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  • 151.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, EMK-endokrin.
    Nya rön talar mot statinbehandling vid akut kranskärlssjukdom. Men vanskligt att bedöma behandlingseffekt utifrån observationella studier.2002Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 99, s. 4348-4349Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 152.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    PPAR agonists do not come up to expectations. Hope about the preventive effect in type 2 diabetes has comte to nought2006Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, nr 35, s. 2454-2455Artikkel i tidsskrift (Fagfellevurdert)
  • 153.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Prove-it2005Inngår i: Information från Läkemedelsverket, ISSN 1101-7104, Vol. 1, s. 14-15Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 154.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Psychosocial factors and coronary heart disease2004Inngår i: Current Atherosclerosis Reports, ISSN 1523-3804, E-ISSN 1534-6242, Vol. 6, nr 1Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    [No abstract available]

  • 155.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Replik: Att följa Ravnskovs råd skulle innebära återgång i ökad dödlighet och sjuklighet. Slutreplik2004Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, s. 1218-1222Artikkel i tidsskrift (Annet vitenskapelig)
  • 156.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Risk factors for reaching renal endpoints in the assessment of lescol in renal transplantation (ALERT) trial2005Inngår i: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 792, s. 205-212Artikkel i tidsskrift (Fagfellevurdert)
  • 157.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Rosuvastatin in dyslipidaemia and coronary heart disease2004Bok (Annet vitenskapelig)
  • 158.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Rosuvastatin in Dyslipidaemia and Coronary Heart Disease2003Annet (Annet (populærvitenskap, debatt, mm))
  • 159.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Statin therapy and reductions in low-density lipoprotein cholesterol: Initial clinical data on the potent new statin rosuvastatin2001Inngår i: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 87, nr 5 SUPPL. 1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The utility of statins with increased potency in reducing low-density lipoprotein cholesterol (LDL-C) is indicated by evidence that aggressive LDL-C lowering is associated with increased reduction in coronary artery disease risk, and the need for such agents is illustrated by the fact that many patients currently fail to achieve LDL-C target levels during treatment with available drugs. In dose-ranging studies of patients with hypercholesterolemia, the new synthetic statin rosuvastatin (formerly ZD4522) produced significant, dose-dependent reductions in LDL-C compared with placebo across a range of doses. Reductions ranged from 34% at 1 mg per day to 65% at 80 mg per day, with linear regression analysis indicating an additional 4.5% reduction in LDL-C with each doubling of the rosuvastatin dose. Rosuvastatin treatment was well tolerated. Phase 3 clinical trials of this agent are under way.

  • 160.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Statiner skall sättas in akut på sjukhus. Livsstilsrelaterade åtgärder vid kranskärlssjukdom får dock inte glömmas.2001Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 98, s. 2704-2706Artikkel i tidsskrift (Annet vitenskapelig)
  • 161.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MC - Medicincentrum, EMT-endo.
    Statins: how far have we come? A review of rosuvastatin.2003Inngår i: International journal of clinical practice (Esher), ISSN 1368-5031, E-ISSN 1742-1241, Vol. 137, s. 15-25Artikkel i tidsskrift (Fagfellevurdert)
  • 162.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    The importance of the emergence of statins toa lipidologist - clinician: a personal perspective2004Inngår i: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 5, s. 27-28Artikkel i tidsskrift (Fagfellevurdert)
  • 163.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    TNT-studien ger skjuts i debatten om högdos statiner2005Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, s. 18-19Artikkel i tidsskrift (Annet vitenskapelig)
  • 164.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MC - Medicincentrum, EMT-endo.
    Vilka målvärden ska vi ha för lipidsänkande behandling?2003Inngår i: Information från Läkemedelsverket, ISSN 1101-7104, Vol. 4, s. 37-42Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 165.
    Olsson, Anders
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Casciano, Roman
    USA.
    Stern, Lee
    USA.
    Svengren, Per
    Pfizer, Sverige.
    A pharmacoeconomic evaluation of aggressive cholesterol lowering in Sweden2004Inngår i: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 96, nr 1, s. 51-57Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To estimate the short-term healthcare costs and incremental cost per event avoided, associated with aggressive atorvastatin treatment in patients with acute coronary syndrome in Sweden. Methods: The total expected 16-week healthcare costs per patient on atorvastatin 80 mg per day and placebo were compared using clinical outcomes data from The Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) study and Swedish cost data sources. The incremental cost per event avoided was also assessed for. The clinical outcomes measured in this pharmacoeconomic analysis included: death, cardiac arrest, non-fatal myocardial infarction, fatal myocardial infarction, angina pectoris, non-fatal stroke, congestive heart failure, and surgical or percutaneous coronary revascularizations. All direct medical costs were taken into account. Results: The probability of the occurrence of an event was 40.4% per patient in the placebo cohort and 36.6% per patient in the atorvastatin cohort. The total expected cost per patient was SEK 17,887 (1950. 21€11 EUR=9.17231 SEK.) in the placebo group and SEK 18,465 (2013.06€) in the atorvastatin group, resulting in an incremental cost of SEK 578 (63.0137€) per patient. The cost per event avoided was SEK 15,076 (1643.64€). Sixty six percent of the cost of atorvastatin treatment was offset by the cost savings obtained through the reduction in the number of events in the atorvastatin group compared to the placebo group. Conclusions: In Sweden, the clinical benefits of aggressive short-term atorvastatin treatment administered within a few days after acute coronary syndrome is associated with a substantial hospitalization cost offset secondary to the clinical benefits of atorvastatin. © 2003 Elsevier Ireland Ltd. All rights reserved.

  • 166.
    Olsson, Anders
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Cherfan, P
    Blomqvist, Henrik
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin.
    Jonasson, Lena
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Serum adiponectin - its association with inflammation and statin treatment2005Inngår i: EAS Congress,2005, 2005Konferansepaper (Annet vitenskapelig)
  • 167.
    Olsson, Anders
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, EMK-endokrin.
    Eriksson, M
    Johnson, O
    Kjellström, T
    Lanke, J
    Lytken Larsen, M
    Pedersen, T
    Tikkanen, MJ
    Wiklund, O
    A 52-week, multicenter, randomized, parallel-group, double-blind, double-dummy study to assess the efficacy of atorvastatin and simvastatin in reaching low-density lipoprotein cholesterol and triglyceride targets: The Treat-to-Target (3T) Study2003Inngår i: Clinical Therapeutics, ISSN 0149-2918, E-ISSN 1879-114X, Vol. 25, nr 1, s. 119-138Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Guidelines for the prevention of coronary heart disease call for low-density lipoprotein cholesterol (LDL-C) reduction as the primary target of treatment and reduction of triglycerides (TG) as an additional target. Objective: The purpose of this study was to investigate the ability of atorvastatin and simvastatin to reduce LDL-C and TG concentrations and to meet 3 target lipid levels: LDL-C =2.6 mmol/L, TG =1.5 mmol/L, and both LDL-C =2.6 mmol/L and TG =1.5 mmol/L. Methods: The Treat-to-Target (3T) Study was a 52-week, multicenter, randomized, parallel-group study. Using the double-blind, double-dummy technique, adult patients aged 35 to 75 years with cardiovascular disease and dyslipidemia, defined as LDL-C concentration =4.0 mmol/L (=155 mg/dL), were randomized in a 1:1 ratio to receive once-daily oral treatment with 20 mg atorvastatin or 20 mg simvastatin. Fasting (12-hour) blood samples for the estimation of lipid levels and clinical laboratory values were collected after 4, 8, 12, 26, and 52 weeks. The dose was doubled after 12 weeks if the target National Cholesterol Education Program level of LDL-C (=2.6 mmol/L [100 mg/dL]) was not reached at 8 weeks. Results: The intent-to-treat analysis included 552 patients (418 men, 134 women) randomized to receive atorvastatin and 535 (404 men, 131 women) randomized to receive simvastatin. The number of patients enrolled in the study allowed the evaluation of the drugs' effects on YG. Patient demographic characteristics were similar for the 2 treatment groups, and there were no differences in baseline lipid values. Compared with simvastatin, atorvastatin produced significantly greater reductions in LDL-C (8 weeks: -46% vs -40%, P < 0.001, 52 weeks: -49% vs -44%, P < 0.001) and in YG (8 weeks: -23% vs -14%, P < 0.001, 52 weeks: -24% vs -16%, P < 0.001). Compared with simvastatin-treated patients, a significantly greater number of atorvastatin-treated patients reached the LDL-C target after 8 weeks (45% vs 24%, P < 0.001). Fewer atorvastatin patients needed to have their dose doubled, nevertheless more atorvastatin patients reached the LDL-C target after 52 weeks (61% vs 41%, P < 0.001). Both statins were well tolerated. Muscular symptoms occurred in 12 patients (2.2%) in the atorvastatin group and in 13 patients (2.4%) in the simvastatin group. Conclusions: Atorvastatin 20 or 40 mg/d for up to 1 year of treatment was significantly more effective than simvastatin 20 or 40 mg/d m reducing LDL-C and YG levels and at achieving recommended lipid targets in this selected patient population with cardiovascular disease and dyslipidemia. Both statins were well tolerated.

