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  • 301.
    Tjomsland, Vegard
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gastroenterology and Hepatology.
    El-Salhy, Magdy
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gastroenterology and Hepatology. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Effects of single, double or triple combinations of octreotide, galanin and serotonin on a human pancreatic cancer cell line2005In: Histology and Histopathology, ISSN 0213-3911, E-ISSN 1699-5848, Vol. 20, no 2, p. 537-541Article in journal (Refereed)
    Abstract [en]

    The human pancreatic cancer cell line (SW 1990) was exposed to 0.2 μg/ml of octreotide, galanin or serotonin as single, double or triple combinations. The tumor cells were checked at 3, 6 and 12 hours. In order to determine the number of viable cancer cells, the MTT-assay was used. Proliferation, apoptosis and the expression of epidermal growth factor were detected with immunohistochemistry using the avidin-biotin complex method. In addition, apoptosis was also detected with (TUNEL) method. The primary antibodies used were proliferating cell nuclear antigen (PCNA), anti-poly (ADP-ribose) polymerase (PARP) and anti-human epidermal growth factor. Single treatment with octreotide or serotonin reduced, the number of viable cells and the proliferation index at all observation times. Galanin increased the number of viable cells and the proliferation index. Whereas double treatments containing octreotide reduced the number of viable cells, those containing galanin increased the number. The effect of single, double or triple treatment on the apoptotic index obtained with both TUNEL method and PARP expression varied depending on the combination and the observation time. Octreotide did not affect the tumor cell expression of EGF. Galanin and serotonin, on the other hand, increased the expression of EGF. Whereas triple combination increased the expression of EGF after 6 h, all the other double combinations decreased this expression. It has been concluded that treatment with a combination of octreotide and serotonin may be useful in clinical settings.

  • 302.
    Tjomsland, Veronica
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gastroenterology and Hepatology.
    El-Salhy, Magdy
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gastroenterology and Hepatology. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Anti-tumour effects of triple therapy with octreotide, galanin and serotonin in comparison with those of 5-fluorouracil/leukovorin on human colon cancer.2005In: International Journal of Oncology, ISSN 1019-6439, Vol. 27, no 2, p. 427-432Article in journal (Refereed)
    Abstract [en]

    Human colon cancer cells were injected subcutaneous in nude mice. After 8 days the animals were divided in two groups, the first group received triple therapy with octreotide, galanin and serotonin (40 microg/kg body weight/day) through an ALZET osmotic pump implanted intraperitoneally (i.p.) for 14 days, followed by 5 days of subcutaneous injections (200 microg/kg body weight/ day). The second group was injected i.p. for 5 days with 5-fluorouracil/leukovorin (5-FU/LV) at concentrations of 4 mg and 2 mg/kg body weight, respectively. After 9 days without any treatment, the mice received i.p. injection with 5-FU/LV (20 mg and 10 mg/kg body weight/day, respectively) for another 5 days. The volume and weight of the tumours were measured at the end of the experiment. Apoptosis, proliferation, blood vessels, epidermal growth factor (EGF) and vascular endothelial cell growth factor (VEGF) were detected with immunocytochemistry. Apoptosis was also detected using the TUNEL-method. Quantification was performed using computed image analysis. There was no statistical significance between tumours treated with 5-FU/LV or triple therapy regarding the volume and weights of the tumours, apoptotic, proliferation, VEGF indces and the density of tumour blood vessels. The EGF labelling index was, however significantly lower in the tumours treated with triple therapy than those treated with 5-FU/LV. In conclusion, treatment with triple therapy using octreotide, galanin and serotonin appear to be comparable with 5-FU/LV that is the standard chemotherapeutic agent for colorectal cancer.

  • 303. Torffvit, Ole
    et al.
    Eriksson, Jan W
    Henricsson, Marianne
    Sundkvist, Göran
    Arnqvist, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of cell biology. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Blohmé, Göran
    Bolinder, Jan
    Nyström, Lennart
    Östman, Jan
    Svensson, Maria
    Early changes in glomerular size selectivity in young adults with type 1 diabetes and retinopathy. Results from the Diabetes Incidence Study in Sweden2007In: Journal of diabetes and its complications, ISSN 1056-8727, E-ISSN 1873-460X, Vol. 21, no 4, p. 246-251Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the relationship between early-onset retinopathy and urinary markers of renal dysfunction. Research Design and Methods: The Diabetes Incidence Study in Sweden (DISS) aims to register all new cases of diabetes in young adults (15-34 years). In 1987-1988, 806 patients were reported and later invited to participate in a follow-up study focusing on microvascular complications after ∼10 years of diabetes. In the present study, 149 patients with type 1 diabetes, completed eye examination, and urine sampling were included. Results: The patients with retinopathy (n=58, 39%) had higher HbA1c (P<.001) and urinary IgG2/creatinine (P<.05) and IgG2/IgG4 ratios (P<.05). Patients with maculopathy had the highest levels. No significant differences in urinary albumin/creatinine, glycosaminoglycans (GAGs)/creatinine, Tamm-Horsfall protein (THP)/creatinine, and IgG4/creatinine ratios were found. Women had higher urinary albumin/creatinine (P<.01) and urinary IgG2/creatinine ratios (P<.01) than men. Conclusions: Young adults with type 1 diabetes and early-onset retinopathy had higher IgG2/creatinine and IgG2/IgG4 ratios than patients without retinopathy indicating that retinopathy is associated with a change in glomerular size selectivity. This was found in association with normal urinary albumin and THP excretion and may be suspected to reflect early general vascular changes. © 2007 Elsevier Inc. All rights reserved.

  • 304.
    Touraine, Philippe A
    et al.
    GH Pitie Salpetriere, Paris, France .
    DSouza, Gwyn
    Pfizer, New York, NY 10017 USA .
    Kourides, Ione
    Pfizer, New York, NY 10017 USA .
    Abs, Roger
    University Antwerp, Antwerp, Belgium .
    Barclay, Paul
    Pfizer, New York, NY 10017 USA .
    Torres, Elena
    Hospital University San Cecilio Granada, Granada, South Africa .
    Ekman, Bertil
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Lipoatrophy in growth hormone deficient patients treated with a long-acting pegylated growth hormone in HORMONE RESEARCH, vol 72, issue , pp 199-2002009In: HORMONE RESEARCH, 2009, Vol. 72, p. 199-200Conference paper (Refereed)
    Abstract [en]

    n/a

  • 305.
    Touraine, Philippe
    et al.
    Department of Endocrinology and Reproductive Medicine, GH Pitié Salpêtrière, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Université Paris VI Pierre et Marie Curie.
    D'Souza, Gwyn A
    Department of Endocrinology and Reproductive Medicine, GH Pitié Salpêtrière, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Université Paris VI Pierre et Marie Curie.
    Kourides, Ione
    Pfizer Limited, Sandwich, Kent, UK.
    Abs, Roger
    Pfizer, New York, New York, USA.
    Barclay, Paul
    Pfizer Limited, Sandwich, Kent, UK.
    Xie, Rujia
    Department of Endocrinology and Reproductive Medicine, GH Pitié Salpêtrière, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Université Paris VI Pierre et Marie Curie.
    Pico, Antonio
    University of Antwerp.
    Torres-Vela, Elena
    Hospital General Universitario de Alicante.
    Ekman, Bertil
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL. Linköping University, Faculty of Health Sciences.
    Lipoatrophy in GH deficient patients treated with a long-acting pegylated GH2009In: European Journal of Endocrinology, ISSN 0804-4643, E-ISSN 1479-683X, Vol. 161, p. 533-540Article in journal (Refereed)
    Abstract [en]

    Objective: Changes observed during adult GH deficiency (GHD) are most often reversed with the administration of recombinant human GH (rhGH). To avoid daily injections, a long-acting GH molecule has been obtained by covalent binding of polyethylene glycol (PEG) with rhGH (PEG–GH), allowing weekly s.c. injections. This study was designed to assess its efficacy and safety, in adult GHD subjects.

