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  • 1.
    Abrahamsson, Thomas R
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics MH.
    Jakobsson, Ted
    Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics MH.
    Böttcher, Malin Fagerås
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Jenmalm, Maria C
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Björkstén, Bengt
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics MH.
    Oldaeus, Göran
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial2007In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 119, no 5, p. 1174-1180Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: An altered microbial exposure may underlie the increase of allergic diseases in affluent societies. Probiotics may alleviate and even prevent eczema in infants.

    OBJECTIVE: To prevent eczema and sensitization in infants with a family history of allergic disease by oral supplementation with the probiotic Lactobacillus reuteri.

    METHODS: Double-blind, randomized, placebo-controlled trial, which comprised 232 families with allergic disease, of whom 188 completed the study. The mothers received L reuteri ATCC 55730 (1 x 10(8) colony forming units) daily from gestational week 36 until delivery. Their babies then continued with the same product from birth until 12 months of age and were followed up for another year. Primary outcome was allergic disease, with or without positive skin prick test or circulating IgE to food allergens.

    RESULTS: The cumulative incidence of eczema was similar, 36% in the treated versus 34% in the placebo group. The L reuteri group had less IgE-associated eczema during the second year, 8% versus 20% (P = .02), however. Skin prick test reactivity was also less common in the treated than in the placebo group, significantly so for infants with mothers with allergies, 14% versus 31% (P = .02). Wheeze and other potentially allergic diseases were not affected.

    CONCLUSION: Although a preventive effect of probiotics on infant eczema was not confirmed, the treated infants had less IgE-associated eczema at 2 years of age and therefore possibly run a reduced risk to develop later respiratory allergic disease. CLINICAL IMPLICATION: Probiotics may reduce the incidence of IgE-associated eczema in infancy.

  • 2.
    Abrahamsson, Thomas R
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics MH.
    Sinkiewicz, Gabriela
    Department of Biomedical Lab Science, Malmö University, Malmö, Sweden.
    Jakobsson, Ted
    Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics MH.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Björkstén, Bengt
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics MH.
    Probiotic lactobacilli in breast milk and infant stool in relation to oral intake during the first year of life2009In: Journal of pediatric gastroenterology and nutrition, ISSN 1536-4801, Vol. 49, no 3, p. 349-354Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: This is to identify factors affecting the prevalence of Lactobacillus reuteri in maternal faeces and breast milk and infant faeces after oral supplementation with L reuteri and to assess the influence on microbial ecology, particularly Clostridium difficile and Bifidobacterium colonization.

    MATERIALS AND METHODS: In this double-blind trial, 232 mothers with a family history of atopic disease were randomized to a daily intake of either L reuteri American-type culture collection (ATCC) 55730 (1 x 10 colony-forming units [CFU]) or placebo for the last 4 weeks of pregnancy. Their babies then continued with the same study product daily from birth until 12 months of age. Bacterial counts and prevalence were assessed in maternal breast milk and faeces and infant faeces, using conventional cultivation methods.

    RESULTS: The prevalence of L reuteri was higher during the first year of life in the stool samples from infants in the active as compared with the placebo-treated group. The highest prevalence was recorded at 5 to 6 days of age (82% in the treated vs 20% in the placebo group, P < 0.001). Lactobacillus reuteri was isolated from 12% and 2%, respectively, in the colostrum samples (P < 0.05). Breast-feeding seemed to reduce faecal L reuteri counts, although antibiotics did not influence the levels of L reuteri. The administration of L reuteri did not affect bifidobacteria or C difficile colonization.

    CONCLUSION: Lactobacillus reuteri may be detected in breast milk after oral supplementation to the mother and in almost all infants after oral supplementation during the first year of life, as well as occasionally in many untreated infants.

  • 3.
    Ahmadi, Ahmad
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Jonsson, Pia
    Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Flodin, Ulf
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Söderkvist, Peter
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Interaction between smoking and glutathione S-transferase polymorphisms in solvent-induced chronic toxic encephalopathy2002In: Toxicology and industrial health, ISSN 0748-2337, E-ISSN 1477-0393, Vol. 18, no 6, p. 289-296Article in journal (Refereed)
    Abstract [en]

    Exposure to organic solvents is still common in industrial and other work environments, and increases the risk of chronic toxic encephalopathy (CTE). Genetic variation in metabolic enzymes for solvents and other xenobiotics may modify the risk of developing toxic effects. Therefore, we investigated the presence of null genotypes for glutathione S-transferases M1 and T1 (GSTM1, GSTT1) and two genetic polymorphisms of microsomal epoxide hydrolase (mEPHX) in relation to the risk for chronic toxic encephalopathy (CTE) when exposed to solvents and smoking. We genotyped 115 patients who were classified into three categories: CTE (n = 56), incipient CTE (n = 27) and non-CTE (n = 32) patients. DNA was isolated from leucocytes and the GSTM 1 and GSTT1 null genotypes were determined by multiplex-polymerase chain reaction. The two polymorphisms of mEPHX were analysed by PCR-RFLP (restriction fragment length polymorphism) based assays. All analyses were performed blindly with regard to both exposure and disease status. An increased binomial regression risk ratio = 2.5, 95% confidence interval (CI) 1.5-4.2, of the GSTM1 null genotype for CTE was found in smokers and for the GSTT1 null genotype (binomial regression risk ratio 1.5, 95% CI 1.0-2.0). In nonsmokers, the GSTM1 null genotype did not confer any risk for CTE. None of the studied mEPHX polymorphisms were associated with an increased risk for CTE. We suggest that the GSTM1 null genotype in smokers is a possible risk for solvent-induced CTE.

  • 4.
    Andersson, Eva
    et al.
    Sahlgrens Univ Hosp, Dept Occupat & Environm Med, SE-40530 Gothenburg, Sweden .
    Persson, Bodil
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Bryngelsson, Ing-Liss
    Magnuson, Anders
    Orebro Univ Hosp, Clin Res Ctr, Stat & Epidemiol Unit, Orebro, Sweden .
    Toren, Kjell
    Sahlgrens Univ Hosp, Dept Occupat & Environm Med, SE-40530 Gothenburg, Sweden .
    Wingren, Gun
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine .
    Westberg, Hakan
    Cohort mortality study of Swedish pulp and paper mill workers - nonmalignant diseases2007In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 33, no 6, p. 470-478Article in journal (Refereed)
    Abstract [en]

    Objectives The aim of this study was to determine mortality among pulp and paper mill workers according to the main mill pulping process, department, and gender, particular reference being given to diseases of the circulatory and respiratory systems. Methods The cohort of 18 163 men and 2291 women employed between 1939 and 1999 and with >1 year of employment was followed for mortality from 1952 to 2001 (acute myocardial infarction from 1969). Standardized mortality ratios (SMR) with 95% confidence intervals (95% CI) were estimated by comparing the observed number of deaths with the expected number for the entire Swedish population. Exposure was assessed from personnel files in the mills. Data from an exposure measurement database are also presented. Results There were 5898 deaths in the cohort. Total mortality had an SMR of 1.02 (95% CI 0.98-1.06) for the men in the sulfate mills and an SMR of 0.93 (95% CI 0.90-0.97) for the men in the sulfite mills. Mortality from acute myocardial infarction was increased among the men in both the sulfate and sulfite mills [SMR 1.22 (95% CI 1.12-1.32) and SMR 1.11 (95% CI 1.02-1.21), respectively] and by department in sulfate pulping (SMR 1.29, 95% CI 1.07-1.54), paper production (SMR 1.26, 95% CI 1.06-1.49), and maintenance (SMR 1.16, 95% CI 1.02-1.30). Mortality from cerebrovascular disease, diabetes mellitus, and nonmalignant respiratory diseases was not increased. Conclusions Death from acute myocardial infarction, but not cerebrovascular diseases, was increased in this cohort and was probably related to a combination of different occupational exposures (eg, dust, sulfur compounds, shift work, and noise).

  • 5.
    Andersson, Eva
    et al.
    Sahlgrens University Hospital.
    Persson, Bodil
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Bryngelsson, Ing-Liss
    Örebro University Hospital.
    Magnuson, Anders
    Örebro University Hospital.
    Westberg, Hakan
    Örebro University Hospital.
    Cancer mortality in a Swedish cohort of pulp and paper mill workers2010In: INTERNATIONAL ARCHIVES OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH, ISSN 0340-0131, Vol. 83, no 2, p. 123-132Article in journal (Refereed)
    Abstract [en]

    To study cancer mortality among Swedish pulp and paper mill workers by main mill pulping process and department, and to present the Swedish part of an international exposure measurements database. A cohort of 18,163 male and 2,290 female workers at four sulfate and four sulfite mills, enrolled from 1939 to 1999, was followed up for mortality during 1952-2001. Standardized mortality ratios (SMRs) relative to the general Swedish population were calculated. There were 1,340 malignant cases out of 5,898 deaths. Total cancer mortality was not increased in either sulfate or sulfite mill workers, or by gender. Lung cancer mortality was increased among female workers (SMR 1.70, 95% CI 1.04-2.63), especially in paper production, but not among male workers (SMR 0.91, 95% CI 0.79-1.04). Exposure to wood dust and sulfur dioxide frequently exceeded occupational exposure limits. Female paper production workers had an increased mortality from lung cancer.

  • 6.
    Andersson, Eva
    et al.
    Sahlgrens University Hospital, Sweden .
    Westberg, Hakan
    Örebro University Hospital, Sweden .
    Bryngelsson, Ing-Liss
    Örebro University Hospital, Sweden .
    Magnuson, Anders
    Örebro University Hospital, Sweden .
    Persson, Bodil
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Cancer incidence among Swedish pulp and paper mill workers: a cohort study of sulphate and sulphite mills2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 5, p. 529-540Article in journal (Refereed)
    Abstract [en]

    Associations between various malignancies and work in the pulp and paper industry have been reported but mostly in analyses of mortality rather than incidence. We aimed to study cancer incidence by main mill pulping process, department and gender in a Swedish cohort of pulp and paper mill workers. The cohort (18,113 males and 2,292 females, enrolled from 1939 to 1999 with greater than 1 year of employment) was followed up for cancer incidence from 1958 to 2001. Information on the workers department and employment was obtained from the mills personnel files, and standardized incidence ratios (SIRs) were calculated using the Swedish population as reference. Overall cancer incidence, in total 2,488 cases, was not increased by work in any department. However, risks of pleural mesothelioma were increased among males employed in sulphate pulping (SIR, 8.38; 95 % CI, 3.37-17) and maintenance (SIR, 6.35; 95 % CI, 3.47-11), with no corresponding increase of lung cancer. Testicular cancer risks were increased among males employed in sulphate pulping (SIR, 4.14; 95 % CI, 1.99-7.61) and sulphite pulping (SIR, 2.59; 95 % CI, 0.95-5.64). Female paper production workers showed increased risk of skin tumours other than malignant melanoma (SIR, 2.92; 95 % CI, 1.18-6.02). Incidence of pleural mesothelioma was increased in the cohort, showing that asbestos exposure still has severe health consequences, and highlighting the exigency of strict asbestos regulations and elimination. Testicular cancer was increased among pulping department workers. Shift work and endocrine disruptors could be of interest in this context.