  • 168.
    Olsson, Anders
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, EMK-endokrin.
    Istad, Helge
    Luurila, Olavi
    Ose, Leiv
    Stender, Steen
    Tuomilehto, Jaakko
    Wiklund, Olov
    Southworth, Harry
    Pears, John
    Wilpshaar, J W
    Effects of rosuvastatin and atorvastatin compared over 52 weeks of treatment in patients with hypercholesterolemia2002Inngår i: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 144, nr 6, s. 1044-1051Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Despite the demonstrated benefits of low-density lipoprotein cholesterol (LDL-C) reduction in reducing the risk of coronary heart disease, many patients receiving lipid-lowering therapy fail to achieve LDL-C goals. We compared the effects of rosuvastatin and atorvastatin in reducing LDL-C and achieving LDL-C goals in patients with primary hypercholesterolemia. Methods and Results: In this 52-week, randomized, double-blind, multicenter trial (4522IL/0026), 412 patients with LDL-C 160 to <250 mg/dL received a 5-mg dose of rosuvastatin (n = 138), a 10-mg dose of rosuvastatin (n = 134), or a 10-mg dose of atorvastatin (n = 140) for 12 weeks, during the following 40 weeks, dosages could be sequentially doubled up to 80 mg if National Cholesterol Education Program Adult Treatment Panel II (ATP-II) LDL-C goals were not achieved. At 12 weeks, 5- and 10-mg doses of rosuvastatin were associated with significantly greater LDL-C reductions than 10-mg doses of atorvastatin (46% and 50% vs 39%, both P < .001). At 12 weeks, both rosuvastatin dosages brought more patients to within ATP-II and European LDL-C goals than atorvastatin (86% and 89% vs 73% and 75%, and 86% vs 55%, respectively). At 52 weeks, compared with atorvastatin, both initial rosuvastatin treatment groups significantly reduced LDL-C (47% and 53% vs 44%, P < .05 and P < .001). Overall, more patients in the initial rosuvastatin 10-mg group achieved their ATP-II LDL-C goal than those in the initial atorvastatin 10-mg group (98% vs 87%), with 82% of patients treated with rosuvastatin achieving their goal at the 10-mg starting dosage without the need for titration, compared with 59% of patients treated with atorvastatin. Both treatments were well tolerated over 52 weeks. Conclusion: Compared with atorvastatin, rosuvastatin produced greater reductions in LDL-C, which may offer advantages in LDL-C goal attainment over existing lipid-lowering therapies.

  • 169.
    Olsson, Anders
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Jardine, A
    Holdaas, H
    Fellström, B
    Cole, E
    Nyberg, G
    Grönhagen-Riska, C
    Madsen, S
    Neumayer, H-H
    Maes, B
    Fluvastatin prevents cardiac death and myocardial infarction in renal transplant recipients: Post-hoc subgroup analyses of the ALERT study2004Inngår i: American Journal of Transplantation, ISSN 1600-6135, E-ISSN 1600-6143, Vol. 4, nr 6, s. 988-995Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Renal transplant recipients have a greatly increased risk of premature cardiovascular disease. The ALERT study was a multicenter, randomized, double-blind, placebo-controlled trial of fluvastatin (40-80 mg/day) in 2102 renal transplant recipients followed for 5-6 years. The main study used a composite cardiac end-point including myocardial infarction, cardiac death and cardiac interventions. Although reduced by fluvastatin, this primary end-point failed to achieve statistical significance thus precluding analysis of predefined subgroups. Therefore, in the present survival analysis, we used an alternative primary end-point of cardiac death or definite nonfatal myocardial infarction (as used in other cardiac outcome trials) which was significantly reduced by Fluvastatin therapy and permits subgroup analysis. Fluvastatin reduced LDL-cholesterol by 1 mmol/L compared with placebo, and the incidence of cardiac death or definite myocardial infarction was reduced from 104 to 70 events (RR 0.65, 95% CI 0.48, 0.88, p = 0.005). Fluvastatin use was associated with reduction in cardiac death or nonfatal myocardial infarction, which achieved statistical significance in many subgroups. The subgroups included patients at lower cardiovascular risk, who were younger, nondiabetic, nonsmokers and without pre-existing CVD. These data support the early introduction of statins following renal transplantation.

  • 170.
    Olsson, Anders
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    McTaggart, F
    Raza, AG
    Rosuvastatin: A highly effective new HMG-CoA reductase inhibitor2002Inngår i: Cardiovascular Drug Reviews, ISSN 0897-5957, E-ISSN 1527-3466, Vol. 20, nr 4, s. 303-328Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Rosuvastatin, a new statin, has been shown to possess a number of advantageous pharmacological properties, including enhanced HMG-CoA reductase binding characteristics, relative hydrophilicity, and selective uptake into/activity in hepatic cells. Cytochrome P450 (CYP) metabolism of rosuvastatin appears to be minimal and is principally mediated by the 2C9 enzyme, with little involvement of 3A4, this finding is consistent with the absence of clinically significant pharmacokinetic drug-drug interactions between rosuvastatin and other drugs known to inhibit CYP enzymes. Dose-ranging studies in hypercholesterolemic patients demonstrated dose-dependent effects in reducing low-density lipoprotein cholesterol (LDL-C) (up to 63%), total cholesterol, and apolipoprotein (apo) B across a 1- to 40-mg dose range and a significant 8.4% additional reduction in LDL-C, compared with atorvastatin, across the dose ranges of the two agents. Rosuvastatin has also been shown to be highly effective in reducing LDL-C, increasing high-density lipoprotein cholesterol (HDL-C), and producing favorable modifications of other elements of the atherogenic lipid profile in a wide range of dyslipidemic patients. In patients with mild to moderate hypercholesterolemia, rosuvastatin has been shown to produce large decreases in LDL-C at starting doses, thus reducing the need for subsequent dose titration, and to allow greater percentages of patients to attain lipid goals, compared with available statins. The substantial LDL-C reductions and improvements in other lipid measures with rosuvastatin treatment should facilitate achievement of lipid goals and reduce the requirement for combination therapy in patients with severe hypercholesterolemia. In addition, rosuvastatin's effects in reducing triglycerides, tfiglyceride-containing lipoproteins, non-HDL-C, and LDL-C and increasing HDL-C in patients with mixed dyslipidemia or elevated triglycerides should be of considerable value in enabling achievement of LDL-C and non-HDL-C goals in the numerous patients with combined dyslipidemias or metabolic syndrome who require lipid-lowering therapy. Rosuvastatin is well tolerated alone, and in combination with fenofibrate, extended-release niacin, and cholestyramine, and has a safety profile similar to that of currently marketed statins. A large, long-term clinical trials program is under way to investigate the effects of rosuvastatin on atherosclerosis and cardiovascular morbidity and mortality.

