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  • 101.
    Matthiesen, Leif
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Khademi, Mohsen
    Ekerfelt, Christina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk immunologi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Berg, Göran
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Sharma, Surendra
    Olsson, Tomas
    Ernerudh, Jan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk immunologi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    In-situ detection of both inflammatory and anti-inflammatory cytokines in resting peripheral blood mononuclear cells during pregnancy2002Ingår i: Journal of Reproductive Immunology, ISSN 0165-0378, E-ISSN 1872-7603, Vol. 58, nr 1, s. 49-59Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Local and possibly systemic curtailment of the maternal immune response is important for a successful pregnancy. Although the local milieu at the utero-placental interface is likely to harbor the most prominent alterations, it is suggested, at least in mice, that systemic immunity is also tolerized during pregnancy. In the present study, we investigated mRNA expression of the key immunomodulatory cytokines, interleukin (IL)-4, IL-10, tumor necrosis factor (TNF)-a and interferon (IFN)-? during normal pregnancy. Material and methods: In-situ hybridization (ISH) of cytokine mRNA in resting peripheral blood mononuclear cells (PBMCs) was used to detect the number of cells spontaneously expressing cytokines. Eleven women with normal gestations were followed during pregnancy as well as 8 weeks postpartum, and compared with 10 non-pregnant healthy controls. Results: The numbers of IFN-? and IL-4 mRNA expressing cells were found to be significantly increased during pregnancy and postpartum compared with non-pregnant controls. Pregnant women and non-pregnant controls did not differ in their expression of TNF-a and IL-10. Conclusion: Our studies demonstrated increased numbers of both IFN-? and IL-4 mRNA expressing cells in blood suggesting that systemic immunomodulation, albeit partial, takes place during normal pregnancy. It is proposed that enhanced IL-4 expression, possibly in concert with other elevated anti-inflammatory immunomodulatory cytokines, curtail the potentially hazardous effects of IFN-? on systemic immunity during pregnancy.

  • 102.
    Mjösberg, Jenny
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk immunologi.
    Berg, Göran
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Ernerudh, Jan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk immunologi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Ekerfelt, Christina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk immunologi.
    CD4+ CD25+ regulatory T cells in human pregnancy - development of a Treg-MLC elispot assay.2005Ingår i: American Society for Reproductive Immunology 2005,2005, 2005, s. 294-294Konferensbidrag (Övrigt vetenskapligt)
  • 103.
    Mjösberg, Jenny
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk immunologi.
    Berg, Göran
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Ernerudh, Jan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk immunologi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Ekerfelt, Christina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk immunologi.
    CD4+ CD25+ regulatory T cells in human pregnancy: Development of a Treg-MLC-ELISPOT suppression assay and indications of paternal specific Tregs2007Ingår i: Immunology, ISSN 0019-2805, E-ISSN 1365-2567, Vol. 120, nr 4, s. 456-466Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The current study was aimed at developing a one-way mixed leucocyte culture-enzyme-linked immunospot (MLC-ELISPOT) assay for the study of CD4 + CD25+ regulatory T (Treg) cells and applying this method in the study of antifetal immune reactions during human pregnancy. Twenty-one pregnant women and the corresponding fathers-to-be, and 10 non-pregnant control women and men, participated in the study. CD4+ CD25+ cells were isolated from peripheral blood mononuclear cells (PBMC) by immunomagnetic selection. Maternal/control PBMC were stimulated with paternal or unrelated PBMC in MLC. Secretion of interleukin-4 (IL-4) and interferon-γ (IFN-γ) from responder cells, with or without the presence of autologous Treg cells, was analysed by ELISPOT. PBMC from pregnant women showed increased secretion of IL-4 compared to controls. In pregnant and non-pregnant controls, Treg cells suppressed IFN-γ reactivity against paternal and unrelated alloantigens. Interestingly, T reg cells suppressed IL-4 secretion against paternal but not unrelated alloantigens during pregnancy. We have successfully developed a model for studying Treg cells in antifetal cytokine reactions during pregnancy. Results indicate that Treg cells contribute to strict regulation of both T helper type 1-like and type 2-like antifetal immune reactions. Interestingly, T helper type 2-like cells specific to unrelated alloantigens are able to escape the suppression of Treg cells, which would allow for IL-4, alongside CD4+ CD25+ Treg cells, to control potentially detrimental IFN-γ reactions during pregnancy. © 2007 Blackwell Publishing Ltd.

  • 104.
    Nedstrand, Elisabeth
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Applied relaxation as treatment of vasomotor symptoms in postmenopausal women2005Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Vasomotor symptoms often disturb the night sleep and may lead to tiredness and mood disturbances. Many women who suffer from vasomotor symptoms ask for medical help and are often prescribed hormonal treatment. During the last years the popularity of HRT among women and doctors has decreased, probably because of the findings of long-term risks of HRT on breast cancer and the fact that the positive effects on cardiovascular health has not been confirmed in prospective randomized studies. The most effective treatment for hot flushes is HR T but for various reasons there is a need for developing alternative treatments. Relaxation therapy and behavioral therapies have been suggested for vasomotor symptoms but there are few randomized, controlled studies in this field, especially in women with breast cancer.

    The general aim of this thesis was to evaluate a technique in behavior therapy, applied relaxation, as a possible treatment of vasomotor symptoms in healthy women and women treated for breast cancer.

    The specific aims were:

    • to assess if stress coping differed between postmenopausal women, who wanted therapy for vasomotor symptoms and postmenopausal women without symptoms and to assess if stress coping changed when women with vasomotor symptoms received estrogen therapy. 18 women were recruited to the target group and 17 women to the comparison group

    • to evaluate if training applied relaxation for 12 weeks would decrease the number ofvasomotor symptoms and to evaluate if applied relaxation for 12 weeks would affect wellbeing in postmenopausal women seeking medical advice for vasomotor symptoms. 30 postmenopausal women were recruited and randomized to applied relaxation or estrogen therapy. In this study we also aimed to compare applied relaxation and estradiol as treatment of vasomotor symptoms in healthy postmenopausal women and also to compare the effects of applied relaxation and estradiol on wellbeing in healthy postmenopausal women

    • to evaluate if applied relaxation or electro-acupuncture for 12 weeks would decrease the number of vasomotor symptoms in postmenopausal women treated for breast cancer and to evaluate if applied relaxation or electro-acupuncture for 12 weeks would affect wellbeing in postmenopausal women treated for breast cancer. 38 women with breast cancer and with moderate to sever vasomotor symptoms were recruited.

    The main results were: Postmenopausal women bothered by vasomotor symptoms had significant lower stress coping ability measured with SCI, than women without symptoms.

    Eleven out of 12 healthy postmenopausal women randomised to treatment with applied relaxation had a mean decrease of flushes about 77% six months after end of therapy. The reduction was significant and persisted six months after end of therapy. General psychological wellbeing and mood were significantly ameliorated in healthy postmenopausal women treated with applied relaxation.

    Ten out of 14 breast cancer treated women randomised to treatment with applied relaxation had a mean decrease of flushes with 78 %. General psychological wellbeing was significantly ameliorated and this phenomenon appeared after the flushes were significantly reduced. Both the significant reduction of flushes and significantly ameliorated wellbeing persisted 6 months after end of therapy.

    In summary: This thesis shows that that behavioral therapy with applied relaxation significantly decreases flushes and ameliorates general psychological wellbeing in postmenopausal women bothered by climacteric symptoms. Therefore we suggest that applied relaxation is a viable alternative treatment of vasomotor symptoms in healthy postmenopausal women and in women treated for breast cancer.

    Delarbeten
    1. The relationship between stress-coping and vasomotor symptoms in postmenopausal women
    Öppna denna publikation i ny flik eller fönster >>The relationship between stress-coping and vasomotor symptoms in postmenopausal women
    1998 (Engelska)Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 31, nr 1, s. 29-34Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objective: The objective was to assess whether menopausal women with vasomotor symptoms had a lower stress-coping than menopausal women without symptoms and if stress-coping changed when vasomotor symptoms had been effectively treated with estrogens. The objective was also to assess whether menopausal women, effectively treated for vasomotor symptoms, had a higher neuroticism score than women without such symptoms.

    Methods: Two groups of physically and mentally healthy postmenopausal women were recruited from the outpatient clinic at the Department of Obstetrics and Gynaecology, University Hospital of Linköping, Sweden. Sixteen women with vasomotor symptoms (target group) were treated with oral 17β-estradiol, 2 mg/day during 3 months. A comparison group was formed comprising 17 women without vasomotor symptoms. The Kupperman Index was used to cover menopausal characteristics in all women at baseline as well as at the second visit after 3 months. Stress-coping was measured by means of the Stress Coping Inventory, which is an instrument developed to measure of the individual's appraisal of having adaptive resources for handling stressful situations. At the second visit all women were also asked to complete the Eysenck Personality Inventory.

    Results: Women in the target group had a significantly lower stress-coping than women in the comparison group at baseline as well as after 3 months. Stress-coping did not change after estrogen therapy, although the vasomotor symptoms had virtually disappeared. Women in the target group successfully treated for vasomotor symptoms, had a significantly higher neuroticism score compared to the comparison group.

    Conclusions: Differences in behaviour patterns and personality are probably two reasons why some women report or seek advice due to vasomotor symptoms and some women do not. Stress-coping in women with moderate to severe vasomotor symptoms is unaffected by estrogens.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-83011 (URN)10.1016/S0378-5122(98)00058-9 (DOI)
    Tillgänglig från: 2012-10-02 Skapad: 2012-10-02 Senast uppdaterad: 2017-12-07Bibliografiskt granskad
    2. Treatment of menopausal symptoms with applied relaxation: a pilot study
    Öppna denna publikation i ny flik eller fönster >>Treatment of menopausal symptoms with applied relaxation: a pilot study
    1997 (Engelska)Ingår i: Journal of Behavior Therapy and Experimental Psychiatry, ISSN 0005-7916, E-ISSN 1873-7943, Vol. 28, nr 4, s. 251-261Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Applied relaxation (AR) was tested in a series of six women with postmenopausal hot flushes. The AR program consisted of group instructions I hour per week over a 12 week duration. The number of flushes were registered from 1 month before to 6 months after training AR. Menopausal symptoms (Kupperman Index), psychological well-being (Symptom Checklist), and mood (MOOD Scale) were measured at various moments during the study. For the six patients the number of flushes decreased from the baseline period to 6 months follow-up with 59, 61, 62, 67, 89 and 100% respectively, in mean 73%. While the scores on the Kupperman Index and the Symptom Checklist followed the pattern of the flushes, a similar trend was not seen for the scores on the MOOD Scale.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-83012 (URN)10.1016/S0005-7916(97)00030-X (DOI)
    Tillgänglig från: 2012-10-02 Skapad: 2012-10-02 Senast uppdaterad: 2017-12-07Bibliografiskt granskad
    3. Applied relaxation and oral estradiol treatment of vasomotor symptoms in postmenopausal women
    Öppna denna publikation i ny flik eller fönster >>Applied relaxation and oral estradiol treatment of vasomotor symptoms in postmenopausal women
    2005 (Engelska)Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 51, nr 2, s. 154-162Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objective: The aim was to evaluate and compare the effects of applied relaxation and oral estradiol treatment on hot flushes, mood and psychological wellbeing in postmenopausal women.

    Patients and methods: In a prospective study, 30 postmenopausal women with vasomotor symptoms were randomized to applied relaxation or oral estradiol treatment during 12 weeks with 6 months follow-up. Number and severity of flushes were registered daily and Kupperman’s Index and a general estimate of climacteric symptoms, Mood Scale and Symptom Check List were completed at baseline, 4, 8 and 12 weeks of treatment, and 3 and 6 months after therapy.