    Design and methods: This was a randomized, double-blind, placebo-controlled, multiple-dose, parallel group study. Subjects were recruited from 34 centers. A total of 105 subjects with GHD were assigned a treatment. They received 6 weekly injections of either PEG–GH or placebo. Subjects were randomized into one out of four treatment groups (Groups A–D) or placebo (Group E). Groups A, B, and C received 1, 3, and 4 mg PEG–GH respectively, for the first 3 weeks followed by 2, 6, and 8 mg PEG–GH respectively, for the remaining 3 weeks. Group D received 4 mg PEG–GH for 6 weeks. Group E received placebo. The study was suspended because of the development of lipoatrophy in certain subjects and restarted with an injection rotation plan, before being terminated due to further subjects developing lipoatrophy.

    Results: A total of 13 cases of injection-site lipoatrophy were reported, of which ten were in females and three occurred after the first injection; all cases were independent of PEG–GH dose or IGF1 levels, either basal or under treatment.

    Conclusion: The unpredictable occurrence of injection-site lipoatrophy with weekly long-acting pegylated GH molecules may be a limiting factor for their development.

  • 306. Tsimikas, S
    et al.
    Witztum, JL
    Miller, ER
    Sasiela, WJ
    Szarek, M
    Olsson, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Schwartz, GG
    High-dose atorvastatin reduces total plasma levels of oxidized phospholipids and immune complexes present on apolipoprotein B-100 in patients with acute coronary syndromes in the MIRACL trial2004In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 110, no 11, p. 1406-1412Article in journal (Refereed)
    Abstract [en]

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

  • 307.
    Tsimikas, Sotirios
    et al.
    Department of Medicine, University of California, San Diego, Calif. USA.
    Witztum, Joseph L
    Department of Medicine, University of California, San Diego, Calif. USA.
    Miller, Elisabeth R
    Department of Medicine, University of California, San Diego, Calif. USA.
    Sasiela, William J
    Pfizer Pharmaceuticals Group, New York, NY, USA.
    Szarek, Michael
    Pfizer Pharmaceuticals Group, New York, NY, USA.
    Olsson, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Internal Medicine. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Schwartz, Gregory G
    Letter regarding article by Tsimikas et al, - "High-dose atorvastatin reduces total plasma levels of oxidized phospholipids and immune complexes present on apolipoprotein B-100 in patients with acute coronary syndromes in the MIRACL trial" - Response2005In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 111, no 18, p. E284-E285p. e284-e285Article in journal (Other academic)
    Abstract [en]

    [abstract not available]

  • 308. Tysk, C
    et al.
    Almer, Sven
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology . Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Andersson, M
    Befrits, R
    Hertervig, E
    Kilander, A
    Lindgren, S
    Suhr, O
    Nationella riktlinjer för handläggning av akut svårt skov av ulcerös kolit2008Report (Other academic)
    Abstract [sv]

      

  • 309.
    Valdimarsson, T
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gastroenterology and Hepatology. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, GE: gastromed.
    Toss, Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Löfman, O
    Linköping University, Faculty of Health Sciences. Linköping University, Department of health and environment. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum, Förebygg.med.
    Ström, Magnus
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gastroenterology and Hepatology. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, GE: gastromed.
    Three years' follow-up of bone density in adult coeliac disease: Significance of secondary hyperparathyroidism2000In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 35, no 3, p. 274-280Article in journal (Refereed)
    Abstract [en]

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

  • 310.
    Vikingsson, Svante
    et al.
    Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Carlsson, Björn
    Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Almer, Sven H C
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Peterson, Curt
    Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Monitoring of thiopurine metabolites in patients with inflammatory bowel disease-what is actually measured?2009In: Therapeutic Drug Monitoring, ISSN 0163-4356, E-ISSN 1536-3694, Vol. 31, no 3, p. 345-50Article in journal (Refereed)
    Abstract [en]

    Azathioprine and 6-mercaptopurine are often used in the treatment of patients with inflammatory bowel disease (IBD). They are prodrugs and undergo a complex metabolism to active and inactive metabolites. Thiopurine treatment is monitored in many laboratories by measuring metabolite concentrations in erythrocytes (red blood cells). The metabolites of interest are not measured directly but as hydrolysis products, which can be produced from several metabolites. The aim of this study was to examine which metabolites are actually measured during routine monitoring. Samples from 18 patients treated with a thiopurine were analyzed by a typical routine high-performance liquid chromatography method for therapeutic drug monitoring and by a newly developed specific method measuring thioguanosine monophosphate (TGMP), thioguanosine diphosphate (TGDP), and thioguanosine triphosphate (TGTP), as well as methylthioinosine monophosphate (meTIMP), and the results were compared. 6-Thioguanine nucleotide (TGN) values detected by the routine method were 69% (range 40%-90%) of the sum of TGMP, TGDP, and TGTP measured by the specific method. TGTP and TGDP contributed 85% (range 78%-90%) and 14% (range 10%-21%) of the TGN total, respectively. Thioguanosine was not found in any patient sample. The concentration of meTIMP obtained by the routine method was 548% of the value obtained by the specific method (range 340%-718%). The difference in TGN measurements between the routine and specific methods can be explained by low hydrolysis efficiency in the routine method, although the most likely explanation for the difference in meTIMP values is that not yet identified metabolites are codetermined in the routine high-performance liquid chromatography method. Concentrations reported as TGN during therapeutic drug monitoring of thiopurine metabolites consist of TGDP and TGTP with a minor contribution of the TGMP. Concentrations reported as meTIMP or methyl mercaptopurine consist in part of meTIMP, but other not yet identified metabolites are codetermined.

  • 311.
    Vikingsson, Svante
    et al.
    Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Carlsson, Björn
    Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Almer, Sven
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Peterson, Curt
    Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    How Should Thiopurine Treatment be Monitored? Methodological Aspects2010In: Nucleosides, Nucleotides & Nucleic Acids, ISSN 1525-7770, E-ISSN 1532-2335, Vol. 29, no 04-Jun, p. 278-283Article in journal (Refereed)
    Abstract [en]

    Monitoring of thiopurine metabolites is important due to a complex metabolism with large interindividual variation, but the suitability of currently used methods has been questioned. The drawbacks include poor reproducibility, the inability to differentiate between the different analytes, as well as the use of a nontarget matrix. Further research should be directed toward measuring thiopurine metabolites in mononuclear cells, measuring the different nucleotides specifically, as well as measuring the incorporation of thioguanine into DNA. The studies should not be limited to thioguanosine nucleotides but include methylthioinosine nucleotides as well.

