METHODS:

    Between 2008 and 2013, we collected bone biopsies including the fracture line from 4 complete and 4 incomplete atypical femoral fractures. 7 female patients reported continuous bisphosphonate use for 10 years on average. 1 patient was a man who was not using bisphosphonates. Dual-energy X-ray absorptiometry of the hip and spine showed no osteoporosis in 6 cases. The bone biopsies were evaluated by micro-computed tomography, infrared spectroscopy, and qualitative histology.

    RESULTS:

    Incomplete fractures involved the whole cortical thickness and showed a continuous gap with a mean width of 180 µm. The gap contained amorphous material and was devoid of living cells. In contrast, the adjacent bone contained living cells, including active osteoclasts. The fracture surfaces sometimes consisted of woven bone, which may have formed in localized defects caused by surface fragmentation or resorption.

    INTERPRETATION:

    Atypical femoral fractures show signs of attempted healing at the fracture site. The narrow width of the fracture gap and its necrotic contents are compatible with the idea that micromotion prevents healing because it leads to strains within the fracture gap that preclude cell survival.

  • 128.
    Shabo, Ivan
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Olsson, Hans
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk patologi och klinisk genetik.
    Elkarim, Rihab
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Sun, Xiao-Feng
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US.
    Svanvik, Joar
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Macrophage Infiltration in Tumor Stroma is Related to Tumor Cell Expression of CD163 in Colorectal Cancer2014Ingår i: Cancer Microenvironment, ISSN 1875-2292, E-ISSN 1875-2284, Vol. 7, nr 1, s. 61-69Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The scavenger receptor, CD163, is a macrophage-specific marker. Recent studies have shown that CD163 expression in breast and rectal cancer cells is associated with poor prognosis. This study was conducted to evaluate the relationship between CD163 expression as a macrophage trait in cancer cells, and macrophage infiltration and its clinical significance in colorectal cancer. Immunostaining of CD163 and macrophage infiltration were evaluated in paraffin-embedded specimens, earlier analyzed for CD31, D2-40 and S-phase fraction, from primary tumors and normal colorectal mucosa of 75 patients with colorectal carcinoma. The outcomes were analyzed in relation to clinical-pathological data. CD163 expression was positive in cancer cells in 20 % of colorectal cancer patients and was related to advanced tumor stages (P = 0.008) and unfavorable prognosis (p = 0.001). High macrophage infiltration was related to shorter survival and positive CD163 expression in tumor cells. The prognostic impact of macrophage infiltration was independent of tumor stage and CD163 expression in cancer cells (p = 0.034). The expression of macrophage phenotype in colorectal cancer cells is associated with macrophage density in tumor stroma and lower survival rates. Macrophage infiltration has an independent prognostic impact on mortality in colorectal cancer. In accordance with previous experimental studies, these findings provide new insights into the role of macrophages in colorectal cancer.

  • 129.
    Shrestha, D. P.
    et al.
    Kathmandu Medical College, Nepal.
    Gurung, D.
    Kathmandu Medical College, Nepal.
    Rosdahl, Inger
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    Prevalence of skin diseases and impact on quality of life in hilly region of Nepal2012Ingår i: Institute of Medicine. Journal, ISSN 1993-2979, Vol. 34, nr 3, s. 44-49Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Skin diseases (SDs) are one of the most common health problems in Nepal. The objectives of this study are to determine the prevalence of SDs and impact on quality of life (QoL) in a rural community in Nepal.

    Methods: A house-to-house survey was conducted in a community with 3,207 inhabitants, to obtain socio-demographic data and identify individuals with SDs. Free examination and treatment was offered at 4 health camps. Individuals with long-standing SDs were interviewed using the Dermatology Life Quality Index (DLQI).

    Results: Of 735 individuals attending the health camps, 645 (mean age 24.9 years, range 0.5-90) had one or more SDs. The overall prevalence of SDs was 20.1% (males 18.1%, females 22.5% and children 28.2%). The most common SD categories were eczemas (12.2%), pigment disorders (4.1%), acne (2.7%), urticaria (2.4%) and moles and lumps (1.6%). In the Nepalese culture, the DLQI question on sexuality was too direct so only 9/10 questions were used. In the 75 patients who were interviewed, the mean DLQI score was 10.7 (range 7-19), indicating a large impact on QoL.

    Conclusions: This population-based study shows that SDs were very common in a rural community in Nepal. The five most common SD categories comprise 77% of all SDs. Targeted training should enable health-care workers to prevent, accurately diagnose and manage these problems on site. An appropriate instrument to measure QoL adjusted to the socio-cultural norms of Nepal has to be developed.

  • 130.
    Shrestha, D. P.
    et al.
    Institute of Medicine, Kathmandu, Nepal.
    Shrestha, R.
    National Academy of Medical Sciences, Kathmandu, Nepal.
    Gurung, D.
    Di Skin Hospital, Kathmandu, Nepal.
    Lama, L.
    National Academy of Medical Sciences, Kathmandu, Nepal.
    Rosdahl, Inger
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland. Kathmandu Medical College, Kathmandu, Nepal.
    Development of skin disease disability index to assess the dermatologic burden in Nepal2013Ingår i: Institute of Medicine. Journal, ISSN 1993-2979, Vol. 35, nr 2, s. 24-29Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Skin disease is one of the leading cause of morbidity worldwide. Most instruments measuring the impact of skin disease on quality of life are developed in the west and not applicable to the socio-cultural situation in Nepal. The aim of the study was to develop and validate a questionnaire to measure quality of life impairment due to skin disease in Nepal.