  • 171.
    Olsson, Anders
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, EMK-endokrin.
    Packard, C
    Glasgow, Scotland.
    New global standards in lipid lowering: a review of emerging evidence and concepts.2002Inngår i: Int J Clin Practice,2002, 2002Konferansepaper (Fagfellevurdert)
  • 172.
    Olsson, Anders
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Pauciullo, P
    Soska, V
    Luley, C
    Pieters, RE
    Broda, G
    Palacios, B
    Comparison of the efficacy and tolerability of fluvastatin extended-release and immediate-release formulations in the treatment of primary hypercholesterolemia: A randomized trial2001Inngår i: Clinical Therapeutics, ISSN 0149-2918, E-ISSN 1879-114X, Vol. 23, nr 1, s. 45-61Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: A new extended-release (ER) formulation of fluvastatin 80 mg has been developed for once-daily treatment of primary hypercholesterolemia. Objective: The purpose of this study was to compare the lipid-lowering efficacy and tolerability of fluvastatin ER (80 mg once daily) versus fluvastatin immediate-release (IR) (40 mg once or twice daily). Methods: Following a 4-week placebo/dietary run-in period, patients with primary hypercholesterolemia type IIa or IIb (low-density lipoprotein cholesterol [LDL-C] =160 mg/dL and triglycerides [TG] =400 mg/dL) were randomized (2:1:1) to receive fluvastatin ER 80 mg once daily at bedtime (QPM), fluvastatin IR 40 mg QPM, or fluvastatin IR 40 mg BID for 24 weeks. Patients who had homozygous familial hypercholesterolemia, type I, III, IV, V, or secondary hyperlipoproteinemia, diabetes, or evidence of liver or renal impairment were excluded. At weeks 0, 2, 4, 8, 12, 16, 20, and 24 of the active-treatment period, levels of LDL-C, high-density lipoprotein cholesterol (HDL-C), TG, and total cholesterol (TC) were measured. Results: Of the 1183 patients enrolled, 695 were randomly assigned to treatment, 346 to fluvastatin ER 80 mg QPM, 174 to fluvastatin IR 40 mg QPM, and 175 to fluvastatin IR 40 mg BID. Patients were well matched between groups, with a mean age of-56 years and body mass index of 27 kg/m2, 56.0% of patients (389/695) were female and 97.7% (679/695) were white. Fluvastatin ER 80 mg QPM lowered LDL-C levels significantly more than did fluvastatin IR 40 mg QPM (33.7% vs 24.4%, P < 0.001) and as effectively as fluvastatin IR 40 mg BID (33.9%). More than half of the patients administered fluvastatin ER 80 mg QPM and IR 40 mg BID achieved reductions in LDL-C levels of =35%, more than half of those administered fluvastatin IR 40 mg QPM experienced reductions in LDL-C levels of =25%. The mean reductions in LDL:HDL ratio, TC, and apolipoprotein B levels in the fluvastatin ER 80 mg QPM group were significantly greater than the reductions in the IR 40 mg QPM group (P < 0.001). In patients with mixed dyslipidemia, fluvastatin ER 80 mg reduced triglycerides by 21.8% (median 28%) and increased HDL-C by 14.5%. Fluvastatin ER 80 mg QPM was well tolerated, with incidences of clinically notable elevations in alanine aminotransferase, aspartate aminotransferase, and creatine kinase levels and musculoskeletal adverse events comparable to those in the IR 40 mg QPM group. Conclusion: The ER 80-mg formulation of fluvastatin is effective and well tolerated as a once-daily starting and maintenance treatment for primary hypercholesterolemia.

  • 173.
    Olsson, Anders
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, EMK-endokrin.
    Schwartz, G G
    Jonasson, Lena
    Linderfalk, C
    Are early clinical effects of cholesterol lowering mediated through effects on inflammation?2002Inngår i: Acta Physiologica Scandinavica, ISSN 0001-6772, E-ISSN 1365-201X, Vol. 176, nr 2, s. 147-150Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In a randomized, double-blind trial in 3086 patients with unstable angina pectoris or non-Q wave myocardial infarction we investigated if 80 mg of atorvastatin daily could improve outcome of cardiovascular events during a short period of time (16 weeks) compared with placebo. Baseline LDL cholesterol was 3.2 mmol L-1 (124 mg dL-1) and decreased by 40% to 1.9 mmol L-1 (72 mg dL-1) during atorvastatin treatment. The primary endpoint, which was a composite of death, non-fatal acute myocardial infarction, cardiac arrest with resuscitation or recurrent symptomatic myocardial ischaemia with objective evidence and requiring emergency rehospitalization occurred in 228 patients (14.8%) in the atorvastatin group and 269 patients (17.4%) in the placebo group. The relative risk was 0.84 and 95% confidence interval was 0.70-1.00 (P = 0.048). Thus for patients with acute coronary syndromes, lipid-lowering therapy with high dose atorvastatin reduces recurrent ischaemic events in the short-term. A possible mechanism behind this rapid clinical effect induced by statin treatment is on inflammatory processes. Recent studies strongly suggest that acute T-cell activation is involved in the pathogenesis of unstable angina. In another study we investigated whether circulating T cells showed signs of activation in patients with stable angina pectoris (SA). Systemic venous blood samples were taken from 38 men with SA and 42 healthy controls. The T-cell receptor expression was assessed by three-colour flow cytometry using monoclonal antibodies against CD3, CD4, CD8, CD25 and human leucocyte antigen (HLA)-DR. Soluble interleukin-2 receptor (sIL-2R) was measured as the circulating form in serum. Levels of circulating CD3+ and CD4+ T cells tended to be higher in patients compared with controls. Patients were also shown to have a significant increase in CD4+ T cells expressing the activation markers CD25 (P < 0.05) and HLA-DR (P < 0.01). Furthermore, serum levels of sIL-2R were significantly higher (P < 0.001) in patients than in controls. We also observed that the T-cell response was more pronounced in patients without simvastatin treatment (n = 18) compared with simvastatin-treated patients (n = 20). In conclusion, our findings indicate that a continuous immune system activation takes place in patients with chronic angina pectoris, predominantly involving proliferation of CD4+ T cells. Statin treatment seems to be able to decrease this inflammatory response.

  • 174.
    Olsson, Anders
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Schwartz, G
    Szarek, M
    Sasiela, W
    Ezekowitz, M
    Ganz, P
    Oliver, M
    Waters, D
    Zeiher, A
    High-density lipoprotein, but not low-density lipoprotein cholesterol levels influence short-term prognosis after acute coronary syndrome: Results from the MIRACL trial2005Inngår i: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 26, nr 9, s. 890-896Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: Patients with acute coronary syndrome (ACS) in the Myocardial lschaemia Reduction with Aggressive Cholesterol Lowering (MIRACL) study had diminished cardiovascular events after 16 weeks of treatment of atorvastatin 80 mg daily. We determined whether plasma lipoproteins at baseline and then at 6 weeks after randomization predicted clinical outcome. Methods and results: Cox proportional hazards models were constructed to determine relations between lipoproteins and clinical endpoint events. Baseline LDL cholesterol (LDL-C) did not predict outcome. In contrast, baseline HDL-C predicted outcome with a hazard ratio of 0.986 per mg/dL increment in HDL-C, P < 0.001, indicating 1.4% reduction in risk for each 1 mg/dL increase in HDL-C. Atorvastatin treatment profoundly lowered LDL-C, but had minimal effect on HDL-C. Neither Week 6 LDL-C nor absolute change of LDL-C from baseline by Week 6 had any significant impact on clinical endpoints occurring between Week 6 and Week 16 after randomization. Conclusion Plasma HDL-C, but not LDL-C, measured in the initial stage of ACS predicts the risk of recurrent cardiovascular events over the ensuing 16 weeks. LDL-C reduction does not account for the clinical risk reduction with atorvastatin treatment after ACS. This finding may suggest that the clinical benefit of atorvastatin after ACS is mediated by qualitative changes in the LDL particle and/or by non-lipid (pleiotropic) effects of the drug.

