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  • 151.
    Bousquet, J.
    et al.
    University Hospital Montpellier, France MACVIA LR, France ARIA, France European Academic Allergy and Clin Immunol, France European Innovat Partnership Act and Health Ageing, France European Innovat Partnership Act and Health Ageing, France University of Montpellier I, France .
    Addis, A.
    European Innovat Partnership Act and Health Ageing, France European Innovat Partnership Act and Health Ageing, Italy .
    Adcock, I.
    University of London Imperial Coll Science Technology and Med, England Royal Brompton and Harefield NIHR Biomed Research Unit, England .
    Agache, I.
    ARIA, France Romanian Alliance Chron Resp Disease, Romania Transylvania University, Romania .
    Agusti, A.
    University of Barcelona, Spain CIBER Enfermedades Resp, Spain .
    Alonso, A.
    Hospital Clin Barcelona, Spain .
    Annesi-Maesano, I.
    ARIA, France .
    M. Anto, J.
    University of Pompeu Fabra, Spain .
    Bachert, C.
    ARIA, France Ghent University Hospital, Belgium Ghent University Hospital, Belgium .
    E. Baena-Cagnani, C.
    ARIA, France Catholic University, Argentina .
    Bai, C.
    Chinese Medical Assoc, Peoples R China .
    Baigenzhin, A.
    EuroAsian Resp Soc, Kazakhstan .
    Barbara, C.
    European Innovat Partnership Act and Health Ageing, France Portuguese National Programme Resp Disease, Portugal .
    Barnes, P.J.
    University of London Imperial Coll Science Technology and Med, England Royal Brompton and Harefield NIHR Biomed Research Unit, England .
    Bateman, E.D.
    ARIA, France University of Cape Town, South Africa .
    Beck, L.
    Health Innovat Centre Southern Denmark, Denmark .
    Bedbrook, A.
    MACVIA LR, France ARIA, France .
    Bel, E.H.
    University of Amsterdam, Netherlands .
    Benezet, O.
    MACVIA LR, France .
    Bennoor, K.S.
    ARIA, France Bangladesh Lung Fdn, Bangladesh National Institute Disease Chest and Hospital, Bangladesh .
    Benson, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Bernabeu-Wittel, M.
    European Innovat Partnership Act and Hlthy Ageing, Spain Andalusian Healthcare Serv, Spain .
    Bewick, M.
    NHS England, England .
    Bindslev-Jensen, C.
    ARIA, France Odense University Hospital, Denmark Odense University Hospital, Denmark .
    Blain, H.
    University Hospital Montpellier, France MACVIA LR, France University of Montpellier I, France .
    Blasi, F.
    University of Milan, Italy .
    Bonini, M.
    ARIA, France University of Roma La Sapienza, Italy .
    Bonini, S.
    ARIA, France University of Naples 2, Italy Italian National Research Council, Italy .
    Boulet, L.P.
    ARIA, France University of Laval, Canada .
    Bourdin, A.
    University Hospital Montpellier, France MACVIA LR, France University of Montpellier I, France INSERM, France .
    Bourret, R.
    University Hospital Montpellier, France MACVIA LR, France .
    Bousquet, P.J.
    ARIA, France .
    Brightling, C.E.
    Glenfield Hospital, England .
    Briggs, A.
    University of Glasgow, Scotland .
    Brozek, J.
    ARIA, France McMaster University, Canada McMaster University, Canada .
    Buh, R.
    Mainz University Hospital, Germany .
    Bush, A.
    ARIA, France University of London Imperial Coll Science Technology and Med, England University of London Imperial Coll Science Technology and Med, England .
    Caimmi, D.
    University Hospital Montpellier, France MACVIA LR, France .
    Calderon, M.
    University of Costa Rica, Costa Rica University of London Imperial Coll Science Technology and Med, England .
    Calverley, P.
    University of Liverpool, England Aintree University Hospital NHS Fdn Trust, England .
    Camargos, P.A.
    ARIA, France University of Federal Minas Gerais, Brazil .
    Camuzat, T.
    MACVIA LR, France .
    Canonica, G.W.
    ARIA, France University of Genoa, Italy .
    Carlsen, K.H.
    ARIA, France University of Oslo, Norway Oslo University Hospital, Norway .
    Casale, T.B.
    ARIA, France .
    Cazzola, M.
    University of Roma Tor Vergata, Italy .
    Cepeda Sarabia, A.M.
    ARIA, France University of Simon Bolivar, Colombia Soc Latinoamer Allergia Asma and Immunol, Italy .
    Cesario, A.
    IRCCS San Raffaele Pisana, Italy .
    Chen, Y.Z.
    Peking and Centre Asthma Research and Educ, Peoples R China .
    Chkhartishvili, E.
    Grigol Robakidze University, Rep of Georgia .
    Chavannes, N.
    ARIA, France Int Primary Care Resp Grp, Netherlands Leiden University, Netherlands .
    Chiron, R.
    University Hospital Montpellier, France MACVIA LR, France .
    Chuchalin, A.
    ARIA, France WHO, Russia Pulmonol Research Institute, Russia Russian Resp Soc, Russia .
    Chung, K.F.
    University of London Imperial Coll Science Technology and Med, England Royal Brompton and Harefield NIHR Biomed Research Unit, England .
    Cox, L.
    ARIA, France Nova SE University, FL USA .
    Crooks, G.
    NHS Scotland, Scotland .
    G. Crooks, M.
    Hull York Medical Sch, England .
    A. Cruz, A.
    ARIA, France WHO, Russia University of Federal Bahia, Brazil CNPq, Brazil .
    Custovic, A.
    ARIA, France European Academic Allergy and Clin Immunol, France University of Manchester, England .
    Dahl, R.
    ARIA, France Odense University Hospital, Denmark Odense University Hospital, Denmark .
    E. Dahlen, S.
    Karolinska Institute, Sweden .
    De Blay, F.
    ARIA, France Soc Francaise Allergol, France Strasbourg University, France .
    Dedeu, T.
    European Regional and Health Author, Belgium .
    Deleanu, D.
    ARIA, France University of Medical and Pharm Iuliu Hatieganu, Romania .
    Demoly, P.
    University Hospital Montpellier, France MACVIA LR, France ARIA, France European Academic Allergy and Clin Immunol, France European Innovat Partnership Act and Health Ageing, France University of Montpellier I, France .
    Devillier, P.
    ARIA, France University of Versailles St Quentin, France .
    Didier, A.
    Soc Pneumol Langue Francaise, France University of Toulouse, France .
    T. Dinh-Xuan, A.
    Paris Descartes University, France .
    Djukanovic, R.
    University of Southampton, England NIHR, England .
    Dokic, D.
    ARIA, France University of Ss Cyril and Methodius, Macedonia .
    Douagui, H.
    ARIA, France Centre Hospital University of Beni Messous, Algeria .
    Dubakiene, R.
    ARIA, France Lithuanian Soc Allergol and Clin Immunol, Lithuania Vilnius State University, Lithuania .
    Eglin, S.
    University of Liverpool, England .
    Elliot, F.
    NHS Scotland, Scotland .
    Emuzyte, R.
    ARIA, France Lithuanian Soc Allergol and Clin Immunol, Lithuania Vilnius State University, Lithuania .
    Fabbri, L.
    University of Modena and Reggio Emilia, Italy .
    Fink Wagner, A.
    Global Allergy and Asthma Patient Platform, Austria .
    Fletcher, M.
    WHO, Russia Educ Heatlh, England .
    Fokkens, W.J.
    ARIA, France University of Amsterdam, Netherlands European Rhinol Soc, Portugal .
    Fonseca, J.
    ARIA, France Portuguese National Programme Resp Disease, Portugal Porto Age Up Consortium, Portugal University of Porto, Portugal University of Porto, Portugal Institute and Hospital CUF Porto, Portugal .
    Franco, A.
    University of Nice Sophia Antipolis, France .
    Frith, P.
    Repatriat Gen Hospital, Australia .
    Furber, A.
    Wakefield Council, England .
    Gaga, M.
    Athens Chest Hospital, Greece Athens Chest Hospital, Greece .
    Garces, J.
    European Innovat Partnership Act and Health Ageing, Spain University of Valencia, Spain .
    Garcia-Aymerich, J.
    University of Pompeu Fabra, Spain .
    Gamkrelidze, A.
    ARIA, France National Centre Disease Control and Public Health Georgia, Rep of Georgia .
    Gonzales-Diaz, S.
    ARIA, France Soc Latinoamer Allergia Asma and Immunol, Italy .
    Gouzi, F.
    University Hospital Montpellier, France INSERM, France .
    A. Guzman, M.
    ARIA, France University of Chile, Chile .
    Haahtela, T.
    ARIA, France Helsinki University Hospital, Finland .
    Harrison, D.
    Public Health Blackburn Darwen, England .
    Hayot, M.
    University Hospital Montpellier, France MACVIA LR, France University of Montpellier I, France .
    G. Heaney, L.
    Queens University of Belfast, North Ireland .
    Heinrich, J.
    MeDALL, Mechanisms of the Development of Allergy.
    Hellings, P. W.
    ARIA, France European Academic Allergy and Clin Immunol, France University Hospital Leuven, Belgium .
    Hooper, J.
    Public Health Kirklees, England .
    Humbert, M.
    Soc Pneumol Langue Francaise, France .
    Hyland, M.
    University of Plymouth, England .
    Iaccarino, G.
    University of Salerno, Italy IRCCS Multimed, Italy .
    Jakovenko, D.
    MACVIA LR, France .
    R. Jardim, J.
    University of Federal Sao Paulo, Brazil .
    Jeandel, C.
    University Hospital Montpellier, France MACVIA LR, France University of Montpellier I, France .
    Jenkins, C.
    George Institute Global Heatlh, Australia University of Sydney, Australia .
    L. Johnston, S.
    ARIA, France University of London Imperial Coll Science Technology and Med, England .
    Jonquet, O.
    University Hospital Montpellier, France MACVIA LR, France University of Montpellier I, France .
    Joos, G.
    Ghent University Hospital, Belgium .
    S. Jung, K.
    Hallym University, South Korea .
    Kalayci, O.
    ARIA, France European Academic Allergy and Clin Immunol, France Hacettepe University, Turkey .
    Karunanithi, S.
    Director of Public Health, Lancashire, UK.
    Keil, T.
    Charite, Germany University of Wurzburg, Germany .
    Khaltaev, N.
    ARIA, France WHO, Russia .
    Kolek, V.
    Czech Alliance Against Chron Resp Disease, Poland .
    L. Kowalski, M.
    Medical University of Lodz, Poland .
    Kull, I.
    Karolinska Institute, Sweden .
    Kuna, P.
    ARIA, France European Innovat Partnership Act and Health Ageing, France WHO, Russia Medical University of Lodz, Poland .
    Kvedariene, V.
    ARIA, France European Academic Allergy and Clin Immunol, France Lithuanian Soc Allergol and Clin Immunol, Lithuania Vilnius State University, Lithuania .
    T. Le, L.
    ARIA, France WHO, Russia University of Medical and Pharm, Vietnam .
    C. Lodrup Carlsen, K.
    ARIA, France University of Oslo, Norway Oslo University Hospital, Norway .
    Louis, R.
    University of Liege, Belgium .
    MacNee, W.
    University of Edinburgh, Scotland .
    Mair, A.
    Scottish Govt, Scotland .
    Majer, I.
    University of Bratislava, Slovakia .
    Manning, P.
    Bon Secours Hospital, Ireland .
    de Manuel Keenoy, E.
    European Innovat Partnership Act and Health Ageing, France Kronikgune, Spain .
    R. Masjedi, M.
    Shahid Beheshti University of Medical Science, Iran .
    Meten, E.
    ARIA, France Karolinska Institute, Sweden .
    Melo-Gomes, E.
    European Innovat Partnership Act and Health Ageing, France Portuguese National Programme Resp Disease, Portugal .
    Menzies-Gow, A.
    Royal Brompton Hospital, England .
    Mercier, G.
    University Hospital Montpellier, France MACVIA LR, France University of Montpellier I, France .
    Mercier, J.
    University Hospital Montpellier, France MACVIA LR, France European Innovat Partnership Act and Health Ageing, France University of Montpellier I, France .
    P. Michel, J.
    Geneva School Med, Switzerland University Hospital Geneva, Switzerland .
    Miculinic, N.
    University Hospital Pulm Disease, Croatia .
    Mihaltan, F.
    ARIA, France Institute Pneumol Marius Nasta, Romania .
    Milenkovic, B.
    University of Belgrade, Serbia COPD Serbia, Serbia .
    Molimard, M.
    Bordeaux University, France .
    Mamas, I.
    Paris Descartes University, France Paris Municipal, France .
    Montilla-Santana, A.
    European Innovat Partnership Act and Hlthy Ageing, Spain .
    Morais-Almeida, M.
    Hospital CUF Descobertas, Portugal .
    Morgan, M.
    NHS England, England .
    NDiaye, M.
    Hop Polyclin Dakar IHS, Senegal .
    Nafti, S.
    ARIA, France Mustapha Hospital, Algeria .
    Nekam, K.
    ARIA, France Hospital Hospital Bros Buda, Hungary .
    Neou, A.
    Charite, Germany .
    Nicod, L.
    CHUV Lausanne, Switzerland .
    OHehir, R.
    ARIA, France Alfred Hospital, Australia Monash University, Australia .
    Ohta, K.
    ARIA, France Tokyo National Hospital, Japan Teikyo University, Japan .
    Paggiaro, P.
    University Hospital Pisa, Italy .
    Palkonen, S.
    ARIA, France .
    Palmer, S.
    University of York, England .
    Papadopoulos, N. G.
    ARIA, France European Academic Allergy and Clin Immunol, France University of Manchester, England University of Athens, Greece .
    Papi, A.
    University of Ferrara, Italy .
    Passalacqua, G.
    ARIA, France University of Genoa, Italy .
    Pavord, I.
    University of Oxford, England .
    Pigearias, B.
    SPLF, Espace francophone de Pneumologie.
    Plavec, D.
    University of JJ Strossmayer, Croatia .
    Postma, D. S.
    University of Groningen, Netherlands .
    Price, D.
    ARIA, France Int Primary Care Resp Grp, Netherlands University of Aberdeen, Scotland .
    Rabe, K. F.
    University of Kiel, Germany .
    Radier Pontal, F.
    MACVIA LR, France .
    Redon, J.
    European Innovat Partnership Act and Health Ageing, France University of Valencia, Spain .
    Rennard, S.
    University of Nebraska Medical Centre, NE USA .
    Roberts, J.
    Salford Royal NHS Fdn Trust, England .
    Robine, J. M.
    MACVIA LR, France INSERM, France .
    Roca, J.
    University of Barcelona, Spain CIBER Enfermedades Resp, Spain .
    Roche, N.
    University of Paris 05, France Soc Pneumol Langue Francaise, France .
    Rodenas, F.
    European Innovat Partnership Act and Health Ageing, Spain University of Valencia, Spain .
    Roggeri, A.
    Arcispedale S Maria Nuova Hospital, Italy .
    Rolland, C.
    Assoc Asthme and Allergies, France .
    Rosado-Pinto, J.
    ARIA, France European Innovat Partnership Act and Health Ageing, France Portuguese National Programme Resp Disease, Portugal WHO, Russia .
    Ryan, D.
    ARIA, France Int Primary Care Resp Grp, Netherlands Woodbrook Medical Centre, England University of Edinburgh, Scotland .
    Samolinski, B.
    European Innovat Partnership Act and Health Ageing, France Medical University of Lodz, Poland Medical University of Warsaw, Poland .
    Sanchez-Borges, M.
    Centre Medical Docente La Trinidad, Venezuela .
    Schunemann, H. J.
    McMaster University, Canada McMaster University, Canada .
    Sheikh, A.
    University of Edinburgh, Scotland Harvard University, MA 02115 USA .
    Shields, M.
    Queens University of Belfast, North Ireland Royal Belfast Hospital Sick Children, North Ireland .
    Siafakas, N.
    University Hospital Heraklion, Greece .
    Sibille, Y.
    Catholic University of Louvain, Belgium .
    Similowski, T.
    University of Paris 06, France INSERM, France Grp Hospital Pitie Salpetriere Charles Foix, France Fonds Dotat Rech Sante Resp Fdn Souffle, France .
    Small, I.
    National Advisory Group, Respiratory Managed Clinical Networks in Scotland.
    Sola-Morales, O.
    Health Institute Technology Transfer, Spain .
    Sooronbaev, T.
    ARIA, France WHO, Russia EuroAsian Resp Soc, Kyrgyzstan National Centre Cardiol and Internal Med, Kyrgyzstan .
    Stelmach, R.
    University of Sao Paulo, Brazil .
    Sterk, P. J.
    University of Amsterdam, Netherlands .
    Stiris, T.
    University of Oslo, Norway .
    Sud, P.
    Regional Medical Manager (North), NHS England, UK.
    Tellier, V.
    Observatoire wallon de la santé, Direction générale opérationnelle Pouvoirs locaux, action sociale et Santé, Service public de Wallonie, Belgium .
    To, T.
    WHO, Russia .
    Todo-Bom, A.
    Coimbra University Hospital, Portugal .
    Triggiani, M.
    University of Salerno, Italy .
    Valenta, R.
    ARIA, France Medical University of Vienna, Austria .
    Valero, A. L.
    University of Barcelona, Spain CIBER Enfermedades Resp, Spain .
    Valiulis, A.
    ARIA, France Lithuanian Soc Allergol and Clin Immunol, Lithuania Vilnius State University, Lithuania .
    Valovirta, E.
    University of Turku, Finland .
    Van Ganse, E.
    CHU Lyon, France CHU Lyon, France University of Lyon 1, France .
    Vandenplas, O.
    ARIA, France INSERM, France .
    Vasankari, T.
    FILHA, Finnish Lung Association.
    Vestbo, J.
    University of Manchester, England Odense University Hospital, Denmark .
    Vezzani, G.
    Arcispedale S Maria Nuova IRCCS, Italy .
    Viegi, G.
    CNR, Italy CNR, Italy Clin Physiol IFC, Italy .
    Visier, L.
    University Hospital Montpellier, France MACVIA LR, France University of Montpellier I, France .
    Vogelmeier, C.
    University of Marburg, Germany .
    Vontetsianos, T.
    Sotiria Hospital, Greece .
    Wagstaff, R.
    Cumbria County Council, PA USA .
    Wahn, U.
    Charite, Germany .
    Wallaert, B.
    Soc Francaise Allergol, France CHRU, France .
    Whalley, B.
    University of Plymouth, England .
    Wickman, M.
    ARIA, France Karolinska Institute, Sweden .
    M. Williams, D.
    University of N Carolina, NC USA .
    Wilson, N.
    North England EU Health Partnership, Belgium .
    Yawn, B. P.
    ARIA, France Olmsted Medical Centre, MN USA University of Minnesota, MN USA .
    Yiallouros, P.K.
    ARIA, France Cyprus University of Technology, Cyprus .
    Yorgancioglu, A.
    ARIA, France .
    Yusuf, O. M.
    WHO, Russia Allergy and Asthma Institute, Pakistan .
    Zar, H. J.
    University of Cape Town, South Africa .
    Zhong, N.
    Guangzhou Medical University, Peoples R China Guangzhou Medical University, Peoples R China .
    Zidarn, M.
    ARIA, France University of Clin Resp and Allerg Disease, Slovenia .
    Zuberbier, T.
    Charite, Germany .
    Integrated care pathways for airway diseases (AIRWAYS-ICPs)2014Ingår i: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 44, nr 2, s. 304-323Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1) proposing a common framework of care pathways for chronic respiratory diseases, which will facilitate comparability and trans-national initiatives; 2) informing cost-effective policy development, strengthening in particular those on smoking and environmental exposure; 3) aiding risk stratification in chronic disease patients, using a common strategy; 4) having a significant impact on the health of citizens in the short term (reduction of morbidity, improvement of education in children and of work in adults) and in the long-term (healthy ageing); 5) proposing a common simulation tool to assist physicians; and 6) ultimately reducing the healthcare burden (emergency visits, avoidable hospitalisations, disability and costs) while improving quality of life. In the longer term, the incidence of disease may be reduced by innovative prevention strategies. AIRWAYS-ICPs was initiated by Area 5 of the Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing. All stakeholders are involved (health and social care, patients, and policy makers).