    Methods: Different aspects of quality of life impairment were identiÞ ed from 35 in-depth interviews and two focus group discussions, with villagers with various skin diseases. Based on this information, 10 questions scoring the influence of skin diseases on quality of life – Skin Disease Disability Index (SDDI) – was developed. This instrument was tested and validated in 212 villagers with skin disease and in 100 healthy villagers.

    Results: The maximum total Skin Disease Disability Index score was 36. There was a wide variation in total Skin Disease Disability Index score between individuals with skin disease (range 1-33) with a mean score of 13.2, while in controls the mean total score was 1 (p<0.001). Thus, the Skin Disease Disability Index clearly discriminates between these two groups. The difference in mean score for single questions between patients and controls was also highly significant (p<0.001).

    Conclusions: The questionnaire clearly covered all aspects of quality of life related to skin disease and was, simple, robust, easy to use and well accepted by the selected population. The Skin Disease Disability Index was reliable in the overall score as well as in individual questions.

  • 131.
    Shrestha, DP
    et al.
    Institute of Medicine, Kathmandu, Nepal.
    Gurung, D
    Di Skin Hospital, Kathmandu, Nepal.
    Shrestha, R
    National Academy of Medical Sciences, Kathmandu, Nepal.
    Rosdahl, Inger
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland. Kathmandu Medical College, Kathmandu, Nepal.
    Skin Diseases and Impact on Quality of Life in the Central Development Region of Nepal: A major public health problem2014Ingår i: Journal of Institute of Medicine, ISSN 1993-2979, Vol. 36, nr 2, s. 15-20Artikel i tidskrift (Refereegranskat)
  • 132.
    Shrestha, R
    et al.
    Department of Dermatology, National Academy of Medical Sciences, Bir Hospital, Nepal .
    Shrestha, DP
    Department of Dermatology & Venereology, Institute of Medicine, Maharajgunj Medical Campus, Kathmandu Nepa,l.
    Lama, L
    Department of Dermatology & Venereology, Institute of Medicine, Maharajgunj Medical Campus, Kathmandu, Nepal .
    Gurung, D
    DI Skin Hospital and Research Center, Kathmandu, Nepal .
    Rosdahl, Inger
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland. Department of Dermatology, Kathmandu Medical College, Kathmandu, Nepal .
    Pattern Of Skin Diseases In A Rural Village Development Community Of Nepal2014Ingår i: Nepal Journal of Dermatology, Venereology & Leprology, ISSN 2091-167X, Vol. 12, nr 1, s. 41-44Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Skin diseases are a common cause of morbidity in Nepal as per the health services report. There is limited information on the prevalence and pattern of skin diseases in the community. The objective of this study was to determine the pattern of skin diseases in a rural village development community of Nepal.

    Materials and methods:  Two  dermatologic  health camps were conducted, during which, the villagers were examined by dermatologists. The skin diseases diagnosed were recorded in a proforma.

    Results: There were 433 individuals examined and 359 (male-47.9%; female-52.1%) had skin disease identified clinically (camp prevalence- 83%). The age of patients ranged from 1 to 80 years (mean-24.5; SD±15.9), with majority in the age group of 10-19 years. The most common skin disease category was eczemas (36.4%), followed by infections (28.4%), acne (22%), pigment disorders (34%) and urticaria (12.3%).

    Conclusion: Skin diseases were common in the community. The five most common Skin disease categories were eczemas, infections, acne and pigment disorders were the more common conditions.

  • 133.
    Sigurdardottir, Gunnthorunn
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Ekman, Anna-Karin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Ståhle, Mona
    Karolinska Institutet, Stockholm .
    Bivik, Cecilia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Enerbäck, Charlotta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    Systemic treatment and narrowband ultraviolet B differentially affect cardiovascular risk markers in psoriasis.2014Ingår i: The Journal of American Academy of Dermatology, ISSN 0190-9622, E-ISSN 1097-6787, Vol. 70, nr 6, s. 1067-1075Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Psoriasis is associated with a systemic inflammation and an increased frequency of the metabolic syndrome, both of which are believed to link psoriasis to an increased risk of cardiovascular disease.

    OBJECTIVE: The study aimed to investigate the systemic expression of markers of cardiovascular risk and determine their response to ultraviolet B therapy and treatment with the tumor necrosis factor-alfa inhibitor, etanercept.

    METHODS: Six markers of cardiovascular risk were measured in 28 patients with psoriasis and 28 control subjects.

    RESULTS: Five of the 6 investigated markers were elevated in patients with psoriasis. Four of these correlated to the body mass index and waist-hip ratio, suggesting a link to the metabolic syndrome. Total plasminogen activator inhibitor-1 remained elevated independently of these factors. The levels of the investigated risk markers decreased considerably after tumor necrosis factor-alfa inhibitor treatment but remained unaffected by ultraviolet therapy.

