liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
Alternative names
Publications (10 of 33) Show all publications
Elawa, S., Mirdell, R., Stefanis, A., Droog Tesselaar, E. & Farnebo, S. (2024). Microcirculatory changes in the skin after postmastectomy radiotherapy in women with breast cancer. Scientific Reports, 14(1), Article ID 4149.
Open this publication in new window or tab >>Microcirculatory changes in the skin after postmastectomy radiotherapy in women with breast cancer
Show others...
2024 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 14, no 1, article id 4149Article in journal (Refereed) Published
Abstract [en]

Postmastectomy radiotherapy (PMRT) increases the risk for complications after breast reconstruction. The pathophysiological mechanism underlying this increased risk is not completely understood. The aim of this study was to examine if there is a relationship between PMRT and microvascular perfusion in the skin directly after, and at 2 and 6 months after PMRT and to assess if there is impaired responsiveness to a topically applied vasodilator (Methyl nicotinate-MN) after PMRT. Skin microvascular responses after PMRT were measured on two sites in the irradiated chest wall of 22 women before, immediately after, and at 2 and 6 months after unilateral PMRT with the contralateral breast as a control. A significant increase in basal skin perfusion was observed in the irradiated chest wall immediately after RT (p < 0.0001). At 2 and 6 months after RT, there was no longer a difference in basal skin perfusion compared to the contralateral breast and compared to baseline. Similarly, the blood flow response in the skin after application of MN was stronger immediately after RT compared to before RT (p < 0.0001), but there was no difference at later time points. These results indicate that the increased risk for complications after surgical procedures are not directly related to changes in skin perfusion and microvascular responsiveness observed after postmastectomy RT.

Place, publisher, year, edition, pages
Nature Publishing Group, 2024
National Category
Cancer and Oncology Surgery
Identifiers
urn:nbn:se:liu:diva-201656 (URN)10.1038/s41598-024-54650-4 (DOI)001173675500030 ()38378732 (PubMedID)2-s2.0-85185473058 (Scopus ID)
Note

Funding: Linköping University

Available from: 2024-03-17 Created: 2024-03-17 Last updated: 2024-04-29Bibliographically approved
Elawa, S., Fredriksson, I., Steinvall, I., Zötterman, J., Farnebo, S. & Droog Tesselaar, E. (2024). Skin perfusion and oxygen saturation after mastectomy and radiation therapy in breast cancer patients. Breast, 75, Article ID 103704.
Open this publication in new window or tab >>Skin perfusion and oxygen saturation after mastectomy and radiation therapy in breast cancer patients
Show others...
2024 (English)In: Breast, ISSN 0960-9776, E-ISSN 1532-3080, Vol. 75, article id 103704Article in journal (Refereed) Epub ahead of print
Abstract [en]

The pathophysiological mechanism behind complications associated with postmastectomy radiotherapy (PMRT) and subsequent implant-based breast reconstruction are not completely understood. The aim of this study was to examine if there is a relationship between PMRT and microvascular perfusion and saturation in the skin after mastectomy and assess if there is impaired responsiveness to a topically applied vasodilator (Methyl nicotinate - MN). Skin microvascular perfusion and oxygenation >2 years after PMRT were measured using white light diffuse reflectance spectroscopy (DRS) and laser Doppler flowmetry (LDF) in the irradiated chest wall of 31 women with the contralateral breast as a control. In the non-irradiated breast, the perfusion after application of MN (median 0.84, 25th-75th centile 0.59-1.02 % RBC × mm/s) was higher compared to the irradiated chest wall (median 0.51, 25th-75th centile 0.21-0.68 % RBC × mm/s, p < 0.001). The same phenomenon was noted for saturation (median 91 %, 25th-75th centile 89-94 % compared to 89 % 25th-75th centile 77-93 %, p = 0.001). Eight of the women (26%) had a ≥10 % difference in skin oxygenation between the non-irradiated breast and the irradiated chest wall. These results indicate that late microvascular changes caused by radiotherapy of the chest wall significantly affect skin perfusion and oxygenation.