  • 152.
    Bousquet, J.
    et al.
    CHRU, France; MACVIA LR, France; INSERM, France; University of Versailles St Quentin En Yvelines, France.
    Farrell, J.
    Department Health Social Serv and Public Safety, North Ireland.
    Crooks, G.
    Scottish Centre Telehealth and Telecare, Scotland.
    Hellings, P.
    Katholieke University of Leuven, Belgium; European Academic Allergy and Clin Immunol, Switzerland.
    Bel, E. H.
    University of Amsterdam, Netherlands; European Resp Soc, Switzerland.
    Bewick, M.
    iQ4U Consultants Ltd, England.
    Chavannes, N. H.
    Leiden University, Netherlands; Global Alliance Chron Resp Disease GARD, South Africa; Int Primary Care Resp Grp, Scotland.
    Correia de Sousa, J.
    University of Minho, Portugal.
    Cruz, A. A.
    Global Alliance Chron Resp Disease GARD, South Africa; University of Federal Bahia, Brazil; GARD Execut Comm, Brazil.
    Haahtela, T.
    EIP AHA Commitment Act, Portugal; Helsinki University Hospital, Finland.
    Joos, G.
    Ghent University Hospital, Belgium.
    Khaltaev, N.
    Global Alliance Chron Resp Disease GARD, South Africa.
    Malva, J.
    University of Coimbra, Portugal; Ageing Coimbra Reference Site, Portugal.
    Muraro, A.
    European Academic Allergy and Clin Immunol, Switzerland; Padua Gen University Hospital, Italy.
    Nogues, M.
    CARSAT LR, France.
    Palkonen, S.
    EFA European Federat Allergy and Airways Disease Patien, Belgium.
    Pedersen, S.
    University of Southern Denmark, Denmark.
    Robalo-Cordeiro, C.
    Coimbra University Hospital, Portugal.
    Samolinski, B.
    Medical University of Warsaw, Poland.
    Strandberg, T.
    University of Helsinki, Finland; University of Oulu, Finland; EUGMS, Norway.
    Valiulis, A.
    Vilnius University, Lithuania; European Assoc Pediat EAP UEMS SP, Belgium.
    Yorgancioglu, A.
    Global Alliance Chron Resp Disease GARD, South Africa; EIP AHA Commitment Act, Portugal; Celal Bayar University, Turkey; Turkish Thorac Soc, Turkey.
    Zuberbier, T.
    Charite, Germany; GA2LEN, Germany.
    Bedbrook, A.
    MACVIA LR, France.
    Aberer, W.
    Medical University of Graz, Austria.
    Adachi, M.
    Sanno Hospital, Japan.
    Agusti, A.
    University of Barcelona, Spain; CIBER Enfermedades Resp, Spain.
    Akdis, C. A.
    University of Zurich, Switzerland.
    Akdis, M.
    University of Zurich, Switzerland.
    Ankri, J.
    INSERM, France; University of Versailles St Quentin En Yvelines, France.
    Alonso, A.
    University of Barcelona, Spain; CIBER Enfermedades Resp, Spain.
    Annesi-Maesano, I.
    European Assoc Pediat EAP UEMS SP, Belgium; INSERM, France.
    Ansotegui, I. J.
    Hospital Quiron Bizkaia, Spain.
    Anto, J. M.
    Centre Research Environm Epidemiol CREAL, Spain; Hospital del Mar, Spain; CIBERESP, Spain; UPF, Spain.
    Arnavielhe, S.
    Digi Heatlh, France.
    Arshad, H.
    David Hide Asthma and Allergy Research Centre, England.
    Bai, C.
    Chinese Medical Assoc, Peoples R China; Chinese Alliance Lung Canc, Peoples R China.
    Baiardini, I.
    University of Genoa, Italy.
    Bachert, C.
    Ghent University Hospital, Belgium.
    Baigenzhin, A. K.
    EuroAsian Resp Soc, Kazakhstan.
    Barbara, C.
    Fac Medical Lisbon, Portugal.
    Bateman, E. D.
    University of Cape Town, South Africa.
    Beghe, B.
    University of Modena and Reggio Emilia, Italy.
    Ben Kheder, A.
    Hop Abderrahman Mami, Tunisia.
    Bennoor, K. S.
    National Institute Disease Chest and Hospital, Bangladesh.
    Benson, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Allergicentrum US.
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    Charite, Germany; GA2LEN, Germany.
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    Rheinische Friedrich Wilhelms University of Bonn, Germany.
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    Odense University Hospital, Denmark; Odense University Hospital, Denmark.
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    University Hospital, Sweden.
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    Montpellier University Hospital, France; University of Montpellier, France.
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    University of Verona Hospital, Italy.
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    Sapienza University of Rome, Italy.
    Bonini, S.
    University of Naples 2, Italy; Italian National Research Council, Italy.
    Bosnic-Anticevitch, S.
    University of Sydney, Australia; Sydney Local Health Dist, Australia.
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    University of Laval, Canada.
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    Montpellier University Hospital, France.
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    INSERM, France.
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    University of Glasgow, Scotland.
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    University Hospital Leicester NHS Trust, England; University of Leicester, England.
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    McMaster University, Canada.
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    Johannes Gutenberg University of Mainz, Germany.
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    Imperial Coll, England; Imperial Coll, England; Imperial Coll, England.
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    Imperial Coll, England; Royal Brompton Hospital, England.
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    Centre Medical Docente Trinidad, Venezuela.
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    Montpellier University Hospital, France.
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    Royal Brompton Hospital NHS, England.
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    University of Liverpool, England; Aintree University Hospital NHS Fdn Trust, England.
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    University of Federal Minas Gerais, Brazil.
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    University of Genoa, Italy.
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    Regional Languedoc Roussillon, France.
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    Oslo University Hospital, Norway; University of Oslo, Norway; Oslo University Hospital, Norway; University of Oslo, Norway.
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    Allergy and Asthma Associates Southern Calif, CA USA.
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    Regional Minist Equal Health and Social Policies Andalusia, Spain.
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    University of S Florida, FL USA.
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    University of Simon Bolivar, Colombia; Soc Latinoamer Allergia, Colombia.
    Chatzi, L.
    University of Crete, Greece.
    Chen, Y. Z.
    Peking and Centre Asthma Research and Educ, Peoples R China; Peking and Centre Asthma Research and Educ, Peoples R China.
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    Montpellier University Hospital, France.
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    Grigol Robakidze University, Rep of Georgia.
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    GARD Execut Comm, Brazil; FMBA, Russia.
    Chung, K. F.
    Imperial Coll, England.
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    IRCCS Azienda Osped University of San Martino, Italy.
    Cirule, I.
    Latvian Allergy Assoc, Latvia.
    Cox, L.
    Nova Southeastern University, FL USA.
    Costa, D. J.
    MACVIA LR, France; Leiden University, Netherlands.
    Custovic, A.
    Imperial Coll London, England.
    Dahl, R.
    Odense University Hospital, Denmark; Odense University Hospital, Denmark.
    Dahlen, S. E.
    Karolinska Institute, Sweden.
    Darsow, U.
    Technical University of Munich, Germany; Technical University of Munich, Germany.
    De Carlo, G.
    EFA European Federat Allergy and Airways Disease Patien, Belgium.
    De Blay, F.
    University Hospital Strasbourg, France.
    Dedeu, T.
    European Regional and Local Health Assoc, Belgium; University of Edinburgh, Scotland.
    Deleanu, D.
    Iuliu Hatieganu University of Medical and Pharm, Romania.
    De Manuel Keenoy, E.
    Kronikgune, Spain.
    Demoly, P.
    INSERM, France; Montpellier University Hospital, France.
    Denburg, J. A.
    McMaster University, Canada.
    Devillier, P.
    Suresnes University of Versailles St Quentin, France.
    Didier, A.
    Rangueil Larrey Hospital, France.
    Dinh-Xuan, A. T.
    University of Paris 05, France.
    Djukanovic, R.
    University of Southampton, England.
    Dokic, D.
    University of Clin Pulmol and Allergy, Macedonia.
    Douagui, H.
    Centre Hospital University of Beni Messous, Algeria.
    Dray, G.
    Ecole Mines, France.
    Dubakiene, R.
    Vilnius University, Lithuania.
    Durham, S. R.
    Imperial Coll London, England.
    Dykewicz, M. S.
    St Louis University, MO USA.
    El-Gamal, Y.
    Ain Shams University, Egypt.
    Emuzyte, R.
    Vilnius University, Lithuania.
    Fabbri, L. M.
    University of Modena, Italy.
    Fletcher, M.
    Educ Heatlh, England.
    Fiocchi, A.
    Bambino Gesu Childrens Research Hospital Holy See, Italy.
    Fink Wagner, A.
    GAAPP, Austria.
    Fonseca, J.
    University of Porto, Portugal; CUF Porto Institute and Hospital, Portugal.
    Fokkens, W. J.
    Academic Medical Centre, Netherlands.
    Forastiere, F.
    Regional Health Serv Lazio Reg, Italy.
    Frith, P.
    Repatriat Gen Hospital, Australia.
    Gaga, M.
    Athens Chest Hospital, Greece.
    Gamkrelidze, A.
    National Centre Disease Control and Public Health Georgia, Rep of Georgia.
    Garces, J.
    University of Valencia, Spain.
    Garcia-Aymerich, J.
    Centre Research Environm Epidemiol CREAL, Spain; Hospital del Mar, Spain; CIBERESP, Spain; UPF, Spain.
    Gemicioglu, B.
    Istanbul University, Turkey.
    Gereda, J. E.
    Clin Ricardo Palma, Peru.
    Gonzalez Diaz, S.
    University of Autonoma Nuevo Leon, Mexico.
    Gotua, M.
    Georgian Assoc Allergol and Clin Immunol, Rep of Georgia.
    Grisle, I.
    Latvian Assoc Allergists, Latvia.
    Grouse, L.
    Washington University, MO 63110 USA.
    Gutter, Z.
    University Hospital Olomouc, Czech Republic.
    Guzman, M. A.
    University of Chile, Chile.
    Heaney, L. G.
    Queens University of Belfast, North Ireland.
    Hellquist-Dahl, B.
    Odense University Hospital, Denmark.
    Henderson, D.
    Scottish Centre Telehealth and Telecare, Scotland.
    Hendry, A.
    NHS Scotland, Scotland.
    Heinrich, J.
    Helmholtz Zentrum Munchen, Germany.
    Heve, D.
    MACVIA LR, France; Agence Regional Sante, France.
    Horak, F.
    Vienna Challenge Chamber, Austria.
    Hourihane, J. O. B.
    University of Coll Cork, Ireland.
    Howarth, P.
    University of Southampton, England.
    Humbert, M.
    University of Paris Sud, France.
    Hyland, M. E.
    University of Plymouth, England.
    Illario, M.
    Federico II University Hospital Campania RS, Italy.
    Ivancevich, J. C.
    Clin Santa Isabel, Argentina.
    Jardim, J. R.
    University of Federal Sao Paulo, Brazil.
    Jares, E. J.
    Libra Fdn, Argentina.
    Jeandel, C.
    MACVIA LR, France; Montpellier University Hospital, France.
    Jenkins, C.
    University of Sydney, Australia.
    Johnston, S. L.
    Imperial Coll, England; MRC and Asthma UK Centre Allerg Mech Asthma, England.
    Jonquet, O.
    Montpellier University Hospital, France.
    Julge, K.
    Tartu University Hospital, Estonia.
    Jung, K. S.
    Hallym University, South Korea.
    Just, J.
    Hop Enfants Armand Trousseau, France; Sorbonne University, France.
    Kaidashev, I.
    Ukrainian Medical Stomatol Acad, Ukraine.
    Kaitov, M. R.
    Federal Medicobiol Agency, Russia.
    Kalayci, O.
    Hacettepe University, Turkey.
    Kalyoncu, A. F.
    Hacettepe University, Turkey.
    Keil, T.
    Charite, Germany; University of Wurzburg, Germany.
    Keith, P. K.
    McMaster University, Canada.
    Klimek, L.
    Centre Rhinol and Allergol, Germany.
    Koffi NGoran, B.
    Soc Pneumol Langue Francaise, France.
    Kolek, V.
    University Hospital Olomouc, Czech Republic.
    Koppelman, G. H.
    University of Groningen, Netherlands.
    Kowalski, M. L.
    Medical University of Lodz, Poland; HARC, Poland.
    Kull, I.
    Sachs Childrens Hospital, Sweden; Karolinska Institute, Sweden.
    Kuna, P.
    Medical University of Lodz, Poland.
    Kvedariene, V.
    Vilnius University, Lithuania.
    Lambrecht, B.
    University of Ghent, Belgium.
    Lau, S.
    Charite, Germany.
    Larenas-Linnemann, D.
    Hospital Medical Sur, Mexico.
    Laune, D.
    Digi Heatlh, France.
    Le, L. T. T.
    University of Medical and Pharm, Vietnam.
    Lieberman, P.
    University of Tennessee, TN USA; University of Tennessee, TN USA; University of Tennessee, TN USA; University of Tennessee, TN USA.
    Lipworth, B.
    University of Dundee, Scotland.
    Li, J.
    Guangzhou Medical University, Peoples R China.
    Lodrup Carlsen, K.
    Oslo University Hospital, Norway; University of Oslo, Norway; Oslo University Hospital, Norway; University of Oslo, Norway.
    Louis, R.
    CHU Sart Tilman, Belgium.
    MacNee, W.
    University of Edinburgh, Scotland.
    Magard, Y.
    Hop St Joseph, France.
    Magnan, A.
    University of Nantes, France; University of Nantes, France.
    Mahboub, B.
    Rashid Hospital, U Arab Emirates.
    Mair, A.
    Scottish Govt Health Department, Scotland.
    Majer, I.
    University of Bratislava, Slovakia.
    Makela, M. J.
    Helsinki University Hospital, Finland.
    Manning, P.
    Bon Secours Hospital, Ireland.
    Mara, S.
    AOU Citta Salute and Science Torino, Italy.
    Marshall, G. D.
    University of Mississippi, MS 39216 USA.
    Masjedi, M. R.
    Shahid Beheshti University of Medical Science, Iran.
    Matignon, P.
    VingCard Elsafe, Norway.
    Maurer, M.
    Charite, Germany.
    Mavale-Manuel, S.
    Maputo Central Hospital, Mozambique.
    Melen, E.
    Karolinska Institute, Sweden.
    Melo-Gomes, E.
    PNDR Portuguese National Programme Resp Disease, Portugal.
    Meltzer, E. O.
    Allergy and Asthma Medical Grp and Research Centre, CA USA.
    Menzies-Gow, A.
    Royal Brompton Hospital, England.
    Merk, H.
    Rhein Westfal TH Aachen, Germany.
    Michel, J. P.
    EUGMS, Norway.
    Miculinic, N.
    Croatian Pulm Soc, Croatia.
    Mihaltan, F.
    National Institute Pneumol M Nasta, Romania.
    Milenkovic, B.
    University of Belgrade, Serbia; Serbian Assoc Asthma, Serbia; COPD, Serbia.
    Mohammad, G. M. Y.
    Tishreen University, Syria.
    Molimard, M.
    University of Bordeaux, France.
    Momas, I.
    Paris Descartes University, France; Paris Municipal Department Social Act Childhood and Heatlh, France.
    Montilla-Santana, A.
    Aura Andalucia, Spain.
    Morais-Almeida, M.
    Hospital CUF Descobertas, Portugal.
    Morgan, M.
    NHS England, England.
    Mosges, R.
    University of Cologne, Germany.
    Mullol, J.
    Sachs Childrens Hospital, Sweden; Karolinska Institute, Sweden; Hospital Clin Barcelona, Spain.
    Nafti, S.
    Mustapha Hospital, Algeria.
    Namazova-Baranova, L.
    Russian Academic Medical Science, Russia.
    Naclerio, R.
    University of Chicago, IL 60637 USA; University of Chicago, IL 60637 USA.
    Neou, A.
    Charite, Germany; GA2LEN, Germany.
    Neffen, H.
    Hospital Ninos Orlando Alassia, Argentina.
    Nekam, K.
    Hospital Hospitaller Bros Buda, Hungary.
    Niggemann, B.
    Charite, Germany.
    Ninot, G.
    University of Montpellier I, France.
    Nyembue, T. D.
    University Hospital Kinshasa, DEM REP CONGO.
    OHehir, R. E.
    Monash University, Australia; Monash University, Australia; Monash University, Australia.
    Ohta, K.
    Tokyo National Hospital, Japan.
    Okamoto, Y.
    Chiba University Hospital, Japan.
    Okubo, K.
    Nippon Medical Sch, Japan.
    Ouedraogo, S.
    Centre Hospital University of Pediat Charles de Gaulle, Burkina Faso.
    Paggiaro, P.
    University Hospital Pisa, Italy.
    Pali-Scholl, I.
    University of Vet Med, Austria; Medical University, Austria.
    Panzner, P.
    Charles University of Prague, Czech Republic; Charles University of Prague, Czech Republic.
    Papadopoulos, N.
    University of Manchester, England; University of Athens, Greece.
    Papi, A.
    University of Ferrara, Italy.
    Park, H. S.
    Ajou University, South Korea.
    Passalacqua, G.
    University of Genoa, Italy.
    Pavord, I.
    University of Oxford, England.
    Pawankar, R.
    Nippon Medical Sch, Japan.
    Pengelly, R.
    Department Health Social Serv and Public Safety, North Ireland.
    Pfaar, O.
    Centre Rhinol and Allergol, Germany; Heidelberg University, Germany.
    Picard, R.
    Minist Econ Ind and Numer, France.
    Pigearias, B.
    Soc Pneumol Langue Francaise, France.
    Pin, I.
    CHU Grenoble, France.
    Plavec, D.
    University of JJ Strossmayer, Croatia.
    Poethig, D.
    Europe Europa Vereinigung Vitalitat and Aktives Alt, Germany.
    Pohl, W.
    Hietzing Hospital, Austria.
    Popov, T. A.
    Medical University of Sofia, Bulgaria.
    Portejoie, F.
    MACVIA LR, France.
    Potter, P.
    University of Cape Town, South Africa.
    Postma, D.
    University of Groningen, Netherlands.
    Price, D.
    University of Aberdeen, Scotland; Research Real Life, England.
    Rabe, K. F.
    German Centre Lung Research DZL, Germany; University of Kiel, Germany; German Centre Lung Research DZL, Germany.
    Raciborski, F.
    Medical University of Warsaw, Poland.
    Radier Pontal, F.
    Maison Profess Liberales, France.
    Repka-Ramirez, S.
    SLAAI, Colombia.
    Reitamo, S.
    Helsinki University Hospital, Finland.
    Rennard, S.
    University of Nebraska Medical Centre, NE USA.
    Rodenas, F.
    University of Valencia, Spain.
    Roberts, J.
    Salford Royal NHS Fdn Trust and NHS England North, England.
    Roca, J.
    University of Barcelona, Spain.
    Rodriguez Manas, L.
    Hospital University of Getafe Serv Madrileno Salud, Spain.
    Rolland, C.
    Assoc Asthme and Allergie, France.
    Roman Rodriguez, M.
    Institute Invest Sanitaria Palma IdisPa, Spain.
    Romano, A.
    Complesso Integrato Columbus, Italy.
    Rosado-Pinto, J.
    Hospital Luz, Portugal.
    Rosario, N.
    University of Parana, Brazil.
    Rosenwasser, L.
    Medical University of Misouri Kansas City, MO USA; Medical University of Misouri Kansas City, MO USA.
    Rottem, M.
    Emek Medical Centre, Israel.
    Ryan, D.
    Woodbrook Medical Centre, England; University of Edinburgh, Scotland.
    Sanchez-Borges, M.
    Centre Medicodocente Trinidad and Clin El Avila, Venezuela.
    Scadding, G. K.
    UCL, England.
    Schunemann, H. J.
    McMaster University, Canada.
    Serrano, E.
    CHU Rangueil Larrey, France.
    Schmid-Grendelmeier, P.
    University of Zurich Hospital, Switzerland.
    Schulz, H.
    Helmholtz Zentrum Munchen, Germany.
    Sheikh, A.
    University of Edinburgh, Scotland.
    Shields, M.
    Queens University of Belfast, North Ireland; Royal Belfast Hospital Sick Children, North Ireland.
    Siafakas, N.
    University Hospital Heraklion, Greece.
    Sibille, Y.
    Catholic University of Louvain, Belgium.
    Similowski, T.
    Sorbonne University, France; INSERM, France; Groupe, France.
    Simons, F. E. R.
    University of Manitoba, Canada.
    Sisul, J. C.
    Soc Paraguaya Alergia Asma and Inmunol, Paraguay.
    Skrindo, I.
    Oslo University Hospital, Norway; University of Oslo, Norway.
    Smit, H. A.
    University of Utrecht, Netherlands.
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    University of Federal Sao Paulo, Brazil.
    Sooronbaev, T.
    Euro Asian Resp Soc, Kyrgyzstan.
    Spranger, O.
    GAAPP, Austria.
    Stelmach, R.
    University of Sao Paulo, Brazil.
    Sterk, P. J.
    University of Amsterdam, Netherlands.
    Sunyer, J.
    Centre Research Environm Epidemiol CREAL, Spain; CIBERESP, Spain; UPF, Spain.
    Thijs, C.
    Maastricht University, Netherlands.
    To, T.
    Sidkkids Hospital and Institute Health Policy Management and Eva, Canada.
    Todo-Bom, A.
    University of Coimbra, Portugal.
    Triggiani, M.
    University of Salerno, Italy.
    Valenta, R.
    Medical University of Vienna, Austria.
    Valero, A. L.
    Hospital Clin Barcelona, Spain.
    Valia, E.
    University of Valencia, Spain.
    Valovirta, E.
    University of Turku, Finland.
    Van Ganse, E.
    University of Claude Bernard, France.
    van Hage, M.
    Karolinska Institute, Sweden; University Hospital, Sweden.
    Vandenplas, O.
    Catholic University of Louvain, Belgium.
    Vasankari, T.
    Finnish Lung Assoc, Finland.
    Vellas, B.
    CHU Toulouse, France.
    Vestbo, J.
    University of Manchester, England; Manchester NHS Fdn Trust, England.
    Vezzani, G.
    Arcispedale S Maria Nuova, Italy; Regional Agency Health and Social Care, Italy.
    Vichyanond, P.
    Mahidol University, Thailand.
    Viegi, G.
    CNR, Italy; CNR, Italy.
    Vogelmeier, C.
    Philipps University of Marburg, Germany.
    Vontetsianos, T.
    Sotiria Hospital, Greece.
    Wagenmann, M.
    University of Klinikum Dusseldorf, Germany.
    Wallaert, B.
    CHRU, France.
    Walker, S.
    Asthma UK, England.
    Wang, D. Y.
    National University of Singapore, Singapore.
    Wahn, U.
    Charite, Germany.
    Wickman, M.
    Karolinska Institute, Sweden.
    Williams, D. M.
    University of N Carolina, NC USA.
    Williams, S.
    Int Primary Care Resp Grp, Scotland.
    Wright, J.
    Bradford Royal Infirm, England.
    Yawn, B. P.
    Olmsted Medical Centre, MN USA.
    Yiallouros, P. K.
    Cyprus University of Technology, Cyprus; Hospital Archbishop Makarios III, Cyprus.
    Yusuf, O. M.
    Allergy and Asthma Institute, Pakistan.
    Zaidi, A.
    University of Southampton, England.
    Zar, H. J.
    University of Cape Town, South Africa; University of Cape Town, South Africa.
    Zernotti, M. E.
    University of Catolica Cordoba, Argentina.
    Zhang, L.
    Capital Medical University, Peoples R China.
    Zhong, N.
    Guangzhou Medical University, Peoples R China.
    Zidarn, M.
    University of Clin Resp and Allerg Disease, Slovenia.
    Mercier, J.
    CHRU, France; University of Montpellier, France.
    Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5)2016Ingår i: Clinical and Translational Allergy, ISSN 2045-7022, E-ISSN 2045-7022, Vol. 6, artikel-id 29Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un Vleillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.