    Results: After 12 weeks of treatment, the number of flushes/24 h decreased significantly over time in both treatment groups. In the group receiving applied relaxation, the mean number of flushes/24 h decreased from 6.0 (95% CI 4.5–7.6) to 3.0 (95% CI 2.1–3.9) after 12 weeks of treatment. The mean number of flushes/24 h was 1.7 (95% CI 0.7–2.5) at 6 months follow-up; i.e. a 72% decrease. In the estrogen group, the mean number of flushes/24 h decreased from 8.4 to 0.8; i.e a 90% decrease in the number of flushes after 12 weeks of treatment. The significant change in flushes reached after 12 weeks of treatment and remained to 6 months after end of treatment in both groups. Estrogen therapy reduced flushes significantly faster than applied relaxation. General climacteric symptoms according to the Visual Analogue Scale and the Kupperman’s Index decreased significantly over time in both groups. General mood (Mood Scale) increased significantly in the estrogen group, but not in the group receiving applied relaxation. Psychological wellbeing according to Symptom Checklist, increased significantly from baseline to 12 weeks in both groups.

    Conclusions: We suggest that applied relaxation may be used as an alternative treatment of vasomotor symptoms for postmenopausal women but should be further evaluated.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-29369 (URN)10.1016/j.maturitas.2004.05.017 (DOI)14701 (Lokalt ID)14701 (Arkivnummer)14701 (OAI)
    Tillgänglig från: 2009-10-09 Skapad: 2009-10-09 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
    4. Vasomotor symptoms decrease in women with breast cancer randomized to treatment with applied relaxation or electro-acupuncture: a preliminary study
    Öppna denna publikation i ny flik eller fönster >>Vasomotor symptoms decrease in women with breast cancer randomized to treatment with applied relaxation or electro-acupuncture: a preliminary study
    2005 (Engelska)Ingår i: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 8, nr 3, s. 243-250Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objective: To evaluate the effect of applied  relaxation and electro-acupuncture on vasomotor symptoms in women treated for breast cancer.

    Methods: Thirty-eight postmenopausal women with  breast cancer and vasomotor symptoms were randomized to treatment with electro-acupuncture (n = 19) or applied relaxation (n = 19) during 12 weeks. The number of hot flushes was registered daily in a logbook before and during treatment and after 3 and 6 months of follow-up.

    Results: Thirty-one women completed 12 weeks of treatment and 6  months of follow-up. After 12 weeks of applied relaxation, the number of flushes/24 h had decreased from 9.2 (95% confidence interval (CI) 6.6-11.9) at baseline to 4.5 (95% CI 3.2-5.8) and to 3.9 (95% CI 1.8-6.0) at 6 months follow-up (n = 14). The flushes/24 h were reduced from 8.4 (95% CI 6.6-10.2) to 4.1 (95% CI 3.0-5.2) after 12 weeks of treatment with electro-acupuncture and to 3.5 (95% CI 1.7-5.3) after 6 months follow-up (n = 17). In both groups, the mean Kupperman Index score was significantly reduced after treatment and remained unchanged 6 months after end of treatment.

    Conclusion: We suggest that applied relaxation and  electro-acupuncture should be further evaluated as possible treatments for vasomotor symptoms in postmenopausal women with breast cancer.

    Ort, förlag, år, upplaga, sidor
    Institutionen för klinisk och experimentell medicin, 2005
    Nyckelord
    Vasomotor symptoms; Menopause; Breast cancer; Applied relaxation; Acupuncture
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-11901 (URN)10.1080/13697130500118050 (DOI)
    Anmärkning
    Original publication: E. Nedstrand, K. Wijma, Y. Wyon, M. Hammar, Vasomotor symptoms decrease in women with breast cancer randomized to treatment with applied relaxation or electro-acupuncture: a preliminary study, 2005, Climacteric, (8), 3, 243-250. http://dx.doi.org/10.1080/13697130500118050. Copyright © Taylor & Francis Group, an informa businessTillgänglig från: 2008-05-23 Skapad: 2008-05-23 Senast uppdaterad: 2017-12-13
    5. Psychological wellbeing ameliorates in women with breast cancer randomized to treatment with applied relaxation or acupuncture for vasomotor symptoms
    Öppna denna publikation i ny flik eller fönster >>Psychological wellbeing ameliorates in women with breast cancer randomized to treatment with applied relaxation or acupuncture for vasomotor symptoms
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    The aim of this study was to evaluate effects of applied relaxation and electro-acupuncture on psychological wellbeing in breast cancer treated women with vasomotor symptoms. Thirty-eight postmenopausal women with breast cancer and vasomotor symptoms were included in the study. They were randomized between treatment with elcctro-acupuncture (n=19, three of them with tamoxifen) or applied relaxation (n=19, five of them with tamoxifen) during 12 weeks with six months follow-up. Vasomotor symptoms were registered daily and a visual analogue scale on climacteric symptoms as well as estimates of general wellbeing using the Symptom Checklist and mood by the Mood Scale, were completed during treatment and follow-up.

    Totally 31 women completed 12 weeks of treatment and 6 months of follow-up. Hot flushes were reduced by more than 50 percent. Climacteric symptoms significantly decreased after treatment and remained so 6 months after treatment in both groups. Simultaneously with the decrease of flushes, psychological wellbeing was significantly ameliorated throughout the study period in both groups. Mood changed significantly in the acupuncture treated group.

    In conclusion psychological wellbeing ameliorates in women with breast cancer randornized to treatment with applied relaxation or acupuncture for vasomotor symptoms.

    Nyckelord
    Vasomotor symptoms, menopause, breast cancer, applied relaxation, acupuncture
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-83191 (URN)
    Tillgänglig från: 2012-10-02 Skapad: 2012-10-02 Senast uppdaterad: 2012-10-02Bibliografiskt granskad
  • 105.
    Nedstrand, Elisabeth
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Wijma, Klaas
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Wyon, Yvonne
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Applied relaxation and oral estradiol treatment of vasomotor symptoms in postmenopausal women2005Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 51, nr 2, s. 154-162Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim was to evaluate and compare the effects of applied relaxation and oral estradiol treatment on hot flushes, mood and psychological wellbeing in postmenopausal women.

    Patients and methods: In a prospective study, 30 postmenopausal women with vasomotor symptoms were randomized to applied relaxation or oral estradiol treatment during 12 weeks with 6 months follow-up. Number and severity of flushes were registered daily and Kupperman’s Index and a general estimate of climacteric symptoms, Mood Scale and Symptom Check List were completed at baseline, 4, 8 and 12 weeks of treatment, and 3 and 6 months after therapy.

    Results: After 12 weeks of treatment, the number of flushes/24 h decreased significantly over time in both treatment groups. In the group receiving applied relaxation, the mean number of flushes/24 h decreased from 6.0 (95% CI 4.5–7.6) to 3.0 (95% CI 2.1–3.9) after 12 weeks of treatment. The mean number of flushes/24 h was 1.7 (95% CI 0.7–2.5) at 6 months follow-up; i.e. a 72% decrease. In the estrogen group, the mean number of flushes/24 h decreased from 8.4 to 0.8; i.e a 90% decrease in the number of flushes after 12 weeks of treatment. The significant change in flushes reached after 12 weeks of treatment and remained to 6 months after end of treatment in both groups. Estrogen therapy reduced flushes significantly faster than applied relaxation. General climacteric symptoms according to the Visual Analogue Scale and the Kupperman’s Index decreased significantly over time in both groups. General mood (Mood Scale) increased significantly in the estrogen group, but not in the group receiving applied relaxation. Psychological wellbeing according to Symptom Checklist, increased significantly from baseline to 12 weeks in both groups.

    Conclusions: We suggest that applied relaxation may be used as an alternative treatment of vasomotor symptoms for postmenopausal women but should be further evaluated.

  • 106.
    Nedstrand, Elizabeth
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Ekseth, Ulrika
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Lindgren, Richard
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    The climacteric among South-American women, who immigrated to Sweden and age-matched Swedish women1995Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 21, nr 1, s. 3-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Forty-nine immigrated South-American (SA) and 48 Swedish women, aged 42-67 years, were studied in a comparative semi-structured interview survey, concerning the climacteric and its treatment. The mean age at natural menopause was 47 for the South-American women and 50 for the Swedish women. The prevalence of moderate to severe vasomotor symptoms at the time of the survey did not differ significantly between the non-treated, non-operated, postmenopausal South-American and Swedish women (36% and 21%; N.S.). One reason for the trend towards a higher prevalence among South-American women could be that a greater number of Swedish women used hormone replacement treatment compared to South-American women (11 vs. 4). The general attitude to hormone replacement therapy was more positive among South-American women, although they did not use hormone therapy, as could be expected from their symptoms. These results are probably an illustration of the difficulties in getting access to treatment for the immigrated SA women.

  • 107.
    Nedstrand, Elizabeth
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Pertl, J.
    Department of Obstetrics and Gynaecology, County Hospital of Kladno, Kladno, Czech Republic.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Climacteric symptoms in a postmenopausal Czech population1996Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 23, nr 1, s. 85-89Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To assess the prevalence of climacteric symptoms and the use of hormone replacement therapy in a former eastern European country. All 55-, 57-, 59- and 61-year-old women in Kladno in the Czech Republic were asked to participate in the study.

    METHOD: In 1993, 1505 women in Kladno of the Czech Republic were sent a postal questionnaire concerning age at menopause and their climacteric symptoms.

    RESULTS: Answers were received from 799 women (53%); 98% were postmenopausal. The median age at spontaneous menopause was 50 years, 49.5 years among women smoking at least 5 cigarettes/day and 51.0 years among non-smokers (P < 0.05). About every fifth woman smoked. Totally 22% of the women had undergone hysterectomy and/or oophorectomy and 3% had been treated for a gynaecological malignancy. The majority of the women (58%) reported ongoing vasomotor symptoms; half of them had moderate to severe vasomotor symptoms. In all, 79% of the women reported ever having vasomotor symptoms. Only 3% of the women had ever tried hormone replacement therapy (HRT) and one woman had current treatment. Dysuria was reported by 22% and 4% had recurrent urinary tract infections; 70% of the women had a partner and 50% were sexually active. Reasons for not being sexually active were mostly lack of a partner, loss of sexual desire or partner's disease or impotence.

    CONCLUSION: Climacteric symptoms including vasomotor and urogenital symptoms had the same prevalence in the Czech Republic as previously reported in other Western Countries. Only a few women had tried HRT. Smokers had a slightly earlier menopause.

  • 108.
    Nedstrand, Elizabeth
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Wijma, Klaas
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Lindgren, Monica
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    The relationship between stress-coping and vasomotor symptoms in postmenopausal women1998Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 31, nr 1, s. 29-34Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The objective was to assess whether menopausal women with vasomotor symptoms had a lower stress-coping than menopausal women without symptoms and if stress-coping changed when vasomotor symptoms had been effectively treated with estrogens. The objective was also to assess whether menopausal women, effectively treated for vasomotor symptoms, had a higher neuroticism score than women without such symptoms.

    Methods: Two groups of physically and mentally healthy postmenopausal women were recruited from the outpatient clinic at the Department of Obstetrics and Gynaecology, University Hospital of Linköping, Sweden. Sixteen women with vasomotor symptoms (target group) were treated with oral 17β-estradiol, 2 mg/day during 3 months. A comparison group was formed comprising 17 women without vasomotor symptoms. The Kupperman Index was used to cover menopausal characteristics in all women at baseline as well as at the second visit after 3 months. Stress-coping was measured by means of the Stress Coping Inventory, which is an instrument developed to measure of the individual's appraisal of having adaptive resources for handling stressful situations. At the second visit all women were also asked to complete the Eysenck Personality Inventory.

    Results: Women in the target group had a significantly lower stress-coping than women in the comparison group at baseline as well as after 3 months. Stress-coping did not change after estrogen therapy, although the vasomotor symptoms had virtually disappeared. Women in the target group successfully treated for vasomotor symptoms, had a significantly higher neuroticism score compared to the comparison group.

    Conclusions: Differences in behaviour patterns and personality are probably two reasons why some women report or seek advice due to vasomotor symptoms and some women do not. Stress-coping in women with moderate to severe vasomotor symptoms is unaffected by estrogens.

