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  • 1. Afshin, A
    et al.
    Forouzanfar, M. H
    Reitsma, M. B
    Sur, P
    Estep, K
    Lee, A
    Marczak, L
    Mokdad, A. H
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala universitet.
    Murray, C. J. L
    Health effects of overweight and obesity in 195 countries over 25 years2017Ingår i: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 377, nr 1, s. 13-27Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain.

    METHODS: We analyzed data from 68.5 million persons to assess the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body-mass index (BMI), according to age, sex, cause, and BMI in 195 countries between 1990 and 2015.

    RESULTS: In 2015, a total of 107.7 million children and 603.7 million adults were obese. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. Although the prevalence of obesity among children has been lower than that among adults, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million deaths globally, nearly 40% of which occurred in persons who were not obese. More than two thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990; however, the rate of this increase has been attenuated owing to decreases in underlying rates of death from cardiovascular disease.

    CONCLUSIONS: The rapid increase in the prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem.

  • 2. Ahlm, Kristin
    et al.
    Lindqvist, Per
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Karolinska institutet.
    Saveman, Britt-Inger
    Björnstig, Ulf
    Suicidal drowning deaths in northern Sweden 1992-2009: The role of mental disorder and intoxication2015Ingår i: Journal of Forensic and Legal Medicine, ISSN 1752-928X, E-ISSN 1878-7487, Vol. 34, s. 168-172Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Suicides by drowning have received limited attention by researchers. A recent finding that almost one-third of all drowning deaths in Sweden were classified as suicide instigated this study. We identified 129 cases of suicide by drowning in Northern Sweden and analyzed the circumstances and the psychiatric history prior to the suicide. Information was obtained from autopsy, police and medical records, as well as from the National Inpatient Register. One-third of the suicide victims had previously attempted suicide and half of the victims had been hospitalized due to mental health problems. One-third of these had left the hospital less than one week before the suicide. Alcohol and psychoactive drugs were present in 16% and 62% of the cases, respectively. A history of mental disorder and previous suicide attempt (s), especially by drowning, is an ominous combination necessitating efficient clinical identification, treatment and follow-up if a complete suicide is to be prevented.

  • 3.
    Andersen, Kasper
    et al.
    Uppsala University, Uppsala, Sweden.
    Lind, Lars
    Uppsala University, Uppsala, Sweden.
    Ingelsson, Erik
    Uppsala University, Uppsala, Sweden.
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala University, Uppsala, Sweden.
    Byberg, Liisa
    Uppsala University, Uppsala, Sweden.
    Michaëlsson, Karl
    Uppsala University, Uppsala, Sweden.
    Sundström, Johan
    Uppsala University, Uppsala, Sweden.
    Skeletal muscle morphology and risk of cardiovascular disease in elderly men2015Ingår i: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 22, nr 2, s. 231-239Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: While it is well known that physical inactivity is a major risk factor for cardiovascular disease, there is still a search for the mechanisms by which exercise exerts its positive effect. Skeletal muscle fibre type can be affected to some extent by exercise, and different fibre types possess different anti-inflammatory and glucometabolic properties that may influence cardiovascular disease risk.

    DESIGN: Population-based cohort study.

    METHODS: We investigated relations of skeletal muscle morphology to risk of cardiovascular events in a sample of 466 71-year-old men without cardiovascular disease, of which 295 were physically active (strenuous physical activity at least 3 h/week).

    RESULTS: During a median of 13.1 years of follow up, 173 major cardiovascular events occurred. Among physically active men, 10% higher proportion of type-I (slow-twitch oxidative) fibres was associated with a hazard ratio (HR) of 0.84 (95% confidence interval 0.74-0.95) for cardiovascular events, and 10% higher proportion of type-IIx (fast-twitch glycolytic) fibres was associated with a HR of 1.24 (1.06-1.45), adjusting for age. Similar results were observed in several sets of multivariable-adjusted models. No association of muscle fibre type with risk of cardiovascular events was observed among physically inactive men.

    CONCLUSIONS: Higher skeletal muscle proportion of type-I fibres was associated with lower risk of cardiovascular events and a higher proportion of type-IIx fibres was associated with higher risk of cardiovascular events. These relations were only observed in physically active men. Skeletal muscle fibre composition may be a mediator of the protective effects of exercise against cardiovascular disease.

