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Zhang C, Nilsson H, Ebihara Y, Yamauchi M, Persson M, Rong Z, Zhong J, Dong C, Chen Y, Zhou X, Sun Y, Harada Y, Halekas J, Xu S, Futaana Y, Shi Z, Yuan C, Yun X, Fu S, Gao J, Holmström M, Wei Y, Barabash S. Detection of magnetospheric ion drift patterns at Mars. Nat Commun 2023; 14:6866. [PMID: 37891189 PMCID: PMC10611764 DOI: 10.1038/s41467-023-42630-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Mars lacks a global magnetic field, and instead possesses small-scale crustal magnetic fields, making its magnetic environment fundamentally different from intrinsic magnetospheres like those of Earth or Saturn. Here we report the discovery of magnetospheric ion drift patterns, typical of intrinsic magnetospheres, at Mars using measurements from Mars Atmosphere and Volatile EvolutioN mission. Specifically, we observe wedge-like dispersion structures of hydrogen ions exhibiting butterfly-shaped distributions (pitch angle peaks at 22.5°-45° and 135°-157.5°) within the Martian crustal fields, a feature previously observed only in planetary-scale intrinsic magnetospheres. These dispersed structures are the results of drift motions that fundamentally resemble those observed in intrinsic magnetospheres. Our findings indicate that the Martian magnetosphere embodies an intermediate case where both the unmagnetized and magnetized ion behaviors could be observed because of the wide range of strengths and spatial scales of the crustal magnetic fields around Mars.
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Affiliation(s)
- Chi Zhang
- Key Laboratory of Earth and Planetary Physics, Institute of Geology and Geophysics, Chinese Academy of Sciences, Beijing, China
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, China
- Center for Space Physics and Department of Astronomy, Boston University, Boston, MA, USA
| | - Hans Nilsson
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - Yusuke Ebihara
- Research Institute for Sustainable Humanosphere, Kyoto University, Uji, Japan
| | | | - Moa Persson
- Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Japan
| | - Zhaojin Rong
- Key Laboratory of Earth and Planetary Physics, Institute of Geology and Geophysics, Chinese Academy of Sciences, Beijing, China.
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, China.
| | - Jun Zhong
- Key Laboratory of Earth and Planetary Physics, Institute of Geology and Geophysics, Chinese Academy of Sciences, Beijing, China
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Chuanfei Dong
- Center for Space Physics and Department of Astronomy, Boston University, Boston, MA, USA
| | - Yuxi Chen
- Center for Space Physics and Department of Astronomy, Boston University, Boston, MA, USA
| | - Xuzhi Zhou
- School of Earth and Space Sciences, Peking University, Beijing, China
| | - Yixin Sun
- School of Earth and Space Sciences, Peking University, Beijing, China
| | - Yuki Harada
- Department of Geophysics, Graduate School of Science, Kyoto University, Kyoto, Japan
| | - Jasper Halekas
- Department of Physics and Astronomy, University of Iowa, Iowa City, IA, USA
| | - Shaosui Xu
- Space Sciences Laboratory, University of California, Berkeley, Berkeley, CA, USA
| | | | - Zhen Shi
- Key Laboratory of Earth and Planetary Physics, Institute of Geology and Geophysics, Chinese Academy of Sciences, Beijing, China
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Chongjing Yuan
- Key Laboratory of Earth and Planetary Physics, Institute of Geology and Geophysics, Chinese Academy of Sciences, Beijing, China
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Xiaotong Yun
- Department of Space Physics, School of Electronic Information, Wuhan University, Wuhan, China
| | - Song Fu
- Department of Space Physics, School of Electronic Information, Wuhan University, Wuhan, China
| | - Jiawei Gao
- Key Laboratory of Earth and Planetary Physics, Institute of Geology and Geophysics, Chinese Academy of Sciences, Beijing, China
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, China
| | | | - Yong Wei
- Key Laboratory of Earth and Planetary Physics, Institute of Geology and Geophysics, Chinese Academy of Sciences, Beijing, China.
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing, China.
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Sunnergren O, Ahonen H, Holmström M, Broström A. Active anterior rhinomanometry: A study on nasal airway resistance, paradoxical reactions to decongestion, and repeatability in healthy subjects. Laryngoscope Investig Otolaryngol 2023; 8:1136-1145. [PMID: 37899860 PMCID: PMC10601575 DOI: 10.1002/lio2.1157] [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: 06/06/2023] [Revised: 08/01/2023] [Accepted: 09/17/2023] [Indexed: 10/31/2023] Open
Abstract
Objectives Anterior active rhinomanometry (AAR) is widely used in Swedish routine clinical practice to decide if septoplasty is necessary. The scientific basis for the method needs to be strengthened. Therefore, the aims were to evaluate nasal airway resistance (NAR), paradoxical reactions to pharmacological decongestion, and test-retest characteristics of the Rhino-Comp® AAR in healthy subjects. Methods A prospective longitudinal design was used. AAR was performed before and after decongestion at baseline and after ≥6 months on 60 healthy volunteers. The relationships between NAR, height, weight, BMI, sex, and allergic rhinitis were evaluated by regression analyses. Descriptive statistics were used to evaluate paradoxical reactions. Test-retest and repeatability characteristics were evaluated with intra-class coefficients (ICC), Cronbach's α, and standard error of measurement. Results No statistically significant differences were found between genders or nasal cavity sides. NAR was statistically significantly related to height. Short- and long-term test-retest characteristics were good with ICC and Cronbach's α > .75. The minimal significant difference in NAR Log10V2 values between the two measurements was 0.11 and 0.09 (long- and short-term). Paradoxical reactions to pharmacological decongestion were rare, mostly weak, and not evidently reproducible. Conclusion In this study, we report reference data for healthy subjects, test-retest capabilities, and the minimal relevant difference between two measurements for the Rhino-Comp® AAR, information that is vital and necessary for the appropriate use of AAR in clinical practice. An effective method for pharmacological decongestion is described and recommended for future studies and clinical practice. Paradoxical reactions to pharmacological decongestants exist but maybe without clinical significance. Level of Evidence NA.
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Affiliation(s)
- Ola Sunnergren
- Ear, Nose and Throat ClinicRegion Jönköping CountyJönköpingSweden
- Centre for Oral Health, Department of Odontology and Oral Health, School of Health and WelfareJönköping UniversityJönköpingSweden
| | - Hanna Ahonen
- Centre for Oral Health, Department of Odontology and Oral Health, School of Health and WelfareJönköping UniversityJönköpingSweden
| | - Mats Holmström
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of EarNose and Throat Diseases, Karolinska InstituteStockholmSweden
| | - Anders Broström
- Department of Nursing, School of Health and WelfareJönköping UniversityJönköpingSweden
- Department of Clinical NeurophysiologyUniversity Hospital LinköpingLinköpingSweden
- Department of Health and Caring SciencesWestern Norway University of Applied SciencesBergenVestlandetNorway
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Holmström M, Davidsson Å, Stridh B, Melén E, Westman M, Brunkhorst A, Nyström U. [Allergic rhinitis in children and adults - international recommendations adapted to the clinical situation in Sweden]. Lakartidningen 2023; 120:23041. [PMID: 37293752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Allergic rhinitis is the most common chronic disease in Sweden, with impact on quality of life and with a heavy economic burden for the society. More than 20 years have passed since national recommendations were launched, and meanwhile both ARIA (Allergic rhinitis and its impact of asthma) and EUFOREA (The European Forum for Research and Education in Allergy and Airway Diseases) have presented international guidelines which in this article have been adapted to the clinical situation in Sweden. Visual analogue scale (VAS) is recommended for symptom evaluation, and the importance of correct allergen analysis and examination for coexisting asthma is emphasized. Treatment is recommended according to EUFOREA. Follow-up is important, and if VAS is ≥5 the disease is regarded as uncontrolled and must lead to a change of treatment. Since self-treatment is common in allergic rhinitis the importance of patient cooperation and information is underlined.
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Affiliation(s)
- Mats Holmström
- docent, specialist, öron-, näs- och halssjukdomar, CLINTEC, enheten för öron-, näs- och halssjukdomar, Karolinska institutet, Stockholm
| | - Åke Davidsson
- docent, överläkare, öron-, näs- och halssjukdomar, Odensbacken
| | - Björn Stridh
- specialist, allmänmedicin, Kry vårdcentral Gallerian, Stockholm
| | - Erik Melén
- professor, överläkare, institutionen för klinisk forskning och utbildning, Södersjukhuset, Karolinska institutet; Sachsska barn- och ungdomssjukhuset, Stockholm
| | - Marit Westman
- med dr, specialist, öron- näs och halssjukdomar samt allergologi, Astma- och allergimottagningen, Capio S:t Görans sjukhus; institutionen för medicin, Karolinska institutet, Solna
| | | | - Ulla Nyström
- specialist, allergologi, Milly Medical, Rimforsa; tidigare överläkare, Allergicentrum, Linköping
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4
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Kyllesbech C, Trier N, Mughal F, Hansen P, Holmström M, El Fassi D, Hasselbalch H, Skov V, Kjær L, Andersen M, Ciplys E, Slibinskas R, Frederiksen J, Højrup P, Houen G. Antibodies to calnexin and mutated calreticulin are common in human sera. Curr Res Transl Med 2023; 71:103380. [PMID: 36738659 DOI: 10.1016/j.retram.2023.103380] [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: 09/15/2022] [Revised: 01/12/2023] [Accepted: 01/24/2023] [Indexed: 01/30/2023]
Abstract
PURPOSE OF THE STUDY Calreticulin is an endoplasmic reticulum chaperone protein, which is involved in protein folding and in peptide loading of major histocompatibility complex class I molecules together with its homolog calnexin. Mutated calreticulin is associated with a group of hemopoietic disorders, especially myeloproliferative neoplasms. Currently only the cellular immune response to mutated calreticulin has been described, although preliminary findings have indicated that antibodies to mutated calreticulin are not specific for myeloproliferative disorders. These findings have prompted us to characterize the humoral immune response to mutated calreticulin and its chaperone homologue calnexin. PATIENTS AND METHODS We analyzed sera from myeloproliferative neoplasm patients, healthy donors and relapsing-remitting multiple sclerosis patients for the occurrence of autoantibodies to wild type and mutated calreticulin forms and to calnexin by enzyme-linked immunosorbent assay. RESULTS Antibodies to mutated calreticulin and calnexin were present at similar levels in serum samples of myeloproliferative neoplasm and multiple sclerosis patients as well as healthy donors. Moreover, a high correlation between antibodies to mutated calreticulin and calnexin was seen for all patient and control groups. Epitope binding studies indicated that cross-reactive antibodies bound to a three-dimensional epitope encompassing a short linear sequence in the C-terminal of mutated calreticulin and calnexin. CONCLUSION Collectively, these findings indicate that calreticulin mutations may be common and not necessarily lead to onset of myeloproliferative neoplasm, possibly due to elimination of cells with mutations. This, in turn, may suggest that additional molecular changes may be required for development of myeloproliferative neoplasm.
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Affiliation(s)
- C Kyllesbech
- Department of Neurology, Valdemar Hansens vej 23, Rigshospitalet, Glostrup, Denmark; Institute of Biochemistry and Molecular Biology, University of Southern Denmark, Campusvej 55, Odense M, Denmark
| | - N Trier
- Department of Neurology, Valdemar Hansens vej 23, Rigshospitalet, Glostrup, Denmark
| | - F Mughal
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, Copenhagen Ø, Denmark
| | - P Hansen
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, Copenhagen Ø, Denmark
| | - M Holmström
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology, Borgmester Ib Juuls Vej 25C, Copenhagen University Hospital, Herlev, Denmark; Department of Immunology and Microbiology, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark
| | - D El Fassi
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, Denmark
| | - H Hasselbalch
- Department of Hematology, Zealand University Hospital Roskilde, Sygehusvej 10, Roskilde, Denmark
| | - V Skov
- Department of Hematology, Zealand University Hospital Roskilde, Sygehusvej 10, Roskilde, Denmark
| | - L Kjær
- Department of Hematology, Zealand University Hospital Roskilde, Sygehusvej 10, Roskilde, Denmark
| | - M Andersen
- Department of Immunology and Microbiology, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark
| | - E Ciplys
- Institute of Biotechnology, University of Vilnius, Sauletékio al. 7, Vilnius, Lithuania
| | - R Slibinskas
- Institute of Biotechnology, University of Vilnius, Sauletékio al. 7, Vilnius, Lithuania
| | - J Frederiksen
- Department of Neurology, Valdemar Hansens vej 23, Rigshospitalet, Glostrup, Denmark
| | - P Højrup
- Institute of Biochemistry and Molecular Biology, University of Southern Denmark, Campusvej 55, Odense M, Denmark
| | - G Houen
- Department of Neurology, Valdemar Hansens vej 23, Rigshospitalet, Glostrup, Denmark; Institute of Biochemistry and Molecular Biology, University of Southern Denmark, Campusvej 55, Odense M, Denmark.
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5
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Orsini S, Milillo A, Lichtenegger H, Varsani A, Barabash S, Livi S, De Angelis E, Alberti T, Laky G, Nilsson H, Phillips M, Aronica A, Kallio E, Wurz P, Olivieri A, Plainaki C, Slavin JA, Dandouras I, Raines JM, Benkhoff J, Zender J, Berthelier JJ, Dosa M, Ho GC, Killen RM, McKenna-Lawlor S, Torkar K, Vaisberg O, Allegrini F, Daglis IA, Dong C, Escoubet CP, Fatemi S, Fränz M, Ivanovski S, Krupp N, Lammer H, Leblanc F, Mangano V, Mura A, Rispoli R, Sarantos M, Smith HT, Wieser M, Camozzi F, Di Lellis AM, Fremuth G, Giner F, Gurnee R, Hayes J, Jeszenszky H, Trantham B, Balaz J, Baumjohann W, Cantatore M, Delcourt D, Delva M, Desai M, Fischer H, Galli A, Grande M, Holmström M, Horvath I, Hsieh KC, Jarvinen R, Johnson RE, Kazakov A, Kecskemety K, Krüger H, Kürbisch C, Leblanc F, Leichtfried M, Mangraviti E, Massetti S, Moissenko D, Moroni M, Noschese R, Nuccilli F, Paschalidis N, Ryno J, Seki K, Shestakov A, Shuvalov S, Sordini R, Stenbeck F, Svensson J, Szalai S, Szego K, Toublanc D, Vertolli N, Wallner R, Vorburger A. Inner southern magnetosphere observation of Mercury via SERENA ion sensors in BepiColombo mission. Nat Commun 2022; 13:7390. [PMID: 36450728 PMCID: PMC9712576 DOI: 10.1038/s41467-022-34988-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
Mercury's southern inner magnetosphere is an unexplored region as it was not observed by earlier space missions. In October 2021, BepiColombo mission has passed through this region during its first Mercury flyby. Here, we describe the observations of SERENA ion sensors nearby and inside Mercury's magnetosphere. An intermittent high-energy signal, possibly due to an interplanetary magnetic flux rope, has been observed downstream Mercury, together with low energy solar wind. Low energy ions, possibly due to satellite outgassing, were detected outside the magnetosphere. The dayside magnetopause and bow-shock crossing were much closer to the planet than expected, signature of a highly eroded magnetosphere. Different ion populations have been observed inside the magnetosphere, like low latitude boundary layer at magnetopause inbound and partial ring current at dawn close to the planet. These observations are important for understanding the weak magnetosphere behavior so close to the Sun, revealing details never reached before.
