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Olsson A, Malmberg C, Zhao C, Friberg LE, Nielsen EI, Lagerbäck P, Tängdén T. Synergy of polymyxin B and minocycline against KPC-3- and OXA-48-producing Klebsiella pneumoniae in dynamic time-kill experiments: agreement with in silico predictions. J Antimicrob Chemother 2024; 79:391-402. [PMID: 38158772 PMCID: PMC10832586 DOI: 10.1093/jac/dkad394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES Combination therapy is often used for carbapenem-resistant Gram-negative bacteria. We previously demonstrated synergy of polymyxin B and minocycline against carbapenem-resistant Klebsiella pneumoniae in static time-kill experiments and developed an in silico pharmacokinetic/pharmacodynamic (PK/PD) model. The present study assessed the synergistic potential of this antibiotic combination in dynamic experiments. METHODS Two clinical K. pneumoniae isolates producing KPC-3 and OXA-48 (polymyxin B MICs 0.5 and 8 mg/L, and minocycline MICs 1 and 8 mg/L, respectively) were included. Activities of the single drugs and the combination were assessed in 72 h dynamic time-kill experiments mimicking patient pharmacokinetics. Population analysis was performed every 12 h using plates containing antibiotics at 4× and 8× MIC. WGS was applied to reveal resistance genes and mutations. RESULTS The combination showed synergistic and bactericidal effects against the KPC-3-producing strain from 12 h onwards. Subpopulations with decreased susceptibility to polymyxin B were frequently detected after single-drug exposures but not with the combination. Against the OXA-48-producing strain, synergy was observed between 4 and 8 h and was followed by regrowth. Subpopulations with decreased susceptibility to polymyxin B and minocycline were detected throughout experiments. For both strains, the observed antibacterial activities showed overall agreement with the in silico predictions. CONCLUSIONS Polymyxin B and minocycline in combination showed synergistic effects, mainly against the KPC-3-producing K. pneumoniae. The agreement between the experimental results and in silico predictions supports the use of PK/PD models based on static time-kill data to predict the activity of antibiotic combinations at dynamic drug concentrations.
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Affiliation(s)
- Anna Olsson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Chenyan Zhao
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Lena E Friberg
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | | | | | - Thomas Tängdén
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Liu Y, Olsson A, Larva T, Cantwell-Jones A, Gill RJ, Cederberg B, Webster MT. Genomic variation in montane bumblebees in Scandinavia: High levels of intraspecific diversity despite population vulnerability. Mol Ecol 2024; 33:e17251. [PMID: 38112228 DOI: 10.1111/mec.17251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/24/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023]
Abstract
Populations of many bumblebee species are declining, with distributions shifting northwards to track suitable climates. Climate change is considered a major contributing factor. Arctic species are particularly vulnerable as they cannot shift further north, making assessment of their population viability important. Analysis of levels of whole-genome variation is a powerful way to analyse population declines and fragmentation. Here, we use genome sequencing to analyse genetic variation in seven species of bumblebee from the Scandinavian mountains, including two classified as vulnerable. We sequenced 333 samples from across the ranges of these species in Sweden. Estimates of effective population size (NE ) vary from ~55,000 for species with restricted high alpine distributions to 220,000 for more widespread species. Population fragmentation is generally very low or undetectable over large distances in the mountains, suggesting an absence of barriers to gene flow. The relatively high NE and low population structure indicate that none of the species are at immediate risk of negative genetic effects caused by high levels of genetic drift. However, reconstruction of historical fluctuations in NE indicates that the arctic specialist species Bombus hyperboreus has experienced population declines since the last ice age and we detected one highly inbred diploid male of this species close to the southern limit of its range, potentially indicating elevated genetic load. Although the levels of genetic variation in montane bumblebee populations are currently relatively high, their ranges are predicted to shrink drastically due to the effects of climate change and monitoring is essential to detect future population declines.
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Affiliation(s)
- Yuanzhen Liu
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Anna Olsson
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Tuuli Larva
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Aoife Cantwell-Jones
- Department of Life Sciences, Georgina Mace Centre for The Living Planet, Imperial College London, Ascot, UK
| | - Richard J Gill
- Department of Life Sciences, Georgina Mace Centre for The Living Planet, Imperial College London, Ascot, UK
| | - Björn Cederberg
- Swedish University of Agricultural Sciences, Swedish Species Information Centre, Uppsala, Sweden
| | - Matthew T Webster
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
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Tornling G, Edenius C, Pauling JD, Denton CP, Olsson A, Kowalski J, Murray A, Anderson M, Bhat S, Del Galdo F, Hall F, Korkosz M, Krasowska D, Olas J, Smith V, van Laar JM, Vonk MC, Wojteczek A, Herrick AL. A phase 2 trial investigating the efficacy and safety of the mPGES-1 inhibitor vipoglanstat in systemic sclerosis-related Raynaud's. Rheumatology (Oxford) 2024:keae049. [PMID: 38291895 DOI: 10.1093/rheumatology/keae049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/19/2023] [Accepted: 01/11/2024] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVE Our objective was to test the hypothesis, in a double-blind, placebo-controlled study that vipoglanstat, an inhibitor of microsomal prostaglandin E synthase-1 (mPGES-1) which decreases prostaglandin E2 (PGE2) and increases prostacyclin biosynthesis, improves RP. METHODS Patients with systemic sclerosis (SSc) and ≥7 RP attacks during the last screening week prior to a baseline visit were randomised to four weeks treatment with vipoglanstat 120 mg or placebo. A daily electronic diary captured RP attacks (duration and pain) and Raynaud's Condition Score, with change in RP attacks/week as primary end point. Cold challenge assessments were performed at baseline and end of treatment. Exploratory endpoints included patients' and physicians' global impression of change, Assessment of Scleroderma-associated Raynaud's Phenomenon questionnaire, mPGES-1 activity, and urinary excretion of arachidonic acid metabolites. RESULTS Sixty-nine subjects received vipoglanstat (n = 33) or placebo (n = 36). Mean weekly number of RP attacks (baseline; vipoglanstat 14.4[SD 6.7], placebo 18.2[12.6]) decreased by 3.4[95% CI -5.8;-1.0] and 4.2[-6.5;-2.0] attacks per week (p= 0.628) respectively. All patient reported outcomes improved, with no difference between the groups. Mean change in recovery of peripheral blood flow after cold challenge did not differ between the study groups. Vipoglanstat fully inhibited mPGES-1, resulting in 57% reduction of PGE2 and 50% increase of prostacyclin metabolites in urine. Vipoglanstat was safe and well tolerated. CONCLUSION Although vipoglanstat was safe, and well tolerated in a dose achieving full inhibition of mPGES-1, it was ineffective in SSc-related RP. Further development and evaluation of vipoglanstat will therefore be in other diseases where mPGES-1 plays a pathogenetic role.
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Affiliation(s)
- Göran Tornling
- Respiratory Medicine Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Gesynta Pharma AB, Stockholm, Sweden
| | - Charlotte Edenius
- Gesynta Pharma AB, Stockholm, Sweden
- Rheumatology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - John D Pauling
- Department of Rheumatology, North Bristol NHS Trust, Bristol, UK
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Royal National Hospital for Rheumatic Diseases (part of the Royal United Hospitals NHS Foundation Trust), Bath, UK
| | - Christopher P Denton
- Centre for Rheumatology, Royal Free Hospital and University College London, London, UK
| | | | | | - Andrea Murray
- Centre for Musculoskeletal Research, The University of Manchester, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Marina Anderson
- Aintree University Hospital, Liverpool University Hospitals NHS Trust, Liverpool, UK
- Lancaster Medical School, Lancaster University, Lancaster
| | - Smita Bhat
- Ninewells Hospital and Medical School, Dundee, UK
| | - Francesco Del Galdo
- Leeds Institute of Rheumatology & Musculoskeletal Medicine, and NIHR Leeds Biomedical Research Centre University of Leeds, Leeds, UK
| | - Frances Hall
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Mariusz Korkosz
- Centrum Medyczne Pratia MCM Krakow, Krakow, Poland
- Jagiellonian University Medical College, Krakow, Poland
| | - Dorota Krasowska
- Department of Dermatology, Venereology and Pediatric Dermatology Medical, University of Lublin, Poland
| | - Jacek Olas
- Małopolskie Centrum Kliniczne, Kraków, Poland
| | - Vanessa Smith
- Department of Internal Medicine, Ghent University, Ghent, Belgium; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent, Belgium
| | | | - Madelon C Vonk
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anna Wojteczek
- Early Phase Clinical Trials Centre, Medical University of Gdańsk, Gdańsk, Poland
- Department of Rheumatology, Clinical Immunology, Geriatrics and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Ariane L Herrick
- Centre for Musculoskeletal Research, The University of Manchester, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Måseide RJ, Berntorp E, Astermark J, Olsson A, Bruzelius M, Frisk T, Nummi V, Lassila R, Tjønnfjord GE, Holme PA. Health-related quality of life and physical activity in Nordic patients with moderate haemophilia A and B (the MoHem study). Haemophilia 2024; 30:98-105. [PMID: 37983883 DOI: 10.1111/hae.14899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/12/2023] [Accepted: 11/04/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION The impact of moderate haemophilia on health-related quality of life (HRQoL) and physical activity (PA) is not well known. In previous studies, persons with factor VIII/factor IX activity (FVIII/FIX:C) below 3 IU/dL were associated with a more severe bleeding phenotype than predicted. AIM To explore HRQoL and PA in patients with moderate haemophilia A (MHA) and B (MHB). METHODS A cross-sectional, multicentre study covering patients with MHA and MHB in Sweden, Finland, and Norway. HRQoL was assessed with the EuroQoL 5-Dimensions (EQ-5D) form and PA with the International Physical Activity Questionnaire among participants aged ≥15 years. RESULTS We report on 104 patients aged 15-84 years from the MoHem study. Overall, EQ-5D utility was .85 (median) (Q1-Q3 0.73-1.0) with corresponding visual analogue scale (VAS) 80 (70-90), which were similar regardless of treatment modality, FVIII/FIX:C, and MHA or MHB. Pain and mobility were most frequently affected dimensions. Utility (r = -.54), VAS (r = -.42), and PA (r = -.32) correlated negatively with arthropathy (HJHS). Only patients aged 41-50 years displayed lower utility (p = .02) and VAS (p < .01) than the Norwegian population norm. Patients on prophylaxis aged 35-54 years reported higher PA than those treated on-demand (p = .01). CONCLUSION Haemophilic arthropathy had negative impact on HRQoL and PA in Nordic patients with moderate haemophilia. Middle-aged patients captured lower utility and VAS than observed in the general population. Tailored prophylaxis and improved joint health may influence positively on HRQoL and PA also in moderate haemophilia.
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Affiliation(s)
- Ragnhild J Måseide
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erik Berntorp
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Jan Astermark
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Haematology, Skåne University Hospital, Malmö, Sweden
| | - Anna Olsson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria Bruzelius
- Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Department of Haematology, Karolinska University Hospital, Stockholm, Sweden
| | - Tony Frisk
- Pediatric Coagulation, Karolinska University Hospital, Stockholm, Sweden
| | - Vuokko Nummi
- Coagulation Disorders Unit, Haematology, Comprehensive Cancer Centre, Helsinki University Hospital and Research Program in Systems Oncology, Faculty of Medicine, Helsinki University, Helsinki, Finland
| | - Riitta Lassila
- Coagulation Disorders Unit, Haematology, Comprehensive Cancer Centre, Helsinki University Hospital and Research Program in Systems Oncology, Faculty of Medicine, Helsinki University, Helsinki, Finland
| | - Geir E Tjønnfjord
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pål A Holme
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Kromann B, Olsson A, Zhang YM, Løvendorf MB, Skov L, Dyring-Andersen B. Proteins in the Skin and Blood in Patients with Psoriasis: A Systematic Review of Proteomic Studies. Dermatology 2023; 240:317-328. [PMID: 37935159 DOI: 10.1159/000533981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/31/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Proteins play a central role in psoriasis as they are involved in the structural phenotypic changes and inflammation that characterize the disease. This systematic review aimed to assess which proteins have been consistently reported as upregulated or downregulated in the skin and blood from patients with psoriasis. METHODS We included proteomic studies reporting differentially expressed proteins (DEPs) in at least one of four predefined comparisons using a standardized procedure to extract and align data. Network analysis of functional protein associations was made with StringApp in Cytoscape. A protocol for this review was registered in the PROSPERO database (ref:CRD42022363226). RESULTS We identified and assessed 772 studies published between December 2, 1996, and April 28, 2023, among which 30 studies met the inclusion and data availability criteria for analysis that together reported a sum of 5,314 DEPs. The majority of consistently reported upregulated and downregulated proteins were found in lesional versus non-lesional skin (n = 313), followed by lesional versus healthy skin (n = 185), blood from patients with psoriasis versus blood from healthy individuals (n = 140), and non-lesional versus healthy skin (n = 1). Network analysis of upregulated proteins revealed different functional clusters with interleukin (IL)-6, IL-8, IL-17A, C-C motif chemokine (CCL) 20, signal transducer and activator of transcription (STAT) 3, and interferon (IFN)-γ along with less well-studied proteins playing central roles. Some of the reported changes are associated with anti-inflammatory effects. Additionally, the proteomic dysregulation also included antimicrobial peptides, alarmins, angiogenic factors, and proteins related to protein synthesis. CONCLUSION Our findings generally support current understandings of the pathological mechanisms in psoriasis. Importantly, some consistent findings have not been discussed before and deserve attention in future research.