  • 4. Arefalk, Gabriel
    et al.
    Hergens, Maria-Pia
    Ingelsson, Erik
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Michaëlsson, Karl
    Lind, Lars
    Ye, Weimin
    Nyrén, Olof
    Lambe, Mats
    Sundström, Johan
    Smokeless tobacco (snus) and risk of heart failure: results from two Swedish cohorts2010Ingår i: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 28, nr suppl.A, s. E48-E49Artikel i tidskrift (Refereegranskat)
  • 5. Arefalk, Gabriel
    et al.
    Hergens, Maria-Pia
    Ingelsson, Erik
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Michaëlsson, Karl
    Lind, Lars
    Ye, Weimin
    Nyrén, Olof
    Lambe, Mats
    Sundström, Johan
    Smokeless tobacco (snus) and risk of heart failure: results from two Swedish cohorts2012Ingår i: European Journal of Cardiovascular Prevention & Rehabilitation, ISSN 1741-8267, E-ISSN 1741-8275, Vol. 19, nr 5, s. 1120-1127Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Oral moist snuff (snus) is discussed as a safer alternative to smoking, and its use is increasing. Based on its documented effect on blood pressure, we hypothesized that use of snus increases the risk of heart failure.

    Design: Two independent Swedish prospective cohorts; the Uppsala Longitudinal Study of Adult Men (ULSAM), a community-based sample of 1076 elderly men, and the Construction Workers Cohort (CWC), a sample of 118,425 never-smoking male construction workers. Methods: Cox proportional hazards models were used to investigate possible associations of snus use with risk of a first hospitalization for heart failure.

    Results: In ULSAM, 95 men were hospitalized for heart failure, during a median follow up of 8.9 years. In a model adjusted for established risk factors including past and present smoking exposure, current snus use was associated with a higher risk of heart failure [hazard ratio (HR) 2.08, 95% confidence interval (CI) 1.03-4.22] relative to non-use. Snus use was particularly associated with risk of non-ischaemic heart failure (HR 2.55, 95% CI 1.12-5.82). In CWC, 545 men were hospitalized for heart failure, during a median follow up of 18 years. In multivariable-adjusted models, current snus use was moderately associated with a higher risk of heart failure (HR 1.28, 95% CI 1.00-1.64) and non-ischaemic heart failure (HR 1.28, 95% CI 0.97-1.68) relative to never tobacco use.

    Conclusion: Data from two independent cohorts suggest that use of snus may be associated with a higher risk of heart failure.

  • 6. Arking, Dan E
    et al.
    Pulit, Sara L
    Crotti, Lia
    van der Harst, Pim
    Munroe, Patricia B
    Koopmann, Tamara T
    Sotoodehnia, Nona
    Rossin, Elizabeth J
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala universitet.
    Newton-Cheh, Christopher
    Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization2014Ingår i: Nature Genetics, ISSN 1061-4036, E-ISSN 1546-1718, Vol. 46, nr 8, s. 826-836Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using a genome-wide association and replication study in up to 100,000 individuals, we identified 35 common variant loci associated with QT interval that collectively explain similar to 8-10% of QT-interval variation and highlight the importance of calcium regulation in myocardial repolarization. Rare variant analysis of 6 new QT interval-associated loci in 298 unrelated probands with LQTS identified coding variants not found in controls but of uncertain causality and therefore requiring validation. Several newly identified loci encode proteins that physically interact with other recognized repolarization proteins. Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies new candidate genes for ventricular arrhythmias, LQTS and SCD.

  • 7. Arkkukangas, Marina
    et al.
    Johnson, Susanna Tuvemo
    Hellström, Karin
    Anens, Elisabeth
    Tonkonogi, Michail
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Larsson, Ulf
    Fall prevention exercises with or without behavior change support for community-dwelling older adults: a two-year follow-up of a randomized controlled trial2019Ingår i: Journal of Aging and Physical Activity, ISSN 1063-8652, E-ISSN 1543-267X, Vol. 28, nr 1, s. 34-41Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study investigates the effectiveness of two fall prevention exercise interventions targeting physical performance, activity level, fall-related self-efficacy, health-related quality of life, and falls: the Otago Exercise Programme (OEP) with and the OEP without behavior change support. In this randomized controlled trial (RCT), 175 participants were randomised into two intervention groups and one control group. A total of 124 community-dwelling older adults over the age of 75 who needed walking aids or home support participated in the two-year follow-up. The OEP with and the OEP without support for behavior change displayed no long-term benefits on physical performance, fall-related self-efficacy, health-related quality of life, and falls compared to a control group. Although no significant differences were detected between the groups, the results implied the control group's physical activity level decreased compared to the intervention groups at two-year follow up.