    LIMITATIONS: A relatively limited study population and nonrandomization are limitations.

    CONCLUSION: These findings suggest that the choice of treatment in psoriasis may influence the cardiovascular risk in patients with psoriasis and the metabolic syndrome.

  • 134.
    Simard, Julia F
    et al.
    Karolinska Institutet, Stockholm; Stanford School of Medicine, CA, USA.
    Sjöwall, Christopher
    Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin.
    Rönnblom, Lars
    Uppsala University, Sweden.
    Jönsen, Andreas
    Lund University, Sweden.
    Svenungsson, Elisabet
    Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
    Systemic Lupus Prevalence in Sweden in 2010: What do national registers say?2014Ingår i: Arthritis care & research, ISSN 2151-4658, Vol. 66, nr 11, s. 1710-1717Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Worldwide prevalence estimates of systemic lupus erythematosus (SLE) range from 3-207 per 100,000 depending on region and population, SLE definition, case sources and other methodological considerations. We aimed to determine the prevalence of SLE in Sweden on January 1, 2010 using population-based registers.

    Methods: Linking multiple national registers we identified all possible inpatient and outpatient visits with SLE-specific discharge diagnoses and relevant prescription dispensations among living individuals registered in Sweden on January 1, 2010. SLE was defined from a lenient classification (requiring only a single visit) to stricter definitions, which required multiple visits with a history of relevant specialist care and a dispensation for common SLE medications. Prevalence was calculated overall, and by sex, age (0-14, 15-49, 50+yrs, as well as in 5-year age groups), and county of residence.

    Result: Overall prevalence ranged from 46 per 100,000 for the strictest definition to 85 per 100,000 for the least strict definition. As expected, SLE was more common among females (ranged from 79 to 144/100,000) than males (12-25/100,000) and varied by age. The up to four-fold variation by county was unexpected. Prevalence generally increased with age (2, 52, and 95 per 100,000 by increasing age group, 0-14/15-49/50+, using a moderately strict definition) and also varied by county.

    Conclusion: Variations of prevalence by age and sex were consistent with previous studies and overall ranged from 46 to 85 per 100,000. We observed a surprising geographical variation in the prevalence of SLE in Sweden on January 1, 2010 according to multiple definitions.

  • 135.
    Sjoberg, M
    et al.
    University of Örebro, Sweden .
    Magnuson, A
    Örebro University Hospital, Sweden .
    Bjork, J
    Karolinska University Hospital, Sweden .
    Benoni, C
    Skåne University Hospital, Sweden .
    Almer, Sven
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken.
    Friis-Liby, I
    Sahlgrens University Hospital, Sweden .
    Hertervig, E
    Skåne University Hospital, Sweden .
    Olsson, M
    NAL Hospital, Sweden .
    Karlen, P
    Soder Sjukhuset, Sweden .
    Eriksson, A
    Ostra Hospital, Sweden .
    Midhagen, Gunnar
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Gastroenterologi och hepatologi. Linköpings universitet, Hälsouniversitetet.
    Carlson, M
    University of Uppsala Hospital, Sweden .
    Lapidus, A
    Ersta Hospital, Sweden .
    Halfvarson, J
    University of Örebro, Sweden .
    Tysk, C
    University of Örebro, Sweden .
    Infliximab as rescue therapy in hospitalised patients with steroid-refractory acute ulcerative colitis: a long-term follow-up of 211 Swedish patients2013Ingår i: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 38, nr 4, s. 377-387Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundRescue therapy with infliximab (IFX) has been proven effective in a steroid-refractory attack of ulcerative colitis (UC). The long-term efficacy is not well described. less thanbrgreater than less thanbrgreater thanAimTo present a retrospective study of IFX as rescue therapy in UC. Primary end points were colectomy-free survival at 3 and 12months. less thanbrgreater than less thanbrgreater thanMethodsIn this multicentre study, 211 adult patients hospitalised between 1999 and 2010 received IFX 5mg/kg as rescue therapy due to a steroid-refractory, moderate-to-severe attack of UC. Exclusion criteria were duration of current flare for andgt;12weeks, corticosteroid treatment for andgt;8weeks before hospitalisation, previous IFX therapy or Crohns disease. less thanbrgreater than less thanbrgreater thanResultsProbability of colectomy-free survival at 3months was 0.71 (95% CI, 0.64-0.77), at 12months 0.64 (95% CI, 0.57-0.70), at 3years 0.59 (95% CI, 0.52-0.66) and at 5years 0.53 (95% CI, 0.44-0.61). Steroid-free, clinical remission was achieved in 105/211 (50%) and 112/209 (54%) patients at 3 and 12months respectively. Of 75 colectomies during the first year, 48 (64%) were carried out during the first 14days, 13 (17%) on days 15-90 and 14 (19%) between 3 and 12months. There were three (1.4%) deaths during the first 3months. less thanbrgreater than less thanbrgreater thanConclusionsInfliximab is an effective rescue treatment, both short- and long-term, in a steroid-refractory attack of UC. Most IFX failures underwent surgery during the first 14days, which calls for studies on how to optimise induction treatment with IFX. Serious complications, including mortality, were rare.