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Affiliation(s)
- Bjørn Kromann
- Department of Dermatology and Allergy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Anna Olsson
- Department of Dermatology and Allergy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Ying Marlene Zhang
- Department of Dermatology and Allergy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Marianne Bengtson Løvendorf
- Department of Dermatology and Allergy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
- Leo Foundation Skin Immunology Research Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Beatrice Dyring-Andersen
- Department of Dermatology and Allergy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
- Leo Foundation Skin Immunology Research Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation (NNF) Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Olsson A, Allander L, Shams A, Al-Farsi H, Lagerbäck P, Tängdén T. Activity of polymyxin B combinations against genetically well-characterised Klebsiella pneumoniae producing NDM-1 and OXA-48-like carbapenemases. Int J Antimicrob Agents 2023; 62:106967. [PMID: 37716575 DOI: 10.1016/j.ijantimicag.2023.106967] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 09/01/2023] [Accepted: 09/09/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Combination therapy can enhance the activity of available antibiotics against multidrug-resistant Gram-negative bacteria. This study assessed the effects of polymyxin B combinations against carbapenemase-producing Klebsiella pneumoniae (K. pneumoniae). METHODS Twenty clinical K. pneumoniae strains producing NDM-1 (n = 8), OXA-48-like (n = 10), or both NDM-1 and OXA-48-like (n = 2) carbapenemases were used. Whole-genome sequencing was applied to detect resistance genes (e.g. encoding antibiotic-degrading enzymes) and sequence alterations influencing permeability or efflux. The activity of polymyxin B in combination with aztreonam, fosfomycin, meropenem, minocycline, or rifampicin was investigated in 24-hour time-lapse microscopy experiments. Endpoint samples were spotted on plates with and without polymyxin B at 4 x MIC to assess resistance development. Finally, associations between synergy and bacterial genetic traits were explored. RESULTS Synergistic and bactericidal effects were observed with polymyxin B in combination with all other antibiotics: aztreonam (11 of 20 strains), fosfomycin (16 of 20), meropenem (10 of 20), minocycline (18 of 20), and rifampicin (15 of 20). Synergy was found with polymyxin B in combination with fosfomycin, minocycline, or rifampicin against all nine polymyxin-resistant strains. Wildtype mgrB was associated with polymyxin B and aztreonam synergy (P = 0.0499). An absence of arr-2 and arr-3 was associated with synergy of polymyxin B and rifampicin (P = 0.0260). Emergence of populations with reduced polymyxin B susceptibility was most frequently observed with aztreonam and meropenem. CONCLUSION Combinations of polymyxin B and minocycline or rifampicin were most active against the tested NDM-1 and OXA-48-like-producing K. pneumoniae. Biologically plausible genotype-phenotype associations were found. Such information might accelerate the search for promising combinations and guide individualised treatment.
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Affiliation(s)
- Anna Olsson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Lisa Allander
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ayda Shams
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Hissa Al-Farsi
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institute, Stockholm, Sweden
| | | | - Thomas Tängdén
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
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Gustavsen S, Olsson A, Oturai AB, Linnet K, Thomsen R, Rasmussen BS, Jørgensen CF, Langkilde AR, Sorensen PS, Sellebjerg F, Søndergaard HB. The peripheral endocannabinoid system and its association with biomarkers of inflammation in untreated patients with multiple sclerosis. Eur J Neurol 2023; 30:3212-3220. [PMID: 37337838 DOI: 10.1111/ene.15930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/11/2023] [Accepted: 06/12/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND AND PURPOSE The endocannabinoid system (ECS) has been found altered in patients with multiple sclerosis (MS). However, whether the ECS alteration is present in the early stage of MS remains unknown. First, we aimed to compare the ECS profile between newly diagnosed MS patients and healthy controls (HCs). Next, we explored the association of the ECS, biomarkers of inflammation, and clinical parameters in newly diagnosed MS patients. METHODS Whole blood gene expression of ECS components and levels of endocannabinoids in plasma were measured by real-time quantitative polymerase chain reaction and ultra-high-pressure liquid chromatography-mass spectrometry, respectively, in 66 untreated MS patients and 46 HCs. RESULTS No differences were found in the gene expression or plasma levels of the selected ECS components between newly diagnosed MS patients and HCs. Interferon-γ, encoded by the gene IFNG, correlated positively (ρ = 0.60) with the expression of G protein-coupled receptor 55 (GPR55), and interleukin1β (IL1B) correlated negatively (ρ = -0.50) with cannabinoid receptor 2 (CNR2) in HCs. CONCLUSIONS We found no alteration in the peripheral ECS between untreated patients with MS and HC. Furthermore, our results indicate that the ECS has a minor overall involvement in the early stage of MS on inflammatory markers and clinical parameters when compared with HCs.
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Affiliation(s)
- Stefan Gustavsen
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - Anna Olsson
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - Annette B Oturai
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - Kristian Linnet
- Department of Forensic Medicine, Section of Forensic Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ragnar Thomsen
- Department of Forensic Medicine, Section of Forensic Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Brian S Rasmussen
- Department of Forensic Medicine, Section of Forensic Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian F Jørgensen
- Department of Forensic Medicine, Section of Forensic Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Annika R Langkilde
- Department of Radiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Per S Sorensen
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Finn Sellebjerg
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Helle B Søndergaard
- Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
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Everitt T, Wallberg A, Christmas MJ, Olsson A, Hoffmann W, Neumann P, Webster MT. The Genomic Basis of Adaptation to High Elevations in Africanized Honey Bees. Genome Biol Evol 2023; 15:evad157. [PMID: 37625795 PMCID: PMC10484329 DOI: 10.1093/gbe/evad157] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
A range of different genetic architectures underpin local adaptation in nature. Honey bees (Apis mellifera) in the Eastern African Mountains harbor high frequencies of two chromosomal inversions that likely govern adaptation to this high-elevation habitat. In the Americas, honey bees are hybrids of European and African ancestries and adaptation to latitudinal variation in climate correlates with the proportion of these ancestries across the genome. It is unknown which, if either, of these forms of genetic variation governs adaptation in honey bees living at high elevations in the Americas. Here, we performed whole-genome sequencing of 29 honey bees from both high- and low-elevation populations in Colombia. Analysis of genetic ancestry indicated that both populations were predominantly of African ancestry, but the East African inversions were not detected. However, individuals in the higher elevation population had significantly higher proportions of European ancestry, likely reflecting local adaptation. Several genomic regions exhibited particularly high differentiation between highland and lowland bees, containing candidate loci for local adaptation. Genes that were highly differentiated between highland and lowland populations were enriched for functions related to reproduction and sperm competition. Furthermore, variation in levels of European ancestry across the genome was correlated between populations of honey bees in the highland population and populations at higher latitudes in South America. The results are consistent with the hypothesis that adaptation to both latitude and elevation in these hybrid honey bees are mediated by variation in ancestry at many loci across the genome.
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Affiliation(s)
- Turid Everitt
- Department Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Andreas Wallberg
- Department Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Matthew J Christmas
- Department Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Anna Olsson
- Department Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Wolfgang Hoffmann
- Grupo de Biocalorimetría, Universidad de Pamplona, Pamplona, Colombia
| | - Peter Neumann
- Institute of Bee Health, Vetsuisse Faculty, University of Bern and Agroscope, Bern, Switzerland
| | - Matthew T Webster
- Department Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
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Hansen JS, Gustavsen S, Roshanisefat H, Kant M, Biering-Sørensen F, Andersen C, Olsson A, Chow HH, Asgari N, Hansen JR, Nielsen HH, Hansen RM, Petersen T, Oturai AB, Sellebjerg F, Sædder EA, Kasch H, Rasmussen PV, Finnerup NB, Svendsen KB. Cannabis-Based Medicine for Neuropathic Pain and Spasticity-A Multicenter, Randomized, Double-Blinded, Placebo-Controlled Trial. Pharmaceuticals (Basel) 2023; 16:1079. [PMID: 37630995 PMCID: PMC10459421 DOI: 10.3390/ph16081079] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
Patients with multiple sclerosis (MS) and spinal cord injury (SCI) commonly sustain central neuropathic pain (NP) and spasticity. Despite a lack of consistent evidence, cannabis-based medicine (CBM) has been suggested as a supplement treatment. We aimed to investigate the effect of CBM on NP and spasticity in patients with MS or SCI. We performed a randomized, double-blinded, placebo-controlled trial in Denmark. Patients aged ≥18 years with NP (intensity >3, ≤9 on a numerical rating scale (NRS0-10) and/or spasticity (>3 on NRS0-10) were randomized to treatment consisting of either delta-9-tetrahydrocannabinol (THC), cannabidiol (CBD), a combination of THC&CBD in maximum doses of 22.5 mg, 45 mg and 22.5/45 mg per day, respectively, or placebo. A baseline registration was performed before randomization. Treatment duration was six weeks followed by a one-week phaseout. Primary endpoints were the intensity of patient-reported NP and/or spasticity. Between February 2019 and December 2021, 134 patients were randomized (MS n = 119, SCI n = 15), where 32 were assigned to THC, 31 to CBD, 31 to THC&CBD, and 40 to placebo. No significant difference was found for: mean pain intensity (THC 0.42 (-0.54-1.38), CBD 0.45 (-0.47-1.38) and THC&CBD 0.16 (-0.75-1.08)), mean spasticity intensity (THC 0.24 (-0.67-1.45), CBD 0.46 (-0.74-1.65), and THC&CBD 0.10 (-1.18-1.39), secondary outcomes (patient global impression of change and quality of life), or any tertiary outcomes. We aimed to include 448 patients in the trial; however, due to COVID-19 and recruitment challenges, fewer were included. Nevertheless, in this four-arm parallel trial, no effect was found between placebo and active treatment with THC or CBD alone or in combination on NP or spasticity in patients with either MS or SCI. The trial was registered with the EU Clinical Trials Register EudraCT (2018-002315-98).
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Affiliation(s)
- Julie Schjødtz Hansen
- Department of Neurology, Aarhus University Hospital (AUH), 8200 Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
| | - Stefan Gustavsen
- Danish Multiple Sclerosis Center (DMSC), Department of Neurology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Homayoun Roshanisefat
- Department of Neurology, Naestved, Slagelse & Ringsted Hospitals, Region Zealand, 4200 Slagelse, Denmark
| | - Matthias Kant
- Department of Neurology, Hospital of Southern Jutland, 6400 Soenderborg, Denmark
- Department of Neurology, Hospital South-West Jutland Esbjerg, 6700 Esbjerg, Denmark
| | - Fin Biering-Sørensen
- Department of Brain and Spinal Cord Injuries, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Claus Andersen
- Department of Brain and Spinal Cord Injuries, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Anna Olsson
- Danish Multiple Sclerosis Center (DMSC), Department of Neurology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Helene Højsgaard Chow
- Danish Multiple Sclerosis Center (DMSC), Department of Neurology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Nasrin Asgari
- Department of Neurology, Naestved, Slagelse & Ringsted Hospitals, Region Zealand, 4200 Slagelse, Denmark
- Institute of Regional Health Research and Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
| | - Julie Richter Hansen
- Danish Multiple Sclerosis Center (DMSC), Department of Neurology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
- Department of Neurology, Herlev Hospital, 2730 Herlev, Denmark
| | | | - Rikke Middelhede Hansen
- Spinal Cord Injury Centre of Western Denmark (SCIWDK), Viborg Regional Hospital, 8800 Viborg, Denmark
| | - Thor Petersen
- Department of Neurology, Hospital of Southern Jutland and Research Unit in Neurology, Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Annette Bang Oturai
- Danish Multiple Sclerosis Center (DMSC), Department of Neurology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Finn Sellebjerg
- Danish Multiple Sclerosis Center (DMSC), Department of Neurology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Eva Aggerholm Sædder
- Department of Clinical Pharmacology, Aarhus University Hospital, 8000 Aarhus, Denmark
| | - Helge Kasch
- Department of Neurology, Aarhus University Hospital (AUH), 8200 Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
| | | | - Nanna Brix Finnerup
- Department of Neurology, Aarhus University Hospital (AUH), 8200 Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
- Danish Pain Research Centre, Aarhus University, 8200 Aarhus, Denmark
| | - Kristina Bacher Svendsen
- Department of Neurology, Aarhus University Hospital (AUH), 8200 Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
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10
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Hayes D, Olsson A, Begum S, Bertotti M, Jarvis-Beesley P, Stapley E. Barriers and facilitators to social prescribing in child and youth mental health: perspectives from the frontline. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02257-x. [PMID: 37405485 DOI: 10.1007/s00787-023-02257-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 06/27/2023] [Indexed: 07/06/2023]
Abstract
There is growing interest in the role of Social Prescribing (SP) to help promote mental well-being and support individuals with mental health difficulties. Yet, implementation of SP to children and young people (CYP) has proved slow and underdeveloped compared with adult populations. Understanding the barriers and facilitators will help key stakeholders to better embed SP for CYP into practice. Using the Theoretical Domains Framework (TDF), a comprehensive, theoretical-led framework, underpinned by 33 behaviour change theories and 128 constructs, perceived barriers and facilitators to SP were investigated. The sample comprised of 11 Link Workers and 9 individuals involved in facilitating SP with CYP, who took part in semi-structured interviews. Transcripts were analysed using a deductive thematic analysis, and themes were coded under each theoretical domain. Overall, 33 barriers and facilitators for SP were identified across 12 domains of the TDF. Under capability, barriers and facilitators were found for knowledge, skills, memory/attention/decision making processes, and behavioural regulation. For opportunity, barriers and facilitators were found for social/professional influences, as well as environmental context and resources. Finally, for motivation, domains covered included: beliefs about consequences, beliefs about capabilities, optimism, motivations/goals, reinforcement, and emotions. Findings suggest that a wide range of barriers and facilitators affect the implementation of CYP SP to improve mental health and well-being. Interventions which target different domains related to capability, opportunity and motivation should be developed to better facilitate CYP SP.
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Affiliation(s)
- D Hayes
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England.
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, England.
| | - A Olsson
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
- The Healthcare Improvement Studies (THIS) Institute, University of Cambridge, Cambridge, England
| | - S Begum
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
| | - M Bertotti
- Institute for Connected Communities, University of East London, London, England
| | - P Jarvis-Beesley
- Social Prescribing Youth Network (SPYN), Streetgames, Manchester, England
| | - E Stapley
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
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11
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Olsson A, Petrini P, Engman Grahn E, Myrin Westesson L. HRQoL and psychosocial aspects of burden on caregivers to children with moderate or severe von Willebrand disease. Haemophilia 2023. [PMID: 37291684 DOI: 10.1111/hae.14811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 05/05/2023] [Accepted: 05/24/2023] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Von Willebrand disease (VWD) is the most widespread congenital bleeding disorder. Caregivers are highly involved in its treatment, and from the time of the child's bleeding diagnosis, they face new demands such as recognition of bleeds and treatment options. AIM The aim of this study was to assess Health related quality of life (HRQoL) in caregivers of children with moderate and severe VWD in Sweden, and to describe the impact of psychosocial aspects on the burden. METHODS A multicentre, cross-sectional study. The Short Form 36 Health Survey (SF-36) was used to assess HRQoL. Caregiver burden was measured using The HEMOphilia associated Caregiver Burden scale (HEMOCAB). Children´s clinical data were collected from the Swedish national registry for bleeding disorders. RESULTS Seventy caregivers of children with moderate or severe VWD were included. Caregivers of children with moderate VWD scored significantly lower in the mental health domains on SF-36, compared to matched normative data. Psychosocial aspects that significantly impacted the caregiver burden negatively measured by HEMOCAB total score were: if the caregiver reported that VWD affected their life in general (p = .001), if the child was absent from preschool/school ≥2 day/12 months due to VWD (p = .002) or that VWD had a financial impact on the family (p = .001). CONCLUSION This study contributes to knowledge about caregivers' HRQoL and highlights the situation of caregivers of children with moderate VWD. Furthermore, the caregiver burden was negatively affected by psychosocial aspects. Clinical follow-ups should include assessment of psychosocial aspects to identify caregivers that are at risk of high burden.