  • 175.
    Olsson, Anders
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, EMK-endokrin.
    Schwartz, GG
    Early initiation of treatment with statins in acute coronary syndromes2002Inngår i: Annals of Medicine, ISSN 0785-3890, E-ISSN 1365-2060, Vol. 34, nr 1, s. 37-41Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Statins may act rapidly to reverse abnormalities of the arterial wall that may predispose to recurrent ischemic events after acute coronary syndromes. Such abnormalities are endothelial dysfunction, a local inflammatory response, and an exaggerated thrombogenic tendency. In one study almost 20 000 patients with first myocardial infarction were studied with regard to statin treatment (28%) or not. Baseline characteristics were adjusted using multivariate regression analysis including propensity analysis. One year mortality was 3.7/5.0% in statin/not statin groups, respectively, P = 0.001, relative risk 0.75. In another study of more than 20 000 patients, 18% were prescribed statin after an acute coronary syndrome and followed for six months. Propensity analysis was performed in this study as well. Deaths in statin/not statin groups were 1.7/3.5%, P < 0.0001, relative risk 0.48. In the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL), a double-blind randomized, placebo-controlled intervention study, 3086 patient with acute non-Q-wave coronary syndromes were allocated immediately in hospital to receive atorvastatin 80 mg daily or placebo for four months. No lower limit for plasma LDL cholesterol was used. Primary endpoint was time to first occurrence of death, non-fatal myocardial infarction, cardiac arrest, and worsening angina with objective evidence of ischemia. This was significantly reduced compared to the placebo group by 2.4% (14.8 versus 17.2%, relative risk 0.84, P = 0.048). Atorvastatin also reduced significantly fatal or non-fatal strokes. Possible mechanisms behind these acute beneficial effects are discussed. The studies highlight the importance of treatment with a statin in the early management of acute coronary syndromes and the need to incorporate this therapeutic strategy in national guidelines and treatment recommendations.

  • 176. Olsson, PO
    et al.
    Lindström, Torbjörn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, EMK-endokrin.
    Combination-therapy with bedtime NPH insulin and sulphonylureas gives similar glycaemic control but lower weight gain than insulin twice daily in patients with type 2 diabetes2002Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: To study the effect on body weight and glycaemic control of two insulin treatment regimens in patients with Type 2 diabetes and moderate failure to oral hypoglycaemic agents. Methods: Sixteen patients treated with oral hypoglycaemic agents (6 men and 10 women) were included in this open-label, randomized, parallel group study. Their age was 62 ▒ 2 (mean ▒ SEM) years (range 44-79 years), body weight 71.3 ▒ 2.9 kg, body mass index (BMI) 24.6 ▒ 0.8 kg/m2. The patients were switched to insulin treatment with bedtime NPH insulin combined with daytime sulphonylurea (combination group) or twice daily injections of a premixed combination of regular human and NPH insulin (insulin twice daily group) with measurements as given below before and after 12 and 24 weeks of treatment. Results: HbA1c was lowered from 8.3 ▒ 0.3% to 7.0 ▒ 0.2% in the insulin twice daily group (p < 0.05) and from 8.3 ▒ 0.3% to 6.8 ▒ 0.5% in the combination group (p < 0.03, ns between treatment groups). Body weight increased from 71.7 ▒ 4.0 kg to 77.6 ▒ 4.4 kg in the insulin twice daily group (p < 0.001) and from 70.8 ▒ 4.6 kg to 72.7 ▒ 5.1 kg in the combination group (ns, p < 0.02 between groups). The dose of insulin at 24 weeks in the insulin twice daily group was 45.8 ▒ 4.2 U and 29.4 ▒ 5.4 U in the combination group (p = 0.03). Combination treatment reduced fasting and stimulated C-peptide levels. Conclusions: Both treatments improved glycaemic control to the same extent but the combination of bedtime NPH insulin and daytime sulphonylurea gave a very small increase of body weight over a 6 months period. We conclude that combination therapy is an attractive alternative when starting insulin treatment in patients with Type 2 diabetes as this is a critical period for weight gain in such patients.

  • 177.
    Ottosson, Anna-.Maria
    Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Linköpings universitet, Hälsouniversitetet.
    NISOLDIPINE: Clinical, biochemical, pharmacokinetic and experimental studies1993Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Nisoldipine is a new calcium channel blocker of the I ,4-dihydropyridine type. It possesses more vasoselective properties than nifedipine. Twenty-nine patients with different types of hypertension (normal renin hypertension, low renin hypertension and low renin hypertension combined with hypercalcaemia) and ten healthy subjects were investigated concerning the immediate effects of nisoldipine. The hypertensive patients received treatment for up to two years. Treattnent with nisoldipine caused an immediate reduction in blood pressure (BP) with the lowest BP values occurring after 6 hours and without reflexogenic tachycardia. The BP-lowering effect was sustained after 2 years' treatment. There were no significant differences regarding these effects between the different hypertensive patient groups. No adverse metabolic effects were observed. An immediate natriuretic and diuretic effect was established but no long-term effects could be found regarding the urinary excretion of sodium and water. Plasma renin activity rose slightly I hour after ingestion of nisoldipine, and the plasma aldosterone concentration decreased after 2 hours, but no clinically relevant long-term effects were seen regarding the renin-angiotensin-aldosterone-system. A slight rise in plasma noradrenaline concentration was noticed after the first dose of nisoldipine but there were no long-term effects on catecholarnines.

    A new technique for the estimation of plasma concentrations of nisoldipine using a gas chromatograph - mass spectrometry method was developed. Plasma concentrations of nisoldipine rose rapidly after ingestion of 10 mg nisoldipine and peaked after a mean of I hour. A correlation was found between the plasma concentration of nisoldipine and the reduction in BP during steady-state conditions.

    Nisoldipine has a marked relaxing effect on both bovine and human vein preparations in vitro and at a considerably lower concentration than the two reference substances nifedipine and glyceryl trinitrate. It was necessary to use a much higher concentration of nisoldipine to achieve relaxation of bovine mesenteric arteries than corresponding veins. 45ca++ influx was reduced in both bovine and human arteries after preexposure to nisoldipine.

  • 178.
    Pålhagen, Sven
    et al.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Neurologi. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Geriatrik. Linköpings universitet, Hälsouniversitetet.
    Lorefält, Birgitta
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Geriatrik. Linköpings universitet, Institutionen för medicin och vård, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Carlsson, M.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Geriatrik. Linköpings universitet, Hälsouniversitetet.
    Ganowiak, Wojchiec
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Geriatrik. Linköpings universitet, Hälsouniversitetet.
    Toss, Göran
    Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Linköpings universitet, Hälsouniversitetet.
    Unosson, Mitra
    Linköpings universitet, Institutionen för medicin och vård, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Granerus, Ann-Kathrine
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Geriatrik. Linköpings universitet, Hälsouniversitetet.
    Does l-dopa treatment contribute to reduction in body weight in elderly patients with Parkinson's disease?2005Inngår i: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 111, nr 1, s. 12-20Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective –  Many patients with Parkinson's disease (PD) lose weight also early during the disease. The objective of the study was to investigate possible causative factors for this loss.

    Materials and methods –  In this report, 28 PD patients and 28 age- and sex-matched controls were repeatedly assessed with the focus on body weight, body fat mass, dysphagia, olfaction, physical activity, PD symptomatology and drug treatment.

    Results –  Weight loss was seen in PD patients both before and during l-dopa treatment.

    Conclusion –  The underlying disease could play a role, but our results also suggest that l-dopa per se could contribute to the weight loss.

  • 179.
    Ratziu, V
    et al.
    Université Pierre et Marie Curie.
    Bugianesi, E
    University of Torino.
    Dixon, J
    Alfred Hospital.
    Fassio, E
    Hospital Nacional Profesor Alejandro Posadas.
    Ekstedt, Mattias
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Gastroenterologi och hepatologi. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Charlotte, F
    Université Pierre et Marie Curie.
    Kechagias, Stergios
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Akutkliniken.
    Poynard, T
    Université Pierre et Marie Curie.
    Olsson, R
    Sahlgrenska University Hospital.
    Histological progress of non-alcoholic fatty liver disease: a critical reassessment based on liver sampling variability.2007Inngår i: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 26, s. 821-830Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

      Background: In non-alcoholic fatty liver disease, histological lesions display a significant sampling variability that is ignored when interpreting histological progression during natural history or therapeutic interventions. Aim: To provide a method taking into account sampling variability when interpreting crude histological data, and to investigate how this alters the conclusions of available studies. Methods: Natural history studies detailing histological progression and therapeutic trials were compared with the results of a previously published sampling variability study. Results: Natural history studies showed an improvement in steatosis, which was significantly higher than expected from sampling variability (47% vs. 8%, P < 0.0001). In contrast, no study showed a change in activity grade or ballooning higher than that of sampling variability. There was only a marginal effect on fibrosis with no convincing demonstration of a worsening of fibrosis, a conclusion contrary to what individual studies have claimed. Some insulin sensitizing drugs and anti-obesity surgery significantly improved steatosis, while most did not significantly impact on fibrosis or activity. Conclusions: Sampling variability of liver biopsy is an overlooked confounding factor that should be considered systematically when interpreting histological progression in patients with non-alcoholic fatty liver disease.