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Affiliation(s)
- S Orsini
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy.
| | - A Milillo
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - H Lichtenegger
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - A Varsani
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - S Barabash
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - S Livi
- Southwest Research Institute, San Antonio, TX, USA
- University of Michigan, Department of Climate and Space Sciences and Engineering, Ann Arbor, MI, USA
| | - E De Angelis
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - T Alberti
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - G Laky
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - H Nilsson
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - M Phillips
- Southwest Research Institute, San Antonio, TX, USA
| | - A Aronica
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - E Kallio
- Aalto University, Department of Electronics and Nanoengineering, School of Electrical Engineering, Helsinki, Finland
| | - P Wurz
- University of Bern, Institute of Physics, Bern, Switzerland
| | | | | | - J A Slavin
- University of Michigan, Department of Climate and Space Sciences and Engineering, Ann Arbor, MI, USA
| | - I Dandouras
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - J M Raines
- University of Michigan, Department of Climate and Space Sciences and Engineering, Ann Arbor, MI, USA
| | | | - J Zender
- ESA-ESTEC, Noordwijk, The Netherlands
| | | | - M Dosa
- Wigner Research Centre for Physics, Budapest, Hungary
| | - G C Ho
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD, 20723, USA
| | - R M Killen
- NASA/Goddard Space Flight Center, Greenbelt, MD, 20771, USA
| | | | - K Torkar
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - O Vaisberg
- IKI Space Research Institute, Moscow, Russia
| | - F Allegrini
- Southwest Research Institute, San Antonio, TX, USA
- University of Texas at San Antonio, Department of Physics and Astronomy, San Antonio, TX, USA
| | - I A Daglis
- National and Kapodistrian University of Athens, Department of Physics, Athens, Greece
- Hellenic Space Center, Athens, Greece
| | - C Dong
- Princeton Plasma Physics Laboratory and Department of Astrophysical Sciences, Princeton University, Princeton, NJ, USA
| | | | - S Fatemi
- Department of Physics, Umeå University, Umeå, Sweden
| | - M Fränz
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077, Göttingen, Germany
| | - S Ivanovski
- Astronomincal Observatory, INAF, Trieste, Italy
| | - N Krupp
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077, Göttingen, Germany
| | - H Lammer
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | - V Mangano
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - A Mura
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - R Rispoli
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - M Sarantos
- NASA/Goddard Space Flight Center, Greenbelt, MD, 20771, USA
| | - H T Smith
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD, 20723, USA
| | - M Wieser
- Swedish Institute of Space Physics, Kiruna, Sweden
| | | | | | - G Fremuth
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - F Giner
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - R Gurnee
- Laboratory for Atmospheric and Space Physics, Boulder, CO, USA
| | - J Hayes
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD, 20723, USA
| | - H Jeszenszky
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - B Trantham
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - J Balaz
- Institute of Experimental Physics SAS, Slovak Academy of Sciences, 040 01, Košice, Slovakia
| | - W Baumjohann
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | | | - M Delva
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - M Desai
- Southwest Research Institute, San Antonio, TX, USA
| | - H Fischer
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077, Göttingen, Germany
| | - A Galli
- University of Bern, Institute of Physics, Bern, Switzerland
| | - M Grande
- Aberystwyth University, Aberystwyth, Ceredigion, UK
| | - M Holmström
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - I Horvath
- Wigner Research Centre for Physics, Budapest, Hungary
| | - K C Hsieh
- University of Arizona, Tucson, AZ, USA
| | - R Jarvinen
- Aalto University, Department of Electronics and Nanoengineering, School of Electrical Engineering, Helsinki, Finland
- Finnish Meteorological Institute FMI, Helsinki, Finland
| | - R E Johnson
- University of Virginia, Charlottesville, VA, 22904, USA
| | - A Kazakov
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - K Kecskemety
- Wigner Research Centre for Physics, Budapest, Hungary
| | - H Krüger
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077, Göttingen, Germany
| | - C Kürbisch
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | - M Leichtfried
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | - S Massetti
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - D Moissenko
- IKI Space Research Institute, Moscow, Russia
| | - M Moroni
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - R Noschese
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - F Nuccilli
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - N Paschalidis
- NASA/Goddard Space Flight Center, Greenbelt, MD, 20771, USA
| | - J Ryno
- Finnish Meteorological Institute FMI, Helsinki, Finland
| | - K Seki
- University of Tokyo, Department of Earth and Planetary Science, Graduate School of Science, Tokyo, Japan
| | - A Shestakov
- IKI Space Research Institute, Moscow, Russia
| | - S Shuvalov
- IKI Space Research Institute, Moscow, Russia
| | - R Sordini
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - F Stenbeck
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - J Svensson
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - S Szalai
- Wigner Research Centre for Physics, Budapest, Hungary
| | - K Szego
- Wigner Research Centre for Physics, Budapest, Hungary
| | - D Toublanc
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - N Vertolli
- Institute of Space Astrophysics and Planetology, INAF, Roma, Italy
| | - R Wallner
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - A Vorburger
- University of Bern, Institute of Physics, Bern, Switzerland
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6
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Barragán-Montero A, Bibal A, Dastarac MH, Draguet C, Valdés G, Nguyen D, Willems S, Vandewinckele L, Holmström M, Löfman F, Souris K, Sterpin E, Lee JA. Towards a safe and efficient clinical implementation of machine learning in radiation oncology by exploring model interpretability, explainability and data-model dependency. Phys Med Biol 2022; 67:10.1088/1361-6560/ac678a. [PMID: 35421855 PMCID: PMC9870296 DOI: 10.1088/1361-6560/ac678a] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 11/30/2021] [Accepted: 04/14/2022] [Indexed: 01/26/2023]
Abstract
The interest in machine learning (ML) has grown tremendously in recent years, partly due to the performance leap that occurred with new techniques of deep learning, convolutional neural networks for images, increased computational power, and wider availability of large datasets. Most fields of medicine follow that popular trend and, notably, radiation oncology is one of those that are at the forefront, with already a long tradition in using digital images and fully computerized workflows. ML models are driven by data, and in contrast with many statistical or physical models, they can be very large and complex, with countless generic parameters. This inevitably raises two questions, namely, the tight dependence between the models and the datasets that feed them, and the interpretability of the models, which scales with its complexity. Any problems in the data used to train the model will be later reflected in their performance. This, together with the low interpretability of ML models, makes their implementation into the clinical workflow particularly difficult. Building tools for risk assessment and quality assurance of ML models must involve then two main points: interpretability and data-model dependency. After a joint introduction of both radiation oncology and ML, this paper reviews the main risks and current solutions when applying the latter to workflows in the former. Risks associated with data and models, as well as their interaction, are detailed. Next, the core concepts of interpretability, explainability, and data-model dependency are formally defined and illustrated with examples. Afterwards, a broad discussion goes through key applications of ML in workflows of radiation oncology as well as vendors' perspectives for the clinical implementation of ML.
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Affiliation(s)
- Ana Barragán-Montero
- Molecular Imaging, Radiation and Oncology (MIRO) Laboratory, Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Belgium
| | - Adrien Bibal
- PReCISE, NaDI Institute, Faculty of Computer Science, UNamur and CENTAL, ILC, UCLouvain, Belgium
| | - Margerie Huet Dastarac
- Molecular Imaging, Radiation and Oncology (MIRO) Laboratory, Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Belgium
| | - Camille Draguet
- Molecular Imaging, Radiation and Oncology (MIRO) Laboratory, Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Belgium
- Department of Oncology, Laboratory of Experimental Radiotherapy, KU Leuven, Belgium
| | - Gilmer Valdés
- Department of Radiation Oncology, Department of Epidemiology and Biostatistics, University of California, San Francisco, United States of America
| | - Dan Nguyen
- Medical Artificial Intelligence and Automation (MAIA) Laboratory, Department of Radiation Oncology, UT Southwestern Medical Center, United States of America
| | - Siri Willems
- ESAT/PSI, KU Leuven Belgium & MIRC, UZ Leuven, Belgium
| | | | | | | | - Kevin Souris
- Molecular Imaging, Radiation and Oncology (MIRO) Laboratory, Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Belgium
| | - Edmond Sterpin
- Molecular Imaging, Radiation and Oncology (MIRO) Laboratory, Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Belgium
- Department of Oncology, Laboratory of Experimental Radiotherapy, KU Leuven, Belgium
| | - John A Lee
- Molecular Imaging, Radiation and Oncology (MIRO) Laboratory, Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Belgium
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7
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Karvonen V, Harjama L, Heliö K, Kettunen K, Elomaa O, Koskenvuo JW, Kere J, Weckström S, Holmström M, Saarela J, Ranki A, Heliö T, Hannula-Jouppi K. A novel desmoplakin mutation causes dilated cardiomyopathy with palmoplantar keratoderma as an early clinical sign. J Eur Acad Dermatol Venereol 2022; 36:1349-1358. [PMID: 35445468 PMCID: PMC9545885 DOI: 10.1111/jdv.18164] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/16/2021] [Revised: 02/16/2022] [Accepted: 03/24/2022] [Indexed: 11/28/2022]
Abstract
Background PPKs represent a heterogeneous group of disorders with hyperkeratosis of palmar and/or plantar skin. PPK, hair shaft abnormalities, cardiomyopathy and arrhythmias can be caused by mutations in desmosomal genes, e.g. desmoplakin (DSP). PPK should trigger genetic testing to reveal mutations with possible related cardiac disease. Objectives To report a large multigenerational family with a novel DSP mutation associated with early‐onset PPK and adult‐onset cardiomyopathy and arrhythmias. Methods A custom‐designed in‐house panel of 35 PPK related genes was used to screen mutations in the index patient with focal PPK. The identified DSP mutation was verified by Sanger sequencing. DNA samples from 20 members of the large multigenerational family were sequenced for the DSP mutation. Medical records were reviewed. Clinical dermatological evaluation was performed, including light microscopy of hair samples. Cardiac evaluation included clinical examination, echocardiography, cardiac magnetic resonance imaging (CMR), electrocardiogram (ECG), Holter monitoring and laboratory tests. Results We identified a novel autosomal dominant truncating DSP c.2493delA p.(Glu831Aspfs*33) mutation associated with dilated cardiomyopathy (DCM) with arrhythmia susceptibility and focal PPK as an early cutaneous sign. The mutation was found in nine affected family members, but not in any unaffected members. Onset of dermatological findings preceded cardiac symptoms which were variable and occurred at adult age. Conclusions We report a novel truncating DSP mutation causing focal PPK with varying severity and left ventricular dilatation and ventricular extrasystoles. This finding emphasizes the importance of genetic diagnosis in patients with PPK for clinical counselling and management of cardiomyopathies and arrhythmias.
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Affiliation(s)
- V Karvonen
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - L Harjama
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - K Heliö
- Department of Cardiology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - K Kettunen
- HUS Diagnostic Center, Division of Genetics and Clinical Pharmacology, Laboratory of Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | - O Elomaa
- Folkhälsan Research Center, Helsinki, Finland and Research Programs Unit, Stem Cells and Metabolism Research Program, University of Helsinki, Finland
| | | | - J Kere
- Folkhälsan Research Center, Helsinki, Finland and Research Programs Unit, Stem Cells and Metabolism Research Program, University of Helsinki, Finland.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - S Weckström
- Department of Cardiology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - M Holmström
- Radiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - J Saarela
- HUS Diagnostic Center, Division of Genetics and Clinical Pharmacology, Laboratory of Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland.,Centre for Molecular Medicine Norway (NCMM), University of Oslo, Oslo, Norway
| | - A Ranki
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - T Heliö
- Department of Cardiology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - K Hannula-Jouppi
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland and Research Programs Unit, Stem Cells and Metabolism Research Program, University of Helsinki, Finland
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8
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Hultman Dennison S, Hertting O, Bennet R, Eriksson M, Holmström M, Schollin Ask L, Lindstrand A, Dimitriou P, Stjärne P, Granath A. A Swedish population-based study of complications due to acute rhinosinusitis in children 5-18 years old. Int J Pediatr Otorhinolaryngol 2021; 150:110866. [PMID: 34416439 DOI: 10.1016/j.ijporl.2021.110866] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/08/2021] [Accepted: 08/04/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND There are few population-based studies of complications due to acute rhinosinusitis in children. The aim was to clarify the admission and complication rate and analyze bacterial cultures in children five to 18 years old in Stockholm, Sweden. METHODS This was a population-based observational cohort study with retrospectively collected data from individual medical records, from 1 July 2003 to 30 June 2016 in Stockholm, Sweden. Hospital admissions of children with a discharge diagnosis of rhinosinusitis and related complications were reviewed. RESULTS Incidence of admission due to acute rhinosinusitis was 7.8 per 100 000 children per year (boys 9.2, girls 6.2) and 61% of the admitted children were boys. A severe - postseptal orbital, intracranial or osseous - complication, was present in 34% of admissions (postseptal orbital 28%, intracranial 6%, osseous 4%), resulting in an incidence of 2.6 severe complications per 100 000 children per year (boys 3.6, girls 1.6). Orbital preseptal cellulitis was present in 88% of admissions. Incidence of surgery was 1.3 per 100 000 per year (boys 1.8, girls 0.8) and the percentage of admitted children that had surgery increased with age. S. pyogenes was the most common pathogen found in the whole cohort (29 admissions), while S. milleri was the most common pathogen found among the children with severe complication and surgery. CONCLUSIONS There is a relative high risk of severe complications in children between five to 18 years that are admitted due to acute rhinosinusitis. There is a need for prospective studies to further analyze the pathogens involved in complications due to acute rhinosinusitis.