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Affiliation(s)
- Anna Olsson
- Region Västra Götaland, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Pia Petrini
- Pediatric Coagulation Center, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Emma Engman Grahn
- Region Skåne, Skåne University Hospital, Department of Hematology, Oncology and Medical physics, Malmö, Sweden
| | - Linda Myrin Westesson
- Region Västra Götaland, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Sahlgrenska Academy, Institution for Nursing Science and Health at Gothenburg University, Gothenburg, Sweden
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12
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Olsson A, Sandblom G, Franneby U, Sondén A, Gunnarsson U, Dahlstrand U. Correction to: Do postoperative complications correlate to chronic pain following inguinal hernia repair? A prospective cohort study from the Swedish Hernia Register. Hernia 2023; 27:481. [PMID: 36645564 PMCID: PMC10126029 DOI: 10.1007/s10029-023-02743-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Affiliation(s)
- A Olsson
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
- Department of Surgery, Södersjukhuset, Stockholm, Sweden.
| | - G Sandblom
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - U Franneby
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - A Sondén
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - U Gunnarsson
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - U Dahlstrand
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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13
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Olsson A, Woxnerud K, Kiwanuka O, Sandblom G, Stackelberg O. The TOR concept (training, operation, and rehabilitation) applied to a cohort of postpartum women with training-resistant symptomatic rectus diastasis: evaluation 1 year after surgery. BJS Open 2023; 7:7025466. [PMID: 36734959 PMCID: PMC9897176 DOI: 10.1093/bjsopen/zrac162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/13/2022] [Accepted: 11/07/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Rectus diastasis is a common sequela of pregnancy and is associated with functional disabilities such as back pain, abdominal core instability, abdominal muscle weakness, urinary incontinence, and psychological issues such as a negative body image. The aim of this study was to evaluate the effect of the TOR concept (training, operation, and rehabilitation), a novel concept for treating abdominal wall insufficiency combined with rectus diastasis, after pregnancy. TOR consists of preoperative evaluation of symptoms and custom-designed abdominal core training, tailored rectus diastasis repair, and individual progressive postoperative rehabilitation. METHODS A consecutive series of women diagnosed with rectus diastasis and core dysfunction resistant to training, underwent plication of the linea alba between 2018 and 2020. After surgery, all patients participated in an individually designed rehabilitation programme over a 4-month interval. Physical function was recorded before surgery and 1 year after surgery using the disability rating index questionnaire. Symptoms associated with core instability were recorded before and 1 year after surgery. Quality of life was assessed using the SF-36. The abdominal wall anatomy was assessed with ultrasound before and 1 year after surgery. RESULTS Seventy-one women were included and all attended 1-year follow-up. Response rate was 81.7 per cent (58) for the disability rating index, and 59.2 per cent (42) for SF-36. Self-reported physical function (disability rating index) improved in 54 of 58 patients (93.1 per cent), with a median score reduction of 91.3 per cent. Core instability symptoms decreased significantly. All SF-36 subscales improved significantly compared with preoperative scores, reaching levels similar to or higher than the normative Swedish female population. No recurrence of rectus diastasis was seen at the 1-year follow-up. CONCLUSIONS Surgical reconstruction within the TOR concept resulted in significant improvements in physical function and quality of life as well as a significant decrease in symptoms of core instability.
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Affiliation(s)
- A Olsson
- Correspondence to: Anders Olsson, PhD, Department of Clinical Science and Education and Department of Surgery, Södersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden (e-mail: )
| | - K Woxnerud
- Stockholm Hernia Center, Stockholm, Sweden,Women's Health Department, Hela Kvinnans Klinik, Stockholm, Sweden
| | - O Kiwanuka
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden,Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - G Sandblom
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden,Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - O Stackelberg
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden,Department of Surgery, Södersjukhuset, Stockholm, Sweden,Unit of Nutritional Epidemiology, Karolinska Institute, Institute of Environmental Medicine, Stockholm, Sweden
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14
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Woxnerud K, Sandblom G, Hedbeck C, Olsson A. Reference Data on the Normal Abdominal Wall Anatomy and Baseline Characteristics in Seventy-One Nulliparous Women. J Abdom Wall Surg 2023; 2:10940. [PMID: 38312400 PMCID: PMC10831656 DOI: 10.3389/jaws.2023.10940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/09/2023] [Indexed: 02/06/2024]
Abstract
Aims: The aim of this study was to describe the prepartum anatomy of the abdominal wall in a cohort of nulliparous women, for use as a reference for management of patients with postpartum abdominal wall insufficiency with or without rectus diastasis. Materials and Methods: Seventy-one women were examined with ultrasonography of the abdominal wall. The inter-recti distance (IRD), anatomical variations of the linea semilunaris, and the oblique muscles were assessed. The waistline was measured during activation and relaxation of the abdominal core. Participant characteristics were registered. Questionnaires regarding habitual physical activity (Baecke), low back pain (Oswestry), physical functioning (DRI), urinary incontinence (UDI-6 and IIQ-7), and quality-of-life (SF-36) were answered. Results: Mean age was 30.5 years (range 19-50 years) and mean BMI 23.5 kg/m2 (range 18-37). Ultrasonography showed a mean IRD of 10 mm (range 3-24) at the superior border of the umbilicus, 9 mm (4-20) 3 cm above the umbilicus, and 2 mm (-5-10) 2 cm below the umbilicus. The mean thickness of the linea alba was 3 mm (1.5-5) and mean distances between the lateral edge of the rectus muscle and the external, internal, and transverse oblique muscles were 12 mm (-10-28), 1 mm (-14-13) and 15 mm (-14-32) at umbilicus level. Responses to the DRI, UDI-6, IIQ-7 and Oswestry questionnaires showed generally lower scores than the normal population whereas Baecke and SF-36 scores were similar. Conclusion: This study provides baseline data on normal abdominal wall anatomy in a healthy nulliparous female cohort, as well as levels of activity, physical function, disability, and quality-of-life.
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Affiliation(s)
- K. Woxnerud
- Hela Kvinnans Klinik, Stockholm, Sweden
- Stockholm Hernia Center, Stockholm, Sweden
| | - G. Sandblom
- Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
- Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | | | - A. Olsson
- Stockholm Hernia Center, Stockholm, Sweden
- Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
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15
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Olsson A, Westesson LM, Baghaei F, Holmström M, Olsson E, Magnusson M, Ranta S, Astermark J, Andersson NG, Thanner J, Szamosi J, Daoura L, Sennfält K. Real-world prophylactic usage of recombinant factor IX Fc in Sweden: A report from the Swedish National Registry for bleeding disorders. Haemophilia 2023; 29:377-381. [PMID: 36469854 DOI: 10.1111/hae.14704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 11/08/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Anna Olsson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Linda Myrin Westesson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Sahlgrenska Academy, Institution for Nursing Science and Health at Gothenburg University, Gothenburg, Sweden
| | - Fariba Baghaei
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Margareta Holmström
- Department of Hematology, Coagulation Unit, Karolinska University Hospital, Stockholm, Sweden.,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Acute Internal Medicine and Geriatrics, Linköping University, Linköping, Sweden
| | - Elsa Olsson
- Department of Hematology, Coagulation Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Magnusson
- Department of Hematology, Coagulation Unit, Karolinska University Hospital, Stockholm, Sweden.,Pediatric Coagulation Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,MMK and CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Susanna Ranta
- Pediatric Coagulation Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Jan Astermark
- Department of Translational Medicine and Department of Hematology, Oncology and Radiation Physics, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Nadine G Andersson
- Department for Paediatric Haematology and Oncology, Children's Hospital, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Paediatrics, Lund University, Malmö, Sweden
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16
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Westesson LM, Petrini P, Grahn EE, Olsson A. Burden on parents of children with moderate or severe von Willebrand disease: The impact of clinical data. Haemophilia 2023; 29:390-393. [PMID: 36524543 DOI: 10.1111/hae.14718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 11/24/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Linda Myrin Westesson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Sahlgrenska Academy, Institution for Nursing Science and Health at Gothenburg University, Gothenburg, Sweden
| | - Pia Petrini
- Pediatric Coagulation Center, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Emma Engman Grahn
- Department of Hematology, Oncology and Medical Physics, Region Skåne, Skåne University Hospital, Malmö, Sweden
| | - Anna Olsson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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17
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Lindahl R, Nummi V, Lehtinen A, Szanto T, Hiltunen L, Olsson A, Glenthoej A, Chaireti R, Vaide I, Funding E, Zetterberg E. Acquired Haemophilia A in four north European countries: survey of 181 patients. Br J Haematol 2022; 201:326-333. [PMID: 36541135 DOI: 10.1111/bjh.18611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
Acquired haemophilia A (AHA) is a rare bleeding disorder caused by acquired antibodies against coagulation factor VIII. In the Nordic countries, treatment and outcomes have not been studied in recent times. To collect retrospective data on patients diagnosed with AHA in the Nordic countries between 2006 and 2018 and compare demographic data and clinical outcomes with previously published reports, data were collected by six haemophilia centres: three Swedish, one Finnish, one Danish and one Estonian. The study included 181 patients. Median age at diagnosis was 76 (range 5-99) years, with even gender distribution. Type and severity of bleeding was comparable to that in the large European Acquired Haemophilia Registry study (EACH2). Bleedings were primarily treated with activated prothrombin complex concentrate (aPCC) with a high success rate (91%). For immunosuppressive therapy, corticosteroid monotherapy was used most frequently and this may be the cause of the overall lower clinical remission rate compared to the EACH2 study (57% vs. 72%). Survey data on 181 patients collected from four north European countries showed similar demographic and clinical features as in previous studies on AHA. aPCC was used more frequently than in the EACH2 study and the overall remission rate was lower.
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Affiliation(s)
- Rickard Lindahl
- Department of Haematology, Oncology and Radiation Physics, Coagulation Unit Skåne University Hospital Malmö and Lund University Lund Sweden
| | - Vuokko Nummi
- Coagulation Disorders Unit, Department of Haematology Helsinki University Hospital Comprehensive Cancer Centre, Helsinki University Helsinki Finland
| | - Anna‐Elina Lehtinen
- Coagulation Disorders Unit, Department of Haematology Helsinki University Hospital Comprehensive Cancer Centre, Helsinki University Helsinki Finland
| | - Timea Szanto
- Coagulation Disorders Unit, Department of Haematology Helsinki University Hospital Comprehensive Cancer Centre, Helsinki University Helsinki Finland
| | - Leena Hiltunen
- Department of Haemostasis Finnish Red Cross Blood Service Helsinki Finland
| | - Anna Olsson
- Department of Medicine Region Västra Götaland, Sahlgrenska University Hospital Gothenburg Sweden
| | - Andreas Glenthoej
- Department of Haematology Rigshospitalet Copenhagen Denmark
- Department of Clinical Medicine Copenhagen University Copenhagen Denmark
| | - Roza Chaireti
- Department of Haematology Karolinska University Hospital Stockholm Sweden
| | - Ines Vaide
- Department of Haematology and Oncology Institute of Clinical Medicine, University of Tartu Tartu Estonia
| | - Eva Funding
- Department of Haematology Rigshospitalet Copenhagen Denmark
- Department of Clinical Medicine Copenhagen University Copenhagen Denmark
| | - Eva Zetterberg
- Department of Haematology, Oncology and Radiation Physics, Coagulation Unit Skåne University Hospital Malmö and Lund University Lund Sweden
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18
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Bixo L, Sandblom G, Österberg J, Stackelberg O, Bewö K, Olsson A. Association Between Inter-Recti Distance and Impaired Abdominal Core Function in Post-Partum Women With Diastasis Recti Abdominis. J Abdom Wall Surg 2022; 1:10909. [PMID: 38314149 PMCID: PMC10831648 DOI: 10.3389/jaws.2022.10909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/14/2022] [Indexed: 02/06/2024]
Abstract
Background and Aim: The definition and management of Diastasis Recti Abdominis (DRA) is under debate. This study aimed to understand the correlation between the post-partum inter-recti distance (IRD) and functional impairments associated with core instability, with the hypothesis that IRD could serve as a proxy for core instability symptoms and constitute a tool in decision-making for DRA treatment. Material and Methods: A cohort of post-partum women with abdominal core instability symptoms combined with DRA were studied. The size of IRD was measured with ultrasonography and cross-sectionally analysed against functional impairments registered with the self-report Disability Rating Index (DRI), which grades the ability to perform 12 different daily activities. Results: A total of 224 women were included in the study. In univariable analysis, IRD was associated with impairment of the activities running (p = 0.007), heavy work (p = 0.036) and exercise/sports (p = 0.047), but not with dressing, walking, sitting for long periods, standing bent over a sink, carrying a suitcase, making a bed, light manual labour or heavy lifting. No significant correlations were seen in the multivariable analysis when adjustments were made for BMI and parity. Conclusion: IRD and post-partum functional impairments had no significant correlation in multivariable analysis. The post-partum core instability condition is complex and probably associated with more factors than solely the IRD. The IRD alone does not seem to be a sufficient proxy for decision-making regarding optimal treatment. A more complete instrument to assess the post-partum abdominal core is warranted.
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Affiliation(s)
- L. Bixo
- Department of Surgery, Mora Hospital, Mora, Sweden
| | - G. Sandblom
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
- Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - J. Österberg
- Department of Surgery, Mora Hospital, Mora, Sweden
- Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - O. Stackelberg
- Department of Surgery, Södersjukhuset, Stockholm, Sweden
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - K. Bewö
- Department of Surgery, Mora Hospital, Mora, Sweden
| | - A. Olsson
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
- Stockholm Hernia Center, Stockholm, Sweden
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19
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Olsson A. P-095 RECTUS DIASTASIS REPAIR: VARIATIONS OF POSTPARTUM ABDOMINAL WALL ANATOMICAL CHANGES PROPOSE A TAILORED SURGICAL REPAIR. EARLY RESULTS OF THE EXTENDED REPAIR TECHNIQUE STUDY. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
A pregnancy can result in permanent anatomical changes such as a persistent rectus diastasis (RD), a widened linea semilunaris and retracted oblique muscles. The diverse anatomical changes contribute to the abdominal deformation and may present in a variety of combinations. A standardized suture repair of the RD may not be sufficient in severe abdominal wall deformation cases. This observational cohort study evaluated an extended repair technique.