Place, publisher, year, edition, pages
Elsevier, 2024
National Category
Cancer and Oncology Surgery
Identifiers
urn:nbn:se:liu:diva-201655 (URN)10.1016/j.breast.2024.103704 (DOI)001216488000001 ()38460441 (PubMedID)2-s2.0-85186992326 (Scopus ID)
Available from: 2024-03-17 Created: 2024-03-17 Last updated: 2024-05-22Bibliographically approved
Moloney, M., Farnebo, S. & Adolfsson, L. (2023). Distal ulna fractures in adults - subcapitular, transverse fractures did not benefit from surgical treatment. Archives of Orthopaedic and Trauma Surgery, 143(1), 381-387
Open this publication in new window or tab >>Distal ulna fractures in adults - subcapitular, transverse fractures did not benefit from surgical treatment
2023 (English)In: Archives of Orthopaedic and Trauma Surgery, ISSN 0936-8051, E-ISSN 1434-3916, Vol. 143, no 1, p. 381-387Article in journal (Refereed) Published
Abstract [en]

Introduction Fractures of the distal ulna, excluding the styloid, are rare. The cause of injury is often a fall on an outstretched hand with an extended wrist, and in most cases there is a concomitant distal radius fracture. The aims of this retrospective study were to investigate the results of the current treatment of distal ulna fractures in adults, with or without a concomitant distal radius fracture, and if a recently presented fracture classification could predict outcome. Materials and methods Patients, 18 years or older, treated for a fracture of the distal third of ulna in our county, were included. Fractures of the styloid tip were excluded. The radiographs of the fractures were independently classified by two specialists in radiology according to the 2018 AO/OTA classification. Follow-up was performed 5-7 years after the injury, through the questionnaire Patient-Rated Wrist Evaluation (PRWE) and new radiographs of both wrists. Results Ninety-six patients with 97 fractures were included and filled out the PRWE. 65 patients also had new radiographs taken. 79 patients were women and the mean age at the time of injury was 63 years (SD 14.5). The most common fracture class was the extra-articular transverse fracture, 2U3A2.3 (42%). We found that 40% of the fractures had been treated by internal fixation and only 2 fractures had not healed, one conservatively treated and one operated. The median PRWE was 15 (IQR 33.5). The PRWE score was significantly worse in the operated ulna fractures (p = 0.01) and this was also true for extra-articular transverse fractures 2U3A2.3 (p = 0.001). Initial displacement was more common in operated transverse fractures, but it could not be proven that this was the reason for the inferior result. Conclusions Distal ulna fractures almost always unite and the result is comparable to that of isolated distal radius fractures when measured by PRWE. Based on the opinions of the radiologists and how often a consensus discussion was needed for classification, we found the updated AO classification system difficult to use, if dependent only on standard radiographic views. In the present study, transverse extra-articular ulna fractures did not benefit from internal fixation regardless if associated with a distal radius fracture or isolated.

Place, publisher, year, edition, pages
Springer, 2023
Keywords
AO, DRUJ, Fracture, PRWE, Distal ulna, Wrist
National Category
Orthopaedics
Identifiers
urn:nbn:se:liu:diva-182625 (URN)10.1007/s00402-022-04336-1 (DOI)000745532900004 ()35064293 (PubMedID)2-s2.0-85123386397 (Scopus ID)
Note

Funding Agencies: Linköping University

Available from: 2022-02-01 Created: 2022-02-01 Last updated: 2024-01-10Bibliographically approved
Wolff, A. L., Kwasnicki, R. M., Farnebo, S. & Horwitz, M. D. (2023). Dynamic assessment of the upper extremity: a review of available and emerging technologies. Journal of Hand Surgery, European Volume, 48(5), 404-411
Open this publication in new window or tab >>Dynamic assessment of the upper extremity: a review of available and emerging technologies
2023 (English)In: Journal of Hand Surgery, European Volume, ISSN 1753-1934, E-ISSN 2043-6289, Vol. 48, no 5, p. 404-411Article, review/survey (Refereed) Published
Abstract [en]