  • 180.
    Samuelsson, Kersti
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Rekonstruktionscentrum, Neurokirurgiska kliniken US.
    Larsson, H.
    Thyberg, Mikael
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Östergötlands Läns Landsting, Medicincentrum, Smärt- och rehabiliteringscentrum.
    Wheelchair intervention - a client centered approach.1999Inngår i: Technology and Disability, ISSN 1055-4181, Vol. 10, s. 123-127Artikkel i tidsskrift (Fagfellevurdert)
  • 181. Schwartz, GG
    et al.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, EMK-endokrin.
    Lipid lowering in acute coronary syndromes: New evidence, new questions2002Inngår i: Current Atherosclerosis Reports, ISSN 1523-3804, E-ISSN 1534-6242, Vol. 4Artikkel i tidsskrift (Fagfellevurdert)
  • 182. Schwartz, Gregory G
    et al.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    The case for intensive statin therapy after acute coronary syndromes2005Inngår i: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 96, nr 5 SUPPL.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Acute coronary syndromes (ACS) consist of unstable angina or acute myocardial infarction and are associated with a high risk of early recurrent ischemic events. Revascularization procedures do not modify underlying pathophysiology and only modestly reduce early ischemic events after an index episode of ACS. Although statins improve dyslipidemia and cardiovascular risk over the long term, efforts to identify new ACS treatments are focusing on the ability of statins to modify the arterial wall-blood interface and reduce the risk of early recurrent ischemic events. Statins have been shown to reduce circulating markers of inflammation within days of an acute ischemic event. Short-term statin therapy also has been associated with improved coronary endothelial function, reversal of prothrombotic states, and reduction in atherosclerotic plaque volume. Findings from 6 randomized, controlled intervention trials were evaluated to determine if risk reduction is associated with the intensity of statin therapy. In addition, the predictive ability of baseline lipid levels and inflammatory markers were examined. High-intensity statin therapy (atorvastatin 80 mg) reduced early recurrent ischemic events after ACS compared with moderate-intensity treatment (eg, pravastatin 40 mg) or placebo. Moderate-intensity regimens (simvastatin 40 mg, pravastatin 20 to 40 mg, fluvastatin 80 mg, cerivastatin 0.4 mg) provided minimal benefit compared with placebo. Although there was no apparent relation between low-density lipoprotein (LDL) cholesterol levels before or during randomized treatment and short-term (4-month) risk of recurrent events, the degree of LDL cholesterol reduction with statin treatment after ACS may be related to longer-term event reduction. Moreover, evidence suggests that anti-inflammatory effects of high-intensity statin treatment are associated with clinical benefit. © 2005 Elsevier Inc. All rights reserved.

  • 183. Schwartz, Gregory
    et al.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Ezekowitz, Michael
    Ganz, Peter
    Oliver, Michael
    Waters, David
    Zeither, Andreas
    Chaitman, Bernard
    Leslie, Sally
    Stern, Theresa
    Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes. The MIRACL study: A randomized controlled trial.2001Inngår i: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 285, s. 1711-1718Artikkel i tidsskrift (Fagfellevurdert)
  • 184.
    Sennfält, Karin
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle.
    Magnusson, Martin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Njurmedicinska kliniken US.
    Carlsson, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle.
    Comparison of hemodialysis and peritoneal dialysis - A cost-utility analysis2002Inngår i: Peritoneal Dialysis International, ISSN 0896-8608, E-ISSN 1718-4304, Vol. 22, nr 1, s. 39-47Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    ? Objective: Our aim was to compare both health-related quality of life and costs for hemodialysis (HD) and peritoneal dialysis (PD) in a defined population. ? Design: Decision-tree modeling to estimate total costs and effects for two treatment strategies, HD and PD, among patients with chronic kidney failure, for 5 years following the start of treatment. Courses of events and health-care consumption were mapped in a retrospective matched-record study. Data on health status were obtained from a matched population by a quality-of-life questionnaire (EuroQol). The study has a societal perspective. ? Setting: All dialysis departments in the southeastern health-care region of Sweden. ? Patients: 136 patients with kidney failure, comprising 68 matched pairs, were included in a retrospective record study, 81 patients with kidney failure, comprising 27 matched triplets, were included in a prospective questionnaire study. ? Main Outcome Measures: Cost per life year and cost per quality-adjusted life year. ? Results: The cost per quality-adjusted life year for PD was lower in all analyzed age groups. There was a 12% difference in the age group 21 - 40 years, a 31% difference in the age group 41 - 60 years, and an 11% difference in the age group 61+ years. Peritoneal dialysis and HD resulted in similar frequencies of transplantation (50% and 41%, respectively) and expected survival (3.58 years and 3.56 years, respectively) during the first 5 years after the initiation of treatment. ? Conclusion: The cost-utility ratio is most favorable for PD as the primary method of treatment for patients eligible for both PD and HD.

  • 185.
    Stenestrand, Ulf
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Ju lägre LDL-kolesterol destö bättre!2004Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, s. 3246-3247Artikkel i tidsskrift (Annet vitenskapelig)
  • 186.
    Strålfors, Peter
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Avdelningen för medicinsk cellbiologi.
    Nyström, Fredrik
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Insulinets verkningsmekanism och insulinresistens vid typ 2 diabetes2005Inngår i: Incitament, ISSN 1103-503X, nr 7, s. 536-538Artikkel i tidsskrift (Fagfellevurdert)
  • 187.
    Tengblad, Anders
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin.
    Länne, Toste
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Engvall, Jan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Lindström, Torbjörn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Mölstad, Sigvard
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin.
    Nyström, Fredrik
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Östgren, Carl-Johan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland.
    Sagittal abdominal diameter is strongly associated with Arterial stiffness and Left ventricular mass in patients with type 2 diabetes.2007Inngår i: EASD2,2007, 2007Konferansepaper (Annet vitenskapelig)
  • 188.
    Tingström, Pia
    Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Linköpings universitet, Hälsouniversitetet.
    Problem-based learning in the rehabilitation of patients with coronary artery disease2005Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Background and aims: A well-informed patient is a prerequisite for adherence to lifestyle changes and drug treatments, which improve prognosis of CAD. Problem-based learning (PBL) is in line with principles of adult learning. The aim was to develop and evaluate a PBL rehabilitation programme for coronary artery disease (CAD) patients.

    The PBL model: In the PBL programme, 6-9 patients and a tutor met ftrst at 9 (I), and after revision at 13 (III and IV) sessions during a one year period. Learning needs related to CAD, its treatment, psychosocial issues, and behavioural changes were focused upon.

    Subjects and methods: To validate the PBL programme, six tutors were interviewed, seven PBL groups were videotaped, and 44 other patients answered a questionnaire (I). To evaluate the validity of the MTI/CSA activity monitor, as a means of measuring physical activity intensity, 34 patients walked on a treadmill at three different speeds. Indirect calorimetry was used to determine energy expenditure (EE) (11). In order to evaluate the effects of the PBL programme (III and IV), 207 patients (55% of all eligible), were randomised to the PBL programme (n=104) or to a control group (n=103). All patients received standard therapy. Physical activity was measured by interview and by the activity monitor, and quality of life by the Ladder of Life, Self-rated Health, Cardiac Health Profile, and SF-36. All measurements were performed before randomisation and at the end of the programme.

    Results: The PBL-model could be incorporated into the clinical routine with a high participation rate. Initial problems with the tutor role and the structured problem-solving process in the group-work were revealed, which led to revision of the model. PBL stimulated participants to search actively for knowledge, while remaining to fmd demands adequate and being positive about the education. According to self-reports, lifestyle changes had been performed (I). The MTI/CSA activity monitor was a valid tool for quantifying both amount and intensity of physical activity during walking (II). The PBL programme did not affect physical activity. No increase in activity was found in any of the groups over the one year period Activity, as measured by the activity monitor, was lower than recommended in guidelines for secondary prevention (III). On the contrary, self-reports indicated higher and adequate physical activity. The PBL programme seemed to have positive effects on quality of life, as measured by global instruments. No effects were found on health-related or disease specific aspects of quality of life (IV).