  • 7.
    Angbratt, Marianne
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum.
    Blomberg, C.
    Kronhed, A.-C.
    Waller, J.
    Vadstena Primary Care Centre, Vadstena, Sweden.
    Wingren, Gun
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine.
    Moller, M.
    Möller, M., Centre for Caring Sciences, ÖrebroCountyCouncil, Örebro, Sweden.
    Prevalence and correlates of insufficient calcium intake in a Swedish population: Populations at risk across the lifespan2007In: Public Health Nursing, ISSN 0737-1209, E-ISSN 1525-1446, Vol. 24, no 6, p. 511-517Article in journal (Refereed)
    Abstract [en]

    To examine associations between calcium intake in the diet, lifestyle factors, and forearm bone mineral density (BMD) in order to identify population subgroups for targeting by screening programs. A questionnaire was sent to a random sample of 15 of the inhabitants aged 20-79 years from 2 Swedish municipalities, and the subsample from one of the municipalities was invited to measurement of BMD. The survey response rate was 74 (n=1,1121,510) and participation in BMD measurements was 68 (n=448659). Only a tendency (p=.085) toward direct association between calcium intake and forearm BMD was found, and the best multiple regression model was retained to explain BMD excluded calcium intake. Low calcium intake was, instead, in complementary analyses, found to be correlated with the factors old age, female sex, and urban residence in the best multiple regression model. Population subgroups whose calcium intake is in a range that justifies preventive action could be identified. Screening programs staffed by public health nurses can thereby be informed regarding the subgroups of the population that are at the highest risk of insufficient calcium intake. © 2007, Blackwell Publishing, Inc.

  • 8.
    Annerbäck, Eva-Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Göran Svedin, Carl
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Prevalence and characteristics of child physical abuse in Sweden - findings from a population-based youth survey2010In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 8, p. 1229-1236Article in journal (Refereed)
    Abstract [en]

    Aim: To examine prevalence rates of child physical abuse perpetrated by a parent/caretaker, abuse characteristics and the extent of disclosures. Methods: A population-based survey was carried out in 2008 amongst all the pupils in three different grades (n = 8494) in schools in Sodermanland County, Sweden. The pupils were asked about their exposure to violence and their experiences of parental intimate-partner violence. Data were analysed with bi- and multivariate models and a comparison between means of accumulating risk factors between three groups were performed. Results: A total of 15.2% of the children reported that they had been hit. There were strong associations between abuse and risk factors and there was a dose-response relationship between risks and reported abuse. It was shown that children who reported parental intimate-partner violence were at a considerably higher risk for abuse than other children and that only 7% of the children exposed to violence had disclosed this to authorities. Conclusion: Even though child abuse in Sweden has decreased markedly during the last 40 years, violence against children is still a considerable problem. It is a challenge to develop methods of assessment and interventions that will ensure that the violence and its underlying causes are directly addressed.

  • 9.
    Axelson, Olav
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Castleman, B
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Epstein, S
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Franco, G
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Giannasi, F
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Grandjean, P
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Greenberg, M
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Hooper, K
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Huff, J
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Jacobson, M
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Joshi, TK
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Kulkarni, GK
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    LaDou, J
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Mazaheri, M
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Mekonnen, Y
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Melnick, R
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Mirabelli, D
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Ofrin, R
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Partanen, T
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Pott, F
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Sass, J
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Soskolne, CL
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Suplido, ML
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Terracini, B
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Tomatis, L
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Ungvary, G
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Watterson, A
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Wesseling, C
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Yassi, A
    Linkoping Univ, Div Environm & Occupat Med, Linkoping, Sweden Univ Illinois, Chicago, IL 60680 USA Univ Modena, I-41100 Modena, Italy Univ So Denmark, Odense, Denmark Labor Inspectorate, Sao Paulo, Brazil NIEHS, Bethesda, MD USA Univ Tehran Med Sci, Dept Occupat Med, Tehran, Iran Univ Addis Ababa, Addis Ababa, Ethiopia San Giovanni Battista Hosp, Canc Epidemiol Unit, Turin, Italy Univ Turin, Dept Biomed Sci & Human Oncol, I-10124 Turin, Italy Univ Philippines, Open Univ, Fac Hlth Sci, Quezon City 1101, Philippines Univ Dusseldorf, Dept Expt Hyg, D-4000 Dusseldorf, Germany Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada NIOSH, Budapest, Hungary Univ Stirling, Occupat & Environm Hlth Res Grp, Stirling FK9 4LA, Scotland Occupat Hlth & Safety Agcy Healthcare, Vancouver, BC, Canada.
    Letter to Dr. Gro Harlem Brundtland, Director-General, WHO2002In: International journal of occupational and environmental health, ISSN 1077-3525, E-ISSN 2049-3967, Vol. 8, no 3, p. 271-273Article in journal (Other academic)
    Abstract [en]

    [Abstract not available]

  • 10.
    Backstrom, D.
    et al.
    Östergötlands Läns Landsting, Anaesthesiology and Surgical Centre, Department of Anaesthesiology and Intensive Care VHN.
    Al-Ayoubi, Fawzi
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Steinvall, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Sjöberg, Folke
    Linköping University, Department of Clinical and Experimental Medicine, Burn Center. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL. Östergötlands Läns Landsting, Sinnescentrum, Department of Anaesthesiology and Surgery UHL.
    Letter: Outcome of trauma patients2010In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 54, no 7, p. 902-903Article in journal (Other academic)
    Abstract [en]

    n/a

  • 11.
    Bengtsson, Torbjörn
    et al.
    Linköping University, Department of Medical and Health Sciences, Pharmacology. Linköping University, Faculty of Health Sciences.
    Karlsson, Helen
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Gunnarsson, Patrik
    Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Skoglund, Caroline
    Linköping University, Department of Medical and Health Sciences, Pharmacology. Linköping University, Faculty of Health Sciences.
    Elison, Charlotte
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Leanderson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Lindahl, Mats
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    The periodontal pathogen Porphyromonas gingivalis cleaves apoB-100 and increases the expression of apoM in LDL in whole blood leading to cell proliferation2008In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 263, no 5, p. 558-571Article in journal (Refereed)
    Abstract [en]

    Objective: Several studies support an association between periodontal disease and atherosclerosis with a crucial role for the pathogen Porphyromonas gingivalis. This study aims to investigate the proteolytic and oxidative activity of P. gingivalis on LDL in a whole blood system by using a proteomic approach and analyze the effects of P. gingivalis-modifed LDL on cell proliferation.

    Methods: The cellular effects of P. gingivalis in human whole blood were assessed using lumi-aggregometry analyzing reactive oxygen species (ROS) production and aggregation. Blood was incubated for 30 min with P. gingivalis, whereafter LDL was isolated and a proteomic approach was applied to examine protein expression. LDL-oxidation was determined by analyzing the formation of protein carbonyls. The effects of P. gingivalis-modifed LDL on fibroblast proliferation were studied using the MTS-assay.

    Results: Incubation of whole blood with P. gingivalis caused an extensive aggregation and ROS-production, indicating platelet and leukocyte activation. LDL prepared from the bacteria-exposed blood showed an increased protein oxidation, elevated levels of apoM and formation of two apoB-100 N-terminal fragments. P. gingivalis-modified LDL markedly increased the growth of fibroblasts. Inhibition of gingipain R suppressed the modification of LDL by P. gingivalis.

    Conclusions: The ability of P. gingivalis to change the protein expression and the proliferative capacity of LDL may represent a crucial event in periodontitis-associated atherosclerosis.

  • 12.
    Berg, Hans-Yngve
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Andersson, F.
    Driving licence or not: What influences young people’s choice?2001Manuscript (preprint) (Other academic)
  • 13.
    Berkius, Johan
    et al.
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences.
    Sundh, J
    Örebro University Hospital, Sweden .
    Nilholm, L
    Örebro University Hospital, Sweden .
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Walther, Sten
    Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Thoracic and Vascular Surgery in Östergötland.
    What determines immediate use of invasive ventilation in patients with COPD?2013In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 57, no 3, p. 312-319Article in journal (Refereed)
    Abstract [en]

    Background The choice between non-invasive ventilation (NIV) and invasive ventilation in patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) may be irrational. The aim of this study was to examine those patient characteristics, and circumstances deemed important in the choice made between NIV and invasive ventilation in the intensive care unit (ICU). Methods We first examined 95 admissions of AECOPD patients on nine ICUs and identified variables associated with invasive ventilation. Thereafter, a questionnaire was sent to ICU personnel to study the relative importance of different factors with a possible influence on the decision to use invasive ventilation at once. Results Univariable analysis showed that increasing age [odds ratio (OR) 1.06 per year] and increasing body mass index (BMI) (OR 1.11 per kg/m2) were associated with immediate invasive ventilation, while there was no such association with arterial blood gases or breath rate. BMI was the only factor that remained associated with immediate invasive ventilation in the multivariable analysis [OR 1.12 (95% confidence interval 1.031.23) kg/m2]. Ranking of responses to the questionnaire showed that consciousness, respiratory symptoms and blood gases were powerful factors determining invasive ventilation, whereas high BMI and age were ranked low. Non-patient-related factors were also deemed important (physician in charge, presence of guidelines, ICU workload). Conclusion Factors other than those deemed most important in guidelines appear to have an inappropriate influence on the choice between NIV and immediate intubation in AECOPD in the ICU. These factors must be identified to further increase the appropriate use of NIV.

  • 14.
    Berkius, Johan
    et al.
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences.
    Sundh, Josefin
    Orebro University Hospital.
    Nilholm, Lennart
    Orebro University Hospital.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Walther, Sten
    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.
    Long-term survival according to ventilation mode in acute respiratory failure secondary to chronic obstructive pulmonary disease: A multicenter, inception cohort study2010In: JOURNAL OF CRITICAL CARE, ISSN 0883-9441, Vol. 25, no 3Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of the study was to investigate 5-year survival stratified by mechanical ventilation modality in chronic obstructive pulmonary disease (COPD) patients treated in the ICU. Materials and Methods: Prospective, observational study of COPD patients with acute respiratory failure admitted to 9 multidisciplinary ICUs in Sweden. Characteristics on admission, including illness severity scores and the first blood gas, and survival were analyzed stratified by ventilation modality (noninvasive [NIV] vs invasive mechanical ventilation). Results: Ninety-three patients, mean age of 70.6 (SD, 9.6) years, were included. Sixteen patients were intubated immediately, whereas 77 were started on NIV. Patients who were started on NIV had a lower median body mass index (BMI) (21.9 vs 27.0; P andlt; .01) and were younger compared to those who were intubated immediately (median age, 70 vs 74.5 years; P andlt; .05). There were no differences in the initial blood gas results between the groups. Long-term survival was greater in patients with NIV (P andlt; .05, log rank). The effect of NIV on survival remained after including age, Acute Physiology and Chronic Health Evaluation II score, and BMI in a multivariate Cox regression model (NIV hazard ratio, 0.44; 95% confidence interval, 0.21-0.92). Fifteen patients with failed NIV were intubated and mechanically ventilated. Long-term survival in patients with failed NIV was not significantly different from patients who were intubated immediately. Conclusion: The short-term survival benefit of NIV previously found in randomized controlled trials still applies after 5 years of observation.