  • 109.
    Nedstrand, Elizabeth
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Wyon, Yvonne
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Wijma, Klaas
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Psychological wellbeing ameliorates in women with breast cancer randomized to treatment with applied relaxation or acupuncture for vasomotor symptomsManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    The aim of this study was to evaluate effects of applied relaxation and electro-acupuncture on psychological wellbeing in breast cancer treated women with vasomotor symptoms. Thirty-eight postmenopausal women with breast cancer and vasomotor symptoms were included in the study. They were randomized between treatment with elcctro-acupuncture (n=19, three of them with tamoxifen) or applied relaxation (n=19, five of them with tamoxifen) during 12 weeks with six months follow-up. Vasomotor symptoms were registered daily and a visual analogue scale on climacteric symptoms as well as estimates of general wellbeing using the Symptom Checklist and mood by the Mood Scale, were completed during treatment and follow-up.

    Totally 31 women completed 12 weeks of treatment and 6 months of follow-up. Hot flushes were reduced by more than 50 percent. Climacteric symptoms significantly decreased after treatment and remained so 6 months after treatment in both groups. Simultaneously with the decrease of flushes, psychological wellbeing was significantly ameliorated throughout the study period in both groups. Mood changed significantly in the acupuncture treated group.

    In conclusion psychological wellbeing ameliorates in women with breast cancer randornized to treatment with applied relaxation or acupuncture for vasomotor symptoms.

  • 110.
    Nelson, Nina
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn.
    Selbing, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Prenatal bowel dilatation: congetinal chloride diarrhoea.2001Ingår i: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 85, s. 65-65Artikel i tidskrift (Refereegranskat)
  • 111.
    Palfi, Miodrag
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Transfusionsmedicin. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Hildén, Jan-Olof
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Transfusionsmedicin. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Matthiesen, Leif
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Selbing, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Berlin, Gösta
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Transfusionsmedicin. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    A case of severe Rh (D) alloimmunization treated by intensive plasma exchange and high-dose intravenous immunoglobulin2006Ingår i: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 35, nr 2, s. 131-136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In extremely severe Rh (D) alloimmunization, during pregnancy, early diagnosis and treatment is essential to avoid hydrops fetalis. Intrauterine transfusion (IUT) is of utmost importance in the prevention of fetal anemia but it is usually feasible only after 20 weeks of pregnancy. Therefore, additional treatment options in early pregnancy are needed. Study design and methods: A 27-year-old severely D + C immunized woman was admitted at 8 weeks of gestation in her fifth pregnancy with an extremely high concentration of anti-D. Her first pregnancy was uneventful but resulted in D + C alloimmunization. The next two pregnancies were unsuccessful, because of hydrops fetalis resulting in fetal death in pregnancy week 20 and 24, respectively, despite treatment with high-dose intravenous immunoglobulin (IVIG) and IUT treatment. A fourth pregnancy was terminated with legal abortion. The patient was eager and persistent to accomplish a successful pregnancy. Therefore, a combination of treatments consisting of plasma exchange (PE) three times/week and IVIG 100 g/week was started in pregnancy week 12. PE was performed 53 times and totally 159 L of plasma was exchanged. Results: The anti-D concentration was 12 μg/mL (IAT titer 2000) before start of treatment by PE and IVIG in pregnancy week 12. The concentration of anti-D was gradually reduced to approximately 3 μg/mL after only two weeks of treatment and was maintained at that level until pregnancy week 22. In pregnancy week 26 and 27, signs of hydrops were detected by ultrasonography and IUT were performed at each occasion. Sectio was inevitable at pregnancy week 28 + 1 and a male baby was born: Hb 58 g/L (cord sample) and 68 g/L (venous sample), weight 1385 g, Apgar score = 4-5-7, Bilirubin 56-150 mmol/L (4 h). Exchange transfusion was performed on day two and day five. Phototherapy was also implemented for eight days. The newborn's recovery thereafter was uneventful and complete. Conclusion: A combination of PE and IVIG may be an efficient treatment possible to start in early pregnancy in patients with extremely severe Rh (D) alloimmunization, with a history of hydrops fetalis in previous pregnancies. © 2006 Elsevier Ltd. All rights reserved.

  • 112.
    Palfi, Miodrag
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Transfusionsmedicin. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Jablonowska, Barbara
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Matthiesen, Leif
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Ernerudh, Jan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk immunologi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Circulating interferon-gamma- and interleukin-4 - secreting cells in recurrent spontaneous abortions. 1999Ingår i: American Journal of Reproductive Immunology and Microbiology, ISSN 8755-8920, Vol. 41, s. 257-263Artikel i tidskrift (Refereegranskat)
  • 113.
    Rugarn, Olof
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Effects of gonadal steroids on galanin and other neuropeptides in the rat brain2001Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Many women experience mental or emotional changes when variations occur in the plasma concentrations of their ovarian hormones. These observations are supported by a large number of scientific reports concerning interactions between ovarian steroids and cerebral functions, e.g. mood, cognition and motor function. Activation of genes is a fundamental principle by which steroids exert effects in neurons, thereby regulating the expression of enzymes, receptor proteins, trophic factors and regulatory peptides. This thesis examines the hypothesis that sex steroid hormones can modify concentrations of peptides important for neuronal transmission in brain areas relevant for the above-mentioned modalities. A necessary starting point in this quest is to develop good quantitative data on neuropeptide concentrations in relation to sex steroid status. Accordingly, the general aim of the thesis is to investigate the influence of gender and sex steroid exposure on neuropeptide concentrations and identify one or several steroid-sensitive neuropeptides in extrahypothalamic brain regions of the rat.

    Neuropeptide concentrations were measured with radioimmunoassay in extracts of extrahypothalarnic brain regions. A new radioimmunoassay, specific for rat galanin, was developed. Concentrations of neuropeptides were compared between sexes, across puberty and in ovariectomized animals treated with different doses and durations of estradiol, progesterone and norethisterone.

    We found that differences in sex steroid exposure between gender, across puberty, and duting exogenous treatment correlate with differences in concentrations of neuropeptide immunoreactivities in several extrahypothalarnic regions of the rat brain. In particular galanin in rat hippocampus is sensitive to estrogen and can be increased in a dose-dependent manner with chronic estradiol treatment. It is likely that the increase mainly sterns from the ascending noradrenergic neuron system originating in locus cemleus. Chromatographic characterization shows that galanin, measured by the antisera Ga1Rat4 and Ga1Rat5, has a high degree of homogeneity in rat brain tissue. Norethisterone and progesterone have different effects on substance P and neuroldnin A in rat frontal cortex and striatum.

    These findings could contribute to the understanding of how mood and cognition are affected by sex steroids in females and how estradiol interacts with neurons affected by Alzheimer's disease.

    Delarbeten
    1. Radioimmunoassay for rat galanin: immunochemical and chromatographic characterization of immunoreactivity in tissue extracts
    Öppna denna publikation i ny flik eller fönster >>Radioimmunoassay for rat galanin: immunochemical and chromatographic characterization of immunoreactivity in tissue extracts
    2000 (Engelska)Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 60, nr 5, s. 411-418Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Galanin is a regulatory peptide with wide distribution in the central and peripheral nervous system and with numerous biological effects. Several radioimmunoassays based on antisera raised against porcine galanin have been used to measure immunoreactivity in rat tissues. However, considerable lack of parallelism has been observed between the porcine standard and rat tissue extracts, which may decrease the reliability of the quantitative data. The purpose of the present study was therefore to raise antibodies against rat galanin and establish a competitive radioimmunoassay for rat galanin. Two antisera, RatGal4 and RatGal5, were characterized in detail. The homogeneity of the immunoreactive material from several tissues was also investigated with column chromatography. At reverse-phase high-pressure liquid chromatography more than 95% of the immunoreactive material from rat CNS eluted as a single peak in the position of synthetic rat galanin, whereas almost half of the immunoreactive material from the intestine eluted in positions different from the synthetic peptide. Extracts of rat brains as well as jejunum diluted in parallel with the standard curve for both antisera. We conclude that measurements of rat galanin based on these antisera are therefore more reliable than those based on antisera raised against porcine galanin.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-25424 (URN)10.1080/003655100750019323 (DOI)9869 (Lokalt ID)9869 (Arkivnummer)9869 (OAI)
    Tillgänglig från: 2009-10-07 Skapad: 2009-10-07 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
    2. Sex differences in neuropeptide distribution in the rat brain
    Öppna denna publikation i ny flik eller fönster >>Sex differences in neuropeptide distribution in the rat brain
    Visa övriga...
    1999 (Engelska)Ingår i: Peptides, ISSN 0196-9781, E-ISSN 1873-5169, Vol. 20, nr 1, s. 81-86Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    We have investigated possible sex differences in the regional concentrations of neuropeptides in the rat brain. Immunoreactive neurotensin (NT), neurokinin A (NKA), galanin (GAL), calcitonin gene-related peptide (CGRP), substance P (SP) and neuropeptide Y (NPY) were measured by radioimmunoassay in frontal cortex, occipital cortex, hippocampus, striatum, hypothalamus and pituitary in male and female pre- and postpubertal rats. Sex differences were found for NPY (p < 0.001), NT (p < 0.01) and GAL (p < 0.05), in particular in hippocampus, striatum, hypothalamus and pituitary, but not for CGRP, SP and NKA. Results from analysis of neuropeptides in one sex may not be entirely applicable to the other.

    Nyckelord
    Sex differences, Neuropeptide Y, Neurotensin, Galanin, Hippocampus, Pituitary, Frontal cortex, Puberty
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-13441 (URN)10.1016/S0196-9781(98)00139-9 (DOI)
    Tillgänglig från: 2005-11-11 Skapad: 2005-11-11 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
    3. Effects of estradiol, progesterone, and norethisterone on regional concentrations of galanin in the rat brain
    Öppna denna publikation i ny flik eller fönster >>Effects of estradiol, progesterone, and norethisterone on regional concentrations of galanin in the rat brain
    1999 (Engelska)Ingår i: Peptides, ISSN 0196-9781, E-ISSN 1873-5169, Vol. 20, nr 6, s. 743-748Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Concentrations of immunoreactive galanin were compared in eight gross brain regions of ovariectomized female rats treated with either estradiol, estradiol + progesterone, estradiol + norethisterone, or placebo. Higher concentrations with estradiol treatment compared with placebo were found in the pituitary (357%), frontal cortex (162%), occipital cortex (174%), hippocampus (170%), and median eminence (202%). A more profound difference with addition of progesterone or norethisterone was seen in the pituitary (529% and 467%, respectively). Sex steroids, particularly estradiol, modulate galanin concentrations not only in reproductive, but also in nonreproductive, brain regions.

    Nyckelord
    Galanin, Estradiol, Progesterone, Norethisterone, Hippocampus, Pituitary, Frontal cortex
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-13442 (URN)10.1016/S0196-9781(99)00057-1 (DOI)
    Tillgänglig från: 2005-11-11 Skapad: 2005-11-11 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
    4. Estradiol causes dose-dependent increase in galanin-like immunoreactivity in both ventral and dorsal hippocampus
    Öppna denna publikation i ny flik eller fönster >>Estradiol causes dose-dependent increase in galanin-like immunoreactivity in both ventral and dorsal hippocampus
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    The purpose of the study was to investigate the dose- and duration effects of estradiol treatment on galanin-like immunoreactivity in ventral and dorsal rat hippocampus. Ovariectomized rats were treated three, 20 or 60 days with low or high pharmacological doses of estradiol or with carrier only. Galanin-like immunoreactivity was measured with radioimmunoassay using antiserum GalRat4 raised against rat galanin. ANOVA revealed a significant effect from dose (p<0.001) and from duration (p<0.001) of estrogen treatment, but not from region, i.e. ventral or dorsal hippocampus. With the high pharmacological dose, galanin-like immunoreactivity increased more than 10-fold in comparison with the vehicle-treated in dorsal hippocampus and about 6-fold in ventral hippocampus. The increment is most likely due to an effect in the noradrenergic galanin-expressing neurons originating in locus ceruleus. The functional interpretation of these results is dependent on the yet unknown role of galanin in their hippocampal nerve terminals.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-81076 (URN)
    Tillgänglig från: 2012-09-06 Skapad: 2012-09-06 Senast uppdaterad: 2012-09-06Bibliografiskt granskad
    5. Progesterone and norethisterone have different effects on tachykinin-like immunoreactivity in rat cortex and striatum
    Öppna denna publikation i ny flik eller fönster >>Progesterone and norethisterone have different effects on tachykinin-like immunoreactivity in rat cortex and striatum
    2001 (Engelska)Ingår i: Regulatory Peptides, ISSN 0167-0115, E-ISSN 1873-1686, Vol. 101, nr 1-3, s. 87-91Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objective: The purpose of this study was to investigate the effects of progesterone and the most commonly prescribed synthetic progestogen, norethisterone, on regional immune-like reactivity of neuropeptide Y (NPY), substance P (SP), neurokinin A (NKA) and neurotensin (NT) in brains of female ovariectomized estradiol-substituted rats.