  • 8. Arkkukangas, Marina
    et al.
    Strömqvist Bååthe, Karin
    Ekholm, Anna
    Tonkonogi, Michail
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Health promotion and prevention: The impact of specifically adapted judo-inspired training program on risk factors for falls among adults.2020Ingår i: Preventive Medicine Reports, E-ISSN 2211-3355, Vol. 19, artikel-id 101126Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Globally, falls and fall-related injuries constitute a severe threat to public health at all ages. New approaches are warranted since existing knowledge and actions have failed to reduce the incidence of falls and fall-related injuries, both at work and during leisure time. The purpose of this quasi-experimental study was to investigate the impact of a 10-week supervised judo-inspired exercise program, Judo4Balance, provided in a workplace setting among men and women targeting: physical functions, activity level, fall-related self-efficacy, and techniques for safe landing when falling. A total of 79 adults from seven different workplaces in Sweden, mean age 45 years (18-68), participated in the program. The study was conducted from May 2018 to June 2019. The 10-week exercise program performed in a workplace setting improved physical and psychological functions, as well as techniques for falling safely, factors of great importance to prevent falls and fall-related injuries among men and women. Therefore, it is suggested that the judo-inspired exercise program may be an effective tool in the quest to promote health and prevention of risk factors for falls and fall-related injuries among those of working age.

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  • 9. Arkkukangas, Marina
    et al.
    Strömqvist Bååthe, Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Hamilton, Julia
    Ekholm, Anna
    Tonkonogi, Michail
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Feasibility of a novel Judo4Balance – fall preventive exercise programme targeting community-dwelling older adults2020Ingår i: Journal of Frailty, Sarcopenia and Falls, ISSN 2459-4148, Vol. 5, nr 3, s. 47-52Artikel i tidskrift (Refereegranskat)
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  • 10.
    Arkkukangas, Marina
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Mälardalen University.
    Sundler, Annelie Johansson
    Söderlund, Anne
    Eriksson, Staffan
    Johansson, Ann Christin
    Older persons’ experiences of a home-based exercise programme with behavioural change support2017Ingår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, nr 12, s. 905-913Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and wellbeing in older persons.

    Purpose: This descriptive study used a qualitative inductive approach to describe older persons’ experiences of a fall-preventive, home-based exercise programme with support for behavioural change.

    Methods: Semi-structured interviews were conducted with twelve older persons aged 75 years or older, and a qualitative content analysis was performed.

    Results: Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise.

    Conclusion: With support from physiotherapists, home-based exercise can be adapted to individual circumstances in a meaningful way. By including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning and give hope for an extended active life in old age.

  • 11. Artzi-Medvedik, Rada
    et al.
    Kob, Robert
    Fabbietti, Paolo
    Lattanzio, Fabrizia
    Corsonello, Andrea
    Melzer, Yehudit
    Roller-Wirnsberger, Regina
    Wirnsberger, Gerhard
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala University; Karolinska Institutet.
    Melzer, Itshak
    Impaired kidney function is associated with lower quality of life among community-dwelling older adults: The screening for CKD among older people across Europe (SCOPE) study.2020Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 20, nr Suppl 1, artikel-id 340Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Quality of life (QoL) refers to the physical, psychological, social and medical aspects of life that are influenced by health status and function. The purpose of this study was to measure the self-perceived health status among the elderly population across Europe in different stages of Chronic Kidney Disease (CKD).

    METHODS: Our series consisted of 2255 community-dwelling older adults enrolled in the Screening for Chronic Kidney Disease (CKD) among Older People across Europe (SCOPE) study. All patients underwent a comprehensive geriatric assessment (CGA), including included demographics, clinical and physical assessment, number of medications taken, family arrangement, Geriatric Depression Scale (GDS), Cumulative Illness Rating Scale, History of falls, Lower urinary tract symptoms, and Short Physical Performance Battery (SPPB). Estimated glomerular filtration rate (eGFR) was calculated by Berlin Initiative Study (BIS) equation. Quality of life was assessed by Euro Qol questionnaire (Euro-Qol 5D) and EQ-Visual Analogue Scale (EQ-VAS). The association between CKD (eGFR < 60, < 45 ml or < 30 ml/min/1.73m2) and low EQoL-VAS was investigated by multivariable logistic regression models.

    RESULTS: CKD was found to be significantly associated with low EQoL-VAS in crude analysis (OR = 1.47, 95%CI = 1.16-1.85 for eGFR< 60; OR = 1.38, 95%CI = 1.08-1.77 for eGFR< 45; OR = 1.57, 95%CI = 1.01-2.44). Such association was no longer significant only when adjusting for SPPB (OR = 1.20, 95%CI = 0.93-1.56 for eGFR< 60; OR = 0.87, 95%CI = 0.64-1.18 for eGFR< 45; OR = 0.84, 95%CI = 0.50-1.42), CIRS and polypharmacy (OR = 1.16, 95%CI = 0.90-1.50 for eGFR< 60; OR = 0.86, 95%CI = 0.64-1.16 for eGFR< 45; OR = 1.11, 95%CI = 0.69-1.80) or diabetes, hypertension and chronic obstructive pulmonary disease (OR = 1.28, 95%CI = 0.99-1.64 for eGFR< 60; OR = 1.16, 95%CI = 0.88-1.52 for eGFR< 45; OR = 1.47, 95%CI = 0.92-2.34). The association between CKD and low EQoL-VAS was confirmed in all remaining multivariable models.