  • 15.
    Bäckman, Carl G
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Orwelius, Lotti
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Sjöberg, Folke
    Linköping University, Department of Clinical and Experimental Medicine, Burn Unit . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Walther, Sten M
    Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Thoracic and Vascular Surgery in Östergötland.
    A case-control study of the influence of the ICU-diary concept on mastery and hopelessness six months after critical illnessManuscript (preprint) (Other academic)
    Abstract [en]

    The ICU-diary concept is associated with less post-traumatic stress syndrome and improved perceived health-related quality-of-life (HRQoL) after critical illness, but little is known about its effect on the coping- mastery process, or whether it reduces hopelessness.

    Objective: To see if the ICU-diary concept improves the patient’s ability to master his/her situation after critical illness, and if it reduces the feeling of hopelessness.

    Design: Case control study (subgroup analysis of a multi-centre study on health-related quality-of-life (HRQoL).

    Setting: Non-academic 8-bed general ICU.

    Patients: Adults admitted between March 2002 and June 2004.

    Measurements: Mastery and hopelessness were determined using validated questionnaires (the Mastery-Coping scale and a consolidated 2–item hopelessness questionnaire) which were sent home to patients 6 months after critical illness. Responses were compared between patients that received (Cases: n=38) or did not receive an ICU-diary (Controls: n=76) . Diaries were used when a long and complicated stay on the ICU was expected. Controls were matched with diary patients by gender and age. The effect of the ICU-diary was also examined using a multiple regression model.

    Results: The ICU-diary concept group scored significantly higher than the No-diary group in mastery (22.1 vs. 20.4, P<0.05) and lower in hopelessness scores (1.3 vs. 1.6, P<0.05). The positive influence of the ICU-diary disappeared after adjustment for confounding factors in a multiple regression model.

    Conclusion: We were unable to verify any positive influence of the ICU-diary concept on mastery and hopelessness 6 months after critical illness.

  • 16.
    Bäckman, Carl
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Orwelius, Lotti
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Sjöberg, Folke
    Linköping University, Department of Clinical and Experimental Medicine, Burn Center. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL. Östergötlands Läns Landsting, Sinnescentrum, Department of Anaesthesiology and Surgery UHL.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Walther, Sten
    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.
    Long-term effect of the ICU-diary concept on quality of life after critical illness2010In: ACTA ANAESTHESIOLOGICA SCANDINAVICA, ISSN 0001-5172, Vol. 54, no 6, p. 736-743Article in journal (Refereed)
    Abstract [en]

    Background Critically ill patients often spend time in the intensive care unit (ICU) either unconscious or sedated. On recovery, they are often in a state of confusion with memory loss that may be associated with a longstanding reduction in health-related quality of life (QoL). We hypothesised that the ICU-diary concept could improve their QoL by filling in their memory gaps. Methods A non-randomised, prospective study in a non-academic eight-bedded general ICU. A group of patients (n=38) were selected to receive the ICU-diary concept (keeping a diary with photos while on the ICU plus a follow-up meeting) when a long and complicated course was expected. Health-related QoL at 6, 12, 24 and 36 months was compared with a group that did not receive the ICU-diary (n=224). The Medical Outcomes Study 36-Item Short-Form (SF-36) was used to measure health-related QoL. Multiple regression models adjusted for age, sex, illness severity, pre-existing disease and diagnostic category was used to analyse the effects of the ICU-diary concept at 6 months, and changes over time were analysed using repeated measures MANOVA. Results Crude and adjusted scores for two dimensions of SF-36 (general health and vitality) and the physical component summary score were significantly higher at 6 months in the ICU-diary group (P andlt; 0.05) and some of the effects remained during the 3-year follow-up period (P andlt; 0.05). Conclusion The ICU-diary concept was associated with improved health-related QoL during the 3-year follow-up period after a critical illness. The effect of this intervention needs to be confirmed in a larger randomised study.

  • 17.
    De Geer, Lina
    et al.
    Linköping University, Department of Medicine and Care, Anaesthesiology. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Oscarsson Tibblin, Anna
    Linköping University, Department of Medical and Health Sciences, Anesthesiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Amino-terminal pro-brain natriuretic peptide as a predictor of outcome in patients admitted to intensive care. A prospective observational study2012In: European Journal of Anaesthesiology, ISSN 0265-0215, E-ISSN 1365-2346, Vol. 29, no 6, p. 275-279Article in journal (Refereed)
    Abstract [en]

    Context: Amino-terminal pro-brain-type natriuretic peptide is known to predict outcome in patients with heart failure, but its role in an intensive care setting is not yet fully established. Objective: To assess the incidence of elevated amino-terminal pro-brain natriuretic peptide (NT-pro-BNP) on admission to intensive care and its relation to death in the ICU and within 30 days. Design: Prospective, observational cohort study. Setting: A mixed noncardiothoracic tertiary ICU in Sweden. Patients and main outcome measures NT-pro-BNP was collected from 481 consecutive patients on admission to intensive care, in addition to data on patient characteristics and outcome. A receiver-operating characteristic curve was used to identify a discriminatory level of significance, a stepwise logistic regression analysis to correct for other clinical factors and a Kaplan-Meier analysis to assess survival. The correlation between Simplified Acute Physiology Score (SAPS) 3, Sequential Organ Failure Assessment score (SOFA) and NT-pro-BNP was analysed using Spearmans correlation test. Quartiles of NT-pro-BNP elevation were compared for baseline data and outcome using a logistic regression model. Results: An NT-pro-BNP more than 1380 ng l(-1) on admission was an independent predictor of death in the ICU and within 30 days [odds ratio (OR) 2.6; 95% confidence interval (CI), 1.5 to 4.4] and was present in 44% of patients. Thirty-three percent of patients with NT-pro-BNP more than 1380 ng l(-1), and 14.6% of patients below that threshold died within 30 days (log rank P 0.005). NT-pro-BNP correlated moderately with SAPS 3 and with SOFA on admission (Spearmans rho 0.5552 and 0.5129, respectively). In quartiles of NT-pro-BNP elevation on admission, severity of illness and mortality increased significantly (30-day mortality 36.1%; OR 3.9; 95% CI, 2.0 to 7.3 in the quartile with the highest values, vs. 12.8% in the lowest quartile). Conclusion: We conclude that NT-pro-BNP is commonly elevated on admission to intensive care, that it increases with severity of illness and that it is an independent predictor of mortality.

  • 18.
    Dellerantz, E
    et al.
    Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Martner, J
    University of Gothenburg.
    Nolin, T
    Central Hospital Kristianstad.
    Wickerts, C-J
    Danderyds Sjukhus.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Walther, Sten
    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.
    LONG-TERM OUTCOME AFTER CARDIAC ARREST TREATED WITH THERAPEUTIC HYPOTHERMIA: RESULTS FROM THE SWEDISH INTENSIVE CARE REGISTRY2009In: in INTENSIVE CARE MEDICINE, vol 35, 2009, Vol. 35, p. 180-180Conference paper (Refereed)
    Abstract [en]

    n/a

  • 19.
    Fall, Per-Arne
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Geriatric . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
    Axelson, Olav
    Linköping University, Department of Molecular and Clinical Medicine.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Hansson, Gunilla
    Lindvall, Björn
    Linköping University, Department of Clinical and Experimental Medicine, Neurology . Linköping University, Faculty of Health Sciences.
    Olsson, Jan-Edvin
    Linköping University, Department of Clinical and Experimental Medicine, Neurology . Linköping University, Faculty of Health Sciences.
    Granérus, Ann-Kathrine.
    Linköping University, Department of Clinical and Experimental Medicine, Geriatric . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
    Age standardised incidence and prevalence of Parkinson´s disease in a Swedish community1996In: Journal of Clinical Epidemiology, ISSN 0895-4356, Vol. 49, no 6, p. 637-641Article in journal (Refereed)
    Abstract [en]

    Parkinson's disease (PD) shows a geographical variation. All prescriptions for anti-parkinsonian drugs were recorded for a half-year in a region with low -dopa consumption. Hospital and outpatient records were studied and physicians were asked to supply details of PD patients in the region, with 147,777 inhabitants. The crude prevalence was 115 PD per 100,000 inhabitants, based on 170 cases. In contrast to other studies we report an age-standardized prevalence, which was 76 per 100,000, using the European Standard Population as reference. The corresponding approximate incidences were 11.0 (crude) and 7.9 (age-standardized) per 100,000 person-years. Male preponderance appeared in all age groups. Mean age at onset was 65.6 years, the highest figure reported. Variation between studies for age at onset, differences in prevalence, and male preponderance suggest environmental risk factors to be of importance for PD.

  • 20.
    Fall, Per-Arne
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Geriatric . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Axelson, Olav
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Granérus, Ann-Kathrine.
    Linköping University, Department of Clinical and Experimental Medicine, Geriatric . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
    Nutritional and occupational factors influencing the risk of Parkinson's disease: a case-control study in southeastern Sweden1999In: Movement Disorders, ISSN 0885-3185, Vol. 14, no 1, p. 28-37Article in journal (Refereed)
    Abstract [en]

    PURPOSE AND METHODS: To investigate the possible impact of nutritional and environmental risk factors for idiopathic Parkinson's disease (IP), a case-control study was performed in the county of Ostergötland in southeastern Sweden. The study involved 113 cases of IP and 263 control subjects. Dietary, drinking, and smoking habits, as well as previous occupation, were requested in a structured questionnaire.

    RESULTS: No increased risk was found for any of the nutritional items in which information was requested. A reduced risk was found for coffee, wine, and liquor at various consumption levels but also for fried or broiled meat, smoked ham or meat, eggs, French loaf or white bread, and tomatoes. All these food and drink items contain niacin. As in many studies, the frequency of preceding and present smoking was reduced in IP patients. Various occupational groups and exposures were analyzed and increased risks of IP in men were found for agricultural work along with pesticide exposure; this was also the case for male carpenters and female cleaners.

    CONCLUSIONS: The findings indicate that nutritional factors and occupational exposures, especially to pesticides, could be of etiologic importance in IP.