  • 136.
    Sjöwall, Christoffer
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Reumatologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Olin, Anders I.
    Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.
    Skogh, Thomas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Wetterö, Jonas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Mörgelin, Matthias
    Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.
    Nived, Ola
    Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden.
    Sturfelt, Gunnar
    Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden.
    Bengtsson, Anders A.
    Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden.
    C-reactive protein, immunoglobulin G and complement co-localize in renal immune deposits of proliferative lupus nephritis2013Ingår i: Autoimmunity, ISSN 0891-6934, E-ISSN 1607-842X, Vol. 46, nr 3, s. 205-214Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The pattern recognition molecules C-reactive protein (CRP) and C1q are of big interest in relation to the pathogenesis of systemic lupus erythematosus (SLE). Circulating autoantibodies against CRP and C1q are frequently found in SLE patients with active disease, particularly in lupus nephritis (LN), and rising levels reportedly relate to disease activity and outcome. If CRP-, or dsDNA- and/or C1q-containing immune complexes (ICs) are pathogenic in LN, glomerular IgG-deposits would be expected to co-localize with these antigens. In search for proof of this concept, renal biospsies from patients with active LN (n=5) were examined with high-resolution immunogold electron microscopy. Renal biopsies from patients with Henoch-Schönlein purpura, pauci-immune nephritis and renal cancer served as controls. IgG antibodies against CRP, C1q and nucleosomes were analyzed in pre–post flare sera. We could demonstrate that CRP, C1q, C3c and dsDNA were co-localized with IgG in electron dense deposits in the glomerular basement membrane/subendothelial space in all of the 5 LN patients. Deposits of IgG, CRP, complement and dsDNA were 10-fold higher in LN compared to controls. All SLE patients had circulating anti-nucleosome antibodies; 4/5 had serum antibodies against CRP, dsDNA, and C1q at biopsy/flare. Despite a limited number of cases, the results support the notion of a pathogenic role not only for anti-dsDNA antibodies, but also for anti-CRP and anti-C1q in LN. The glomerular ICs may have been generated by deposition of circulating ICs or by in situ IC formation.

  • 137.
    Sjöwall, Christopher
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Cöster, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Belimumab may not prevent lupus nephritis in serologically active patientswith ongoing non-renal disease activity2014Ingår i: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 43, nr 5, s. 428-430Artikel i tidskrift (Övrigt vetenskapligt)
  • 138.
    Skold, Caroline
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Tropp, Hans
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Berg, Svante
    Karolinska Institute, Sweden .
    Five-year follow-up of total disc replacement compared to fusion: a randomized controlled trial2013Ingår i: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 22, nr 10, s. 2288-2295Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To evaluate long-term clinical results of lumbar total disc replacement (TDR) compared with posterior lumbar fusion. less thanbrgreater than less thanbrgreater thanThis prospective randomized controlled trial comprised 152 patients; 80 were randomized to TDR and 72 to fusion. All patients had chronic low back pain (CLBP) and had not responded to nonsurgical treatment. Primary outcome measure was global assessment of back pain (GA), secondary outcome measures were back and leg pain, Oswestry Disability Index (ODI), EQ5D, and SF-36. All measures were collected from SweSpine (Swedish national register for spinal surgery) at 1, 2, and 5 years. Follow-up rate at 5 years was 99.3 %. less thanbrgreater than less thanbrgreater thanBoth groups showed clinical improvement at 5-year follow-up. For GA, 38 % (30/80) in the TDR group were totally pain free vs. 15 % (11/71) in the fusion group (p andlt; 0.003). Back pain and improvement of back pain were better in the TDR group: VAS back pain at 5 years 23 +/- A 29 vs. 31 +/- A 27, p = 0.009, and VAS improvement of back pain at 5 years 40 +/- A 32 vs. 28 +/- A 32, p = 0.022. ODI and improvement in ODI were also better in the TDR group: ODI at 5 years 17 +/- A 19 vs. 23 + 17, p = 0.02 and ODI improvement at 5 years 25 +/- A 18 vs. 18 +/- A 19 (p = 0.02). There was no difference in complications and reoperations between the two groups. less thanbrgreater than less thanbrgreater thanGlobal assessment of low back pain differed between the two surgical groups at all follow-up occasions. Significant differences between groups concerning back pain, pain improvement, and ODI were present at 1 year and disappeared at 2 years, but reappeared at the 5-year follow-up.