    CONCLUSIONS: CKD may significantly affect QoL in community-dwelling older adults. Physical performance, polypharmacy, diabetes, hypertension and COPD may affect such association, which suggests that the impact of CKD on QoL is likely multifactorial and partly mediated by co-occurrent conditions/risk factors.

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  • 12.
    Axelsson, Johanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Tellström, Linda
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Mobil hälsa (m-hälsa) genom användning av mobiltelefon som intervention för barn med övervikt eller fetma.: En systematisk litteraturstudie.2018Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund:

    Förekomsten av övervikt och fetma bland barn ökar i stora delar av världen.

    Brist på fysisk aktivitet är en av orsakerna bakom övervikt och fetma. För barn med

    fetma kan små mängder fysisk aktivitet ha stora positiva hälsoeffekter. Det finns ett

    behov av att utveckla nya effektiva strategier för att öka mängden fysisk aktivitet bland

    barn med övervikt eller fetma. Mobil hälsa (m-hälsa) används som ett paraplybegrepp

    för hälsotjänster förmedlade genom mobila enheter och definieras som ”medicinsk eller

    offentlig hälsoutövning som stöds av mobila enheter så som mobiltelefoner, anordningar

    för patientövervakning, personliga digitala assistenter och andra trådlösa enheter”. En

    potentiell strategi för att påverka mängden fysisk aktivitet bland barn med övervikt eller

    fetma är m-hälsa genom användning av mobiltelefon.

    Syfte:

    Att kartlägga och beskriva vilka interventioner med m-hälsokomponent genom

    användning av mobiltelefon som utvärderat fysisk aktivitet eller Body Mass Index

    (BMI) bland barn med övervikt eller fetma.

    Metod:

    En systematisk litteraturstudie där studier som beskrev interventioner med mhälsokomponenter

    för målgruppen barn 0-18 år med övervikt eller fetma inkluderades.

    Sökning genomfördes i tre vetenskapliga databaser.

    Resultat:

    Sökningarna resulterade i 649 studier av vilka 16 mötte uppsatta

    inklusionskriterier. M-hälsokomponenten innefattade i de flesta studier användning av

    sms och i några studier användning av app. Funktionen med m-hälsokomponenten

    studerades och delades in i självregistrering, kommunikation, uppmuntran, utbildning

    och påminnelse. De inkluderade studierna rapporterade olika former av BMI där två

    studier visade på signifikanta skillnader mellan interventions-och kontrollgrupp med

    störst minskning för interventionsgruppen. Få studier rapporterade objektivt mätt tid i

    fysisk aktivitet på måttlig till hög intensitet.

    Slutsats:

    Den vanligast förekommande interventionen med m-hälsokomponent genom

    användning av mobiltelefon bland barn med övervikt eller fetma var sms. För att kunna

    förstå och jämföra på vilket sätt m-hälsa kan användas skulle ett ramverk för beskrivning

    av dessa interventioner underlätta.

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  • 13. B Åhman, Hanna
    et al.
    Berglund, Lars
    Cedervall, Ylva
    Kilander, Lena
    Giedraitis, Vilmantas
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Ingelsson, Martin
    Rosendahl, Erik
    Åberg, Anna Cristina
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala University.
    Dual-Task Tests Predict Conversion to Dementia-A Prospective Memory-Clinic-Based Cohort Study2020Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, nr 21, artikel-id E8129Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to investigate whether Timed Up-and-Go (TUG) dual-task (TUGdt) tests predict dementia incidence among patients with subjective or mild cognitive impairment (SCI; MCI). Other study objectives were to determine whether TUGdt improves dementia prediction compared to a) demographic characteristics and standard cognitive tests alone; and b) TUG and Verbal Fluency performed separately. Patients (n = 172, age range 39-91 years, 78 women) with SCI or MCI performed TUGdt tests, including 1) naming animals and 2) reciting months backwards, and clinical cognitive tests at baseline. Diagnoses were identified at follow-up after 2.5 years. Logistic regression was used to predict dementia incidence, receiver operating characteristic (ROC) curves and c-statistics for predictive capacity. Analyses were stratified by age and gender. At follow-up, 51 patients had developed dementia. The TUGdt result "animals/10 s" was associated with dementia incidence (standardized odds ratio (OR) = 4.06, 95% confidence interval (CI) 2.28-7.23, p < 0.001), more so among patients under the median age of 72 years (standardized OR = 19.4, 95% CI 3.53-106.17, p < 0.001). TUGdt "animals/10 s" improved dementia prediction compared to demographic characteristics and standard tests alone (c-statistics 0.88 to 0.94) and single-task tests (c-statistics 0.86 to 0.89), but only in the younger patient group. TUGdt has the potential to become a useful tool for dementia prediction.