The purpose of this review article is to provide an update on the realm of emerging technology available for the assessment of dynamic functional movement of the hand and upper limb. A critical overview of the literature and a conceptual framework for use of such technologies is proposed. The framework explores three broad purpose categories including customization of care, functional surveillance and interventions through biofeedback strategies. State-of-the-art technologies are described, from basic activity monitors to feedback-enabled robotic gloves, along with exemplar trials and clinical applications. The future of technologies innovation in hand pathology is proposed in the context of the current obstacles and opportunities for hand surgeons and therapists.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD, 2023
Keywords
Hand therapy; wearable technology; motion capture; inertial sensors; real-world activity
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-192314 (URN)10.1177/17531934231153559 (DOI)000935980600001 ()36803302 (PubMedID)
Available from: 2023-03-14 Created: 2023-03-14 Last updated: 2024-03-12Bibliographically approved
Miller, R., Farnebo, S. & Horwitz, M. D. (2023). Insights and trends review: artificial intelligence in hand surgery. Journal of Hand Surgery, European Volume, 48(5), 396-403
Open this publication in new window or tab >>Insights and trends review: artificial intelligence in hand surgery
2023 (English)In: Journal of Hand Surgery, European Volume, ISSN 1753-1934, E-ISSN 2043-6289, Vol. 48, no 5, p. 396-403Article, review/survey (Refereed) Published
Abstract [en]

Artificial intelligence (AI) in hand surgery is an emerging and evolving field that will likely play a large role in the future care of our patients. However, there remain several challenges to makes this technology meaningful, acceptable and usable at scale. In this review article, we discuss basic concepts in AI, including challenges and key considerations, provide an update on how AI is being used in hand and wrist surgery and propose potential future applications. The aims are to equip clinicians and researchers with the basic knowledge needed to understand and explore the incorporation of AI in hand surgery within their own practice and recommends further reading to develop knowledge in this emerging field.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD, 2023
Keywords
Artificial intelligence; hand surgery; machine learning; deep learning
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-192320 (URN)10.1177/17531934231152592 (DOI)000930654100001 ()36756841 (PubMedID)
Available from: 2023-03-14 Created: 2023-03-14 Last updated: 2024-03-07
Booij, R., Sandstedt, M., Droog Tesselaar, E. & Farnebo, S. (2023). Photon-counting detector computed tomography (PCD-CT) – an emerging technology in hand and wrist imaging. Journal of Hand Surgery, European Volume, 48(5), 489-494
Open this publication in new window or tab >>Photon-counting detector computed tomography (PCD-CT) – an emerging technology in hand and wrist imaging
2023 (English)In: Journal of Hand Surgery, European Volume, ISSN 1753-1934, E-ISSN 2043-6289, Vol. 48, no 5, p. 489-494Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD, 2023
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:liu:diva-190072 (URN)10.1177/17531934221132692 (DOI)000878342500001 ()36324209 (PubMedID)
Available from: 2022-11-21 Created: 2022-11-21 Last updated: 2024-02-09Bibliographically approved
Moloney, M., Kåredal, J., Persson, T., Farnebo, S. & Adolfsson, L. (2022). Poor reliability and reproducibility of 3 different radiographical classification systems for distal ulna fractures. Acta Orthopaedica, 93, 438-443
Open this publication in new window or tab >>Poor reliability and reproducibility of 3 different radiographical classification systems for distal ulna fractures
Show others...
2022 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 93, p. 438-443Article in journal (Refereed) Published
Abstract [en]

Background and purpose - Classification of fractures can be valuable for research purposes but also in clinical work. Especially with rare fractures, such as distal ulna fractures, a treatment algorithm based on a classification can be helpful. We compared 3 different classification systems of distal ulna fractures and investigated their reliability and reproducibility. Patients and methods - patients with 97 fractures of the distal ulna, excluding the ulnar styloid, were included. All fractures were independently classified by 3 observers according to the classification by Biyani, AO/OTA 2007, and AO/OTA 2018. The classification process was repeated after a minimum of 3 weeks. We used Kappa value analysis to determine inter- and intra-rater agreement.