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    Bousquet, J.
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    Montpellier University Hospital, France; European Innovat Partnership Act and Health Ageing Re, France; INSERM, France; CHRU Arnaud Villeneuve, France.
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    Katholieke University of Leuven, Belgium.
    Agache, I.
    Transylvania University of Brasov, Romania.
    Bedbrook, A.
    European Innovat Partnership Act and Health Ageing Re, France.
    Bachert, C.
    Ghent University Hospital, Belgium.
    Bergmann, K. C.
    Charite, Germany; Global Allergy and Asthma European Network, Germany.
    Bewick, M.
    iQ4U Consultants Ltd, England.
    Bindslev-Jensen, C.
    Odense University Hospital, Denmark.
    Bosnic-Anticevitch, S.
    Odense University Hospital, Denmark.
    Bucca, C.
    University of Sydney and Sydney Local Health Dist, Australia.
    Caimmi, D. P.
    Hospital City Health and Science Torino, Italy.
    Camargos, P. A. M.
    Montpellier University Hospital, France.
    Canonica, G. W.
    University of Federal Minas Gerais, Brazil.
    Casale, T.
    Humanitas University, Italy.
    Chavannes, N. H.
    University of S Florida, FL USA.
    Cruz, A. A.
    Leiden University, Netherlands; University of Federal Bahia, Brazil.
    De Carlo, G.
    GARD Execut Comm, Brazil.
    Dahl, R.
    Leiden University, Netherlands.
    Demoly, P.
    Hospital City Health and Science Torino, Italy; EFA European Federat Allergy and Airways Disease Patien, Belgium; INSERM, France.
    Devillier, P.
    University of Paris 06, France.
    Fonseca, J.
    Suresnes University of Versailles, France; Institute CUF Porto, Portugal.
    Fokkens, W. J.
    Hospital CUF Porto, Portugal.
    Guldemond, N. A.
    University of Porto, Portugal.
    Haahtela, T.
    Academic Medical Centre, Netherlands.
    Illario, M.
    Erasmus University, Netherlands.
    Just, J.
    Helsinki University Hospital, Finland.
    Keil, T.
    University of Naples Federico II, Italy; University of Paris 06, France.
    Klimek, L.
    Charite, Germany.
    Kuna, P.
    University of Wurzburg, Germany.
    Larenas-Linnemann, D.
    Centre Rhinol and Allergol, Germany.
    Morais-Almeida, M.
    Medical University of Lodz, Poland.
    Mullol, J.
    University of Barcelona, Spain.
    Murray, R.
    University of Chicago, IL 60637 USA.
    Naclerio, R.
    University of Chicago, IL 60637 USA.
    OHehir, R. E.
    Monash University, Australia; Monash University, Australia.
    Papadopoulos, N. G.
    Monash University, Australia; University of Manchester, England.
    Pawankar, R.
    University of Athens, Greece.
    Potter, P.
    Nippon Medical Sch, Japan.
    Ryan, D.
    University of Cape Town, South Africa; Woodbrook Medical Centre, England.
    Samolinski, B.
    University of Edinburgh, Scotland.
    Schunemann, H. J.
    Medical University of Warsaw, Poland.
    Sheikh, A.
    McMaster University, Canada.
    Simons, F. E. R.
    University of Edinburgh, Scotland.
    Stellato, C.
    University of Manitoba, Canada.
    Todo-Bom, A.
    University of Salerno, Italy.
    Tomazic, P. V.
    University of Coimbra, Portugal.
    Valiulis, A.
    Medical University of Graz, Austria; Vilnius University, Lithuania; Vilnius University, Lithuania.
    Valovirta, E.
    European Academic Paediat EAP UEMS SP, Belgium; University of Turku, Finland.
    Ventura, M. T.
    Terveystalo, Finland.
    Wickman, M.
    University of Bari, Italy; Soder Sjukhuset, Sweden.
    Young, I.
    Karolinska Institute, Sweden.
    Yorgancioglu, A.
    Queens University, North Ireland.
    Zuberbier, T.
    Charite, Germany; Global Allergy and Asthma European Network, Germany.
    Aberer, W.
    Celal Bayar University, Turkey.
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    Medical University of Graz, Austria.
    Akdis, M.
    Medical University of Graz, Austria.
    Annesi-Maesano, I.
    EFA European Federat Allergy and Airways Disease Patien, Belgium; INSERM, France.
    Ankri, J.
    INSERM, France.
    Ansotegui, I. J.
    University of Zurich, Switzerland.
    Anto, J. M.
    Hospital Quiron Bizkaia, Spain; Barcelona Institute Global Health ISGlobal, Spain; IMIM Hospital Mar Research Institute, Spain; CIBER Epidemiol and Salud Public CIBERESP, Spain.
    Arnavielhe, S.
    University of Pompeu Fabra, Spain.
    Asarnoj, A.
    University of Edinburgh, Scotland; Kyomed, France; Karolinska Institute, Sweden.
    Arshad, H.
    Karolinska University Hospital, Sweden.
    Avolio, F.
    David Hide Asthma and Allergy Research Centre, England.
    Baiardini, I.
    University of Federal Minas Gerais, Brazil.
    Barbara, C.
    Regional Puglia, Italy.
    Barbagallo, M.
    Portuguese National Programme Resp Disease PNDR, Portugal.
    Bateman, E. D.
    University of Palermo, Italy.
    Beghe, B.
    University of Cape Town, South Africa.
    Bel, E. H.
    University of Modena and Reggio Emilia, Italy.
    Bennoor, K. S.
    University of Amsterdam, Netherlands.
    Benson, Mikael
    Region Östergötland, Hjärt- och Medicincentrum, Allergicentrum US. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten.
    Bialoszewski, A. Z.
    University of Edinburgh, Scotland.
    Bieber, T.
    Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany.
    Bjermer, L.
    University of Bonn, Germany.
    Blain, H.
    Lund University Hospital, Sweden; Montpellier University Hospital, France.
    Blasi, F.
    University of Montpellier, France.
    Boner, A. L.
    University of Milan, Italy.
    Bonini, M.
    Sapienza University, Rome, Italy.
    Bonini, S.
    University of Verona Hospital, Italy; University of Roma La Sapienza, Italy.
    Bosse, I.
    University of Naples 2, Italy.
    Bouchard, J.
    Italian National Research Council, Italy.
    Boulet, L. P.
    University of Laval, Canada.
    Bourret, R.
    Montpellier University Hospital, France.
    Bousquet, P. J.
    EFA European Federat Allergy and Airways Disease Patien, Belgium.
    Braido, F.
    University of Federal Minas Gerais, Brazil.
    Briggs, A. H.
    University of Glasgow, Scotland.
    Brightling, C. E.
    University Hospital Leicester NHS Trust, England; University of Leicester, England.
    Brozek, J.
    Medical University of Warsaw, Poland.
    Buhl, R.
    Johannes Gutenberg University of Mainz, Germany.
    Bunu, C.
    University of Medical and Farm Timisoara, Romania.
    Burte, E.
    INSERM, France.
    Bush, A.
    University of Medical and Farm Timisoara, Romania; University of London Imperial Coll Science Technology and Med, England.
    Caballero-Fonseca, F.
    Centre Medical Docente Trinidad, Venezuela.
    Calderon, M. A.
    University of Medical and Farm Timisoara, Romania; University of London Imperial Coll Science Technology and Med, England; University of London Imperial Coll Science Technology and Med, England.
    Camuzat, T.
    Regional Languedoc Roussillon, France.
    Cardona, V.
    Hospital Valle De Hebron, Spain.
    Carreiro-Martins, P.
    CEDOC, Portugal; Centre Hospital Lisboa Cent, Portugal.
    Carriazo, A. M.
    Regional Minist Health Andalusia, Spain.
    Carlsen, K. H.
    Oslo University Hospital, Norway; University of Oslo, Norway; University of Oslo, Norway.
    Carr, W.
    Allergy and Asthma Associates Southern Calif, CA USA.
    Cepeda Sarabia, A. M.
    Metropolitan University, Colombia; SLaai Sociedad Latinoamer Allergia Asma and Immunol, Colombia.
    Cesari, M.
    Gerontopole Toulouse, France.
    Chatzi, L.
    University of Crete, Greece.
    Chiron, R.
    Hospital City Health and Science Torino, Italy.
    Chivato, T.
    University of CEU San Pablo, Spain.
    Chkhartishvili, E.
    Grigol Robakidze University, Rep of Georgia.
    Chuchalin, A. G.
    Pulmonolory Research Institute FMBA, Russia; GARD Execut Comm, Russia.
    Chung, K. F.
    University of London Imperial Coll Science Technology and Med, England.
    Ciprandi, G.
    IRCCS Azienda Osped University of San Martino, Italy.
    Correia de Sousa, J.
    University of Minho, Portugal.
    Cox, L.
    Nova Southeastern University, FL USA.
    Crooks, G.
    Scottish Centre Telehealth and Telecare, Scotland.
    Custovic, A.
    University of London Imperial Coll Science Technology and Med, England.
    Dahlen, S. E.
    Karolinska Institute, Sweden.
    Darsow, U.
    Technical University of Munich, Germany; Helmholtz Centre Munich, Germany.
    Dedeu, T.
    AQuAS, Spain; European Regional and Local Health Assoc, Belgium.
    Deleanu, D.
    Luliu Hatieganu University of Medical and Pharm, Romania.
    Denburg, J. A.
    McMaster University, Canada.
    De Vries, G.
    Peercode DV, Netherlands.
    Didier, A.
    Rangueil Larrey Hospital, France.
    Dinh-Xuan, A. T.
    University of Paris 05, France.
    Dokic, D.
    Ss Cyril and Methodius University, Macedonia.
    Douagui, H.
    Centre Hospital University of Beni Messous, Algeria.
    Dray, G.
    Ecole Mines, France.
    Dubakiene, R.
    Vilnius University, Lithuania.
    Durham, S. R.
    University of London Imperial Coll Science Technology and Med, England.
    Du Toit, G.
    Kings Coll London, England.
    Dykewicz, M. S.
    St Louis University, MO USA.
    Eklund, P.
    Umeå University, Sweden; Four Comp Oy, Finland.
    El-Gamal, Y.
    Ain Shams University, Egypt.
    Ellers, E.
    Odense University Hospital, Denmark.
    Emuzyte, R.
    Medical University of Graz, Austria; Vilnius University, Lithuania; Vilnius University, Lithuania.
    Farrell, J.
    Social Serv and Public Safety, North Ireland.
    Fink Wagner, A.
    Global Allergy and Asthma Platform, Austria.
    Fiocchi, A.
    Bambino Gesu Childrens Research Hospital Holy See, Italy.
    Fletcher, M.
    Educ Heatlh, England.
    Forastiere, F.
    Regional Health Serv Lazio Reg, Italy.
    Gaga, M.
    Athens Chest Hospital, Greece.
    Gamkrelidze, A.
    National Centre Disease Control and Public Health Georgia, Rep of Georgia.
    Gemicioglu, B.
    Istanbul University, Turkey.
    Gereda, J. E.
    Clin Ricardo Palma, Peru.
    Gerth van Wick, R.
    Erasmus MC, Netherlands.
    Gonzalez Diaz, S.
    University of Autonoma Nuevo Leon, Mexico.
    Grisle, I.
    Latvian Assoc Allergists, Latvia.
    Grouse, L.
    University of Washington, WA 98195 USA.
    Gutter, Z.
    University Hospital Olomouc, Czech Republic.
    Guzman, M. A.
    University of Chile, Chile.
    Hellquist-Dahl, B.
    Odense University Hospital, Denmark.
    Heinrich, J.
    German Research Centre Environm Heatlh, Germany.
    Horak, F.
    Vienna Challenge Chamber, Austria.
    Hourihane, J. O. B.
    University of Coll Cork, Ireland.
    Humbert, M.
    University of Paris 11, France; Hop Bicetre, France; INSERM, France.
    Hyland, M.
    University of Plymouth, England.
    Iaccarino, G.
    University of Salerno, Italy.
    Jares, E. J.
    Libra Fdn, Argentina.
    Jeandel, C.
    European Innovat Partnership Act and Health Ageing Re, France; University Hospital, Sweden.
    Johnston, S. L.
    University of London Imperial Coll Science Technology and Med, England; MRC and Asthma UK Centre Allerg Mech Asthma, England.
    Joos, G.
    Ghent University Hospital, Belgium.
    Jonquet, O.
    Montpellier University Hospital, France.
    Jung, K. S.
    Hallym University, South Korea.
    Jutel, M.
    Wroclaw Medical University, Poland.
    Kaidashev, I.
    Ukrainian Medical Stomatol Acad, Ukraine.
    Khaitov, M.
    Federal Medicobiol Agency, Russia.
    Kalayci, O.
    Hacettepe University, Turkey.
    Kalyoncu, A. F.
    Hacettepe University, Turkey.
    Kardas, P.
    Medical University of Lodz, Poland.
    Keith, P. K.
    McMaster University, Canada.
    Kerkhof, M.
    University of Groningen, Netherlands.
    Kerstjens, H. A. M.
    University of Groningen, Netherlands.
    Khaltaev, N.
    GARD, Switzerland.
    Kogevinas, M.
    Hospital Quiron Bizkaia, Spain; Barcelona Institute Global Health ISGlobal, Spain; IMIM Hospital Mar Research Institute, Spain; CIBER Epidemiol and Salud Public CIBERESP, Spain.
    Kolek, V.
    University Hospital Olomouc, Czech Republic.
    Koppelman, G. H.
    University of Groningen, Netherlands.
    Kowalski, M. L.
    Medical University of Lodz, Poland.
    Kuitunen, M.
    University of Helsinki, Finland.
    Kull, I.
    University of Bari, Italy; Soder Sjukhuset, Sweden.
    Kvedariene, V.
    Vilnius University, Lithuania.
    Lambrecht, B.
    University of Ghent, Belgium.
    Lau, S.
    Charite, Germany.
    Laune, D.
    University of Pompeu Fabra, Spain.
    Le, L. T. T.
    University of Medical and Pharm, Vietnam.
    Lieberman, P.
    University of Tennessee, TN USA.
    Lipworth, B.
    University of Dundee, Scotland.
    Li, J.
    Guangzhou Medical University, Peoples R China.
    Lodrup Carlsen, K. C.
    Oslo University Hospital, Norway; University of Oslo, Norway; University of Oslo, Norway.
    Louis, R.
    CHU Sart Tilman, Belgium.
    Lupinek, C.
    Medical University of Vienna, Austria.
    MacNee, W.
    University of Edinburgh, Scotland.
    Magar, Y.
    Hop St Joseph, France.
    Magnan, A.
    University of Nantes, France; University of Nantes, France.
    Mahboub, B.
    Rashid Hospital, U Arab Emirates.
    Maier, D.
    Biomax Informat AG, Germany.
    Majer, I.
    University of Bratislava, Slovakia.
    Malva, J.
    University of Coimbra, Portugal; Ageing@Coimbra EIP AHA Reference Site, Portugal.
    Manning, P.
    Bon Secours Hospital, Ireland.
    De Manuel Keenoy, E.
    Kronikgune, Spain.
    Marshall, G. D.
    University of Mississippi, MS USA.
    Masjedi, M. R.
    Iranian Anti Tobacco Assoc, Iran.
    Mathieu-Dupas, E.
    University of Pompeu Fabra, Spain.
    Maurer, M.
    Charite, Germany.
    Mavale-Manuel, S.
    Maputo Central Hospital, Mozambique.
    Melen, E.
    University of Bari, Italy; Soder Sjukhuset, Sweden.
    Melo-Gomes, E.
    Regional Puglia, Italy.
    Meltzer, E. O.
    Allergy and Asthma Medical Grp and Research Centre, CA USA.
    Mercier, J.
    University of Montpellier, France.
    Merk, H.
    Rhein Westfal TH Aachen, Germany.
    Miculinic, N.
    Croatian Pulm Soc, Croatia.
    Mihaltan, F.
    National Institute Pneumol M Nasta, Romania.
    Milenkovic, B.
    University of Belgrade, Serbia; Serbian Assoc Asthma and COPD, Serbia.
    Millot-Keurinck, J.
    Caisse Assurance Retraite and Sante Travail Langued, France.
    Mohammad, Y.
    Tishreen University, Syria.
    Momas, I.
    Paris Descartes University, France; Paris Municipal Department Social Act Childhood and Heatlh, France.
    Mosges, R.
    University of Cologne, Germany.
    Muraro, A.
    Padua Gen University Hospital, Italy.
    Namazova-Baranova, L.
    Russian Academic Medical Science, Russia.
    Nadif, R.
    INSERM, France.
    Neffen, H.
    Hospital Ninos Orlando Alassia, Argentina.
    Nekam, K.
    Hospital Hospital Bros Buda, Hungary.
    Nieto, A.
    Hospital La Fe, Spain.
    Niggemann, B.
    Charite, Germany.
    Nogueira-Silva, L.
    Suresnes University of Versailles, France; University of Porto, Portugal; Institute CUF Porto, Portugal; Centre Hospital Sao Joao, Portugal.
    Nogues, M.
    European Innovat Partnership Act and Health Ageing Re, France; Caisse Assurance Retraite and Sante Travail Langued, France.
    Nyembue, T. D.
    University Hospital Kinshasa, DEM REP CONGO.
    Ohta, K.
    Tokyo National Hospital, Japan.
    Okamoto, Y.
    Chiba University Hospital, Japan.
    Okubo, K.
    Nippon Medical Sch, Japan.
    Olive-Elias, M.
    Montpellier University Hospital, France; University of Porto, Portugal; Academic Medical Centre, Netherlands.
    Ouedraogo, S.
    Centre Hospital University of Pediatr Charles Gaulle, Burkina Faso.
    Paggiaro, P.
    University Hospital Pisa, Italy.
    Pali-Schoell, I.
    Medical University, Austria.
    Palkonen, S.
    GARD Execut Comm, Brazil.
    Panzner, P.
    Charles University of Prague, Czech Republic.
    Papi, A.
    University of Ferrara, Italy.
    Park, H. S.
    Ajou University, South Korea.
    Passalacqua, G.
    University of Federal Minas Gerais, Brazil.
    Pedersen, S.
    University of Southern Denmark, Denmark.
    Pereira, A. M.
    Suresnes University of Versailles, France; University of Porto, Portugal; Institute CUF Porto, Portugal; CUF Porto Hospital and Institute, Portugal.
    Pfaar, O.
    Charite, Germany; Heidelberg University, Germany.
    Picard, R.
    Minist Econ Ind and Numer, France.
    Pigearias, B.
    Espace Francophone Pneumol, France.
    Pin, I.
    CHU Grenoble, France.
    Plavec, D.
    Childrens Hospital Srebrnjak, Croatia; University of JJ Strossmayer, Croatia.
    Pohl, W.
    Hietzing Hospital, Austria.
    Popov, T. A.
    Medical University of Sofia, Bulgaria.
    Portejoie, F.
    European Innovat Partnership Act and Health Ageing Re, France.
    Postma, D.
    University of Groningen, Netherlands.
    Poulsen, L. K.
    Copenhagen University Hospital Gentofte, Denmark.
    Price, D.
    University of Aberdeen, Scotland; Research Real Life, England.
    Rabe, K. F.
    German Centre Lung Research DZL, Germany; University of Kiel, Germany.
    Raciborski, F.
    University of Edinburgh, Scotland.
    Roberts, G.
    Southampton University Hospital, England.
    Robalo-Cordeiro, C.
    Coimbra University Hospital, Portugal.
    Rodenas, F.
    University of Valencia, Spain.
    Rodriguez-Manas, L.
    Getafe University Hospital, Spain.
    Rolland, C.
    Assoc Asthme and Allergie, France.
    Roman Rodriguez, M.
    Institute Invest Sanitaria Palma IdisPa, Spain.
    Romano, A.
    Complesso Integrato Columbus, Italy.
    Rosado-Pinto, J.
    Hospital Luz, Portugal.
    Rosario, N.
    University of Parana, Brazil.
    Rottem, M.
    Emek Medical Centre, Israel.
    Sanchez-Borges, M.
    Centre Medical Docente Trinidad and Clin El Avila, Venezuela.
    Sastre-Dominguez, J.
    Autononous University of Madrid, Spain.
    Scadding, G. K.
    UCL, England.
    Scichilone, N.
    University of Palermo, Italy.
    Schmid-Grendelmeier, P.
    University of Zurich Hospital, Switzerland.
    Serrano, E.
    CHU Rangueil Larrey, France.
    Shields, M.
    Queens University, North Ireland; Royal Belfast Hospital Sick Children, North Ireland.
    Siroux, V.
    University of Joseph Fourier, France.
    Sisul, J. C.
    Soc Paraguaya Alergia Asma and Inmunol, Paraguay.
    Skrindo, I.
    Oslo University Hospital, Norway; University of Oslo, Norway.
    Smit, H. A.
    University of Utrecht, Netherlands.
    Sole, D.
    University of Federal Sao Paulo, Brazil.
    Sooronbaev, T.
    Euro Asian Resp Soc, Kyrgyzstan.
    Spranger, O.
    Global Allergy and Asthma Platform, Austria.
    Stelmach, R.
    University of Sao Paulo, Brazil.
    Sterk, P. J.
    University of Amsterdam, Netherlands.
    Strandberg, T.
    European Union Geriatr Medical Soc EUGMS, Finland.
    Sunyer, J.
    Hospital Quiron Bizkaia, Spain; Barcelona Institute Global Health ISGlobal, Spain; IMIM Hospital Mar Research Institute, Spain; CIBER Epidemiol and Salud Public CIBERESP, Spain.
    Thijs, C.
    Maastricht University, Netherlands.
    Triggiani, M.
    University of Manitoba, Canada.
    Valenta, R.
    Medical University of Vienna, Austria.
    Valero, A.
    IDIBAPS, Spain.
    van Eerd, M.
    Peercode DV, Netherlands.
    van Ganse, E.
    PELyon, France; University of Claude Bernard Lyon, France.
    van Hague, M.
    Kyomed, France; Karolinska Institute, Sweden; University Hospital, Sweden.
    Vandenplas, O.
    Catholic University of Louvain, Belgium.
    Varona, L. L.
    Philippines Soc Allergy Asthma and Immunol, Philippines.
    Vellas, B.
    Gerontopole Toulouse, France.
    Vezzani, G.
    Research Hospital, Italy; Regional Agency Health and Social Care, Italy.
    Vazankari, T.
    Finnish Lung Assoc FILHA, Finland.
    Viegi, G.
    CNR Institute Clin Physiol, Italy; CNR, Italy.
    Vontetsianos, T.
    Sotiria Hospital, Greece.
    Wagenmann, M.
    University of Klinikum Dusseldorf, Germany.
    Walker, S.
    Asthma UK, England.
    Wang, D. Y.
    National University of Singapore, Singapore.
    Wahn, U.
    Charite, Germany.
    Werfel, T.
    Hannover Medical Sch, Germany.
    Whalley, B.
    University of Plymouth, England.
    Williams, D. M.
    University of N Carolina, NC USA.
    Williams, S.
    IPCRG, Scotland.
    Wilson, N.
    Northern Health Alliance, England.
    Wright, J.
    Bradford Royal Infirm, England.
    Yawn, B. P.
    Olmsted Medical Centre, MN USA.
    Yiallouros, P. K.
    University of Cyprus, Cyprus.
    Yusuf, O. M.
    Allergy and Asthma Institute, Pakistan.
    Zaidi, A.
    University of Southampton, England.
    Zar, H. J.
    University of Cape Town, South Africa; University of Cape Town, South Africa.
    Zernotti, M. E.
    University of Catolica Cordoba, Argentina.
    Zhang, L.
    Beijing TongRen Hospital, Peoples R China; Beijing Institute Otolaryngol, Peoples R China.
    Zhong, N.
    Guangzhou Medical University, Peoples R China.
    Zidarn, M.
    University of Clin Resp and Allerg Disease, Slovenia.
    ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle2016Ingår i: Clinical and Translational Allergy, ISSN 2045-7022, E-ISSN 2045-7022, Vol. 6, artikel-id 47Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA-disseminated and implemented in over 70 countries globally-is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.