    Conclusion: The PBL programme was feasible to run in clinical practice. Education of tutors was crucial and required time. The programme stimulated participants to become active learners. The PBL model had no effects on physical activity, but some effects on global quality of life. Physical activity remained unchanged and low in both groups, as measured by the activity monitor, which was a useful and reliable tool, while self-reports seemed to overestimate performed physical activity. Quality of life improved in both groups over the year. More data are needed to evaluate the usefulness of the PBL-model.

    Delarbeid
    1. Validation and feasibility of problem-based learning in rehabilitation of patients with coronary artery disease
    Åpne denne publikasjonen i ny fane eller vindu >>Validation and feasibility of problem-based learning in rehabilitation of patients with coronary artery disease
    2002 (engelsk)Inngår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 47, nr 4, s. 337-345Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    A patient education programme applying problem-based learning (PBL) was developed for patients with coronary artery disease (CAD). Groups with 6–8 patients and a tutor from the rehabilitation team met nine times for 1.5 h each. The feasibility and validity of the model was evaluated using patient questionnaires, interviews with tutors and video observations of tutorials. The participants were active (69% of all input) and discussions of acquired knowledge and lifestyle changes took place in all groups. A total of 89% of the patients reported implementation of lifestyle changes and over 90% rated their learning and overall experience of the programme as acceptable or high and the demands as acceptable. Shortcomings were the limited use of some of the steps in the problem-solving process and tutors’ difficulties in adapting to their new role; their answering of questions was higher than planned (35% of their total input). The programme was feasible in clinical routine.

    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-26807 (URN)10.1016/S0738-3991(02)00007-1 (DOI)11416 (Lokal ID)11416 (Arkivnummer)11416 (OAI)
    Tilgjengelig fra: 2009-10-08 Laget: 2009-10-08 Sist oppdatert: 2017-12-13bibliografisk kontrollert
    2. The validity of the Computer Science and Applications activity monitor for use in coronary artery disease patients during level walking
    Åpne denne publikasjonen i ny fane eller vindu >>The validity of the Computer Science and Applications activity monitor for use in coronary artery disease patients during level walking
    Vise andre…
    2002 (engelsk)Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 22, nr 4, s. 248-253Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    The principal aim of the present study was to examine the validity of the Computer Science and Applications (CSA) activity monitor during level walking in coronary artery disease (CAD) patients. As a secondary aim, we evaluated the usefulness of two previously published energy expenditure (EE) prediction equations. Thirty-four subjects (29 men and five women), all with diagnosed CAD, volunteered to participate. Oxygen uptake (VO2) was measured by indirect calorimetry during walking on a motorized treadmill at three different speeds (3·2, 4·8 and 6·4 km h−1). Physical activity was measured simultaneously using the CSA activity monitor, secured directly to the skin on the lower back (i.e. lumbar vertebrae 4–5) with an elastic belt. The mean (±SD) activity counts were 1208 ± 429, 3258 ± 753 and 5351 ± 876 counts min−1, at the three speeds, respectively (P<0·001). Activity counts were significantly correlated to speed (r=0·92; P<0·001), VO2 (ml kg−1 min−1; r=0·87; P<0·001) and EE (kcal min−1; r=0·85, P<0·001). A stepwise linear regression analysis showed that activity counts and body weight together explained 75% of the variation in EE. Predicted EE from previously published equations differed significantly when used in this group of CAD patients. In conclusion, the CSA activity monitor is a valid instrument for assessing the intensity of physical activity during treadmill walking in CAD patients. Energy expenditure can be predicted from body weight and activity counts.

    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-24803 (URN)10.1046/j.1475-097X.2002.00426.x (DOI)7070 (Lokal ID)7070 (Arkivnummer)7070 (OAI)
    Tilgjengelig fra: 2009-10-07 Laget: 2009-10-07 Sist oppdatert: 2017-12-13bibliografisk kontrollert
    3. Effects of a problem-based learning rehabilitation program on physical activity in patients with coronary artery disease
    Åpne denne publikasjonen i ny fane eller vindu >>Effects of a problem-based learning rehabilitation program on physical activity in patients with coronary artery disease
    2006 (engelsk)Inngår i: Journal of Cardiopulmonary Rehabilitation (JCR), ISSN 0883-9212, E-ISSN 1539-0691, Vol. 26, nr 1, s. 32-38Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    PURPOSE: To evaluate the effects of a problem-based learning (PBL) rehabilitation program on physical activity.

    METHODS: We randomized 207 consecutive patients younger than 70 years, with a recent event of coronary artery disease (CAD), to a PBL group (n = 104) or a control group (n = 103). In addition to standard treatment, the PBL patients participated in a 1-year program with 13 sessions in small groups, where learning needs and behavior change were focused upon. Physical activity was assessed by means of interviews with all patients and by an activity monitor in 69 patients at pretest and in 175 after 1 year.

    RESULTS: Only small differences between groups were found at posttest. Interview data revealed significantly less activity at low-intensity level in the control group, whereas the activity monitor showed no significant differences. No changes were found in total physical activity during the year within the 2 groups. The self-reported physical activity indicating a level of brisk walking was markedly higher than that measured by the activity monitor, the latter indicating that only 35% of the patients achieved a 10-minute period of continued physical activity per day on an adequate level.

    CONCLUSIONS: Our PBL program had no important impact on the physical activity pattern of patients with CAD. The activity monitor is a feasible way of measuring physical activity in these patients, indicating a lower level of physical activity than interview data.

    Emneord
    Cardiac rehabilitation, Coronary artery disease, Physical activity, Problem-based learning
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-50323 (URN)10.1097/00008483-200601000-00007 (DOI)
    Tilgjengelig fra: 2009-10-11 Laget: 2009-10-11 Sist oppdatert: 2017-12-12bibliografisk kontrollert
    4. Effects of a problem-based learning rehabilitation programme on quality of life in patients with coronary artery disease
    Åpne denne publikasjonen i ny fane eller vindu >>Effects of a problem-based learning rehabilitation programme on quality of life in patients with coronary artery disease
    2005 (engelsk)Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 4, nr 4, s. 324-330Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background: The aim of cardiac rehabilitation (CR) is not only physical improvement but also increased quality of life (QoL). A CR programme based upon problem based learning (PBL) philosophy was developed, to achieve and apply new knowledge related to coronary artery disease (CAD). The aim of this paper was to evaluate the impact of the PBL programme on QoL.

    Methods: 207 consecutive patients < 70 years of age with a recent event of CAD were randomised to a PBL group (n = 104) or a control group (n = 103). In addition to standard treatment, the PBL patients participated in 13 group sessions during 1 year, where individual learning needs and behavioural changes were focused upon. QoL was measured by the Ladder of Life, Self-Rated Health (SRH), SF 36, and Cardiac Health Profile (CHP).

    Results: Significant differences between the groups, favouring the PBL patients, were found by global instruments: more optimistic expectations of the future QoL and a better general condition. No differences were found by SRH, SF 36 or subscales of CHP, but QoL increased in both groups during the year.

    Conclusions: The main outcome was that QoL improved in both groups with some effects favouring the PBL programme.

    Emneord
    Coronary artery disease, Cardiac rehabilitation, Problem-based learning, Quality of life
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-31058 (URN)10.1016/j.ejcnurse.2005.04.008 (DOI)16778 (Lokal ID)16778 (Arkivnummer)16778 (OAI)
    Tilgjengelig fra: 2009-10-09 Laget: 2009-10-09 Sist oppdatert: 2017-12-13bibliografisk kontrollert
  • 189.
    Tingström, Pia
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Linköpings universitet, Hälsouniversitetet.
    Ekelund, U.
    Department of Physical Education and Health, Örebro University, Örebro, Sweden and MRC Epidemiology Unit, Cambridge, United Kingdom.
    Kamwendo, Kitty
    Department of Caring Sciences, Örebro University, Örebro, Sweden.
    Bergdahl, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet.
    Effects of a problem-based learning rehabilitation program on physical activity in patients with coronary artery disease2006Inngår i: Journal of Cardiopulmonary Rehabilitation (JCR), ISSN 0883-9212, E-ISSN 1539-0691, Vol. 26, nr 1, s. 32-38Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To evaluate the effects of a problem-based learning (PBL) rehabilitation program on physical activity.