  • 21.
    Flodin, Ulf
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Landtblom, Anne-Marie
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Axelson, Olav
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Multiple sclerosis in nurse anaesthetists2003In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 60, no 1, p. 66-68Article in journal (Refereed)
    Abstract [en]

    Background: Volatile anaesthetics are chemically related to organic solvents used in industry. Exposure to industrial solvents may increase the incidence of multiple sclerosis (MS). Aim: To examine the risk among nurse anaesthetists of contracting MS. Methods: Nurses with MS were identified by an appeal in the monthly magazine of the Swedish Nurse Union and a magazine of the Neurological Patients Association in Sweden. Ninety nurses with MS responded and contacted our clinic. They were given a questionnaire, which was filled in by 85 subjects, 13 of these were nurse anaesthetists. The questionnaire requested information about work tasks, exposure, diagnosis, symptoms, and year. The number of active nurse anaesthetists was estimated based on information from the National Board of Health and Welfare and The Nurse Union. Incidence data for women in the region of Gothenburg and Denmark were used as the reference to estimate the risk by calculation of the standardised incidence ratio (SIR). Results: Eleven of the 13 nurse anaesthetists were exposed to anaesthetic gases before onset of MS. Mean duration of exposure before diagnosis was 14.4 years (range 4-27 years). Ten cases were diagnosed in the study period 1980-99, resulting in significantly increased SIRS of 2.9 and 2.8 with the Gothenburg and the Danish reference data, respectively. Conclusion: Although based on crude data and a somewhat approximate analysis, this study provides preliminary evidence for an excess risk of MS in nurse anaesthetists. The risk may be even greater than observed, as the case ascertainment might have been incomplete because of the crude method applied. Further studies in this respect are clearly required to more definitely assess the risk.

  • 22.
    Fornander, Louise
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Work and Environmental Science.
    Ghafouri, Bijar
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Occupational and Environmental Medicine Centre. Östergötlands Läns Landsting, Sinnescentrum, Pain and Rehabilitation Centre.
    Kihlström, Erik
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Microbiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Microbiology.
    Åkerlind, Britt
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Microbiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Microbiology.
    Schön, Thomas
    Kalmar County Hospital.
    Tagesson, Christer
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Occupational and Environmental Medicine Centre.
    Lindahl, Mats
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Work and Environmental Science.
    Innate immunity proteins and a new truncated form of SPLUNC1 in nasopharyngeal aspirates from infants with respiratory syncytial virus infection2011In: PROTEOMICS CLINICAL APPLICATIONS, ISSN 1862-8346, Vol. 5, no 9-10, p. 513-522Article in journal (Refereed)
    Abstract [en]

    Purpose: Respiratory syncytial virus (RSV) is the most common cause of severe respiratory tract infection in infants. The aim was to identify host defence components in nasopharyngeal aspirate (NPA) from infants with RSV infection and to study the expression of the novel 25 kDa innate immunity protein SPLUNC1. less thanbrgreater than less thanbrgreater thanExperimental design: NPAs from infants were analyzed with 2-DE and MS in a pilot study. The levels of SPLUNC1 were analyzed with immunoblotting in 47 NPAs, admitted for RSV diagnosis. less thanbrgreater than less thanbrgreater thanResults: Totally, 35 proteins were identified in NPA, including several innate immunity proteins such as group X phospholipase A(2), different S100 proteins and SPLUNC1. In addition, a new truncated 15 kDa form of SPLUNC1 was identified that was detected in about 50% of the aspirates admitted for RSV diagnosis. RSV-positive boys had significantly less 25 kDa SPLUNC1 than RSV-negative boys while there were no significant differences among girls. less thanbrgreater than less thanbrgreater thanConclusions and clinical relevance: Several important innate immunity proteins were identified in NPA. Notably, a new truncated form of the newly suggested anti-bacterial protein SPLUNC1 was found. It is possible that a decrease in SPLUNC1 in the upper airways may increase the risk for severe pneumonia in boys.

  • 23.
    Fornander, Louise
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Ghafouri, Bijar
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Lindahl, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Graff, Pål
    Linköping University, Department of Clinical and Experimental Medicine, Work and Environmental Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Airway irritation among indoor swimming pool personnel: trichloramine exposure, exhaled NO and protein profiling of nasal lavage fluids2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 5, p. 571-580Article in journal (Refereed)
    Abstract [en]

    Purpose

    Occurrence of airway irritation among indoor swimming pool personnel was investigated. The aims of this study were to assess trichloramine exposure levels and exhaled nitric oxide in relation to the prevalence of airway symptoms in swimming pool facilities and to determine protein effects in the upper respiratory tract.

    Methods

    The presence of airway symptoms related to work was examined in 146 individuals working at 46 indoor swimming pool facilities. Levels of trichloramine, as well as exhaled nitric oxide, were measured in five facilities with high prevalence of airway irritation and four facilities with no airway irritation among the personnel. Nasal lavage fluid was collected, and protein profiles were determined by a proteomic approach.

    Results

    17 % of the swimming pool personnel reported airway symptoms related to work. The levels of trichloramine in the swimming pool facilities ranged from 0.04 to 0.36 mg/m3. There was no covariance between trichloramine levels, exhaled nitric oxide and prevalence of airway symptoms. Protein profiling of the nasal lavage fluid showed that the levels alpha-1-antitrypsin and lactoferrin were significantly higher, and S100-A8 was significantly lower in swimming pool personnel.

    Conclusions

    This study confirms the occurrence of airway irritation among indoor swimming pool personnel. Our results indicate altered levels of innate immunity proteins in the upper airways that may pose as potential biomarkers. However, swimming pool facilities with high prevalence of airway irritation could not be explained by higher trichloramine exposure levels. Further studies are needed to clarify the environmental factors in indoor swimming pools that cause airway problems and affect the immune system.

  • 24.
    Fornander, Louise
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Graff, Pål
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Wåhlén, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Ydreborg, Kjell
    County Hospital Ryhov, Jönköping, Sweden.
    Flodin, Ulf
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Leanderson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Lindahl, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Ghafouri, Bijar
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Airway symptoms and biological markers in nasal lavage fluid in subjects exposed to metalworking fluids2013In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 12, p. e83089-Article in journal (Refereed)
    Abstract [en]

    BACKGROUNDS: Occurrence of airway irritation among industrial metal workers was investigated. The aims were to study the association between exposures from water-based metal working fluids (MWF) and the health outcome among the personnel, to assess potential effects on the proteome in nasal mucous membranes, and evaluate preventive actions.

    METHODS: The prevalence of airway symptoms related to work were examined among 271 metalworkers exposed to MWF and 24 metal workers not exposed to MWF at the same factory. At the same time, air levels of potentially harmful substances (oil mist, morpholine, monoethanolamine, formaldehyde) generated from MWF was measured. Nasal lavage fluid was collected from 13 workers and 15 controls and protein profiles were determined by a proteomic approach.

    RESULTS: Airway symptoms were reported in 39% of the workers exposed to MWF although the measured levels of MWF substances in the work place air were low. Highest prevalence was found among workers handling the MWF machines but also those working in the same hall were affected. Improvement of the ventilation to reduce MWF exposure lowered the prevalence of airway problems. Protein profiling showed significantly higher levels of S100-A9 and lower levels of SPLUNC1, cystatin SN, Ig J and β2-microglobulin among workers with airway symptoms.

    CONCLUSIONS: This study confirms that upper airway symptoms among metal workers are a common problem and despite low levels of MWF-generated substances, effects on airway immune proteins are found. Further studies to clarify the role of specific MWF components in connection to airway inflammation and the identified biological markers are warranted.

  • 25.
    Frisk, Jessica
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Östergötland.
    Källström, Ann-Christine
    Clinical Department of Surgery, Division of Oncology, Helsingborg Hospital, Helsingborg, Sweden.
    Wall, Najme
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology UHL.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Hammar, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Acupuncture improves health-related quality-of-life (HRQoL) and sleep in women with breast cancer and hot flushes2012In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 20, no 4, p. 715-724Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Evaluate effects of electro-acupuncture (EA) and hormone therapy (HT) on health-related quality-of-life (HRQoL) and sleep in breast cancer survivors with vasomotor symptoms.

    METHODS: Forty-five women, randomized to EA (n = 27) for 12 weeks or HT (n = 18) for 24 months, were followed for up to 2 years. Distress caused by, and numbers of, hot flushes, hours slept and times woken up/night, Psychological and General Well-being Index (PGWB) and Women's Health Questionnaire (WHQ) were registered before and during treatment and at 6, 9, 12, 18 and 24 months after start of treatment.

    RESULTS: After 12 weeks of EA (n = 19), WHQ improved from 0.32 (IQR 0.23-0.53) at baseline to 0.24 (IQR 0.12-0.39; p < 0.001) and PGWB from 78 (IQR 53-89) to 79 (IQR 68-93; p = 0.002). All sleep parameters improved and Hot Flush Score (HFS) decreased by 80%. At 12 months, WHQ, PGWB and all sleep parameters remained significantly improved (n = 14) and HFS decreased by 65%. After 12 weeks of HT (n = 18), WHQ improved from 0.29 (IQR 0.15-0.44) at baseline to 0.15 (IQR 0.05-0.22; p = 0.001), PGWB from 75 (IQR 59-88) to 90 (62-97; p = 0.102) and three of five sleep parameters improved.

    CONCLUSION: Both EA and HT increased HRQoL and sleep, probably through decreasing numbers of and distress by hot flushes. Although flushes decreased less in the EA group than in the HT group, HRQoL improved at least to the same extent maybe due to other effects of EA, not induced by HT, e.g. on anxiety, vitality and sleep, supported by subscale analyses. EA should be further evaluated as treatment for women with breast cancer and climacteric complaints, since HT no longer can be recommended for these women.

  • 26.
    Furuhjelm, Catrin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Warstedt, Kristina
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Fagerås Böttcher, Malin
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Fälth-Magnusson, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Larsson, Johanna
    Pediatric Clinic, Ryhov Hospital, Jönköping, Sweden.
    Fredriksson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Duchén, Karel
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Allergic disease in infants up to 2 yr of age in relation to plasma omega-3 fatty acids and maternal fish oil supplementation inpregnancy and lactation2011In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 22, no 5, p. 505-514Article in journal (Refereed)
    Abstract [en]

    We have previously reported a protective effect of maternal omega-3 long-chain polyunsaturated fatty acids (x-3 LCPUFA) supplementation in pregnancy and lactation on IgE-associated eczema and food allergy in the infant during the first year of life. Here we investigate whether the effects of the LCPUFA supplementation on IgE-associated diseases last up to 2 yr of age and assess the relationship between plasma proportions of x-3 PUFAs and the frequency and severity of infant allergic disease. 145 pregnant women, at risk of having an allergic infant, were randomized to daily supplementation with 1.6 g eicosapentaenoic acid (EPA) and 1.1 g docosahexaenoic acid (DHA) or placebo starting in the 25th gestational week and continuing through 3.5 months of breastfeeding. Clinical examinations, skin prick tests and analysis of maternal and infant plasma phospholipid fatty acids and infant specific IgE were performed. No difference in the prevalence of allergic symptoms was found between the intervention groups. Thecumulative incidence of IgE-associated disease was lower in the x-3-supplemented group (6/54, 13%) compared with the placebo group (19/62, 30%, p = 0.01). Higher maternal and infant proportions of DHA and EPA were associated with lower prevalence of IgE associated disease (p = 0.01–0.05) in a dose-dependent manner. Higher maternal and infant proportions of DHA and EPA were found if the infants presented none, when compared with multiple allergic symptoms, (p < 0.05) regardless of sensitization. In summary, the x-3 supplementation offered no obvious preventive effect on the prevalence of clinical symptoms of allergic disease, but the decrease in cumulative incidence of IgE-associated disease seen during the first year still remained until 2 yr of age. Furthermore, high proportions of DHA and EPA in maternal and infant plasma phospholipids were associated with less IgE-associated disease and a reduced severity of the allergic phenotype.