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    McMaster University, Canada.
    Fonseca, J.
    University of Porto, Portugal; University of Porto, Portugal; University of Porto, Portugal; University of Porto, Portugal; University of Porto, Portugal.
    Samolinski, B.
    Medical University of Warsaw, Poland.
    Bachert, C.
    Ghent University Hospital, Belgium.
    Canonica, G. W.
    University of Genoa, Italy.
    Casale, T.
    University of S Florida, FL USA.
    Cruz, A. A.
    University of Federal Bahia, Brazil; GARD Execut Comm, Brazil.
    Demoly, P.
    Montpellier University Hospital, France; INSERM, France; UPMC, France.
    Hellings, P.
    Katholieke University of Leuven, Belgium.
    Valiulis, A.
    Vilnius University, Lithuania.
    Wickman, M.
    Sachs Childrens Hospital, Sweden; Karolinska Institute, Sweden.
    Zuberbier, T.
    Charite, Germany.
    Bosnic-Anticevitch, S.
    University of Sydney, Australia; Sydney Local Health Dist, Australia.
    Bedbrook, A.
    European Innovat Partnership Act and Health Ageing Re, France.
    Bergmann, K. C.
    Charite, Germany.
    Caimmi, D.
    Montpellier University Hospital, France.
    Dahl, R.
    Odense University Hospital, Denmark; Odense University Hospital, Denmark.
    Fokkens, W. J.
    University of Amsterdam, Netherlands.
    Grisle, I.
    Latvian Assoc Allergists, Latvia.
    Lodrup Carlsen, K.
    Oslo University Hospital, Norway; .
    Mullol, J.
    IDIBAPS, Spain.
    Muraro, A.
    Padua Gen University Hospital, Italy.
    Palkonen, S.
    EFA European Federat Allergy and Airways Disease Patien, Belgium.
    Papadopoulos, N.
    University of Manchester, England; University of Athens, Greece.
    Passalacqua, G.
    University of Genoa, Italy.
    Ryan, D.
    Woodbrook Medical Centre, England; University of Edinburgh, Scotland.
    Valovirta, E.
    University of Turku, Finland.
    Yorgancioglu, A.
    Celal Bayar University, Turkey.
    Aberer, W.
    Medical University of Graz, Austria.
    Agache, I.
    Transylvania University of Brasov, Romania.
    Adachi, M.
    Int University of Health and Welfare, Japan.
    Akdis, C. A.
    University of Zurich, Switzerland.
    Akdis, M.
    University of Zurich, Switzerland.
    Annesi-Maesano, I.
    INSERM, France; UPMC, France.
    Ansotegui, I. J.
    Hospital Quiron Bizkaia, Spain.
    Anto, J. M.
    Centre Research Environm Epidemiol, Spain; Hospital del Mar, Spain; CIBER Epidemiol and Salud Publ, Spain; University of Pompeu Fabra, Spain.
    Arnavielhe, S.
    Digi Heatlh, France.
    Arshad, H.
    David Hide Asthma and Allergy Research Centre, England.
    Baiardini, I.
    University of Genoa, Italy.
    Baigenzhin, A. K.
    EuroAsian Resp Soc, Kazakhstan.
    Barbara, C.
    Fac Medical Lisbon, Portugal.
    Bateman, E. D.
    University of Cape Town, South Africa.
    Beghe, B.
    University of Modena and Reggio Emilia, Italy.
    Bel, E. H.
    University of Amsterdam, Netherlands.
    Ben Kheder, A.
    Hop Abderrahman Mami, Tunisia.
    Bennoor, K. S.
    National Institute Disease Chest and Hospital, Bangladesh.
    Benson, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Allergicentrum US.
    Bewick, M.
    Bieber, T.
    University of Bonn, Germany.
    Bindslev-Jensen, C.
    Odense University Hospital, Denmark;.
    Bjermer, L.
    University of Lund Hospital, Sweden.
    Blain, H.
    University of Montpellier, France; .
    Boner, A. L.
    University of Verona Hospital, Italy.
    Boulet, L. P.
    University of Laval, Canada.
    Bonini, M.
    University of Roma La Sapienza, Italy.
    Bonini, S.
    University of Naples 2, Italy; Italian National Research Council, Italy.
    Bosse, I.
    Bourret, R.
    Montpellier University Hospital, France.
    Bousquet, P. J.
    INSERM, France; UPMC, France.
    Braido, F.
    University of Genoa, Italy.
    Briggs, A. H.
    University of Glasgow, Scotland.
    Brightling, C. E.
    University Hospital Leicester NHS Trust, England; University of Leicester, England.
    Brozek, J.
    McMaster University, Canada.
    Buhl, R.
    Johannes Gutenberg University of Mainz, Germany.
    Burney, P. G.
    University of London Imperial Coll Science Technology and Med, England; University of London Imperial Coll Science Technology and Med, England; University of London Imperial Coll Science Technology and Med, England.
    Bush, A.
    University of London Imperial Coll Science Technology and Med, England; Royal Brompton Hospital, England.
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    Centre Medical Docente La Trinidad, Venezuela.
    Calderon, M. A.
    University of London Imperial Coll Science Technology and Med, England.
    Camargos, P. A. M.
    University of Federal Minas Gerais, Brazil.
    Camuzat, T.
    Regional Languedoc Roussillon, France.
    Carlsen, K. H.
    Oslo University Hospital, Norway; .
    Carr, W.
    Allergy and Asthma Associates Southern Calif, CA USA.
    Cepeda Sarabia, A. M.
    University of Simon Bolivar, Colombia; SLaai, Colombia.
    Chavannes, N. H.
    Leiden University, Netherlands.
    Chiron, R.
    Montpellier University Hospital, France.
    Chkhartishvili, E.
    Grigol Robakidze University, Rep of Georgia.
    Chuchalin, A. G.
    Pulmonolory Research Institute FMBA, Russia; GARD Execut Comm, Russia.
    Ciprandi, G.
    Azienda Osped University of San Martino, Italy.
    Cirule, I.
    University of Children Hospital Latvia, Latvia.
    Correia de Sousa, J.
    University of Minho, Portugal.
    Cox, L.
    Nova SE University, FL USA.
    Crooks, G.
    NHS Scotland, Scotland.
    Costa, D. J.
    European Innovat Partnership Act and Health Ageing Re, France; Montpellier University Hospital, France.
    Custovic, A.
    University of Manchester, England.
    Dahlen, S. E.
    Karolinska Institute, Sweden.
    Darsow, U.
    Technical University of Munich, Germany.
    De Carlo, G.
    EFA European Federat Allergy and Airways Disease Patien, Belgium.
    De Blay, F.
    University Hospital Strasbourg, France.
    Deleanu, D.
    European Regional and Local Health Assoc, Belgium; Iuliu Hatieganu University of Medical and Pharm, Romania.
    Denburg, J. A.
    McMaster University, Canada.
    Devillier, P.
    Suresnes University of Versailles St Quentin, France.
    Didier, A.
    Rangueil Larrey Hospital, France.
    Dinh-Xuan, A. T.
    University of Paris 05, France.
    Dokic, D.
    University of Skopje, Macedonia.
    Douagui, H.
    Centre Hospital University of Beni Messous, Algeria.
    Dray, G.
    Ecole Mines, France.
    Dubakiene, R.
    Vilnius State University, Lithuania.
    Durham, S. R.
    University of London Imperial Coll Science Technology and Med, England.
    Dykewicz, M. S.
    St Louis University, MI USA.
    El-Gamal, Y.
    Ain Shams University, Egypt.
    Emuzyte, R.
    Vilnius State University, Lithuania.
    Fink Wagner, A.
    Global Allergy and Asthma Platform GAAPP, Austria.
    Fletcher, M.
    Educ Heatlh, England.
    Fiocchi, A.
    Bambino Gesu Childrens Research Hospital Holy See, Italy.
    Forastiere, F.
    Regional Health Serv Lazio Reg, Italy.
    Gamkrelidze, A.
    National Centre Disease Control and Public Health Georgia, Rep of Georgia.
    Gemicioglu, B.
    Turkish Thorac Soc, Turkey.
    Gereda, J. E.
    Clin Ricardo Palma, Peru.
    Gonzalez Diaz, S.
    Sociedad Latinoamer Allergia Asma and Immunol, Mexico.
    Gotua, M.
    Georgian Assoc Allergol and Clin Immunol, Rep of Georgia.
    Grouse, L.
    University of Washington, WA USA.
    Guzman, M. A.
    University of Chile, Chile.
    Haahtela, T.
    Helsinki University Hospital, Finland.
    Hellquist-Dahl, B.
    Odense University Hospital, Denmark.
    Heinrich, J.
    Helmholtz Zentrum Munchen, Germany.
    Horak, F.
    Vienna Challenge Chamber, Austria.
    Hourihane, J. O. B.
    National University of Ireland University of Coll Cork, Ireland.
    Howarth, P.
    University of Southampton, England.
    Humbert, M.
    University of Paris 11, France; Hop Bicetre, France.
    Ivancevich, J. C.
    Clin Santa Isabel, Argentina.
    Jares, E. J.
    Libra Fdn, Argentina.
    Johnston, S. L.
    University of London Imperial Coll Science Technology and Med, England; MRC, England; Asthma UK Centre Allerg Mech Asthma, England.
    Joos, G.
    Ghent University Hospital, Belgium.
    Jonquet, O.
    Montpellier University Hospital, France.
    Jung, K. S.
    Hallym University, South Korea.
    Just, J.
    Hop Enfants Armand Trousseau, France; University of Paris 06, France.
    Kaidashev, I.
    Ukrainian Medical Stomatol Acad, Ukraine.
    Kalayci, O.
    Hacettepe University, Turkey.
    Kalyoncu, A. F.
    Hacettepe University, Turkey.
    Keil, T.
    Charite, Germany; University of Wurzburg, Germany.
    Keith, P. K.
    McMaster University, Canada.
    Khaltaev, N.
    GARD, Switzerland.
    Klimek, L.
    Centre Rhinol and Allergol, Germany.
    Koffi NGoran, B.
    Soc Pneumol Langue Francaise, France; Espace Francophone Pneumol, France.
    Kolek, V.
    University Hospital Olomouc, Czech Republic.
    Koppelman, G. H.
    University of Groningen, Netherlands.
    Kowalski, M. L.
    Medical University of Lodz, Poland.
    Kull, I.
    Sachs Childrens Hospital, Sweden; Karolinska Institute, Sweden.
    Kuna, P.
    Medical University of Lodz, Poland.
    Kvedariene, V.
    Vilnius State University, Lithuania.
    Lambrecht, B.
    University of Ghent, Belgium.
    Lau, S.
    Charite, Germany.
    Larenas-Linnemann, D.
    Hospital Medical Sur, Mexico.
    Laune, D.
    Digi Heatlh, France.
    Le, L. T. T.
    University of Medical and Pharm, Vietnam.
    Lieberman, P.
    University of Tennessee, TN USA; University of Tennessee, TN USA; University of Tennessee, TN USA.
    Lipworth, B.
    University of Dundee, Scotland.
    Li, J.
    Guangzhou Medical University, Peoples R China.
    Louis, R.
    CHU Sart Tilman, Belgium.
    Magard, Y.
    Hop St Joseph, France.
    Magnan, A.
    University of Nantes, France.
    Mahboub, B.
    Rashid Hospital, U Arab Emirates.
    Makela, M. J.
    Helsinki University Hospital, Finland.
    De Manuel Keenoy, E.
    Kronikgune, Spain.
    Marshall, G. D.
    University of Mississippi, MS 39216 USA.
    Masjedi, M. R.
    Shahid Beheshti University of Medical Science, Iran.
    Maurer, M.
    Charite, Germany; Charite, Germany.
    Mavale-Manuel, S.
    Maputo Central Hospital, Mozambique.
    Melen, E.
    Karolinska Institute, Sweden.
    Melo-Gomes, E.
    Fac Medical Lisbon, Portugal.
    Meltzer, E. O.
    Allergy and Asthma Medical Grp and Research Centre, CA USA.
    Merk, H.
    Rhein Westfal TH Aachen, Germany.
    Miculinic, N.
    Croatian Pulm Soc, Croatia.
    Mihaltan, F.
    National Institute Pneumol M Nasta, Romania.
    Milenkovic, B.
    University of Belgrade, Serbia; Serbian Assoc Asthma and COPD, Serbia.
    Mohammad, Y.
    Tishreen University, Syria.
    Molimard, M.
    University of Bordeaux, France.
    Momas, I.
    Paris Descartes University, France; Paris Municipal Department Social Act Childhood and Heatlh, France.
    Montilla-Santana, A.
    Aura Andalucia, Spain.
    Morais-Almeida, M.
    Hospital CUF Descobertas, Portugal.
    Moesges, R.
    University of Cologne, Germany.
    Namazova-Baranova, L.
    Russian Academic Medical Science, Russia.
    Naclerio, R.
    University of Chicago, IL 60637 USA; University of Chicago, IL 60637 USA.
    Neou, A.
    Charite, Germany.
    Neffen, H.
    Hospital Ninos Orlando Alassia, Argentina.
    Nekam, K.
    Hospital Hospitaller Bros Buda, Hungary.
    Niggemann, B.
    Charite, Germany.
    Nyembue, T. D.
    University Hospital Kinshasa, Zaire.
    OHehir, R. E.
    Monash University, Australia; Monash University, Australia.
    Ohta, K.
    Tokyo National Hospital, Japan.
    Okamoto, Y.
    Chiba University Hospital, Japan.
    Okubo, K.
    Nippon Medical Sch, Japan.
    Ouedraogo, S.
    Centre Hospital University of Pediat Charles Gaulle, Burkina Faso.
    Pali-Schoell, I.
    University of Vienna, Austria; University of Vet Medical Vienna, Austria; University of Vet Medical Vienna, Austria; University of Vienna, Austria.
    Palmer, S.
    University of York, England.
    Panzner, P.
    Charles University of Prague, Czech Republic; .
    Papi, A.
    University of Ferrara, Italy.
    Park, H. S.
    Ajou University, South Korea.
    Pavord, I.
    University of Oxford, England.
    Pawankar, R.
    Nippon Medical Sch, Japan.
    Pfaar, O.
    Centre Rhinol and Allergol, Germany; Heidelberg University, Germany.
    Picard, R.
    Conseil Gen Econ, France.
    Pigearias, B.
    Soc Pneumol Langue Francaise, France; Espace Francophone Pneumol, France.
    Pin, I.
    CHU Grenoble, France.
    Plavec, D.
    University Hospital Pisa, Italy; University of JJ Strossmayer, Croatia.
    Pohl, W.
    Hietzing Hospital, Austria.
    Popov, T. A.
    Medical University of Sofia, Bulgaria.
    Portejoie, F.
    European Innovat Partnership Act and Health Ageing Re, France.
    Postma, D.
    University of Groningen, Netherlands.
    Potter, P.
    University of Cape Town, South Africa.
    Price, D.
    University of Aberdeen, Scotland; Research Real Life, England.
    Rabe, K. F.
    LungenClin Grosshansdorf, Germany; University of Kiel, Germany.
    Raciborski, F.
    Medical University of Warsaw, Poland.
    Radier Pontal, F.
    Maison Profess Liberales, France.
    Repka-Ramirez, S.
    SLAAI, Mexico.
    Robalo-Cordeiro, C.
    Hospital University of Coimbra, Portugal.
    Rolland, C.
    Assoc Asthme and Allergie, France.
    Reitamo, S.
    Helsinki University Hospital, Finland.
    Roman Rodriguez, M.
    Institute Invest Sanitaria Palma IdisPa, Spain.
    Romano, A.
    Complesso Integrato Columbus, Italy.
    Rosario, N.
    University of Federal Parana, Brazil.
    Rosenwasser, L.
    University of Misouri, MI USA.
    Rottem, M.
    Emek Medical Centre, Israel.
    Sanchez-Borges, M.
    Centre Meddocente La, Venezuela; Clin El Avila, Venezuela.
    Scadding, G. K.
    UCL, England.
    Serrano, E.
    CHU Rangueil Larrey, France.
    Schmid-Grendelmeier, P.
    University of Zurich Hospital, Switzerland.
    Sheikh, A.
    University of Edinburgh, Scotland.
    Simons, F. E. R.
    University of Manitoba, Canada.
    Sisul, J. C.
    Soc Paraguaya Alergia Asma and Inmunol, Paraguay.
    Skrindo, I.
    Oslo University Hospital, Norway; University of Oslo, Norway.
    Smit, H. A.
    University of Utrecht, Netherlands.
    Sole, D.
    University of Federal Sao Paulo, Brazil.
    Sooronbaev, T.
    Euroasian Resp Soc, Kyrgyzstan.
    Spranger, O.
    Global Allergy and Asthma Platform GAAPP, Austria.
    Stelmach, R.
    University of Sao Paulo, Brazil.
    Strandberg, T.
    European Union Geriatr Medical Soc, Austria.
    Sunyer, J.
    Centre Research Environm Epidemiol, Spain; Hospital del Mar, Spain; CIBER Epidemiol and Salud Publ, Spain; University of Pompeu Fabra, Spain.
    Thijs, C.
    Maastricht University, Netherlands.
    Todo-Bom, A.
    University of Coimbra, Portugal.
    Triggiani, M.
    University of Salerno, Italy.
    Valenta, R.
    Medical University of Vienna, Austria.
    Valero, A. L.
    IDIBAPS, Spain.
    van Hage, M.
    Karolinska Institute, Sweden.
    Vandenplas, O.
    Catholic University of Louvain, Belgium.
    Vezzani, G.
    Research Hospital, Italy; Regional Agency Health and Social Care, Italy.
    Vichyanond, P.
    Mahidol University, Thailand.
    Viegi, G.
    CNR, Italy.
    Wagenmann, M.
    University of Klinikum Dusseldorf, Germany.
    Walker, S.
    Asthma UK, England.
    Wang, D. Y.
    National University of Singapore, Singapore.
    Wahn, U.
    Aura Andalucia, Jaen, Spain.
    Williams, D. M.
    University of N Carolina, NC USA.
    Wright, J.
    Bradford Royal Infirm, England.
    Yawn, B. P.
    Olmsted Medical Centre, MN USA.
    Yiallouros, P. K.
    Cyprus University of Technology, Cyprus; Hospital Archbishop Makarios III, Cyprus.
    Yusuf, O. M.
    Allergy and Asthma Institute, Pakistan.
    Zar, H. J.
    University of Cape Town, South Africa.
    Zernotti, M. E.
    University of Catolica Cordoba, Argentina.
    Zhang, L.
    Capital Medical University, Peoples R China.
    Zhong, N.
    Guangzhou Medical University, Peoples R China.
    Zidarn, M.
    University of Clin Resp and Allerg Disease, Slovenia.
    Chatzi, L,
    Mercier, J.
    University of Montpellier, France.
    Dedeu, T,
    Hyland, ME,
    Majer, I,
    Manning, P,
    Paggiaro, P,
    Rosado-Pinto, J,
    Rodenas, F,
    MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation2015Ingår i: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 70, nr 11, s. 1372-1392Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards.

  • 155.
    Brannstrom, Fredrik
    et al.
    Umeå University, Sweden.
    Bjerregaard, Jon K.
    Odense University Hospital, Denmark.
    Winbladh, Anders
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård.
    Nilbert, Mef
    Lund University, Sweden; University of Copenhagen, Denmark.
    Revhaug, Arthur
    University of Tromsoe, Norway.
    Wagenius, Gunnar
    Karolinska Institute, Sweden.
    Morner, Malin
    Karolinska Institute, Sweden.
    Multidisciplinary team conferences promote treatment according to guidelines in rectal cancer2015Ingår i: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 54, nr 4, s. 447-453Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Multidisciplinary team (MDT) conferences have been introduced into standard cancer care, though evidence that it benefits the patient is weak. We used the national Swedish Rectal Cancer Register to evaluate predictors for case discussion at a MDT conference and its impact on treatment. Material and methods. Of the 6760 patients diagnosed with rectal cancer in Sweden between 2007 and 2010, 78% were evaluated at a MDT. Factors that influenced whether a patient was discussed at a preoperative MDT conference were evaluated in 4883 patients, and the impact of MDT evaluation on the implementation of preoperative radiotherapy was evaluated in 1043 patients with pT3c-pT4 M0 tumours, and in 1991 patients with pN + M0 tumours. Results. Hospital volume, i.e. the number of rectal cancer surgical procedures performed per year, was the major predictor for MDT evaluation. Patients treated at hospitals with less than 29 procedures per year had an odds ratio (OR) for MDT evaluation of 0.15. Age and tumour stage also influenced the chance of MDT evaluation. MDT evaluation significantly predicted the likelihood of being treated with preoperative radiotherapy in patients with pT3c-pT4 M0 tumours (OR 5.06, 95% CI 3.08 - 8.34), and pN + M0 (OR 3.55, 95% CI 2.60 -4.85), even when corrected for co-morbidity and age. Conclusion. Patients with rectal cancer treated at high-volume hospitals are more likely to be discussed at a MDT conference, and that is an independent predictor of the use of adjuvant radiotherapy. These results indirectly support the introduction into clinical practice of discussing all rectal cancer patients at MDT conferences, not least those being treated at low-volume hospitals.

  • 156.
    Bransell, Sara
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Pappors reflektioner om hur, över tid pågående, konflikter med mamman drabbar barnet.2014Självständigt arbete på avancerad nivå (yrkesexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Huvudsyftet med föreliggande studie var att undersöka och beskriva hur pappor, som gått i samtalsgrupp med syfte att hjälpa föräldrar samarbeta om sina barn, resonerar angående barnens situation i familjer där det funnits allvarliga samarbetsproblem mellan föräldrarna. Hur och i vilken omfattning kunde de se barnets utsatthet?

    Tio pappor, vilka var separerade från medföräldern, som deltagit i samtalsgrupp i socialtjänstens regi intervjuades om vad de själva uppgav som väsentligt för hur barnet påverkades av pågående konflikt. De hade varierande former av vårdnad för sina barn. Gemensam, enskild eller var under förhandling för att få tillbaka gemensam eller enskild vårdnad. Intervjuerna genomfördes individuellt där deltagarna fick ta ställning till två fiktiva fall med barn vars föräldrar strider om sitt barn. Samtliga pappor betonade svårigheterna med att ha barnets bästa i främsta rummet när det finns en pågående konflikt med mamman. De uttryckte att det var svårt att bedöma vilka åtgärder som i realiteten är barnets bästa under pågående konflikt. Att de inte klarade av att fokusera på att vara förälder utan istället lagt kraft på att bemöta och bekämpa sin expartner på bekostnad av sin relation till barnet. Resultatet visade även att det finns en oro hos dessa pappor att förvärra en redan svår livssituation för barnet genom att föräldrarna inte uppfattar barnets situation för såväl sina egna barn som gällande de fiktiva barnen i vinjetterna.

    Sammanfattningsvis har papporna blivit medvetna om att de skall vara mer uppmärksamma och känsliga för sina barns behov. Att de kan urskilja att föräldraskapet är livslångt även om parrelationen är avslutad.

  • 157. Beställ onlineKöp publikationen >>
    Brohede, Sabina
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Body Dysmorphic Disorder: Capturing a prevalent but under-recognized disorder2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Background

    Individuals with body dysmorphic disorder (BDD) are highly distressed due to defects they perceive in their physical appearance that are not noticeable to others. The condition often leads to impaired functioning in relationships, socialization, and intimacy and a decreased ability to function in work, school, or other daily activities. Although BDD seems to be relatively prevalent, it is under-recognized by people in general and by health care professionals. Individuals with BDD are secretive about their symptoms, and they usually do not recognize that they are suffering from a psychiatric disorder. Instead, in an attempt to relieve their symptoms by correcting their perceived defects, they commonly seek dermatological treatment or cosmetic surgery. However, such interventions usually do not result in any decrease in BDD symptom severity, but can rather aggravate the symptoms. Therefore, it is crucial that health care professionals recognize BDD in order to offer adequate care. Prior to the studies conducted for this thesis, there were no known data regarding the prevalence of BDD in Sweden.

    Main aims

    (i) To translate a screening questionnaire for BDD (the Body Dysmorphic Disorder Questionnaire, BDDQ) into Swedish and validate the questionnaire in a community sample. (ii) To estimate the prevalence of BDD in the general population of Swedish women and in female dermatology patients. (iii) To explore BDD patients’ experiences of living with the disorder, including their experiences of the health care system.

    Methods

    The BDDQ was validated using the Structured Clinical Interview for DSM-IV (SCID) as the gold standard for diagnosing BDD (Study I). The validated BDDQ was used to estimate the prevalence of BDD in a randomly selected population-based sample of Swedish women (n=2 885) (Study II) and in a consecutive sample of female dermatology patients (n=425) (Study III). In Studies II and III, the Hospital Anxiety and Depression Scale was used to assess symptoms of depression and anxiety. In Study III, quality of life was evaluated by the Dermatology Life Quality Index. BDD patients’ lived experiences were explored using a qualitative research design (Study IV). Fifteen individuals with BDD were interviewed, and the interviews were analysed using Interpretive Description.

    Results

    The Swedish translation of the BDDQ displayed a sensitivity of 94%, a specidicity of 90% and a (positive) likelihood ratio of 9.4. The prevalence of women screening positive for BDD was 2.1% (95% CI 1.7–2.7) in the population-based sample of women and 4.9% (95% CI 3.2–7.4) in the dermatology patients’ sample. The positive predictive value of the BDDQ (71%) gave an estimated BDD prevalence of 1.5% (95% CI 1.1–2.0) in the female Swedish population. Women screening positive for BDD had signidicantly more symptoms of anxiety and depression compared to those screening negative for BDD in both samples. In the dermatology patients, quality of life was severely impaired in patients with positive BDD screening. The overarching concept found in Study IV was that patients with BDD felt imprisoned and were struggling to become free and to no longer feel abnormal. The participants had encountered difdiculties in accessing health care and had disappointing experiences of the health care system.

    Conclusion

    The findings of this thesis indicate that BDD is a relatively common disorder in the Swedish female population, and that it is more prevalent in dermatology patients. BDD patients struggle to be free from a feeling of imprisonment, and in this struggle they encounter difficulties in accessing health care. Therefore, it is important to increase awareness and recognition of BDD among health care professionals to ensure that patients with BDD receive the appropriate care.

    Delarbeten
    1. Validation of the Body Dysmorphic Disorder Questionnaire in a community sample of Swedish women
    Öppna denna publikation i ny flik eller fönster >>Validation of the Body Dysmorphic Disorder Questionnaire in a community sample of Swedish women
    2013 (Engelska)Ingår i: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 210, nr 2, s. 647-652Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Body Dysmorphic Disorder (BDD) is characterized by a distressing and impairing preoccupation with a nonexistent or slight defect in appearance. Patients with the disorder present to both psychiatric and non-psychiatric physicians. A few studies have assessed BDD prevalence in the general population and have shown that the disorder is relatively common. To date, no BDD assessment instruments have been validated in the general population. Our aim was to validate a brief self-screening instrument, the Body Dysmorphic Disorder Questionnaire (BDDQ), in a female community sample. The BDDQ was translated into Swedish and filled out by 2891 women from a randomly selected community sample. The questionnaire was validated in a subsample of 88 women, using the Structured Clinical Interview for DSM-IV (SCID) together with clinical assessment as the gold standard. In the validation subsample, the BDDQ showed good concurrent validity, with a sensitivity of 94%, a specificity of 90% and a likelihood ratio of 9.4. The questionnaire can therefore be of value when screening for BDD in female populations.

    Ort, förlag, år, upplaga, sidor
    Elsevier, 2013
    Nyckelord
    Self-report instrument; Measurement; Somatoform disorders; Appearance concerns; Body image
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-103301 (URN)10.1016/j.psychres.2013.07.019 (DOI)000328518600044 ()
    Tillgänglig från: 2014-01-17 Skapad: 2014-01-16 Senast uppdaterad: 2018-11-15
    2. Prevalence of body dysmorphic disorder among Swedish women: A population-based study
    Öppna denna publikation i ny flik eller fönster >>Prevalence of body dysmorphic disorder among Swedish women: A population-based study
    2015 (Engelska)Ingår i: Comprehensive Psychiatry, ISSN 0010-440X, E-ISSN 1532-8384, Vol. 58, s. 108-115Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background: Body dysmorphic disorder (BDD) is characterized by a highly distressing and impairing preoccupation with nonexistent or slight defects in appearance. Patients with BDD present to both psychiatric and non-psychiatric physicians. A few studies have assessed BDD prevalence in representative samples of the general population and have demonstrated that this disorder is relatively common. Our primary objective was to assess the prevalence of BDD in the Swedish population because no data are currently available. Methods: In the current cross-sectional study, 2891 randomly selected Swedish women aged 18-60 years participated. The occurrence of BDD was assessed using the Body Dysmorphic Disorder Questionnaire (BDDQ), which is a validated self-report measure derived from the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria for BDD. In addition, symptoms of depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Results: The prevalence of BDD among Swedish women was 2.1%. The women with BDD had significantly more symptoms of depression and anxiety than the women without BDD. Depression (HADS depression score greater than= 8) and anxiety (HADS anxiety score greater than= 8) were reported by 42% and 72% of the women with BDD, respectively. Conclusions: The results of the present study indicate that BDD is relatively common among Swedish women (2.1%) and that it is associated with significant morbidity.