  • 139.
    Soderman, Jan
    et al.
    Ryhov County Hospital, Sweden .
    Noren, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet. Ryhov County Hospital, Sweden.
    Christiansson, Malin
    Ryhov County Hospital, Sweden .
    Bragde, Hanna
    Ryhov County Hospital, Sweden .
    Thiebaut, Raphaele
    University of Paris Diderot, France University of Paris Diderot Sorbonne Paris Cite, France .
    Hugot, Jean-Pierre
    University of Paris Diderot, France University of Paris Diderot Sorbonne Paris Cite, France Hop Robert Debre, France .
    Tysk, Curt
    Örebro University, Sweden Örebro Uni, Sweden .
    OMorain, Colm A.
    Adelaide and Meath Hospital, Ireland Trinity Coll Dublin, Ireland .
    Gassull, Miquel
    Health Science Research Institute, Spain .
    Finkel, Yigael
    Sachs Childrens Hospital, Sweden .
    Colombel, Jean-Frederic
    Hop Calmette, France Icahn School Medical Mt Sinai, NY 10029 USA .
    Lemann, Marc
    Hop St Louis, France .
    Almer, Sven
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken.
    Analysis of single nucleotide polymorphisms in the region of CLDN2-MORC4 in relation to inflammatory bowel disease2013Ingår i: World Journal of Gastroenterology, ISSN 1007-9327, E-ISSN 2219-2840, Vol. 19, nr 30, s. 4935-4943Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To investigate a possible genetic influence of claudin (CLDN) 1, CLDN2 and CLDN4 in the etiology of inflammatory bowel disease. METHODS: Allelic association between genetic regions of CLDN1, CLDN2 or CLDN4 and patients with inflammatory bowel disease, Crohns disease (CD) or ulcerative colitis were investigated using both a case-control study approach (one case randomly selected from each of 191 Swedish inflammatory bowel disease families and 333 controls) and a family-based study (463 non-Swedish European inflammatory bowel disease-families). A nonsynonymous coding single nucleotide polymorphism in MORC4, located on the same linkage block as CLDN2, was investigated for association, as were two novel CLDN2 single nucleotide polymorphism markers, identified by resequencing. RESULTS: A single nucleotide polymorphism marker (rs12014762) located in the genetic region of CLDN2 was significantly associated to CD (case-control allelic OR = 1.98, 95% CI: 1.17-3.35, P = 0.007). MORC4 was present on the same linkage block as this CD marker. Using the case-control approach, a significant association (case control allelic OR = 1.61, 95% CI: 1.08-2.41, P = 0.018) was found between CD and a nonsynonymous coding single nucleotide polymorphism (rs6622126) in MORC4. The association between the CLDN2 marker and CD was not replicated in the family-based study. Ulcerative colitis was not associated to any of the single nucleotide polymorphism markers. CONCLUSION: These findings suggest that a variant of the CLDN2-MORC4 region predisposes to CD in a Swedish population.

  • 140.
    Stegmayr, B
    et al.
    Umeå, Sweden.
    Ptak, J
    Frydek-Mistek, Czech Republic.
    Nilsson, T
    Uppsala, Sweden.
    Berlin, Gösta
    Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin.
    Mirea, V
    Örebro, Sweden.
    Axelsson, C G
    Örebro, Sweden.
    Griskevicius, A
    Vilnius, Lithuania.
    Centoni, P
    Livorno, Italy.
    Liumbruno, G
    Livorno, Italy.
    Audzijoniene, J
    Vilnius, Lithuania.
    Mokvist, K
    Uppsala, Sweden.
    Lassen, E
    Umeå, Sweden.
    Knutson, F
    Uppsala, Sweden.
    Norda, R
    Uppsala, Sweden.
    Mörtzell, M
    Umeå, Sweden.
    Prophet, H
    Rostock, Germany.
    Ramlow, W
    Rostock, Germany.
    Blaha, M
    Hradec Kralove, Czech Republic.
    Witt, V
    Vienne, Austria.
    Efvergren, M
    Huddinge, Sweden.
    Tomaz, J
    Coimbra, Portugal.
    Newman, E
    Concord, Australia.
    Eloot, S
    Ghent, Belgium.
    Dhondt, A
    Ghent, Belgium.
    Lalic, K
    Belgrade, Serbia.
    Sikole, A
    Skopje, Macedonia.
    Derfler, K
    Vienna, Austria.
    Hrdlickova, R
    Ostrava, Czech Republic.
    Tomsova, H
    Ostrava, Czech Republic.
    Gasova, Z
    Prague, Czech Republic.
    Bhuiyan-Ludvikova, Z
    Prague, Czech Republic.
    Ramsauer, B
    Skövde, Sweden.
    Vrielink, H
    Amsterdam, The Netherlands.
    Panorama of adverse events during cytapheresis2013Ingår i: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 48, nr 2, s. 155-156Artikel i tidskrift (Refereegranskat)
  • 141.
    Stensson, M.
    et al.
    Center of Oral Health, School of Health Sciences, Jönköping.
    Koch, G.
    Department of Pediatric Dentistry, Institute for Postgraduate Dental Education, Jönköping.
    Coric, S.
    Department of Pediatric Dentistry, Institute for Postgraduate Dental Education, Jönköping.
    Abrahamsson, Thomas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Jenmalm, Maria
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Birkhed, D.
    Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Wendt, L.-W.
    Center of Oral Health, School of Health Sciences, Jönköping.
    Oral Administration of Lactobacillus reuteri during the First Year of Life Reduces Caries Prevalence in the Primary Dentition at 9 Years of Age2014Ingår i: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 48, nr 2, s. 111-117Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to evaluate the effect on oral health, at age 9 years, of daily oral supplementation with the probiotic Lactobacillus reuteri, strain ATCC 55730, to mothers during the last month of gestation and to children through the first year of life. The study was a single-blind, placebo-controlled, multicenter trial involving 113 children: 60 in the probiotic and 53 in the placebo group. The subjects underwent clinical and radiographic examination of the primary dentition and carious lesions, plaque and gingivitis were recorded. Saliva and plaque were sampled for determination of mutans streptococci (MS) and lactobacilli (LB) in saliva and plaque as well as salivary secretory IgA (SIgA). Forty-nine (82%) children in the probiotic group and 31 (58%) in the placebo group were caries-free (p < 0.01). The prevalence of approximal caries lesions was lower in the probiotic group (0.67 ± 1.61 vs. 1.53 ± 2.64; p < 0.05) and there were fewer sites with gingivitis compared to the placebo group (p < 0.05). There were no significant differences between the groups with respect to frequency of toothbrushing, plaque and dietary habits, but to intake of fluoride supplements (p < 0.05). There were no intergroup differences with respect to L. reuteri, MS, LB or SIgA in saliva. Within the limitation of this study it seems that daily supplementation with L. reuteri from birth and during the first year of life is associated with reduced caries prevalence and gingivitis score in the primary dentition at 9 years of age.