Results - The inter-rater agreement of the AO/OTA 2007 classification was judged as fair,. 0.40, whereas the agreement of AO/OTA 2018 and Biyani was moderate at. 0.42 and 0.43 respectively. The intra-rater agreement was judged as moderate for all classifications. Interpretation - The differences between the classifications were small and the overall impression was that neither of them was good enough to be of substantial clinical value. The Biyani classification, being developed specifically for distal ulna fractures, was the easiest and most fitting for the fracture patterns seen in our material, but lacking options for fractures of the distal diaphysis. Standard radiographs were considered insufficient for an accurate classification. A better radiographic method combined with a revised classification might improve accuracy, reliability, and reproducibility.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Classification, Fractures, Radiological imaging, Ulna, Wrist
National Category
Orthopaedics
Identifiers
urn:nbn:se:liu:diva-185054 (URN)10.2340/17453674.2022.2509 (DOI)000790823500066 ()35438183 (PubMedID)
Available from: 2022-05-19 Created: 2022-05-19 Last updated: 2024-01-10Bibliographically approved
Högstedt, A., Farnebo, S., Tesselaar, E. & Ghafouri, B. (2021). Investigation of proteins important for microcirculation using in vivo microdialysis after glucose provocation: a proteomic study. Scientific Reports, 11(1), Article ID 19093.
Open this publication in new window or tab >>Investigation of proteins important for microcirculation using in vivo microdialysis after glucose provocation: a proteomic study
2021 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 19093Article in journal (Refereed) Published
Abstract [en]

Insulin has metabolic and vascular effects in the human body. What mechanisms that orchestrate the effects in the microcirculation, and how the responds differ in different tissues, is however not fully understood. It is therefore of interest to search for markers in microdialysate that may be related to the microcirculation. This study aims to identify proteins related to microvascular changes in different tissue compartments after glucose provocation using in vivo microdialysis. Microdialysis was conducted in three different tissue compartments (intracutaneous, subcutaneous and intravenous) from healthy subjects. Microdialysate was collected during three time periods; recovery after catheter insertion, baseline and glucose provocation, and analyzed using proteomics. Altogether, 126 proteins were detected. Multivariate data analysis showed that the differences in protein expression levels during the three time periods, including comparison before and after glucose provocation, were most pronounced in the intracutaneous and subcutaneous compartments. Four proteins with vascular effects were identified (angiotensinogen, kininogen-1, alpha-2-HS-glycoprotein and hemoglobin subunit beta), all upregulated after glucose provocation compared to baseline in all three compartments. Glucose provocation is known to cause insulin-induced vasodilation through the nitric oxide pathway, and this study indicates that this is facilitated through the interactions of the RAS (angiotensinogen) and kallikrein-kinin (kininogen-1) systems.

Place, publisher, year, edition, pages
NATURE PORTFOLIO, 2021
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-180545 (URN)10.1038/s41598-021-98672-8 (DOI)000700619200012 ()34580391 (PubMedID)
Note

Funding agencies: Linkoping University; ALF grants, Region Ostergotland, Linkoping

Available from: 2021-10-25 Created: 2021-10-25 Last updated: 2024-01-10Bibliographically approved
Moloney, M., Farnebo, S. & Adolfsson, L. (2020). Incidence of distal ulna fractures in a Swedish county: 74/100,000 person-years, most of them treated non-operatively. Acta Orthopaedica, 91(1), 104-108
Open this publication in new window or tab >>Incidence of distal ulna fractures in a Swedish county: 74/100,000 person-years, most of them treated non-operatively
2020 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 91, no 1, p. 104-108Article in journal (Refereed) Published
Abstract [en]