    Ort, förlag, år, upplaga, sidor
    WB Saunders, 2015
    Nationell ämneskategori
    Klinisk medicin
    Identifikatorer
    urn:nbn:se:liu:diva-117368 (URN)10.1016/j.comppsych.2014.12.014 (DOI)000351807800015 ()25617963 (PubMedID)
    Anmärkning

    Funding Agencies|Linkoping University; Ostergotland County Council

    Tillgänglig från: 2015-04-24 Skapad: 2015-04-24 Senast uppdaterad: 2018-11-15
    3. I will be at deaths door and realize that Ive wasted maybe half of my life on one body part: the experience of living with body dysmorphic disorder
    Öppna denna publikation i ny flik eller fönster >>I will be at deaths door and realize that Ive wasted maybe half of my life on one body part: the experience of living with body dysmorphic disorder
    2016 (Engelska)Ingår i: International journal of psychiatry in clinical practice (Print), ISSN 1365-1501, E-ISSN 1471-1788, Vol. 20, nr 3, s. 191-198Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objectives: The purpose of this study was to explore the experiences of patients living with body dysmorphic disorder (BDD), including their experiences with the health care system. Methods: Fifteen individuals with BDD were interviewed, and interpretive description was used to analyse the interviews. Results: The following six themes were identified: being absorbed in time-consuming procedures, facing tension between ones own ideal and the perceived reality, becoming the disorder, being restricted in life, attempting to reduce ones problems and striving to receive care. The overarching concept derived from the themes was feeling imprisoned - struggling to become free and to no longer feel abnormal. Conclusions: Ideas of imprisonment and abnormality compose the entire experience of living with this disorder. Although the participants suffered greatly from their BDD, these patients encountered difficulties in accessing health care and had disappointing experiences during their encounters with the health care system. Therefore, it is important to increase awareness and knowledge of BDD among health care professionals to ensure that patients with BDD receive the appropriate care.

    Ort, förlag, år, upplaga, sidor
    TAYLOR & FRANCIS LTD, 2016
    Nyckelord
    Body dysmorphic disorder; body image; interview; qualitative research
    Nationell ämneskategori
    Psykiatri
    Identifikatorer
    urn:nbn:se:liu:diva-131206 (URN)10.1080/13651501.2016.1197273 (DOI)000380144000013 ()27314665 (PubMedID)
    Tillgänglig från: 2016-09-16 Skapad: 2016-09-12 Senast uppdaterad: 2018-11-15
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  • 158.
    Brohede, Sabina
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Wijma, Barbro
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Wijma, Klaas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten.
    Blomberg, Karin
    University of Örebro, Sweden.
    I will be at deaths door and realize that Ive wasted maybe half of my life on one body part: the experience of living with body dysmorphic disorder2016Ingår i: International journal of psychiatry in clinical practice (Print), ISSN 1365-1501, E-ISSN 1471-1788, Vol. 20, nr 3, s. 191-198Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: The purpose of this study was to explore the experiences of patients living with body dysmorphic disorder (BDD), including their experiences with the health care system. Methods: Fifteen individuals with BDD were interviewed, and interpretive description was used to analyse the interviews. Results: The following six themes were identified: being absorbed in time-consuming procedures, facing tension between ones own ideal and the perceived reality, becoming the disorder, being restricted in life, attempting to reduce ones problems and striving to receive care. The overarching concept derived from the themes was feeling imprisoned - struggling to become free and to no longer feel abnormal. Conclusions: Ideas of imprisonment and abnormality compose the entire experience of living with this disorder. Although the participants suffered greatly from their BDD, these patients encountered difficulties in accessing health care and had disappointing experiences during their encounters with the health care system. Therefore, it is important to increase awareness and knowledge of BDD among health care professionals to ensure that patients with BDD receive the appropriate care.

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  • 159.
    Brohede, Sabina
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Wingren, Gun
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Hälsouniversitetet.
    Wijma, Barbro
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Wijma, Klaas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Prevalence of body dysmorphic disorder among Swedish women: A population-based study2015Ingår i: Comprehensive Psychiatry, ISSN 0010-440X, E-ISSN 1532-8384, Vol. 58, s. 108-115Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Body dysmorphic disorder (BDD) is characterized by a highly distressing and impairing preoccupation with nonexistent or slight defects in appearance. Patients with BDD present to both psychiatric and non-psychiatric physicians. A few studies have assessed BDD prevalence in representative samples of the general population and have demonstrated that this disorder is relatively common. Our primary objective was to assess the prevalence of BDD in the Swedish population because no data are currently available. Methods: In the current cross-sectional study, 2891 randomly selected Swedish women aged 18-60 years participated. The occurrence of BDD was assessed using the Body Dysmorphic Disorder Questionnaire (BDDQ), which is a validated self-report measure derived from the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria for BDD. In addition, symptoms of depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Results: The prevalence of BDD among Swedish women was 2.1%. The women with BDD had significantly more symptoms of depression and anxiety than the women without BDD. Depression (HADS depression score greater than= 8) and anxiety (HADS anxiety score greater than= 8) were reported by 42% and 72% of the women with BDD, respectively. Conclusions: The results of the present study indicate that BDD is relatively common among Swedish women (2.1%) and that it is associated with significant morbidity.

  • 160.
    Brohede, Sabina
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Medicinsk psykologi. Linköpings universitet, Hälsouniversitetet.
    Wingren, Gun
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Wijma, Barbro
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Wijma, Klaas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Validation of the Body Dysmorphic Disorder Questionnaire in a community sample of Swedish women2013Ingår i: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 210, nr 2, s. 647-652Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Body Dysmorphic Disorder (BDD) is characterized by a distressing and impairing preoccupation with a nonexistent or slight defect in appearance. Patients with the disorder present to both psychiatric and non-psychiatric physicians. A few studies have assessed BDD prevalence in the general population and have shown that the disorder is relatively common. To date, no BDD assessment instruments have been validated in the general population. Our aim was to validate a brief self-screening instrument, the Body Dysmorphic Disorder Questionnaire (BDDQ), in a female community sample. The BDDQ was translated into Swedish and filled out by 2891 women from a randomly selected community sample. The questionnaire was validated in a subsample of 88 women, using the Structured Clinical Interview for DSM-IV (SCID) together with clinical assessment as the gold standard. In the validation subsample, the BDDQ showed good concurrent validity, with a sensitivity of 94%, a specificity of 90% and a likelihood ratio of 9.4. The questionnaire can therefore be of value when screening for BDD in female populations.

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  • 161.
    Browaldh, Lars
    et al.
    Sachsska barnsjukhuset, Södersjukhuset, Stockholm.
    Sandstrom, Olof
    Norrlands universitetssjukhus, Umeå.
    Agardh, Daniel
    Skånes universitetssjukhus.
    Stenhammar, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Norrköping.
    Ivarsson, Anneli
    Umeå universitet.
    Celiaki är en vanlig sjukdom som är lätt att missa2014Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, nr 11, s. 484-488Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

    Celiaki ansågs länge som en ovanlig barnsjukdom, men är en vanlig sjukdom som drabbar alla åldrar.

    Genomförda screeningar av normalbefolkningen visar att merparten inte fått dia­gnos eller behandling.

    Den kliniska bilden varierar: alltifrån diffusa besvär eller inga symtom alls till allvarliga gastrointestinala symtom med grav avmagring och tillväxtrubbning till följd av malabsorption.

    Klinisk misstanke om eller hereditet för celiaki bör föranleda analys av specifika serologiska markörer. Gastroskopi med tunntarmsbiopsi bör övervägas för att bekräfta eller utesluta diagnosen.

  • 162.
    Bruhn, Sören
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Fang, Yu
    Guiyang Medical Coll, Peoples R China University of Gothenburg, Sweden .
    Barrenäs, Fredrik
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Gustafsson, Mika
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Zhang, Huan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Konstantinell, Aelita
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Kronke, Andrea
    Cenix BioScience GmbH, Germany .
    Sonnichsen, Birte
    Cenix BioScience GmbH, Germany .
    Bresnick, Anne
    Albert Einstein Coll Med, NY 10461 USA .
    Dulyaninova, Natalya
    Albert Einstein Coll Med, NY 10461 USA .
    Wang, Hui
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Zhao, Yelin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Klingelhofer, Jorg
    University of Copenhagen, Denmark .
    Ambartsumian, Noona
    University of Copenhagen, Denmark .
    Beck, Mette K.
    Technical University of Denmark, Denmark .
    Nestor, Colm
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Bona, Elsa
    Boras Hospital, Sweden .
    Xiang, Zou
    University of Gothenburg, Sweden .
    Benson, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    A Generally Applicable Translational Strategy Identifies S100A4 as a Candidate Gene in Allergy2014Ingår i: Science Translational Medicine, ISSN 1946-6234, E-ISSN 1946-6242, Vol. 6, nr 218Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The identification of diagnostic markers and therapeutic candidate genes in common diseases is complicated by the involvement of thousands of genes. We hypothesized that genes co-regulated with a key gene in allergy, IL13, would form a module that could help to identify candidate genes. We identified a T helper 2 (T(H)2) cell module by small interfering RNA-mediated knockdown of 25 putative IL13-regulating transcription factors followed by expression profiling. The module contained candidate genes whose diagnostic potential was supported by clinical studies. Functional studies of human TH2 cells as well as mouse models of allergy showed that deletion of one of the genes, S100A4, resulted in decreased signs of allergy including TH2 cell activation, humoral immunity, and infiltration of effector cells. Specifically, dendritic cells required S100A4 for activating T cells. Treatment with an anti-S100A4 antibody resulted in decreased signs of allergy in the mouse model as well as in allergen-challenged T cells from allergic patients. This strategy, which may be generally applicable to complex diseases, identified and validated an important diagnostic and therapeutic candidate gene in allergy.

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  • 163.
    Bruun, Jarle
    et al.
    Oslo University Hospital, Norway; Oslo University Hospital, Norway; University of Oslo, Norway.
    Kolberg, Matthias
    Oslo University Hospital, Norway; Oslo University Hospital, Norway; University of Oslo, Norway.
    Ahlquist, Terje C.
    Oslo University Hospital, Norway; Oslo University Hospital, Norway.
    Royrvik, Ellen C.
    Oslo University Hospital, Norway; University of Oslo, Norway; University of Oxford, England.
    Nome, Torfinn
    Oslo University Hospital, Norway; University of Oslo, Norway.
    Leithe, Edward
    Oslo University Hospital, Norway; Oslo University Hospital, Norway; University of Oslo, Norway.
    Lind, Guro E.
    Oslo University Hospital, Norway; Oslo University Hospital, Norway; University of Oslo, Norway.
    Merok, Marianne A.
    Oslo University Hospital, Norway; University of Oslo, Norway; Oslo University Hospital, Norway.
    Rognum, Torleiv O.
    University of Oslo, Norway; Norwegian Institute Public Heatlh, Norway.
    Bjorkoy, Geir
    University of Coll Sor Trondelag, Norway.
    Johansen, Terje
    University of Tromso, Norway.
    Lindblom, Annika
    Karolinska Institute, Sweden.
    Sun, Xiao-Feng
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US.
    Svindland, Aud
    University of Oslo, Norway; Oslo University Hospital, Norway.
    Liestol, Knut
    University of Oslo, Norway; Fac Math and Nat Science, Norway.
    Nesbakken, Arild
    Oslo University Hospital, Norway; University of Oslo, Norway; Oslo University Hospital, Norway; University of Oslo, Norway.
    Skotheim, Rolf I.
    Oslo University Hospital, Norway; Oslo University Hospital, Norway; University of Oslo, Norway; Fac Math and Nat Science, Norway.
    Lothe, Ragnhild A.
    Oslo University Hospital, Norway; Oslo University Hospital, Norway; University of Oslo, Norway; University of Oslo, Norway.
    Regulator of Chromosome Condensation 2 Identifies High-Risk Patients within Both Major Phenotypes of Colorectal Cancer2015Ingår i: Clinical Cancer Research, ISSN 1078-0432, E-ISSN 1557-3265, Vol. 21, nr 16, s. 3759-3770Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Colorectal cancer has high incidence and mortality worldwide. Patients with microsatellite instable (MSI) tumors have significantly better prognosis than patients with microsatellite stable (MSS) tumors. Considerable variation in disease outcome remains a challenge within each subgroup, and our purpose was to identify biomarkers that improve prediction of colorectal cancer prognosis. Experimental Design: Mutation analyses of 42 MSI target genes were performed in two independent MSI tumor series (n = 209). Markers that were significantly associated with prognosis in the test series were assessed in the validation series, followed by functional and genetic explorations. The clinical potential was further investigated by immunohistochemistry in a population-based colorectal cancer series (n = 903). Results: We identified the cell-cycle gene regulator of chromosome condensation 2 (RCC2) as a cancer biomarker. We found a mutation in the 50 UTR region of RCC2 that in univariate and multivariate analyses was significantly associated with improved outcome in the MSI group. This mutation caused reduction of protein expression in dual luciferase gene reporter assays. siRNA knockdown in MSI colon cancer cells (HCT15) caused reduced cell proliferation, cell-cycle arrest, and increased apoptosis. Massive parallel sequencing revealed few RCC2 mutations in MSS tumors. However, weak RCC2 protein expression was significantly associated with poor prognosis, independent of clinical highrisk parameters, and stratifies clinically important patient subgroups with MSS tumors, including elderly patients (greater than 75 years), stage II patients, and those with rectal cancer. Conclusions: Impaired RCC2 affects functional and clinical endpoints of colorectal cancer. High-risk patients with either MSI or MSS tumors can be identified with cost-effective routine RCC2 assays. (C) 2015 AACR.

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  • 164.
    Brüggemann, Jelmer
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten.
    Exploring patient strategies in response to untoward healthcare encounters2017Ingår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 24, nr 2, s. 190-197Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Increasing attention to patients’ rights and their ability to choose their healthcare provider have changed the way patients can respond to untoward, disempowering and abusive healthcare encounters. These responses are often seen as crucial for quality improvement, yet they are little explored and conceptualized.

    Objective: To explore patients’ potential responses to untoward healthcare encounters and looking at their possible consequences for care quality improvement as well as for the individual patient.

    Research design: The article is structured looking at two primary strategies: patient exit (leaving a healthcare provider) and patient voice (expressing grievances), derived from Hirschman (1970). These strategies were explored by the use of theoretical and empirical literature and applied to an individual patient case. The case functions as a pedagogical tool to illustrate and problematize what exit and voice strategies can mean for a single patient.

    Ethical considerations: The patient case is my version of a generalized scenario that is described elsewhere. It does not represent an individual patient’s story, but aims to be realistic and recognizable.

    Findings and conclusion: Based on the existing literature, it is hypothesized that, in their current form, exit and voice strategies have a limited effect on care quality and can come at a price for patients. However, both strategies may be of value to patients and providers. Therefore, the healthcare system could empower patients to engage in action and could further develop ways for providers to effectively use patients’ responses to improve practice and find ways to prevent patients from untoward experiences in healthcare.

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  • 165.
    Brüggemann, Jelmer
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Swahnberg, Katarina
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Department of Health and Caring Sciences, Linnaeus University, Sweden.
    Staff silence about abuse in health care: An exploratory study at a Swedish women’s clinic2014Ingår i: Clinical Ethics, ISSN 1477-7509, E-ISSN 1758-101X, Vol. 9, s. 71-76Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    It has been well documented that patients can feel abused in health care and that many patients suffer from these experiences. Insight lacks into contributing factors behind such events. Silence surrounding the abuse has been suggested as a possible mechanism. The present study explores silence surrounding the abuse as a possible contributing factor. We have explored whether this silence is connected with the staff’s hierarchical position and with the staff’s own experiences as patients abused in health care.

    Methods During January 2008, a paper questionnaire was sent to all staff members at a Swedish women’s clinic. The questionnaire included questions on sociodemography and profession and multiple questions about abuse in health care. After univariate testing, a binary logistic regression model including variables concerning profession and staff’s own experiences of abuse was built.

    Results Our data show that in contrast to midwives and gynaecologists, auxiliary nurses seldom report hearing about cases of abuse in health care. Staff who themselves experienced abuse in health care as patients, so-called wounded healers, were more likely to have heard about abuse in health care during the last 12 months.

    Conclusions This study suggests that a form of silence reigns over events of abuse in health care that is not randomly distributed over staff. Professional hierarchies and staff’s own experiences of abuse as patients could be considered in the design of interventions to break the silence surrounding patients’ experiences of abuse in health care.

  • 166.
    Brüggemann, Jelmer
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten.
    Swahnberg, Katarina
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Linnaeus University, Sweden.
    Wijma, Barbro
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    A first online intervention to increase patients perceived ability to act in situations of abuse in health care: reports of a Swedish pre-post study2015Ingår i: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 16, nr 35Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Efforts to counteract abuse in health care, defined as patient-experienced abuse, have mainly focused on interventions among caregivers. This study is the first to test an online intervention focusing on how patients can counteract such abuse. The intervention aimed at increasing patients intention and perceived ability to act in future situations where they risk experiencing abuse. Methods: Participants were recruited through a nephrology clinic in Sweden. The intervention consisted of an online program that aimed to stimulate patients to think of possible actions in situations in which they risk experiencing abuse. The program comprised stories and exercises in text and comic form. The participants filled out a questionnaire immediately before and after going through the program, as well as during follow-up four to eight weeks later. Results: Forty-eight patients (39 %) participated in the study and spent, on average, 41 min responding to questions and going through the program. Both men and women, of various ages and educational backgrounds, participated. An increase in participants self-reported ability to identify opportunities to act in a given situation was seen immediately afterwards, as well as during follow up. Conclusion: The current study suggests that it is feasible and most likely useful to a variety of patients to work with the provided material that has the aim of counteracting abuse in health care. It would be of interest to further develop ways of using comics and to test similar interventions in other health care settings.

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  • 167.
    Busch, Susann
    et al.
    Gothenburg University, Sweden.
    Sims, Andrew H.
    University of Edinburgh, Scotland.
    Stål, Olle
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US.
    Ferno, Marten
    Lund University, Sweden.
    Landberg, Goran
    Gothenburg University, Sweden; University of Manchester, England.
    Loss of TGF beta Receptor Type 2 Expression Impairs Estrogen Response and Confers Tamoxifen Resistance2015Ingår i: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 75, nr 7, s. 1457-1469Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    One third of the patients with estrogen receptor alpha (ER alpha)-positive breast cancer who are treated with the antiestrogen tamoxifen will either not respond to initial therapy or will develop drug resistance. Endocrine response involves crosstalk between ER alpha and TGF beta signaling, such that tamoxifen non-responsiveness or resistance in breast cancer might involve aberrant TGF beta signaling. In this study, we analyzed TGF beta receptor type 2 (TGFBR2) expression and correlated it with ER alpha status and phosphorylation in a cohort of 564 patients who had been randomized to tamoxifen or no-adjuvant treatment for invasive breast carcinoma. We also evaluated an additional four independent genetic datasets in invasive breast cancer. In all the cohorts we analyzed, we documented an association of low TGFBR2 protein and mRNA expression with tamoxifen resistance. Functional investigations confirmed that cell cycle or apoptosis responses to estrogen or tamoxifen in ER alpha-positive breast cancer cells were impaired by TGFBR2 silencing, as was ER alpha phosphorylation, tamoxifen-induced transcriptional activation of TGF beta, and upregulation of the multidrug resistance protein ABCG2. Acquisition of low TGFBR2 expression as a contributing factor to endocrine resistance was validated prospectively in a tamoxifen-resistant cell line generated by long-term drug treatment. Collectively, our results established a central contribution of TGF beta signaling in endocrine resistance in breast cancer and offered evidence that TGFBR2 can serve as an independent biomarker to predict treatment outcomes in ER alpha-positive forms of this disease.

  • 168.
    Bågesund, Mats
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Region Östergötland, Folktandvården. Linköpings universitet, Medicinska fakulteten. TakoCentre, National Resource Centre for Oral Health in Rare Medical Conditions, Lovisenberg Diakonale Hospital, Oslo, Norway.
    Shafiee, Z.
    TakoCentre, National Resource Centre for Oral Health in Rare Medical Conditions, Lovisenberg Diakonale Hospital, Oslo, Norway.
    Drivdal, M.
    Centre for Rare Disorders, Oslo University Hospital, Oslo, Norway.
    Berden, J.
    TakoCentre, National Resource Centre for Oral Health in Rare Medical Conditions, Lovisenberg Diakonale Hospital, Oslo, Norway.
    Storhaug, K.
    TakoCentre, National Resource Centre for Oral Health in Rare Medical Conditions, Lovisenberg Diakonale Hospital, Oslo, Norway.
    Dental care and oral health in Aagenaes syndrome/lymphedema cholestasis syndrome 12015Ingår i: Special Care in Dentistry, ISSN 0275-1879, Vol. 35, nr 2, s. 83-89Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aagenaes syndrome/lymphedema cholestasis syndrome 1 (LCS1) is a rare genetic disorder characterized by neonatal cholestasis and lymphedema. The aim was to assess dental care and oral health in adults with LCS1. Fifteen (9M, 6F) individuals diagnosed with LCS1, aged 19-59 years participated. The study evaluated salivary secretion rate, dental radiographs, intraoral photos and included a questionnaire. Eight (53%) had regular dental checkups. Three had received subsidized dental care. Seven (47%) had two or more subjective symptoms of xerostomia. Three (20%) had a decreased stimulated salivary secretion rate below 0.7 mL/minute. Seven (47%) had dentin caries. Marginal periodontitis was found in all six patients above 35 years of age, but not before that age. Thirteen (87%) had tooth discoloration, which was extensive in three (20%). Conclusion. Several patients with LCS1 have problems with periodontitis and tooth discoloration. Frequent dental checkups are therefore recommended. © 2014 Special Care Dentistry Association and Wiley Periodicals, Inc.

  • 169.
    Börjeson, Sussanne
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US.
    Hursti, T J
    Department of Psychology, Uppsala University, Uppsala, Sweden.
    Peterson, C
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet. Department of Clinical Pharmacology, Karolinska Hospital, Stockholm, Sweden.
    Fredikson, M
    Department of Psychology, Uppsala University, Uppsala, Sweden.
    Fürst, C J
    Stockholms Sjukhem, Stockholm, Sweden.
    Avall-Lundqvist, E
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Dept. of Gynaecological Oncology, Karolinska Hospital, Stockholm, Sweden.
    Steineck, G
    Clinical Epidemiology, Department of Oncology, Karolinska Hospital, Stockholm, Sweden.
    Similarities and differences in assessing nausea on a verbal category scale and a visual analogue scale.1997Ingår i: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 20, nr 4, s. 260-266Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The use of verbal category scales in assessing patient symptoms is evolving, but the extent to which reliability and precision are lost in using them as opposed to a visual analogue scale (VAS) remains uncertain. The present study analyzed the concordance between a four-point verbal category scale and a VAS in assessing nausea intensity in patients undergoing chemotherapy. The analysis of a total of 348 simultaneous ratings by 104 women over four cycles revealed good concordance between the scales. The means of the VAS ratings (range 0-100 mm) corresponding to the four verbal categories divided the scale in four almost equally large parts (no nausea = 0.7, mild = 24.8, moderate = 48.3, severe = 75.1). However, the VAS ranges were wide. On an individual level a one-step change in the verbal category was associated with an average change of 20 mm on the VAS. The choice of scale to use should be based on the need in the particular situation. When measuring intensity of nausea in patients, the VAS is a reasonable choice due to its possibly greater ability to detect changes over time. On the group level, findings on a four-point category scale and a VAS on the average seem similar.