Method
A cohort of 44 postpartum women with training resistant core instability symptoms planned for surgical repair were examined with ultrasonography prior to surgery. Participants with severe anatomical changes i.e. diastasis of the linea semilunaris exceeding one cm, were offered an extended repair, re-approximation of both linea alba and linea semilunaris. Results were evaluated with ultrasonography and the Disability Rating Index (DRI), two and twelve months after surgery.
A standardized rectus diastasis suture repair was used in 24 participants with an isolated rectus diastasis. A combined repair with reapproximation of both the linea alba and the linea semilunaris was performed in 20 participants.
Results
Preoperative mean rectus diastasis (widest measurement) was 45 mm (30–75 mm), a mean diastasis of the linea semilunaris (umbilical level) of 15 mm (0–35 mm).
There were no recurrencies at the 12-month follow-up. Early results showed significant improvements of physical function (DRI) but no differences between the two repair technique groups.
Conclusion
The extended repair seems to be a safe and sufficient repair technique in cases with a RD combined with a linea semilunaris diastasis.
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Affiliation(s)
- A Olsson
- Department of Clinical Science and Education, Karolinska Institutet , Stockholm , Sweden
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20
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Olsson A, Sandblom G, Franneby U, Sondén A, Gunnarsson U, Österberg J, Dahlstrand U. OC-038 RISK FOR CONTRALATERAL INGUINAL HERNIA REPAIR FOLLOWING PRIMARY UNILATERAL HERNIA REPAIR – A REGISTER-BASED STUDY. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
To investigate the incidence as well as the factors predictive for a subsequent hernia repair on the contralateral side following a primary unilateral hernia repair.
Material & Methods
Prospective population-based study of data from the Swedish Hernia Register based on 151,297 patients operated with an index unilateral inguinal hernia mesh repair using open and endo-laparoscopic technique, during 2007–2019. Incidence, predictive factors and time to a contralateral hernia repair was analysed.
Results
There were 7.4% registered contralateral hernia repairs with a median time of 2.7 years to a subsequent contralateral repair following the index unilateral hernia repair. Median follow-up time was 7.5 years. Significant predictors for a subsequent contralateral hernia were, male sex (HR 1.78, 95% CI 1.61–1.97), high age (HR 1.01 95% CI 1.006–1.009), medial inguinal hernia (HR 1.05, 95% CI 1.003–1.098), combined inguinal hernia (HR 1.10, 95% CI 1.03–1.18), hernia defect size 1.5–3.0 cm (HR 1.10, 95% CI 1.03–1.17), hernia defect size > 3 cm (HR 1.36, 95% CI 1.27–1.45) and a repair on the left side (HR 1.30, 95% CI 1.25–1.35). Endo-laparoscopic repairs and obesity were associated with a lower incidence of a later contralateral repair.
Conclusion
If the relevant risk factors, i.e., male sex, high age, large hernia defect size, medial or combined hernia, are present at a unilateral endo-laparoscopic groin hernia repair and the decision has been shared with the patient, exploration of the contralateral groin and prophylactic mesh placement may be considered.
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Affiliation(s)
- A Olsson
- Department of Clinical Science and Education, Karolinska Institutet , Stockholm , Sweden
| | - G Sandblom
- Department of Clinical Science and Education, Karolinska Institutet , Stockholm , Sweden
| | - U Franneby
- Department of Clinical Science, Intervention and Technology (CLINTEC)), Karolinska Institutet , Stockholm , Sweden
| | - A Sondén
- Department of Clinical Science and Education, Karolinska Institutet , Stockholm , Sweden
| | - U Gunnarsson
- Department of Surgical and perioperative sciences, division of surgery, Umeå Universitet , Umeå , Sweden
| | - J Österberg
- Department of Clinical Science, Intervention and Technology (CLINTEC)), Karolinska Institutet , Stockholm , Sweden
| | - U Dahlstrand
- Department of Clinical Science, Intervention and Technology (CLINTEC)), Karolinska Institutet , Stockholm , Sweden
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21
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Woxnerud K, Sandblom G, Olsson A. OC-063 BASELINE DATA AND NORMAL ANATOMY OF THE ABDOMINAL WALL IN AN OBSERVATIONAL PROSPECTIVE COHORT STUDY OF NULLIPAROUS WOMEN. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
The aim of this study was to describe the pre-partum anatomy of the abdominal wall in a cohort of nulliparous women, with the main purpose to use as a reference for management of patients with postpartum abdominal core instability.
Materials & Methods
Seventy consecutive women were examined with ultrasonography measuring inter-recti distance (IRD), anatomical variations of linea semilunaris and the oblique muscles. Waistline was assessed during activated and relaxed abdominal core. Participant characteristics were registered. Questionnaires regarding habitual physical activity (Baecke), low back pain (Oswestry), physical functioning (DRI), urinary incontinence (UDI-6 and IIQ-7) and quality of life (SF-36) were answered.
Results
Response rate was 100%. Mean age was 30.5 years (19–50), mean BMI 23.5 kg/m2 (18.4–37.1). Ultrasonography showed a mean IRD 1.02 mm (0.27–2.35) at the superior border of the umbilicus, 0.93 mm (0.36–2.01) three cm above the umbilicus, 0.21 mm (-0.53–0.98) two cm below the umbilicus; mean thickness of the linea alba 0.28 mm (0.15–0.5); mean distance between the lateral lining of the rectus muscle and the external, internal and transverse oblique muscles of respectively 1.19 (-0.99–2.82), 0.09 mm (-1.37–1.3) and 1.46 mm (-1.36–3.19) at umbilicus level. Responses to the questionnaires showed overall low values on DRI, UDI-6, IIQ-7 and Oswestry; and overall values on Baecke and SF-36 similar to the normative population.
Conclusions
This study provides baseline data on the normal abdominal wall anatomy as well as mean values of activity, physical function, disabilities and quality of life, in a healthy nulliparous female cohort.
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Affiliation(s)
- K Woxnerud
- Womens Health, Hela Kvinnans Klinik , Stockholm , Sweden
| | - G Sandblom
- Department of Clinical Science and Education, Karolinska Institutet , Stockholm , Sweden
| | - A Olsson
- Department of Clinical Science and Education, Karolinska Institutet , Stockholm , Sweden
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22
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Acar K, Horntvedt O, Cabrera A, Olsson A, Ingvar M, Lebedev AV, Petrovic P. COVID-19 conspiracy ideation is associated with the delusion proneness trait and resistance to update of beliefs. Sci Rep 2022; 12:10352. [PMID: 35725585 PMCID: PMC9208343 DOI: 10.1038/s41598-022-14071-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 06/01/2022] [Indexed: 11/09/2022] Open
Abstract
The rapid spread of conspiracy ideas associated with the recent COVID-19 pandemic represents a major threat to the ongoing and coming vaccination programs. Yet, the cognitive factors underlying the pandemic-related conspiracy beliefs are not well described. We hypothesized that such cognitive style is driven by delusion proneness, a trait phenotype associated with formation of delusion-like beliefs that exists on a continuum in the normal population. To probe this hypothesis, we developed a COVID-19 conspiracy questionnaire (CCQ) and assessed 577 subjects online. Their responses clustered into three factors that included Conspiracy, Distrust and Fear/Action as identified using principal component analysis. We then showed that CCQ (in particular the Conspiracy and Distrust factors) related both to general delusion proneness assessed with Peter's Delusion Inventory (PDI) as well as resistance to belief update using a Bias Against Disconfirmatory Evidence (BADE) task. Further, linear regression and pathway analyses suggested a specific contribution of BADE to CCQ not directly explained by PDI. Importantly, the main results remained significant when using a truncated version of the PDI where questions on paranoia were removed (in order to avoid circular evidence), and when adjusting for ADHD- and autistic traits (that are known to be substantially related to delusion proneness). Altogether, our results strongly suggest that pandemic-related conspiracy ideation is associated with delusion proneness trait phenotype.
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Affiliation(s)
- K Acar
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden.
| | - O Horntvedt
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Cabrera
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - M Ingvar
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A V Lebedev
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - P Petrovic
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
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23
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Szanto T, Zetterberg E, Ramström S, Leinøe EB, Holme PA, Antovic JP, Holmström M, Onundarson PT, Pikta M, Vaide I, Olsson A, Magnusson M, Kärkkäinen S, Bitar M, Poulsen LH, Lassila R. Platelet function testing: Current practice among clinical centres in Northern Europe. Haemophilia 2022; 28:642-648. [PMID: 35510959 PMCID: PMC9540416 DOI: 10.1111/hae.14578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/31/2022] [Accepted: 04/12/2022] [Indexed: 11/28/2022]
Abstract
Introduction Platelet function tests are used to screen and diagnose patients with possible inherited platelet function defects (IPFD). Some acquired platelet dysfunction may be caused by certain drugs or comorbidities, which need to be excluded before testing. Aims To identify current practice among centres performing platelet function tests in Northern Europe. Methods A total of 14 clinical centres from Sweden (six), Finland (two), Denmark (two), Norway (one), Estonia (two) and Iceland (one) completed the survey questionnaire, the population capture area of about 29.5 million. Results Six of the 14 (42.8%) centres providing platelet function assessment represent comprehensive treatment centres (EUHANET status). A Bleeding score (BS) or ISTH bleeding assessment tool (ISTH BAT score) is evaluated in 11/14 (78.6%) centres and family history in all. Five/14 centres (35.7%) use structured preanalytical patient instructions, and 10/14 (71.4%) recorded questionnaire on the preassessment of avoidance of any drugs or natural products affecting platelet functions. Preliminary investigations of screening tests of coagulation are performed in 10/14 (71.4%), while in 4/14 (28.6%), the diagnostic work‐up of IPFD and von Willebrand disease (VWD) is performed simultaneously. The work‐up of IPFD includes peripheral blood smear in 10/14 (71.4%), platelet aggregometry in all, flow cytometry in 10/14 (71.4%) and Platelet Function Analysis (PFA) in 3/11 (28.6%). Molecular genetic diagnosis is available in 7/14 (50%) centres. Conclusions The considerable variability in the current practice illustrates the need for harmonization between the Northern European centres according to the international registers (i.e. EUHASS) and IPFD guidelines (ISTH, EHA).
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Affiliation(s)
- Timea Szanto
- Coagulation Disorders Unit, Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.,Research Program in Systems Oncology, Helsinki University, Helsinki, Finland
| | - Eva Zetterberg
- Department of Translational Medicine & Centre for Thrombosis and Haemostasis, Lund University, Malmö, Sweden
| | - Sofia Ramström
- Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Eva B Leinøe
- Department of Haematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Pål A Holme
- Department of Haematology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jovan P Antovic
- Coagulation Research, Institute for Molecular Medicine and Surgery, Karolinska Institute & Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - Margareta Holmström
- Department of Health and Department of Acute Internal Medicine and Geriatrics, Medicine and Caring Sciences Linköping University, Linköping, Sweden
| | | | - Marika Pikta
- Laboratory, North Estonia Medical Centre, Tallinn, Estonia
| | - Ines Vaide
- Department of Hemato-Oncology, University of Tartu, Institute of Clinical Medicine, Tartu, Estonia
| | - Anna Olsson
- Region Västra Götaland, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria Magnusson
- Department of Haematology and Coagulation Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Satu Kärkkäinen
- Hemostasis and Platelet Laboratory, Fimlab Laboratoriot, Tampere, Finland
| | - Manar Bitar
- Department of Laboratory Medicine, Clinical Chemistry, Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden
| | | | - Riitta Lassila
- Coagulation Disorders Unit, Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.,Research Program in Systems Oncology, Helsinki University, Helsinki, Finland
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- Coagulation Disorders Unit, Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
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24
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Olsson A, Hedlund S, Landgren K. To Use or Not Use Complementary and Alternative Medicine (CAM) in Psychiatric Care: Interviews with Clinical Decision-Makers in Sweden. Issues Ment Health Nurs 2022; 43:463-472. [PMID: 34666589 DOI: 10.1080/01612840.2021.1986759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Complementary and alternative medicine (CAM) is used as a complementary intervention in psychiatric healthcare. The reasons for using or not using CAM in psychiatric care in Sweden, and how such decisions are taken, are largely unknown. The aim was to investigate arguments for and against the use of CAM in Swedish psychiatric care, and how decisions are made. Interviews with 10 persons in decision-making positions in psychiatric health care were analysed thematically. The result shows diverging understandings of the evidence base for CAM. Arguments against CAM referred to scepticism, the importance of evidence-based practice and the obligation to follow national guidelines. Arguments in favour of CAM were that CAM was person-centred, safe, cost-effective, nursing interventions with positive effects, appreciated and demanded by patients, providing space for non-verbal communication and reflection, supporting the therapeutic alliance. Decision paths were described as top-down through a hierarchical structure, or bottom-up, driven by committed staff members. We discuss how detailed national guidelines should be to achieve equal and evidence-based care, while still allowing clinics to make local exceptions, adjusting the care according to clinical expertise and patients' preferences. Conclusion: Evidence-based, safe and cost-effective CAM methods may be relevant complementary interventions in psychiatric care, or as self-care, not to cure the psychiatric disease, but to reduce symptoms and promote sleep. With better knowledge of CAM, health professionals could guide patients through the jungle of CAM methods. Due to research problems on complex multicomponent interventions, high-quality pragmatic trials, including biomarkers, and qualitative studies are recommended.