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Affiliation(s)
- S Hultman Dennison
- Department of otorhinolaryngology, Karolinska University Hospital, Eugeniavägen 3, 171 64, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Solnavägen 1, 171 77, Stockholm, Sweden.
| | - Olof Hertting
- Section for Pediatric Infectious Diseases, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Anna Steckséns gata 35, 171 64, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Solnavägen 1, 171 77, Stockholm, Sweden
| | - Rutger Bennet
- Section for Pediatric Infectious Diseases, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Anna Steckséns gata 35, 171 64, Stockholm, Sweden
| | - Margareta Eriksson
- Section for Pediatric Infectious Diseases, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Anna Steckséns gata 35, 171 64, Stockholm, Sweden
| | - Mats Holmström
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Solnavägen 1, 171 77, Stockholm, Sweden
| | - Lina Schollin Ask
- Public Health Agency of Sweden, Nobels väg 18, 171 65, Stockholm, Sweden; Sach's Children and Youth Hospital, South General Hospital, Sjukhusbacken 10, 118 83, Stockholm, Sweden; Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Solnavägen 1, 171 77, Stockholm, Sweden
| | - Ann Lindstrand
- WHO Department of Immunization, vaccines and Biologicals, Avenue Appia 20, 1211, Geneva 27, Switzerland
| | - Praxitelis Dimitriou
- Department of Neuroradiology, Karolinska University Hospital, Eugeniavägen 3, 171 64, Stockholm, Sweden
| | - Pär Stjärne
- Department of otorhinolaryngology, Karolinska University Hospital, Eugeniavägen 3, 171 64, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Solnavägen 1, 171 77, Stockholm, Sweden
| | - Anna Granath
- Department of otorhinolaryngology, Karolinska University Hospital, Eugeniavägen 3, 171 64, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Solnavägen 1, 171 77, Stockholm, Sweden
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9
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Barragán-Montero A, Javaid U, Valdés G, Nguyen D, Desbordes P, Macq B, Willems S, Vandewinckele L, Holmström M, Löfman F, Michiels S, Souris K, Sterpin E, Lee JA. Artificial intelligence and machine learning for medical imaging: A technology review. Phys Med 2021; 83:242-256. [PMID: 33979715 PMCID: PMC8184621 DOI: 10.1016/j.ejmp.2021.04.016] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 04/15/2021] [Accepted: 04/18/2021] [Indexed: 02/08/2023] Open
Abstract
Artificial intelligence (AI) has recently become a very popular buzzword, as a consequence of disruptive technical advances and impressive experimental results, notably in the field of image analysis and processing. In medicine, specialties where images are central, like radiology, pathology or oncology, have seized the opportunity and considerable efforts in research and development have been deployed to transfer the potential of AI to clinical applications. With AI becoming a more mainstream tool for typical medical imaging analysis tasks, such as diagnosis, segmentation, or classification, the key for a safe and efficient use of clinical AI applications relies, in part, on informed practitioners. The aim of this review is to present the basic technological pillars of AI, together with the state-of-the-art machine learning methods and their application to medical imaging. In addition, we discuss the new trends and future research directions. This will help the reader to understand how AI methods are now becoming an ubiquitous tool in any medical image analysis workflow and pave the way for the clinical implementation of AI-based solutions.
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Affiliation(s)
- Ana Barragán-Montero
- Molecular Imaging, Radiation and Oncology (MIRO) Laboratory, UCLouvain, Belgium.
| | - Umair Javaid
- Molecular Imaging, Radiation and Oncology (MIRO) Laboratory, UCLouvain, Belgium
| | - Gilmer Valdés
- Department of Radiation Oncology, Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Dan Nguyen
- Medical Artificial Intelligence and Automation (MAIA) Laboratory, Department of Radiation Oncology, UT Southwestern Medical Center, USA
| | - Paul Desbordes
- Information and Communication Technologies, Electronics and Applied Mathematics (ICTEAM), UCLouvain, Belgium
| | - Benoit Macq
- Information and Communication Technologies, Electronics and Applied Mathematics (ICTEAM), UCLouvain, Belgium
| | - Siri Willems
- ESAT/PSI, KU Leuven Belgium & MIRC, UZ Leuven, Belgium
| | | | | | | | - Steven Michiels
- Molecular Imaging, Radiation and Oncology (MIRO) Laboratory, UCLouvain, Belgium
| | - Kevin Souris
- Molecular Imaging, Radiation and Oncology (MIRO) Laboratory, UCLouvain, Belgium
| | - Edmond Sterpin
- Molecular Imaging, Radiation and Oncology (MIRO) Laboratory, UCLouvain, Belgium; KU Leuven, Department of Oncology, Laboratory of Experimental Radiotherapy, Belgium
| | - John A Lee
- Molecular Imaging, Radiation and Oncology (MIRO) Laboratory, UCLouvain, Belgium
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10
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Orsini S, Livi SA, Lichtenegger H, Barabash S, Milillo A, De Angelis E, Phillips M, Laky G, Wieser M, Olivieri A, Plainaki C, Ho G, Killen RM, Slavin JA, Wurz P, Berthelier JJ, Dandouras I, Kallio E, McKenna-Lawlor S, Szalai S, Torkar K, Vaisberg O, Allegrini F, Daglis IA, Dong C, Escoubet CP, Fatemi S, Fränz M, Ivanovski S, Krupp N, Lammer H, Leblanc F, Mangano V, Mura A, Nilsson H, Raines JM, Rispoli R, Sarantos M, Smith HT, Szego K, Aronica A, Camozzi F, Di Lellis AM, Fremuth G, Giner F, Gurnee R, Hayes J, Jeszenszky H, Tominetti F, Trantham B, Balaz J, Baumjohann W, Brienza D, Bührke U, Bush MD, Cantatore M, Cibella S, Colasanti L, Cremonese G, Cremonesi L, D'Alessandro M, Delcourt D, Delva M, Desai M, Fama M, Ferris M, Fischer H, Gaggero A, Gamborino D, Garnier P, Gibson WC, Goldstein R, Grande M, Grishin V, Haggerty D, Holmström M, Horvath I, Hsieh KC, Jacques A, Johnson RE, Kazakov A, Kecskemety K, Krüger H, Kürbisch C, Lazzarotto F, Leblanc F, Leichtfried M, Leoni R, Loose A, Maschietti D, Massetti S, Mattioli F, Miller G, Moissenko D, Morbidini A, Noschese R, Nuccilli F, Nunez C, Paschalidis N, Persyn S, Piazza D, Oja M, Ryno J, Schmidt W, Scheer JA, Shestakov A, Shuvalov S, Seki K, Selci S, Smith K, Sordini R, Svensson J, Szalai L, Toublanc D, Urdiales C, Varsani A, Vertolli N, Wallner R, Wahlstroem P, Wilson P, Zampieri S. SERENA: Particle Instrument Suite for Determining the Sun-Mercury Interaction from BepiColombo. Space Sci Rev 2021; 217:11. [PMID: 33487762 PMCID: PMC7803725 DOI: 10.1007/s11214-020-00787-3] [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] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 12/03/2020] [Indexed: 06/12/2023]
Abstract
The ESA-JAXA BepiColombo mission to Mercury will provide simultaneous measurements from two spacecraft, offering an unprecedented opportunity to investigate magnetospheric and exospheric particle dynamics at Mercury as well as their interactions with solar wind, solar radiation, and interplanetary dust. The particle instrument suite SERENA (Search for Exospheric Refilling and Emitted Natural Abundances) is flying in space on-board the BepiColombo Mercury Planetary Orbiter (MPO) and is the only instrument for ion and neutral particle detection aboard the MPO. It comprises four independent sensors: ELENA for neutral particle flow detection, Strofio for neutral gas detection, PICAM for planetary ions observations, and MIPA, mostly for solar wind ion measurements. SERENA is managed by a System Control Unit located inside the ELENA box. In the present paper the scientific goals of this suite are described, and then the four units are detailed, as well as their major features and calibration results. Finally, the SERENA operational activities are shown during the orbital path around Mercury, with also some reference to the activities planned during the long cruise phase.
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Affiliation(s)
- S Orsini
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - S A Livi
- Southwest Research Institute, San Antonio, TX USA
- Department of Climate and Space Sciences and Engineering, University of Michigan, Ann Arbor, MI USA
| | - H Lichtenegger
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - S Barabash
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - A Milillo
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - E De Angelis
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - M Phillips
- Southwest Research Institute, San Antonio, TX USA
| | - G Laky
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - M Wieser
- Swedish Institute of Space Physics, Kiruna, Sweden
| | | | | | - G Ho
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - R M Killen
- NASA/Goddard Space Flight Center, Greenbelt, MD 20771 USA
| | - J A Slavin
- Department of Climate and Space Sciences and Engineering, University of Michigan, Ann Arbor, MI USA
| | - P Wurz
- Physics Institute, University of Bern, Bern, Switzerland
| | | | - I Dandouras
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - E Kallio
- School of Electrical Engineering, Department of Electronics and Nanoengineering, Aalto University, Helsinki, Finland
| | | | - S Szalai
- Wigner Research Centre for Physics, Budapest, Hungary
| | - K Torkar
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - O Vaisberg
- IKI Space Research Institute, Moscow, Russia
| | - F Allegrini
- Southwest Research Institute, San Antonio, TX USA
| | - I A Daglis
- Department of Physics, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Space Center, Athens, Greece
| | - C Dong
- Department of Astrophysical Sciences and Princeton Plasma Physics Laboratory, Princeton University, Princeton, NJ USA
| | | | - S Fatemi
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - M Fränz
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077 Göttingen, Germany
| | - S Ivanovski
- Astronomical Observatory, INAF, Trieste, Italy
| | - N Krupp
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077 Göttingen, Germany
| | - H Lammer
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | - V Mangano
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - A Mura
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - H Nilsson
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - J M Raines
- Department of Climate and Space Sciences and Engineering, University of Michigan, Ann Arbor, MI USA
| | - R Rispoli
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - M Sarantos
- NASA/Goddard Space Flight Center, Greenbelt, MD 20771 USA
| | - H T Smith
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - K Szego
- Wigner Research Centre for Physics, Budapest, Hungary
| | - A Aronica
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | | | | | - G Fremuth
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - F Giner
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - R Gurnee
- Laboratory for Atmospheric and Space Physics, Boulder, CO USA
| | - J Hayes
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - H Jeszenszky
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | - B Trantham
- Southwest Research Institute, San Antonio, TX USA
| | - J Balaz
- Institute of Experimental Physics SAS, Slovak Academy of Sciences, 040 01 Košice, Slovakia
| | - W Baumjohann
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - D Brienza
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - U Bührke
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077 Göttingen, Germany
| | - M D Bush
- Physics Institute, University of Bern, Bern, Switzerland
| | | | - S Cibella
- Istituto di Struttura della Materia (CNR-ISM), 00133 Roma, Italy
| | - L Colasanti
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - G Cremonese
- Astronomical Observatory, INAF, Padova, Italy
| | | | - M D'Alessandro
- Istituto di Struttura della Materia (CNR-ISM), 00133 Roma, Italy
| | | | - M Delva
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - M Desai
- Southwest Research Institute, San Antonio, TX USA
| | - M Fama
- Comisión Nacional de Energía Atómica, cnea, Centro Atómico Bariloche, Bariloche, Argentina
| | - M Ferris
- Southwest Research Institute, San Antonio, TX USA
| | - H Fischer
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077 Göttingen, Germany
| | - A Gaggero
- Istituto di Struttura della Materia (CNR-ISM), 00133 Roma, Italy
| | - D Gamborino
- Physics Institute, University of Bern, Bern, Switzerland
| | - P Garnier
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - W C Gibson
- Southwest Research Institute, San Antonio, TX USA
| | - R Goldstein
- Southwest Research Institute, San Antonio, TX USA
| | - M Grande
- Aberystwyth University, Aberystwyth, Ceredigion SY23 3FL UK
| | - V Grishin
- IKI Space Research Institute, Moscow, Russia
| | - D Haggerty
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - M Holmström
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - I Horvath
- Wigner Research Centre for Physics, Budapest, Hungary
| | - K-C Hsieh
- University of Arizona, Tucson, AZ USA
| | - A Jacques
- NASA/Goddard Space Flight Center, Greenbelt, MD 20771 USA
| | - R E Johnson
- University of Virginia, Charlottesville, VA 22904 USA
| | - A Kazakov
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - K Kecskemety
- Wigner Research Centre for Physics, Budapest, Hungary
| | - H Krüger
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077 Göttingen, Germany
| | - C Kürbisch
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | | | - M Leichtfried
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | - A Loose
- Max-Planck-Institut für Sonnensystemforschung, MPS, 37077 Göttingen, Germany
| | - D Maschietti
- Istituto Fotonica e Nanotecnologie, CNR-IFN, Roma, Italy
| | - S Massetti
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | | | - G Miller
- Southwest Research Institute, San Antonio, TX USA
| | - D Moissenko
- IKI Space Research Institute, Moscow, Russia
| | - A Morbidini
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - R Noschese
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - F Nuccilli
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - C Nunez
- Southwest Research Institute, San Antonio, TX USA
| | - N Paschalidis
- NASA/Goddard Space Flight Center, Greenbelt, MD 20771 USA
| | - S Persyn
- Southwest Research Institute, San Antonio, TX USA
| | - D Piazza
- Physics Institute, University of Bern, Bern, Switzerland
| | - M Oja
- Swedish Institute of Space Physics, Kiruna, Sweden
| | - J Ryno
- Finnish Meteorological Institute FMI, Helsinki, Finland
| | - W Schmidt
- Finnish Meteorological Institute FMI, Helsinki, Finland
| | | | - A Shestakov
- IKI Space Research Institute, Moscow, Russia
| | - S Shuvalov
- IKI Space Research Institute, Moscow, Russia
| | - K Seki
- Department of Earth and Planetary Science, Graduate School of Science, University of Tokyo, Tokyo, Japan
| | - S Selci
- Istituto di Struttura della Materia (CNR-ISM), 00133 Roma, Italy
| | - K Smith
- Southwest Research Institute, San Antonio, TX USA
| | - R Sordini
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | | | - L Szalai
- Wigner Research Centre for Physics, Budapest, Hungary
| | - D Toublanc
- Institut de Recherche en Astrophysique et Planétologie, CNRS, CNES, Université de Toulouse, Toulouse, France
| | - C Urdiales
- Southwest Research Institute, San Antonio, TX USA
| | - A Varsani
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - N Vertolli
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
| | - R Wallner
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - P Wahlstroem
- Physics Institute, University of Bern, Bern, Switzerland
| | - P Wilson
- Southwest Research Institute, San Antonio, TX USA
| | - S Zampieri
- Institute of Space Astrophysics and Planetology, INAF, via del Fosso del Cavaliere 100, 00133 Rome, Italy
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11
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Koivuniemi R, Kuuliala A, Kivistö S, Holmström M, Hämäläinen M, Moilanen E, Rajamäki K, Kautiainen H, Eklund KK, Leirisalo-Repo M. Induction of remission in female rheumatoid arthritis patients is associated with stabilization of myocardial abnormalities: a prospective cardiac magnetic resonance follow-up study. Scand J Rheumatol 2020; 50:104-112. [PMID: 33243062 DOI: 10.1080/03009742.2020.1818819] [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: 10/22/2022]
Abstract
Objectives: To study whether female patients with active rheumatoid arthritis (RA) have myocardial abnormalities and whether progression of myocardial involvement can be attenuated by disease-modifying anti-rheumatic drugs (DMARDs).Method: Cardiac magnetic resonance (cMR; 1.5 or 3.0 T), including late gadolinium enhancement (LGE), T1 relaxation time, and ventricular functions, was performed in 30 patients with untreated active early RA starting first DMARDs, and 28 patients with chronic RA with inadequate response to conventional synthetic DMARDs starting biological DMARDs. cMR was repeated in RA patients 1 year later. cMR was conducted once in 22 fibromyalgia (FM) subjects and in 35 healthy volunteers serving as controls. All subjects were non-smoking females without coronary heart disease, heart failure, or diabetes.Results: Compared with controls, 58 RA patients had slightly lower ventricular function, although in the normal range, and longer T1 time at baseline. None of the FM subjects had LGE, but it was frequent in RA (67%). During the 1 year DMARD treatment, Disease Activity Score based on 28-joint count-C-reactive protein declined, ventricular functions tended to improve, but the number of patients with LGE remained unchanged. However, the number of LGE-positive heart segments either decreased or stayed the same in 91% of RA patients. In early RA patients, achieving tight remission was associated with LGE stabilization, after adjustment for age, metabolic syndrome, baseline inflammatory activity, and leisure-time physical activity.Conclusion: Treatment targeted to tight remission in early stages of RA seems to be important to prevent not only joint damage but also myocardial abnormalities.