  • 142.
    Strömfors, Lina
    et al.
    Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Wilhelmsson, Susan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Höst, Gunnar E.
    Linköpings universitet, Institutionen för teknik och naturvetenskap, Medie- och Informationsteknik. Linköpings universitet, Tekniska högskolan.
    Condition-related knowledge among children and adolescents with spina bifida in a Swedish county2014Ingår i: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 16, nr 2, s. 127-140Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Spina bifida is a congenital birth defect, resulting in physical and cognitive dysfunctions. Condition-related knowledge among children and adolescents with spina bifida is essential to facilitate independent management of their condition. The aim was to describe the condition-related knowledge among children and adolescents with spina bifida in a Swedish county. Thirteen persons with spina bifida (10 to 17 years) participated. Condition-related knowledge was assessed (n = 13) using a questionnaire (KOSB) and a semi-structured interview (n = 8). Interview data were analyzed using qualitative content analysis. The participants had well-developed knowledge concerning proper bladder management, but were lacking knowledge of signs of shunt malfunctioning and etiology. Some participants were uninterested in learning about their condition, despite being aware that they lacked knowledge. The findings indicate potential areas that may be included in local educational initiatives. It should be considered that persons with spina bifida may not be motivated to learn more about their condition.

  • 143.
    Sundbom, Per
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Hübbert, Laila
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Armeryd, Therése
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Karlsson, Monica
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Lindén, Marita
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Anderson, Chris
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    The place of skin cancer screening in heart transplant recipient follow-up protocols: a case series2014Ingår i: Enliven: Surgery and Transplantation, ISSN 2379-5719, Vol. 1, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    ObjectivesFor solid organ transplant recipients the risk of skin cancer is markedly increased due to immunosuppression. Many studies propose an annual, or morefrequent, skin screening program by a dermatologist. As the number of transplant recipients increases and survival times improve, the need for screeningand rapid response (as required) access is increasing.

    DesignIn a quality control study we retrospectively examined the medical records of patients participating in an annual screening program between 1997 and2012. A total of 69 medical records were studied and we here describe the program and present the findings.

    ResultsWe found malignant melanoma in 3 cases. Cutaneous squamous cell carcinoma occurred in 16 patients and basal cell carcinoma in 12 patients. Themost frequent skin lesions were actinic keratoses, reported in 20 patients.

    ConclusionsIncidence rates for all diagnoses were elevated compared to the general population. Awareness of the increased risk for skin malignancies is of importanceto those involved in the care of solid organ transplant recipients. Routines for early discovery of skin tumors are needed both in the form of screening,which can also establish risk group status and give preventive education, and as rapid response access for skin lesion diagnosis and treatment.