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Affiliation(s)
- Anna Olsson
- Health Sciences Centre, Faculty of Medicine, Lund University, Lund, Sweden
| | - Siiri Hedlund
- Health Sciences Centre, Faculty of Medicine, Lund University, Lund, Sweden
| | - Kajsa Landgren
- Health Sciences Centre, Faculty of Medicine, Lund University, Lund, Sweden.,Psychiatric Clinic in Lund, Region Skåne, Lund, Sweden
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25
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Letelier A, Ljung R, Olsson A, Andersson NG. Silent variant in F8:c.222G>T (p.Thr74Thr) causes a partial exon skipping in a patient with mild hemophilia A. Mol Genet Genomic Med 2021; 10:e1856. [PMID: 34962362 PMCID: PMC8801133 DOI: 10.1002/mgg3.1856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/04/2021] [Accepted: 12/14/2021] [Indexed: 11/30/2022] Open
Abstract
One of the challenges of genetic testing in patients with hemophilia A is the interpretation of sequence variants. Here we report a silent variant found in exon 2 in the F8 gene in a 47‐year‐old patient with a previous von Willebrand disease (VWD) type 1 diagnosis. Clinically he had mild bleeding symptoms restricted to prolonged bleeding from minor wounds. Sanger sequencing of F8 gene using genomic DNA showed a hemizygous silent variant in exon 2: c.222G>T, p.Thr74Thr. When applying ACMG criteria, the variant was predicted to be “likely benign” in the analyzing software or VUS after curating. Sanger sequencing of the patient's cDNA after nested polymerase chain reaction showed that the patient had both a normal transcript containing exons 1–4 and a defect transcript lacking exon 2. These findings explain the patient's low FVIII:C level and led to the diagnosis of mild hemophilia A instead of VWD type 1. This case illustrates that mRNA work‐up may be needed to clarify a patient's phenotype–genotype.
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Affiliation(s)
- Anna Letelier
- Department of Clinical Sciences Lund (IKVL)-Pediatrics, Lund University, Lund, Sweden.,Department for Molecular Diagnostics, Clinical Genetics Hemophilia Laboratory, Region Skåne, Skåne University Hospital, Lund, Sweden
| | - Rolf Ljung
- Department of Clinical Sciences Lund (IKVL)-Pediatrics, Lund University, Lund, Sweden
| | - Anna Olsson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Nadine G Andersson
- Department of Clinical Sciences Lund (IKVL)-Pediatrics, Lund University, Lund, Sweden.,Department of Pediatric Hematology and Oncology, Region Skåne, Skåne University Hospital, Lund, Sweden
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26
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Christmas MJ, Jones JC, Olsson A, Wallerman O, Bunikis I, Kierczak M, Whitley KM, Sullivan I, Geib JC, Miller-Struttmann NE, Webster MT. A genomic and morphometric analysis of alpine bumblebees: Ongoing reductions in tongue length but no clear genetic component. Mol Ecol 2021; 31:1111-1127. [PMID: 34837435 DOI: 10.1111/mec.16291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022]
Abstract
Over the last six decades, populations of the bumblebees Bombus sylvicola and Bombus balteatus in Colorado have experienced decreases in tongue length, a trait important for plant-pollinator mutualisms. It has been hypothesized that this observation reflects selection resulting from shifts in floral composition under climate change. Here we used morphometrics and population genomics to determine whether morphological change is ongoing, investigate the genetic basis of morphological variation, and analyse population structure in these populations. We generated a genome assembly of B. balteatus. We then analysed whole-genome sequencing data and morphometric measurements of 580 samples of both species from seven high-altitude localities. Out of 281 samples originally identified as B. sylvicola, 67 formed a separate genetic cluster comprising a newly-discovered cryptic species ("incognitus"). However, an absence of genetic structure within species suggests that gene flow is common between mountains. We found a significant decrease in tongue length between bees collected between 2012-2014 and in 2017, indicating that morphological shifts are ongoing. We did not discover any genetic associations with tongue length, but a SNP related to production of a proteolytic digestive enzyme was implicated in body size variation. We identified evidence of covariance between kinship and both tongue length and body size, which is suggestive of a genetic component of these traits, although it is possible that shared environmental effects between colonies are responsible. Our results provide evidence for ongoing modification of a morphological trait important for pollination and indicate that this trait probably has a complex genetic and environmental basis.
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Affiliation(s)
- Matthew J Christmas
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Julia C Jones
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| | - Anna Olsson
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Ola Wallerman
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Ignas Bunikis
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Marcin Kierczak
- Department of Cell and Molecular Biology, National Bioinformatics Infrastructure Sweden, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Kaitlyn M Whitley
- Department of Biology, Appalachian State University, Boone, North Carolina, USA.,U.S. Department of Agriculture, Agriculture Research Service, Charleston, South Carolina, USA
| | - Isabel Sullivan
- Department of Biology, Appalachian State University, Boone, North Carolina, USA.,Marine Estuarine Environmental Sciences, University of Maryland, College Park, Maryland, USA
| | - Jennifer C Geib
- Department of Biology, Appalachian State University, Boone, North Carolina, USA
| | | | - Matthew T Webster
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
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27
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Fager C, Gebäck T, Hjärtstam J, Röding M, Olsson A, Lorén N, von Corswant C, Särkkä A, Olsson E. Correlating 3D porous structure in polymer films with mass transport properties using FIB-SEM tomography. Chemical Engineering Science: X 2021. [DOI: 10.1016/j.cesx.2021.100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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28
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Olsson A, Thoren I, Mohammad M, Rylance R, Platonov P, Sparv D, Erlinge D. Christmas holiday triggers of myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Christmas holidays have been associated with the highest incidence of myocardial infarction (MI). We wanted to assess possible triggers of MI during Christmas.
Method
A nationwide, retrospective postal survey with case-control design. All individuals suffering a MI during the Christmas holidays 2018 and 2019 in Sweden were identified through the SWEDEHEART registry and a control group matched in age and gender with chronic coronary syndrome who did not seek medical attention during Christmas, were asked for participation. Subjects completed a questionnaire asking them to rate 27 potential MI-triggers as having occurred more or less than usual.
Results
A total of 189 patients suffering a MI on Christmas Eve, Christmas Day, or Boxing Day and 157 patients in control-group responded to the questionnaire, representing response rates of 66% and 62%, respectively. Patients with MI on Christmas experienced more stress (36.7% vs 20.9%, p=0.002), depression (20.9% vs 10.5%, p=0.024) and worry (25.9% vs 10.1%, p<0.001) compared to the control-group. The food and sweets-consumption were increased in both groups, but to a greater extent in the control-group (33.0% vs 49.7%, p=0.002 and 32.4% vs 43.3, p=0.031). There were no increases in quarrels, anger, economic worries or reduced compliance with medication.
Conclusions
Patients suffering MI on Christmas holiday experienced higher levels of stress and emotional distress compared to patients with chronic coronary syndrome, possibly explaining the phenomenon of holiday heart attack. Understanding what factors increase the number of MI on Christmas may help reduce the excess number of MIs and cardiovascular burden.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Swedish Heart and Kund FoundationSwedish Scientific Research Council
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Affiliation(s)
- A Olsson
- Lund University, Cardiology, Lund, Sweden
| | - I Thoren
- Skane University Hospital, Lund, Sweden
| | - M Mohammad
- Lund University, Cardiology, Lund, Sweden
| | - R Rylance
- Lund University, Cardiology, Lund, Sweden
| | - P Platonov
- Lund University, Cardiology, Lund, Sweden
| | - D Sparv
- Lund University, Cardiology, Lund, Sweden
| | - D Erlinge
- Lund University, Cardiology, Lund, Sweden
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29
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Gustavsen S, Olsson A, Søndergaard HB, Andresen SR, Sørensen PS, Sellebjerg F, Oturai A. The association of selected multiple sclerosis symptoms with disability and quality of life: a large Danish self-report survey. BMC Neurol 2021; 21:317. [PMID: 34399707 PMCID: PMC8365982 DOI: 10.1186/s12883-021-02344-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background People with multiple sclerosis (MS) experience a wide range of unpredictable and variable symptoms. The symptomatology of MS has previously been reported in large sample registry studies; however, some symptoms may be underreported in registries based on clinician-reported outcomes and how the symptoms are associated with quality of life (QoL) are often not addressed. The aim of this study was to comprehensively evaluate the frequency of selected MS related symptoms and their associations with disability and QoL in a large self-report study. Methods We conducted a cross-sectional questionnaire survey among all patients at the Danish Multiple Sclerosis Center, Copenhagen University Hospital, Denmark. The questionnaire included information on clinical and sociodemographic characteristics, descriptors of QoL and disability, as well as prevalence and severity of the following MS symptoms: impaired ambulation, spasticity, chronic pain, fatigue, bowel and bladder dysfunction, and sleep disturbances. Results Questionnaires were returned by 2244/3606 (62%). Participants without MS diagnosis or incomplete questionnaires were excluded, n = 235. A total of 2009 questionnaires were included for analysis (mean age 49.4 years; mean disease duration 11.7 years; and 69% were women). The most frequently reported symptoms were bowel and bladder dysfunction (74%), fatigue (66%), sleep disturbances (59%), spasticity (51%) and impaired ambulation (38%). With exception of fatigue and sleep disturbances, all other symptoms increased in severity with higher disability level. Invisible symptoms (also referred to as hidden symptoms) such as fatigue, pain and sleep disturbances had the strongest associations with the overall QoL. Conclusion We found invisible symptoms highly prevalent, even at mild disability levels. Fatigue, pain and sleep disturbances had the strongest associations with the overall QoL and were more frequently reported in our study compared with previous registry-based studies. These symptoms may be underreported in registries based on clinician reported outcomes, which emphasizes the importance of including standardized patient reported outcomes in nationwide registries to better understand the impact of the symptom burden in MS.
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Affiliation(s)
- S Gustavsen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.
| | - A Olsson
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - H B Søndergaard
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - S R Andresen
- Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - P S Sørensen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - F Sellebjerg
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - A Oturai
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
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Brajon S, Morello GM, Capas-Peneda S, Hultgren J, Gilbert C, Olsson A. All the Pups We Cannot See: Cannibalism Masks Perinatal Death in Laboratory Mouse Breeding but Infanticide Is Rare. Animals (Basel) 2021; 11:2327. [PMID: 34438784 PMCID: PMC8388445 DOI: 10.3390/ani11082327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 07/29/2021] [Accepted: 08/03/2021] [Indexed: 12/21/2022] Open
Abstract
Perinatal mortality is a major issue in laboratory mouse breeding. We compared a counting method using daily checks (DAILY_CHECK) with a method combining daily checks with detailed video analyses to detect cannibalisms (VIDEO_TRACK) for estimating the number of C57BL/6 pups that were born, that died and that were weaned in 193 litters from trios with (TRIO-OVERLAP) or without (TRIO-NO_OVERLAP) the presence of another litter. Linear mixed models were used at litter level. To understand whether cannibalism was associated with active killing (infanticide), we analysed VIDEO_TRACK recordings of 109 litters from TRIO-OVERLAP, TRIO-NO_OVERLAP or SOLO (single dams). We used Kaplan-Meier method and logistic regression at pup level. For DAILY_CHECK, the mean litter size was 35% smaller than for VIDEO_TRACK (p < 0.0001) and the number of dead pups was twice lower (p < 0.0001). The risk of pup loss was higher for TRIO-OVERLAP than TRIO-NO_OVERLAP (p < 0.0001). A high number of pup losses occurred between birth and the first cage check. Analyses of VIDEO_TRACK data indicated that pups were clearly dead at the start of most of the cannibalism events and infanticide was rare. As most pups die and disappear before the first cage check, many breeding facilities are likely to be unaware of their real rates of mouse pup mortality.
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Affiliation(s)
- Sophie Brajon
- Laboratory Animal Science, IBMC—Instituto de Biologia Molecular e Celular, and i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal; (S.B.); (G.M.M.); (S.C.-P.)
- Babraham Institute, Babraham, Cambridge CB22 3AT, UK;
| | - Gabriela Munhoz Morello
- Laboratory Animal Science, IBMC—Instituto de Biologia Molecular e Celular, and i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal; (S.B.); (G.M.M.); (S.C.-P.)
| | - Sara Capas-Peneda
- Laboratory Animal Science, IBMC—Instituto de Biologia Molecular e Celular, and i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal; (S.B.); (G.M.M.); (S.C.-P.)
- ICBAS School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
- The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK
| | - Jan Hultgren
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences, 53223 Skara, Sweden;
| | - Colin Gilbert
- Babraham Institute, Babraham, Cambridge CB22 3AT, UK;
| | - Anna Olsson
- Laboratory Animal Science, IBMC—Instituto de Biologia Molecular e Celular, and i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal; (S.B.); (G.M.M.); (S.C.-P.)
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Olsson A, Fahlén E, Tornemo M, Oleröd G, Hultén L, Sandstedt J. Multivariate analysis by OPLS as a novel tool to identify cause of variation between assays for direct LDL measurement in frozen and fresh plasma samples. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Olsson A, Kiwanuka O, Sandblom G, Stackelberg O. Evaluation of functional outcomes following rectus diastasis repair-an up-to-date literature review. Hernia 2021; 25:905-914. [PMID: 34302558 PMCID: PMC8370918 DOI: 10.1007/s10029-021-02462-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/16/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Over the last decade rectus diastasis has gained attention as a condition that may benefit from surgery. Numerous surgical techniques have been presented but scientifically proper studies reporting functional outcome are few and evidence is incomplete. The aim of this up-to-date review is to analyse the outcomes of rectus diastasis repair in recently published papers, focusing on functional changes following surgery. METHOD A comprehensive search in PubMed and Web of Science was performed. Suitable papers were selected using titles and abstracts with terms suggesting surgical treatment of rectus diastasis. All abstracts were scrutinised, and irrelevant studies excluded in four stages. Reports providing original data, including outcome assessment following surgery, were included. RESULT Ten papers with a total of 780 patients were found to fulfil the search criteria. Study design, surgical procedure, follow-up time, functional outcome and assessment instruments were compiled. All included studies reported improvements in a variety of functional aspects regardless of surgical method. The outcomes assessed include core stability, back pain, abdominal pain, posture, urinary incontinence, abdominal muscle strength and quality of life. CONCLUSION The results of this review show that surgical repair of rectus diastasis is a safe and effective treatment that improves functional disability. However, the absence of standardized instruments for assessing outcome makes it impossible to compare studies. Since indications for surgery are relative and related to core function, valid instruments for assessing indication and outcome are needed to ensure benefit of the procedure.