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Affiliation(s)
- R Koivuniemi
- Department of Rheumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Medicine, Kanta-Häme Central Hospital, Riihimäki, Finland.,Hematology Research Unit, University of Helsinki and Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland
| | - A Kuuliala
- Department of Bacteriology and Immunology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - S Kivistö
- Department of Radiology HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland
| | - M Holmström
- Department of Radiology HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland
| | - M Hämäläinen
- The Immunopharmacology Research Group, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - E Moilanen
- The Immunopharmacology Research Group, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - K Rajamäki
- Department of Rheumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - H Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - K K Eklund
- Department of Rheumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - M Leirisalo-Repo
- Department of Rheumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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12
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Huiskes M, Kierkels R, Van Bruggen I, Holmström M, Gruselius H, Fredriksson A, Berggren K, Both S, Langendijk J, Löfman F, Korevaar E. PO-1462: Automated robust planning for IMPT in oropharyngeal cancer patients using machine learning. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01480-8] [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: 11/16/2022]
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13
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Van Bruggen I, Kierkels R, Holmström M, Gruselius H, Lidberg D, Berggren K, Both S, Langendijk J, Löfman F, Korevaar E. PO-1459: Fully automated machine learning optimization VMAT planning for oropharyngeal cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01477-8] [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: 11/25/2022]
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14
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Sahlstrand-Johnson P, Holmström M, Ehnhage A. Does the oral steroid treatment of patients with nasal polyposis cause osteopenia or osteoporosis? Clin Otolaryngol 2019; 44:1011-1016. [PMID: 31529761 DOI: 10.1111/coa.13431] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 08/19/2019] [Accepted: 09/13/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We aimed to investigate the bone mineral density (BMD) in a group of Swedish patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) with or without asthma, as well as to evaluate whether the treatment of this patient group is in accordance with the EPOS recommendations. DESIGN, SETTINGS AND PARTICIPANTS Adult patients with a diagnosis of CRSwNP, and a history of at least two courses of oral corticosteroids (OCS) during the last year, were consecutively included in this study at five centres. MAIN OUTCOME MEASURES The BMD of the patients was measured by Dual-energy X-ray absorptiometry (DXA), which is the only technology for classifying BMD according to the criteria established by WHO. RESULTS A total of 51 patients, with an average number of 7 years with OCS treatment, were enrolled. During the last 12 months, the mean number of OCS courses was 2.76, and the total mean intake was 891 mg of Prednisone equivalents. According to the T-scores, 17 patients were measured to have ≤-1 SD T-score lumbar spine, which is considered to be osteopenia, and five patients had <-2.5 SD T-score, considered as osteoporosis. However, when taking age and gender into account and analysing the Z-scores, only 2 patients had a reduced density of the spine and none in the hip, which is no difference compared to a matched Swedish population. CONCLUSIONS This prospective study shows that 2-3 moderate courses of OCS annually may be used without high risk of causing osteopenia/osteoporosis in patients with CRSwNP.
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Affiliation(s)
| | - Mats Holmström
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Anders Ehnhage
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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15
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Bengtsson C, Jonsson L, Holmström M, Hellgren J, Franklin K, Gíslason T, Holm M, Johannessen A, Jõgi R, Schlünssen V, Janson C, Lindberg E. Incident Chronic Rhinosinusitis Is Associated With Impaired Sleep Quality: Results of the RHINE Study. J Clin Sleep Med 2019; 15:899-905. [PMID: 31138385 DOI: 10.5664/jcsm.7846] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 09/26/2018] [Accepted: 02/18/2019] [Indexed: 12/23/2022]
Abstract
STUDY OBJECTIVES Chronic rhinosinusitis (CRS) is a common inflammatory disease of the nasal cavity and paranasal sinuses. Associations between CRS and poor sleep quality have been reported. This 10-year follow-up study investigates possible associations between incident CRS and sleep quality. METHODS A questionnaire was sent to 16,500 individuals in Sweden, Norway, Denmark, Iceland and Estonia in 2000. It included questions on airway diseases, age, sex, body mass index, smoking habits, comorbidities, education and sleep quality. In 2010, a second questionnaire was sent to the same individuals, with a response rate of 53%. A subgroup of 5,145 individuals without nasal symptoms in 2000 was studied. Multiple logistic regression was performed to examine associations between CRS (defined according to the European position paper on rhinosinusitis and nasal polyps epidemiological criteria) at follow-up and sleep quality, with adjustment for potential confounders. Individuals with the respective sleep problem at baseline were excluded. RESULTS Over 10 years, 141 (2.7%) of the individuals without nasal symptoms in 2000 had developed CRS. CRS was associated with difficulties inducing sleep (adjusted odds ratio 2.81 [95% CI 1.67-4.70]), difficulties maintaining sleep (2.07 [1.35-3.18]), early morning awakening (3.03 [1.91-4.81]), insomnia (2.21 [1.46-3.35]), excessive daytime sleepiness (2.85 [1.79-4.55]), and snoring (3.31 [2.07-5.31]). Three insomnia symptoms at baseline increased the risk of CRS at follow-up by 5.00 (1.93-12.99). CONCLUSIONS Incident CRS is associated with impaired sleep quality and excessive daytime sleepiness. Insomnia symptoms may be a risk factor for the development of CRS.
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Affiliation(s)
- Caroline Bengtsson
- Department of Surgical Sciences, Otorhinolaryngology, Head and Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Lars Jonsson
- Department of Surgical Sciences, Otorhinolaryngology, Head and Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Mats Holmström
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital, Huddinge, Sweden
| | - Johan Hellgren
- Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska Academy, Gothenburg, Institute of Clinical Science, University of Gothenburg, Sweden
| | - Karl Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Tórarinn Gíslason
- Department of Respiratory Medicine and Sleep, University of Iceland, Reykjavik, Iceland
| | - Mathias Holm
- Department of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Rain Jõgi
- Department of Pulmonology, Tartu University Hospital, Tartu, Estonia
| | - Vivi Schlünssen
- Department of Public Health, Aarhus University, Aarhus, Denmark, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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16
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Bjermer L, Westman M, Holmström M, Wickman MC. The complex pathophysiology of allergic rhinitis: scientific rationale for the development of an alternative treatment option. Allergy Asthma Clin Immunol 2019; 15:24. [PMID: 31015846 PMCID: PMC6469109 DOI: 10.1186/s13223-018-0314-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/20/2018] [Indexed: 01/27/2023] Open
Abstract
Allergic rhinitis (AR) poses a global health problem and can be challenging to treat. Many of the current symptomatic treatments for AR have been available for decades, yet there has been little improvement in patient quality of life or symptom burden over the years. In this review, we ask why this might be and explore the pathophysiological gaps that exist within the various AR treatment classes. We focus on the benefits and drawbacks of different treatment options and delivery routes for AR treatments and consider how, given what is known about AR pathophysiology and symptomatology, patients may be offered more effective treatment options for rapid, effective, and sustained AR control. In particular, we consider how a new AR preparation, MP-AzeFlu (Dymista®, Meda, Sweden), comprising a formulation of an intranasal antihistamine (azelastine hydrochloride), an intranasal corticosteroid (fluticasone propionate), and excipients delivered in a single spray, may offer benefits over and above single and multiple AR therapy options. We review the evidence in support of this treatment across the spectrum of AR disease. The concept of AR control is also reviewed within the context of new European Union and Contre les Maladies Chroniques pour un VIeillissement Actif-Allergic Rhinitis and its Impact on Asthma initiatives.
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Affiliation(s)
- Leif Bjermer
- 1Department of Respiratory Medicine & Allergology, Skane University Hospital, 22185, Lund, Sweden
| | - Marit Westman
- 2Dept. of ENT-diseases, Karolinska University Hospital, 171 76 Stockholm, Sweden.,3Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Mats Holmström
- 4Dept. of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Magnus C Wickman
- 5Department of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.,Sach's Children's Hospital, 118 83 Stockholm, Sweden
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17
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Frahm RA, Winningham JD, Coates AJ, Gérard J, Holmström M, Barabash S. The Largest Electron Differential Energy Flux Observed at Mars by the Mars Express Spacecraft, 2004-2016. J Geophys Res Space Phys 2018; 123:6576-6590. [PMID: 31032167 PMCID: PMC6473521 DOI: 10.1029/2018ja025311] [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] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 07/09/2018] [Accepted: 07/14/2018] [Indexed: 06/09/2023]
Abstract
The goal of this paper is to understand the processes by which solar wind electrons are energized in the Martian magnetosphere and how this compares to processes at Venus and Earth. Each is unique in the source of its magnetic field topology and how this influences electron energization. To achieve this goal, 24 million spectra spanning 13 years have been examined using the electron spectrometer from the Mars Express spacecraft between about 12,000 km and about 250 km altitude, and from all latitudes and local times. The top 10 largest differential energy flux at energies above the differential energy flux peak have been found: seven spectra from the magnetosheath near noon, three from the dark tail (the largest two from the middle and ionospheric edge of the magnetosheath). Spectral comparisons show a decade range in the peak of the electron distributions; however, all distributions show a similar energy maximum dictated by solar wind/planet interaction. Similarly derived, the largest Venus spectrum occurred near the magnetosheath bow shock and had the same shape as the most intense Mars inner magnetosheath spectrum. The Mars and Venus dayside spectra compared to the Mars nightside spectrum that included an enhanced optical signal attributed to discrete "auroral" precipitation show a similar shape. These spectra are also compared to a selected auroral zone electron spectra from the Earth. The Mars and Venus results suggest that there is no more energy needed to generate electrons forming the nightside precipitation than is gained during the solar wind/planet interaction.
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Affiliation(s)
- R. A. Frahm
- Southwest Research InstituteSan AntonioTXUSA
| | | | - A. J. Coates
- Mullard Space Science LaboratoryUniversity College LondonSurreyUK
| | - J.‐C. Gérard
- Laboratory of Planetary and Atmospheric PhysicsUniversité de LiègeLiègeBelgium
| | | | - S. Barabash
- Swedish Institute of Space PhysicsKirunaSweden
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18
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Farm M, Siddiqui AJ, Onelöv L, Järnberg I, Eintrei J, Maskovic F, Kallner A, Holmström M, Antovic JP. Age-adjusted D-dimer cut-off leads to more efficient diagnosis of venous thromboembolism in the emergency department: a comparison of four assays. J Thromb Haemost 2018; 16:866-875. [PMID: 29505695 DOI: 10.1111/jth.13994] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 07/28/2017] [Indexed: 11/29/2022]
Abstract
Essentials Age-adjusted D-dimer cut-offs decrease the false positives in the elderly. Four D-dimer assays were compared in venous thromboembolism outpatients in an emergency ward. Age-adjusted cut-off resulted in improved specificity with maintained sensitivity for all assays. There was a substantial decrease in false positive results, especially in the older population. SUMMARY Background The study compares different D-dimer assays and age-adjusted cut-offs in outpatients with suspected venous thromboembolism (VTE). The plasma concentration of this sensitive biomarker is increased by activated coagulation, but also by several conditions that are linked to an increased risk of VTE. One such condition is old age, which poses a common clinical problem where many prefer not to analyze D-dimer in elderly patients. Age-adjusted cut-offs have been validated for both deep venous thrombosis (DVT) and pulmonary embolism, aiming to increase specificity without notably decreasing sensitivity. Objectives We evaluated four common D-dimer assays in parallel, with and without applying age-adjusted cut offs for VTE. Patients/methods The prospective single-center study was conducted in 940 outpatients attending the emergency department with clinically suspected pulmonary embolism or DVT. Four automated D-dimer assays were compared (Siemens INNOVANCE® , Roche Tina-quant, Medirox MRX and STA® -Liatest® D-Di PLUS). Results All assays performed with areas under the ROC curve (AUC) > 0.9 and maintained their sensitivities after implementation of age-adjusted cut-offs. Specificities increased by 6-7% and number needed to test decreased by < 0.3. The rate of false positive results decreased by 6% overall and by 10-20% for patients ≥ 70. Conclusions Age-adjusted cut-offs resulted in maintained high sensitivity and a modest improvement in specificity and number needed to test for all evaluated D-dimer assays. There was a significant reduction in false positive results, which reflects avoidable unnecessary imaging without any compromise of clinical safety. This suggests a potential to benefit the management of VTE in elderly patients, both clinically and economically.