  • 144.
    Svensson-Arvelund, Judit
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Ernerudh, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Buse, Eberhard
    Covance Laboratories, Muenster, Germany .
    Cline, J Mark
    Department of Pathology/Section on Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA .
    Haeger, Jan-Dirk
    Department of Anatomy, University of Veterinary Medicine, Hannover, Germany .
    Dixon, Darlene
    National Institute of Environmental Health Sciences, National Toxicology Program (NTP), Molecular Pathogenesis, NTP Laboratory, Research Triangle Park, North Carolina, USA.
    Markert, Udo R
    Placenta-Labor, Department of Obstetrics, University Hospital, Jena, Germany.
    Pfarrer, Christiane
    Department of Anatomy, University of Veterinary Medicine, Hannover, Germany .
    De Vos, Paul
    University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands.
    Faas, Marijke M
    University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands.
    The placenta in toxicology. Part II: Systemic and local immune adaptations in pregnancy2014Ingår i: Toxicologic pathology (Print), ISSN 0192-6233, E-ISSN 1533-1601, Vol. 42, nr 2, s. 327-338Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    During pregnancy, the maternal immune system is challenged by the semiallogeneic fetus, which must be tolerated without compromising fetal or maternal health. This review updates the systemic and local immune changes taking place during human pregnancy, including some examples in rodents. Systemic changes are induced by contact of maternal blood with placental factors and include enhanced innate immunity with increased activation of granulocytes and nonclassical monocytes. Although a bias toward T helper (Th2) and regulatory T cell (Treg) immunity has been associated with healthy pregnancy, the relationship between different circulating Th cell subsets is not straightforward. Instead, these adaptations appear most evidently at the fetal-maternal interface, where for instance Tregs are enriched and promote fetal tolerance. Also innate immune cells, that is, natural killer cells and macrophages, are enriched, constituting the majority of decidual leukocytes. These cells not only contribute to immune regulation but also aid in establishing the placenta by promoting trophoblast recruitment and angiogenesis. Thus, proper interaction between leukocytes and placental trophoblasts is necessary for normal placentation and immune adaptation. Consequently, spontaneous maladaptation or interference of the immune system with toxic substances may be important contributing factors for the development of pregnancy complications such as preeclampsia, preterm labor, and recurrent miscarriages.

  • 145.
    Sverker, Anette
    et al.
    Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Rehabgruppen NSC. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Thyberg, Ingela
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Östlund, Gunnel
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Waltersson, Eva
    Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Rehabgruppen NSC.
    Thyberg, Mikael
    Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Participation in work in early rheumatoid arthritis: a qualitative interview study interpreted in terms of the ICF2014Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 3, s. 242-249Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To explore what work-related dilemmas are experienced by patients with early rheumatoid arthritis (RA), according to their own descriptions, and to interpret this in terms of participation categories of the International Classification of Functioning, Disability and Health (ICF). Method: In 48 patients with early RA, qualitative interviews were analyzed, followed by linking of concepts to the activity/participation component of the ICF and interpretation of general themes. Results: Work-related dilemmas represented different societal perspectives on work related to acquiring, keeping and terminating a job, self-employment, part-time, full-time and non-remunerative employment. Dilemmas also represented participation priorities in economic self-sufficiency, self-care such as health care, and avoiding social relationships and recreation in favor of work. Leisure time was influenced because efforts of working took energy and time of day-to-day procedures. Embedded actions in work-related dilemmas were carrying out daily routine, mobility including using transportation, self-care, domestic life and social interaction. Conclusion: The general themes societal perspectives, participation priorities and embedded actions, with the included ICF categories that are described in detail according to the experiences of the patients, can support clinical reasoning and research on quantitative relations to disease activity, body functions, ability and contextual factors. Implications for Rehabilitation In early rheumatoid arthritis, keeping a job is complex; patients and practitioners need to know and handle the perspectives of, e.g. employers and social insurance agents. Participation in work is an issue of prioritizing against, e.g. maintaining one's health and social relationships. Rehabilitation practitioners need to analyze what actions are embedded in a work situation.

     

     

     

  • 146.
    Sverker, Annette
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Björk, M
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Valtersson, E
    Östlund, G
    Mälardalen University, Eskilstuna, Sweden.
    AB1154-HPR Men's Strategies of Handling Participation Restrictions Related to Rheumatoid Arthritis (The Swedish Tira Study)2014Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Background: In spite of early interventions and advancements in medication disability and restricted work capacity is closely related to rheumatoid arthritis (RA). Around 1/3 of diagnosed patients are men, however few studies describe men's need and experiences of living with RA [1].Objectives: To explore male strategies of handling participating restriction in everyday life.Methods: In this study 25 men with early RA from the TIRA2 cohort [2], age 20 – 63, were interviewed about participation restrictions with Critical Incident Technique [3]. Transcribed interviews were synthesized into dilemmas and linked to ICF participation [4] codes and the strategies in handling these dilemmas were analyzed and categorized using content analysis [5].Results: The men described four types of strategies of handling participating restriction in everyday life. Resilience strategies; to find enjoyments, develop self-trust, and a new body-knowledge. Daily routine strategies; use more time on each task and rest in between activities, adjust medication to activity, adjust movements finding new ways to conduct work tasks and physical training. Avoidance strategies; avoid alcohol, social contacts after work, inform of RA and sometimes medicine. Action strategies; continue activities, attend activities as a spectator instead of being an active participant, go home if needed, say no, ask for help, and talk about RA. Acceptance strategies; accept pain, accept less work pace, accept less endurance and fewer activities.Conclusions: Men described dilemmas in everyday life due to RA, but not all experienced being restricted in life they rather expressed reorganizing their everyday lives.References:Shuttleworth RP (2004). Disabled masculinity; Expanding the masculine repertoire. In Smith BG, Hutchinson B (Eds). Gendering disability, New Brunswick, NJ; Rutgers University Press.Björk M, Thyberg I, Rikner K, Balogh I, Gerdle B. Sick leave before and after diagnosis of rheumatoid arthritis: a report from the Swedish TIRA project. J Rheumatol 2009;36:1170-1179.Flanagan, C (1954). The critical incident technique. Psychological Bulletin, 51: p. 327-358.Cieza A, Geyh S, Chatterji S, Kostanjsek N, Ustun B, Stucki G ICF linking rules: an update based on lessons learned. J Rehabil Med. 2005;37:212-8.Sverker A, Thyberg I, Östlund G, Valtersson E, Thyberg M. (2013). Participation in work in early rheumatoid arthritis: A qualitative interview study interpreted in terms of the ICF. Disability & Rehabilitation May (3); ISSN1464-5165