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Affiliation(s)
- A Olsson
- Department of Clinical Science and Education, Södersjukhuset, and Department of Surgery, Södersjukhuset, Karolinska Institute, Sjukhusbacken 10, 11883, Stockholm, Sweden.
| | - O Kiwanuka
- Department of Clinical Science and Education, Södersjukhuset, and Department of Surgery, Södersjukhuset, Karolinska Institute, Sjukhusbacken 10, 11883, Stockholm, Sweden
| | - G Sandblom
- Department of Clinical Science and Education, Södersjukhuset, and Department of Surgery, Södersjukhuset, Karolinska Institute, Sjukhusbacken 10, 11883, Stockholm, Sweden
| | - O Stackelberg
- Department of Clinical Science and Education, Södersjukhuset, and Department of Surgery, Södersjukhuset, Karolinska Institute, Sjukhusbacken 10, 11883, Stockholm, Sweden.,Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Karolinska Institute, Stockholm, Sweden
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Lebedev AV, Acar K, Garzón B, Almeida R, Råback J, Åberg A, Martinsson S, Olsson A, Louzolo A, Pärnamets P, Lövden M, Atlas L, Ingvar M, Petrovic P. Psychedelic drug use and schizotypy in young adults. Sci Rep 2021; 11:15058. [PMID: 34301969 PMCID: PMC8302700 DOI: 10.1038/s41598-021-94421-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Abstract
Despite recently resurrected scientific interest in classical psychedelics, few studies have focused on potential harms associated with abuse of these substances. In particular, the link between psychedelic use and psychotic symptoms has been debated while no conclusive evidence has been presented. Here, we studied an adult population (n = 1032) with a special focus on young (18–35 years) and healthy individuals (n = 701) to evaluate the association of psychedelic drug use with schizotypy and evidence integration impairment typically observed in psychosis-spectrum disorders. Experimental behavioural testing was performed in a subsample of the subjects (n = 39). We observed higher schizotypy scores in psychedelic users in the total sample. However, the effect size was notably small and only marginally significant when considering young and healthy subjects (Cohen’s d = 0.13). Controlling for concomitant drug use, none of our analyses found significant associations between psychedelic use and schizotypal traits. Results from experimental testing showed that total exposure to psychedelics (frequency and temporal proximity of use) was associated with better evidence integration (Cohen’s d = 0.13) and a higher sensitivity of fear responses (Cohen’s d = 1.05) to the effects instructed knowledge in a reversal aversive learning task modelled computationally with skin conductance response and pupillometry. This effect was present even when controlling for demographics and concomitant drug use. On a group level, however, only difference in sensitivity of fear responses to instructed knowledge reached statistical significance. Taken together, our findings suggest that psychedelic drug use is only weakly associated with psychosis-like symptoms, which, in turn, is to a large extent explained by psychiatric comorbidities and use of other psychoactive substances. Our results also suggest that psychedelics may have an effect on flexibility of evidence integration and aversive learning processes, that may be linked to recently suggested therapeutic effects of psychedelic drugs in non-psychotic psychiatric populations.
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Affiliation(s)
- Alexander V Lebedev
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden.
| | - K Acar
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - B Garzón
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Department of Psychology, University of Gothenburg, Göteborg, Sweden
| | - R Almeida
- Stockholm University Brain Imaging Center (SUBIC), Stockholm University, Stockholm, Sweden
| | - J Råback
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Åberg
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - S Martinsson
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - A Louzolo
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - P Pärnamets
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden.,Department of Psychology, New York University, New York, USA
| | - M Lövden
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Department of Psychology, University of Gothenburg, Göteborg, Sweden
| | - L Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA.,National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA.,National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Martin Ingvar
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
| | - P Petrovic
- Department of Clinical Neuroscience, Karolinska Institutet, K8 Klinisk neurovetenskap, K8 Neuro Ingvar, 171 77, Stockholm, Sweden
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Olsson A, Gustavsen S, Langkilde AR, Hansen TH, Sellebjerg F, Bach Søndergaard H, Oturai AB. Circulating levels of tight junction proteins in multiple sclerosis: Association with inflammation and disease activity before and after disease modifying therapy. Mult Scler Relat Disord 2021; 54:103136. [PMID: 34247104 DOI: 10.1016/j.msard.2021.103136] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/19/2021] [Accepted: 06/29/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Tight junction proteins contribute to maintenance of epithelial and endothelial barriers such as the intestinal barrier and the blood brain barrier (BBB). Increased permeability of these barriers has been linked to disease activity in MS and there is currently a lack of easily accessible biomarkers predicting disease activity in MS. AIM To investigate whether levels of circulating tight junction proteins occludin and zonula occludens-1 (ZO-1) are associated with biomarkers of inflammation and disease activity; and to determine whether they could serve as clinical biomarkers. METHODS We prospectively included 72 newly diagnosed patients with relapsing remitting MS or clinically isolated syndrome with no prior disease modifying therapy (DMT) use and 50 healthy controls (HCs). Patients were followed with blood samples, 3 tesla MRI, and clinical evaluation for 12 months. Occludin, ZO-1, calprotectin and soluble urokinase-type plasminogen activator receptor (suPAR) were measured by ELISA; serum neurofilament light (NfL) and IL-6 by single-molecule array (SIMOA). The mRNA expression of IFNG, IL1R1, IL10, IL1B, ARG1 and TNF was measured by quantitative real time polymerase chain reaction (qPCR) in whole blood. RESULTS Plasma occludin levels were higher in MS patients compared with HCs. After 12 months on DMT, occludin levels were reduced by approximately 25% irrespective of 1st or 2nd line DMT (p<0.001). Furthermore, NfL and calprotectin levels were significantly reduced by 31% and 29%, respectively. Occludin and ZO-1 did not correlate with biomarkers of inflammation and did not predict disease activity at baseline or after 12 months. CONCLUSIONS Higher levels of occludin suggest an increased permeability of the BBB and/or the intestinal barrier in MS patients. The reduction of occludin after 12 months on DMTs might reflect repair of these barriers upon treatment. However, plasma levels of ZO-1 and occludin could not predict clinical or MRI disease activity as determined by regression and ROC-curve analysis. Our results do not indicate a clear clinically relevant role for circulating tight junction proteins as biomarkers of disease activity in MS and further investigations in larger cohorts are needed to clarify this issue.
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Affiliation(s)
- A Olsson
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.
| | - S Gustavsen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - A R Langkilde
- Department of Radiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - T H Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - F Sellebjerg
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - H Bach Søndergaard
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - A B Oturai
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
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Olsson A, Gustavsen S, Gisselø Lauridsen K, Chenoufi Hasselbalch I, Sellebjerg F, Bach Søndergaard H, Bang Oturai A. Neutrophil-to-lymphocyte ratio and CRP as biomarkers in multiple sclerosis: A systematic review. Acta Neurol Scand 2021; 143:577-586. [PMID: 33591593 DOI: 10.1111/ane.13401] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/20/2021] [Accepted: 01/25/2021] [Indexed: 01/22/2023]
Abstract
Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system, which causes demyelination and neuroaxonal damage. Low-grade systemic inflammation has been suggested to contribute to the pathogenesis due to amplification of pathogenic immune activation. However, there is a lack of reliable biomarkers of systemic inflammation predicting disease activity and progression in MS. The neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) have been identified as biomarkers of severity and disease activity in various disorders. In September 2020, we conducted a systematic literature search on multiple databases on studies reporting NLR values or CRP levels in MS. The aim of this systematic review was to highlight the current knowledge about the potential of NLR and CRP as biomarkers in MS. A total of nineteen articles qualified for inclusion. Data on CRP were included in fourteen studies and NLR in nine studies. The results regarding CRP were inconsistent, and present literature does not support the use of CRP as a diagnostic or prognostic biomarker in MS. In contrast, NLR values were increased in MS patients compared with healthy controls in all case-control studies. Furthermore, NLR was associated with disease activity in untreated patients. Our systematic review therefore indicates that NLR might serve as a potential biomarker of disease activity. Given that the results of NLR are mainly drawn from retrospective case-control or cross-sectional studies, future prospective studies with long-term follow-up are required to accurately determine optimal timing and cutoff values that may be used in the clinical setting.
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Affiliation(s)
- Anna Olsson
- Department of Neurology Danish Multiple Sclerosis Center RigshospitaletUniversity of Copenhagen Glostrup Denmark
| | - Stefan Gustavsen
- Department of Neurology Danish Multiple Sclerosis Center RigshospitaletUniversity of Copenhagen Glostrup Denmark
| | - Katrine Gisselø Lauridsen
- Department of Neurology Danish Multiple Sclerosis Center RigshospitaletUniversity of Copenhagen Glostrup Denmark
| | - Ida Chenoufi Hasselbalch
- Department of Neurology Danish Multiple Sclerosis Center RigshospitaletUniversity of Copenhagen Glostrup Denmark
| | - Finn Sellebjerg
- Department of Neurology Danish Multiple Sclerosis Center RigshospitaletUniversity of Copenhagen Glostrup Denmark
| | - Helle Bach Søndergaard
- Department of Neurology Danish Multiple Sclerosis Center RigshospitaletUniversity of Copenhagen Glostrup Denmark
| | - Annette Bang Oturai
- Department of Neurology Danish Multiple Sclerosis Center RigshospitaletUniversity of Copenhagen Glostrup Denmark
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Holmström M, Olsson E, Astermark J, Axelsson M, Olsson A, Myrin Westesson L, Falk A, Szamosi J, Sennfält K. Real-world prophylactic usage of recombinant factor VIII Fc in Sweden: A report from the Swedish national registry for bleeding disorders. Haemophilia 2021; 27:e554-e558. [PMID: 33982353 DOI: 10.1111/hae.14316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/23/2021] [Accepted: 04/03/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Margareta Holmström
- Coagulation Unit, Dept of Hematology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Elsa Olsson
- Coagulation Unit, Dept of Hematology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Jan Astermark
- Department of Translational Medicine, Lund University, Malmö, Sweden.,Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Malmö, Sweden
| | - Malin Axelsson
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Malmö, Sweden
| | - Anna Olsson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Linda Myrin Westesson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Aletta Falk
- Swedish Orphan Biovitrum AB, Stockholm, Sweden
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Astermark J, Olsson A, Chelle P, Täckström K, Walger M, Magnusson M, Iorio A. Comparison of single subject and population-based pharmacokinetics for optimizing prophylaxis with simoctocog alfa in patients with haemophilia A. Haemophilia 2021; 27:626-633. [PMID: 33966319 DOI: 10.1111/hae.14329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/30/2021] [Accepted: 04/21/2021] [Indexed: 01/19/2023]
Abstract
INTRODUCTION The use of pharmacokinetic assessment for optimal prophylactic dosing of factor concentrates in haemophilia has gained increasing enthusiasm over the last decade. However, blood sampling on several occasions is burdensome and limited sampling using population-based PK is appealing. AIM To compare the pharmacokinetics and dosing recommendations for prophylaxis using six-point single subject versus population-based method (WAPPS-Hemo) for simoctocog alfa (Nuwiq® ). METHODS Twelve adult patients with severe haemophilia A received a factor VIII (FVIII) dose of ≈50 IU/kg, and the activity was measured pre-infusion and at 30 min, 6, 9, 24 and 48 h post-infusion. Half-life (t1 /2 ), weight-normalized AUC and time to troughs of 5%, 3% and 1% were calculated. The correlation between the PK algorithms was assessed using intraclass correlations (ICC) and dosing estimations were provided. RESULTS WAPPS-Hemo yielded a slightly longer mean t1 /2 , but the overall correlation between the methods was good (ICC ≥0.79) The time to troughs of 5%, 3% and 1% showed ICCs ≥0.86. For all variables, the most converging limited time point was 6+48 h. Additional time points did not improve the correlation. Despite similar pharmacokinetics, the mean estimated dose for a specific trough level varied from 60% less to 20% more using the population-based approach. The time to 1% and the corresponding dose was sensitive to the baseline assumption. CONCLUSION Our data support the use of population-based PK for patients on simoctocog alfa prophylaxis but also indicates differences, stressing the importance of the sampling scheme and monitoring actual FVIII levels achieved.
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Affiliation(s)
- Jan Astermark
- Department of Translational Medicine, Lund University, Malmö, Sweden.,Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Malmö, Sweden
| | - Anna Olsson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Pierre Chelle
- School of Pharmacy, University of Waterloo, Waterloo, Canada
| | | | | | - Maria Magnusson
- Karolinska Institutet, Coagulation Unit, Department of Hematology, Department of Pediatrics, CLINTEC, Clinical Chemistry & Coagulation, MMK, Karolinska University Hospital, Stockholm, Sweden
| | - Alfonso Iorio
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
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Olsson A, Gustavsen S, Nguyen TD, Nyman M, Langkilde AR, Hansen TH, Sellebjerg F, Oturai AB, Bach Søndergaard H. Serum Short-Chain Fatty Acids and Associations With Inflammation in Newly Diagnosed Patients With Multiple Sclerosis and Healthy Controls. Front Immunol 2021; 12:661493. [PMID: 34025661 PMCID: PMC8134701 DOI: 10.3389/fimmu.2021.661493] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/16/2021] [Indexed: 12/14/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic immune-mediated disease characterized by demyelination and neuroaxonal damage in the central nervous system. The etiology is complex and is still not fully understood. Accumulating evidence suggests that our gut microbiota and its metabolites influence the MS pathogenesis. Short-chain fatty acids (SCFAs), such as acetate, propionate and butyrate, are metabolites produced by gut microbiota through fermentation of indigestible carbohydrates. SCFAs and kynurenine metabolites have been shown to have important immunomodulatory properties, and propionate supplementation in MS patients has been associated with long-term clinical improvement. However, the underlying mechanisms of action and its importance in MS remain incompletely understood. We analyzed serum levels of SCFAs and performed targeted metabolomics in relation to biomarkers of inflammation, and clinical and MRI measures in newly diagnosed patients with relapsing-remitting MS before their first disease modifying therapy and healthy controls (HCs). We demonstrated that serum acetate levels were nominally reduced in MS patients compared with HCs. The ratios of acetate/butyrate and acetate/(propionate + butyrate) were significantly lower in MS patients in a multivariate analysis (orthogonal partial least squares discriminant analysis; OPLS-DA). The mentioned ratios and acetate levels correlated negatively with the pro-inflammatory biomarker IFNG, indicating an inverse relation between acetate and inflammation. In contrast, the proportion of butyrate was found higher in MS patients in the multivariate analysis, and both butyrate and valerate correlated positively with proinflammatory cytokines (IFNG and TNF), suggesting complex bidirectional regulatory properties of SCFAs. Branched SCFAs were inversely correlated with clinical disability, at a nominal significance level. Otherwise SCFAs did not correlate with clinical variables or MRI measures. There were signs of an alteration of the kynurenine pathway in MS, and butyrate was positively correlated with the immunomodulatory metabolite 3-hydroxyanthranilic acid. Other variables that influenced the separation between MS and HCs were NfL, ARG1 and IL1R1, D-ribose 5-phosphate, pantothenic acid and D-glucuronic acid. In conclusion, we provide novel results in this rapidly evolving field, emphasizing the complexity of the interactions between SCFAs and inflammation; therefore, further studies are required to clarify these issues before supplementation of SCFAs can be widely recommended.