    Results: Norethisterone+estradiol-treated rats had 44% lower SP levels compared with estradiol-only-treated in frontal cortex and 20% lower NKA levels in comparison with progesterone+estradiol-treated in frontal cortex. Progesterone+estradiol-treated rats had 66% lower SP levels in striatum in comparison with both estradiol-only-treated and norethisterone+estradiol-treated. No significant results were found for NPY and NT.

    Conclusion: Progesterone and the synthetic progestogen, norethisterone, have different effects on SP- and NKA-like immunoreactivity in rat cortex and striatum.

    The effects of NET on SP- and NKA-like immunoreactivity in frontal cortex may contribute to the mood effects ascribed to this progestogen in clinical usage.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-25336 (URN)10.1016/S0167-0115(01)00265-8 (DOI)9778 (Lokalt ID)9778 (Arkivnummer)9778 (OAI)
    Tillgänglig från: 2009-10-07 Skapad: 2009-10-07 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
  • 114. Rugarn, Olof
    et al.
    Carling Moen, Susanne
    Berg, Göran
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Eclampsia at a tertiary hospital 1973-992004Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 83, nr 3, s. 240-245Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. To investigate changes in incidence, patient characteristics, comorbidity and in the care provided in cases of eclampsia at a tertiary hospital during the period 1973-99. Methods. Thirty-nine cases were identified through the Swedish National Birth Registry. Incidences and rates regarding patient characteristics and outcomes (duration of intensive care unit surveillance, assisted ventilation, multiple seizures, predefined major complications, perinatal mortality, small for gestational age, and neonatal intensive care surveillance) were compared between the time periods 1973-79, 1980-89 and 1990-99 with trend analysis. Results. The incidences in the three time periods were 3.0/10 000 births [95% confidence interval (CI) 0.1-5.9], 6.2/10 000 births (95% CI 2.7-9.7) and 10.9/10 000 births (95% CI 6.4-15.4), respectively, which constitutes a significant difference according to trend analysis (p = 0.006). There were no differences in patient characteristics or comorbidity. Onset occurred in hospital in 85% of the cases. Conclusions. The increase in the incidence of eclampsia reported here is contrary to international trends up until the early 1990s. The incidence in 1990-99 is also higher than the reported national incidence in Sweden 1976-80, which was 2.9/10 000 births. Despite successful identification of women at risk for eclampsia and hospital surveillance, several cases were not prevented. Better prognostic tests that identify impending eclampsia are needed to bring the incidence down further.

  • 115.
    Rugarn, Olof
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Theodorsson, Annette
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurokirurgi. Linköpings universitet, Hälsouniversitetet.
    Theodorsson, Elvar
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Stenfors, Carina
    Department of Laboratory Medicine, Karolinska Hospital, Stockholm, Sweden.
    Sex differences in neuropeptide distribution in the rat brain1999Ingår i: Peptides, ISSN 0196-9781, E-ISSN 1873-5169, Vol. 20, nr 1, s. 81-86Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We have investigated possible sex differences in the regional concentrations of neuropeptides in the rat brain. Immunoreactive neurotensin (NT), neurokinin A (NKA), galanin (GAL), calcitonin gene-related peptide (CGRP), substance P (SP) and neuropeptide Y (NPY) were measured by radioimmunoassay in frontal cortex, occipital cortex, hippocampus, striatum, hypothalamus and pituitary in male and female pre- and postpubertal rats. Sex differences were found for NPY (p < 0.001), NT (p < 0.01) and GAL (p < 0.05), in particular in hippocampus, striatum, hypothalamus and pituitary, but not for CGRP, SP and NKA. Results from analysis of neuropeptides in one sex may not be entirely applicable to the other.

  • 116.
    Rugarn, Olof
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Theodorsson, Elvar
    Linköpings universitet, Institutionen för biomedicin och kirurgi, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Estradiol causes dose-dependent increase in galanin-like immunoreactivity in both ventral and dorsal hippocampusManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    The purpose of the study was to investigate the dose- and duration effects of estradiol treatment on galanin-like immunoreactivity in ventral and dorsal rat hippocampus. Ovariectomized rats were treated three, 20 or 60 days with low or high pharmacological doses of estradiol or with carrier only. Galanin-like immunoreactivity was measured with radioimmunoassay using antiserum GalRat4 raised against rat galanin. ANOVA revealed a significant effect from dose (p<0.001) and from duration (p<0.001) of estrogen treatment, but not from region, i.e. ventral or dorsal hippocampus. With the high pharmacological dose, galanin-like immunoreactivity increased more than 10-fold in comparison with the vehicle-treated in dorsal hippocampus and about 6-fold in ventral hippocampus. The increment is most likely due to an effect in the noradrenergic galanin-expressing neurons originating in locus ceruleus. The functional interpretation of these results is dependent on the yet unknown role of galanin in their hippocampal nerve terminals.

  • 117.
    Rugarn, Olof
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Theodorsson, Elvar
    Linköpings universitet, Institutionen för biomedicin och kirurgi, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Progesterone and norethisterone have different effects on tachykinin-like immunoreactivity in rat cortex and striatum2001Ingår i: Regulatory Peptides, ISSN 0167-0115, E-ISSN 1873-1686, Vol. 101, nr 1-3, s. 87-91Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The purpose of this study was to investigate the effects of progesterone and the most commonly prescribed synthetic progestogen, norethisterone, on regional immune-like reactivity of neuropeptide Y (NPY), substance P (SP), neurokinin A (NKA) and neurotensin (NT) in brains of female ovariectomized estradiol-substituted rats.

    Results: Norethisterone+estradiol-treated rats had 44% lower SP levels compared with estradiol-only-treated in frontal cortex and 20% lower NKA levels in comparison with progesterone+estradiol-treated in frontal cortex. Progesterone+estradiol-treated rats had 66% lower SP levels in striatum in comparison with both estradiol-only-treated and norethisterone+estradiol-treated. No significant results were found for NPY and NT.

    Conclusion: Progesterone and the synthetic progestogen, norethisterone, have different effects on SP- and NKA-like immunoreactivity in rat cortex and striatum.

    The effects of NET on SP- and NKA-like immunoreactivity in frontal cortex may contribute to the mood effects ascribed to this progestogen in clinical usage.

  • 118.
    Ryding, Elsa Lena
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Institutionen för hälsa och miljö. Linköpings universitet, Hälsouniversitetet.
    Psychological Aspects of Emergency Cesarean Section1998Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    According to earlier research, emergency cesarean section (Em CS) can have a deleterious effect on maternal psychological well-being. Whether the women thus delivered already had more psychological problems during pregnancy than other women, is not known.

    ln our pilot study of 25 women who underwent EmCS, we found that the concept of post-traumatic stress was relevant to the subject.

    In the main study, 1,981 Swedish-speaking women completed questionnaires concerning fear of childbirth, general anxiety, and coping with stress at about 32 weeks' gestation. Those 97 women who were subsequently delivered by Em CS were compared with 194 controls, matched for age and parity.

    All told, 124 women, who underwent Em CS, participated in the study postpartum. Fiftythree of these were randomized for early postpartum counselling, which began with an interview about the delivery experience. The remainder (n = 71) participated in comparisons with women who underwent other types of delivery. Those delivered by elective cesarean section (n = 70) or who had an instrumental vaginal delivery (n = 89) participated, as did 96 of those who had a completely normal vaginal delivery. Questionnaires inquiring into the birth experience, post-traumatic stress reactions, and general mental distress were filled in a few days and again at one month postpartum. The Em CS groups also completed questionnaires 6 months postpartum. Altogether 79 women who underwent EmCS completed questionnaires, both during pregnancy and up to one month postpartum.

    Healthy pregnant women with a serious fear of childbirth appeared to be at greater risk of subsequent EmCS. The degree of fear of childbirth during pregnancy was the best predictor of the degree of maternal well-being after an Em CS. Many of the women had experienced during the delivery an intense fear for their own life and health and/or for that of their baby. Thus, the trauma of EmCS may well meet the stressor criterion of the Diagnostic and Statistical Manual of Mental Disorders. Appraisal of the delivery was more negative after an EmCS than after other modes of deliveries. The women reported more post-traumatic stress reactions following Em CS as well as after instrumental vaginal delivery, than after elective cesarean section or normal vaginal birth. Generally speaking, early postpartum counselling had a beneficial effect on maternal well-being and especially on appraisal of delivery. The women with most frequent symptoms of post-traumatic stress reactions and mental distress did not get adequate help by our mode of counselling.

    In conclusion, an emergency cesarean section is often a traumatic experience. Antenatal fear of childbirth may increase the risk of an Em CS. More intense fear of childbirth late during pregnancy is associated with a more negative appraisal of an experienced EmCS, and also with more frequent symptoms of post-traumatic stress reactions and general mental distress following a surgical delivery. The psychological well-being of mothers is generally not so good after EmCS or an instrumental vaginal delivery, as after elective cesarean section or normal vaginal birth.

  • 119.
    Selbing, Anders
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Anghagen, O
    Bylund, B
    Nelson, Nina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Nylander, Eva
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Engvall, Jan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Velocity vector imaging to assess fetal myocardial function2007Ingår i: Ultrasound Obstet Gynecol.,2007, 2007Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

         

  • 120.
    Skamris Matthiesen, Leif
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Immune Changes in Pregnancy: A Survey of some Immunological Variables in Normal and Complicated Pregnancies1998Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The maternal systemic immune response during pregnancy is only fragmentarily understood. An adequate immune response to the gestational product is of vital importance for a successful pregnancy. Research in the field of reproductive immunology could clarify whether there is a difference between the immune responses in women with normal pregnancies and women with complicated pregnancies.

    The present thesis is a survey of selected immunological variables in non-pregnant women and in women with uncomplicated and complicated pregnancies. This was done by studying Jymphocyte populations, the proliferative capacity of lymphocytes as stimulated with mitogcns and immunomodulating drugs, the presence of iL-4 and JFN-g secreting cells, and the presence of certain autoantibodies in a low-risk pregnant population.

    Normal pregnancies were characterised by decreased levels of B cells (CD19+),_ NK cells (CD56+), expression of the IL-2 Receptor on lymphocytcs (CD25+) as well as HLA-DR+ on T cells (CD3+) and increased level of inactivated CD4+CD45RA+ T cells. Increased levels of NK cells, expression ofHLA-DR on T cells and antigen activated CD4+CD45R0+ T cells was found in preeclamptic patients compared with normal pregnancies. Thus, the immunosuppression that was found in normal pregnancies was not seen in pregnancies complicated by prccclampsia.

    Addition ofmitogens to cell cultures in either autologous or AB serum culture media demonstrated the existence of serum and cell mediated suppressor activity. The lymphoprolifcrative response to mitogens was reduced during nmmal pregnancies, possibly mediated by PGE2 and the presence ofT lymphocytes with suppressor function. The lymphoproliferative response in pregnancies complicated with severe precclampsia was further reduced as compared with normal pregnancies.

    Circulating IFN-g and IL-4 secreting cells increased during nonnal pregnancies. By the use of a mixed lymphocyte culture test it was found that paternal lymphocytes as stimulator-cells generated an elevated IL-4 secretion from maternal responder cells. These results indicate that the maternal immune response is shifted towards humoral immunity (TH2) by the recognition of the paternal allo-antigens, possibly to avoid maternal allo-reactivity against the fetus. The present findings also indicate that cell-mediated immunity (THl) to antigens were allowed to occur.