  • 312. Waernbaum, I
    et al.
    Blohmé, G
    Östman, J
    Sundkvist, G
    Eriksson, JW
    Arnqvist, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of cell biology. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Bolinder, J
    Nyström, L
    Excess mortality in incident cases of diabetes mellitus aged 15 to 34 years at diagnosis: A population-based study (DISS) in Sweden2006In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 49, no 4, p. 653-659Article in journal (Refereed)
    Abstract [en]

    Aims/hypothesis: The objective of the study was to analyse the mortality, survival and cause of death patterns in incident cases of diabetes in the 15-34-year age group that were reported to the nationwide prospective Diabetes Incidence Study in Sweden (DISS). Methods: During the study period 1983-1999, 6,771 incident cases were reported. Identification of deaths was made by linking the records to the nationwide Cause of Death Register. Results: With an average follow-up of 8.5 years, resulting in 59,231 person-years, 159 deaths were identified. Diabetes was reported as the underlying cause of death in 51 patients (32%), and as a contributing cause of death in another 42 patients (26%). The standardised mortality ratio (SMR) was significantly elevated (RR=2.4, 95% CI: 2.0-2.8). The SMR was higher for patients classified by the reporting physician as having type 2 diabetes at diagnosis than for those classified as type 1 diabetic (2.9 and 1.8, respectively). Survival analysis showed significant differences in survival curves between males and females (p=0.0003) as well as between cases with different types of diabetes (p=0.005). This pattern was also reflected in the Cox regression model showing significantly increased hazard for males vs females (p=0.0002), and for type 2 vs type 1 (p=0.015) when controlling for age. Conclusions/ interpretation: This study shows a two-fold excess mortality in patients with type 1 diabetes and a three-fold excess mortality in patients with type 2 diabetes. Thus, despite advances in treatment, diabetes still carries an increased mortality in young adults, even in a country with a good economic and educational patient status and easy access to health care. © Springer-Verlag 2006.

  • 313.
    Wahlberg, J
    et al.
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Lindström, Torbjörn
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Jenmalm, Maria
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Ekman, Bertil
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Alterations in the Chemokine Th1/Th2 Balance and Not the Mode of Dosing Hydrocortisone May Explain the Increased Fatigue in Addisons Disease. in ENDOCRINE REVIEWS, vol 31, issue 3, pp2010In: ENDOCRINE REVIEWS, Endocrine Society , 2010, Vol. 31, no 3Conference paper (Refereed)
    Abstract [en]

    n/a

  • 314. Wallerstedt, Sven
    et al.
    Olsson, Rolf
    Simrén, Magnus
    Broomé, Ulrika
    Wahlin, Staffan
    Lööf, Lars
    Hultcrantz, Rolf
    Sjöberg, Klas
    Sandberg Gertzén, Hanna
    Prytz, Hanne
    Almer, Sven
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gastroenterology and Hepatology. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Abdominal tenderness in ascites patients indicates spontaneous bacterial peritonitis2007In: European journal of internal medicine, ISSN 0953-6205, E-ISSN 1879-0828, Vol. 18, no 1, p. 44-47Article in journal (Refereed)
    Abstract [en]

    Background: Spontaneous bacterial peritonitis (SBP), which has been reported to be present in 10-30% of patients with cirrhotic ascites, may easily be overlooked. An important aim of our study was to determine whether there are any clinical signs which, in clinical practice, may predict or exclude SBP. Methods: We studied 133 patients with cirrhotic ascites from medical units at nine Swedish university hospitals where there had been at least one diagnostic ascites tap with analysis of polymorphonuclear leukocytes in the ascites fluid. The patients had initially been questioned about background factors and physically examined according to a standardized case record form. Samples of blood, urine, and ascites were then drawn for analysis according to a structured schedule. Results: SBP could be excluded in 80% of all the cases and was confirmed in 8% of the 133 patients in the final analysis. Abdominal pain and abdominal tenderness were more common in patients with SBP (p < 0.01), but no other physical sign or laboratory test could separate SBP cases from the others. Conclusions: SBP was present in about one-tenth of the hospitalized patients with cirrhotic ascites in this cohort. Performing repeated physical examinations and paying particular attention to abdominal tenderness may be the best way to become aware of the possible development of this complication. © 2006 Elsevier B.V. All rights reserved.

  • 315.
    Wallhuss, Andreas
    et al.
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Isik, Markus
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Nystrom, Fredrik H
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Comparison of the subjective sense of high or low metabolism and objectively measured resting metabolic rate2010In: Scandinavian journal of clinical and laboratory investigation, ISSN 1502-7686, Vol. 70, no 5, p. 334-337Article in journal (Refereed)
    Abstract [en]

    Abstract Objective. To measure caloric intake, physical activity level and resting metabolic rate in participants having the subjective opinion of either having a high or low metabolic rate. Methods. Recruitment by local advertising of healthy subjects feeling that they have high or low metabolism, i.e. either a tendency to easily stay lean ('high') or to very easily gain weight ('low') also when taking food intake in comparison with physical activity into account. Walking distance was estimated by pedometry, assessment of caloric intake was determined by food registration. Measurement of resting metabolic rate was performed in the fasting state. Results. We recruited 44 participants with a sense of 'high' metabolism and 12 subjects in the contrasting group. Subjects with 'high' metabolism were leaner ('high': 20.4 +/- 2.1 kg/m(2), 'low': 27.8 +/- 7.5 kg/m(2), p < 0.0001) and reported a higher caloric intake than those with 'low' metabolism ('high': 11435 +/- 2420 kJ/24 h, 'low': 8339 +/- 2679 kJ/24 h, p = 0.001). Despite this there was no difference in the measured resting metabolic rate between the two groups ('high': 7230 +/- 1233 kJ/24 h, 'low': 7430 +/- 1422 kJ/24 h, p = 0.6), nor was there any difference in physical activity measured by pedometry. Resting metabolic rate was negatively correlated with age and positively correlated with BMI in multivariate analyses of the total cohort. Conclusion. The sense of having a low or high metabolic rate is not related to actual resting metabolic rate.

  • 316.
    Walter, Susanna
    et al.
    Linköping University, Department of Molecular and Clinical Medicine. Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Hallböök, Olof
    Linköping University, Department of Clinical and Experimental Medicine, Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Gotthard, Ricci
    Bergmark, M.
    Sjödahl, Rune
    Linköping University, Department of Clinical and Experimental Medicine, Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    A population-based study on bowel habits in a Swedish community: prevalence of faecal incontinence and constipation2002In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, Vol. 37, no 8, p. 911-916Article in journal (Refereed)
    Abstract [en]

    Background: The self-reported bowel habits and the prevalence of faecal incontinence and constipation in men and women between the ages of 31 and 76 are assessed.

    Methods: A postal questionnaire was sent to a random sample ( n = 2000) of the total population of persons between the ages of 31 and 76 living in the County of Östergötland, Sweden.

    Results: The response rate was 80.5%. Overall, 67.8% reported one bowel movement per day and 4.4% had more than 21 or less than 3 bowel movements per week. This means that 95.6% had between 3 bowel movements a day to 3 bowel movements a week. Among women, 4.3%, and among men, 1.7%, reported less than 3 bowel movements per week. Women and men used the same terms to describe the definition of constipation. Women had a significantly higher self-reported prevalence of constipation than men ( P < 0.0001). About 20% of all women considered themselves constipated. The use of laxatives increased with age and 22% and 10% of elderly women and men, respectively, used laxatives including bulking agents for at least every fourth toilet procedure. About 10% reported leakage of faeces more often than once a month in the case of loose stools. With solid faeces, the rate of leakage was 1.4% and 0.4% for women and men, respectively. Soiling of underclothes more than once a month occurred in 21% of men and in 14.5% of women ( P = 0.006) and involuntary daily leakage of gas in 5.9% of men and 4.9% of women (n.s.).