Background and purpose - Fractures of the distal ulna can occur in isolation or in conjunction with a distal radius fracture. They may result in incongruence and instability of the distal radioulnar joint. We investigated the incidence of distal ulna fractures, whether any fracture types were more common, and the methods of treatment used. Patients and methods - Data were collected from patients 18 years or older, treated for a fracture of the distal ulna in ostergotland, Sweden, during 2010-2012. Patients were identified in the patient registry. The fractures were classified according to the AO comprehensive classification of fractures. Results - The incidence of distal ulna fractures was 74/100,000 person-years. The most common fracture type was that of the ulnar styloid Q1 (79%), followed by the ulnar neck Q2 (11%). Rarest was ulna head fracture, type Q4 (1%). Incidental findings were a mean age of 63 years (SD 18), a concomitant distal radius fracture in 92% of the patients and that 79% were caused by falling from standing height. Internal fixation was performed in 30% of the Q2-Q6 fractures. This indicates that most were considered stable without internal fixation or stable after fixation of a concomitant radius fracture. Interpretation - Our results show that fractures of the distal ulna are not very common, and some fracture types are even rare. There seem to be no consensus on treatment.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2020
National Category
Orthopaedics
Identifiers
urn:nbn:se:liu:diva-162051 (URN)10.1080/17453674.2019.1686570 (DOI)000493871300001 ()31680591 (PubMedID)
Available from: 2019-11-19 Created: 2019-11-19 Last updated: 2024-01-10
Zötterman, J., Opsomer, D., Farnebo, S., Blondeel, P., Monstrey, S. & Tesselaar, E. (2020). Intraoperative Laser Speckle Contrast Imaging in DIEP Breast Reconstruction: A Prospective Case Series Study. Plastic and Reconstructive Surgery - Global Open, 8(1), e2529-e2529
Open this publication in new window or tab >>Intraoperative Laser Speckle Contrast Imaging in DIEP Breast Reconstruction: A Prospective Case Series Study
Show others...
2020 (English)In: Plastic and Reconstructive Surgery - Global Open, E-ISSN 2169-7574, Vol. 8, no 1, p. e2529-e2529Article in journal (Refereed) Published
Abstract [en]

Laser speckle contrast imaging (LSCI) is a laser-based perfusion imaging technique that recently has been shown to predict ischemic necrosis in an experimental flap model and predicting healing time of scald burns. The aims were to investigate perfusion in relation to the selected perforator during deep inferior epigastric artery perforator (DIEP) flap surgery, and to evaluate LSCI in assisting of prediction of postoperative complications. METHODS: Twenty-three patients who underwent DIEP-procedures for breast reconstruction at 2 centers were included. Perfusion was measured in 4 zones at baseline, after raising, after anastomosis, and after shaping the flap. The perfusion in relation to the selected perforator and the accuracy of LSCI in predicting complications were analyzed. RESULTS: After raising the flap, zone I showed the highest perfusion (65 ± 10 perfusion units, PU), followed by zone II (58 ± 12 PU), zone III (53 ± 10 PU), and zone IV (45 ± 10 PU). The perfusion in zone I was higher than zone III (P = 0.002) and zone IV (P < 0.001). After anastomosis, zone IV had lower perfusion than zone I (P < 0.001), zone II (P = 0.01), and zone III (P = 0.02). Flaps with areas <30 PU after surgery had partial necrosis postoperatively (n = 4). CONCLUSIONS: Perfusion is highest in zone I. No perfusion difference was found between zones II and III. Perfusion <30 PU after surgery was correlated with partial necrosis. LSCI is a promising tool for measurement of flap perfusion and assessment of risk of postoperative ischemic complications.

Place, publisher, year, edition, pages
Wolters Kluwer, 2020
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-164324 (URN)10.1097/GOX.0000000000002529 (DOI)000528608600005 ()32095386 (PubMedID)
Available from: 2020-03-17 Created: 2020-03-17 Last updated: 2024-01-17Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4997-6835

Search in DiVA

Show all publications