  • 27.
    Furuhjelm, Catrin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Warstedt, Kristina
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Larsson, Johanna
    Ryhov Hospital.
    Fredriksson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Böttcher, Malin
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Fälth-Magnusson, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Duchén, Karel
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Fish oil supplementation in pregnancy and lactation may decrease the risk of infant allergy2009In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 98, no 9, p. 1461-1467Article in journal (Refereed)
    Abstract [en]

    Maternal intake of omega-3 (-3) polyunsaturated fatty acids (PUFAs) during pregnancy has decreased, possibly contributing to a current increased risk of childhood allergy. Aim: To describe the effects of maternal -3 long-chain PUFA supplementation during pregnancy and lactation on the incidence of allergic disease in infancy. Methods: One hundred and forty-five pregnant women, affected by allergy themselves or having a husband or previous child with allergies, were included in a randomized placebo-controlled trial. Daily maternal supplementation with either 1.6 g eicosapentaenoic acid and 1.1 g docosahexaenoic acid or placebo was given from the 25(th) gestational week to average 3-4 months of breastfeeding. Skin prick tests, detection of circulating specific immunoglobulin E (IgE) antibodies and clinical examinations of the infants were performed. Results: The period prevalence of food allergy was lower in the -3 group (1/52, 2%) compared to the placebo group (10/65, 15%, p andlt; 0.05) as well as the incidence of IgE-associated eczema (-3 group: 4/52, 8%; placebo group: 15/63, 24%, p andlt; 0.05). Conclusion: Maternal -3 fatty acid supplementation may decrease the risk of food allergy and IgE-associated eczema during the first year of life in infants with a family history of allergic disease.

  • 28.
    Ghafouri, Bijar
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Karlsson, Helen
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Lewander, Andreas
    Linköping University, Department of Clinical and Experimental Medicine, Oncology . Linköping University, Faculty of Health Sciences.
    Tagesson, Christer
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Lindahl, Mats
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Peptide mass fingerprint data from silver stained proteins can be improved by using 2,5-dihydroxybenzoic acid instead of α-cyano-4-hydroxycinnamic acid as matrix in MALDI-TOF MS2007Article in journal (Refereed)
  • 29.
    Ghafouri, Bijar
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Larsson, Britt
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Sjörs, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Leandersson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Heart and Medicine Centre, Occupational and Environmental Medicine Centre. Linköping University, Faculty of Health Sciences.
    Gerdle, Björn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Pain and Rehabilitation Centre.
    Interstitial concentration of serotonin is increased in myalgic human trapezius muscle during rest, repetitive work and mental stress - an in vivo microdialysis study2010In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 70, no 7, p. 478-486Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The pathophysiology of trapezius myalgia is not fully elucidated. Serotonin (5-HT) is involved in modulation of nociception and hyperalgesia. Our aim was to compare the interstitial 5-HT levels of the trapezius muscle in women with chronic trapezius myalgia and in pain-free controls.

    MATERIALS AND METHODS: Microdialysate of the trapezius muscle collected every 20 minutes during rest, work (100 min) and stress (20 min) was used to study the dynamics of 5-HT in women with chronic trapezius myalgia (MYA; n=18) and in pain-free controls (CON; n=30).

    RESULTS: MYA had higher levels of 5-HT than CON at baseline, during repetitive work, during mental stress and during recovery. There were no significant time effects on 5-HT levels.

    CONCLUSION: 5-HT has the potential of a biomarker of chronic myalgia. Elevated levels of 5-HT may be involved in maintenance of habitual chronic pain and might contribute to increased pain during exercise by facilitating the effect of released algesic substances linked to such muscle demands.

  • 30.
    Ghafouri, Bijar
    et al.
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Persson, H Lennart
    Linköping University, Department of Medical and Health Sciences, Pulmonary Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine.
    Tagesson, Christer
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Intriguing bronchoalveolar lavage proteome in a case of pulmonary langerhans cell histiocytosis2013In: The American journal of case reports, ISSN 1941-5923, Vol. 14, p. 129-133Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Pulmonary Langerhans cell histiocytosis (PLCH) is a rare interstitial lung disease associated with tobacco smoke exposure. New insights into its pathogenesis and how it differs from that of chronic obstructive pulmonary disease (COPD) may be provided by proteomic studies on bronchoalveolar lavage fluid (BALF).

    CASE REPORT: We present the BALF proteome in a biopsy-proven case of PLCH and compare it with typical proteomes of COPD and of the healthy lung. The BALF proteins were separated by two-dimensional gel electrophoresis (2-DE) and the protein patterns were analyzed with a computerized 2-DE imaging system. As compared to the healthy subject and the COPD case, the PLCH case showed a strikingly different 2-DE pattern. There was much more IgG (heavy chain) and orosomucoid, and less α1-antitrypsin, surfactant protein-A, haptoglobin, cystatin-S, Clara cell protein 10, transthyretin and gelsolin. Moreover, no apolipoprotein-A1, pro-apolipoprotein-A1, amyloid P, calgranulin A, or calgranulin B was detected at all.

    CONCLUSIONS: This case of PLCH presents with an extreme BALF proteome lacking significant amounts of protective and anti-inflammatory proteins. Thus, the intriguing BALF proteome opens up new lines of research into the pathophysiology of PLCH and how its pathogenesis differs from that in COPD.

  • 31.
    Graff, Pål
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre. Östergötlands Läns Landsting, Centre for Medicine.
    Bozhkov, Georgi
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre. Östergötlands Läns Landsting, Centre for Medicine.
    Hedenlof, Karin
    Sensia Health AB.
    Johannesson, Olof
    Sensia Health AB.
    Flodin, Ulf
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Epistaxis in a Low Level Hydrogen Fluoride Exposed Industrial Staff2009In: AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, ISSN 0271-3586, Vol. 52, no 3, p. 240-245Article in journal (Refereed)
    Abstract [en]

    Objectives To assess the effect of exposure to hydrogen fluoride (HF) on the airway mucosa in an industrial setting.

    Methods A cross-sectional study encompassing 33 industrial workers in a flame soldering plant and 44 assembly workers unexposed to HF was performed by means of a questionnaire on symptoms and diagnosis regarding upper and lower airways as well as through conduct of a clinical examination of the exposed group. Air concentrations of HF that were monitored in winter amounted to 1.0 mg/m(3) and in summer time to 0.15 mg/m(3).

    Results A threefold risk for epistaxis (RR = 3.6, 95% confidence interval 1.1-11.0) was observed in the exposed group. Time from the start of exposure to HF until debut of a nose bleeding period varied from 1 month to 6 years. Mean induction (latency) time was 42 months. Mean duration of symptoms was 26 months, range 3-72 months, indicating that the exposure level in summer time was sufficient to maintain the propensity of almost daily, nose bleeding.

    Conclusion HF is an irritating vapor, even at relatively low air concentrations. We recommend an 8 hr TLV lower than 1.0 mg/m(3).

  • 32.
    Graff, Pål
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine.
    Elmsjo, Lisa
    Eksjo Industrial Health Care Unit.
    Bjorkander, Janne
    Ryhov City Hospital.
    Flodin, Ulf
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Occupational rhinitis caused by tolyltriazole in metalworking fluids2008In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 34, no 5, p. 403-404Article in journal (Other academic)
    Abstract [en]

    Objectives: Exposure to metalworking fluids is known to cause mucous membrane inflammation of the airways. In this case report, the authors attempted to identify responsible components in the metalworking fluids for the rhinitis of an exposed patient.

    Methods: The patient underwent two provocation tests. The first provocation was performed with the different metalworking fluids used in the factory, and the second was done double blind for some of the components in the metalworking fluids. The patient was asked to quantify her symptoms before, immediately after, 24 hours after, and finally 96 hours after the exposure.

    Results: The patient reacted to tolyltriazole with rhinitis and headache. These symptoms started about 8 hours after the exposure and persisted for 24 hours.

    Conclusion: The double-blind provocation exposure to the components of the metalworking fluids showed that the patient reacted to the corrosion inhibitor tolyltriazole. To the authors knowledge, no such reaction to tolyltriazole in the airways has previously been reported.

  • 33.
    Graff, Pål
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Jönsson, Pia
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Flodin, Ulf
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Non-sensitising air pollution at workplaces and adult-onset asthma in the beginning of this millennium2011In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 84, no 7, p. 797-804Article in journal (Refereed)
    Abstract [en]

    Purpose: This case-control study was undertaken to elucidate the controversy concerning whether low-level, long-term exposure to non-sensitising air pollution at workplaces may cause asthma. Methods: A case-control study of 192 adult-onset asthma cases aged 20-65 years and 323 controls was conducted in the southeast of Sweden. Cases were identified from computerised registers from the region, diagnosed 2000-2004 and diagnoses were confirmed via medical files. Referents were randomised from the population register of the region. Exposure was monitored by a 16-page questionnaire. Special attention was devoted to identifying and in the final analyses excluding subjects exposed to sensitising agents. Results: Three years or more of occupational exposure to air pollution from dust, smoke, fumes or vapours before the year of diagnosis by analyses adjusting for age yielded an increased risk for asthma (OR = 2.3, 95% CI 1.2-4.2) in men, while in women, no risk was seen. In a multiple logistic regression analysis in men without allergy in childhood, a significant risk was seen (OR = 2.8, 95% CI 1.07-7.4), when subjects exposed to identified allergens were excluded. In women, no excess risk was observed from occupational air pollution. Conclusion: The results of this study support an association between occupational exposure to low level non-sensitising air pollution and adult-onset asthma in men.