    The prevalence of anticardiolipin antibodies (aCL, IgG, ELISA), antinuclear antibodies (ANA, Indirect immunofluorescence) and rheumatoid factor (RF, agglutination test) in a low-risk pregnant population was low. However, there was an association, albeit weak, between ANA and women with preeclampsia.

    In summary, the maternal systemic immune response is characterised by suppression and non-aggression in nmmal human pregnancies. In women with pregnancy complications, such as preeclampsia, this suppression and inactivation is only partially achieved.

  • 121. Skarsgård, Constance
    et al.
    Berg, Göran
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Ekblad, G
    Wiklund, I
    Hammar, Mats
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Effects of estrogen therapy on well-being in postmenopausal women without vasomotor complaints2000Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 36, nr 2, s. 123-130Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To establish whether estrogen treatment affects well-being in postmenopausal women without current or previous vasomotor symptoms. Design: Forty postmenopausal women, aged 45-59 years, without current or previous vasomotor complaints, were included. They were randomized to masked treatment with either transdermal 17▀-estradiol 50 ╡g/24 h or to placebo. At baseline and after 12 and 14 weeks of treatment, the women completed a questionnaire which reflects well-being, the Psychological General Well-Being (PGWB) Index. Results: The women scored high on the PGWB Index, both at baseline and after 12 and 14 weeks of treatment. There was no significant difference in well- being according to PGWB Index between the groups treated with estrogen and placebo, neither at baseline, nor after therapy. Furthermore, there was no difference in change during therapy between the treatment groups. Conclusion: There is a gradual decline in estrogen during the climacteric, and it is controversial to which extent this affects women's mental health. The PGWB scores in this study were high before therapy, reflecting that these women without previous or current vasomotor complaints represented a selected sample. Neither short-term estrogen treatment over 12 weeks nor addition with medroxyprogesterone acetate during 2 weeks improved well-being in postmenopausal women without vasomotor symptoms who had high well-being at baseline. (C) 2000 Elsevier Science Ireland Ltd.

  • 122.
    Spetz, Anna-Clara
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Institutionen för biomedicin och kirurgi, Urologi. Linköpings universitet, Hälsouniversitetet.
    Vasomotor symptoms in men and the role of Calcitonin Gene-Related Peptide2002Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Hot flushes is a cotmnon phenomenon in women during the menopausal transition. In men treated with castration because of prostate cancer, hot flushes are probably the most cotmnon and distressing side-effect and are as common in these men as in menopausal women but the course of the flushes is unknown. Flushes also occur in healthy aging men, but the prevalence is unknown. The mechanisms behind hot flushes are not fully understood. They are probably caused by instability in the thermoregulatory centre due to a decrease in sex hotmone concentrations. Calcitonin Gene-Related Peptide (CGRP) and perhaps also Neuropeptide Y (NPY) are probably involved in menopausal hot flushes in women and could also be involved in men following therapeutic castration.

    The aims of this thesis were to compare different methods of castration as regards the occunence and course of hot flushes, and to investigate the prevalence of hot flushes in an unselected population of elderly men. A further aim was to see if CGRP and NPY are involved in hot flushes in men, in the same way as has previously been suggested in women.

    In this thesis two different modalities of castration therapy were compared: 1. castration by means of estrogens (Polyestradiol phosphate) and 2. total androgen blockade (a. bilateral orchiectomy or b. GnRH-analogue combined with oral anti-androgen). A much lower incidence of hot flushes were seen in the first group (1). Flushes induced by castration with estrogen were also milder and tended to disappear with time.

    The prevalence of hot flushes in a male population 55 years of age and above was investigated by means of a questionnaire. Thirty per cent of the men repotted flushes and half of these found the flushes distressing, i.e. every sixth man in the study. There was an association between flushes and a number of symptoms that are often related to low testosterone concentrations in the blood.

    The 24-hour urinaty excretion of CGRP was investigated in 17 men with prostate cancer before and after castration. Thirteen of the 17 men developed hot flushes after castration, but the urinary excretion of CGRP was not significantly altered.

    Blood-samples were taken during hot flushes in 10 men for analysis of CGRP- and NPY-plasma concentrations. CGRP increased in 6 men (we failed to obtain CGRP measurements in the other men due to technical problems). NPY concentrations were below the detection limit for the analysis in all samples.

    In conclusion vasomotor symptoms are common in men subjected to castration therapy. Different castration modalities result in different prevalence of hot flushes, something that should be considered when choosing the method of castration for men with prostate cancer. Hot flushes also occur in normal, aging men. The mechanisms behind hot flushes in men and women may be similar. CGRP may be involved in hot flushes in castrated men.

    In order to be able to develop new treatment regimens for these vasomotor symptoms fmther studies on the mechanisms behind hot flushes should be undertaken, in both castrated and in otherwise healthy elderly men.

    Delarbeten
    1. Prospective evaluation of hot flashes during treatment with parenteral estrogen or complete androgen ablation for metastatic carcinoma of the prostate
    Öppna denna publikation i ny flik eller fönster >>Prospective evaluation of hot flashes during treatment with parenteral estrogen or complete androgen ablation for metastatic carcinoma of the prostate
    Visa övriga...
    2001 (Engelska)Ingår i: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 166, nr 2, s. 517-520Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Purpose

    We evaluated the incidence and frequency of, and distress due to hot flashes after castration therapy with polyestradiol phosphate and complete androgen ablation.

    Materials and Methods

    A total of 915 men with metastatic prostate carcinoma enrolled in the Scandinavian Prostatic Cancer Group-5 trial study were randomized to intramuscular injections of 240 mg. Polyestradiol phosphate every 2 weeks for 8 weeks followed by monthly subcutaneous injections or complete androgen ablation, that is bilateral orchiectomy or 3.75 mg. of the gonadotropin-releasing hormone analog triptorelin monthly combined with 250 mg. of the antiandrogen flutamide 3 times daily. The incidence and frequency of, and distress due to hot flashes were recorded at regular intervals using a questionnaire.

    Results

    Of the 915 men 901 were evaluated at a median followup of 18.5 months. The incidence of hot flashes was 30.1% and 74.3% in the polyestradiol phosphate and complete androgen ablation groups, respectively (p <0.001). In the polyestradiol phosphate group the frequency of and distress due to hot flashes were significantly lower than in the androgen ablation group. There was complete relief from hot flashes in 50% of the men on polyestradiol phosphate during followup compared with none on androgen ablation. The incidence of hot flashes did not differ in men with and without tumor progression.

    Conclusions

    Endocrine treatment with polyestradiol phosphate induced fewer and less distressing hot flashes than complete androgen ablation. Flashes also disappeared to a greater extent during polyestradiol phosphate than during androgen ablation. The data in this study enable us to provide thorough individual information to patients on the risk and grade of expected distress and duration of hot flashes during polyestradiol phosphate or complete androgen ablation treatment.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-25368 (URN)10.1016/S0022-5347(05)65973-3 (DOI)9811 (Lokalt ID)9811 (Arkivnummer)9811 (OAI)
    Tillgänglig från: 2009-10-07 Skapad: 2009-10-07 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
    2. Hot flushes in a male population aged 55, 65, and 75 years, living in the community of Linköping, Sweden
    Öppna denna publikation i ny flik eller fönster >>Hot flushes in a male population aged 55, 65, and 75 years, living in the community of Linköping, Sweden
    2003 (Engelska)Ingår i: Menopause: The Journal of the North American Menopause, ISSN 1072-3714, E-ISSN 1530-0374, Vol. 10, nr 1, s. 81-87Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    OBJECTIVE:

    Hot flushes are as common in castrated men as in menopausal women. We investigated whether hot flushes exist in a normal aging male population and to what extent.

    DESIGN:

    A questionnaire was sent to all men living in Linköping, Sweden, who were 55, 65, and 75 years old ( = 1,885). The questionnaire asked for demographic data, medical history, mood status, medication, castrational therapy, and smoking, exercise, and alcohol habits, among other items. We asked specifically for current hot flushes unrelated to exercise or a warm environment.

    RESULTS:

    Of the questionnaires received, 1,381 were eligible for evaluation; 33 were analyzed separately because these men had been castrated. Hot flushes of any frequency were reported by 33.1% of noncastrated men, 4.3% reported flushes at least a few times per week, and 1.3% reported daily flushes. Half of the men reporting flushes were also bothered by them, ie, almost every sixth man in total. We found a relation between occurrence of hot flushes and other symptoms thought to be related to low testosterone concentration, such as decreased muscle strength or endurance, decreased enjoyment of life, sadness or grumpiness, and lack of energy ( < 0.05).

    CONCLUSIONS:

    Hot flushes occur in one third of a population of noncastrated older men, approximately half of whom consider flushes as bothersome. Neither the mechanisms nor whether the symptoms would respond to testosterone supplementation is known. Androgen substitution to treat symptoms possibly related to a male climacteric is still controversial. Studies are needed to evaluate the needs for and the effects of androgen treatment on vasomotor symptoms.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-26461 (URN)10.1097/00042192-200310010-00013 (DOI)11009 (Lokalt ID)11009 (Arkivnummer)11009 (OAI)
    Tillgänglig från: 2009-10-08 Skapad: 2009-10-08 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
    3. Urinary excretion of calcitonin gene-related peptide in males with hot flushes after castration for carcinoma of the prostate
    Öppna denna publikation i ny flik eller fönster >>Urinary excretion of calcitonin gene-related peptide in males with hot flushes after castration for carcinoma of the prostate
    Visa övriga...
    2001 (Engelska)Ingår i: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 35, nr 2, s. 92-96Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objective: The majority of men who undergo surgical or medical castration due to prostatic carcinoma develop vasomotor symptoms with hot flushes. The mechanisms behind these symptoms are poorly understood. One possible explanation is a release of the vasodilatory peptide calcitonin gene-related peptide (CGRP) from perivascular nerves, which seem to be involved in the mechanisms behind vasomotion and sweating in postmenopausal women. The aim of this report was to investigate whether CGRP is involved in vasomotion in men after castration therapy.

    Material and methods: Twenty-four hour urine excretion of CGRP was analysed in 15 men with prostatic carcinoma, using radioimmunoassay before and 3 months after surgical or medical castration.

    Results: Eleven of the 15 men developed hot flushes during the observation period of 3 months. Twenty-four hour urine excretion of CGRP did not change significantly after castration, either in the group as a whole or in those 11 men who developed hot flushes.

    Conclusions: Even though we did not observe any significant changes in 24-h urine excretion of the potent vasodilator CGRP after castration it is possible that serum levels of CGRP increase during hot flushes, without having an effect on the 24-h urine excretion of the peptide.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-25429 (URN)10.1080/003655901750170380 (DOI)9875 (Lokalt ID)9875 (Arkivnummer)9875 (OAI)
    Tillgänglig från: 2009-10-07 Skapad: 2009-10-07 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
    4. Momentary increase in plasma calcitonin gene-related peptide is involved in hot flashes in men treated with castration for carcinoma of the prostate
    Öppna denna publikation i ny flik eller fönster >>Momentary increase in plasma calcitonin gene-related peptide is involved in hot flashes in men treated with castration for carcinoma of the prostate
    Visa övriga...
    2001 (Engelska)Ingår i: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 166, nr 5, s. 1720-1723Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Purpose

    In women the vasodilatory neuropeptides calcitonin gene-related peptide and neuropeptide Y seem to be involved in menopausal hot flashes. We assessed whether plasma calcitonin gene-related peptide and neuropeptide Y change during hot flashes in men after castration.

    Materials and Methods

    We evaluated 10 men 61 to 81 years old who underwent castration due to cancer of the prostate and had frequent hot flashes for changes in plasma calcitonin gene-related peptide and neuropeptide Y during 1 day at the outpatient clinic. At least 5 blood samples were obtained between flashes and 4 were obtained during each flash. The samples were analyzed for calcitonin gene-related peptide and neuropeptide Y using radioimmunoassay technique. Hot flashes were objectively recorded by measuring peripheral skin temperature and skin conductance.