  • 147.
    Sverker, Annette
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Waltersson, Eva
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Östlund, Gunnel
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten.
    Deltagande i arbete vid tidig reumatoid artrit – en kvalitativ intervjustudie tolkad i termer av ICF2014Ingår i: Reumatologi, nr 18Artikel i tidskrift (Övrigt vetenskapligt)
  • 148.
    Szymanowski, Aleksander
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Li, Wei
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Lundberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet.
    Evaldsson, Chamilly
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk kemi.
    Nilsson, Lennart
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Backteman, Karin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Ernerudh, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Jonasson, Lena
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Soluble Fas ligand is associated with natural killer cell dynamics in coronary artery disease2014Ingår i: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 233, nr 2, s. 616-622Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Apoptosis of natural killer (NK) cells is increased in patients with coronary artery disease (CAD) and may explain why NK cell levels are altered in these patients. Soluble forms of Fas and Fas ligand (L) are considered as markers of apoptosis. Here, we investigated whether plasma levels of Fas and FasL were associated with NK cell apoptosis and NK cell levels in CAD patients. Methods: Fas and FasL in plasma were determined by ELISA in 2 cohorts of CAD patients; one longitudinal study measuring circulating NK cells and apoptotic NK cells by flow cytometry 1 day, 3 months and 12 months after a coronary event and one cross-sectional study measuring NK cell apoptosis ex vivo. Both studies included matched healthy controls. Fas and FasL were also determined in supernatants from NK cells undergoing cytokine-induced apoptosis in cell culture. Results: In the 12-month longitudinal study, plasma FasL increased by 15% (p less than 0.001) and NK cell levels by 31% (p less than 0.05) while plasma Fas did not change. Plasma FasL and NK cell levels were significantly related at 3 months and 12 months, r = 0.40, p less than 0.01. Furthermore, plasma FasL, but not plasma Fas, correlated with NK cell apoptosis ex vivo in CAD patients, r = 0.54, p less than 0.05. In vitro, cytokine-induced apoptosis of NK cells resulted in abundant release of FasL. Conclusion: In CAD patients, FasL in plasma is associated with both apoptotic susceptibility of NK cells and dynamic changes in circulating NK cells. NK cells are also themselves a potential source of soluble FasL. Our findings link NK cell status to a soluble marker with possible atheroprotective effects thereby supporting a beneficial role of NK cells in CAD.

  • 149.
    Thunell, Lena
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Hälsouniversitetet.
    Bivik, Cecilia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Wäster, Petra
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Hälsouniversitetet.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Stjernstrom, Annika
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Hälsouniversitetet.
    Synnerstad, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    Rosdahl, Inger
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    Enerbäck, Charlotta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    MDM2 SNP309 promoter polymorphism confers risk for hereditary melanoma2014Ingår i: Melanoma research, ISSN 0960-8931, E-ISSN 1473-5636, Vol. 24, nr 3, s. 190-197Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The p53 pathway regulates stress response, and variations in p53, MDM2, and MDM4 may predispose an individual to tumor development. The aim of this study was to study the impact of genetic variation on sporadic and hereditary melanoma. We have analyzed a combination of three functionally relevant variants of the p53 pathway in 258 individuals with sporadic malignant melanomas, 50 with hereditary malignant melanomas, and 799 healthy controls. Genotyping was performed by PCR-restriction fragment length polymorphism, pyrosequencing, and allelic discrimination. We found an increased risk for hereditary melanoma in MDM2 GG homozygotes, which was more pronounced among women (P=0.035). In the event of pairwise combinations of the single nucleotide polymorphisms, a risk elevation was shown for MDM2 GG homozygotes/p53 wild-type Arg in hereditary melanoma (P=0.01). Individuals with sporadic melanomas of the superficial spreading type, including melanoma in situ, showed a slightly higher frequency of the MDM2 GG genotype compared with those with nodular melanomas (P=0.04). The dysplastic nevus phenotype, present in the majority of our hereditary melanoma cases and also in some sporadic cases, further enhanced the effect of the MDM2 GG genotype on melanoma risk (P=0.005). In conclusion, the results show an association between MDM2 SNP309 and an increased risk for hereditary melanoma, especially among women. Analysis of sporadic melanoma also shows an association between MDM2 and the superficial spreading melanoma subtype, as well as an association with the presence of dysplastic nevi in sporadic melanoma.

  • 150.
    Thyberg, Ingrid
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Opava, C
    Rehabilitering vid reumatisk sjukdom2011Ingår i: Reumatologi / [ed] Lars Klareskog, Tore Saxne, Yvonne Enman, 2011, 2, s. 423-Kapitel i bok, del av antologi (Övrigt vetenskapligt)
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