  • 170.
    Cardemil, Carina
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Käkkliniken US.
    Bisfosfonatinducerad käkbensnekros (ONJ)2016Övrigt (Övrigt vetenskapligt)
  • 171.
    Carlander, Johan
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Department of Surgery and Center for Clinical Research Uppsala University.
    Wagner, Philippe
    Department of Surgery and Center for Clinical Research Uppsala University, Västmanland County Hospital, Västerås, Sweden.
    Gimm, Oliver
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Nordenström, Erik
    Department of Surgery, Lund University Hospital, Malmö, Sweden.
    Jansson, Svante
    Department of Surgery, Sahlgrenska University Hospital Gothenburg, Göteborg, Sweden.
    Bergkvist, Leif
    Department of Surgery and Center for Clinical Research Uppsala University, Västmanland County Hospital, Västerås, Sweden.
    Johansson, Kenth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Department Surgery, Västervik Hospital, Västervik,Gothenburg, Göteborg, Sweden .
    Risk of Complications with Energy-Based Surgical Devices in Thyroid Surgery: A National Multicenter Register Study2016Ingår i: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 40, nr 1, s. 117-123Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Energy-based surgical devices (EBD) combining cutting and coagulation are increasingly used in thyroid surgery. However, there is a lack of information about potential benefits and risk of complications outside controlled trials. The aims of this national multicenter register study were to describe the use of EDB, their potential effect on complication rates, and on operation time.

    Materials and methods

    The Scandinavian Quality Register for Thyroid and Parathyroid surgery includes 35 surgical units in Sweden and covered 88 % of the thyroid procedures performed during 2008–2009. The use of the EBD was specifically registered for 12 months, and 1297 patients were included. Surgically related complications and operation time were evaluated. The clamp-and-tie group (C-A-T) constituted the control group for comparison with procedures where EBD was used.

    Results

    The thyroid procedures performed included C-A-T (16.6 %), bipolar electrosurgery (ES: 56.5 %), electronic vessel sealing (EVS: 12.2 %), and ultrasonic dissection (UD: 14.5 %). Mean operative time was longer with EVS (p < 0.001) and shorter with UD (p < 0.05) than in the other groups. The bipolar ES group and the EVS group had higher incidence of calcium treatment at discharge and after 6 weeks than the UD group. No significant difference in nerve injury was found between the groups. There was a significant more frequent use of topical hemostatic agents in the EBD group compared to C-A-T.

    Conclusion

    In this national multicenter study, the use of UD shortened and EVS increased operating time. There was a higher risk of calcium treatment at discharge and after 6 weeks after use of EVS and bipolar ES than after UD use. There was a significant more frequent use of topical hemostatic agents in the EBD groups compared to C-A-T.

  • 172.
    Carlhäll, Sara
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten.
    Bladh, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Brynhildsen, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Claesson, Ing-Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Josefsson, Ann
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Sydsjö, Gunilla
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Thorsell, Annika
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Medicinska fakulteten.
    Blomberg, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Maternal obesity (Class I-III), gestational weight gain and maternal leptin levels during and after pregnancy: a prospective cohort study2016Ingår i: BMC Obesity, ISSN 2052-9538, Vol. 3, nr 28Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Maternal obesity is accompanied by maternal and fetal complications during and after pregnancy. The risks seem to increase with degree of obesity. Leptin has been suggested to play a role in the development of obesity related complications. Whether maternal leptin levels differ between obese and morbidly obese women, during and after pregnancy, have to our knowledge not been previously described. Neither has the association between maternal leptin levels and gestational weight gain in obese women. The aim was to evaluate if maternal plasma leptin levels were associated with different degrees of maternal obesity and gestational weight gain.

    Methods

    Prospective cohort study including women categorized as obesity class I-III (n = 343) and divided into three gestational weight gain groups (n = 304). Maternal plasma leptin was measured at gestational week 15, 29 and 10 weeks postpartum. Maternal Body Mass Index (BMI) was calculated from early pregnancy weight. Gestational weight gain was calculated using maternal weight in delivery week minus early pregnancy weight. The mean value and confidence interval of plasma-leptin were analysed with a two-way ANOVA model. Interaction effect between BMI and gestational weight gain group was tested with a two-way ANOVA model.

    Results

    The mean maternal leptin concentrations were significantly higher in women with obesity class III compared to women in obesity class I, at all times when plasma leptin were measured. The mean leptin concentrations were also significantly higher in women with obesity class II compared to women in obesity class I, except in gestational week 29. There was no difference in mean levels of plasma leptin between the gestational weight gain groups. No significant interaction between BMI and gestational weight gain group was found.

    Conclusions

    Plasma leptin levels during and after pregnancy were associated with obesity class but not with degree of gestational weight gain. These results are in concordance with epidemiological findings where the risk of obstetric complications increases with increased maternal obesity class. The effect on obstetric outcome by degree of gestational weight gain is less pronounced than the adverse effects associated with maternal obesity.

    Ladda ner fulltext (pdf)
    Maternal obesity (Class I-III), gestational weight gain and maternal leptin levels during and after pregnancy: a prospective cohort study
  • 173. Beställ onlineKöp publikationen >>
    Carlsson, Anders
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Role of mast cells and probiotics in the regulation of intestinal barrier function2013Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The intestinal mucosa is the largest contact area and one of the most important barriers to the outside environment. It is highly specialized in aiding us digest and absorb nutrients. It is daily exposed to several potentially dangerous substances and microorganisms, which if they were allowed to pass into the body, could give rise to diseases. Throughout the small intestine certain sites specialized in antigen sampling are found. These sites are named Peyer’s patches and are lymphoid follicles. The epithelium covering the Peyer’s patches is called follicle-associated epithelium and is specialized in antigen sampling and uptake. The special epithelium enables presentation of luminal antigen to immune cells in the underlying follicle.

    Persistent life stress and stressful life events affect the course of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) through largely unknown mechanisms. Regulation of epithelial permeability to antigens is crucial for the balance between inflammation and immune-surveillance, and increased intestinal permeability has been shown in patients with ulcerative colitis and Crohns disease. Vasoactive intestinal polypeptide (VIP) and corticotropin-releasing factor have been implicated as important mediators of stress-induced abnormalities in intestinal mucosal functions in animal models. Both of these mediators have been reported to regulate bowel ion secretion in humans during stress and uptake of horseradish peroxidase in rodents. Probiotics have been shown to ameliorate the deleterious effects of stress on intestinal function, but mechanisms remain to be elucidated.

    The aim of this thesis was to elucidate whether mast cells play an important role in intestinal barrier function during stress and inflammation. Moreover, we wanted to determine whether probiotics can ameliorate the mucosal barrier integrity during stress and inflammation.

    To study the function of mast cells we conducted in vitro experiments on cell lines and ex vivo experiments in Ussing chambers on mouse, rat and human intestinal tissue. The Ussing chamber technique measures electrophysiological properties of the tissue and also gives the possibility to study transcellular and paracellular passage of markers and bacteria. Immunohistology and confocal microscopy have been used to identify mast cells and receptors of interest.

    Our results show that stress affects the follicle-associated epithelium barrier by mechanisms involving VIP and mast cells. These findings were corroborated by the localization of VIP receptors on mucosal mast cells. Furthermore, pretreatment with probiotics was effective in protecting the gut against stress-induced intestinal barrier dysfunction and mucosal inflammation. This protection appeared to involve a mast cell and peroxisome proliferatoractivated receptor-γ dependent mechanism.

    Delarbeten
    1. Vasoactive intestinal polypeptide regulates barrier function via mast cells in human intestinal follicle-associated epithelium and during stress in rats
    Öppna denna publikation i ny flik eller fönster >>Vasoactive intestinal polypeptide regulates barrier function via mast cells in human intestinal follicle-associated epithelium and during stress in rats
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    2013 (Engelska)Ingår i: Neurogastroenterology and Motility, ISSN 1350-1925, E-ISSN 1365-2982, Vol. 25, nr 6, s. e406-e417Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background Vasoactive intestinal polypeptide (VIP) has been implicated as a regulator of intestinal barrier function and inflammation. Our aim was to elucidate the role of VIP in follicle-associated epithelium (FAE) and villus epithelium (VE) permeability following stress in rats and on human intestinal barrier function. Methods Rats were injected intraperitoneally (i.p.) with VIP receptor-antagonists (anti-VPACs), a mast cell stabilizer, doxantrazole (DOX), or NaCl, and submitted to acute water avoidance stress. Ileal segments were mounted in Ussing chambers to assess 51chromium-edta (51Cr-edta) and Escherichia (E.) coli (strain K-12) permeability. Rat ileal and human ileal and colonic segments were exposed to VIP +/- anti-VPACs or DOX. An in vitro co-culture model of human FAE was used to study epithelial-VIP effects. VIP/VPACs distribution was assessed by microscopy. Key Results Stress increased 51Cr-edta and E.coli permeability in VE and FAE. The increases were abolished by i.p. injection of DOX or anti-VPACs. Ileal VIP-exposure ex vivo increased bacterial passage and this was reduced by DOX. In human FAE ex vivo, VIP treatment doubled bacterial uptake, which was normalized by DOX or anti-VPACs. No barrier effects were observed in human colonic tissue. VPACs were found in rat and human ileal follicles, with partial mast cell co-localization. The co-culture model confirmed VIPmast cellepithelial interactions in the regulation of barrier function. Conclusions andamp; Inferences Stress affects the FAE barrier by mechanisms involving VIP and VPACs on mucosal mast cells. We suggest a regulatory role for VIP in the control of ileal permeability that may be relevant to bacterialepithelial interactions in stress-related intestinal disorders.

    Ort, förlag, år, upplaga, sidor
    Wiley-Blackwell, 2013
    Nyckelord
    Inflammatory bowel disease, permeability, Peyers patch, Ussing chamber
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-94315 (URN)10.1111/nmo.12127 (DOI)000318945400005 ()
    Anmärkning

    Funding Agencies|Swedish Research Council|K2012-55X-12618-16-3|

    Tillgänglig från: 2013-06-24 Skapad: 2013-06-24 Senast uppdaterad: 2017-12-06
    2. Protective Effects of Probiotics on Chronic Stress-Induced Intestinal Permeability in Rats are mediated via Mast Cells and PPARγ
    Öppna denna publikation i ny flik eller fönster >>Protective Effects of Probiotics on Chronic Stress-Induced Intestinal Permeability in Rats are mediated via Mast Cells and PPARγ
    Visa övriga...
    2013 (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    BACKGROUND: Chronic stress, which may affect in the clinical course of inflammatory and functional bowel diseases, disrupts intestinal barrier function by routes involving mast cells. Probiotics have been shown to ameliorate the deleterious effects of stress on intestinal function, but mechanisms remain to be elucidated. Peroxisome proliferator-activated receptor (PPAR)-γ signaling is activated as an endogenous defense mechanism during chronic stress and evidence suggests that probiotics reduce the degradation of PPAR-γ. As a source of the endogenous agonist for PPAR-γ, 15d-PGJ2, and as an important mediator of the stress response, mast cells may have both a beneficial and a deleterious role in the effects on intestinal function by probiotics.

    AIM: Our aim was to study if mast cells contribute to the positive effects of probiotic therapy on intestinal function in a rat model of chronic stress.

    METHODS: 32 Mast cell deficient (Ws/Ws) and 32 wild-type (+/+) rats were subjected to water avoidance stress (WAS) or sham stress (SS) 1hr/day for 10 days. Seven days prior to the onset of stress, probiotics (PB, multispecies combination of 10 different lactic acid bacteria) were added to the standard diet (St) in half of the animals. To determine dependence of PPAR-γ, 8 probiotic-fed wild-type rats subjected to WAS were injected daily with the specific PPAR-γ antagonist T0070907. The colonic mucosa was exposed to E. coli HB101 incorporated with green fluorescent protein and permeability was assessed in Ussing chambers. Mesenteric lymph nodes (MLN) were cultured to determine bacterial translocation.

    RESULTS: Chronic stress induced a marked increase in ileal permeability to E.coli HB101 in +/+ rats (0.17±0.1 x106CFU/hr in SS/St/++ vs. 2.13±0.4 in WAS/St/++; P<0.001). This breach in barrier integrity was less pronounced in Ws/Ws rats (2.13±0.4 in WAS/St/++ vs. 1.19±0.3 in WAS/St/WsWs; P<0.01). Probiotics prevented stress-induced effects in E.coli HB101 passage only in wild-type rats (82% decrease in +/+ vs. 0% in Ws/Ws rats). Furthermore, only in the presence of mast cells did probiotics reduce the enhanced bacterial translocation to MLNs during chronic stress. In wild-type rats treated with a PPAR-γ antagonist, the barrier protective effects of probiotics were diminished.

    CONCLUSIONS: Mast cells acting via a PPAR-γ dependent pathway contribute to the beneficial effects of probiotics on chronic stress-induced mucosal dysfunction in rats.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-100767 (URN)
    Tillgänglig från: 2013-11-12 Skapad: 2013-11-12 Senast uppdaterad: 2014-03-25
    3. Probiotics modulate mast cell degranulation and reduce stress-induced barrier dysfunction in vitro
    Öppna denna publikation i ny flik eller fönster >>Probiotics modulate mast cell degranulation and reduce stress-induced barrier dysfunction in vitro
    Visa övriga...
    2013 (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    BACKGROUND: Stress has well-established deleterious effects on intestinal barrier function and stressful life events are known to contribute to the development and perpetuation of inflammatory bowel diseases. Mast cells play a pivotal role in pathogenesis of stressinduced barrier dysfunction due to the release of barrier-disruptive content. Conversely, they also have recently been suggested to contribute to barrier protective properties of probiotics, through the release of 15d-PGJ2 and enhanced epithelial PPAR-γ activity. However, mechanisms remain to be elucidated.

    AIM: To study if probiotics can modulate mast cell mediator release, resulting in amelioration of stress-induced barrier dysfunction in vitro.

    METHODS: Confluent monolayers of the human colon-derived T84 epithelial cell line were co-cultured with rat basophilic leukemia (RBL)-2H3 mast cells and pretreated with probiotics (125x104 CFU/ml, 1hr) before addition of 100nM CRF to activate mast cells. Release of beta hexosaminidase, TNF-α and 15d-PGJ2 from mast cells was determined. Transepithelial resistance (TER), and permeability to microspheres (0.2μm) were measured over a 24h period. To determine dependence of PPAR-γ, monolayers were incubated with the specific PPAR-γ antagonist T0070907 before treatment with probiotics.

    RESULTS: CRF-induced activation of mast cells resulted in decreased TERs and increased permeability to microspheres. Both pretreatment with probiotics and filter-sterilized probiotic supernatant resulted in lower levels of mast cell-released beta hexosaminidase and TNF-α, and increased 15d-PGJ2. Furthermore, probiotics ameliorated epithelial barrier dysfunction in monolayers exposed to CRF-activated mast cells. However, when T84 monolayers were exposed to conditioned medium of CRF-activated mast cells or were incubated with T0070907, probiotics showed little or no effect.

    CONCLUSIONS: Probiotics modulate mast cell mediator release to a more barrier protective profile, resulting in amelioration of stress-induced epithelial barrier dysfunction, which is putatively mediated by a PPAR-γ dependent pathway.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-100768 (URN)
    Tillgänglig från: 2013-11-12 Skapad: 2013-11-12 Senast uppdaterad: 2014-03-25Bibliografiskt granskad
    4. Faecalibacterium prausnitzii supernatant improves intestinal barrier function in mice DSS colitis
    Öppna denna publikation i ny flik eller fönster >>Faecalibacterium prausnitzii supernatant improves intestinal barrier function in mice DSS colitis
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    2013 (Engelska)Ingår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 48, nr 10, s. 1136-1144Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objective. The intestinal microbiota plays a substantial role in the pathogenesis of inflammatory bowel disease (IBD). Faecalibacterium prausnitzii (FP) is underrepresented in IBD patients and have been suggested to have anti-inflammatory effects in mice. Increased intestinal permeability is common in IBD but the relationship between FP and intestinal barrier function has not been investigated. Our aim was to study treatment with FP supernatant on intestinal barrier function in a dextran sodium sulfate (DSS) colitis mice model. Material and methods. C57BL/6 mice received 3% DSS in tap water ad libitum during five days to induce colitis. From day 3 the mice received a daily gavage with FP supernatant or broth during seven days. Ileum and colon were mounted in Ussing chambers for permeability studies with Cr-51-EDTA and Escherichia coli K-12. Colon was saved for Western blot analyses of tight junction proteins. Results. DSS-treated mice showed significant weight loss and colon shortening. Gavage with FP supernatant resulted in a quicker recovery after DSS treatment and less extensive colonic shortening. Ileal mucosa of DSS mice showed a significant increase in Cr-51-EDTA-passage compared to controls. Cr-51-EDTA passage was significantly decreased in mice receiving FP supernatant. No significant differences were observed in passage of E. coli K12. Western blots showed a trend to increased claudin-1 and claudin-2 expressions in DSS mice. Conclusions. Supernatant of FP enhances the intestinal barrier function by affecting paracellular permeability, and may thereby attenuate the severity of DSS-induced colitis in mice. These findings suggest a potential role of FP in the treatment of IBD.

    Ort, förlag, år, upplaga, sidor
    Informa Healthcare, 2013
    Nyckelord
    dextran sodium sulfate, inflammatory bowel disease, permeability, probiotics, tight junctions
    Nationell ämneskategori
    Teknik och teknologier
    Identifikatorer
    urn:nbn:se:liu:diva-99406 (URN)10.3109/00365521.2013.828773 (DOI)000324761000005 ()
    Anmärkning

    Funding Agencies|Swedish Research Council|VR-M: K2012-55X-12618-16-3|

    Tillgänglig från: 2013-10-17 Skapad: 2013-10-17 Senast uppdaterad: 2018-04-27
    Ladda ner fulltext (pdf)
    Role of mast cells and probiotics in the regulation of intestinal barrier function
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    omslag
  • 174.
    Carlsson, Anders H.
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Lutgendorff, Femke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet. Gastrointestinal Research Unit, Department of Surgery, University Medical Center, Utrecht, The Netherlands.
    Akkermans, Louis M.A.
    Gastrointestinal Research Unit, Department of Surgery, University Medical Center, Utrecht, The Netherlands..
    McKay, Derek M
    Gastrointestinal Research Group, Department of Physiology & Pharmacology, The Calvin, Phoebe and Joan Snyder Institute of Infection, Inflammation and Immunology, University of Calgary, Calgary, Alberta, Canada.
    Söderholm, Johan D.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Probiotics modulate mast cell degranulation and reduce stress-induced barrier dysfunction in vitro2013Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    BACKGROUND: Stress has well-established deleterious effects on intestinal barrier function and stressful life events are known to contribute to the development and perpetuation of inflammatory bowel diseases. Mast cells play a pivotal role in pathogenesis of stressinduced barrier dysfunction due to the release of barrier-disruptive content. Conversely, they also have recently been suggested to contribute to barrier protective properties of probiotics, through the release of 15d-PGJ2 and enhanced epithelial PPAR-γ activity. However, mechanisms remain to be elucidated.

    AIM: To study if probiotics can modulate mast cell mediator release, resulting in amelioration of stress-induced barrier dysfunction in vitro.

    METHODS: Confluent monolayers of the human colon-derived T84 epithelial cell line were co-cultured with rat basophilic leukemia (RBL)-2H3 mast cells and pretreated with probiotics (125x104 CFU/ml, 1hr) before addition of 100nM CRF to activate mast cells. Release of beta hexosaminidase, TNF-α and 15d-PGJ2 from mast cells was determined. Transepithelial resistance (TER), and permeability to microspheres (0.2μm) were measured over a 24h period. To determine dependence of PPAR-γ, monolayers were incubated with the specific PPAR-γ antagonist T0070907 before treatment with probiotics.

    RESULTS: CRF-induced activation of mast cells resulted in decreased TERs and increased permeability to microspheres. Both pretreatment with probiotics and filter-sterilized probiotic supernatant resulted in lower levels of mast cell-released beta hexosaminidase and TNF-α, and increased 15d-PGJ2. Furthermore, probiotics ameliorated epithelial barrier dysfunction in monolayers exposed to CRF-activated mast cells. However, when T84 monolayers were exposed to conditioned medium of CRF-activated mast cells or were incubated with T0070907, probiotics showed little or no effect.

    CONCLUSIONS: Probiotics modulate mast cell mediator release to a more barrier protective profile, resulting in amelioration of stress-induced epithelial barrier dysfunction, which is putatively mediated by a PPAR-γ dependent pathway.

  • 175.
    Carlsson, Anders H.
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Yakymenko, Olena
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Olivier, Isabelle
    External - unknown .
    Håkansson, Fathima
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Postma, Emily
    External - unknown .
    Keita, Asa V.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Soderholm, Johan D.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Faecalibacterium prausnitzii supernatant improves intestinal barrier function in mice DSS colitis2013Ingår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 48, nr 10, s. 1136-1144Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. The intestinal microbiota plays a substantial role in the pathogenesis of inflammatory bowel disease (IBD). Faecalibacterium prausnitzii (FP) is underrepresented in IBD patients and have been suggested to have anti-inflammatory effects in mice. Increased intestinal permeability is common in IBD but the relationship between FP and intestinal barrier function has not been investigated. Our aim was to study treatment with FP supernatant on intestinal barrier function in a dextran sodium sulfate (DSS) colitis mice model. Material and methods. C57BL/6 mice received 3% DSS in tap water ad libitum during five days to induce colitis. From day 3 the mice received a daily gavage with FP supernatant or broth during seven days. Ileum and colon were mounted in Ussing chambers for permeability studies with Cr-51-EDTA and Escherichia coli K-12. Colon was saved for Western blot analyses of tight junction proteins. Results. DSS-treated mice showed significant weight loss and colon shortening. Gavage with FP supernatant resulted in a quicker recovery after DSS treatment and less extensive colonic shortening. Ileal mucosa of DSS mice showed a significant increase in Cr-51-EDTA-passage compared to controls. Cr-51-EDTA passage was significantly decreased in mice receiving FP supernatant. No significant differences were observed in passage of E. coli K12. Western blots showed a trend to increased claudin-1 and claudin-2 expressions in DSS mice. Conclusions. Supernatant of FP enhances the intestinal barrier function by affecting paracellular permeability, and may thereby attenuate the severity of DSS-induced colitis in mice. These findings suggest a potential role of FP in the treatment of IBD.

  • 176.
    Carlsson, Annelie
    et al.
    Lund University, Sweden .
    Forsander, Gun
    Sahlgrens University Hospital, Sweden .
    Ludvigsson, Johnny
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Larsen, Sara
    Novo Nordisk Scandinavia AB, Sweden .
    Ortqvist, Eva
    Karolinska University Hospital, Sweden .
    A multicenter observational safety study in Swedish children and adolescents using insulin detemir for the treatment of type 1 diabetes2013Ingår i: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 14, nr 5, s. 358-365Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This 26-wk observational study in children and adolescents with type 1 diabetes (T1D) in Sweden investigated the safety and efficacy of insulin detemir (IDet) in newly diagnosed (ND) patients and those with established diabetes (ED) switching to IDet. A total of 159 patients initiated IDet as part of basal-bolus therapy, 59 in the ND stratum (mean age 9.7yr) and 97 in the ED stratum (mean age 12.5 yr). The primary outcome measure was the incidence of severe adverse drug reactions; just one major hypoglycemic event occurred in a patient in the ND stratum during the study and one patient was withdrawn due to injection-site reactions. All other events were classified as mild. In the ED stratum, there was a reduction in hypoglycemic events in the 4wk prior to study end from baseline (mean reduction of 2.46 events, not significant) and a significant reduction in nocturnal hypoglycemia (mean reduction of 2.24 events, p=0.0078). Glycemic control improved in the ND stratum as expected and, in the ED stratum, there was no significant change in HbA1c from baseline (mean reduction of -0.45%). At study end, mean daily IDet doses were 0.39U/kg (ND) and 0.54U/kg (ED). Weight increased by 5.7 and 2.0kg in the ND and ED strata, respectively, and was within the normal limits for growing children. IDet provided good glycemic control and was well tolerated, with a reduced risk of nocturnal hypoglycemia in a heterogeneous cohort of children and adolescents with T1D.