    METHODS: We randomized 207 consecutive patients younger than 70 years, with a recent event of coronary artery disease (CAD), to a PBL group (n = 104) or a control group (n = 103). In addition to standard treatment, the PBL patients participated in a 1-year program with 13 sessions in small groups, where learning needs and behavior change were focused upon. Physical activity was assessed by means of interviews with all patients and by an activity monitor in 69 patients at pretest and in 175 after 1 year.

    RESULTS: Only small differences between groups were found at posttest. Interview data revealed significantly less activity at low-intensity level in the control group, whereas the activity monitor showed no significant differences. No changes were found in total physical activity during the year within the 2 groups. The self-reported physical activity indicating a level of brisk walking was markedly higher than that measured by the activity monitor, the latter indicating that only 35% of the patients achieved a 10-minute period of continued physical activity per day on an adequate level.

    CONCLUSIONS: Our PBL program had no important impact on the physical activity pattern of patients with CAD. The activity monitor is a feasible way of measuring physical activity in these patients, indicating a lower level of physical activity than interview data.

  • 190.
    Tingström, Pia
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Linköpings universitet, Hälsouniversitetet.
    Kamwendo, Kitty
    Department of Caring Sciences, Örebro University, Örebro, Sweden.
    Bergdahl, Björn
    Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Linköpings universitet, Hälsouniversitetet.
    Effects of a problem-based learning rehabilitation programme on quality of life in patients with coronary artery disease2005Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 4, nr 4, s. 324-330Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The aim of cardiac rehabilitation (CR) is not only physical improvement but also increased quality of life (QoL). A CR programme based upon problem based learning (PBL) philosophy was developed, to achieve and apply new knowledge related to coronary artery disease (CAD). The aim of this paper was to evaluate the impact of the PBL programme on QoL.

    Methods: 207 consecutive patients < 70 years of age with a recent event of CAD were randomised to a PBL group (n = 104) or a control group (n = 103). In addition to standard treatment, the PBL patients participated in 13 group sessions during 1 year, where individual learning needs and behavioural changes were focused upon. QoL was measured by the Ladder of Life, Self-Rated Health (SRH), SF 36, and Cardiac Health Profile (CHP).

    Results: Significant differences between the groups, favouring the PBL patients, were found by global instruments: more optimistic expectations of the future QoL and a better general condition. No differences were found by SRH, SF 36 or subscales of CHP, but QoL increased in both groups during the year.

    Conclusions: The main outcome was that QoL improved in both groups with some effects favouring the PBL programme.

  • 191. Tsimikas, S
    et al.
    Witztum, JL
    Miller, ER
    Sasiela, WJ
    Szarek, M
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Schwartz, GG
    High-dose atorvastatin reduces total plasma levels of oxidized phospholipids and immune complexes present on apolipoprotein B-100 in patients with acute coronary syndromes in the MIRACL trial2004Inngår i: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 110, nr 11, s. 1406-1412Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background-Oxidized phospholipids (OxPL) are present within atherosclerotic plaques and bound by lipoprotein (a) [Lp(a)] in plasma. This study evaluated the impact of atorvastatin on oxidized LDL (OxLDL) in patients with acute coronary syndromes (ACS). Methods and Results-OxLDL-E06 (OxPL content on apolipoprotein B-100 [apoB] detected by antibody E06), apoB-100 immune complexes (apoB-IC), OxLDL autoantibodies, and Lp(a) levels were measured in 2341 patients at baseline and after 16 weeks of treatment with atorvastatin 80 mg/d or placebo. The OxLDL-E06 and apoB-IC data are reported per apoB-100 particle (OxPL/apoB, IC/apoB) and as total levels on all apoB-100 particles (total apoB-OxPL and total apoB-IC [eg, OxPL/apoB or IC/apoBXapoB-100 levels]). Compared with baseline values, atorvastatin reduced apoB-100 (-33%), total apoB-OxPL (-29.7%), total apoB-IC IgG (-29.5%), and IgM (-25.7%) (P<0.0001 for all), whereas no change or an increase was observed with placebo. When normalized per apoB-100, compared with placebo, atorvastatin increased OxPL/apoB (9.5% versus -3.9%, P<0.0001) and Lp(a) (8.8% versus -0.7%, (P<0.0001). A strong correlation was noted between OxPL/apoB and Lp(a) (R=0.85, P<0.0001), consistent with previous data that Lp(a) binds OxPL. Conclusions-After atorvastatin treatment, total OxPL on all apoB-100 particles was decreased. However, there was enrichment of OxPL on a smaller pool of apoB-100 particles, in parallel with similar increases in Lp(a), suggesting binding by Lp(a). These data support the hypothesis that atorvastatin promotes mobilization and clearance of proinflammatory OxPL, which may contribute to a reduction in ischemic events after ACS.

  • 192.
    Tysk, Curt
    Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Linköpings universitet, Hälsouniversitetet.
    Epidemiology and genetics in ulcerative colitis with special reference to twins and smoking1991Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    In an epidemiologic study of ulcerative proctocolitis during the period 1963-1987, annual incidence rates increased fourfold and was during the last 10 years 13.1/105 inhabitants. The prevalence on December 31, 1987 was 234/105 inhabitants. Both rates are high but close to recent reports. No second peak in older age groups and no cohot t at higher risk for the disease was found. The male:female ratio was 1,59:1, and the highest incidence rate was seen in 20-40 year old men, who to a higher extent than women were ex-smokers. The distribution of affected male and female cases has changed during the last 60 years. A review of 56studies from 1930-1990 revealed that the earlier female predominance now has been replaced by a male predominance. The age at diagnosis increased 7 years by the end of the study period. With respect to the sex-distribution and the age at diagnosis, a hypothesis is proposed that an environmental factor, viz smoking, has caused this changing pattern.

    The genetic influence was analysed in a study of 36 twin pairs with ulcerative colitis, of which 16 pairs were monozygotic. The proband concordance rate among monozygotic twins was 6.3%, and the heritability of liability 0.53. No concordant pair was found among the dizygotic twins. A comparison indicated that the genetic influence was less significant inulcerative colitis than in Crohn's disease. Earlier reported twin pairs with ulcerative colitis probably overestimated concordance rates due to selection bias.

    Abnormal colonic glycoproteins have earlier been reported in ulcerative colitis. Colonic glycoproteins were analysed in the monozygotic twins according to the method described by Podolsky et al. Similar alterations in glycoprotein composition were found in both the twins with ulcerative colitis and in their healthy twin siblings, indicating that changes in colonicglycoproteins probably are genetically defined, precede the onset of colitis and are not a secondary consequence of inflammation.

    A case-control study of smoking habits at the time of diagnosis was performed among 260 cases and 455 matched population controls to evaluate the association between smoking and ulcerative colitis. Compared to lifetime non-smokers, a reduced risk of acquiring ulcerative colitis was seen among smokers (relative risk 0.6) which seemed to be dose dependant. Exsmokers had an increased risk, which was especially increased in former heavy smokers (relative risk 4.4).

    A study of primary sclerosing cholangitis in ulcerative colitis showed a prevalence of 3.7%. Male excess and extensive to total colitis was found in the cases complicated with cholangitis, which in most cases was asymptomatic and had a non-progressive course.

    As 15 of the 16 monozygotic twin pairs were discordant for ulcerative colitis, the combination of identical genotype, shared environment in childhood and adolescence, similar levels of colonic glycoproteins and similar smoking habits is apparently not sufficient to cause manifest colitis and additional factors are needed.