    Results

    Plasma calcitonin gene-related peptide increased 46% (95% confidence interval 21 to 71) during flashes in the 6 men in whom it was measurable. This change was statistically significant (p = 0.028). The concentration of neuropeptide Y was below the detection limit. Skin conductance and temperature increased significantly during flashes.

    Conclusions

    Calcitonin gene-related peptide is involved in the mechanisms of hot flashes in men who underwent castration due to prostate carcinoma. Thus, there may be a similar mechanism of hot flashes in women and in men deprived of sex steroids.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-25313 (URN)10.1016/S0022-5347(05)65660-1 (DOI)9754 (Lokalt ID)9754 (Arkivnummer)9754 (OAI)
    Tillgänglig från: 2009-10-07 Skapad: 2009-10-07 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
  • 123.
    Spetz, Anna-Clara
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Ellefsen, Katrine
    Theodorsson, Elvar
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Avdelningen för klinisk kemi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk kemi.
    Lassvik, Claes
    Hammar, Mats
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Calcitonin gene-related peptide during sweating in young healthy women2005Ingår i: Gynecologic and Obstetric Investigation, ISSN 0378-7346, E-ISSN 1423-002X, Vol. 60, nr 3, s. 149-153Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Calcitonin gene-related peptide (CGRP) concentrations are increased in postmenopausal women and castrated men with symptomatic flushing. We wanted to determine if a CGRP increase exists in the plasma of healthy fertile-age women during sweating. Plasma concentrations of CGRP were measured by radioimmunoassay at maximal sweating during a sauna session and during bicycle exercise both at maximal and 70% of maximal work capacity in 8 healthy women of fertile age. Plasma concentrations of CGRP were unaffected (>90% statistical power) during both experimental sessions. We suggest that sweating itself does not expiai n the rise in CGRP concentrations observed in flushing postmenopausal women. Copyright © 2005 S. Karger AG.

  • 124.
    Spetz, Anna-Clara
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Yrkes- och miljömedicin. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hot flushes in a male population aged 55, 65, and 75 years, living in the community of Linköping, Sweden2003Ingår i: Menopause: The Journal of the North American Menopause, ISSN 1072-3714, E-ISSN 1530-0374, Vol. 10, nr 1, s. 81-87Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:

    Hot flushes are as common in castrated men as in menopausal women. We investigated whether hot flushes exist in a normal aging male population and to what extent.

    DESIGN:

    A questionnaire was sent to all men living in Linköping, Sweden, who were 55, 65, and 75 years old ( = 1,885). The questionnaire asked for demographic data, medical history, mood status, medication, castrational therapy, and smoking, exercise, and alcohol habits, among other items. We asked specifically for current hot flushes unrelated to exercise or a warm environment.

    RESULTS:

    Of the questionnaires received, 1,381 were eligible for evaluation; 33 were analyzed separately because these men had been castrated. Hot flushes of any frequency were reported by 33.1% of noncastrated men, 4.3% reported flushes at least a few times per week, and 1.3% reported daily flushes. Half of the men reporting flushes were also bothered by them, ie, almost every sixth man in total. We found a relation between occurrence of hot flushes and other symptoms thought to be related to low testosterone concentration, such as decreased muscle strength or endurance, decreased enjoyment of life, sadness or grumpiness, and lack of energy ( < 0.05).

    CONCLUSIONS:

    Hot flushes occur in one third of a population of noncastrated older men, approximately half of whom consider flushes as bothersome. Neither the mechanisms nor whether the symptoms would respond to testosterone supplementation is known. Androgen substitution to treat symptoms possibly related to a male climacteric is still controversial. Studies are needed to evaluate the needs for and the effects of androgen treatment on vasomotor symptoms.

  • 125.
    Spetz, Anna-Clara
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Hammar, Mats
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Hot flushes in men: prevalence and possible mechanisms.2002Ingår i: Journal of the British Menopause Society, ISSN 1362-1807, s. 57-62Artikel i tidskrift (Övrigt vetenskapligt)
  • 126.
    Spetz, Anna-Clara
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi.
    Hammar, Mats
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Vasomotor symptoms in men - causes and mechanisms.2003Ingår i: British Journal of Sexual Medicine, ISSN 0301-5572, Vol. 27, s. 16-19Artikel i tidskrift (Refereegranskat)
  • 127.
    Spetz, Anna-Clara
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Lindberg, Bengt
    Department of Surgery, Kungälv Hospital, Kungälv, Sweden.
    Spångberg, Anders
    Linköpings universitet, Institutionen för biomedicin och kirurgi, Urologi. Linköpings universitet, Hälsouniversitetet.
    Varenhorst, Eberhard
    Linköpings universitet, Institutionen för biomedicin och kirurgi, Urologi. Linköpings universitet, Hälsouniversitetet.
    Prospective evaluation of hot flashes during treatment with parenteral estrogen or complete androgen ablation for metastatic carcinoma of the prostate2001Ingår i: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 166, nr 2, s. 517-520Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    We evaluated the incidence and frequency of, and distress due to hot flashes after castration therapy with polyestradiol phosphate and complete androgen ablation.

    Materials and Methods

    A total of 915 men with metastatic prostate carcinoma enrolled in the Scandinavian Prostatic Cancer Group-5 trial study were randomized to intramuscular injections of 240 mg. Polyestradiol phosphate every 2 weeks for 8 weeks followed by monthly subcutaneous injections or complete androgen ablation, that is bilateral orchiectomy or 3.75 mg. of the gonadotropin-releasing hormone analog triptorelin monthly combined with 250 mg. of the antiandrogen flutamide 3 times daily. The incidence and frequency of, and distress due to hot flashes were recorded at regular intervals using a questionnaire.

    Results

    Of the 915 men 901 were evaluated at a median followup of 18.5 months. The incidence of hot flashes was 30.1% and 74.3% in the polyestradiol phosphate and complete androgen ablation groups, respectively (p <0.001). In the polyestradiol phosphate group the frequency of and distress due to hot flashes were significantly lower than in the androgen ablation group. There was complete relief from hot flashes in 50% of the men on polyestradiol phosphate during followup compared with none on androgen ablation. The incidence of hot flashes did not differ in men with and without tumor progression.

    Conclusions

    Endocrine treatment with polyestradiol phosphate induced fewer and less distressing hot flashes than complete androgen ablation. Flashes also disappeared to a greater extent during polyestradiol phosphate than during androgen ablation. The data in this study enable us to provide thorough individual information to patients on the risk and grade of expected distress and duration of hot flashes during polyestradiol phosphate or complete androgen ablation treatment.

  • 128.
    Spetz, Anna-Clara
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Hammar, Mats
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Pettersson, W
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Urologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Urologiska kliniken i Östergötland.
    Varenhorst, Eberhard
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Urologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Urologiska kliniken i Östergötland.
    Hot flushes and prostate cancer: pathogenesis and treatment2002Ingår i: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 90, s. 476-476Artikel i tidskrift (Refereegranskat)
  • 129.
    Spetz, Anna-Clara
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Palmefors, Lennart
    Skobe, Staffan
    Strömstedt, Martin
    Fredriksson, Mats
    Theodorsson, Elvar
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Avdelningen för klinisk kemi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk kemi.
    Hammar, Mats
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Testosterone correlated to symptoms of partial androgen deficiency in aging men (PADAM) in an elderly Swedish population2007Ingår i: Menopause: The Journal of the North American Menopause, ISSN 1072-3714, E-ISSN 1530-0374, Vol. 14, nr 6, s. 999-1005Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate the prevalence of different symptoms of partial androgen deficiency in aging men (PADAM) and to correlate them with blood concentrations of testosterone and bioavailable testosterone. DESIGN: A total of 370 men, aged 55 to 75 years, were invited to one of three primary healthcare centers in Sweden. They were asked to complete a questionnaire regarding demographic data, medical history, mood status, medication, castration therapy and smoking, exercise and alcohol habits, as well as different symptoms of PADAM. The 10 questions from a previously used questionnaire (the ADAM questionnaire) were included. The men were offered blood tests for analyses of testosterone, follicle stimulating hormone, luteinizing hormone, steroid hormone-binding globulin, and albumin. From these test results, we calculated the bioavailable testosterone. RESULTS: Of the questionnaires sent out, 81.6% were returned and eligible for evaluation. Blood samples were obtained from 85.8% of men answering the questionnaire. Many of the symptoms, including five from the ADAM questionnaire, were more common in older age groups (P < 0.05). Three symptoms, deterioration in work performance, decreased strength and/or endurance, and bothersome hot flushes, were associated with low bioavailable testosterone and/or testosterone (P < 0.05). Testosterone and bioavailable testosterone did not differ between age groups, but bioavailable testosterone was higher in men with three or fewer symptoms on the ADAM questionnaire. CONCLUSIONS: Symptoms associated with PADAM often occur in an elderly population, but we could only find an association between three symptoms and blood testosterone concentrations, one being bothersome hot flushes. It is likely that these symptoms have a more complex background than only PADAM. ©2007The North American Menopause Society.

  • 130.
    Spetz, Anna-Clara
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Pettersson, Bill
    Linköpings universitet, Institutionen för biomedicin och kirurgi, Urologi. Linköpings universitet, Hälsouniversitetet.
    Varenhorst, Eberhard
    Linköpings universitet, Institutionen för biomedicin och kirurgi, Urologi. Linköpings universitet, Hälsouniversitetet.
    Theodorsson, Elvar
    Linköpings universitet, Institutionen för biomedicin och kirurgi, Klinisk kemi. Linköpings universitet, Hälsouniversitetet.
    Thorell, Lars-Håkan
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Psykiatri. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Momentary increase in plasma calcitonin gene-related peptide is involved in hot flashes in men treated with castration for carcinoma of the prostate2001Ingår i: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 166, nr 5, s. 1720-1723Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    In women the vasodilatory neuropeptides calcitonin gene-related peptide and neuropeptide Y seem to be involved in menopausal hot flashes. We assessed whether plasma calcitonin gene-related peptide and neuropeptide Y change during hot flashes in men after castration.

    Materials and Methods

    We evaluated 10 men 61 to 81 years old who underwent castration due to cancer of the prostate and had frequent hot flashes for changes in plasma calcitonin gene-related peptide and neuropeptide Y during 1 day at the outpatient clinic. At least 5 blood samples were obtained between flashes and 4 were obtained during each flash. The samples were analyzed for calcitonin gene-related peptide and neuropeptide Y using radioimmunoassay technique. Hot flashes were objectively recorded by measuring peripheral skin temperature and skin conductance.

    Results

    Plasma calcitonin gene-related peptide increased 46% (95% confidence interval 21 to 71) during flashes in the 6 men in whom it was measurable. This change was statistically significant (p = 0.028). The concentration of neuropeptide Y was below the detection limit. Skin conductance and temperature increased significantly during flashes.

    Conclusions

    Calcitonin gene-related peptide is involved in the mechanisms of hot flashes in men who underwent castration due to prostate carcinoma. Thus, there may be a similar mechanism of hot flashes in women and in men deprived of sex steroids.

  • 131.
    Spetz, Anna-Clara
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi.
    Zetterlund, Eva-Lena
    Varenhorst, Eberhard
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Urologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Urologiska kliniken i Östergötland.
    Hammar, Mats
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Incidence and management of hot flashes in prostate cancer.2003Ingår i: The journal of supportive oncology, ISSN 1544-6794, Vol. 1, nr 4Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Hot flashes are as common in men who have been castrated due to prostate cancer as hot flashes are in women after menopause. The symptom can cause significant discomfort for a considerable length of time. The hot flashes are most likely caused by a reduction in sex-hormone levels, which, in turn, causes an instability in the hypothalamic thermoregulatory center. Calcitonin gene-related peptide is involved in menopausal hot flashes in women and possibly also in castrated men. The mainstays of treatment for castrated men with hot flashes remain estrogens, progesterone, and cyproterone acetate, each of which has different side effects. Other treatments for hot flashes include clonidine and antidepressants and, according to one uncontrolled study, electrostimulated acupuncture. Nonetheless, there is a need for more effective and less toxic treatments. In this review, we will discuss the prevalence, duration, distress, physiology, and treatment options of hot flashes in men subjected to castration therapy due to prostate cancer.