    Conclusions: Constipation and faecal incontinence are common problems in a general Swedish population.

  • 317.
    Walter, Susanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Kjellstrom, Lars
    Karolinska Institute.
    Nyhlin, Henry
    Karolinska Institute.
    Talley, Nicholas J
    Mayo Clinic Florida.
    Agreus, Lars
    Karolinska Institute.
    Assessment of normal bowel habits in the general adult population: the Popcol study2010In: SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, ISSN 0036-5521, Vol. 45, no 5, p. 556-566Article in journal (Refereed)
    Abstract [en]

    Objective. Defining normal stool habit is important when evaluating diarrhoea or constipation, but common confounders such as irritable bowel syndrome (IBS) or the intake of medications with gastrointestinal side effects have not been considered in earlier population based studies defining what is normal. We hypothesized that the exclusion of subjects with common confounders would help to better understand what are "normal bowel habits". We aimed to prospectively study bowel habits in a carefully studied random sample of the general population. Material and methods. Two hundred and sixty-eight randomly selected subjects between 18 and 70 years completed symptom diaries for one week and were clinically evaluated by a gastroenterologist. They also had a colonoscopy and laboratory investigations to exclude organic disease. Results. One hundred and twenty-four subjects had no organic gastrointestinal abnormality, IBS, or relevant medication; 98% of them had between three stools per day and three per week. Seventy-seven percent of all stools were normal, 12% hard, and 10% loose in consistency. Urgency was reported by 36%; straining by 47% and incomplete defecation by 46%. After the exclusion of subjects with organic abnormalities, women had significantly more symptoms than men in terms of abdominal pain, bloating, constipation, urgency, and feeling of incomplete evacuation but these gender differences disappeared after excluding subjects with IBS. Conclusions. This study confirms that normal stool frequency is between three per week and three per day. We could not demonstrate any gender or age differences in terms of stool frequency, defecatory symptoms or abdominal bloating. Some degree of urgency, straining, and incomplete evacuation should be considered normal.

  • 318.
    Walter, Susanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Münch, Andreas
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Ost, A
    Karolinska Institute.
    Ström, Magnus
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology and Gastroenterology UHL.
    Anorectal function in patients with collagenous colitis in active and clinically quiescent phase, in comparison with healthy controls2010In: Neurogastroenterology and Motility, ISSN 1350-1925, E-ISSN 1365-2982, Vol. 22, no 5, p. 534-+Article in journal (Refereed)
    Abstract [en]

    Background Collagenous colitis (CC) is characterized by chronic watery diarrhea, a macroscopically normal colonic mucosa but typical microscopic inflammation. Chronic mucosal inflammation of the colon and rectum has earlier been associated with altered visceral sensitivity, but anorectal function has never been reported in cases of CC. Methods Fifteen patients with CC in active phase recorded their symptoms. The severity of inflammation was determined in mucosal biopsies. Anorectal function was assessed and compared with that of 15 healthy volunteers of corresponding age and matched for gender. After 6 weeks of budesonide treatment when the patients were in clinical remission anorectal function was re-assessed. Key Results All patients had inflammation also in rectum. Patients in active phase had, during rectal balloon distension a higher rectal sensory threshold for the feeling of first sensation, compared with controls (P = 0.02). There were no differences in rectal sensory threshold for the feeling of urgency or maximum distension, between patients with CC in active phase and healthy controls. Rectal volume at first sensation was significantly greater in patients than in controls (P = 0.02), but there were no differences at urgency or maximum distension. Twelve of 15 patients completed 6 weeks of budesonide treatment and all went into clinical remission. No differences in anorectal function were measured when patients had active disease, compared with clinical remission. Conclusions andamp; Inferences Collagenous colitis was not associated with rectal hypersensitivity or disturbed anal function despite rectal inflammation. On the contrary, the sensation threshold for light rectal pressure was elevated in patients with active CC.

  • 319.
    Walter, Susanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Skagerström, Eva
    Bodemar, Göran
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Subgroups of irritable bowel syndrome: a new approach2004In: European Journal of Gastroenterology and Hepatology, ISSN 0954-691X (print) 1473-5687 (online), Vol. 16, no 10, p. 991-994Article in journal (Refereed)
    Abstract [en]

    Objectives: The newly revised Rome criteria for the definition of irritable bowel syndrome (IBS), derived from the consensus of experts in the field, were developed in order to identify subgroups of IBS patients for research. The criteria have, to our knowledge, never been validated. Both when trying to include IBS patients in studies and in clinical practice we found it difficult to apply the Rome 2 supportive criteria.

    Aim: To study the variation of stool consistency and defecatory symptoms in IBS patients prospectively with diary cards and to validate the Rome 2 supportive criteria.

    Methods: Sixty IBS patients, included by interview according to the Rome 1 criteria, recorded their bowel symptoms on diary cards over 40 days. Four subgroups were found, characterised by loose-stool-predominant, hard-stool-predominant, alternating stool consistency, and loose stools only. Urgency, straining and feeling of incomplete evacuation occurred in all but seven individuals, irrespective of subgroup.

    Results: The Rome 2 criteria could subclassify seven patients into diarrhoea-predominant IBS based on stool consistency and absence of straining and could subclassify no patients into constipation-predominant IBS, as urge was present in nearly all patients. Fifty-three patients could not be classified according to the Rome 2 criteria, as they had defecatory symptoms of all kinds.

    Conclusion: As the Rome 2 supportive criteria use the presence or absence of specific defecatory symptoms as an instrument for categorising IBS patients into diarrhoea- and constipation-predominant subgroups, these criteria could not be used for the majority of IBS patients in this study and should be reconsidered.