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Affiliation(s)
- M Farm
- Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - A J Siddiqui
- Emergency Department, Karolinska University Hospital, Stockholm, Sweden
| | - L Onelöv
- Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - I Järnberg
- Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - J Eintrei
- Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - F Maskovic
- Emergency Department, Karolinska University Hospital, Stockholm, Sweden
| | - A Kallner
- Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - M Holmström
- Coagulation Unit, Hematology Center Karolinska, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - J P Antovic
- Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
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Abstract
The aim of this study was to estimate nasal ciliary beat frequency (CBF) before and after nasal allergen challenge. Patients were challenged with Pharmalgen D Pteronyssinus or grass pollen. The nasal reaction was measured with active anterior rhinomanometry and visual analog scale. CBF was measured by a photometric technique, on nasal specimens obtained with a brush from the inferior turbinate before and 20 minutes after challenge. A positive response to nasal challenge was seen in 12 patients and associated with a decrease in CBF in all but one patient. The CBF mean value for this group fell from 13.1 (±1.9) Hz to 11.5 (±1.8) Hz (p < .01). In another 11 patients where the challenge was negative, there was a tendency to increased CBF after challenge, 14.1 (±2.1) Hz before and 14.8 (±2.1) Hz after (p = .07). Thus, in this study CBF was decreased when an allergic reaction was provoked and, in contrast, moderately increased after a negative challenge. In a nasal allergic reaction it is possible that decreased mucociliary function contributes to nasal obstruction and decreased ventilation of the sinuses.
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Affiliation(s)
- Mats Holmström
- Department of Oto-rhino-laryngology, Huddinge University Hospital, Sweden
| | - Valerie J. Lund
- Royal National Throat Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA, England
| | - Glenis Scadding
- Royal National Throat Nose and Ear Hospital, Gray's Inn Road, London WC1X 8DA, England
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20
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Abstract
To investigate health effects of long-term exposure to formaldehyde a cross-sectional field study was performed. Seventy formaldehyde-exposed workers were compared with a control group. A higher frequency of symptoms from upper and lower airways, headache, and dermal discomfort was found in the formaldehyde-exposed group. Further, formaldehyde-exposed workers showed disturbances of nasal physiologic conditions, such as slow nasal clearance, impairment of the sense of smell, more pronounced nasal mucosal swelling, and by spirometry lower forced vital capacity than expected was found. Nasal biopsies from the concha media showed more frequent histologic changes such as loss of cilia and metaplasia in the formaldehyde-exposed group. Histologic lesions did not correlate to current or cumulative exposure doses to formaldehyde. In an experimental study of Sprague-Dawley rats exposed to formaldehyde (12.7 mg/m3, 6 hours/day, 5 days/week for 24 months), one rat developed a squamous cell carcinoma in the nose and another nasal dysplasia and in seven other rats pronounced nasal metaplasia was seen in the nasal mucosa. In a control group of rats no significant histologic lesions were found.
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Affiliation(s)
- M. Holmström
- Department of Otolaryngology, Huddinge Hospital, Karolinska Institutet, S-14186, Huddinge, Sweden
| | - B. Wilhelmsson
- Department of Otolaryngology, Huddinge Hospital, Karolinska Institutet, S-14186, Huddinge, Sweden
| | - H. Hellquist
- Department of Otolaryngology, Huddinge Hospital, Karolinska Institutet, S-14186, Huddinge, Sweden
| | - B. Drettner
- Department of Otolaryngology, Huddinge Hospital, Karolinska Institutet, S-14186, Huddinge, Sweden
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21
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Abstract
In this study, the effect on olfaction of surgical procedures, performed distant to the nose, was analyzed. Twenty-three patients planned for surgery of minor or moderate degree under general anaesthesia were examined before surgery for evaluation of sense of smell with the University of Pennsylvania Smell Identification Test and a smell threshold test (Olfacto-Labs). Reexamination was performed 24–48 hours postoperatively. Both tests demonstrated significant improvement in olfaction following surgery. The improvement was more obvious in younger patients and in patients undergoing moderate surgery compared with the minor surgery group but was, however, not statistically significant.
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Affiliation(s)
- Mats Holmström
- Institute of Laryngology and Otology, London, and Department of Oto-Rhino-Laryngology, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden
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22
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Abstract
Background Exposure to high ambient levels of nitrogen dioxide (NO2) enhances the bronchial inflammatory reaction to allergen in humans. We tested whether this NO2 effect occurs also in the upper airways. Methods Sixteen allergic subjects with rhinitis and mild asthma were exposed at rest to either purified air or 500 μg/m3 NO2 for 30 minutes, followed 4 hours later by a nasal allergen challenge. Nasal lavage was performed before air/NO2 exposure, before allergen challenge, and 1, 4 and 18 hours after allergen challenge. Symptoms were recorded. Results The percentage of eosinophils and neutrophils, eosinophil cationic protein, and myeloperoxidase were similar after exposure to air + allergen and to NO2 + allergen. We noticed a tendency to increased sneezing the day after exposure to NO2 + allergen. Conclusion The priming effect of an ambient brief NO2 exposure on subsequent allergic response was not noticeable in activation of inflammatory cells and mediators in the upper airways.
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Affiliation(s)
- Charlotte Barck
- Division of Respiratory Medicine and Allergology, Karolinska Institutet, Department of Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Joachim Lundahl
- Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Mats Holmström
- Department of Otorhinolaryngology, Uppsala University Hospital, Uppsala, Sweden
| | - Gunnar Bylin
- Division of Respiratory Medicine and Allergology, Karolinska Institutet, Department of Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
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23
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Morén S, Lindestad PÅ, Holmström M, Mani M. Voice Quality in Adults Treated for Unilateral Cleft Lip and Palate: Long-Term Follow-Up After One- or Two-Stage Palate Repair. Cleft Palate Craniofac J 2018; 55:1103-1114. [PMID: 29561718 DOI: 10.1177/1055665618764521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of the current study was to assess voice quality among adults treated for unilateral cleft lip and palate (UCLP), after one- or two-stage palate closure, and compare it to a noncleft control group. STUDY DESIGN Cross-sectional study of patients with UCLP with long-term follow-up and noncleft controls. PARTICIPANTS Patients with UCLP born between 1960 and 1987, treated at Uppsala University Hospital, Sweden, were examined (n = 73) at a mean of 35 years after primary surgery. Forty-seven (64%) patients had been treated with 1-stage palate closure and 26 with 2-stage closure (36%). The noncleft control group consisted of 63 age-matched volunteers. MAIN OUTCOME MEASURES Ratings of perceptual voice characteristics from blinded voice recordings with Swedish Voice Evaluation Approach method. Acoustic voice analysis including pitch and spectral measures. RESULTS Among the patients, the mean values for the 12 evaluated variables on a visual analog scale (0 = no abnormality, 100 = maximal abnormality) ranged between 0.1 and 17, and the mean for all was 6 mm. Voice variables were similar between patients and controls, except the total mean of all the perceptual voice variables, as well as "vocal fry"; both slightly lower among patients ( P = .018 and P = .009). There was no difference in any variable between patients treated with 1-stage and 2-stage palate closure. No clear relationship was found between velopharyngeal insufficiency and dysphonia. CONCLUSIONS The voice characteristics among adults treated for UCLP in childhood are not different from those of individuals without cleft.
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Affiliation(s)
- Staffan Morén
- 1 Otorhinolaryngology and Head and Neck Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Per Åke Lindestad
- 2 Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Mats Holmström
- 2 Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Mani
- 3 Plastic Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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Morén S, Lindestad PÅ, Holmström M, Mani M. Voice Quality in Adults Treated for Unilateral Cleft Lip and Palate: Long-term Follow-up After 1- or 2-Stage Palate Repair. Cleft Palate Craniofac J 2018; 55:758-768. [PMID: 29461876 DOI: 10.1177/1055665618754946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of the current study was to assess voice quality among adults treated for unilateral cleft lip and palate (UCLP), after 1- or 2-stage palate closure, and compare it to a noncleft control group. STUDY DESIGN Cross-sectional study in UCLP patients with long-term follow-up and noncleft controls. PARTICIPANTS UCLP patients born 1960-1987, treated at Uppsala University Hospital, Sweden, were examined (n = 73) at a mean of 35 years after primary surgery. Forty-seven patients (64%) had been treated with 1-stage palate closure and 26 with 2-stage closure (36%). The noncleft control group consisted of 63 age-matched volunteers. MAIN OUTCOME MEASURE(S) Ratings of perceptual voice characteristics from blinded voice recordings with Swedish Voice Evaluation Approach (SVEA) method. Acoustic voice analysis including pitch and spectral measures. RESULTS Among the patients, the mean values for the 12 evaluated variables on a VAS scale (0 = no abnormality, 100 = maximal abnormality) ranged between 1 and 22 and the mean for all was 6 mm. Voice variables were similar between patients and controls except the total mean of all the perceptual voice variables, as well as "vocal fry"-both slightly lower among patients ( P = .018 and P = .009). There was no difference in any variable between patients treated with 1-stage and 2-stage palate closure. No clear relationship was found between VPI and dysphonia. CONCLUSION The voice characteristics among adults treated for UCLP in childhood are not different from those of individuals without cleft.
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Affiliation(s)
- Staffan Morén
- 1 Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Per Åke Lindestad
- 2 Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Mats Holmström
- 2 Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Maria Mani
- 3 Department of Surgical Sciences, Plastic Surgery, Uppsala University, Uppsala, Sweden
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25
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Eriksson H, Frison L, Hansson PO, Held P, Holmström M, Hägg A, Jonsson T, Lapidus L, Leijd B, Stockelberg D, Säfwenberg U, Taghavi A, Thorsén M, Eriksson UG. Pharmacokinetics and Pharmacodynamics of Melagatran, a Novel Synthetic LMW Thrombin Inhibitor, in Patients with Acute DVT. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1614477] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryForty-eight patients with acute proximal deep vein thrombosis (DVT) were randomised to intravenous infusions for 4 to 6 days with melagatran, a novel synthetic low molecular weight thrombin inhibitor, or unfractionated heparin adjusted by the activated partial thromboplastin time (APTT). The aim of the study was to investigate the pharmacokinetics, pharmacodynamics and the safety of melagatran therapy at three different doses. Steady-state plasma concentrations were rapidly achieved and maintained throughout the infusion period. The mean plasma concentrations in the low, medium and high dose groups were 0.17, 0.31 and 0.53 μmol/l, respectively. The prolongation of APTT was stable during the melagatran infusions and correlated to the plasma concentration. Phlebographically verified regression of thrombus size measured as decrease in Marder score was seen after 4 to 6 days in 8 of 12 patients, 6 of 12 patients and 5 of 11 patients in the low, medium and high dose groups of melagatran and in 5 of the heparin-treated patients. In the low dose group with melagatran, thrombus extension was seen in one patient. At the dose levels studied, melagatran was well tolerated with no clinically significant bleeding problems, suggesting that melagatran could safely be given to patients suffering from DVT.
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Åberg W, Lockner D, Paul C, Holmström M. Long-term Clinical Follow-up in 265 Patients with Deep Venous Thrombosis Initially Treated with either Unfractionated Heparin or Dalteparin: A Retrospective Analysis. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1614364] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryThe primary objective of this retrospective study was to describe the frequency of a post-thrombotic syndrome in 265 patients previously treated for deep venous thrombosis (DVT). The secondary objectives were to document the frequency of recurrent venous thromboembolism (VTE) and mortality, especially from malignant disease. The patients were evaluated 5-14 years after inclusion in three randomized trials comparing continuous intravenous (i. v.) infusion of unfractionated heparin (UFH) (n = 85) with a low molecular weight heparin (LMWH), dalteparin (n = 180). The median post-thrombotic score at follow-up was 2 (range 0-8). In a multiple step-wise regression analysis the post-thrombotic score was significantly higher among patients with initial proximal DVT (p = 0,0001) as compared with those who had distal DVT. A recurrent venous thromboembolic event was diagnosed in 29,4% of the patients treated with dalteparin and in 23,5% of the patients treated with UFH (ns). A secondary risk factor for venous thromboembolism and a longer duration of treatment with oral anticoagulants (OAC) were significantly associated with a lower risk for recurrent VTE, whereas malignant disease diagnosed during follow-up was associated with a higher risk. During follow-up a total of 40,7% of patients had died. No difference in total mortality or mortality from malignant disease was demonstrated between the two drugs. In conclusion, a severe post-thrombotic syndrome occured relatively infrequent. considering the long observation period. Proximal DVT was significantly associated with a more severe post-thrombotic syndrome. After 14 years follow-up, no significant differences were observed in overall mortality, mortality from malignant disease or recurrent VTE between UFH- and dalteparin-treated patients. Malignant disease was a risk factor for recurrent VTE, the presence of a secondary risk factor and a longer duration of treatment with OAC decreased the risk for recurrent VTE.
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Bengtsson C, Janson C, Jonsson L, Holmström M, Theorell-Haglöw J, Lindberg E. Chronic rhinosinusitis is an independent risk factor for sleeping problems – a 10-year-follow-up study. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.082] [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: 10/18/2022]
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Bengtsson C, Lindberg E, Jonsson L, Holmström M, Sundbom F, Hedner J, Malinovschi A, Middelveld R, Forsberg B, Janson C. Chronic Rhinosinusitis Impairs Sleep Quality: Results of the GA2LEN Study. Sleep 2017; 40:2756098. [PMID: 28364469 DOI: 10.1093/sleep/zsw021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2016] [Indexed: 11/12/2022] Open
Abstract
Study objectives To analyze the prevalence of sleep problems in subjects with Chronic rhinosinusitis (CRS) and to determine whether the disease severity of CRS affects sleep quality. Methods Questionnaires were sent to a random sample of 45 000 adults in four Swedish cities. Questions on CRS, asthma, allergic rhinitis, co-morbidities, tobacco use, educational level, and physical activity were included. CRS was defined according to the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) epidemiological criteria. The disease severity of CRS was defined by the number of reported CRS symptoms. Sleep quality was assessed using the Basic Nordic Sleep Questionnaire. Results Of the 26 647 subjects, 2249 (8.4%) had CRS. Reported sleep problems were 50%-90% more common among subjects with CRS compared with those without or the total population. The prevalence of reported sleep problems increased in conjunction with the severity of CRS. After adjusting for gender, BMI, age, tobacco use, asthma, somatic diseases, physical activity level, and educational level, participants with four symptoms of CRS (compared with subjects without CRS symptoms) displayed a higher risk of snoring (adj. OR [95% CI]: 3.13 [2.22-4.41]), difficulties inducing sleep (3.98 [2.94-5.40]), difficulties maintaining sleep (3.44 [2.55-4.64]), early morning awakening (4.71 [3.47-6.38]) and excessive daytime sleepiness (4.56 [3.36-6.18]). The addition of persistent allergic rhinitis to CRS further increased the risk of sleep problems. Conclusions Sleep problems are highly prevalent among subjects with CRS. The disease severity of CRS negatively affects sleep quality.