  • 132.
    Stening, Kent
    et al.
    Linköpings universitet, Institutionen för biomedicin och kirurgi. Linköpings universitet, Hälsouniversitetet.
    Eriksson, Olle
    Linköpings universitet, Institutionen för datavetenskap, Statistik. Linköpings universitet, Filosofiska fakulteten.
    Wahren, Lis Karin
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier. Linköpings universitet, Hälsouniversitetet.
    Berg, Göran
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Hammar, Mats
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Blomqvist, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Avdelningen för medicinsk cellbiologi.
    Pain sensations to the cold pressor test in normally menstruating women: Comparison with men and relation to menstrual phase and serum sex steroid levels2007Ingår i: American Journal of Physiology. Regulatory Integrative and Comparative Physiology, ISSN 0363-6119, E-ISSN 1522-1490, Vol. 293, nr 4Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The role of gonadal hormones on pain sensations was investigated in normally menstruating women (n = 16) using the cold pressor test. Tolerance time, pain threshold, and pain intensity were examined once a week during a 4-wk period, and serum concentrations of 17β-estradiol and progesterone were determined at each test session, which were classified into the early follicular phase, late follicular phase, early luteal phase, and late luteal phase, as determined by the first day of menses and the actual hormone levels recorded. A group of men (n = 10) of the same age interval was examined for comparison. The data show that pain threshold was reduced during the late luteal phase compared with the late follicular phase, and hormone analyses showed significant positive correlation between the progesterone concentration and lowered pain threshold and increasing pain intensity. Hormone analysis also showed an interaction between S-estradiol and S-progesterone on pain intensity, demonstrating that the increased perceived pain intensity that was associated with high progesterone concentrations was significantly reduced with increasing levels of estradiol. While no statistically significant sex differences in pain measurements were found, women displayed much more pronounced, and statistically significant, session-to-session effects than men, with increased pain threshold and decreased pain intensity with each test session. Hence, these data suggest that the changes in the serum concentration of gonadal hormones that occur during the menstrual cycle influence pain sensations elicited by noxious tonic cold stimulation and show that adaptation to the cold pressor test may be sex dependent. © 2007 the American Physiological Society.

  • 133. Suhonen, Satu
    et al.
    Haukkamaa, Maija
    Jakobsson, Tell
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi.
    Rauramo, Ilkka
    Clinical performance of a levonorgestrel-releasing intrauterine system and oral contraceptives in young nulliparous women: A comparative study2004Ingår i: Contraception, ISSN 0010-7824, E-ISSN 1879-0518, Vol. 69, nr 5, s. 407-412Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This 1-year randomized study was carried out at family-planning clinics of two university hospitals to compare the safety and acceptability of a levonorgestrel-releasing intrauterine system (LNG IUS) and oral contraceptives (OCs) in young nulliparous women. The study population consisted of 200 women aged 18-25 years seeking contraception. Ninety-four women entered the LNG IUS group and 99 entered the OC group. Continuation rates, reasons leading to discontinuation, adverse events, menstrual questionnaires, subjective well-being and sexual behavior were evaluated. Nineteen women (20%) in the LNG IUS group discontinued the study during the 1-year observation period, and 27 discontinued (27%) in the OC group. The most common reason (31%) for discontinuation in the IUS group was pain. In the OC group, hormonal side effects were the predominant medical reason for study termination. The safety and acceptability of the LNG IUS for contraception was observed to be as good as with OCs, with a high continuation rate.

  • 134.
    Svanborg, Eva
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Klinisk Neurofysiologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Neurofysiologiska kliniken US.
    Harder, Lena
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Klinisk Neurofysiologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Neurofysiologiska kliniken US.
    Sarberg, Maria
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Broström, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Klinisk Neurofysiologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Neurofysiologiska kliniken US.
    Josefsson, Ann
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Development of snoring during pregnancy. Relationship to blood pressure increases and pre-eclampsia2007Ingår i: World Sleep 07,2007, 2007, s. 111-111Konferensbidrag (Övrigt vetenskapligt)
  • 135.
    Svanborg, Eva
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Klinisk Neurofysiologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Neurofysiologiska kliniken US.
    Harder, Lena
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Öronkliniken US.
    Sarberg, Maria
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Josefsson, Ann
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Development of restless legs syndrome during pregnancy. Relationship to snoring and edemas2007Ingår i: World Sleep 07,2007, 2007, s. 177-177Konferensbidrag (Övrigt vetenskapligt)
  • 136.
    Svedin, Carl Göran
    et al.
    Lund .
    Wadsby, Marie
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Barn- och ungdomspsykiatri.
    Sydsjö, Gunilla
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Mental health, behaviour problems and incidence of child abuse at the age of 16 years: A prospective longitudinal study of children born at psychosocial risk2005Ingår i: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 14, nr 7, s. 386-396Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Of the 1,575 pregnant women registered at the public Antenatal Health Care Service in the city of Linköping, Sweden during 1983, an index group of 78 women was identified that met specific well-defined psychosocial risk criteria related to drug addiction, mental insufficiency, and particular social circumstances of possible relevance to problems of pregnancy and early child development. A further 78 pregnant women who did not meet the inclusion criteria were used as a reference group. The present study is a 16-year follow-up in which 43 (57%) of the original index children and 63 (82%) of the original reference children were examined on indices of mental health, and the presence of child abuse. Their mental health was assessed with the Child Behaviour Checklist (CBCL) completed by the mothers and the Youth Self-Report (YSR) completed by the adolescents. The incidence of child abuse and Social Welfare interventions was obtained from Social Welfare records. The index children, especially the boys, displayed significantly poorer mental health as assessed by both CBCL (p<0.05) and YSR (p<0.02). Being an index child increased the odds ratio 16-27 times for different Social Welfare interventions, and child abuse had been investigated in 27% of the index children compared to 1% of the reference children. © Steinkopff Verlag 2005.

  • 137.
    Sydsjö, Adam
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Sickness absence during pregnancy1998Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The present study represents a series of surveys concerning the variation in rate and average duration of sickness absence during pregnancy from 1978 to 1997 in two Swedish communities, Linköping and Värnamo. The variation observed was related to the obstetrical course and outcome of the pregnancies, the reproductive histories of the women investigated, the occcupations held, the degree of employment, the prevalence of "back-pain during pregnancy" as a cause of sick-listing and the use before delivery of the special social benefits associated with childbearing, i.e. the Parental benefit and the Pregnancy benefit. The attitudes towards the subjective consequences of the state of pregnancy and the concept of being off-work for different reasons while pregnant, were examined by means of a questionnaire. A direct comparison was made between all pregnant women delivered during 1986 in the Värnamo community and the Hamar community in Norway, with special regard to the amounts of sickness absence registered during pregnancy in the two communities. Finally, with the help of two independent data bases, one computerized and based on routine reports and one manually extracted, we estimated the proportion of pregnant women among all sicklisted women, aged 16-44 years, during 1986 in Linköping, and their contribution to the total amount of sickness absence registered within these age strata. In total, 6 628 Swedish and 645 Norwegian pregnant women were included in the surveys.

    As a main result we found that the mean number of days of sickness absence per pregnant woman, aged 16-44 years, rose by more than 100 per cent, from 1978 to 1986. The corresponding increase for all women aged 16-44, was 20 per cent. Concurrently, there was no evidence of an "obstetric" explanation for these findings. "Back-pain during pregnancy" was the most frequent "complaint "to legitimate the sick-leave spells, increasing to about 30 per cent among employed pregnant women 1986. In 1997 it had decreased to 17 per cent. It was most often found in the younger pregnant women (< 25 years).

    No relation was observed between the occupation held by the pregnant women and the variation in sickness rate or the average duration of the sickness absence observed between 1978 and 1997. Nor was there any simple relation observed between the degree of unemployment among pregnant women and the amount of sickness absence registered.

    The variations in the social benefits offered to pregnant women was not found, either, to be related in a simple way to the rate and duration of sickness absence during pregnancy. Thus, when the social benefits, i.e. the Parental and the Pregnancy benefits, were substantially ameliorated in Sweden between 1978 and 1986, the sickness absence among pregnant women rose dramatically. In 1992 and 1997, when a modest reduction in the pregnancy associated social benefits had taken place, a decline in the amount of sickness absence was registered, i.e. down to 0.60 and 0.53. In 1986, 48 per cent of the employed pregnant women in Hamar were sicklisted during pregnancy as compared with 75 per cent in Vlimamo. This was in spite of the fact that the social benefits available to pregnant and employed women were much more favourable in Sweden than in Norway.

    In the questionnaire study about personal attitudes in 1995 we found, that 74 per cent of the women who had been sick-listed during pregnancy stated that they had enjoyed a "good" or "excellent" health during the whole of their pregnancy. Only 4.2 per cent of the women stated that they had suffered from a clearly pregnancy-related disorder. The present findings may indicate that a change in attitude towards pregnancy and its subjective consequences, together with a sensible adaptation to the prevailing conditions within the social security insurance system, may well be the most plausible explanation to the observed variations in sick-listing during the study period. When data from the two independent data bases were compared, it was found that 5.4 per cent of all sicklisted women aged 16-44, were pregnant. These women contributed as much as 22 per cent of all sickness absence registered. Only 46 per cent of the actually pregnant women could be identified in the computerized data base with the help of "pregnancy-related" diagnoses noted in the sick-leave certificates. To preclude misinterpretations, based on public health statistics, one must be properly informed on the reproductive state of thewomen sick-listed.

  • 138.
    Sydsjö, Adam
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Viktigt veta vem som är gravid när man jämför sjukskrivning vid ryggbesvär.2004Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 6, s. 448-448Artikel i tidskrift (Övrigt vetenskapligt)
  • 139.
    Sydsjö, Adam
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Alexanderson, K
    Dastserri, M
    Sydsjö, Gunilla
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Gender differences in sick leave related to back pain diagnoses.2002Ingår i: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 28, s. 385-389Artikel i tidskrift (Refereegranskat)
  • 140.
    Sydsjö, Adam
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Brynhildsen, Jan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Ekholm, Katarina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi.
    Josefsson, Ann
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Sydsjö, Gunilla
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Influence of rest during pregnancy on birth weight in working women2006Ingår i: Obstetrics and Gynecology, ISSN 0029-7844, E-ISSN 1873-233X, Vol. 107, nr 5, s. 991-996Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Birth weight in Sweden has increased during the past decades. We investigated whether rest provided by the combination of time off from work and social benefits among working pregnant women contributed to the observed changes. METHOD: A total of 7,459 consecutively delivered women in 1978, 1986, 1992, and 1997 at 2 delivery wards in southeastern Sweden were studied. RESULTS: Between 1978 and 1997, the average birth weight among the children of the women studied increased from 3,484 to 3,566 grams (P < .001). The increase in weight was most evident among infants born to women who were employed during pregnancy. The use of social benefits and increased rest during pregnancy did not significantly influence birth weight (P = .107), even after adjustment for gestational length, parity, smoking, age, and occupation. CONCLUSION: The continuous increase in infants' birth weight among pregnant women in this study did not correlate with rest periods in the form of leave supported by social benefit programs. The effects of social benefit programs on pregnancy outcome may thus be overrated and merits further research. © 2006 by The American College of Obstetricians and Gynecologists. Published by Lippincott Williams & Wilkins.