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Affiliation(s)
- Anna Olsson
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Stefan Gustavsen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Thao Duy Nguyen
- Department of Food Technology, Engineering and Nutrition, Kemicentrum, Lund University, Lund, Sweden
| | - Margareta Nyman
- Department of Food Technology, Engineering and Nutrition, Kemicentrum, Lund University, Lund, Sweden
| | - Annika R Langkilde
- Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Tue H Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Finn Sellebjerg
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Annette B Oturai
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
| | - Helle Bach Søndergaard
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark
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Christmas MJ, Jones JC, Olsson A, Wallerman O, Bunikis I, Kierczak M, Peona V, Whitley KM, Larva T, Suh A, Miller-Struttmann NE, Geib JC, Webster MT. Genetic Barriers to Historical Gene Flow between Cryptic Species of Alpine Bumblebees Revealed by Comparative Population Genomics. Mol Biol Evol 2021; 38:3126-3143. [PMID: 33823537 PMCID: PMC8321533 DOI: 10.1093/molbev/msab086] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Evidence is accumulating that gene flow commonly occurs between recently diverged species, despite the existence of barriers to gene flow in their genomes. However, we still know little about what regions of the genome become barriers to gene flow and how such barriers form. Here, we compare genetic differentiation across the genomes of bumblebee species living in sympatry and allopatry to reveal the potential impact of gene flow during species divergence and uncover genetic barrier loci. We first compared the genomes of the alpine bumblebee Bombus sylvicola and a previously unidentified sister species living in sympatry in the Rocky Mountains, revealing prominent islands of elevated genetic divergence in the genome that colocalize with centromeres and regions of low recombination. This same pattern is observed between the genomes of another pair of closely related species living in allopatry (B. bifarius and B. vancouverensis). Strikingly however, the genomic islands exhibit significantly elevated absolute divergence (dXY) in the sympatric, but not the allopatric, comparison indicating that they contain loci that have acted as barriers to historical gene flow in sympatry. Our results suggest that intrinsic barriers to gene flow between species may often accumulate in regions of low recombination and near centromeres through processes such as genetic hitchhiking, and that divergence in these regions is accentuated in the presence of gene flow.
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Affiliation(s)
- Matthew J Christmas
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Julia C Jones
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| | - Anna Olsson
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Ola Wallerman
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Ignas Bunikis
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Marcin Kierczak
- Department of Cell and Molecular Biology, National Bioinformatics Infrastructure Sweden, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Valentina Peona
- Department of Organismal Biology-Systematic Biology, Uppsala University, Uppsala, Sweden
| | - Kaitlyn M Whitley
- Department of Biology, Appalachian State University, Boone, NC, USA.,U.S. Department of Agriculture, Agriculture Research Service, Charleston, SC, USA
| | - Tuuli Larva
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Alexander Suh
- Department of Organismal Biology-Systematic Biology, Uppsala University, Uppsala, Sweden.,School of Biological Sciences, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | | | - Jennifer C Geib
- Department of Biology, Appalachian State University, Boone, NC, USA
| | - Matthew T Webster
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
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Måseide RJ, Berntorp E, Astermark J, Hansen J, Olsson A, Bruzelius M, Frisk T, Aspdahl M, Nummi V, Tjønnfjord GE, Holme PA. Haemophilia early arthropathy detection with ultrasound and haemophilia joint health score in the moderate haemophilia (MoHem) study. Haemophilia 2021; 27:e253-e259. [PMID: 33550602 DOI: 10.1111/hae.14245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/10/2020] [Accepted: 12/17/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Detection of early arthropathy is crucial for the management of haemophilia, but data on moderate haemophilia are limited. Therefore, we evaluated joint health and treatment modalities in Nordic patients with moderate haemophilia A (MHA) and B (MHB). AIM To explore and compare the Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) and Haemophilia Joint Health Score (HJHS) to detect early arthropathy in moderate haemophilia. METHODS A cross-sectional, multicentre study covering Nordic patients with MHA and MHB. Arthropathy was evaluated by HEAD-US and HJHS 2.1. RESULTS We assessed 693 joints in 118 patients. HEAD-US scores (medians [interquartile ranges]) were as follows: elbows 0 points (0-0), knees 0 (0-0) and ankles 0 (0-1). Respectively, by HJHS: elbows 0 (0-1), knees 0 (0-1) and ankles 0 (0-1). Cartilage (14%) and bone (13%) were most commonly affected by HEAD-US. Frequent HJHS findings were crepitus on motion in knees (39%), and loss of flexion (23%) and extension (13%) in ankles. HEAD-US correlated strongly with HJHS (elbows r = .70, knees r = .60 and ankles r = .65), but 24% had discordant scores. Joints with HJHS zero points, 5% captured HEAD-US ≥1 point. Moreover, 26% had HJHS findings without HEAD-US pathology. Notably, 31% of knees had crepitus on motion and normal HEAD-US. CONCLUSION Overall, the joints attained low scores implying good joint health. HEAD-US correlated strongly with HJHS. In 5%, HEAD-US detected subclinical pathology. Crepitus on motion was frequently reported despite normal HEAD-US, thus not necessarily reflecting arthropathy. HEAD-US therefore improves the joint assessment in moderate haemophilia.
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Affiliation(s)
- Ragnhild J Måseide
- Department of Haematology, Oslo University Hospital, Oslo, Norway.,Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erik Berntorp
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Jan Astermark
- Department of Translational Medicine, Lund University, Malmö, Sweden.,Department of Haematology, Skåne University Hospital, Malmö, Sweden
| | - Jessica Hansen
- Rehabilitation Unit, Emergency care/Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Anna Olsson
- Department of Medicine, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Maria Bruzelius
- Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.,Department of Haematology, Karolinska University Hospital, Stockholm, Sweden
| | - Tony Frisk
- Pediatric Coagulation, Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Aspdahl
- Function Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Vuokko Nummi
- Coagulation Disorders Unit, Haematology, Comprehensive Cancer Centre, Helsinki University Hospital and Research Program in Systems Oncology, Faculty of Medicine, Helsinki University, Helsinki, Finland
| | - Geir E Tjønnfjord
- Department of Haematology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pål A Holme
- Department of Haematology, Oslo University Hospital, Oslo, Norway.,Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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41
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Sorensen PS, Kopp TI, Joensen H, Olsson A, Sellebjerg F, Magyari M. Age and sex as determinants of treatment decisions in patients with relapsing-remitting MS. Mult Scler Relat Disord 2021; 50:102813. [PMID: 33578207 DOI: 10.1016/j.msard.2021.102813] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND . Most patients with relapsing-remitting multiple sclerosis (RRMS) are initially treated with moderate efficacy disease-modifying therapies (meDMTs), and only a smaller group of highly active patients are initiated on a high efficacy disease-modifying therapy (heDMT). Real-world data have shown that choosing a heDMT as the initial therapy in highly active RRMS patients is more effective than using a meDMT, and that in patients with breakthrough disease on a meDMT escalation of treatment to a heDMT is more effective than staying on the same or switching to another meDMT. The role of age and sex as determinants for selection of the initial treatment intensity, and for using escalation of treatment intensity in patients with relapse activity on treatment with meDMTs, is only partially known. METHODS . We included all Danish patients with RRMS registered in The Danish Multiple Sclerosis Registry who began a DMT since 2014 and stratified the cohort according to sex and age < 40 and ≥ 40 years at first DMT treatment. We studied determinants, with emphasis on age and sex, for the primary choice of therapy, for adherence to the initial therapy and for treatment escalation. Based on existing literature and clinical relevance, we included the following potential confounders in the analyses: DMT efficacy, pre-treatment relapse activity, disease duration, Expanded Disability Status Scale (EDSS) score, and, in a subgroup, MRI activity. RESULTS . With all covariates mutually adjusted, patient age was a strong decisive factor for choosing a heDMT with odds ratio 1.69 for starting a heDMT in patients < 40 years compared with patients ≥ 40 years. Men had odds ratio 1.53 for starting with a heDMT compared with women. The odds ratio of heDMT in patients with EDSS > 3 vs ≤ 3 was 3.49, and every additional relapse was associated with increased odds ratio 2.33 for heDMT. Patients were more adherent to the initial heDMTs than to the initial meDMTs. Patients above 40 years were more prone to stay on the initial treatment compared to patients below 40, regardless of whether the initial treatment was meDMT (p<0.001) or heDMT (p=0.008) (covariates mutually adjusted). Relapse activity resulted in escalation of therapy to a heDMT in 67% of patients aged < 40 years (N=273) and in 56% patients aged 40 years or above (N=159) (p=0.008), and younger patients had odds ratio 1.46 of escalating therapy compared to older patients. Male patients were more likely to have treatment escalation to heDMTs than female patients (odds ratio 2.03). CONCLUSION . Age and sex appear to be independent determinants for the choice of the initial DMT and for the decision of treatment escalation in patients with breakthrough disease on a meDMT. It is unfortunate, if older age is a factor that make choice of a heDMT more unlikely, as many DMTs seems to be less efficacious in older patients.
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Affiliation(s)
- Per Soelberg Sorensen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | - Tine Iskov Kopp
- The Danish Multiple Sclerosis Registry, Department of Neurology, Rigshospitalet, Denmark
| | - Hanna Joensen
- The Danish Multiple Sclerosis Registry, Department of Neurology, Rigshospitalet, Denmark
| | - Anna Olsson
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Finn Sellebjerg
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Melinda Magyari
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; The Danish Multiple Sclerosis Registry, Department of Neurology, Rigshospitalet, Denmark
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Ogmundsdottir Michelsen H, Sjolin I, Back M, Gonzalez M, Olsson A, Sandberg C, Schiopu A, Leosdottir M. Effect of a lifestyle-focused electronic patient support application on risk factor management in post-myocardial infarction patients – a randomized controlled trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiac rehabilitation (CR) is central in reducing morbidity and mortality after myocardial infarction (MI). However, the fulfillment of guideline recommended CR targets is unsatisfactory. eHealth offers new possibilities to improve clinical care.
Purpose
The aim of this study was to assess the efficacy of a mobile device application to support adherence to lifestyle advice and self-control of risk factors as a complement to traditional CR after MI.
Method
This unblinded multi-centre randomized controlled trial included 150 patients with MI (81% men, 60.4±8.8 years). All patients in the intervention (INT) and control (CON) groups participated in a 1-year CR program. Additionally, INT patients (n=101) received access to the mobile device application for 25 weeks post-MI where information about lifestyle (i.e., diet, physical activity, smoking), modifiable risk factors (i.e., weight, blood pressure (BP)), and symptoms could be registered. The software provided direct positive feedback and lifestyle advice. Data was reviewed twice weekly by the CR nurse. The primary outcome was change in sub-maximal exercise capacity (W) between an exercise test 2-weeks post MI and at follow-up 4 month later. Secondary outcomes included changes in lifestyle and modifiable risk factors including body mass index, waist circumference, blood-lipids, fasting glucose and HbA1c, between baseline and 2-week, 2-month and 1-year follow-up visits. Regression analysis was used, adjusting for relevant baseline variables.
Results
Participation in CR was high, with 96% of INT patients and 98% of the CON patients attending the 1-year follow-up visit. Forty-six percent of the INT patients and 57% of the CON patients attended centre-based exercise training (p=0.1). In the INT group 86% logged data in the application at least once. Adherence, defined as logging data at least twice per week, was 92% in week 1 and 57% in week 25. There was a numerical trend toward better exercise capacity improvement in the INT group (INT +14.4±19.0 vs. CON +10.3±16.1 W, p=0.2) although differences were non-significant. INT patients achieved larger BP reduction at 2-weeks (systolic) and 2-months (systolic and diastolic) (Figure). At 2-months 70% vs. 46% of smokers in the INT vs CON groups had quit smoking, and at 1-year the respective percentages were 57% vs. 36%. The number of smokers in the study was however low (n=33) and the differences non-significant. For other secondary endpoints no differences were observed.
Conclusion
Complementing CR with a mobile device application improved BP during the first months after MI, and non-significant trends towards better exercise capacity and higher smoking cessation rates were observed. Even though the differences were non-significant in our small study sample, they indicate that using eHealth in the form of a mobile device application could clinically benefit post-MI patients participating in CR.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Governmental funding of clinical research within the National Health Services in Sweden.
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Affiliation(s)
| | - I Sjolin
- Lund University, Department of Clinical Sciences, Malmo, Sweden
| | - M Back
- Linkoping University, Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linkoping, Sweden
| | - M Gonzalez
- Umea University, Department of Public Health and Clinical Medicine, Cardiology, Umea, Sweden
| | - A Olsson
- Skane University Hospital, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - C Sandberg
- Umea University, Department of Public Health and Clinical Medicine, Cardiology, Umea, Sweden
| | - A Schiopu
- Lund University, Department of Clinical Sciences, Malmo, Sweden
| | - M Leosdottir
- Lund University, Department of Clinical Sciences, Malmo, Sweden
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Abstract
Mental ill-health has been termed the pandemic of the 21st century, and a large share of those exposed do not receive treatment. Many people with depression, anxiety and other mental health problems consult complementary or alternative medicine (CAM), and CAM is used in conventional psychiatric care, in Sweden and in other countries. However, the extent to which CAM is used in psychiatric care, and for what purposes, are largely unknown. This study is based on a survey distributed to all heads of regional, municipal, private and governmental health care units treating persons with psychiatric symptoms across Sweden in 2019. CAM was reportedly used by 62% of the 489 responding health care units, for symptoms including anxiety, sleep disturbances and depression. Main motivations for CAM use were symptom relief, meeting patients' requests and reduced demand for pharmaceutical medication. Very few respondents reported side effects. The most common reason for interrupting CAM use at a unit was a lack of trained professionals. This study confirms the need for further research about CAM, and for CAM education and training among healthcare professionals.