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Affiliation(s)
- Caroline Bengtsson
- Department of Surgical Sciences, Otorhinolaryngology, Head and Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Lars Jonsson
- Department of Surgical Sciences, Otorhinolaryngology, Head and Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Mats Holmström
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital, Huddinge, Sweden
| | - Fredrik Sundbom
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Jan Hedner
- Department of Sleep Medicine, Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Andrei Malinovschi
- Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Roelinde Middelveld
- The Centre for Allergy Research, Karolinska Institutet and The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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Morén S, Mani M, Lilian S, Lindestad PÅ, Holmström M. Speech in Adults Treated for Unilateral Cleft Lip and Palate: Long-Term Follow-Up after One- or Two-Stage Palate Repair. Cleft Palate Craniofac J 2017; 54:639-649. [DOI: 10.1597/15-037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate speech in adults treated for unilateral cleft lip and palate with one-stage or two-stage palate closure and compare the speech of the patients with that of a noncleft control group. Design Cross-sectional study with long-term follow-up. Participants/Setting All unilateral cleft lip and palate patients born from 1960 to 1987 and treated at Uppsala University Hospital, Sweden, were invited (n = 109). Participation rate was 67% (n = 73) at a mean of 35 years after primary surgery. Forty-seven had been treated according to one-stage palate closure and 26 according to two-stage palate closure. Pharyngeal flap surgery had been performed in 11 of the 73 patients (15%). The noncleft control group consisted of 63 age-matched volunteers. Main Outcome Measure(s) Speech-language pathologists rated perceptual speech characteristics from blinded audio recordings. Results Among patients, seven (10%) presented with hypernasality, 12 (16%) had audible nasal emission and/or nasal turbulence, five (7%) had consonant production errors, one (2%) had glottal reinforcements/substitutions, and one (2%) had reduced intelligibility. Controls had no audible signs of velopharyngeal insufficiency and no quantifiable problems with the other speech production variables. No significant differences were identified between patients treated with one-stage and two-stage palate closure for any of the variables. Conclusions The prevalence of speech outcome indicative of velopharyngeal insufficiency among adult patients treated for unilateral cleft lip and palate was low but higher compared with individuals without cleft. Whether palatal closure is performed in one or two stages does not seem to affect the speech outcome at a mean age of 35 years.
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Affiliation(s)
- Staffan Morén
- Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Maria Mani
- Department of Surgical Sciences, Plastic Surgery, Uppsala University, Uppsala, Sweden
| | - Stålhammar Lilian
- Retired Speech Language Pathologist, Department of Neural Sciences, Logopedics, Uppsala University, Uppsala, Sweden
| | - Per Åke Lindestad
- Division of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Mats Holmström
- Division of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
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Löfstedt H, Hagström K, Bryngelsson IL, Holmström M, Rask-Andersen A. Respiratory symptoms and lung function in relation to wood dust and monoterpene exposure in the wood pellet industry. Ups J Med Sci 2017; 122:78-84. [PMID: 28276782 PMCID: PMC5441376 DOI: 10.1080/03009734.2017.1285836] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 01/13/2017] [Accepted: 01/16/2017] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Wood pellets are used as a source of renewable energy for heating purposes. Common exposures are wood dust and monoterpenes, which are known to be hazardous for the airways. The purpose of this study was to study the effect of occupational exposure on respiratory health in wood pellet workers. MATERIALS AND METHODS Thirty-nine men working with wood pellet production at six plants were investigated with a questionnaire, medical examination, allergy screening, spirometry, and nasal peak expiratory flow (nasal PEF). Exposure to wood dust and monoterpenes was measured. RESULTS The wood pellet workers reported a higher frequency of nasal symptoms, dry cough, and asthma medication compared to controls from the general population. There were no differences in nasal PEF between work and leisure time. A lower lung function than expected (vital capacity [VC], 95%; forced vital capacity in 1 second [FEV1], 96% of predicted) was noted, but no changes were noted during shifts. There was no correlation between lung function and years working in pellet production. Personal measurements of wood dust at work showed high concentrations (0.16-19 mg/m3), and exposure peaks when performing certain work tasks. Levels of monoterpenes were low (0.64-28 mg/m3). There was no association between exposure and acute lung function effects. CONCLUSIONS In this study of wood pellet workers, high levels of wood dust were observed, and that may have influenced the airways negatively as the study group reported upper airway symptoms and dry cough more frequently than expected. The wood pellet workers had both a lower VC and FEV1 than expected. No cross-shift changes were found.
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Affiliation(s)
- Håkan Löfstedt
- Department of Occupational and Environmental Medicine, Faculty of Medicine and Health Örebro University, Örebro, Sweden
| | - Katja Hagström
- Department of Occupational and Environmental Medicine, Faculty of Medicine and Health Örebro University, Örebro, Sweden
| | - Ing-Liss Bryngelsson
- Department of Occupational and Environmental Medicine, Faculty of Medicine and Health Örebro University, Örebro, Sweden
| | - Mats Holmström
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Anna Rask-Andersen
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
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Loomans JI, Eckhardt CL, Reitter-Pfoertner SE, Holmström M, van Gorkom BL, Leebeek FWG, Santoro C, Haya S, Meijer K, Nijziel MR, van der Bom JG, Fijnvandraat K. Mortality caused by intracranial bleeding in non-severe hemophilia A patients. J Thromb Haemost 2017; 15:1115-1122. [PMID: 28374963 DOI: 10.1111/jth.13693] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 12/21/2016] [Indexed: 11/26/2022]
Abstract
Essentials Data on bleeding-related causes of death in non-severe hemophilia A (HA) patients are scarce. Such data may provide new insights into areas of care that can be improved. Non-severe HA patients have an increased risk of dying from intracranial bleeding. This demonstrates the need for specialized care for non-severe HA patients. SUMMARY Background Non-severe hemophilia (factor VIII concentration [FVIII:C] of 2-40 IU dL-1 ) is characterized by a milder bleeding phenotype than severe hemophilia A. However, some patients with non-severe hemophilia A suffer from severe bleeding complications that may result in death. Data on bleeding-related causes of death, such as fatal intracranial bleeding, in non-severe patients are scarce. Such data may provide new insights into areas of care that can be improved. Aims To describe mortality rates, risk factors and comorbidities associated with fatal intracranial bleeding in non-severe hemophilia A patients. Methods We analyzed data from the INSIGHT study, an international cohort study of all non-severe hemophilia A patients treated with FVIII concentrates during the observation period between 1980 and 2010 in 34 participating centers across Europe and Australia. Clinical data and vital status were collected from 2709 patients. We report the standardized mortality rate for patients who suffered from fatal intracranial bleeding, using a general European male population as a control population. Results Twelve per cent of the 148 deceased patients in our cohort of 2709 patients died from intracranial bleeding. The mortality rate between 1996 and 2010 for all ages was 3.5-fold higher than that in the general population (95% confidence interval [CI] 2.0-5.8). Patients who died from intracranial bleeding mostly presented with mild hemophilia without clear comorbidities. Conclusion Non-severe hemophilia A patients have an increased risk of dying from intracranial bleeding in comparison with the general population. This demonstrates the need for specialized care for non-severe hemophilia A patients.
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Affiliation(s)
- J I Loomans
- Pediatric Hematology, Academic Medical Center, Amsterdam, the Netherlands
| | - C L Eckhardt
- Pediatric Hematology, Academic Medical Center, Amsterdam, the Netherlands
| | | | - M Holmström
- Karolinska University Hospital, Stockholm, Sweden
| | | | - F W G Leebeek
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | - C Santoro
- Sapienza University of Rome, Rome, Italy
| | - S Haya
- University Hospital la Fe, Valencia, Spain
| | - K Meijer
- Hematology Department, University Medical Center Groningen, Groningen, the Netherlands
| | - M R Nijziel
- Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - J G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - K Fijnvandraat
- Pediatric Hematology, Academic Medical Center, Amsterdam, the Netherlands
- Department of Plasma Proteins, Sanquin Research, Amsterdam, the Netherlands
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Osooli M, Steen Carlsson K, Baghaei F, Holmström M, Rauchensteiner S, Holme PA, Hvitfeldt L, Astermark J, Berntorp E. The association between health utility and joint status among people with severe haemophilia A: findings from the KAPPA register. Haemophilia 2017; 23:e180-e187. [DOI: 10.1111/hae.13231] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2017] [Indexed: 01/19/2023]
Affiliation(s)
- M. Osooli
- Centre for Thrombosis and Haemostasis; Skåne University Hospital; Malmö Sweden
- Department of Translational Sciences; Faculty of Medicine; Lund University; Malmo Sweden
| | - K. Steen Carlsson
- Department of Clinical Sciences; Faculty of Medicine; Lund University; Malmo Sweden
- Swedish Institute for Health Economics; Lund Sweden
| | - F. Baghaei
- Section of Haematology and Coagulation; Department of Medicine; Coagulation Centre; Sahlgrenska University Hospital; Gothenburg Sweden
| | - M. Holmström
- Coagulation Unit; Haematology Centre; Karolinska University Hospital; Stockholm Sweden
- Department of Internal Medicine; Karolinska Institute; Solna Stockholm Sweden
| | - S. Rauchensteiner
- Department of Global Medical Affairs Haematology; Bayer HealthCare Pharmaceuticals; Berlin Germany
| | - P. A. Holme
- Department of Haematology; Oslo University Hospital, Rikshospitalet; Oslo Norway
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - L. Hvitfeldt
- Center for Haemophilia and Thrombosis; Aarhus University Hospital; Aarhus Denmark
| | - J. Astermark
- Centre for Thrombosis and Haemostasis; Skåne University Hospital; Malmö Sweden
- Department of Translational Sciences; Faculty of Medicine; Lund University; Malmo Sweden
| | - E. Berntorp
- Centre for Thrombosis and Haemostasis; Skåne University Hospital; Malmö Sweden
- Department of Translational Sciences; Faculty of Medicine; Lund University; Malmo Sweden
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Peroz R, Holmström M, Mani M. Can objective measurements of the nasal form and function represent the clinical picture in unilateral cleft lip and palate? J Plast Reconstr Aesthet Surg 2017; 70:653-658. [PMID: 28325563 DOI: 10.1016/j.bjps.2017.01.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 12/17/2016] [Accepted: 01/31/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND The present study aimed to evaluate the potential correlations between objective measurements of nasal function and self-assessed nasal symptoms or clinical findings at nasal examination among adults treated for unilateral cleft lip and palate (UCLP), respectively. METHODS All UCLP patients born between 1960 and 1987 (n = 109) treated at a tertiary referring center were invited. Participation rate was 76% (n = 83) at a mean of 37 years after the initial surgery. All participants completed the same study protocol including acoustic rhinometry (AR), rhinomanometry (RM), anterior rhinoscopy, and questionnaires regarding self-experienced nasal symptoms. RESULTS A reduced volume of the anterior nasal cavity on the operated side (measured by AR) correlated to an expressed wish by the patient to change the function of the nose. A similar correlation was seen for the minimal cross-sectional area of anterior nasal cavity on the operated side. Furthermore, correlations were found between smaller volume and area of nasal cavity and a greater frequency of nasal obstruction. No further correlations were found. CONCLUSION Objective measurements partly correlate to the clinical picture among adults treated for UCLP. However, these need to be combined with findings at clinical examination and patient self-assessment to represent the complete clinical picture.
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Affiliation(s)
- Roshan Peroz
- Department of Plastic and Reconstructive Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Mats Holmström
- Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Mani
- Department of Plastic and Reconstructive Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
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Osooli M, Lövdahl S, Steen Carlsson K, Knobe K, Baghaei F, Holmström M, Astermark J, Berntorp E. Comparative burden of arthropathy in mild haemophilia: a register-based study in Sweden. Haemophilia 2017; 23:e79-e86. [PMID: 28155262 DOI: 10.1111/hae.13166] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2016] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Mild haemophilia is a congenital bleeding disorder affecting males. The burden of arthropathy in mild haemophilia has not been comprehensively described. AIM The aim of this study was to compare the incidence, age at diagnosis and surgery for arthropathy and related hospitalizations between people with mild haemophilia and the general population in Sweden. METHODS This was a register-based cohort study. Eligible participants were those with mild haemophilia born between 1941 and 2008 and a randomly selected, birthdate and sex-matched comparison group from the general population. Follow-up was from birth (or earliest 1984) until death, emigration or end of the study in 2008. Data on arthropathy were obtained from a national patient register. Negative binomial and competing risk regression and Kaplan-Meier estimate curves were used in the analysis. RESULTS Overall, 315 people with haemophilia and 1529 people in the comparison group were included. Participants with haemophilia born between 1984 and 2008 had a ninefold (95% CI: 3.3-27.2) and 16-fold (95% CI: 6.7-36.5) increased incidence of arthropathy-related hospital admission and arthropathy diagnosis respectively. None in this cohort underwent surgery. Among participants with haemophilia born prior to 1984, the rates of arthropathy diagnosis and surgery of the index joints (knee, elbow, ankle) were increased twofold (95% CI: 1.0-3.2) and fivefold (95% CI: 1.7-17.8) respectively. CONCLUSION Our data suggested a higher burden of arthropathy among individuals with mild haemophilia compared to the general population. Further research should investigate the need for targeted joint screening programmes among individuals with mild haemophilia.