  • 193.
    Valdimarsson, T
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Gastroenterologi och hepatologi. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, GE: gastromed.
    Toss, Göran
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Löfman, O
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Ström, Magnus
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Gastroenterologi och hepatologi. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, GE: gastromed.
    Three years' follow-up of bone density in adult coeliac disease: Significance of secondary hyperparathyroidism2000Inngår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 35, nr 3, s. 274-280Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The mechanisms of disturbances in bone mineral density (BMD) in coeliac disease are not completely understood. The aim of this prospective study was to investigate the possible significance of secondary hyperparathyroidism (SHPT) with regard to BMD in patients with untreated coeliac disease. Methods: One hundred and five adult patients with untreated coeliac disease were examined for BMD and serum parathyroid hormone (PTH) concentration. BMD in the hip, lumbar spine, and forearm were examined up to 3 years after the introduction of a gluten-free diet. Results: SHPT was found in 27% (28 of 105) of the patients. In patients with SHPT serum levels of 25- hydroxy-vitamin D were lower and those of alkaline phosphatase higher than in patients with normal PTH, but ionized serum calcium did not differ between the two groups. BMD was more severely reduced in patients with SHPT. Although the BMD increment was more rapid in patients with than in those without SPTH, only in the latter group did mean BMD became normal after 1-3 years on a gluten-free diet (GFD). After 3 years on a GFD more than half of the patients with initial SHPT still had low BMD in both the hip and the forearm. Furthermore, in patients with SHPT the intestinal mucosa more often remained atrophic at the 1-year follow-up, despite good compliance with the diet. Conclusions: Low BMD in patients with untreated coeliac disease is often associated with SHPT. After 3 years on a GFD the BMD remains low only in patients with initial SHPT. We therefore suggest that PTH should be measured when the diagnosis of coeliac disease is made, as an indicator of more serious intestinal disorder and complicating bone disease.

  • 194.
    Valdimarsson, Trausti
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Gastroenterologi och hepatologi. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, GE: gastromed.
    Arnqvist, Hans
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Cellbiologi.
    Toss, Göran
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Järnerot, G
    IHM Gastroenterologi och hepatologi.
    Nyström, Fredrik
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC-2, GE: endomed.
    Ström, Magnus
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Gastroenterologi och hepatologi. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, GE: gastromed.
    Low circulating insulin-like growth factor I in coeliac disease and its relation to bone mineral density.1999Inngår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 34, nr 9, s. 904-908Artikkel i tidsskrift (Fagfellevurdert)
  • 195.
    Vrethem, Magnus
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Boivie, Jörgen
    Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Arnqvist, Hans
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Cellbiologi.
    Holmgren, Helen
    Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Lindström, Torbjörn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, EMK-endokrin.
    Painful polyneuropathy in patients with and without diabetes: Clinical, neurophysiologic, and quantitative sensory characteristics2002Inngår i: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 18, nr 2, s. 122-127Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To study pain characteristics and peripheral nerve involvement in patients with painful diabetic and nondiabetic polyneuropathy in comparison with patients with nonpainful polyneuropathy. Patients and Methods: Fifty-five patients with polyneuropathy (37 with painful polyneuropathy, of whom 19 had diabetes and 18 had no diabetes, and 18 with painless polyneuropathy of different etiologies) were examined clinically using quantitative sensory tests and neurophysiology. Pain intensity and characteristics were analyzed by daily ratings on a 10-step verbal scale and by a questionnaire. Results: Most patients experienced pain of more than one character. There was no clear difference in character or duration of pain between patients with and without diabetes. The mean value of the daily rating of pain intensity showed that pain was more severe in the evenings than in the mornings and that diabetic patients reported worse pain than nondiabetic patients. Thirty-two of the 37 patients with pain had paresthesias and/or dysesthesias, whereas only 7 of 18 patients without pain had paresthesias. Pain was always located in the feet, and, in most patients, also in the lower part of the legs. Some patients also experienced pain in the hands. Tactile sensibility, measured by quantitative tests, was more affected in both diabetic and nondiabetic patients with painful polyneuropathy compared with patients without pain (p = 0.02). Temperature, pain, and vibratory sensibility were equally affected in all patient groups. Nerve conduction velocity, amplitudes, and distal latency were equally affected in the pain group as compared with the control group, indicating that both thin and thick nerve afferents are affected in patients with painful as well as nonpainful polyneuropathy and that etiology has no clear impact on nerve involvement. Conclusions: Neuropathy pain was always located in the feet and more severe in diabetic patients compared with patients with neuropathy pain of other etiologies. The authors also found evidence for a greater tactile sensibility involvement in patients with neuropathy pain, irrespective of etiology, whereas other quantitative sensibility and neurography parameters were equally affected in all patient groups.

  • 196.
    Wallby, Lars
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Falldiskuttion (Idrottshjärtat och screening - svenska riktlinjer och hur gör vi?)2007Inngår i: IX Svenska Kardiovaskulära vårmötet,2007, 2007Konferansepaper (Annet vitenskapelig)
  • 197. Wallin, Anders
    et al.
    Jennersjö, Cecilia
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Akutkliniken.
    Granérus, Ann-Kathrine
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Geriatrik. Östergötlands Läns Landsting, MC - Medicincentrum, Geriatrik-LAH.
    Prevalence of dementia and regional brain syndromes in long-standing Parkinson´s disease.1999Inngår i: Parkinsonism & Related Disorders, ISSN 1353-8020, E-ISSN 1873-5126, Vol. 5, s. 103-110Artikkel i tidsskrift (Fagfellevurdert)
  • 198. Waters, DD
    et al.
    Schwartz, GG
    Olsson, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, EMK-endokrin.
    Zeiher, A
    Oliver, MF
    Ganz, P
    Ezekowitz, M
    Chaitman, BR
    Leslie, SJ
    Stern, T
    Effects of atorvastatin on stroke in patients with unstable angina or non-Q-wave myocardial infarction: A myocardial ischemia reduction with aggressive cholesterol lowering (MIRACL) substudy2002Inngår i: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 106, nr 13, s. 1690-1695Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background - This report describes the effect of intensive cholesterol lowering with atorvastatin on the incidence of nonfatal stroke, a secondary end point, in a randomized, placebo-controlled trial of patients with unstable angina or non-Q-wave myocardial infarction. The primary end point, a composite of death, nonfatal myocardial infarction, resuscitated cardiac arrest, or recurrent symptomatic myocardial ischemia with objective evidence requiring emergency rehospitalization, was reduced from 17.4% in the placebo group to 14.8% in the atorvastatin group over the 16 weeks of the trial (P=0.048). Methods and Results - Strokes were adjudicated by a blinded end-point committee using standard clinical and imaging criteria. The outcomes of nonfatal stroke and fatal plus nonfatal stroke were analyzed by time to first occurrence during the 16-week trial. Of 38 events (in 36 patients) adjudicated as fatal or nonfatal strokes, 3 were classified as hemorrhagic, one as embolic, and 29 as thrombotic or embolic, 5 could not be categorized. Nonfatal stroke occurred in 9 patients in the atorvastatin group and 22 in the placebo group (relative risk, 0.40, 95% confidence intervals, 0.19 to 0.88, P=0.02). Fatal or nonfatal stroke occurred in 12 atorvastatin patients and 24 placebo patients (relative risk, 0.49, 95% confidence intervals, 0.24 to 0.98, P=0.04). All 3 hemorrhagic strokes occurred in the placebo group. Conclusion - Intensive cholesterol lowering with atorvastatin over 16 weeks in patients with acute coronary syndromes reduced the overall stroke rate by half and did not cause hemorrhagic stroke. These findings need to be confirmed in future trials.

  • 199.
    Whiss, Per A
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Farmakologi.
    Larsson, Rutger
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Njurmedicinska kliniken US.
    Adenosine 5' -Diphosphate-induced platelet aggregation in uremia shows resistance til inhibition by the novel nitric oxide donor GEA 31 75 but not by S-Nitro-N-acetylpenicillamine.1999Inngår i: Haemostasis, ISSN 0301-0147, E-ISSN 1423-0038, Vol. 28, s. 260-267Artikkel i tidsskrift (Fagfellevurdert)
  • 200.
    Whiss, Per A
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Farmakologi.
    Lundahl, Tom
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Klinisk kemi.
    Bengtsson, Torbjörn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Medicinsk mikrobiologi.
    Lunell, Erik
    Larsson, Rutger
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Internmedicin. Östergötlands Läns Landsting, Medicincentrum, Njurmedicinska kliniken US.
    Effekter av nikotin på trombocyter vid normal och nedsatt njurfunktion2001Inngår i: Vårdfacket, ISSN 0347-0911, Vol. 163, s. 63-63Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
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