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Affiliation(s)
- Maria Wemrell
- Unit for Social Epidemiology, Faculty of Medicine, Lund University, Malmö, Sweden.,Department of Gender Studies, Faculty of Social Sciences, Lund University, Lund, Sweden
| | - Anna Olsson
- Health Sciences Center, Faculty of Medicine, Lund University, Sweden
| | - Kajsa Landgren
- Health Sciences Center, Faculty of Medicine, Lund University, Sweden.,Office of Psychiatry and Habilitation, Psychiatric Clinic in Lund, Sweden Region Skåne
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44
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Carlstedt A, Bringman S, Egberth M, Emanuelsson P, Olsson A, Petersson U, Pålstedt J, Sandblom G, Sjödahl R, Stark B, Strigård K, Tall J, Theodorsson E. Management of Diastasis of the Rectus Abdominis Muscles: Recommendations for Swedish National Guidelines. Scand J Surg 2020; 110:452-459. [PMID: 32988320 PMCID: PMC8551433 DOI: 10.1177/1457496920961000] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Diastasis of the rectus abdominis muscle is a common condition. There are no generally accepted criteria for diagnosis or treatment of diastasis of the rectus abdominis muscle, which causes uncertainty for the patient and healthcare providers alike. Methods: The consensus document was created by a group of Swedish surgeons and based on a structured literature review and practical experience. Results: The proposed criteria for diagnosis and treatment of diastasis of the rectus abdominis muscle are as follows: (1) Diastasis diagnosed at clinical examination using a caliper or ruler for measurement. Diagnostic imaging by ultrasound or other imaging modality, should be performed when concurrent umbilical or epigastric hernia or other cause of the patient’s symptoms cannot be excluded. (2) Physiotherapy is the firsthand treatment for diastasis of the rectus abdominis muscle. Surgery should only be considered in diastasis of the rectus abdominis muscle patients with functional impairment, and not until the patient has undergone a standardized 6-month abdominal core training program. (3) The largest width of the diastasis should be at least 5 cm before surgical treatment is considered. In case of pronounced abdominal bulging or concomitant ventral hernia, surgery may be considered in patients with a smaller diastasis. (4) When surgery is undertaken, at least 2 years should have elapsed since last childbirth and future pregnancy should not be planned. (5) Plication of the linea alba is the firsthand surgical technique. Other techniques may be used but have not been found superior. Discussion: The level of evidence behind these statements varies, but they are intended to lay down a standard strategy for treatment of diastasis of the rectus abdominis muscle and to enable uniformity of management.
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Affiliation(s)
- A Carlstedt
- Department of Surgery, Karlstad Central Hospital, Karlstad, Sweden
| | - S Bringman
- Department of Surgery, Södertälje Hospital, Stockholm, Sweden.,Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden
| | - M Egberth
- Department of Surgery, Mora hospital, Mora, Sweden
| | - P Emanuelsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden
| | - A Olsson
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Clinic of Surgery, Capio CFTK, Stockholm, Sweden
| | - U Petersson
- Department of Surgery, Skåne University Hospital, Lund University, Malmö, Sweden
| | - J Pålstedt
- Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery, Ersta Hospital, Stockholm, Sweden
| | - G Sandblom
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - R Sjödahl
- Department of Surgery, Linköping University Hospital, Linköping, Sweden
| | - B Stark
- Department of Molecular Medicine and Surgery, Karolinska Institute, Solna, Sweden
| | - K Strigård
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - J Tall
- Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery, Ersta Hospital, Stockholm, Sweden
| | - E Theodorsson
- Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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45
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Wistrand-Yuen P, Olsson A, Skarp KP, Friberg L, Nielsen E, Lagerbäck P, Tängdén T. Evaluation of polymyxin B in combination with 13 other antibiotics against carbapenemase-producing Klebsiella pneumoniae in time-lapse microscopy and time-kill experiments. Clin Microbiol Infect 2020; 26:1214-1221. [DOI: 10.1016/j.cmi.2020.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/17/2020] [Accepted: 03/10/2020] [Indexed: 12/17/2022]
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46
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Fager C, Röding M, Olsson A, Lorén N, von Corswant C, Särkkä A, Olsson E. Optimization of FIB-SEM Tomography and Reconstruction for Soft, Porous, and Poorly Conducting Materials. Microsc Microanal 2020; 26:837-845. [PMID: 32438937 DOI: 10.1017/s1431927620001592] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Tomography using a focused ion beam (FIB) combined with a scanning electron microscope (SEM) is well-established for a wide range of conducting materials. However, performing FIB–SEM tomography on ion- and electron-beam-sensitive materials as well as poorly conducting soft materials remains challenging. Some common challenges include cross-sectioning artifacts, shadowing effects, and charging. Fully dense materials provide a planar cross section, whereas pores also expose subsurface areas of the planar cross-section surface. The image intensity of the subsurface areas gives rise to overlap between the grayscale intensity levels of the solid and pore areas, which complicates image processing and segmentation for three-dimensional (3D) reconstruction. To avoid the introduction of artifacts, the goal is to examine porous and poorly conducting soft materials as close as possible to their original state. This work presents a protocol for the optimization of FIB–SEM tomography parameters for porous and poorly conducting soft materials. The protocol reduces cross-sectioning artifacts, charging, and eliminates shadowing effects. In addition, it handles the subsurface and grayscale intensity overlap problems in image segmentation. The protocol was evaluated on porous polymer films which have both poor conductivity and pores. 3D reconstructions, with automated data segmentation, from three films with different porosities were successfully obtained.
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Affiliation(s)
- Cecilia Fager
- Department of Physics, Chalmers University of Technology, GothenburgSE-41296, Sweden
| | - Magnus Röding
- RISE Research Institutes of Sweden, Agrifood and Bioscience, Gothenburg, Sweden
| | - Anna Olsson
- AstraZeneca R&D Mölndal, MölndalSE43183, Sweden
| | - Niklas Lorén
- Department of Physics, Chalmers University of Technology, GothenburgSE-41296, Sweden
- RISE Research Institutes of Sweden, Agrifood and Bioscience, Gothenburg, Sweden
| | | | - Aila Särkkä
- Department of Mathematical Sciences, Chalmers University of Technology and University of Gothenburg, Gothenburg, Sweden
| | - Eva Olsson
- Department of Physics, Chalmers University of Technology, GothenburgSE-41296, Sweden
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47
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Måseide RJ, Berntorp E, Astermark J, Olsson A, Bruzelius M, Frisk T, Nummi V, Lassila R, Tjønnfjord GE, Holme PA. Joint health and treatment modalities in Nordic patients with moderate haemophilia A and B – The MoHem study. Haemophilia 2020; 26:891-897. [DOI: 10.1111/hae.14114] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/29/2020] [Accepted: 07/08/2020] [Indexed: 01/10/2023]
Affiliation(s)
- Ragnhild J. Måseide
- Department of Haematology Oslo University Hospital Oslo Norway
- Research Institute of Internal Medicine Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Erik Berntorp
- Department of Translational Medicine Lund University Malmö Sweden
| | - Jan Astermark
- Department of Translational Medicine Lund University Malmö Sweden
- Department of Haematology Skåne University Hospital Malmö Sweden
| | - Anna Olsson
- Department of Medicine Sahlgrenska University Hospital Gothenburg Sweden
| | - Maria Bruzelius
- Molecular Medicine and Surgery Karolinska Institute Stockholm Sweden
- Department of Haematology Karolinska University Hospital Stockholm Sweden
| | - Tony Frisk
- Pediatric Coagulation Karolinska University Hospital Stockholm Sweden
| | - Vuokko Nummi
- Coagulation Disorders Unit Haematology Comprehensive Cancer Centre Helsinki University Hospital and Research Program in Systems Oncology Faculty of Medicine Helsinki University Helsinki Finland
| | - Riitta Lassila
- Coagulation Disorders Unit Haematology Comprehensive Cancer Centre Helsinki University Hospital and Research Program in Systems Oncology Faculty of Medicine Helsinki University Helsinki Finland
| | - Geir E. Tjønnfjord
- Department of Haematology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Pål A. Holme
- Department of Haematology Oslo University Hospital Oslo Norway
- Research Institute of Internal Medicine Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
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48
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Olsson A, Landgren K. Getting Well Is More Than Gaining Weight - Patients' Experiences of a Treatment Program for Anorexia Nervosa Including Ear Acupuncture. Issues Ment Health Nurs 2020; 41:328-338. [PMID: 31939693 DOI: 10.1080/01612840.2019.1663567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study illuminates how 25 in-patients who were treated for anorexia nervosa in a highly specialized clinic for eating disturbances in Sweden experienced the treatment program. The program included structured eating, medication, restrictions in physical activity and supportive dialogues. Patients were also offered semi-standardized NADA ear acupuncture as a complement to relieve stress, anxiety and tension. In total, 46 interviews were analysed qualitatively using latent content analysis. The results showed how participants strived with their slow transition towards recovery. The novelty of integrating acupuncture in psychiatric treatment makes this study interesting. Acupuncture was experienced to relieve anxiety and somatic symptoms through the whole process. Further research is needed to evaluate the effect of acupuncture on the patient's subjective sense of well-being when used as an adjunct to usual care.
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Affiliation(s)
- Anna Olsson
- Health Sciences Center, Faculty of Medicine, Lund University, Lund, Sweden
| | - Kajsa Landgren
- Psychiatric Clinic in Lund, Office of Psychiatry and Habilitation, Region Skåne, Lund, Sweden
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49
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Schüz J, Kovalevskiy E, Moissonnier M, Olsson A, Hashim D, Kromhout H, Kashanskiy S, Chernov O, Bukhtiyarov I, Ostroumova E. Comparison of Two Information Sources for Cause-of-Death Follow-up in the Russian Federation: The Asbest Chrysotile Cohort Study. Methods Inf Med 2020; 59:9-17. [PMID: 32535878 PMCID: PMC7446113 DOI: 10.1055/s-0040-1710381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/26/2020] [Indexed: 10/28/2022]
Abstract
BACKGROUND The Asbest chrysotile cohort was set up in Asbest town, Sverdlovsk oblast, Russian Federation, among the current and former workforce of the world's largest operating chrysotile mine and its processing mills, to investigate cancer risk in relation to occupational exposure to chrysotile. OBJECTIVES The cohort of 35,837 people was followed-up for mortality using cause-of-death information from official death certificates issued by the Civil Act Registration Office (ZAGS) of Sverdlovsk oblast from 1976 to 2015. Data were also retrieved from the electronic cause-of-death registry of the Medical Information Analytical Centre (MIAC) of Sverdlovsk oblast, which was launched in 1990 and operates independently of ZAGS. The objectives were to compare the completeness of record linkage (RL) with ZAGS and with MIAC, and to compare the agreement of cause-of-death information obtained from ZAGS and from MIAC, with a focus on malignant neoplasms. METHODS RL completeness of identifying cohort members in ZAGS and in MIAC was compared for the period 1990 to 2015. In the next step, for the comparison of the retrieved cause-of-death information, 5,463 deaths (1,009 from cancer) were used that were registered in 2002 to 2015, when causes of death were coded using International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) nomenclature by MIAC. For ZAGS, original cause-of-death text from the death certificates was obtained and then coded according to ICD-10 by the International Agency for Research on Cancer/World Health Organization (IARC/WHO). Agreement was evaluated at various levels of detail, and reasons for any disagreements between the MIAC and the IARC/WHO ICD-10-coded cancer diagnosis were systematically explored. RESULTS A total of 10,886 deaths were obtained from all avenues of follow-up for the period 1990 to 2015 in the cohort; 10,816 (99.4%) of these were found in ZAGS. This percentage was 88.3% if only automated deterministic RL was used and 99.4% when deterministic RL was complemented with manual searches of cohort members. Comparison of the cause-of-death information showed agreement of 97.9% at the ICD-10 main group level between ZAGS (coded by IARC/WHO) and MIAC. Of 1,009 cancer deaths, 679 (67.3%) cases had identical coding, 258 (25.6%) cases corresponded at the three-character ICD-10 level, 36 (3.6%) had codes that were within the same anatomical or morphological cluster, and for only 36 (3.6%) cases were major discrepancies identified. Altogether, the agreement between IARC/WHO coding of cause-of-death information from ZAGS and MIAC coding of malignant neoplasms was therefore 96.4%. CONCLUSIONS RL completeness and agreement of cause-of-death information obtained from ZAGS and from MIAC were both very high. This is reassuring for the quality of cancer mortality follow-up of the Asbest chrysotile cohort. For future epidemiological studies in the Russian Federation, ZAGS appears to be a reliable information source for mortality follow-up, if the automated RL is complemented with manual searches of cohort members. MIAC is a good resource for prospective studies.
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Affiliation(s)
- J. Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - E. Kovalevskiy
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health,” Moscow, Russian Federation
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - M. Moissonnier
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - A. Olsson
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - D. Hashim
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - H. Kromhout
- Institute of Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - S. Kashanskiy
- Yekaterinburg Medical Research Center for Prophylaxis and Health Protection in Industrial Workers, Yekaterinburg, Russian Federation
| | - O. Chernov
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health,” Moscow, Russian Federation
| | - I. Bukhtiyarov
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health,” Moscow, Russian Federation
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - E. Ostroumova
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC/WHO), Lyon, France
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Jorhem L, Afthan G, Cumont G, Dypdahl HP, Gadd K, Havre GN, Julshamn K, Kaverud K, Lind B, Loimaranta J, Merseburg M, Olsson A, Piepponen S, Sundstrom B, Uppstad BJ, Waaler T, Winnerstam L. Determination of Metals in Foodstuffs by Atomic Absorption Spectrophotometry after Dry Ashing: NMKL Interlaboratory Study of Lead, Cadmium, Zinc, Copper, Iron, Chromium, and Nickel. J AOAC Int 2020. [DOI: 10.1093/jaoac/76.4.798] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
An interlaboratory study of a method for determination of lead, cadmium, zinc, copper, iron, chromium, and nickel in foodstuffs by atomic absorption spectrophotometry (AAS) after dry ashing at 450°C was conducted in 16 laboratories. The study was preceded by a practice round of familiarization samples and another round in which solutions were distributed and the metals were determined directly by AAS. The study included 5 different foods (liver paste, apple sauce, minced fish, wheat bran, and milk powder) and 2 composite diets. A single analysis was carried out on each sample. Suitable sample combinations were used as split level combinations for determination of the repeatability standard deviation. The relative reproducibility standard deviation for each of the elements ranged as follows: lead, 74-18% at 0.025-0.28 mg/kg; cadmium, 80-11% (0.002-0.51 mg/kg); zinc, 12-7% (44- 72 mg/kg); copper, 47-10% (0.48-41 mg/kg); iron, 35-9% (2-228 mg/kg); chromium, 48-21 % (0.008- 0.22 mg/kg); nickel, 64-39% (0.025-0.39 mg/kg).
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Affiliation(s)
- Lars Jorhem
- Swedish National Food Administration, PO Box 622, S-751 26 Uppsala, Sweden
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