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  • 14.
    Balaile, Gunnel
    Högskolan Dalarna, Akademin Hälsa och samhälle, Medicinsk vetenskap.
    The Meaning of Health and Sexuality as experienced by Tanzanian Men and Women living with HIV/AIDS2007Licentiatavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    Background: Sub-Saharan Africa has for more than two decades been hit by Human immunodeficiency virus/ Acquired immune-deficiency Syndrome, HIV/AIDS pandemic with a few signs of decline. In Tanzania, the prevalence of HIV is estimated to 7 percent and about 1.8 million Tanzanians are living with HIV. Women are the hardest hit and most vulnerable are young women 15-24 years old, who are three times more likely to be infected than young men in the same age group and the prevalence is higher in urban than in rural areas. Aim: The overall aim of this thesis was to explore the meaning of health and sexuality among men and women living with HIV/AIDS. Methods: Two studies were conducted in Tanzania, Dar es Salaam during January and February in year 2004 (I, II). Twenty participants were recruited (10 men and 10 women) by the help from health staff and sampled purposely in order to get an equal variety of age, education, religion, sex, and marital status. The interviews took place at one district hospital, and at two different clinics run by Non Governmental Organizations (NGO) one located in a business area in central town, the other NGO clinic outside town in an industrial area. The interviews were transcribed and translated into English. A phenomenological – hermeneutic approach and in-depth interviews were used to collect data. The text was ana¬lysed following Ricoeur’s interpretation theory for text. Findings: The thesis presents aspects of men’s and women’s experiences of living with HIV/AIDS. Adjustment to living with the virus was different between men and women. Men often conceived a growing suspicion that they might be in¬fected by HIV, while women had to be asked by relatives or had to wait for others to be tested. The overwhelming fear of being tested was related to the fear of being stigmatized. Under¬standing the meaning of health and sexuality when living with HIV/AIDS, was for the men living life with a preserved sense of integrity and self-esteem, this meant not to be seen as victims. To the women, however, the reality was it meant being cast into poverty and created devastation of intimate relations. Men had learnt to perform safe sex and had chosen to live with one partner/wife giving them an opportunity to develop new aspects of their intimate life. Conversely, the women felt miserable and had not accepted their diagnosis in the same way. They lacked resources to maintain health and the ability to support their children. The women who lived in a single household had abandoned sex life, their worries and deep concerns were for their children who brought meaning and joy in their lives. Conclusion: For both men and women the meaning of health and sexuality had changed after knowing their sero-status. The men had accepted to live with an altered health and treated symptoms early. The were able to handle feelings, they felt optimistic and strived to live a normal life as possible health had for the women lost meaning in that sense it was not possible to maintain. The men viewed their sex life still important, and tried to be able live a normal life. The women had accepted a life there sexuality had no place. To prevent further HIV infection meant to be educated and fully understand how to prevent the spread of HIV, to act in a responsible way, to be faithful, and/or to accept abstinence. This new way of living meant to be a caring man or woman. The use of condoms had not been completely accepted as the knowledge on how to use the condoms properly was not entirely accomplished. Support from counselors and peers were proved invaluable adjust to a life of living with HIV/AIDS.

  • 15.
    Balaile, Gunnel
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Laisser, Rose
    Ransjö-Arvidson, Anna-Berit
    Höjer, Bengt
    Poverty and devastation of intimate relations: Tanzanian women's experience of living with HIV/AIDS2007Ingår i: Journal of the Association of Nurses in AIDS Care, ISSN 1055-3290, E-ISSN 1552-6917, Vol. 18, nr 5, s. 6-16Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In Tanzania, women of reproductive age constitute the largest group infected by HIV. This study aimed to explore the lived experiences related to health and sexuality of Tanzanian women who had known their positive serostatus for I year. In-depth interviews with 10 women were analyzed using a phenomeno-logical-hermeneutic approach and showed frustration and despair at not having resources to maintain daily life. The women needed regular medical treatment for themselves and for their HIV-positive children. Their sexual desires had declined or vanished, and they had come to view sexuality as a source of transmittable disease. For some women, casual sex was an option to solve urgent financial needs. Happiness was something for their children, not for them. Access to social support from the women's community would help prevent further HIV transmission and enhance survival so the children could grow up with at least one devoted parent.