  • 177.
    Carlsson, E
    et al.
    The Biomedical Platform, Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University, Jönköping.
    Ludvigsson, Johnny
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Huus, K
    CHILD Research Group, Department of Nursing, School of Health Sciences, Jönköping University, Jönköping.
    Faresjö, M
    The Biomedical Platform, Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University, Jönköping.
    High physical activity in young children suggests positive effects by altering autoantigen-induced immune activity2016Ingår i: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 26, nr 4, s. 441-450Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Physical activity in children is associated with several positive health outcomes such as decreased cardiovascular risk factors, improved lung function, enhanced motor skill development, healthier body composition, and also improved defense against inflammatory diseases. We examined how high physical activity vs a sedentary lifestyle in young children influences the immune response with focus on autoimmunity. Peripheral blood mononuclear cells, collected from 55 5-year-old children with either high physical activity (n = 14), average physical activity (n = 27), or low physical activity (n = 14), from the All Babies In Southeast Sweden (ABIS) cohort, were stimulated with antigens (tetanus toxoid and beta-lactoglobulin) and autoantigens (GAD65 , insulin, HSP60, and IA-2). Immune markers (cytokines and chemokines), C-peptide and proinsulin were analyzed. Children with high physical activity showed decreased immune activity toward the autoantigens GAD65 (IL-5, P < 0.05), HSP60 and IA-2 (IL-10, P < 0.05) and also low spontaneous pro-inflammatory immune activity (IL-6, IL-13, IFN-γ, TNF-α, and CCL2 (P < 0.05)) compared with children with an average or low physical activity. High physical activity in young children seems to have positive effects on the immune system by altering autoantigen-induced immune activity.

  • 178.
    Carlsson, Emma
    et al.
    School of Health Sciences, Department of Natural Science and Biomedicine, Jonköping University, Jönköping, Sweden, Division of Medical Diagnostics, Ryhov County Hospital, Jönköping, Sweden.
    Frostell, Anneli
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Ludvigsson, Johnny
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Faresjo, Maria
    School of Health Sciences, Department of Natural Science and Biomedicine, Jonköping University, Jönköping, Sweden, Division of Medical Diagnostics, Ryhov County Hospital, Jonköping, Sweden.
    Psychological stress in children may alter the immune response2014Ingår i: Journal of Immunology, ISSN 0022-1767, E-ISSN 1550-6606, Vol. 192, nr 5, s. 2071-2081Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Psychological stress is a public health issue even in children and has been associated with a number of immunological diseases. The aim of this study was to examine the relationship between psychological stress and immune response in healthy children, with special focus on autoimmunity. In this study, psychological stress was based on a composite measure of stress in the family across the domains: 1) serious life events, 2) parenting stress, 3) lack of social support, and 4) parental worries. PBMCs, collected from 5-y-old high-stressed children (n = 26) and from 5-y-old children without high stress within the family (n = 52), from the All Babies In Southeast Sweden cohort, were stimulated with Ags (tetanus toxoid and b-lactoglobulin) and diabetes-related autoantigens (glutamic acid decarboxylase 65, insulin, heat shock protein 60, and tyrosine phosphatase). Immune markers (cytokines and chemokines), clinical parameters (C-peptide, proinsulin, glucose), and cortisol, as an indicator of stress, were analyzed. Children from families with high psychological stress showed a low spontaneous immune activity (IL-5, IL-10, IL-13, IL-17, CCL2, CCL3, and CXCL10; p less than 0.01) but an increased immune response to tetanus toxoid, b-lactoglobulin, and the autoantigens glutamic acid decarboxylase 65, heat shock protein 60, and tyrosine phosphatase (IL-5, IL-6, IL-10, IL-13, IL-17, IFN-g, TNF-A, CCL2, CCL3, and CXCL10; p less than 0.05). Children within the high-stress group showed high level of cortisol, but low level of C-peptide, compared with the control group (p less than 0.05). This supports the hypothesis that psychological stress may contribute to an imbalance in the immune response but also to a pathological effect on the insulin-producing b cells.Copyright © 2014 by The American Association of Immunologists.

  • 179.
    Carlsson, Per
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Medicinska fakulteten.
    Sjödahl, Rune
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Theodorsson, Elvar
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Diagnostikcentrum, Klinisk kemi.
    Robotassisterad kirurgi ökar – trots osäker kostnadseffektivitet2016Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, nr 48, s. 1-5Artikel, forskningsöversikt (Refereegranskat)
  • 180.
    Chavali, Sreenivas
    et al.
    MRC Laboratory of Molecular Biology, Cambridge, United Kingdom.
    Bruhn, Sören
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Tiemann, Katrin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Sætrom, Pål
    Norwegian University of Science and Technology, Trondheim, Norway.
    Barrenäs, Fredrik
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Saito, Takaya
    Norwegian University of Science and Technology, Trondheim, Norway.
    Kanduri, Kartiek
    University of Gothenburg, Sweden .
    Wang, Hui
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Benson, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    MicroRNAs act complementarily to regulate disease-related mRNA modules in human diseases2013Ingår i: RNA: A publication of the RNA Society, ISSN 1355-8382, E-ISSN 1469-9001, Vol. 19, nr 11, s. 1552-1562Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    MicroRNAs (miRNAs) play a key role in regulating mRNA expression, and individual miRNAs have been proposed as diagnostic and therapeutic candidates. The identification of such candidates is complicated by the involvement of multiple miRNAs and mRNAs as well as unknown disease topology of the miRNAs. Here, we investigated if disease-associated miRNAs regulate modules of disease-associated mRNAs, if those miRNAs act complementarily or synergistically, and if single or combinations of miRNAs can be targeted to alter module functions. We first analyzed publicly available miRNA and mRNA expression data for five different diseases. Integrated target prediction and network-based analysis showed that the miRNAs regulated modules of disease-relevant genes. Most of the miRNAs acted complementarily to regulate multiple mRNAs. To functionally test these findings, we repeated the analysis using our own miRNA and mRNA expression data from CD4+ T cells from patients with seasonal allergic rhinitis. This is a good model of complex diseases because of its well-defined phenotype and pathogenesis. Combined computational and functional studies confirmed that miRNAs mainly acted complementarily and that a combination of two complementary miRNAs, miR-223 and miR-139-3p, could be targeted to alter disease-relevant module functions, namely, the release of type 2 helper T-cell (Th2) cytokines. Taken together, our findings indicate that miRNAs act complementarily to regulate modules of disease-related mRNAs and can be targeted to alter disease-relevant functions.

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  • 181.
    Chen, Ke-Ling
    et al.
    Sichuan University, Peoples R China.
    Lv, Zhao-Ying
    Sichuan University, Peoples R China.
    Yang, Hong-Wei
    Sichuan University, Peoples R China.
    Liu, Yong
    Sichuan University, Peoples R China.
    Long, Fei-Wu
    Sichuan University, Peoples R China.
    Zhou, Bin
    Sichuan University, Peoples R China.
    Sun, Xiao-Feng
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US. Sichuan University, Peoples R China.
    Peng, Zhi-Hai
    Shanghai Jiao Tong University, Peoples R China.
    Zhou, Zong-Guang
    Sichuan University, Peoples R China.
    Li, Yuan
    Sichuan University, Peoples R China.
    Effects of Tocilizumab on Experimental Severe Acute Pancreatitis and Associated Acute Lung Injury2016Ingår i: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 44, nr 8, s. E664-E677Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine the therapeutic effects of tocilizumab, an antibody against interleukin-6 receptor, on experimental severe acute pancreatitis and associated acute lung injury. The optimal dose of tocilizumab and the activation of interleukin-6 inflammatory signaling were also investigated. Design: Randomized experiment. Setting: Research laboratory at a university hospital. Subject: Experimental severe acute pancreatitis in rats. Interventions: Severe acute pancreatitis was induced by retrograde injection of sodium taurocholate (50 mg/kg) into the biliopancreatic duct. In dose-study, rats were administered with different doses of tocilizumab (1, 2, 4, 8, and 16 mg/kg) through the tail vein after severe acute pancreatitis induction. In safety-study, rats without severe acute pancreatitis induction were treated with high doses of tocilizumab (8, 16, 32, and 64 mg/kg). Serum and tissue samples of rats in time-study were collected for biomolecular and histologic evaluations at different time points (2, 6, 12, 18, and 24 hr). Measurements and Main Results: 1) Under the administration of tocilizumab, histopathological scores of pancreas and lung were decreased, and severity parameters related to severe acute pancreatitis and associated lung injury, including serum amylase, C-reactive protein, lung surfactant protein level, and myeloperoxidase activity, were all significant alleviated in rat models. 2) Dose-study demonstrated that 2 mg/kg tocilizumab was the optimal treatment dose. 3) Basing on multi-organ pathologic evaluation, physiological and biochemical data, no adverse effect and toxicity of tocilizumab were observed in safety-study. 4) Pancreatic nuclear factor-kappa B and signal transducer and activator of transcription 3 were deactivated, and the serum chemokine (C-X-C motif) ligand 1 was down-regulated after tocilizumab administration. Conclusions: Our study demonstrated tocilizumab, as a marketed drug commonly used for immune-mediated diseases, was safe and effective for the treatment of experimental severe acute pancreatitis and associated acute lung injury. Our findings provide experimental evidences for potential clinical application of tocilizumab in severe acute pancreatitis and associated complications.

  • 182.
    Cheng, Dantong
    et al.
    Shanghai Jiao Tong University, Peoples R China.
    Zhao, Senlin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Shanghai Jiao Tong University, Peoples R China.
    Tang, Huamei
    Shanghai Jiao Tong University, Peoples R China.
    Zhang, Dongyuan
    Shanghai Jiao Tong University, Peoples R China.
    Sun, Hongcheng
    Shanghai Jiao Tong University, Peoples R China.
    Yu, Fudong
    Shanghai Jiao Tong University, Peoples R China.
    Jiang, Weiliang
    Shanghai Jiao Tong University, Peoples R China.
    Yue, Ben
    Shanghai Jiao Tong University, Peoples R China.
    Wang, Jingtao
    Shanghai Jiao Tong University, Peoples R China.
    Zhang, Meng
    Fudan University, Peoples R China.
    Yu, Yang
    Shanghai Jiao Tong University, Peoples R China.
    Liu, Xisheng
    Shanghai Jiao Tong University, Peoples R China.
    Sun, Xiao-Feng
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US.
    Zhou, Zongguang
    Sichuan University, Peoples R China.
    Qin, Xuebin
    Temple University, PA 19122 USA.
    Zhang, Xin
    Zhejiang Prov Peoples Hospital, Peoples R China.
    Yan, Dongwang
    Shanghai Jiao Tong University, Peoples R China.
    Wen, Yugang
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US. Shanghai Jiao Tong University, Peoples R China.
    Peng, Zhihai
    Shanghai Jiao Tong University, Peoples R China.
    MicroRNA-20a-5p promotes colorectal cancer invasion and metastasis by downregulating Smad42016Ingår i: Oncotarget, E-ISSN 1949-2553, Vol. 7, nr 29, s. 45199-45213Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Tumor metastasis is one of the leading causes of poor prognosis for colorectal cancer (CRC) patients. Loss of Smad4 contributes to aggression process in many human cancers. However, the underlying precise mechanism of aberrant Smad4 expression in CRC development is still little known. Results: miR-20a-5p negatively regulated Smad4 by directly targeting its 3UTR in human colorectal cancer cells. miR-20a-5p not only promoted CRC cells aggression capacity in vitro and liver metastasis in vivo, but also promoted the epithelial-to-mesenchymal transition process by downregulating Smad4 expression. In addition, tissue microarray analysis obtained from 544 CRC patients clinical characters showed that miR-20a-5p was upregulated in human CRC tissues, especially in the tissues with metastasis. High level of miR-20a-5p predicted poor prognosis in CRC patients. Methods: Five miRNA target prediction programs were applied to identify potential miRNA(s) that target(s) Smad4 in CRC. Luciferase reporter assay and transfection technique were used to validate the correlation between miR-20a-5p and Smad4 in CRC. Wound healing, transwell and tumorigenesis assays were used to explore the function of miR-20a-5p and Smad4 in CRC progression in vitro and in vivo. The association between miR-20a-5p expression and the prognosis of CRC patients was evaluated by Kaplan-Meier analysis and multivariate cox proportional hazard analyses based on tissue microarray data. Conclusions: miR-20a-5p, as an onco-miRNA, promoted the invasion and metastasis ability by suppressing Smad4 expression in CRC cells, and high miR-20a-5p predicted poor prognosis for CRC patients, providing a novel and promising therapeutic target in human colorectal cancer.

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  • 183.
    Christmann, Benjamin S.
    et al.
    University of Alabama Birmingham, AL 35294 USA.
    Abrahamsson, Thomas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Region Östergötland, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping. Linköpings universitet, Medicinska fakulteten.
    Bernstein, Charles N.
    University of Manitoba, Canada.
    Wayne Duck, L.
    University of Alabama Birmingham, AL 35294 USA.
    Mannon, Peter J.
    University of Alabama Birmingham, AL 35294 USA.
    Berg, Göran
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Bjorksten, Bengt
    Karolinska Institute, Sweden; University of Örebro, Sweden.
    Jenmalm, Maria
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Elson, Charles O.
    University of Alabama Birmingham, AL 35294 USA.
    Human seroreactivity to gut microbiota antigens2015Ingår i: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 136, nr 5, s. 1378-1386Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Although immune responses directed against antigens from the intestinal microbiota are observed in certain diseases, the normal human adaptive immune response to intestinal microbiota is poorly defined. Objective: Our goal was to assess the adaptive immune response to the intestinal microbiota present in 143 healthy adults and compare this response with the response observed in 52 children and their mothers at risk of having allergic disease. Methods: Human serum was collected from adults and children followed from birth to 7 years of age, and the serum IgG response to a panel of intestinal microbiota antigens was assessed by using a novel protein microarray. Results: Nearly every subject tested, regardless of health status, had serum IgG that recognized a common set of antigens. Seroreactivity to the panel of antigens was significantly lower in atopic adults. Healthy infants expressed the highest level of IgG seroreactivity to intestinal microbiota antigens. This adaptive response developed between 6 and 12 months of age and peaked around 2 years of age. Low IgG responses to certain clusters of microbiota antigens during infancy were associated with allergy development during childhood. Conclusions: There is an observed perturbation of the adaptive response to antigens from the microbiota in allergic subjects. These perturbations are observable even in childhood, suggesting that optimal stimulation of the adaptive immune system by the microbiota might be needed to prevent certain immune-mediated diseases.

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  • 184.
    Christofer Juhlin, C.
    et al.
    Yale University, CT 06520 USA; Yale University, CT 06520 USA; Karolinska Institute, Sweden.
    Stenman, Adam
    Karolinska Institute, Sweden.
    Haglund, Felix
    Karolinska Institute, Sweden.
    Clark, Victoria E.
    Yale University, CT 06520 USA.
    Brown, Taylor C.
    Yale University, CT 06520 USA; Yale University, CT 06520 USA.
    Baranoski, Jacob
    Yale University, CT 06520 USA.
    Bilguvar, Kaya
    Yale University, CT 06520 USA; Yale University, CT 06520 USA.
    Goh, Gerald
    Yale University, CT 06520 USA; Yale University, CT 06520 USA.
    Welander, Jenny
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Medicinska fakulteten.
    Svahn, Fredrika
    Karolinska Institute, Sweden.
    Rubinstein, Jill C.
    Yale University, CT 06520 USA; Yale University, CT 06520 USA.
    Caramuta, Stefano
    Karolinska Institute, Sweden.
    Yasuno, Katsuhito
    Yale University, CT 06520 USA.
    Guenel, Murat
    Yale University, CT 06520 USA.
    Backdahl, Martin
    Karolinska Institute, Sweden.
    Gimm, Oliver
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Söderkvist, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Diagnostikcentrum, Klinisk patologi och klinisk genetik.
    Prasad, Manju L.
    Yale University, CT 06520 USA.
    Korah, Reju
    Yale University, CT 06520 USA; Yale University, CT 06520 USA.
    Lifton, Richard P.
    Yale University, CT 06520 USA; Yale University, CT 06520 USA; Yale Centre Mendelian Genom, CT USA.
    Carling, Tobias
    Yale University, CT 06520 USA; Yale University, CT 06520 USA.
    Whole-exome sequencing defines the mutational landscape of pheochromocytoma and identifies KMT2D as a recurrently mutated gene2015Ingår i: Genes, Chromosomes and Cancer, ISSN 1045-2257, E-ISSN 1098-2264, Vol. 54, nr 9, s. 542-554Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    As subsets of pheochromocytomas (PCCs) lack a defined molecular etiology, we sought to characterize the mutational landscape of PCCs to identify novel gene candidates involved in disease development. A discovery cohort of 15 PCCs wild type for mutations in PCC susceptibility genes underwent whole-exome sequencing, and an additional 83 PCCs served as a verification cohort for targeted sequencing of candidate mutations. A low rate of nonsilent single nucleotide variants (SNVs) was detected (6.1/sample). Somatic HRAS and EPAS1 mutations were observed in one case each, whereas the remaining 13 cases did not exhibit variants in established PCC genes. SNVs aggregated in apoptosis-related pathways, and mutations in COSMIC genes not previously reported in PCCs included ZAN, MITF, WDTC1, and CAMTA1. Two somatic mutations and one constitutional variant in the well-established cancer gene lysine (K)-specific methyltransferase 2D (KMT2D, MLL2) were discovered in one sample each, prompting KMT2D screening using focused exome-sequencing in the verification cohort. An additional 11 PCCs displayed KMT2D variants, of which two were recurrent. In total, missense KMT2D variants were found in 14 (11 somatic, two constitutional, one undetermined) of 99 PCCs (14%). Five cases displayed somatic mutations in the functional FYR/SET domains of KMT2D, constituting 36% of all KMT2D-mutated PCCs. KMT2D expression was upregulated in PCCs compared to normal adrenals, and KMT2D overexpression positively affected cell migration in a PCC cell line. We conclude that KMT2D represents a recurrently mutated gene with potential implication for PCC development. (c) 2015 The Authors. Genes, Chromosomes and Cancer Published by Wiley Periodicals, Inc.

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  • 185.
    Cieślar-Pobuda, Artur
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Medicinska fakulteten. Institute of Automatic Control, Silesian University of Technology, Gliwice, Poland.
    Vilas Jain, Mayur
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Medicinska fakulteten.
    Kratz, Gunnar
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Hand- och plastikkirurgiska kliniken US.
    Rzeszowska-Wolny, Joanna
    Institute of Automatic Control, Silesian University of Technology, Gliwice, Poland.
    Ghavami, Saeid
    Department of Human Anatomy and Cell Science, University of Manitoba, Manitoba, Canada.
    Wiechec, Emilia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    The expression pattern of PFKFB3 enzyme distinguishes between induced-pluripotent stem cells and cancer stem cells.2015Ingår i: Oncotarget, E-ISSN 1949-2553, Vol. 6, nr 30, s. 29753--29770Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Induced pluripotent stem cells (iPS) have become crucial in medicine and biology. Several studies indicate their phenotypic similarities with cancer stem cells (CSCs) and a propensity to form tumors. Thus it is desirable to identify a trait which differentiates iPS populations and CSCs. Searching for such a feature, in this work we compare the restriction (R) point-governed regulation of cell cycle progression in different cell types (iPS, cancer, CSC and normal cells) based on the expression profile of 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase3 (PFKFB3) and phosphofructokinase (PFK1). Our study reveals that PFKFB3 and PFK1 expression allows discrimination between iPS and CSCs. Moreover, cancer and iPS cells, when cultured under hypoxic conditions, alter their expression level of PFKFB3 and PFK1 to resemble those in CSCs. We also observed cell type-related differences in response to inhibition of PFKFB3. This possibility to distinguish CSC from iPS cells or non-stem cancer cells by PFKB3 and PFK1 expression improves the outlook for clinical application of stem cell-based therapies and for more precise detection of CSCs.

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  • 186.
    Claesson, Ing-Marie
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping. Linköpings universitet, Medicinska fakulteten.
    Hultgren, Eva
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Blomberg, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping. Linköpings universitet, Medicinska fakulteten.
    Lifestyle habits and womens attitudes towards discussing them at a visit for contraceptive advice2015Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 6, nr 3, s. 114-118Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aims of this study was to use visits for contraceptive counselling as opportunities for examining womens actual life style habits with the main focus being placed on alcohol consumption but also to evaluate the womens opinions about discussing their alcohol and tobacco habits and their weight status. Methods: A total of 535/802 (67%) women completed a study-specific anonymous questionnaire after a contraceptive counselling visit with a midwife. Results: A majority of the women thought that a discussion concerning alcohol habits at a contraceptive counselling session was important (85.5%) and not intrusive (86.4%) neither embarrassing (81.7%). Women with high-risk drinking habits were younger, more often tobacco users and more often planning for childbirth in the future, compared with women who did not display high-risk drinking behaviour. A significantly higher percentage of women who practiced high-risk drinking thought that a discussion of alcohol was intrusive (10.9%) and embarrassing (46.7%), compared with women not practicing highrisk alcohol consumption. Most women (72.9%) stated that no other caregiver during the preceding year except the midwife had discussed drinking habits with them. The weight was a good thing that the midwife brought up for discussion according to 82.5% of the women but the discussions about weight was more often found embarrassing (18.4%) than the discussion about alcohol habits. Conclusion: Women who came for contraceptive counselling found the discussion concerning alcohol habits important, not intrusive or embarrassing and a good thing to be brought up by the midwife. (C) 2014 Elsevier B.V. All rights reserved.

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  • 187.
    Claesson, Ing-Marie
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Josefsson, Ann
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Sydsjö, Gunilla
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Weight six years after childbirth: a follow-up of obese women in a weight-gain restriction programmme2014Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 30, nr 5, s. 506-511Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: to compare weight development in an intervention group and a control group, six years after participation in a gestational weight-gain restriction programme.

    DESIGN: follow-up of a prospective intervention study.

    SETTINGS: antenatal care clinics.

    PARTICIPANTS: a total of 129 women (88.4%) from the original intervention group and 166 women (88.8%) from the original control group.

    MEASUREMENTS: the women answered a study specific questionnaire, covering socio-demographic data and health- and weight status.

    FINDINGS: after adjusting for socio-demographic factors, the mean weight was lower (4.1kg) among the women in the intervention group, compared to the controls (p=0.028). Furthermore, the mean weight change, e.g. the weight at the six year assessment compared with the weight at the start of the intervention at the first antenatal care visit, was greater in the intervention group than in the control group. The women in the intervention group had a larger mean weight change (-5.2kg), e.g. weighed less than the women in the control group (-1.9kg) (p=0.046). Mean weight change expressed in 5kg classes also showed a significant difference between the two groups (p=0.030).

    KEY CONCLUSIONS: the results indicate that attending a gestational weight-gain-restriction programme can have a positive effect on weight up to six years after the intervention.

    IMPLICATION FOR PRACTISE: a restrictive gestational weight gain can result in a positive weight development during the first years after childbirth. It might provide both short- and long term medical health benefits for the mother as well as the child.

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  • 188.
    Claesson, Ing-Marie
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken US.
    Klein, Sofia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken US.
    Sydsjö, Gunilla
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Josefsson, Ann
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Physical activity and psychological well-being in obese pregnant and postpartum women attending a weight-gain restriction programme2014Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 30, nr 1, s. 11-16Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    the objective of the study was to compare the differences in psychological well-being and quality of life during pregnancy and post partum of obese physically active women and obese physically inactive women enroled in a weight gain restriction programme. We also wanted to explore whether physical activity influences weight change or health status during pregnancy.

    Design

    a prospective intervention study.

    Setting

    antenatal care clinic.

    Participants

    a total of 74 obese pregnant women in a physically active group and 79 obese women in a physically inactive group.

    Measurements

    the women kept diaries of their physical activity during pregnancy and answered the Beck Anxiety Inventory, the Edinburgh Postnatal Depression Scale and Medical Study Short-Form Health Survey in gestational weeks 15 and 35 and 11 weeks post partum. Physical activity was measured in metabolic equivalents.

    Findings

    the physically active women experienced fewer depressive symptoms and estimated an improved quality of life during their pregnancies as measured by physical functioning, bodily pain, social functioning, role limitations due to emotional problems and general mental health as compared with the physically inactive women. There were no differences between the groups in gestational weight gain or weight change from early pregnancy to post partum or in prevalence of complications.

    Key conclusions

    physical activity among obese pregnant women provides better psychological well-being and improved quality of life, but does not prevent weight change.

    Implications for practice

    staff at Antenatal Care Clinics that face obese pregnant women, should encourage and emphasise the benefits of being physically active throughout pregnancy.