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Affiliation(s)
- M Osooli
- Centre for Thrombosis and Haemostasis, Skane University Hospital, Malmo, Sweden.,Department of Translational Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - S Lövdahl
- Centre for Thrombosis and Haemostasis, Skane University Hospital, Malmo, Sweden.,Department of Translational Sciences, Faculty of Medicine, Lund University, Lund, Sweden.,Novo Nordisk A/S, Søborg, Denmark
| | - K Steen Carlsson
- Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.,Swedish Institute for Health Economics, Lund, Sweden
| | - K Knobe
- Centre for Thrombosis and Haemostasis, Skane University Hospital, Malmo, Sweden.,Department of Translational Sciences, Faculty of Medicine, Lund University, Lund, Sweden.,Novo Nordisk A/S, Søborg, Denmark
| | - F Baghaei
- Coagulation Centre, Department of Medicine/Haematology and Coagulation, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - M Holmström
- Coagulation Unit, Haematology Centre, Karolinska University Hospital, Stockholm, Sweden
| | - J Astermark
- Centre for Thrombosis and Haemostasis, Skane University Hospital, Malmo, Sweden.,Department of Translational Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - E Berntorp
- Centre for Thrombosis and Haemostasis, Skane University Hospital, Malmo, Sweden.,Department of Translational Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Schmidt DE, Majeed A, Bruzelius M, Odeberg J, Holmström M, Ågren A. A prospective diagnostic accuracy study evaluating rotational thromboelastometry and thromboelastography in 100 patients with von Willebrand disease. Haemophilia 2016; 23:309-318. [DOI: 10.1111/hae.13121] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2016] [Indexed: 01/15/2023]
Affiliation(s)
- D. E. Schmidt
- Division of Haematology; Department of Medicine; Coagulation Unit; Karolinska University Hospital and Karolinska Institutet; Stockholm Sweden
- University Medical Center Utrecht; Utrecht The Netherlands
| | - A. Majeed
- Division of Haematology; Department of Medicine; Coagulation Unit; Karolinska University Hospital and Karolinska Institutet; Stockholm Sweden
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm Sweden
| | - M. Bruzelius
- Division of Haematology; Department of Medicine; Coagulation Unit; Karolinska University Hospital and Karolinska Institutet; Stockholm Sweden
| | - J. Odeberg
- Division of Haematology; Department of Medicine; Coagulation Unit; Karolinska University Hospital and Karolinska Institutet; Stockholm Sweden
| | - M. Holmström
- Division of Haematology; Department of Medicine; Coagulation Unit; Karolinska University Hospital and Karolinska Institutet; Stockholm Sweden
| | - A. Ågren
- Division of Haematology; Department of Medicine; Coagulation Unit; Karolinska University Hospital and Karolinska Institutet; Stockholm Sweden
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Berntorp E, Dolan G, Hay C, Linari S, Santagostino E, Tosetto A, Castaman G, Álvarez-Román MT, Parra Lopez R, Oldenburg J, Albert T, Scholz U, Holmström M, Schved JF, Trossaërt M, Hermans C, Boban A, Ludlam C, Lethagen S. European retrospective study of real-life haemophilia treatment. Haemophilia 2016; 23:105-114. [DOI: 10.1111/hae.13111] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2016] [Indexed: 12/24/2022]
Affiliation(s)
- E. Berntorp
- Clinical Coagulation Research Unit; Lund University; Malmö Sweden
| | - G. Dolan
- St Thomas’ Hospital Haemophilia Centre; St Thomas’ Hospital; London UK
| | - C. Hay
- Department of Haematology; Manchester Royal Infirmary; Manchester UK
| | - S. Linari
- Center for Bleeding Disorders; Careggi University Hospital; Florence Italy
| | - E. Santagostino
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center; IRCCS Ca’ Granda Foundation; Maggiore Hospital Policlinico; Milan Italy
| | - A. Tosetto
- Department of Cell Therapy and Hematology; Hemophilia and Thrombosis Center; San Bortolo Hospital; Vicenza Italy
| | - G. Castaman
- Center for Bleeding Disorders; Careggi University Hospital; Florence Italy
- Department of Cell Therapy and Hematology; Hemophilia and Thrombosis Center; San Bortolo Hospital; Vicenza Italy
| | - MT. Álvarez-Román
- Hospital Universitario La Paz, Thrombosis and Haemostasis Unit; Madrid Spain
| | - R. Parra Lopez
- Unidad de Hemofilia; Hospital Vall d'Hebrón; Barcelona Spain
| | - J. Oldenburg
- Institut für Experimentelle Hämatologie und Transfusionsmedizin; Universitätsklinik Bonn; Bonn Germany
| | - T. Albert
- Institut für Experimentelle Hämatologie und Transfusionsmedizin; Universitätsklinik Bonn; Bonn Germany
| | - U. Scholz
- Center of Haemostasis; Leipzig Germany
| | - M. Holmström
- Coagulation Unit; Hematology Centre Karolinska; Karolinska University Hospital; Stockholm Sweden
- Department of Medicine; Karolinska Institutet; Solna Sweden
| | - J.-F. Schved
- Hôpital Saint Eloi; Laboratoire d'hématologie; Montpellier France
| | - M. Trossaërt
- Centre Régional de Traitement de l'Hémophilie CHU; Nantes France
| | - C. Hermans
- Haemostasis and Thrombosis Unit; Haemophilia Clinic St-Luc University Hospital; Brussels Belgium
| | - A. Boban
- Haemostasis and Thrombosis Unit; Haemophilia Clinic St-Luc University Hospital; Brussels Belgium
- Department of Hematology; Medical School of Zagreb; University Hospital Center Zagreb; Zagreb Croatia
| | - C. Ludlam
- Sobi; Stockholm Sweden
- University of Edinburgh; Edinburgh UK
| | - S. Lethagen
- Sobi; Stockholm Sweden
- Copenhagen University; Copenhagen Denmark
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Holmström M, Nangarhari A, Öhman J, Duberg AS, Majeed A, Aleman S. Long-term liver-related morbidity and mortality related to chronic hepatitis C virus infection in Swedish patients with inherited bleeding disorders. Haemophilia 2016; 22:e494-e501. [PMID: 27704656 DOI: 10.1111/hae.13020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2016] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Hepatitis C virus (HCV) infection is common in patients with inherited bleeding disorders treated with clotting factor concentrates prior to the introduction of viral inactivation of these products. The long-term consequences of hepatitis C infection in Swedish patients are not fully understood. AIM To examine the impact of HCV infection on liver-related morbidity and mortality in Swedish patients with inherited bleeding disorders. METHODS We retrospectively collected data on 183 patients with inherited bleeding disorders infected with HCV who attended the Coagulation Unit at Karolinska University Hospital, Sweden. Data regarding end-stage liver disease (ESLD), defined as presence of ascites, encephalopathy, variceal bleeding, hepatocellular carcinoma or liver-related death, were collected from the patient records and the national registers. RESULTS The median follow-up time was 35.9 years (IQR 29.0-41.2). A total of 41% had achieved sustained virological response (SVR) after treatment. In total, 14.2% developed ESLD at the median age of 52.6 years (IQR 46.5-64.7). Nineteen (35.8%) of all deaths were due to liver-related causes. Co-infection with human immunodeficiency virus (HIV), older age at time of infection and severe form of bleeding disorder was associated with higher risk of developing ESLD, while SVR was a strong protective factor. CONCLUSIONS This study demonstrated that liver-related morbidity and mortality was significant in patients with bleeding disorders and HCV infection in Sweden. Patients with HCV-infection should be candidates for treatment with the new highly effective antiviral drugs, since SVR proved to be a strong protective factor.
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Affiliation(s)
- M Holmström
- Coagulation Unit, Department of Medicine Solna, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
| | - A Nangarhari
- Department of Infectious Diseases, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
| | - J Öhman
- Karolinska Institutet at Karolinska Hospital, Stockholm, Sweden
| | - A-S Duberg
- Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - A Majeed
- Coagulation Unit, Department of Medicine Solna, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
| | - S Aleman
- Department of Infectious Diseases, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
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Ehnhage A, Johnsson PS, Ahlström-Emanuelsson C, Andersson M, Knutsson J, Lien J, Norlander T, Olsson P, Friis-Liby JE, Holmström M. Treatment of idiopathic rhinitis with kinetic oscillations - a multi-centre randomized controlled study. Acta Otolaryngol 2016; 136:852-9. [PMID: 27052839 DOI: 10.3109/00016489.2016.1155231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS The potential effects of KOS are still uncertain regarding the most effective air pressure to be used as well as the physiological effects on the nasal mucosa. The results of the study do not support a convincing treatment effect by KOS on IR. OBJECTIVES Idiopathic rhinitis (IR) is a common disorder, affecting ∼10-20% of the population. A new method for treating IR, Kinetic Oscillation Stimulation (KOS), has been reported to have beneficial effects on total vasomotor symptom scores (TVRSS). The primary objective with this study was to evaluate if a mean pressure of 65 mbar, pressure amplitude of 100 mbar, and 68 Hz treatment with KOS had a positive effect on total vasomotor symptom scores (TVRSS), as compared with a mean pressure of 65 mbar, pressure amplitude of 4 mbar, and 68 Hz treatment in patients with idiopathic rhinitis. METHODS Two hundred and seven patients were randomized (Full Analysis Set, FAS) in the study, including five visits and lasting for ∼25 weeks. All patients had two treatment episodes, and all patients had at least one treatment, meant as active, with high amplitude pressure for 10 min in each nostril. Group 1 had two such treatments, and Group 2 had one treatment with low amplitude pressure, initially meant as placebo, on one occasion. Because of numerical improvements in these two groups, a new control group, Group 3, was introduced. They had one new control treatment where the balloon was inserted into the nose, without any air inflation and without oscillations. RESULTS KOS treatment with high amplitude pressure did not have significant beneficial effects as compared to low amplitude pressure on TVRSS. Numerical improvements in TVRSS and SNOT 22 were found when comparing high and low amplitude pressure treatments with uninflated balloon treatment. However, this part of the study was initially single-blinded, and these results were secondary objectives.
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Affiliation(s)
- Anders Ehnhage
- Department of Clinical Science, Intervention and Technology, Division of Otorhinolaryngology, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Morgan Andersson
- Department of Otorhinolaryngology, Head and Neck Surgery, Skåne University Hospital, Lund and Malmö, Sweden
| | - Johan Knutsson
- Department of Otorhinolaryngology, Centre for Clinical Research Västmanland Hospital, Västerås, Sweden
| | - Jacob Lien
- Department of Clinical Science, Intervention and Technology, Division of Otorhinolaryngology, Karolinska Institutet, Stockholm, Sweden
| | | | - Petter Olsson
- Department of Clinical Science, Intervention and Technology, Division of Otorhinolaryngology, Karolinska Institutet, Stockholm, Sweden
| | | | - Mats Holmström
- Department of Clinical Science, Intervention and Technology, Division of Otorhinolaryngology, Karolinska Institutet, Stockholm, Sweden
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Holmström M, Davidsson Å, Hellgren J. [Allergic rhinitis affects one third of the population]. Lakartidningen 2016; 113:DSAS. [PMID: 27046750] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Allergic rhinitis is the most common form of allergy with a prevalence of 30%. Allergic rhinitis is associated with substantial health economic costs and patient suffering. Asthma is strongly associated with allergic rhinitis. The treatment of allergic rhinitis should be individualized and include the whole airway. The treatment goals should be a patient free of symptoms affecting their daily life or sleep.
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Affiliation(s)
- Mats Holmström
- ÖNH-kliniken - Karolinska Universitetssjukhuset Stockholm, Sweden ÖNH-kliniken - Karolinska Universitetssjukhuset Stockholm, Sweden
| | - Åke Davidsson
- Örebro Universitet - Örebro, Sweden Örebro Universitet - Örebro, Sweden
| | - Johan Hellgren
- ÖNH-kliniken - Sahlgrenska Göteborg, Sweden Institutionen för Kliniska Vetenskaper - Avdelningen för ÖNH Göteborg, Sweden
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Andrews DJ, Barabash S, Edberg NJT, Gurnett DA, Hall BES, Holmström M, Lester M, Morgan DD, Opgenoorth HJ, Ramstad R, Sanchez-Cano B, Way M, Witasse O. Plasma observations during the Mars atmospheric "plume" event of March-April 2012. J Geophys Res Space Phys 2016; 121:3139-3154. [PMID: 29552437 PMCID: PMC5854877 DOI: 10.1002/2015ja022023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We present initial analysis and conclusions from plasma observations made during the reported "Mars plume event" of March - April 2012. During this period, multiple independent amateur observers detected a localized, high-altitude "plume" over the Martian dawn terminator [Sanchez-Lavega et al., Nature, 2015, doi:10.1038/nature14162], the cause of which remains to be explained. The estimated brightness of the plume exceeds that expected for auroral emissions, and its projected altitude greatly exceeds that at which clouds are expected to form. We report on in-situ measurements of ionospheric plasma density and solar wind parameters throughout this interval made by Mars Express, obtained over the same surface region, but at the opposing terminator. Measurements in the ionosphere at the corresponding location frequently show a disturbed structure, though this is not atypical for such regions with intense crustal magnetic fields. We tentatively conclude that the formation and/or transport of this plume to the altitudes where it was observed could be due in part to the result of a large interplanetary coronal mass ejection (ICME) encountering the Martian system. Interestingly, we note that the only similar plume detection in May 1997 may also have been associated with a large ICME impact at Mars.