  • 141.
    Sydsjö, Adam
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Claesson, Ing-Marie
    Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi.
    Ekholm, Katarina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi.
    Josefsson, Ann
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Brynhildsen, Jan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Sydsjö, Gunilla
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Influence of obesity on the use of sickness absence and social benefits among pregnant working women2007Ingår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 121, nr 9, s. 656-662Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate if obesity in early pregnancy has any possible impact on the capacity of pregnant women to engage in gainful employment. Methods: Register data from a database on sickness absence and pregnancy benefit and parental benefit claims were combined with type of occupation and body mass index (BMI) for 693 women consecutively delivered during the course of one year at a county hospital in Sweden. Results: The results showed the lowest BMI among women who had administrative jobs and the highest BMI in women who undertook more burdensome and heavy types of manual work. A significant increase in BMI was also seen among those pregnant women who were registered as unemployed. The finding that in the manual types of occupation, obese pregnant women took almost twice as many days of leave provided by the parental benefit programme as did women with a BMI of <25, indicates that obese pregnant women perhaps do not have the same physical endurance required to manage the combined demands of work and pregnancy. No differences were found with regard to sickness absence between obese women and pregnant women with normal BMI, however, differences were found between different occupational groups. Conclusions: Our study indicates that a woman's BMI at the beginning of pregnancy is associated with her occupational status. Obesity among pregnant women may well be used as a psychosocial indicator as obesity correlates with social and economic problems. Any planned weight reduction programme in antenatal care must therefore consider this important psychosocial aspect. © 2006 The Royal Institute of Public Health.

  • 142.
    Sydsjö, Adam
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Sydsjö, Gunilla
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Gravidas sjukfrånvaro ligger bakom ökat sjuktal för kvinnor i fertil ålder. Studie av gravida kvinnors sjukfrånvaro 1978-1997.2001Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 98, s. 3410-3414Artikel i tidskrift (Övrigt vetenskapligt)
  • 143.
    Sydsjö, Adam
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Sydsjö, Gunilla
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Alexanderson, Kristina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap.
    Influence of pregnancy-related diagnoses on sick-leave data in women aged 16-442001Ingår i: Journal of Womens Health & Gender-Based Medicine, ISSN 1524-6094, E-ISSN 2168-7722, Vol. 10, nr 7, s. 707-714Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Data on sickness absence frequently are used as a measure of morbidity and its social consequences in the employed population. The effects of sickness absence, as well as any possible differences in diagnoses among pregnant women as compared the sick leave data among the total population of women in fertile age have so far not been studied. The aim of this study was to investigate the relative contribution of pregnant women to the level of sickness absence, in general and in different diagnostic groups, as well as the extent to which sick-listed pregnant women can be identified through diagnoses on sickness certificates. In a cross-sectional study of all sick leave insured women aged 16-44 years (n=24,481) in Link÷ping, Sweden (117,000 inhabitants), data from two population-based research registers were used, one of sickness absence for the whole population, one of sickness absence among pregnant women in the same population and year. Pregnant women (5%) had a significantly higher cumulative incidence of sickness absence (0.64) compared with all women (0.18) and accounted for 20% of the women listed as absent because of sickness. The duration of the sickness absence was also significantly longer among pregnant women, 44.8 days compared with 9.7 days among all women. Practically all diagnoses among pregnant women were related to pregnancy or back pain (93%). When using diagnoses on the sickness certificates, only 46% of all sick-listed pregnant women could be identified, suggesting methodological difficulties in studies on sickness absence. Studies on sickness absence among women of fertile age should also contain information on the proportion of sick-listed pregnant women, as a small proportion of pregnant women may have a deep impact on the results and conclusions among all women.

  • 144.
    Sydsjö, Gunilla
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Psykosociala riskgraviditeter och deras utfall1992Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The present study describes a prospective survey of an index-group of78 pregnant women, who during pregnancy met with certain arbitrarily selected, but well defined criteria associated with drug addiction, moderate mental insufficiency or particular social circumstances of possible relevance to the course of pregnancy and early child development. For comparison, a referencegroup of 78 pregnant women who did not meet the present inclusion criteria, were studied in equal detail. The two groups of women were derived out of a total number of 1575 pregnant women who during the year 1983 registered at the public Antenatal Health Care Service in the community of Linköping. The two groups of women were followed and compared until their children were four years old. By means of repeated personal, semistructured interviews with all the women, together with standardized observations of the women and their children and collection of a range of social, economic, medical,obstetrical and neonatal data, the duration and outcome of pregnancy in relation to the need for medical antenatal care and social wellfare was illustrated in some detail. Furthermore, the psychosocial conditions of the pregnant women, apparent during early pregnancy were related to the development of the interaction and relationship between mother and child as observed during the first 18 months as well as to the somatic and psycho-motor development of the child at four years of age.

    In summary, at least five per cent of all pregnant women in the community of Linköping were found, already during early pregnancy, to be characterized by drug addiction, suffering from modefate mental insufficiency symptoms or being associated with one or more defined social attributes thought to be of relevance to the course of pregnancy and early child development. These women, when compared to the reference group of pregnant women, were eventually found to require a significantly increased amount of medical attention and social wellfare during pregnancy. However, no significant differences were observed between the groups regarding duration and outcome of pregnancy, thestates of the neonates or the somatic wellbeing of mother and child postnatally.

    With the beginning soon after delivery, the indexchildren appeared to run a considerably increased risk for an unfavourable somatic as well as psycho-motor development during their ftrst four years of life, as compared to the reference children.

    It is obvious that present efforts and routines with regard to antenatal medical and social care, at least as presendy practised in Linköping, Sweden, are consistent with regular obstetric courses and outcomes of pregnancies in general in women stigmatized by certain impaired psychosocial conditions. However, if we are to prevent and eventually eliminate the significantly increased risks for an unfavourable somatic and psycho-motor development of the children of these women, we mustprobably introduce complementary elements of an educational and socially reassuring type in the Antenatal Health Care Service.

  • 145.
    Sydsjö, Gunilla
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Ekholm, Katarina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi.
    Wadsby, Marie
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Barn- och ungdomspsykiatri.
    Kjellberg, Svante
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Sydsjö, Adam
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Relationships in couples after failed IVF treatment: A prospective follow-up study2005Ingår i: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 20, nr 7, s. 1952-1957Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There are few studies of couples that analyse satisfaction with treatment, adoption plans and relationships in couples after unsuccessful IVF. Methods: ENRICH marital inventory was used to describe marital dynamics and to gain information about treatment and adoption plans. A specially designed questionnaire was used. Of the 51 couples without previous children who were asked to participate after their first failed IVF cycle, 45 participated. The next stage of the study was carried out when the couples had reached the 6 months point after the first IVF cycle, and the last stage after the couples had been through one to three treatments, 1 1/2 years after the last treatment. Results: The couples displayed a stable relationship from the start as well as 1 year after the last IVF cycle. The vast majority of the couples had decided to go through with an adoption. Seventy-three percent of the women were interested in more IVF treatment compared to 33% of the men. Conclusion: The stresses associated with IVF treatment did not have a negative impact on the couples' appreciation of their relationships during and after the treatment period. After treatment had been completed, the couples seemed to have reoriented themselves toward other solutions to childlessness.

  • 146.
    Sydsjö, Gunilla
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Lampic, C
    Sunnerud, S
    Skoog Svanberg, A
    Nurses promote openness regarding the genetic origins after gamete donation2007Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, nr 10, s. 1500-1504Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To study attitudes and knowledge concerning different aspects of sperm and oocyte donation among paediatric nurses at child health care centres (CHCs) in Sweden. Method: A study-specific questionnaire, to be completed anonymously, was sent to 188 nurses, 141 of whom (75%) responded. Results: The majority of the respondents (62%) stated that they had no professional experience of families created with the help of a donor. A majority (53%) stated that they had good knowledge of the procedure followed in sperm donation, whereas 43% stated that they had good knowledge of the procedure of oocyte donation. More than 80% agreed that the parents should be honest with their child with regard to the child's genetic origin. Among the respondents who were in favour of disclosure, the preferred age for informing the child varied between 0 to 19 years (mean 7.2, SD 5.7). Conclusion: We conclude that the nurses working in CHCs need guidance and information about gamete donation in order to be able to support parents in the disclosure of information to their children and also how to inform or withhold information to significant others in their surrounding milieu. © 2007 The Author(s).

  • 147.
    Sydsjö, Gunilla
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Sydsjö, Adam
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Newly delivered women's evaluation of personal health status and attitudes towards sickness absence and social benefits2002Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 81, nr 2, s. 104-111Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Unexpectedly high rates of sickness absence have been observed among pregnant women. No clear medical causes for illnesses reported as the basis for sick leave have yet been identified with certainty. An explanation proposed is the pregnant women's own attitudes towards their own states of well being during pregnancy. The aim of this study was to investigate the validity of this hypothesis. Methods. All of the 384 women who were delivered at the University Hospital during a 2-month period were asked to answer a questionnaire anonymously. Information was sought concerning sickness absence and the use of parental benefits. In addition, questions were asked about working conditions and about each mother's own estimate of her level of 'well being'. The women's attitudes towards work absence due to illness and towards social benefit programs were registered. Results. Forty-three per cent of the women stated that they had been on sick leave during pregnancy. The main reason for sick leave was reported back pain. Seventy-four per cent of the women who were on sick leave stated, nevertheless, that they had been in 'good' or 'excellent' health during pregnancy. Of the 149 women who did not take sick leave, 10 reported being in 'bad' or 'very bad' health during pregnancy. 4.3% of the women stated that they had considered themselves to be ill due to an obstetric condition. Conclusion. In addition to actual disease and severe discomfort, certain social conditions and attitudes as well, are likely to explain the increase of pregnant women on sick leave.

  • 148.
    Sydsjö, Gunilla
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Sydsjö, Adam
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Wijma, Barbro
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Variations in sickness absence and use of social benefits among pregnant women in a Swedish community 1978-1997.1999Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 78, s. 383-387Artikel i tidskrift (Refereegranskat)
  • 149.
    Sydsjö, Gunilla
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Wadsby, Marie
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Barn- och ungdomspsykiatri.
    Period prevalence and types of psychosocial risk factors in pregnant women in an urban Swedish community2003Ingår i: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 12, nr 4, s. 302-306Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    During a three-year period a total population of pregnant women attending antenatal clinics in Link÷ping, Sweden was screened for being at psychosocial risk. The prevalence of different psychosocial risk factors was compared with the corresponding prevalence in women referred to and accepting or declining to take part in a specialised training programme at a parent-baby clinic. In general, the present study showed that there was a constant proportion of about 4-5% of pregnant women with psychosocial risk factors. Psychiatric problems and social problems of relevance for pregnancies/parenthood were about equally frequent (i.e. 44 and 45%), while drug-addiction problems were at 11%. Only one in three women with risk factors were eventually referred to the parent-baby clinic, and every second woman referred finally took part in the programme. With the knowledge that an early intervention in families with psychosocial risk factors may alleviate some adverse or disadvantageous developments in children, it is a challenge to identify and to motivate these women to enrol in various support and training programmes. There are still too few pregnant women at risk who are ready to accept the further support that they may need, and the rationale for their reluctance must be better known.

  • 150.
    Sydsjö, Gunilla
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Wadsby, Marie
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Barn- och ungdomspsykiatri.
    Kjellberg, Svante
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Sydsjö, Adam
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Relationships and parenthood in couples after assisted reproduction and in spontaneous primiparous couples: A prospective long-term follow-up study2002Ingår i: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 17, nr 12, s. 3242-3250Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The aim of this study was to analyse relationships and parenthood in primiparous IVF couples and spontaneous primiparous couples. Method: In total, 110 consecutive IVF couples were studied. The control group was matched for women's age and selected out of the total spontaneous pregnant population in the study area. Questionnaires and semi-structured telephone interviews were used to gain information about sociodemographic data, couples' relationships, and the children's health, temperament and behaviour. Obstetrical variables concerning the course and outcome of pregnancy and delivery as well as the health status of the new-borns were obtained from standardized antenatal care and delivery files. Results: There weere no differences concerning gestational age, mode of delivery or neonatal health between the two groups. The IVF couples were more stable over time - from pregnancy until the child was 1 year old - in their relationship, while the control group experienced a decrease in marital satisfaction. The children in the IVF group were assessed by their parents as being more regular/habitual, sensitive and manageable than the control children. Conclusion: The differences present between the groups were in favour of the IVF families, and the effects of the infertility crisis were not notable when the children were 1 year old.

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