  • 320.
    Waters, D
    et al.
    Univ Calif San Francisco, San Francisco Gen Hosp, San Francisco, CA 94143 USA Univ Colorado, Hlth Sci Ctr, Denver, CO USA Linkoping Univ, S-58183 Linkoping, Sweden Natl Heart & Lung Inst, Imperial Coll, London, England Harvard Univ, Brigham & Womens Hosp, Sch Med, Boston, MA 02115 USA Med Coll Penn & Hahnemann Univ, Philadelphia, PA USA Pfizer, New York, NY USA Pfizer, Ann Arbor, MI USA.
    Schwartz, GG
    Univ Calif San Francisco, San Francisco Gen Hosp, San Francisco, CA 94143 USA Univ Colorado, Hlth Sci Ctr, Denver, CO USA Linkoping Univ, S-58183 Linkoping, Sweden Natl Heart & Lung Inst, Imperial Coll, London, England Harvard Univ, Brigham & Womens Hosp, Sch Med, Boston, MA 02115 USA Med Coll Penn & Hahnemann Univ, Philadelphia, PA USA Pfizer, New York, NY USA Pfizer, Ann Arbor, MI USA.
    Olsson, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Oliver, MF
    Univ Calif San Francisco, San Francisco Gen Hosp, San Francisco, CA 94143 USA Univ Colorado, Hlth Sci Ctr, Denver, CO USA Linkoping Univ, S-58183 Linkoping, Sweden Natl Heart & Lung Inst, Imperial Coll, London, England Harvard Univ, Brigham & Womens Hosp, Sch Med, Boston, MA 02115 USA Med Coll Penn & Hahnemann Univ, Philadelphia, PA USA Pfizer, New York, NY USA Pfizer, Ann Arbor, MI USA.
    Ganz, P
    Univ Calif San Francisco, San Francisco Gen Hosp, San Francisco, CA 94143 USA Univ Colorado, Hlth Sci Ctr, Denver, CO USA Linkoping Univ, S-58183 Linkoping, Sweden Natl Heart & Lung Inst, Imperial Coll, London, England Harvard Univ, Brigham & Womens Hosp, Sch Med, Boston, MA 02115 USA Med Coll Penn & Hahnemann Univ, Philadelphia, PA USA Pfizer, New York, NY USA Pfizer, Ann Arbor, MI USA.
    Ezekowitz, MD
    Univ Calif San Francisco, San Francisco Gen Hosp, San Francisco, CA 94143 USA Univ Colorado, Hlth Sci Ctr, Denver, CO USA Linkoping Univ, S-58183 Linkoping, Sweden Natl Heart & Lung Inst, Imperial Coll, London, England Harvard Univ, Brigham & Womens Hosp, Sch Med, Boston, MA 02115 USA Med Coll Penn & Hahnemann Univ, Philadelphia, PA USA Pfizer, New York, NY USA Pfizer, Ann Arbor, MI USA.
    Leslie, S
    Univ Calif San Francisco, San Francisco Gen Hosp, San Francisco, CA 94143 USA Univ Colorado, Hlth Sci Ctr, Denver, CO USA Linkoping Univ, S-58183 Linkoping, Sweden Natl Heart & Lung Inst, Imperial Coll, London, England Harvard Univ, Brigham & Womens Hosp, Sch Med, Boston, MA 02115 USA Med Coll Penn & Hahnemann Univ, Philadelphia, PA USA Pfizer, New York, NY USA Pfizer, Ann Arbor, MI USA.
    Stern, T
    Univ Calif San Francisco, San Francisco Gen Hosp, San Francisco, CA 94143 USA Univ Colorado, Hlth Sci Ctr, Denver, CO USA Linkoping Univ, S-58183 Linkoping, Sweden Natl Heart & Lung Inst, Imperial Coll, London, England Harvard Univ, Brigham & Womens Hosp, Sch Med, Boston, MA 02115 USA Med Coll Penn & Hahnemann Univ, Philadelphia, PA USA Pfizer, New York, NY USA Pfizer, Ann Arbor, MI USA.
    Stroke reduction with atorvastatin in acute coronary syndromes: Results of the myocardial ischemia reduction with aggressive cholesterol lowering (MIRACL) trial2001In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 104, no 17, p. 2503-Conference paper (Other academic)
  • 321.
    Waters, David
    et al.
    Division of Cardiology, San Francisco General Hospital, San Francisco, CA, USA .
    Schwartz, Gregory G
    Cardiology Section, Denver VA Medical Center, Denver, CO, USA.
    Olsson, Anders G
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    The Myocardial Ischemia Reduction with Acute Cholesterol Lowering (MIRACL) trial: a new frontier for statins?2001In: Current controlled trials. Cardiovascular medicine (Online), ISSN 1468-6708, E-ISSN 1468-6694, Vol. 2, no 3, p. 111-114p. 111-114Article in journal (Other academic)
    Abstract [en]

    The Myocardial Ischemia Reduction with Acute Cholesterol Lowering (MIRACL) Trial tested the hypothesis that intensive lowering of cholesterol with atorvastatin (80 mg/day) initiated 24-96 h after an acute coronary syndrome would, over 4 months, reduce the incidence of the composite endpoint of death, nonfatal infarction, resuscitated cardiac arrest, and recurrent symptomatic myocardial ischemia with new objective symptoms requiring emergency rehospitalization. This primary composite endpoint was reduced from 17.4% to 14.8% (P = 0.048) among the 3086 patients enrolled. The results of MIRACL suggest that patients with acute coronary syndromes should begin to receive this treatment before leaving hospital, irrespective of baseline levels of low-density lipoprotein-cholesterol.

  • 322.
    Wei, G.
    et al.
    Section of Gastroenterology and Hepatology, Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Bergquist, A.
    Department of Gastroenterology and Hepatology, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
    Broome, U.
    Broomé, U., Department of Gastroenterology and Hepatology, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
    Lindgren, S.
    Gastroenterology and Hepatology Division, Department of Medicine, University Hospital MAS, Malmö, Sweden.
    Wallerstedt, S.
    Section of Gastroenterology and Hepatology, Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Almer, Sven
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology . Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Sangfelt, P.
    Gastroenterology and Hepatology Division, Department of Medicine, University Hospital, Uppsala, Sweden.
    Danielsson, A.
    Danielsson, Å., Gastroenterology and Hepatology Division, Department of Medicine, University Hospital, Umeå, Sweden.
    Sandberg-Gertzen, H.
    Sandberg-Gertzén, H., Gastroenterology and Hepatology Division, Department of Medicine, University Hospital, Örebro, Sweden.
    Loof, L.
    Lööf, L., Center for Clinical Research, Central Hospital, Västerås, Sweden.
    Prytz, H.
    Gastroenterology and Hepatology Division, Department of Medicine, University Hospital, Lund, Sweden.
    Bjornsson, E.
    Björnsson, E., Section of Gastroenterology and Hepatology, Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden, Department of Internal Medicine, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
    Acute liver failure in Sweden: Etiology and outcome2007In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 262, no 3, p. 393-401Article in journal (Refereed)
    Abstract [en]

    Objective. To determine the causes and outcome of all patients with acute liver failure (ALF) in Sweden 1994-2003 and study the diagnostic accuracy of King's College Hospital (KCH) criteria and the model for end-stage liver disease (MELD) score with transplant-free deaths as a positive outcome. Research design and methods. Adult patients in Sweden with international normalized ratio (INR) of =1.5 due to severe liver injury with and without encephalopathy at admission between 1994-2003 were included. Results. A total of 279 patients were identified. The most common cause of ALF were acetaminophen toxicity in 42% and other drugs in 15%. In 31 cases (11%) no definite etiology could be established. The KCH criteria had a positive-predictive value (PPV) of 67%, negative-predictive value (NPV) of 84% in the acetaminophen group. Positive-predictive value and negative-predictive value of KCH criteria in the nonacetaminophen group were 54% and 63% respectively. MELD score >30 had a positive-predictive value of 21%, negative-predictive value of 94% in the acetaminophen group. The corresponding figures for the nonacetaminophen group were 64% and 76% respectively. Conclusions. Acetaminophen toxicity was the most common cause in unselected patients with ALF in Sweden. KCH criteria had a high NPV in the acetaminophen group, and in combination with MELD score <30 predicts a good prognosis in acetaminophen patients without transplantation. © 2007 Blackwell Publishing Ltd.