  • 16. Bandak, Ghassan
    et al.
    Sang, Yingying
    Gasparini, Alessandro
    Chang, Alex R
    Ballew, Shoshana H
    Evans, Marie
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala universitet.
    Lund, Lars H
    Inker, Lesley A
    Grams, Morgan E
    Hyperkalemia after initiating renin-angiotensin system blockade: The Stockholm creatinine measurements (SCREAM) project2017Ingår i: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 6, nr 7, artikel-id e005428Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Concerns about hyperkalemia limit the use of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs), but guidelines conflict regarding potassium-monitoring protocols. We quantified hyperkalemia monitoring and risks after ACE-I/ARB initiation and developed and validated a hyperkalemia susceptibility score.

    METHODS AND RESULTS: We evaluated 69 426 new users of ACE-I/ARB therapy in the Stockholm Creatinine Measurements (SCREAM) project with medication initiation from January 1, 2007 to December 31, 2010, and follow-up for 1 year thereafter. Three fourths (76%) of SCREAM patients had potassium checked within the first year. Potassium >5 and >5.5 mmol/L occurred in 5.6% and 1.7%, respectively. As a comparison, we propensity-matched new ACE-I/ARB users to 20 186 new β-blocker users in SCREAM: 64% had potassium checked. The occurrence of elevated potassium levels was similar between new β-blocker and ACE-I/ARB users without kidney disease; only at estimated glomerular filtration rate <60 mL/min per 1.73 m(2) were risks higher among ACE-I/ARB users. We developed a hyperkalemia susceptibility score that incorporated estimated glomerular filtration rate, baseline potassium level, sex, diabetes mellitus, heart failure, and the concomitant use of potassium-sparing diuretics in new ACE-I/ARB users; this score accurately predicted 1-year hyperkalemia risk in the SCREAM cohort (area under the curve, 0.845, 95% CI: 0.840-0.869) and in a validation cohort from the US-based Geisinger Health System (N=19 524; area under the curve, 0.818, 95% CI: 0.794-0.841), with good calibration.

    CONCLUSIONS: Hyperkalemia within the first year of ACE-I/ARB therapy was relatively uncommon among people with estimated glomerular filtration rate >60 mL/min per 1.73 m(2), but rates were much higher with lower estimated glomerular filtration rate. Use of the hyperkalemia susceptibility score may help guide laboratory monitoring and prescribing strategies.

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  • 17. Barber, Ryan M
    et al.
    Fullman, Nancy
    Sorensen, Reed J
    Bollyky, Thomas
    McKee, Martin
    Nolte, Ellen
    Abajobir, Amanuel Alemu
    Abete, Kalkidan Hassen
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Karolinska institutet.
    Murray, Christopher J L
    Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 20152017Ingår i: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 390, nr 10091, s. 231-266Artikel i tidskrift (Refereegranskat)
    Ladda ner fulltext (pdf)
    fulltext
  • 18.
    Bartholdsson, Åsa
    et al.
    Barn- och ungdomsvetenskapliga institutionen, Stockholms Universitet.
    Vixner, Linda
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    När kvinnor lyfter: Flickors och kvinnors föreställningar om, och erfarenheter av att utöva styrkeidrott2019Rapport (Övrigt vetenskapligt)
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  • 19. Basu, S
    et al.
    Zethelius, B
    Helmersson, J
    Berne, C
    Larsson, A
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Cytokine-mediated inflammation is independently associated with insulin sensitivity measured by the euglycemic insulin clamp in a community-based cohort of elderly men2011Ingår i: International Journal of Clinical and Experimental Medicine, E-ISSN 1940-5901, Vol. 4, nr 2, s. 164-168Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Both clinical and experimental studies suggest a close relation between an inflammatory state and insulin resistance. We investigated the association between cytokine-mediated inflammation (high sensitivity C reactive protein [hsCRP] and interleukin [IL] 6) and insulin sensitivity (insulin-mediated glucose disposal rate, assessed by the euglycemic insulin clamp) in a community-based cohort, with subgroup analyses of normal weight individuals without diabetes mellitus and metabolic syndrome (NCEP). hsCRP and IL- 6 were inversely associated with insulin sensitivity (multivariable-adjusted regression coefficient for 1-SD increase of hsCRP -0.12 (-0.21-(-0.03), p=0.01) and of IL-6 - 0.11 (-0.21-(-0.02), p=0.01) in models adjusting for age and components of the metabolic syndrome (systolic and diastolic blood pressure, antihypertensive drugs, HDL-cholesterol, triglycerides, fasting plasma glucose, waist circumference). The multivariable-adjusted association between hsCRP, IL-6 and insulin sensitivity were of a similar magnitude in normal weight individuals without diabetes and without the metabolic syndrome. Our data show that cytokine -mediated subclinical inflammation is independently associated with decreased insulin sensitivity also in apparently metabolically healthy normal weight individuals, indicating that the interplay between inflammatory processes and insulin resistance is present already in the early stages of the development of glucometabolic disease. (IJCEM1012002).