  • 34.
    Gustafsson, Mats
    et al.
    Swedish National Road and Transport Research Institute .
    Blomqvist, Göran
    Swedish National Road and Transport Research Institute .
    Gudmundsson, Anders
    Lund University.
    Dahl, Andreas
    Lund University.
    Swietlicki, Erik
    Lund University.
    Bohgard, Mats
    Lund University.
    Lindbom, John
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Ljungman, Anders
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Properties and toxicological effects of particles from the interaction between tyres, road pavement and winter traction material2008In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 393, no 2-3, p. 226-240Article in journal (Refereed)
    Abstract [en]

    In regions where studded tyres and traction material are used during winter, e.g. the Nordic countries, northern part of USA, Canada, and Japan, mechanically generated particles from traffic is the main reason for high particle concentrations in busy street- and road environments. In many Nordic municipalities the European environmental quality standard for inhalable particles (PM10) is exceeded due to these particles. In this study, particles from the wear of studded and studless friction tyres on two pavements and traction sanding were generated using a road simulator. The particles were characterized using particle sizers, PIXE and electron microscopy. Cell studies were conducted on particles sampled from the tests with studded tyres and compared with street environment, diesel exhaust and subway PM10, respectively. The results show that in the road simulator, where resuspension is minimised, studded tyres produce tens of times more particles than friction tyres. Chemical analysis of the sampled particles shows that the generated wear particles consists almost entirely of minerals from the pavement stone material, but also that S is enriched for the sub-micron particles and that Zn is enriched for friction tyres for all particles sizes. The chemical data can be used for source identification and apportionment in urban aerosol studies. A mode of ultra-fine particles was also present and is hypothesised to originate in the tyres. Further, traction material properties affect PM10 emission. The inflammatory potential of the particles from wear of pavements seems to depend on type of pavement and can be at least as potent as diesel exhaust particles. The results implies that there is a need and a good potential to reduce particle emission from pavement wear and winter time road and street operation by adjusting both studded tyre use as well as pavement and traction material properties.

  • 35.
    Götmar, Anders
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Hammar, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Samsioe, Göran
    Departments of Clinical Sciences in Lund and Malmö, Lund University, Sweden.
    Nerbrand, Christina
    Departments of Clinical Sciences in Lund and Malmö, Lund University, Sweden.
    Lidfeldt, Jonas
    Departments of Clinical Sciences in Lund and Malmö, Lund University, Sweden.
    Spetz, Anna-Clara
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Symptoms in peri- and postmenopausal women in relation to testosterone concentrations. Data fromThe Women's Health in the Lund Area (WHILA) study2008In: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 11, no 4, p. 304-314Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to investigate possible associations between androgen concentrations in perimenopausal women and symptoms that may be associated with low androgen concentrations in the blood.

    Methods: All women born 1935 to 1945 living in a defined geographic area in Sweden (n=10766) were invited to a screening program that included physical and laboratory examinations and a questionnaire. Three groups were identified; premenopausal women, women on hormone replacement therapy (HRT) and postmenopausal women without HRT. Concentrations of testosterone (T), androstendione, Sex Hormone Binding Globulin and estradiol were measured. Waist Hip Ratio, Body Mass Index and Free Testosterone Index (FTI) were calculated.

    Results: 6908 women participated. The women on HRT had lower T and FTI and were less satisfied with mood and energy (p<0.05). Women with hot flushes had higher T and FTI and women reporting coldness had lower concentrations (p<0.05). Sexual well-being were not correlated to T or FTI (p>0.05).

    Conclusions: Lower T concentrations were associated with lower quality of life in perimenopausal women but not to sexual well-being. There must be other factors than decrements in sex hormones that contribute to the emergence of some perimenopausal symptoms.

  • 36. Hatzinikolaou, DG
    et al.
    Lagesson, Verner
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Stavridou, AJ
    Pouli, AE
    Lagesson-Andrasko, L
    Stavrides, JC
    Analysis of the gas phase of cigarette smoke by gas chromatography coupled with UV-diode array detection2006In: Analytical Chemistry, ISSN 0003-2700, E-ISSN 1520-6882, Vol. 78, no 13, p. 4509-4516Article in journal (Refereed)
    Abstract [en]

    A gas chromatography method, coupled with diode array photometric spectral detection in the ultraviolet region (167-330 nm), was developed for the analysis of the gas phase of cigarette smoke. The method enabled us to identify more than 20 volatiles present in the vapor phase of cigarette smoke. In that way, all major volatile organic compounds ( including aldehydes, conjugated dienes, ketones, sulfides, furans, and single-ring aromatics), as well as nitric oxide ( NO) and hydrogen sulfide (H2S), can be analyzed in a straightforward manner through a single chromatographic run of < 50-min duration. The method can easily be applied by the introduction of a small volume of the gas-phase stream into the GC injection loop directly through the smoking apparatus exhaust circuit, thus providing an excellent alternative to available methods, which usually require extraction or concentration steps prior to any chromatographic analysis. Furthermore, all problems concerning aging of the gas phase are eliminated. Twelve compounds ( including NO) were chosen for quantification through the use of appropriate calibration standards. Comparison of the vapor phase yields of these compounds for the reference cigarette Kentucky 1R4F with already reported data indicates that this method is very reliable as far as accuracy and reproducibility of the results are concerned. Finally, the proposed methodology was used to compare the concentration of these cigarette smoke gas-phase constituents among individual puffs.

  • 37.
    Hodgson, S.
    et al.
    Institute of Health and Society, Newcastle University, The Medical School, William Leech Building, Newcastle upon Tyne NE2 4HH, United Kingdom, Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom.
    Thomas, L.
    Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom.
    Fattore, E.
    Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Milano, Italy.
    Lind, P.M.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Alfven, T.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Hellström, Lennart
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine .
    Hakansson, H.
    Håkansson, H., Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Carubelli, G.
    Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Milano, Italy.
    Fanelli, R.
    Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Milano, Italy.
    Jarup, L.
    Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom.
    Bone mineral density changes in relation to environmental PCB exposure2008In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 116, no 9, p. 1162-1166Article in journal (Refereed)
    Abstract [en]

    Background: Bone toxicity has been linked to organochlorine exposure following a few notable poisoning incidents, but epidemiologic studies in populations with environmental organochlorine exposure have yielded inconsistent results. Objectives: The aim of this study was to investigate whether organochlorine exposure was associated with bone mineral density (BMD) in a population 60-81 years of age (154 males, 167 females) living near the Baltic coast, close to a river contaminated by polychlorinated biphenyls (PCBs). Methods: We measured forearm BMD in participants using dual energy X-ray absorptiometry, and we assessed low BMD using age- and sex-standardized Z-scores. We analyzed blood samples for five dioxin-like PCBs, the three most abundant non-dioxin-like PCBs, and p,p'-dichlorophenyldichloroethylene (p,p'-DDE). Results: In males, dioxin-like chlorobiphenyl (CB)-118 was negatively associated with BMD, the odds ratio for low BMD (Z-score less than -1) was 1.06 (95% confidence interval, 1.01-1.12) per 10 pg/mL CB-118. The sum of the three most abundant non-dioxin-like PCBs was positively associated with BMD, but not with a decreased risk of low BMD. In females, CB-118 was positively associated with BMD, but this congener did not influence the risk of low BMD in women. Conclusions: Environmental organochlorine exposures experienced by this population sample since the 1930s in Sweden may have been sufficient to result in sex-specific changes in BMD.

  • 38.
    Holleboom, Adriaan G
    et al.
    Department of Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands.
    Karlsson, Helen
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Occupational and Environmental Medicine Centre.
    Lin, Ruei-Shiuan
    Section on Biological Chemistry, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA.
    Beres, Thomas M
    Section on Biological Chemistry, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA.
    Sierts, Jeroen A
    Department of Experimental Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands.
    Herman, Daniel S
    Department of Genetics, Harvard Medical School, Boston, MA 02115, USA.
    Stroes, Erik S G
    Department of Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands.
    Aerts, Johannes M
    Department of Medical Biochemistry, Academic Medical Center, Amsterdam 1105AZ, The Netherlands.
    Kastelein, John J P
    Department of Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands.
    Motazacker, Mohammad M
    Department of Experimental Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands.
    Dallinga-Thie, Geesje M
    Department of Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands.
    Levels, Johannes H M
    Department of Experimental Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands.
    Zwinderman, Aeilko H
    Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, Amsterdam 1105AZ, The Netherlands.
    Seidman, Jonathan G
    Department of Genetics, Harvard Medical School, Boston, MA 02115, USA.
    Seidman, Christine E
    Department of Genetics, Harvard Medical School, Boston, MA 02115, USA.
    Ljunggren, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Lefeber, Dirk J
    Department of Neurology, Radboud University Nijmegen Medical Center, Nijmegen 6525GA, The Netherlands.
    Morava, Eva
    Institute for Genetic and Metabolic Disease, Radboud University Nijmegen Medical Center, Nijmegen 6525GA, The Netherlands.
    Wevers, Ron A
    Department of Laboratory Medicine, Radboud University Nijmegen Medical Center, Nijmegen 6525GA, The Netherlands.
    Fritz, Timothy A
    Food and Drug Administration, Rockville, MD 20852, USA.
    Tabak, Lawrence A
    Section on Biological Chemistry, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA.
    Lindahl, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Hovingh, G Kees
    Department of Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands.
    Kuivenhoven, Jan Albert
    Department of Experimental Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands.
    Heterozygosity for a Loss-of-Function Mutation in GALNT2 Improves Plasma Triglyceride Clearance in Man2011In: Cell Metabolism, ISSN 1550-4131, E-ISSN 1932-7420, Vol. 14, no 6, p. 811-8Article in journal (Refereed)
    Abstract [en]

    Genome-wide association studies have identified GALNT2 as a candidate gene in lipid metabolism, but it is not known how the encoded enzyme ppGalNAc-T2, which contributes to the initiation of mucin-type O-linked glycosylation, mediates this effect. In two probands with elevated plasma high-density lipoprotein cholesterol and reduced triglycerides, we identified a mutation in GALNT2. It is shown that carriers have improved postprandial triglyceride clearance, which is likely attributable to attenuated glycosylation of apolipoprotein (apo) C-III, as observed in their plasma. This protein inhibits lipoprotein lipase (LPL), which hydrolyses plasma triglycerides. We show that an apoC-III-based peptide is a substrate for ppGalNAc-T2 while its glycosylation by the mutant enzyme is impaired. In addition, neuraminidase treatment of apoC-III which removes the sialic acids from its glycan chain decreases its potential to inhibit LPL. Combined, these data suggest that ppGalNAc-T2 can affect lipid metabolism through apoC-III glycosylation, thereby establishing GALNT2 as a lipid-modifying gene.