  • 323. Werner, M
    et al.
    Prytz, H
    Ohlsson, B
    Almer, Sven
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology . Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Bjornsson, E
    Bergquist, A
    Wallerstedt, S
    Sandberg-Gertzen, H
    Hultcrantz, R
    Sangfelt, P
    Weiland, O
    Danielsson, A
    Epidemiology and the initial presentation of autoimmune hepatitis in Sweden: A nationwide study2008In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 43, no 10, p. 1232-1240Article in journal (Refereed)
    Abstract [en]

    Objective. Autoimmune hepatitis (AIH) is a chronic liver disease, which if untreated can lead to cirrhosis and hepatic failure. The aim of the study was to investigate the incidence, prevalence, diagnostic tradition and clinical initial presentation of AIH. Material and methods. Analyses were performed in 473 patients identified as having probable or definite AIH. Results. The incidence of AIH was 0.85/100,000 (95% CI 0.69-1.01) inhabitants, which is somewhat lower than reported previously. The point prevalence amounted to 10.7/100,000 (95% CI 8.8-13.1), and 76% of the cases were females. The age-related incidence curve was bimodal but men were found to have only one incidence peak in the late teens, whereas women had a peak after menopause. AIH was presented as a spectrum of clinical settings from detected "en passant" to acute liver failure. Almost 30% of patients already had liver cirrhosis at diagnosis. Autoantibodies indicative of AIH type 1 were found in 79% of cases. Other concomitant autoimmune diseases were frequently found (49%). Conclusions. The incidence and prevalence figures confirm that AIH is a fairly uncommon disease in the Swedish population. Symptoms at presentation were unspecific, but almost half of the patients were jaundiced, with around 30% having liver cirrhosis. The majority of Swedish AIH patients had AIH type 1. © 2008 Informa UK Ltd.

  • 324.
    Werner, Marten
    et al.
    Umeå University Hospital.
    Almer, Sven
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Prytz, Hanne
    Lund University Hospital.
    Lindgren, Stefan
    Malmö University Hospital.
    Wallerstedt, Sven
    Karolinska University Hospital.
    Sandberg-Gertzen, Hanna
    Örebro University Hospital.
    Hultcrantz, Rolf
    Karolinska University Hospital.
    Sangfelt, Per
    Uppsala University Hospital.
    Weiland, Ola
    Karolinska University Hospital.
    Danielsson, Ake
    Umeå University Hospital.
    Hepatic and extrahepatic malignancies in autoimmune hepatitis. A long-term follow-up in 473 Swedish patients2009In: Journal of Hepatology, ISSN 0168-8278, E-ISSN 1600-0641, Vol. 50, no 2, p. 388-393Article in journal (Refereed)
    Abstract [en]

    Background/Aims: Autoimmune Hepatitis (AIH) is a liver disease which may lead to liver cirrhosis. Cirrhosis is a well-known risk factor for hepatocellular cancer. Lymphoma is a disease, where immune modulating drugs as well as the autoimmune disease itself may contribute to the elevated risk. The aim was to investigate the risks of malignancies in a large cohort of AIH patients.

    Methods: Four hundred and seventy-three patients with AIH were matched to the Swedish national cancer register as well as to the death cause register.

    Results: We found an overall higher risk of malignancies in the cohort of A I H patients from the date of diagnosis with a SIR of 1.51 (95% CI 1.10-2.03). SIR in the subpopulation of well defined catchment areas and complete case finding was 23.28 (95% CI 7.5-54.34) for HCC. Lymphomas were found a SIR of 13.09 (95% CI 4.22-30.56).

    Conclusions: There was an overall increased risk of malignancies in a cohort of AIH patients, which manly was caused by hepatobiliary cancers. However, the true risk of HCC in an AIH cirrhotic cohort has yet to be investigated. A significantly higher risk of lymphomas was also found, but no clear cut association to the use of immune modulators.

  • 325.
    Werner, Marten
    et al.
    Umeå University Hospital.
    Wallerstedt, Sven
    Sahlgrens University Hospital.
    Lindgren, Stefan
    Malmö University Hospital.
    Almer, Sven
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Bjornsson, Einar
    Sahlgrens University Hospital.
    Bergquist, Annika
    Karolinska University Hospital.
    Prytz, Hanne
    Lund University Hospital.
    Sandberg-Gertzen, Hanna
    Örebro University Hospital.
    Hultcrantz, Rolf
    Karolinska University Hospital.
    Sangfelt, Per
    Uppsala University Hospital.
    Weiland, Ola
    Karolinska University Hospital.
    Ohlsson, Bodil
    Malmö University Hospital.
    Danielsson, Ake
    Umeå University Hospital.
    Characteristics and long-term outcome of patients with autoimmune hepatitis related to the initial treatment response2010In: SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, ISSN 0036-5521, Vol. 45, no 4, p. 457-467Article in journal (Refereed)
    Abstract [en]

    Objectives. Autoimmune hepatitis (AIH) is a liver disease which, if untreated, may lead to liver cirrhosis and hepatic failure. Limited data exist regarding factors predicting the long-term outcome. The aims of this study were to investigate symptoms at presentation, prognostic features, management and treatment in relation to long-term outcome of AIH. Material and methods. A cohort of 473 Swedish patients with AIH was characterized regarding initial symptoms and signs, factors predicting death and future need for liver transplantation. Survival and causes of death were retrieved from Swedish national registers. Results. At diagnosis, fatigue was a predominant symptom (69%), 47% of the patients were jaundiced and 30% had liver cirrhosis. Another 10% developed cirrhosis during follow-up. Markedly elevated alanine aminotransferase levels at presentation were correlated with a better outcome. A high international normalized ratio (INR) at diagnosis was the only risk factor predicting a need for later liver transplantation. Histological cirrhosis, decompensation and non-response to initial treatment were all factors that correlated with a worse outcome. Overall life expectancy was generally favourable. However, most deaths were liver-related, e.g. liver failure, shock and gastrointestinal bleeding. Conclusions. Cirrhosis at diagnosis, a non-response to initial immune-suppressive treatment or elevated INR values were associated with worse outcome and a need for later liver transplantation. In contrast, an acute hepatitis-like onset with intact synthetic capacity indicated a good response to treatment and favourable long-term prognosis. Lifetime maintenance therapy is most often required.

  • 326. Werner, Mårten
    et al.
    Björnsson, Einar
    Prytz, Hanne
    Lindgren, Stefan
    Almer, Sven
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gastroenterology and Hepatology. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Broomé, Ulrika
    Wallerstedt, Sven
    Sandberg-Gertzén, Hanna
    Hultcrantz, Rolf
    Sangfeldt, Per
    Nilsson, Jenny
    Danielsson, Åke
    Autoimmune hepatitis among fertile women: Strategies during pregnancy and breastfeeding?2007In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 42, no 8, p. 986-991Article in journal (Refereed)
    Abstract [en]

    Objective. In published studies there is a lack of data about the risks, management and how women with autoimmune hepatitis (AIH) decide on and are advised about pregnancy. The aim of this study was to investigate how women with AIH consider pregnancies, are advised and pharmacologically treated, as well as the outcome. Material and methods. A questionnaire was mailed to 128 women with AIH diagnosed during their fertile period and data from the Swedish National Birth Register was also used for matched controls. Results. There was an 83% response rate to the questionnaires. Sixty-three pregnancies were reported by 35 women. 48% did not consult their doctors before getting pregnant. More than half of the women reduced or stopped the immune suppression during pregnancy or breastfeeding. Some women were advised to abstain from pregnancy or even to have an abortion. Caesarean sections were performed more frequently in the AIH group (16% compared with 6.5% in the control group p<0.01).There were no significant differences in the number of stillborn infants or infants with malformations. However, 30% of the patients experienced flare-up after delivery. Conclusions. In general, the outcome of pregnancy in women with AIH seems to be good. Current pharmacological treatment appears to be safe, including azathioprine during pregnancy and lactation. After delivery an active preparedness to increase pharmacotherapy should be considered. © 2007 Taylor & Francis.