  • 20. Beijer, K.
    et al.
    Nowak, C.
    Sundström, J.
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Karolinska Institutet.
    Fall, T.
    Lind, L.
    In search of causal pathways in diabetes: a study using proteomics and genotyping data from a cross-sectional study2019Ingår i: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 62, nr 11, s. 1998-2006Artikel i tidskrift (Refereegranskat)
    Ladda ner fulltext (pdf)
    fulltext
  • 21.
    Bellardini, Helena
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Idrotts- och hälsovetenskap.
    Henriksson, Anders
    Högskolan Dalarna, Akademin Hälsa och samhälle, Idrotts- och hälsovetenskap.
    Tonkonogi, Michail
    Högskolan Dalarna, Akademin Hälsa och samhälle, Medicinsk vetenskap.
    Bra och enkla fystester2013Bok (Övrigt vetenskapligt)
  • 22.
    Bellardini, Helena
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Medicinsk vetenskap.
    Henriksson, Anders
    Högskolan Dalarna, Akademin Hälsa och samhälle, Medicinsk vetenskap.
    Tonkonogi, Michail
    Högskolan Dalarna, Akademin Hälsa och samhälle, Medicinsk vetenskap.
    Tester och mätmetoder för idrott och hälsa2009Bok (Övrigt vetenskapligt)
  • 23.
    Bellardini, Helena
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Medicinsk vetenskap.
    Knutsson, Magnus
    Högskolan Dalarna, Akademin Hälsa och samhälle, Medicinsk vetenskap.
    Tonkonogi, Michail
    Högskolan Dalarna, Akademin Hälsa och samhälle, Medicinsk vetenskap.
    Inverkan av olika farthållningsstrategier på prestationsförmåga vid kortvarigt maximalt fysiskt arbete.2006Ingår i: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, nr 2, s. 20-26Artikel i tidskrift (Övrigt vetenskapligt)
  • 24. Bellardini, Helena
    et al.
    Knutsson, Magnus
    Tonkonogi, Michail
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    The influence of pacing strategy during short-term maximal exercise2007Konferensbidrag (Refereegranskat)
  • 25.
    Bellardini, Helena
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Idrotts- och hälsovetenskap.
    Tonkonogi, Michail
    Högskolan Dalarna, Akademin Hälsa och samhälle, Medicinsk vetenskap.
    Senior Power - Styrketräning för äldre2013 (uppl. 1)Bok (Övrigt vetenskapligt)
  • 26.
    Bengtsson, Anette
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Medicinsk vetenskap.
    Lyckström, Marie
    Högskolan Dalarna, Akademin Hälsa och samhälle, Medicinsk vetenskap.
    Anhörigvårdarnas upplevelser i hemmet vid livets slutskede, med hjälp av palliativa teamet2008Självständigt arbete på grundnivå (kandidatexamen)Studentuppsats (Examensarbete)
    Abstract [sv]

    Idag ökar den palliativa omvårdnaden i hemmet. För att den sjuke ofta har en önskan om att få dö hemma. Det ställer krav på anhörigvårdarna som är dem som kommer att bli dem primära vårdarna. Syftet med studien var att undersöka anhörigvårdarnas upplevelser av att vårda hemma, i livets slutskede, med hjälp av det palliativa teamet. Studien genomfördes som en systematisk litteraturstudie. Genom litteraturstudien fick man fram de positiva och negativa upplevelserna från anhörigvårdarna som vårdat den sjuke i hemmet. Studien visade att anhörigvårdarna skulle välja att vårda den sjuke i hemmet igen med hjälp av det palliativa teamet. Detta trots att flera negativa upplevelser kom fram. Anhörigvårdarna ville vara mer delaktiga i omvårdnadsarbetet och detta gjorde att anhörigvårdarna upplevde en större tillfredställelse av själv, genom att kunna ge något tillbaka till den sjuke. Anhörigvårdarna önskade mer stöd från vårdpersonalen eftersom de ansåg sig ha bristande kompetens om medicinteknik, kroppens hälsa, sjukdomen, dess symptom, behandling, och prognos etc.