  • 39.
    Jayawardena, Umesh
    et al.
    Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Tollemark, Linda
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Tagesson, Christer
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Leanderson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Pyrogenic effect of respirable road dust particles2009In: Inhaled Particles X / [ed] Lee Kenny, Fintan Hurley, Institute of Physics Publishing (IOPP), 2009, Vol. 151, p. 012015-Conference paper (Refereed)
    Abstract [en]

    Because pyrogenic (fever-inducing) compounds on ambient particles may play an important role for particle toxicity, simple methods to measure pyrogens on particles are needed. Here we have used a modified in vitro pyrogen test (IPT) to study the release of interleukin 1β (IL-1β) in whole human blood exposed to respirable road-dust particles (RRDP). Road dusts were collected from the roadside at six different streets in three Swedish cities and particles with a diameter less than 10 μm (RRDP) were prepared by a water sedimentation procedure followed by lyophilisation. RRDP (200 μl of 1 - 106 ng/ml) were mixed with 50 μl whole blood and incubated at 37 °C overnight before IL-1β was analysed with chemiluminescence ELISA in 384-well plates. Endotoxin (lipopolysaccharide from Salmonella minnesota), zymosan B and Curdlan (P-1,3-glucan) were used as positive controls. All RRDP samples had a pyrogenic effect and the most active sample produced 1.6 times more IL-1β than the least active. This formation was of the same magnitude as in samples with 10 ng LPS/ml and was larger than that evoked by zymosan B and Curdlan (by mass basis). The method was sensitive enough to determine formation of IL-1β in mixtures with 10 ng RRDP/ml or 0.01 ng LPS/ml. The endotoxin inhibitor, polymyxin B (10 μg/ml), strongly reduced the RRDP-induced formation of IL-1β at 1μg RRDP/ml (around 80 % inhibition), but had only marginal or no effects at higher RRDP-concentrations (10 and 100 μg /ml). In summary, all RRDP tested had a clear pyrogen effect in this in vitro model. Endotoxin on the particles but also other factors contributed to the pyrogenic effect. As opposed to the limulus amebocyte lysate (LAL) assay (which measures endotoxin alone), IPT measures a broad range of pyrogens that may be present on particulate matter. The IPT method thus affords a simple, sensitive and quantitative determination of the total pyrogenic potential of ambient particles.

  • 40.
    Karlsson, Helen
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Leandersson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Tagesson, Christer
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Lindahl, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Lipoproteomics I: Mapping of proteins in low-density lipoprotein using two-dimensional gel electrophoresis and mass spectrometry2005In: Proteomics, ISSN 1615-9853, Vol. 5, no 2, p. 551-565Article in journal (Refereed)
    Abstract [en]

    The molecular mechanisms underlying the relationship between low-density lipoprotein (LDL) and the risk of atherosclerosis are not clear. Therefore, detailed information about the protein composition of LDL may contribute to reveal its role in atherogenesis and the mechanisms that lead to coronary disease in humans. Here, we sought to map the proteins in human LDL by a proteomic approach. LDL was isolated by two-step discontinuous density-gradient ultracentrifugation and the proteins were separated with two-dimensional gel electrophoresis and identified with peptide mass fingerprinting, using matrix assisted laser desorption/ionization-time of flight-mass spectrometry and with amino acid sequencing using electrospray ionization tandem mass spectrometry. These procedures identified apo B-100, apo C-II, apo C-III (three isoforms), apo E (four isoforms), apo A-I (two isoforms), apo A-IV, apo J and apo M (three isoforms not previously described). In addition, three proteins that have not previously been identified in LDL were found: serum amyloid A-IV (two isoforms), calgranulin A, and lysozyme C. The identities of apo M, calgranulin A, and lysozyme C were confirmed by sequence information obtained after collision-induced dissociation fragmentation of peptides characteristic for these proteins. Moreover, the presence of lysozyme C was further corroborated by demonstrating enriched hydrolytic activity in LDL against Micrococcus lysodeikticus. These results indicate that in addition to the dominating apo B-100, LDL contains a number of other apolipoproteins, many of which occur in different isoforms. The demonstration, for the first time, that LDL contains calgranulin A and lysozyme C raises the possibility that LDL proteins may play hitherto unknown role(s) in immune and inflammatory reactions of the arterial wall.

  • 41.
    Karlsson, Helen
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Leandersson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Tagesson, Christer
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Lindahl, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Lipoproteomics II: Mapping of proteins in high-density lipoprotein using two-dimensional gel electrophoresis and mass spectrometry2005In: Proteomics, ISSN 1615-9853, Vol. 5, no 5, p. 1431-1445Article in journal (Refereed)
    Abstract [en]

    High-density lipoprotein (HDL) is the most abundant lipoprotein particle in the plasma and a negative risk factor of atherosclerosis. By using a proteomic approach it is possible to obtain detailed information about its protein content and protein modifications that may give new information about the physiological roles of HDL. In this study the two subfractions; HDL2 and HDL3, were isolated by two-step discontinuous density-gradient ultracentrifugation and the proteins were separated with two-dimensional gel electrophoresis and identified with peptide mass fingerprinting, using matrix-assisted laser desorption/ionisation time of flight mass spectrometry. Identified proteins in HDL were: the dominating apo A-I as six isoforms, four of them with a glycosylation pattern and one of them with retained propeptide, apolipoprotein (apo) A-II, apo A-IV, apo C-I, apo C-II, apo C-III (two isoforms), apo E (five isoforms), the recently discovered apo M (two isoforms), serum amyloid A (two isoforms) and serum amyloid A-IV (six isoforms). Furthermore, alpha-1-antitrypsin was identified in HDL for the first time. Additionally, salivary alpha-amylase was identified as two isoforms in HDL2, and apo L and a glycosylated apo A-II were identified in HDL3. Besides confirming the presence of different apolipoproteins, this study indicates new patterns of glycosylated apo A-I and apo A-II. Furthermore, the study reveals new proteins in HDL; alpha-1-antitrypsin and salivary alpha-amylase. Further investigations about these proteins may give new insight into the functional role of HDL in coronary artery diseases.

  • 42.
    Karlsson, Helen
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Lindbom, John
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Ghafouri, Bijar
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Lindahl, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Tagesson, Christer
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Gustafsson, Mats
    Östergötlands Läns Landsting, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Ljungman, Anders G
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Wear Particles from Studded Tires and Granite Pavement Induce Pro-inflammatory Alterations in Human Monocyte-Derived Macrophages: A Proteomic Study.2011In: Chemical Research in Toxicology, ISSN 0893-228X, E-ISSN 1520-5010, Vol. 24, p. 45-53Article in journal (Refereed)
    Abstract [en]

    Airborne particulate matter is considered to be one of the environmental contributors to the mortality in cancer, respiratory, and cardiovascular diseases. For future preventive actions, it is of major concern to investigate the toxicity of defined groups of airborne particles and to clarify their pathways in biological tissues. To expand the knowledge beyond general inflammatory markers, this study examined the toxicoproteomic effects on human monocyte derived macrophages after exposure to wear particles generated from the interface of studded tires and a granite-containing pavement. As comparison, the effect of endotoxin was also investigated. The macrophage proteome was separated using two-dimensional gel electrophoresis. Detected proteins were quantified, and selected proteins were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry. Among analyzed proteins, seven were significantly decreased and three were increased by exposure to wear particles as compared to unexposed control cells. Endotoxin exposure resulted in significant changes in the expression of six proteins: four decreased and two increased. For example, macrophage capping protein was significantly increased after wear particle exposure only, whereas calgizzarin and galectin-3 were increased by both wear particle and endotoxin exposure. Overall, proteins associated with inflammatory response were increased and proteins involved in cellular functions such as redox balance, anti-inflammatory response, and glycolysis were decreased. Investigating the effects of characterized wear particles on human macrophages with a toxicoproteomic approach has shown to be useful in the search for more detailed information about specific pathways and possible biological markers.

  • 43.
    Karlsson, Helen
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Lindqvist, Helen
    Department of Chemistry and Bioscience/Food Science, Chalmers University of Technology, Göteborg, Sweden.
    Tagesson, Christer
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Lindahl, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Characterization of apolipoprotein M isoforms in low-density lipoprotein2006In: Journal of proteome research, ISSN 1535-3893, Vol. 5, no 10, p. 2685-2690Article in journal (Refereed)
    Abstract [en]

    Apo M is a recently discovered human lipoprotein thought to be involved in the metabolism of lipids and lipoprotein particles. Here, a proteomic approach was applied to examine the glycosylation pattern of apo M in human LDL. We treated LDL proteins with N-glycosidase or neuraminidase, studied mobility shifts of Apo M by two-dimensional gel electrophoresis, and different isoforms were then identified with mass spectrometry. This way, we demonstrated the presence of five isoforms of apo M in LDL:  three that are both N-glycosylated and sialylated, one that is N-glycosylated but not sialylated, and one that is neither N-glycosylated nor sialylated. As judged from the examination of LDL from 20 healthy human subjects, the three N-glycosylated and sialylated forms are most abundant (80−100% of the total apo M in LDL) whereas the unsialylated and unglycosylated variants constitute at most 20%. Comparative analysis showed that the same five isoforms of apo M are also present in HDL. Further studies aiming at elucidating the role of apo M in health and disease will have to take this polymorphism of apo M proteins into account.

  • 44.
    Karlsson, Helen
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre. Östergötlands Läns Landsting, Centre for Medicine.
    Mortstedt, Harriet
    n/a.
    Lindqvist, Helen
    Chalmers.
    Tagesson, Christer
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Lindahl, Mats
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Protein profiling of low-density lipoprotein from obese subjects2009In: PROTEOMICS CLINICAL APPLICATIONS, ISSN 1862-8346, Vol. 3, no 6, p. 663-671Article in journal (Refereed)
    Abstract [en]

    Although obesity and high levels of low-density lipoprotein (LDL) are well-known risk factors for cardiovascular disease, the precise role(s) of different LDL constituents in obesity has not been explored. In the present study, we compared the LDL proteome of healthy control adults (body mass index less than 25) and obese subjects (body mass index greater than 30). LDL was isolated by density-gradient ultracentrifugation and proteins were separated with 2-D PAGE, quantified, and identified by peptide mass fingerprinting using MALDI-TOF MS. A new LDL-associated protein was identified as transthyretin and found to be significantly more abundant in LDL from the obese subjects. In addition, LDL from the obese subjects contained relatively more alpha(1)-antitrypsin, apo J, apo C-II, than LDL from controls, and also more of an acidic isoform (pI/Mr; 5.2/23 100) of apo A-I. On the other hand, the relative amounts of apo A-IV and the major isoform of apo A-I (pI/Mr; 5.3/23 100) were significantly less in LDL from the obese subjects. Apo E was less and non-sialylated apo C-III more abundant in LDL from obese men than control men, while there were no such differences between LDL from obese and control women. These findings illustrate that obesity is not only associated with increased LDL-cholesterol levels but also with alterations in the LDL protein composition. The presence of transthyretin in LDL from obese subjects may reflect over-nutrition and affect the lipid metabolism in obesity.