  • 327.
    Westerberg, Per-Anton
    et al.
    Departments of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
    Olauson, Hannes
    Departments of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
    Toss, Göran
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Wikström, Björn
    Departments of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
    Morales, Ollallo
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping.
    Linde, Torbjörn
    Departments of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
    Jonsson, Kenneth
    Departments of Surgical Science, Uppsala University Hospital, Uppsala, Sweden.
    Ljunggren, Östen
    Departments of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
    Larsson, Tobias
    Departments of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
    Preoperative tumor localization by means of venous sampling for fibroblast growth factor-23 in a patient with tumor-induced osteomalacia2008In: Endocrine Practice, ISSN 1530-891X, E-ISSN 1934-2403, Vol. 14, no 3, p. 362-367Article in journal (Refereed)
    Abstract [en]

    Objective: To report on a novel strategy for tumor localization in a 62-year-old man with hypophosphatemic tumor-induced osteomalacia (TIO).

    Methods: Repeated computed tomographic and magnetic resonance imaging scans failed to localize any tumor in a patient with adult-onset hypophosphatemic osteomalacia. Therefore, venous sampling for fibroblast growth factor-23 (FGF23)—a circulating hormone that has been identified as a causative factor for TIO—in major veins was conducted. Serum FGF23 was measured from collected samples by an intact FGF23 enzyme-linked immunosorbent assay.

    Results: Venous sampling suggested a local increase in serum FGF23 in the left femoral vein; this finding prompted performance of octreotide scintigraphy restricted to the left leg. A tumor was located at the lateral condyle of the left femur, which was also confirmed by magnetic resonance imaging. Surgical resection of the tumor normalized the serum phosphorus and 1,25-dihydroxyvitamin D3 levels within 5 to 10 days, and FGF23 declined to normal levels within 24 hours. Histologic analysis supported the diagnosis of a soft-tissue giant cell tumor.

    Conclusion: Our study case demonstrates the diagnostic complexity and difficulties in localizing a small tumor in a patient with TIO. Venous sampling for FGF23 may be helpful in tumor localization in sporadic cases of hypophosphatemic osteomalacia, especially when noninvasive diagnostic techniques prove insufficient.

  • 328.
    Wijkman, Magnus
    et al.
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences.
    Länne, Toste
    Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Engvall, Jan
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Lindström, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Östgren, Carl Johan
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Primary Health Care Centres.
    Nystrom, Fredrik H
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Masked nocturnal hypertension - a novel marker of risk in type 2 diabetes.2009In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 52, no 7, p. 1258-64Article in journal (Refereed)
    Abstract [en]

    AIMS/HYPOTHESIS: This study was designed to evaluate the prevalence of masked nocturnal hypertension (MNHT) and its impact on arterial stiffness and central blood pressure in patients with type 2 diabetes. METHODS: Middle-aged patients (n = 414) with type 2 diabetes underwent clinic and ambulatory BP measurements and applanation tonometry. RESULTS: MNHT (clinic BP < 130/80 mmHg and night-time BP > or = 120/70 mmHg) was found in 7.2% of patients (n = 30). Compared with patients with both clinical and nocturnal normotension (n = 70), patients with MNHT had higher aortic pulse wave velocity (PWV) (10.2 +/- 1.8 m/s vs 9.4 +/- 1.7 m/s; p = 0.03) and higher central BP (117.6 +/- 13.9/74.0 +/- 9.1 mmHg vs 110.4 +/- 16.4/69.7 +/- 9.6 mmHg, p = 0.04). In patients with clinical normotension, night-time systolic BP correlated significantly with PWV. CONCLUSIONS/INTERPRETATION: Thirty per cent of patients with clinical normotension had nocturnal hypertension. This was accompanied by increased arterial stiffness and higher central BP. We conclude that in clinically normotensive patients with type 2 diabetes, ambulatory BP measurement may help clinicians to identify patients with increased cardiovascular risk.

  • 329.
    Wijkman, Magnus
    et al.
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences.
    Länne, Toste
    Linköping University, Department of Medicine and Health Sciences, Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Engvall, Jan
    Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Lindström, Torbjörn
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Östgren, Carl Johan
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, West County Primary Health Care.
    Nyström, Fredrik
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    MASKED NOCTURNAL HYPERTENSION IN TYPE 2 DIABETES - A NEW MARKER OF RISK2009In: in JOURNAL OF HYPERTENSION, vol 27, 2009, Vol. 27, p. S169-S169Conference paper (Refereed)
    Abstract [en]

    n/a

  • 330.
    Wijkman, Magnus
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology.
    Länne, Toste
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Engvall, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Lindström, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Östgren, Carl-Johan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland.
    Arterial stiffness in patients with type 2 diabetes correlates with both ambulatory and central blood pressure but not with glycemic control2007In: 17th meeting on Hypertension,2007, 2007Conference paper (Other academic)
  • 331.
    Wijkman, Magnus
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology.
    Länne, Toste
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Engvall, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Lindström, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Östgren, Carl-Johan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland.
    Correlations between left ventricular mass and conventional, ambulatory and central blood pressure in patients with type 2 diabetes.2007In: 17th meeting on Hypertension,2007, 2007Conference paper (Other academic)
  • 332.
    Wijkman, Magnus
    et al.
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Länne, Toste
    Linköping University, Department of Medicine and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Lindström, Torbjörn
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Östgren, Carl Johan
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, West County Primary Health Care.
    Nystrom, Fredrik
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Treatment with beta-blockers is associated with high aortic but not brachial blood pressure and with cardiac hypertrophy in men with type 2 diabetes2008In: Journal of Hypertension, 2008, p. S29-S29Conference paper (Refereed)
  • 333.
    Willenheimer, Ronnie
    et al.
    Lunds universitet Malmö.
    Nyström, Fredrik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Berggren, Bosse
    Lindström, Torbjörn
    Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Cizinsky, Stella
    Universitetssjukhuset Örebro.
    Weiss, Lars
    Centralsjukhuset Karlstad.
    Problemet är en enastående underbehandling av hypertoni2008In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, no 43, p. 3055-3056Article in journal (Refereed)
  • 334.
    Yamaguchi, M.
    et al.
    Faculty of Engineering Toyama University, Japan.
    Kawabata, Y.
    Faculty of Engineering Toyama University, Japan.
    Kambe, S.
    Faculty of Engineering Toyama University, Japan.
    Wårdell, Karin
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Nyström, Fredrik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Naitoh, K.
    Suzuken Co. Ltd. Nagoya, Japan.
    Yoshida, H.
    Nipro Co. Shiga, Japan.
    Non-invasive monitoring of gingival crevicular fluid for estimation of blood glucose level2004In: Medical and Biological Engineering and Computing, ISSN 0140-0118, E-ISSN 1741-0444, Vol. 42, no 3, p. 322-327Article in journal (Refereed)
    Abstract [en]

    Development of a non-invasive method for measuring the blood glucose level is an urgent necessity, and putting such a method into practical use will enable some of the physical and mental stress that patients with diabetes have to endure to be removed. To realise a non-invasive blood glucose monitor, the gingival crevicular fluid (GCF) was measured. A GCF-collecting device was developed that was designed to be disposable, biocompatible and small enough to be inserted in the gingival crevice for collection of a sub-microlitre sample of GCF. Also, a high-sensitivity glucose testing tape incorporated in the device was developed. Red laser light in a portable optical device measured the colour density of the testing tape. Standard glucose solutions were used to investigate the measurement accuracy of the GCF glucose monitor and showed a correlation coefficient of R=0.99 (n=20) between the optical density and the glucose levels. The GCF glucose monitor was evaluated on healthy Swedish and Japanese adults (n=10) and both GCF glucose levels (GCFLs) and blood glucose levels (BGLs) were measured in conjunction with meal loads. The GCFLs were about 1/10-1/560 lower than the BGLs. No difference in the range of GCFLs between the Swedish and the Japanese subjects was observed. Therefore it was concluded that physique, body mass index and life-style, such as dietary habit, did not significantly influence the GCFLs. Further, the correlation coefficients of all the subjects were 0.70 and 0.88 with each group. It was suggested that GCF could be used as a method of non-invasive blood glucose measurement.