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Affiliation(s)
- D J Andrews
- Swedish Institute of Space Physics (Uppsala), Uppsala, Sweden
| | - S Barabash
- Swedish Institute of Space Physics (Kiruna), Kiruna, Sweden
| | - N J T Edberg
- Swedish Institute of Space Physics (Uppsala), Uppsala, Sweden
| | - D A Gurnett
- Department of Physics and Astronomy, University of Iowa, Iowa City, Iowa, USA
| | - B E S Hall
- Department of Physics and Astronomy, University of Leicester, Leicester, United Kingdom
| | - M Holmström
- Swedish Institute of Space Physics (Kiruna), Kiruna, Sweden
| | - M Lester
- Department of Physics and Astronomy, University of Leicester, Leicester, United Kingdom
| | - D D Morgan
- Department of Physics and Astronomy, University of Iowa, Iowa City, Iowa, USA
| | - H J Opgenoorth
- Swedish Institute of Space Physics (Uppsala), Uppsala, Sweden
| | - R Ramstad
- Swedish Institute of Space Physics (Kiruna), Kiruna, Sweden
| | - B Sanchez-Cano
- Department of Physics and Astronomy, University of Leicester, Leicester, United Kingdom
| | - M Way
- NASA Goddard Institute for Space Studies, 2880 Broadway, New York, New York, USA
- Department of Physics and Astronomy, Uppsala University, Box 516, SE-751 20, Uppsala, Sweden
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41
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Fischer K, Nijdam A, Holmström M, Petrini P, Ljung R, van der Schouw YT, Berntorp E. Evaluating outcome of prophylaxis in haemophilia: objective and self-reported instruments should be combined. Haemophilia 2016; 22:e80-e86. [PMID: 26856807 DOI: 10.1111/hae.12901] [Citation(s) in RCA: 22] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Routine outcome assessment of prophylaxis should use validated tools, while balancing comprehensiveness and burden. Collecting overlapping information should be avoided. AIM To assess correlations between different outcome assessment tools in haemophilia. METHODS From an international cross-sectional study, data on objective outcome (Haemophilia Joint Health Score (HJHS 2.1, range 0-124), radiological Pettersson score) and self-reported joint bleeding, Haemophilia Activities List (HAL, range 100-0), health-related quality of life (SF-36, including five physical and five mental domain scores, range 100-0), and Utility (SF6D and EQ-5D, range 1.0-0) were extracted. Spearman's correlations were calculated: ≥0.8 very strong, 0.60-0.79 strong, 0.40-0.59 moderate. RESULTS Ninety patients with severe haemophilia, on prophylaxis since median age 3.4 years, were evaluated at median 25.5 years (range 16.0-37.6). Objective outcome was favourable (median HJHS 2.1 6 points, Pettersson score 9 points). Self-reported outcome showed a median of 7 joint bleeds in 5 years, median HAL sum 96 points, high scores for physical domains of SF-36 (median 80-95) and high Utility values (median SF6D 0.87; EQ-5D 0.84). Physical examination (HJHS 2.1) showed strong correlation with radiological scores, moderate correlation with physical domains of the SF-36 and Utility, but no correlation with self-reported bleeding or limitations in activities (HAL). Bleeding was not associated with any other outcome parameter. The HAL was only correlated with the SF36 'Physical functioning' domain. CONCLUSION For the evaluation of patients on early prophylaxis, information on bleeding should be complemented by objective joint assessment as well as self-reported limitations in activities and quality of life.
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Affiliation(s)
- K Fischer
- Van Creveldkliniek, Department of Hematology, University Medical Center Utrecht, Utrecht, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - A Nijdam
- Van Creveldkliniek, Department of Hematology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - M Holmström
- Coagulation Unit, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - P Petrini
- Coagulation Unit, Karolinska University Hospital, Stockholm, Sweden.,Department of Paediatrics, Karolinska University Hospital, Stockholm, Sweden
| | - R Ljung
- Department of Paediatrics, Lund University, Malmö, Sweden.,Malmö centre for Thrombosis and Haemostasis, Skåne University Hospital, Malmö, Sweden
| | - Y T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - E Berntorp
- Malmö centre for Thrombosis and Haemostasis, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
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Westman M, Stjärne P, Bergström A, Kull I, Toskala E, Cardell LO, Wickman M, Holmström M. Chronic rhinosinusitis is rare but bothersome in adolescents from a Swedish population-based cohort. J Allergy Clin Immunol 2015; 136:512-4.e6. [DOI: 10.1016/j.jaci.2015.02.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 01/31/2015] [Accepted: 02/10/2015] [Indexed: 11/29/2022]
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Koivuniemi R, Kivistö S, Holmström M, Laine M, Korpi K, Kupari M, Leirisalo-Repo M. THU0165 Rheumatoid Arthritis Patients Show Myocardial Damage on Cardiac Magnetic Resonance Imaging. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Westman M, Lupinek C, Bousquet J, Andersson N, Pahr S, Baar A, Bergström A, Holmström M, Stjärne P, Lødrup Carlsen KC, Carlsen KH, Antó JM, Valenta R, van Hage M, Wickman M. Early childhood IgE reactivity to pathogenesis-related class 10 proteins predicts allergic rhinitis in adolescence. J Allergy Clin Immunol 2014; 135:1199-206.e1-11. [PMID: 25528361 DOI: 10.1016/j.jaci.2014.10.042] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/25/2014] [Accepted: 10/20/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND Component-resolved diagnosis might improve the prediction of future allergy in young children. OBJECTIVE We sought to investigate the association between IgE reactivity to the pathogenesis-related class 10 (PR-10) protein family and allergic rhinitis to birch pollen (ARbp) from early childhood up to age 16 years. METHOD Questionnaire data and sera obtained at 4, 8, and 16 years of age from the Barn/Children Allergi/Allergy Milieu Stockholm Epidemiologic (BAMSE) study birth cohort were used. Sera from 764 children were analyzed for IgE reactivity to 9 PR-10 allergen proteins at the 3 time points by using an allergen chip based on ISAC technology. ARbp was defined as upper airway symptoms during birch pollen exposure. RESULTS IgE reactivity to Bet v 1 was found in 12%, 17%, and 25% of children at 4, 8, and 16 years of age. IgE reactivity of PR-10 proteins showed a hierarchic intrarelationship: Bet v 1 > Mal d 1 > Cor a 1.04 > Ara h 8 > Pru p 1 > Aln g 1 > Api g 1 > Act d 8 > Gly m 4. There was an increased risk of incidence and persistence of ARbp up to age 16 years with increasing levels of Bet v 1-specific IgE or increasing numbers of IgE-reactive PR-10 proteins at 4 years. Children with severe ARbp at age 16 years had higher levels of Bet v 1-specific IgE at age 4 years compared with children with mild symptoms. CONCLUSION ARbp at age 16 years can be predicted by analysis of IgE reactivity to PR-10 proteins in early childhood.
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Affiliation(s)
- Marit Westman
- Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden; Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden.
| | - Christian Lupinek
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Jean Bousquet
- University Hospital of Montpellier, Hôpital Arnaud de Villeneuve, Montpellier, INSERM 1018, Villejuif, France
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sandra Pahr
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Alexandra Baar
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mats Holmström
- Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden; Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Pär Stjärne
- Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden; Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | - Kaj-Håkon Carlsen
- Department of Pediatrics, University of Oslo, Oslo University Hospital, Oslo, Norway
| | - Josep M Antó
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Marianne van Hage
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Magnus Wickman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden
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Olsson A, Hellgren M, Berntorp E, Holmström M, Baghaei F. Bleeding phenotype in carriers of haemophilia A does not correlate with thrombin generation. Haemophilia 2014; 21:e111-3. [PMID: 25422177 DOI: 10.1111/hae.12585] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2014] [Indexed: 11/30/2022]
Affiliation(s)
- A Olsson
- Department of Haematology and Coagulation Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
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Kislyakova KG, Holmström M, Lammer H, Odert P, Khodachenko ML. Magnetic moment and plasma environment of HD 209458b as determined from Lyα observations. Science 2014; 346:981-4. [DOI: 10.1126/science.1257829] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Kristina G. Kislyakova
- Space Research Institute, Austrian Academy of Sciences, Schmiedlstrasse 6, A-8042 Graz, Austria
| | - Mats Holmström
- Swedish Institute of Space Physics, PO Box 812, SE-98128 Kiruna, Sweden
| | - Helmut Lammer
- Space Research Institute, Austrian Academy of Sciences, Schmiedlstrasse 6, A-8042 Graz, Austria
| | - Petra Odert
- Institute of Physics, University of Graz, Universitätsplatz 5, A-8010 Graz, Austria
| | - Maxim L. Khodachenko
- Space Research Institute, Austrian Academy of Sciences, Schmiedlstrasse 6, A-8042 Graz, Austria
- Skobeltsyn Institute of Nuclear Physics, Moscow State University, Leninskie Gory, 119992 Moscow, Russia
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Bengtsson C, Jonsson L, Holmström M, Svensson M, Theorell-Haglöw J, Lindberg E. Impact of nasal obstruction on sleep quality: a community-based study of women. Eur Arch Otorhinolaryngol 2014; 272:97-103. [PMID: 24792065 DOI: 10.1007/s00405-014-3067-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 04/15/2014] [Indexed: 10/25/2022]
Abstract
The aim of the study was to analyse the impact of self-reported nasal obstruction on sleep quality in women. A community-based sample of 400 women underwent a full night of polysomnography. Airway diseases, allergies and sleep-related symptoms were assessed by questionnaires. Women with subjective nasal obstruction were subdivided into three groups: persistent nasal obstruction (PNO, n = 46), hay fever (n = 88) and nasal obstruction at night (NON, n = 30). Sleep problems and related daytime symptoms were most prevalent among women with NON. After adjusting for age, BMI, smoking and asthma, NON was an independent predictor of 'Difficulties inducing sleep due to nasal obstruction' [adjusted odds ratio (95 % CI): 89.5 (27.0-296.7)], 'Snoring' [4.2 (1.7-10.2)], 'Sweating at night' [2.6 (1.1-6.1)], 'Difficulties maintaining sleep' [2.7 (1.2-6.2)], and 'Waking up hastily gasping for breath' [32.2 (8.7-119.1)]. 'Dry mouth on awakening' [7.7 (3.2-18.4)], 'Waking up unrefreshed' [2.7 (1.2-6.0)], 'Excessive daytime sleepiness' [2.6 (1.1-6.0)], and 'Daytime nasal obstruction' [12.2 (4.8-31.2)] were also associated with NON. Persistent nasal obstruction and hay fever were both associated with some reported sleep problems due to an overlap with NON. When women with NON were excluded, only 'Daytime nasal obstruction' was still significantly associated with PNO, while hay fever was associated with 'Daytime nasal obstruction' and 'Waking up hastily gasping for breath'. There were no significant differences in objectively measured sleep variables between any of the three subgroups and the study cohort. Self-reported nasal obstruction at night in women has a significant effect on several subjective day- and nighttime symptoms, but it does not appear to affect objectively measured sleep quality.
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Affiliation(s)
- Caroline Bengtsson
- Department of Surgical Sciences, Otorhinolaryngology, Head and Neck Surgery, Uppsala University, Akademiska Sjukhuset, 751 85, Uppsala, Sweden,
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Pätilä T, Lehtinen M, Vento A, Schildt J, Sinisalo J, Laine M, Hämmäinen P, Nihtinen A, Alitalo R, Nikkinen P, Ahonen A, Holmström M, Lauerma K, Pöyhiä R, Kupari M, Kankuri E, Harjula A. Bone marrow mononuclear cells for ischemic cardiac failure - a prospective, controlled, randomized, double-blinded study of cell transplantation combined with coronary bypass surgery. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.021] [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: 10/25/2022]
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Lövdahl S, Henriksson KM, Baghaei F, Holmström M, Berntorp E, Astermark J. A longitudinal study of family structure in Swedish persons with haemophilia. Haemophilia 2013; 20:493-9. [DOI: 10.1111/hae.12350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2013] [Indexed: 01/13/2023]
Affiliation(s)
- S. Lövdahl
- Clinical Coagulation Research Unit; Department of Clinical Sciences; Lund University; Skåne University Hospital; Malmö Sweden
| | - K. M. Henriksson
- Cardiovascular Epidemiology; Department of Medical Science; Uppsala University Hospital; Uppsala Sweden
- Department of Epidemiology; AstraZeneca R&D; Mölndal Sweden
| | - F. Baghaei
- Coagulation Centre; Department of Medicine/Hematology and Coagulation Disorders; Sahlgrenska University Hospital; Gothenburg Sweden
| | - M. Holmström
- Coagulation Unit; Hematology Centre; Karolinska University Hospital and Department of Medicine; Karolinska Institute; Stockholm Sweden
| | - E. Berntorp
- Clinical Coagulation Research Unit; Department of Clinical Sciences; Lund University; Skåne University Hospital; Malmö Sweden
| | - J. Astermark
- Department of Hematology and Coagulation Disorders; Skåne University Hospital; Malmö Sweden
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50
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Kislyakova KG, Lammer H, Holmström M, Panchenko M, Odert P, Erkaev NV, Leitzinger M, Khodachenko ML, Kulikov YN, Güdel M, Hanslmeier A. XUV-exposed, non-hydrostatic hydrogen-rich upper atmospheres of terrestrial planets. Part II: hydrogen coronae and ion escape. Astrobiology 2013; 13:1030-48. [PMID: 24283926 PMCID: PMC3865724 DOI: 10.1089/ast.2012.0958] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
We studied the interactions between the stellar wind plasma flow of a typical M star, such as GJ 436, and the hydrogen-rich upper atmosphere of an Earth-like planet and a "super-Earth" with a radius of 2 R(Earth) and a mass of 10 M(Earth), located within the habitable zone at ∼0.24 AU. We investigated the formation of extended atomic hydrogen coronae under the influences of the stellar XUV flux (soft X-rays and EUV), stellar wind density and velocity, shape of a planetary obstacle (e.g., magnetosphere, ionopause), and the loss of planetary pickup ions on the evolution of hydrogen-dominated upper atmospheres. Stellar XUV fluxes that are 1, 10, 50, and 100 times higher compared to that of the present-day Sun were considered, and the formation of high-energy neutral hydrogen clouds around the planets due to the charge-exchange reaction under various stellar conditions was modeled. Charge-exchange between stellar wind protons with planetary hydrogen atoms, and photoionization, lead to the production of initially cold ions of planetary origin. We found that the ion production rates for the studied planets can vary over a wide range, from ∼1.0×10²⁵ s⁻¹ to ∼5.3×10³⁰ s⁻¹, depending on the stellar wind conditions and the assumed XUV exposure of the upper atmosphere. Our findings indicate that most likely the majority of these planetary ions are picked up by the stellar wind and lost from the planet. Finally, we estimated the long-time nonthermal ion pickup escape for the studied planets and compared them with the thermal escape. According to our estimates, nonthermal escape of picked-up ionized hydrogen atoms over a planet's lifetime within the habitable zone of an M dwarf varies between ∼0.4 Earth ocean equivalent amounts of hydrogen (EO(H)) to <3 EO(H) and usually is several times smaller in comparison to the thermal atmospheric escape rates.
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Affiliation(s)
- Kristina G. Kislyakova
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
- Institute of Physics, University of Graz, Graz, Austria
| | - Helmut Lammer
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | | | | | - Petra Odert
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
- Institute of Physics, University of Graz, Graz, Austria
| | - Nikolai V. Erkaev
- Institute of Computational Modelling, Siberian Division of the Russian Academy of Sciences, Krasnoyarsk, Russian Federation
| | | | - Maxim L. Khodachenko
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
- SINP, Moscow State University, Moscow, Russian Federation
| | - Yuri N. Kulikov
- Polar Geophysical Institute (PGI), Russian Academy of Sciences, Murmansk, Russian Federation
| | - Manuel Güdel
- Institute of Astrophysics, University of Vienna, Austria
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