  • 45.
    Karlsson, Helen
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Occupational and Environmental Medicine Centre. Östergötlands Läns Landsting.
    Sundberg, Sofie
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Levels, J H M
    Acad Med Centre, Amsterdam, Netherlands .
    Turkina, Maria
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Daniel, G
    National Centre for Science Research Demokritos.
    Chroni, A
    National Centre for Science Research Demokritos.
    Kuivenhoven, J A
    Acad Med Centre, Amsterdam, Netherlands .
    Hovingh, G K
    Acad Med Centre, Amsterdam, Netherlands.
    Holleboom, A G
    Acad Med Centre, Amsterdam, Netherlands.
    Lindahl, Mats
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    MUTANT apo A-I (L178P) IDENTIFIED IN HDL FROM HETEROZYGOTES OF A FAMILY WITH ENDOTHELIAL DYSFUNCTION AND INCREASED ARTERIAL WALL THICKNESS in ATHEROSCLEROSIS SUPPLEMENTS, vol 11, issue 2, pp 67-672010In: ATHEROSCLEROSIS SUPPLEMENTS, Elsevier Science B.V., Amsterdam. , 2010, Vol. 11, no 2, p. 67-67Conference paper (Refereed)
    Abstract [en]

    n/a

  • 46.
    Karlsson, Pia M.
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Dermatology and Venerology . Linköping University, Faculty of Health Sciences.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Cutaneous malignant melanoma in children and adolescents in Sweden, 1993–2002: the increasing trend is broken2007In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 121, no 2, p. 323-328Article in journal (Refereed)
    Abstract [en]

    The incidence of cutaneous malignant melanoma rose rapidly in teenagers in Sweden during 1973-1992, while it remained low in younger children. To study the further trends and characteristics of melanoma in this young population, data on all cases in individuals under 20 years of age reported to the Swedish Cancer Registry during 1993-2002, and the corresponding pathology reports were examined. Seventy-nine cases were reported to the Registry. There were 24 males and 55 females. Most melanomas occurred on the trunk followed by the legs in both genders. The median tumor thickness was 0.8 mm. Children under age 15 had thicker melanomas than individuals aged 15-19. Superficial spreading melanoma was the most common histological subtype (43/78, 55%). The melanoma-specific 5-year survival rate was 90%. During 1993-2002, the age-standardized incidence fell to 3.6/million from 5.0/million in 1983-1992 (RR 0.74, 95% CI 0.58-0.92). The most pronounced decrease was for melanomas on the trunk in boys and on the legs in girls. The incidence for 15-19-year-old boys peaked for the cohort born between 1968 and 1972 and for girls between 1973 and 1977. The decrease in incidence may be a result of public health campaigns aiming at reducing sun exposure in childhood. A contributing effect from an increased immigration of individuals with darker complexions and at a lower melanoma risk is probable.

  • 47.
    Kastbom, Alf
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences.
    Verma, Deepti
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Eriksson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences.
    Skogh, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences.
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Söderkvist, Peter
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
    Genetic variation in proteins of the cryopyrin inflammasome influences susceptibility and severity of rheumatoid arthritis (the Swedish TIRA project)2008In: Rheumatology, ISSN 1462-0324, Vol. 47, no 4, p. 415-417Article in journal (Refereed)
    Abstract [en]

    Objectives: The genetic background to RA is incompletely understood.As new cytokine-targeted therapies emerge, early predictorsof disease severity are becoming increasingly important. Theinflammasomes are essential regulators of cytokine production.We investigated whether two polymorphisms in the genes encodingcryopyrin (CIAS1) and TUCAN (CARD8) influence susceptibilityand disease course in RA.

    Methods: Genotype frequencies were assessed in 174 Swedish patientswith early RA and 360 population-based controls without rheumaticdisease. Genotypes were categorized according to the presence(+) or absence (–) of two wild-type alleles and comparedbetween patients and controls. In the RA patients, antibodiestowards cyclic citrullinated peptides (anti-CCP) and the ‘sharedepitope’ (SE) were assessed, and medication and measuresof disease activity were monitored regularly during 3 yrs.

    Results: The combination of CIAS1/TUCAN/–, ascompared with CIAS1/TUCAN +/+, was significantly more commonamong patients than in controls [odds ratio (OR) 2.2, 95% CI1.03–4.6]. This association was strengthened when patientswere divided into anti-CCP+ [OR 2.8 (1.1–6.7)] or presenceof 1 SE copy [OR 2.8 (1.3–6.2)]. At most time-points duringthe 3-yr follow-up, patients with CIAS1/TUCAN/–showed significantly higher disease activity. Furthermore, CIAS1/TUCAN/– patients proved to be much more likely to receiveTNF-blocking therapy [relative risk 20 (2.6–149)].

    Conclusions: Compound polymorphisms in CIAS1 and TUCAN associatewith RA susceptibility and severity. The cryopyrin inflammasomeneeds further attention regarding a possible aetiopathogeneticconnection with RA.

  • 48.
    Kjellman, Britt-Marie
    et al.
    Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Glad Mattsson, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Sjöberg, Folke
    Linköping University, Department of Clinical and Experimental Medicine, Burn Center. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL. Östergötlands Läns Landsting, Sinnescentrum, Department of Anaesthesiology and Surgery UHL.
    Huss, Fredrik
    Linköping University, Department of Clinical and Experimental Medicine, Burn Center. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL.
    Comparing ambient, air-convection, and fluid-convection heating techniques in treating hypothermic burn patients, a clinical RCT2011In: Annals of Surgical Innovation and Research, ISSN 1750-1164, Vol. 5Article in journal (Refereed)
    Abstract [en]

    Background: Hypothermia in burns is common and increases morbidity and mortality. Several methods are available to reach and maintain normal core body temperature, but have not yet been evaluated in critical care for burned patients. Our units ordinary technique for controlling body temperature (Bair Hugger®+ radiator ceiling + bed warmer + Hotline®) has many drawbacks e.g.; slow and the working environment is hampered.The aim of this study was to compare our ordinary heating technique with newly-developed methods: the Allon™2001 Thermowrap (a temperature regulating water-mattress), and Warmcloud (a temperature regulating air-mattress).Methods: Ten consecutive burned patients (andgt; 20% total burned surface area and a core temperature andlt; 36.0C) were included in this prospective, randomised, comparative study. Patients were randomly exposed to 3 heating methods. Each treatment/measuring-cycle lasted for 6 hours. Each heating method was assessed for 2 hours according to a randomised timetable. Core temperature was measured using an indwelling (bladder) thermistor. Paired t-tests were used to assess the significance of differences between the treatments within the patients. ANOVA was used to assess the differences in temperature from the first to the last measurement among all treatments. Three-way ANOVA with the Tukey HSD post hoc test and a repeated measures ANOVA was used in the same manner, but included information about patients and treatment/measuring-cycles to control for potential confounding. Data are presented as mean (SD) and (range). Probabilities of less than 0.05 were accepted as significant.Results: The mean increase, 1.4 (SD 0.6C; range 0.6-2.6C) in core temperature/treatment/measuring-cycle highly significantly favoured the Allon™2001 Thermowrap in contrast to the conventional method 0.2 (0.6)C (range -1.2 to 1.5C) and the Warmcloud 0.3 (0.4)C (range -0.4 to 0.9C). The procedures for using the Allon™2001 Thermowrap were experienced to be more comfortable and straightforward than the conventional method or the Warmcloud.Conclusions: The Allon™2001 Thermowrap was more effective than the Warmcloud or the conventional method in controlling patients temperatures. © 2011 Kjellman et al; licensee BioMed Central Ltd.

  • 49.
    Kjölhede, Preben
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Borendal Wodlin, Ninnie
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Nilsson, Lena
    Linköping University, Department of Medical and Health Sciences, Anesthesiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Impact of stress coping capacity on recovery from abdominal hysterectomy in a fast-track programme: a prospective longitudinal study2012In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 119, no 8, p. 998-1007Article in journal (Refereed)
    Abstract [en]

    Objective To evaluate the effect of stress coping capacity in combination with mode of anaesthesia on postoperative recovery in fast-track abdominal hysterectomy. Design Prospective longitudinal study. Setting Five hospitals in the south-east of Sweden. Population A cohort of 162 women undergoing fast-track abdominal hysterectomy for benign conditions. Methods Self-administered questionnaires, the Stress Coping Inventory (SCI) and the Swedish Postoperative Symptom Questionnaire (SPSQ), and clinical information were collected prospectively. Stress coping capacity was categorised as high or low according to the summed score of the SCI. Comparisons of effect variables were adjusted using a propensity score-matching model. Main outcome measures Associations between stress coping capacity and hospital stay, sick leave, use of analgesic and self-reported postoperative symptoms. Results Women with high stress coping capacity had a significantly shorter sick leave, experienced postoperative symptoms significantly less often, and with lower intensity, than women with low stress coping capacity. With the exception of symptom intensity, these findings were related to having had the operation under spinal anaesthesia as opposed to general anaesthesia. Hospital stay, use of analgesics and abdominal pain were not related to stress coping capacity. Conclusions In patients for whom spinal anaesthesia was applied, high stress coping seems to be a quality that helps patients manage the burden of surgery. It is desirable for the individual, as well as for the healthcare system, to enhance recovery by using intervention programmes designed to improve or manage stress coping, particularly for individuals with low stress coping capacity. This recommendation merits further investigation.

  • 50.
    Kjölhede, Preben
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wahlström, Johan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Wingren, Gun
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine .
    Pelvic floor dysfunction after Burch colposuspension - A comprehensive study. Part II2005In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 84, no 9, p. 902-908Article in journal (Refereed)
    Abstract [en]

    Objective. To evaluate the prevalence of pelvic floor dysfunction (PFD) concerning bowel function at long-term follow-up after Burch colposuspension (Bc) in relation to the bowel function in an age-matched sample of women in the general population. Methods and material. This is a follow-up study of a cohort of 190 patients who underwent Bc in 1980-1988 and 305 age-matched control women without urinary anti-incontinence surgery, randomly selected from the general population. The participants answered a postal questionnaire with detailed questions about the pelvic floor function in 1998. Univariate and multivariate analyses were performed. Results. The patients showed considerable signs of bowel dysfunction compared with the general population in the following aspects: they used the fingers to help emptying the bowel [odds ratio (OR) 3.25 (1.35-7.86)], had feeling of incomplete emptying of the bowel [OR 2.29 (1.11-4.73)], felt no warning before passing a motion [OR 3.04 (1.20-7.71)], had gas incontinence [OR 1.98 (1.17-3.37), had loose stool incontinence [OR 3.67 (1.43-9.42)], used protection against fecal leakage during daytime [OR 3.22 (1.30-7.95)], and experienced that the bowel function affected the general well-being adversely [OR 2.15 (1.30-3.56)]. Conclusion. The patients who have undergone colposuspension for stress urinary incontinence have more symptoms of PFD concerning the bowel function than women without urinary anti-incontinence surgery in the general population. This affects the general well-being. A comprehensive concept of multidisciplinary assessment and treatment of PFD should be encouraged. © Acta Obstet Gynecol Scand 2005.

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