  • 335. Zieden, B
    et al.
    Kaminskas, A
    Kristenson, M
    Olsson, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Kucinskiene, Z
    Long chain polyunsaturated fatty acids may account for higher low-density lipoprotein oxidation susceptibility in Lithuanian compared to Swedish men2002In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 62, no 4, p. 307-314Article in journal (Refereed)
    Abstract [en]

    Objectives: Mortality in coronary heart disease among middle-aged men is four times higher in Lithuania than in Sweden. Traditional risk factors cannot account for this difference. We earlier reported that low-density lipoprotein (LDL) in Lithuanian men showed a lower resistance to oxidation, measured as LDL lag time during copper oxidation, than that in Swedish men. Serum concentrations of several fat-soluble antioxidant vitamins were lower among Lithuanian men. The aim of this study was to investigate whether differences in LDL fatty acid composition could account for the difference in LDL oxidation susceptibility between men in the two countries. Methods: This cross-sectional study included randomly selected healthy 50-year-old men from Vilnius, Lithuania (n = 50) and Link÷ping, Sweden (n = 50). Main outcome measures were fatty acids in LDL, phospholipid (PL) and cholesterol ester (CE) fractions of LDL and LDL oxidation susceptibility. Results: The mean proportions of PL 20:5n3 (eicosapentaenoic acid, EPA) were higher in Vilnius men (2.09▒1.05 vs. 1.53▒0.58%, p = 0.004). LDL lag time was shorter in Vilnius men, mean▒SD (75.4▒13.6 vs. 89.5▒13.1 mins, p<0.0001) than in Link÷ping men. Mean serum ?-tocopherol was lower in Vilnius men (0.07▒0.05 vs. 0.12▒0.04 ╡g/mmol, p<0.0001) but a-tocopherol did not differ. In a multiple regression analysis controlled for city, high PL-EPA, low a-tocopherol, and high plasma triglycerides significantly contributed to a short LDL lag time, r2 = 0.53. Conclusions: Fat quality, i.e. poly unsaturated fatty acids especially LDL-EPA, plasma triglycerides and antioxidative vitamins may partly account for the increased LDL oxidation susceptibility found in Vilnius men compared with Link÷ping men.

  • 336.
    Zouali, H
    et al.
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    Lesage, S
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    Merlin, F
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    Cezard, J
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    Colombel, J
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    Belaiche, J
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    Almer, Sven
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology . Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Tysk, C
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    O'Morain, C
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    Gassull, M
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    Modigliani, R
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    Gower-Rousseau, C
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    Chamaillard, M
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    Thomas, G
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    Hugot, JP
    Hop St Louis, Dept Gastroenterol, Paris, France Hosp Germans Trias & Pujol, Dept Gastroenterol, Badalona, Spain Adelaide & Meath Hosp, Dept Gastroenterol, Dublin, Ireland Orebro Med Ctr Hosp, Dept Gastroenterol, S-70185 Orebro, Sweden Linkoping Univ, Inst Mol & Klin Med, Linkoping, Sweden CHU Liege, Dept Gastroenterol, Liege, Belgium Hop Calmette, Lille, France Hop Robert Debre, F-75019 Paris, France Fdn Jean Dausset, Paris, France.
    CARD4/NOD1 in inflammatory bowel disease.2002In: American Journal of Human Genetics, ISSN 0002-9297, E-ISSN 1537-6605, Vol. 71, no 4, p. 1877-Conference paper (Other academic)
  • 337.
    Östgren, Carl Johan
    et al.
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Sjöblom, Peter
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Tengblad, Anders
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Löfgren, Ulla-Britt
    Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Rosenqvist, Ulf
    Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Department of Medical Specialist.
    Mölstad, Sigvard
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Fördel minska diabetesbehandling hos svårt multisjuka med lågt HbA1c: Positiva resultat från utsättningsstudie bland äldre i särskilt boende2009In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, no 24-25, p. 1649-1651Article in journal (Other academic)
    Abstract [en]

    Hypoglykemier kan orsaka försämring av intellektuella funktioner och ge symtom som oro och agitation. Äldre multisjuka patienter torde vara särskilt känsliga för sådana bieffekter.

    Vi har på patienter med typ 2-diabetes i särskilt boende genomfört en öppen strukturerad utsättningsstudie av insulin och perorala diabetesläkemedel hos patienter med HbA1c ≤6,0 procent.

    Av de 32 patienter som fick sina diabetesläkemedel minskade eller utsatta kunde 24 fullfölja studien. I denna grupp steg HbA1c under stu­dien från 5,2 procent till måttliga 5,8 procent efter såväl 3 som 6 månader.

    Resultaten bör kunna tjäna som stöd för att under kontrollerade former minska eller avveckla diabetesbehandlingen i livets slutskede hos svårt mul­ti­sjuka patien­­ter med låga HbA1c-nivåer.

  • 338. Östman, J
    et al.
    Lönnberg, G
    Arnqvist, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Blohme, G
    Bolinder, A
    Ekbom Schnell, J W
    Eriksson, J W
    Gudbjornsdottir, S
    Sundkvist, G
    Nystrom, L
    Gender differences and temporal variation in the incidence of type 1 diabetes: Results of 8012 cases in the nationwide Diabetes Incidence Study in Sweden 1983-20022008In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 263, no 4, p. 386-394Article in journal (Refereed)
    Abstract [en]

    Objectives. To establish the gender difference amongst newly diagnosed type 1 diabetic patients aged 15-34 years, considering age at diagnosis, temporal trend and seasonal variation at time of diagnosis. Study design. A population-based prospective study with a mean annual population at risk of 2.3 million. Setting. All departments of medicine, endocrinology and paediatrics and primary health care units in Sweden. Subjects. Incident cases of diabetes aged 15-34 years at diagnosis 1983-2002. Measure instrument. Basic characteristics of patients at diagnosis were reported by the diagnosing doctor on a standardized form. Level of ascertainment was estimated at 80-90%. Results. Amongst all incident cases (n = 8012), 74% was diagnosed with type 1 diabetes. The mean annual incidence rate of type 1 diabetes was 12.7/100 000, in men 16.4/100 000 and in women 8.9/100 000. The incidence of type 1 diabetes decreased slowly by increasing age but was in all age groups higher in men, yielding an overall male/female ratio of 1.8. In both genders the incidence of type 1 diabetes decreased in average of 1.0% per year. A seasonal pattern with significantly higher incidence during January-March and lower during May-July was seen in both genders. Conclusions. A clear male predominance of type 1 diabetes was seen in all ages. The temporal trend and the seasonal pattern was similar in men and women. Hence, internal factors related to the gender rather than differences in the exposure to environmental factors seem to explain the consistent male-female bias in the postpubertal risk of developing type 1 diabetes. © 2008 Blackwell Publishing Ltd.

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