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  • 189.
    Claesson, Ing-Marie
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping. Linköpings universitet, Medicinska fakulteten.
    Sydsjö, Gunilla
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Olhager, Elisabeth
    Lund University, Sweden.
    Oldin, Carin
    Regional Jonköping County, Sweden.
    Josefsson, Ann
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Effects of a Gestational Weight Gain Restriction Program for Obese Pregnant Women: Childrens Weight Development during the First Five Years of Life2016Ingår i: CHILDHOOD OBESITY, ISSN 2153-2168, Vol. 12, nr 3, s. 162-170Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Maternal prepregnancy obesity (BMI 30kg/m(2)) and excessive gestational weight gain (GWG) have shown a strong positive association with a higher BMI and risk of obesity in the offspring. The aim of this study is to estimate the effect of a GWG restriction program for obese pregnant women on the childrens BMI at 5 years of age and weight-for-length/height (WL/H) development from 2 months of age until 5 years of age. Methods: This was a follow-up study of 302 children (137 children in an intervention group and 165 children in a control group) whose mothers participated in a weight gain restriction program during pregnancy. Results: BMI at five years of age did not differ between girls and boys in the intervention and control group. The degree of maternal GWG, amp;lt;7kg or 7kg, did not affect the offsprings WL/H. Compared with Swedish reference data, just over half of the children in both the intervention and control group had a BMI within the average range, whereas slightly more than one-third of the children had a higher BMI. Conclusion: Despite a comprehensive gestational intervention program for obese women containing individual weekly visits and opportunity to participate in aqua aerobic classes, there were no differences between BMI or weight development among the offspring at 5 years of age in the intervention and control group.

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  • 190.
    Collin, A.
    et al.
    Uppsala University, Sweden.
    Jung, Bärbel
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Nilsson, E.
    Umeå University, Sweden.
    Pahlman, L.
    Uppsala University, Sweden.
    Folkesson, J.
    Uppsala University, Sweden.
    Impact of mechanical bowel preparation on survival after colonic cancer resection2014Ingår i: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 101, nr 12, s. 1594-+Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: A randomized study in 1999-2005 of mechanical bowel preparation (MBP) preceding colonic resection found no decrease in postoperative complications. The aim of the present study was to evaluate the long-term effect of MBP regarding cancer recurrence and survival after colonic resections. Methods: The cohort of patients with colonic cancer in the MBP study was followed up for 10 years. Data were collected from registers run by the National Board of Health and Welfare. Register data were validated against information in patient charts. Cox proportional hazards model was used for multivariable analysis of factors predictive of cancer-specific survival. Results: Register analysis showed significantly fewer recurrences, and better cancer-specific and overall survival in the MBP group. After validation, 839 of 1343 patients remained for analysis (448 MBP, 391 no MBP). Eighty (17.9 per cent) of 448 patients in the MBP group and 88 (22.5 per cent) of 391 in the no-MBP group developed a cancer recurrence (P = 0.093). The 10-year cancer-specific survival rate was 84.1 per cent in the MBP group and 78.0 per cent in the no-MBP group (P = 0.019). Overall survival rates were 58.8 and 56.0 per cent respectively (P = 0.186). Conclusion: Patients receiving MBP before elective colonic cancer surgery had significantly better cancer-specific survival after 10 years.

  • 191.
    Comasco, Erika
    et al.
    Uppsala University, Sweden.
    Gustafsson, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Sydsjö, Gunilla
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Agnafors, Sara
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Aho, Nikolas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Svedin, Carl Göran
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Psychiatric symptoms in adolescents: FKBP5 genotype-early life adversity interaction effects2015Ingår i: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 24, nr 12, s. 1473-1483Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Psychiatric disorders are multi-factorial and their symptoms overlap. Constitutional and environmental factors influence each other, and this contributes to risk and resilience in mental ill-health. We investigated functional genetic variation of stress responsiveness, assessed as FKBP5 genotype, in relation to early life adversity and mental health in two samples of adolescents. One population-based sample of 909 12-year-old adolescents was assessed using the Life Incidence of Traumatic Events scale and the Strengths and Difficulties Questionnaire. One sample of 398 17-year-old adolescents, enriched for poly-victimized individuals (USSS), was assessed using the Juvenile Victimization Questionnaire and the Trauma Symptom Checklist for Children (TSCC). The FKBP5 rs1360780 and rs3800373 polymorphisms were genotyped using a fluorescence-based competitive allele-specific PCR. Most prominently among poly-victimized older male adolescents, the least common alleles of the polymorphisms, in interaction with adverse life events, were associated with psychiatric symptoms, after controlling for ethno-socio-economic factors. The interaction effect between rs3800373 and adverse life events on the TSCC sub-scales-anxiety, depression, anger, and dissociation-and with the rs1360780 on dissociation in the USSS cohort remained significant after Bonferroni correction. This pattern of association is in line with the findings of clinical and neuroimaging studies, and implies interactive effects of FKBP5 polymorphisms and early life environment on several psychiatric symptoms. These correlates add up to provide constructs that are relevant to several psychiatric symptoms, and to identify early predictors of mental ill-health.

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  • 192.
    Corvigno, Sara
    et al.
    Karolinska Institute, Sweden.
    Wisman, G. Bea A.
    University of Groningen, Netherlands.
    Mezheyeuski, Artur
    Karolinska Institute, Sweden.
    van der Zee, Ate G. J.
    University of Groningen, Netherlands.
    Nijman, Hans W.
    University of Groningen, Netherlands.
    Åvall-Lundqvist, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US. Karolinska Institute, Sweden.
    Ostman, Arne
    Karolinska Institute, Sweden.
    Dahlstrand, Hanna
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Markers of fibroblast-rich tumor stroma and perivascular cells in serous ovarian cancer: Inter- and intra-patient heterogeneity and impact on survival2016Ingår i: Oncotarget, E-ISSN 1949-2553, Vol. 7, nr 14, s. 18573-18584Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Inter- and intra-patient variations in tumor microenvironment of serous ovarian cancer are largely unexplored. We aimed to explore potential co-regulation of tumor stroma characteristics, analyze their concordance in primary and metastatic lesions, and study their impact on survival. A tissue microarray (TMA) with 186 tumors and 91 matched metastases was subjected to immunohistochemistry double staining with endothelial cell marker CD34 and fibroblast and pericyte markers alpha-SMA, PDGF beta R and desmin. Images were digitally analyzed to yield "metrics" related to vasculature and stroma features. Intra-case analyses showed that PDGF beta R in perivascular cells and fibroblasts were strongly correlated. Similar findings were observed concerning `-SMA. Most stroma characteristics showed large variations in intra-case comparisons of primary tumors and metastasis. Large PDGF beta R-positive stroma fraction and high PDGF beta FR positive perivascular intensity were both significantly associated with shorter survival in uni- and multi-variate analyses (HR 1.7, 95% CI 1.1-2.5; HR 1.7, 95% CI 1.1-2.8). In conclusion, we found PDGF beta R- and alpha-SMA-expression to be largely independent of each other but concordantly activated in perivascular cells and in fibroblasts within the primary tumor. Stromal characteristics differed between primary tumors and metastases. PDGF beta R in perivascular cells and in fibroblasts may be novel prognostic markers in serous ovarian cancer.

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  • 193.
    Couper, Jennifer J.
    et al.
    Womens and Childrens Hospital, Australia; University of Adelaide, Australia; University of Adelaide, Australia.
    Haller, Michael J.
    University of Florida, FL USA.
    Ziegler, Annette-G
    Technical University of Munich, Germany; Technical University of Munich, Germany.
    Knip, Mikael
    University of Helsinki, Finland.
    Ludvigsson, Johnny
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Craig, Maria E.
    Childrens Hospital Westmead, Australia; University of Sydney, Australia; University of New S Wales, Australia .
    Phases of type 1 diabetes in children and adolescents2014Ingår i: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 15, s. 18-25Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    n/a

  • 194.
    Couto Alves, Alexessander
    et al.
    University of London Imperial Coll Science Technology and Med, England .
    Bruhn, Sören
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Ramasamy, Adaikalavan
    University of London Imperial Coll Science Technology and Med, England .
    Wang, Hui
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Holloway, John W.
    University of Southampton, England .
    Hartikainen, Anna-Liisa
    University of Oulu, Finland .
    Jarvelin, Marjo-Riitta
    University of London Imperial Coll Science Technology and Med, England .
    Benson, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Balding, David J.
    University of London Imperial Coll Science Technology and Med, England .
    Coin, Lachlan J M.
    University of London Imperial Coll Science Technology and Med, England .
    Dysregulation of Complement System and CD4+T Cell Activation Pathways Implicated in Allergic Response2013Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 8, nr 10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Allergy is a complex disease that is likely to involve dysregulated CD4+ T cell activation. Here we propose a novel methodology to gain insight into how coordinated behaviour emerges between disease-dysregulated pathways in response to pathophysiological stimuli. Using peripheral blood mononuclear cells of allergic rhinitis patients and controls cultured with and without pollen allergens, we integrate CD4+ T cell gene expression from microarray data and genetic markers of allergic sensitisation from GWAS data at the pathway level using enrichment analysis; implicating the complement system in both cellular and systemic response to pollen allergens. We delineate a novel disease network linking T cell activation to the complement system that is significantly enriched for genes exhibiting correlated gene expression and protein-protein interactions, suggesting a tight biological coordination that is dysregulated in the disease state in response to pollen allergen but not to diluent. This novel disease network has high predictive power for the gene and protein expression of the Th2 cytokine profile (IL-4, IL-5, IL-10, IL-13) and of the Th2 master regulator (GATA3), suggesting its involvement in the early stages of CD4+ T cell differentiation. Dissection of the complement system gene expression identifies 7 genes specifically associated with atopic response to pollen, including C1QR1, CFD, CFP, ITGB2, ITGAX and confirms the role of C3AR1 and C5AR1. Two of these genes (ITGB2 and C3AR1) are also implicated in the network linking complement system to T cell activation, which comprises 6 differentially expressed genes. C3AR1 is also significantly associated with allergic sensitisation in GWAS data.

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  • 195.
    Dabrosin, Charlotta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US.
    An overview of pregnancy and fertility issues in breast cancer patients2015Ingår i: Annals of Medicine, ISSN 0785-3890, E-ISSN 1365-2060, Vol. 47, nr 8, s. 673-678Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Breast cancer is one of the most common malignancies of women in the reproductive years. In the Western world there is a trend towards delaying pregnancy to later in life, and in combination with an increased incidence of breast cancer an increased number of women are diagnosed with breast cancer before they have completed their reproductive plans. In addition, breast cancer during pregnancy may affect an increased number of women as the childbearing years are delayed. The survival rate after breast cancer has improved during the last decades, and many young breast cancer survivors will consider a pregnancy subsequent to the completion of adjuvant breast cancer therapy. Traditionally, many women are advised against a pregnancy due to a fear of increased risk of recurrence, especially women with estrogen receptor-positive breast cancer. Due to feasibility issues, evidence from large prospective randomized trials is missing regarding the safety of pregnancy after breast cancer. Today guidelines are based on cohort studies and population-based registry evidence with its limitations. Overall, data suggest that pregnancy after breast cancer therapy is safe, and the current evidence is summarized in this overview.

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  • 196.
    Dahlrot, R. H.
    et al.
    Odense Univ Hosp, Denmark.
    Dowsett, J.
    Odense Univ Hosp, Denmark.
    Fosmark, S.
    Odense Univ Hosp, Denmark.
    Malmström, Annika
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, LAH Linköping.
    Henriksson, R.
    Umea Univ, Sweden; Reg Canc Ctr Stockholm Gotland, Sweden.
    Boldt, H.
    Odense Univ Hosp, Denmark.
    de Stricker, K.
    Odense Univ Hosp, Denmark.
    Sorensen, M. D.
    Odense Univ Hosp, Denmark; Univ Southern Denmark, Denmark.
    Poulsen, H. S.
    Rigshosp, Denmark.
    Lysiak, Malgorzata
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Medicinska fakulteten.
    Söderkvist, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Diagnostikcentrum, Klinisk genetik.
    Rosell, Johan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för verksamhetsstöd och utveckling, Regionalt Cancercentrum.
    Hansen, S.
    Odense Univ Hosp, Denmark; Univ Southern Denmark, Denmark.
    Kristensen, B. W.
    Odense Univ Hosp, Denmark; Univ Southern Denmark, Denmark.
    Prognostic value of O-6-methylguanine-DNA methyltransferase (MGMT) protein expression in glioblastoma excluding nontumour cells from the analysis2018Ingår i: Neuropathology and Applied Neurobiology, ISSN 0305-1846, E-ISSN 1365-2990, Vol. 44, nr 2, s. 172-184Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: It is important to predict response to treatment with temozolomide (TMZ) in glioblastoma (GBM) patients. Both MGMT protein expression and MGMT promoter methylation status have been reported to predict the response to TMZ. We investigated the prognostic value of quantified MGMT protein levels in tumour cells and the prognostic importance of combining information of MGMT protein level and MGMT promoter methylation status. Methods: MGMT protein expression was quantified in tumour cells in 171 GBMs from the population-based Region of Southern Denmark (RSD)cohort using a double immunofluorescence approach. Pyrosequencing was performed in 157 patients. For validation we used GBM-patients from a Nordic Study (NS) investigating the effect of radiotherapy and different TMZ schedules. Results: When divided at the median, patients with low expression of MGMT protein (AF-low) had the best prognosis (HR = 1.5, P = 0.01). Similar results were observed in the subgroup of patients receiving the Stupp regimen (HR = 2.0, P = 0.001). In the NS-cohort a trend towards superior survival (HR = 1.6, P = 0.08) was seen in patients with AF-low. Including MGMT promoter methylation status, we found for both cohorts that patients with methylated MGMT promoter and AF-low had the best outcome; median OS 23.1 and 20.0 months, respectively. Conclusion: Our data indicate that MGMT protein expression in tumour cells has an independent prognostic significance. Exclusion of nontumour cells contributed to a more exact analysis of tumour-specific MGMT protein expression. This should be incorporated in future studies evaluating MGMT status before potential integration into clinical practice.

  • 197.
    Dahlström, Örjan
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Filosofiska fakulteten.
    Zetterqvist, Maria
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Lundh, Lars-Gunnar
    Department of Psychology, Lund University, Lund, Sweden..
    Svedin, Carl Göran
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Functions of Nonsuicidal Self-Injury: Exploratory and Confirmatory Factor Analyses in a Large Community Sample of Adolescents2015Ingår i: Psychological Assessment, ISSN 1040-3590, E-ISSN 1939-134X, Vol. 27, nr 1, s. 302-313Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Given that nonsuicidal self-injury (NSSI) is prevalent in adolescents, structured assessment is an essential tool to guide treatment interventions. The Functional Assessment of Self-Mutilation (FASM) is a self-report scale that assesses frequency, methods, and functions of NSSI. FASM was administered to 3,097 Swedish adolescents in a community sample. With the aim of examining the underlying factor structure of the functions of FASM in this sample, the adolescents with NSSI who completed all function items (n = 836) were randomly divided into 2 subsamples for cross-validation purposes. An exploratory factor analysis (EFA) was followed by a confirmatory factor analysis (CFA) using the mean and variance adjusted weighted least squares (WLSMV) estimator in the Mplus statistical modeling program. The results of the EFA suggested a 3-factor model (social influence, automatic functions, and nonconformist peer identification), which was supported by a good fit in the CFA. Factors differentiated between social/interpersonal and automatic/intrapersonal functions. Based on learning theory and the specific concepts of negative and positive reinforcement, the nonconformist peer identification factor was then split into 2 factors (peer identification and avoiding demands). The resulting 4-factor model showed an excellent fit. Dividing social functions into separate factors (social influence, peer identification, and avoiding demands) can be helpful in clinical practice, where the assessment of NSSI functions is an important tool with direct implications for treatment.

  • 198.
    Dahm-Kähler, Pernilla
    et al.
    Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden. Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Borgfeldt, Christer
    Department of Obstetrics and Gynecology, Skane University Hospital, Lund University, Lund, Sweden.
    Holmberg, Erik
    Regional Cancer Center Western Sweden, Sahlgrenska University Hospital, Gothenburg, Sweden. Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Staf, Christian
    Regional Cancer Center Western Sweden, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Falconer, Henrik
    Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
    Bjurberg, Maria
    Department of Clinical Sciences, Skåne University Hospital, Lund, Sweden.
    Kjölhede, Preben
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för barns och kvinnors hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Rosenberg, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US.
    Stålberg, Karin
    Department of Women's and Children's health Uppsala University, Uppsala, Sweden.
    Högberg, Thomas
    Department of Cancer Epidemiology, Lund University, Lund, Sweden.
    Åvall-Lundqvist, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US. Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
    Population-based study of survival for women with serous cancer of the ovary, fallopian tube, peritoneum or undesignated origin - on behalf of the Swedish gynecological cancer group (SweGCG).2017Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 144, nr 1, s. 167-173Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The aim of the study was to determine survival outcome in patients with serous cancer in the ovary, fallopian tube, peritoneum and of undesignated origin.

    METHODS: Nation-wide population-based study of women≥18years with histologically verified non-uterine serous cancer, included in the Swedish Quality Registry for primary cancer of the ovary, fallopian tube and peritoneum diagnosed 2009-2013. Relative survival (RS) was estimated using the Ederer II method. Simple and multivariable analyses were estimated by Poisson regression models.

    RESULTS: Of 5627 women identified, 1246 (22%) had borderline tumors and 4381 had malignant tumors. In total, 2359 women had serous cancer; 71% originated in the ovary (OC), 9% in the fallopian tube (FTC), 9% in the peritoneum (PPC) and 11% at an undesignated primary site (UPS). Estimated RS at 5-years was 37%; for FTC 54%, 40% for OC, 34% for PPC and 13% for UPS. In multivariable regression analyses restricted to women who had undergone primary or interval debulking surgery for OC, FTC and PPC, site of origin was not independently associated with survival. Significant associations with worse survival were found for advanced stages (RR 2.63, P<0.001), moderate (RR 1.90, P<0.047) and poor differentiation (RR 2.20, P<0.009), neoadjuvant chemotherapy (RR1.33, P<0.022), residual tumor (RR 2.65, P<0.001) and platinum single (2.34, P<0.001) compared to platinum combination chemotherapy.

    CONCLUSION: Survival was poorer for serous cancer at UPS than for ovarian, fallopian tube and peritoneal cancer. Serous cancer at UPS needs to be addressed when reporting and comparing survival rates of ovarian cancer.

  • 199.
    Dalin, Frida
    et al.
    Karolinska Institutet, Stockholm, Sweden, Uppsala University, Uppsala, Sweden.
    Nordling Eriksson, Gabriel
    Karolinska Institutet, Stockholm, Sweden.
    Dahlqvist, Per
    Umeå University, Umeå, Sweden.
    Hallgren, Åsa
    Karolinska Institutet, Stockholm, Sweden.
    Wahlberg, Jeanette
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Region Östergötland, Hjärt- och Medicincentrum, Endokrinmedicinska kliniken. Linköpings universitet, Medicinska fakulteten.
    Ekwall, Olov
    The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Söderberg, Stefan
    Umeå University, Umeå, Sweden.
    Rönnelid, Johan
    The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Olcén, Per
    Örebro University, Örebro, Sweden.
    Winqvist, Ola
    Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Catrina, Sergiu-Bogdan
    Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Kriström, Berit
    Umeå University, Umeå, Sweden.
    Laudius, Maria
    Umeå University, Umeå, Sweden.
    Isaksson, Magnus
    Uppsala University, Uppsala, Sweden.
    Halldin Stenlid, Maria
    Uppsala University, Uppsala, Sweden.
    Gustafsson, Jan
    Uppsala University, Uppsala, Sweden.
    Gebre-Medhin, Gennet
    Uppsala University, Uppsala, Sweden.
    Björnsdottir, Sigridur
    Karolinska In Karolinska University Hospital, Stockholm, Sweden.
    Janson, Annika
    Karolinska Institutet, Stockholm, Sweden.
    Åkerman, Anna-Karin
    Örebro University, Örebro, Sweden.
    Åman, Jan
    Örebro University, Örebro, Sweden.
    Duchen, Karel
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Region Östergötland, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping. Linköpings universitet, Medicinska fakulteten.
    Bergthorsdottir, Ragnhildur
    Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Johannsson, Gudmundur
    Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Lindskog, Emma
    The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Landin-Olsson, Mona
    Skåne University Hospital, Malmö, Sweden..
    Elfving, Maria
    Lund University, Lund, Sweden..
    Waldenström, Erik
    Skåne University Hospital, Malmö, Sweden.
    Hulting, Anna-Lena
    Karolinska Institutet, Stockholm, Sweden.
    Kämpe, Olle
    Karolinska University Hospital, Stockholm, Karolinska Institutet, Stockholm, Sweden.
    Bensing, Sophie
    Karolinska University Hospital, Stockholm, Karolinska Institutet, Stockholm, Sweden.
    Clinical and immunological characteristics of Autoimmune Addison's disease: a nationwide Swedish multicenter study.2017Ingår i: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 102, nr 2, s. 379-389Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    CONTEXT: Studies on clinical and immunological features of Autoimmune Addison's disease (AAD) are needed to understand the disease burden and increased mortality.

    OBJECTIVE: To provide upgraded data on autoimmune comorbidities, replacement therapy, autoantibody profiles and cardiovascular risk factors.

    DESIGN, SETTING AND PARTICIPANTS: Cross sectional, population-based study. 660 AAD patients were included utilizing the Swedish Addison Registry (SAR) 2008-2014. When analyzing cardiovascular risk factors, 3,594 individuals from the population-based survey in Northern Sweden, MONICA (MONItoring of Trends and Determinants of CArdiovascular Disease), served as controls.

    MAIN OUTCOME MEASURE: Prevalence of autoimmune comorbidities and cardiovascular risk factors. Autoantibodies against 13 autoantigens were determined.

    RESULTS: Sixty percent of the SAR cohort consisted of females. Mean age at diagnosis was significantly higher for females than for males (36.8 vs. 31.1 years). The proportion of 21-hydroxylase autoantibody positive patients was 83% and 62% of patients had one or more associated autoimmune diseases, more frequently coexisting in females (p<0.0001). AAD patients had lower BMI (p<0.0001) and prevalence of hypertension (p=0.027) compared with controls. Conventional hydrocortisone tablets were used by 89% of patients; with the mean dose 28.1±8.5 mg/day. The mean hydrocortisone equivalent dose normalized to body surface was 14.8±4.4 mg/m(2)/day. Higher hydrocortisone equivalent dose was associated with higher incidence of hypertension (p=0.046).

    CONCLUSIONS: Careful monitoring of AAD patients is warranted to detect associated autoimmune diseases. Contemporary Swedish AAD patients do not have increased prevalence of overweight, hypertension, T2DM or hyperlipidemia. However, high glucocorticoid replacement doses may be a risk factor for hypertension.

  • 200.
    Dam-Larsen, Sanne
    et al.
    Koege Hospital, Denmark.
    Darkahi, Bahman
    Enkoping Hospital, Sweden.
    Glad, Arne
    Bispebjerg Hospital, Denmark.
    Gleditsch, Dagfinn
    Drammen Hospital, Norway.
    Gustavsson, Lena
    Sahlgrens University Hospital, Sweden.
    Halttunen, Jorma
    University of Helsinki, Finland; University of Helsinki, Finland.
    Johansson, Karl-Erik
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Pischel, Andreas
    Sahlgrens University Hospital, Sweden.
    Reiertsen, Ola
    Akershus University Hospital, Norway.
    Tornqvist, Bjorn
    Karolinska University, Sweden.
    Zebski, Hubert
    Department Gastroenterol, Germany.
    Best practice in placement of percutaneous endoscopic gastrostomy with jejunal extension tube for continuous infusion of levodopa carbidopa intestinal gel in the treatment of selected patients with Parkinsons disease in the Nordic region2015Ingår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 50, nr 12, s. 1500-1507Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. Continuous infusion of levodopa carbidopa intestinal gel (LCIG) is associated with a significant improvement in the symptoms and quality of life of selected patients with advanced Parkinsons disease. Percutaneous endoscopic gastrostomy with jejunal extension (PEG/J) was first described in 1998 and has become the most common and standard technique for fixing the tubing in place for LCIG infusion. Material and methods. A workshop was held in Stockholm, Sweden, to discuss the PEG/J placement for the delivery of LCIG in Parkinsons disease patients with the primary goal of providing guidance on best practice for the Nordic countries. Results. Suggested procedures for preparation of patients for PEG/J placement, aftercare, troubleshooting and redo-procedures for use in the Nordic region are described and discussed. Conclusions. LCIG treatment administered through PEG/J-tubes gives a significant increase in quality of life for selected patients with advanced Parkinsons disease. Although minor complications are common, serious complications are infrequent, and the tube insertion procedures have a good safety record. Further development of delivery systems and evaluation of approaches designed to reduce the demand for redo endoscopy are required.

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