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    FULLTEXT01
  • 27.
    Bergqvist, Yngve
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Bergquist, Jonas
    In memory of Niklas Lindegardh2012Ingår i: Bioanalysis, ISSN 1757-6180, E-ISSN 1757-6199, Vol. 4, nr 6, s. 751-751Artikel i tidskrift (Refereegranskat)
  • 28. Bergström, Aileen L
    et al.
    Guidetti, Susanne
    Tistad, Malin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Tham, Kerstin
    von Koch, Lena
    Eriksson, Gunilla
    Perceived occupational gaps one year after stroke: An explorative study2011Ingår i: Journal of Rehabilitation Medicine, ISSN 1651-2081, Vol. 44, nr 1, s. 36-42Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To explore and describe factors associated with occupational gaps and to identify factors at 3 months that predict occupational gaps one year post-stroke. A gap, a restriction in participation, is considered to be present when there is a discrepancy between what the individual wants to do and what they actually do in everyday life. DESIGN: Prospective longitudinal study. SUBJECTS: Two hundred persons with stroke. METHODS: Data from the Occupational Gaps Questionnaire, one year post-stroke, was used as the dependent variable in 3- and 12-month regression analyses. Domains of the Stroke Impact Scale, global life satisfaction, demographic and medical factors were used as independent variables. RESULTS: At 3 months, activities of daily living abilities, social participation and not being born in Sweden predicted occupational gaps at 12 months. Stroke severity and not being born in Sweden and 3 factors at 12 months: social participation, self-rated recovery, and global life satisfaction were associated with occupational gaps. CONCLUSION: Activities of daily living ability at 3 months predicted occupational gaps after stroke. Thus, it is possible to identify early on, and provide interventions for, those that risk participation restrictions. Not being born in the country might be an indicator of a risk for participation restrictions.

  • 29.
    Berterud Andersson, Catarina
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Dennis, Katarina
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Lumbal spinal stenos och fotbäddar: Kan av formgjutna fotbäddar minska kvarstående ländrygg- och bensmärta hos patienter som opererats för lumbal spinal stenos? En kvasi-experimentell jämförande studie.2018Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Lumbal spinal stenos (LSS) är ett vanligt förekommande patologiskt tillstånd i ländryggen. Det vanligaste målet för interventioner vid behandling av LSS är minskad smärta i rygg och ben. Kunskapsläget gällande fotbäddar vid ländryggssmärta är bristfälligt. Syfte: Syftet med denna studie var att undersöka om individuellt utformade fotbäddar minskar självskattad smärtintensitet i rygg och i ben bland patienter med kvarstående smärta efter operation för LSS. Syftet var också att jämföra interventionsgruppens självskattade smärtintensitet i rygg och ben samt ryggrelaterade funktion efter interventionen med hur en kontrollgrupp, som genomgått samma operation två år tidigare, skattade vid sin ettårs-uppföljning. Metod: Elva personer som opererats för LSS på Ryggkirurgiska kliniken i Strängnäs fick individuellt utformade fotbäddar i sex veckor. Bakgrundskaraktäristika var kön, ålder, självskattad smärta i rygg och ben samt självskattad ryggrelaterad funktion. Primära utfallsmått var smärtintensitet i rygg och ben, utvärderat med Numeric Rating Scale (NRS). Sekundärt utfallsmått var ryggrelaterad funktion mätt med Oswestry Low Back Pain Disability Index (ODI). Förändring av interventionsgruppens medianvärde för smärtintensitet före jämfört med efter intervention beräknades med Wilcoxon signed rank sum test (CI 95%). Uppföljningsvärdet på variablerna jämfördes med motsvarande värden från en kontrollgrupp vars data kom från Svenska ryggregistret, Swespine. Resultat: Det var ingen skillnad i självskattad smärtintensitet för rygg före och efter interventionen (p=0,76). Det var inte heller någon skillnad i självskattad smärtintensitet för ben före och efter intervention (p=0,40). Ingen skillnad sågs mellan interventionsgruppens uppföljningsvärde och kontrollgruppens skattningar vid ettårskontroll avseende smärta i rygg (p=0,078) eller ben (p=0,85). Slutsats: Resultatet i denna studie visade ingen skillnad i självskattad smärtintensitet avseende rygg- eller bensmärta hos interventionsgruppen efter sex veckors användning av fotbäddar. Det var ingen skillnad för självskattad smärtintensitet för rygg- eller bensmärta mellan interventionsgrupp och kontrollgrupp.

  • 30. Bikbov, Boris
    et al.
    Purcell, Carrie
    Levey, Andrew S.
    Smith, Mari
    Abdoli, Amir
    Abebe, Molla
    Adebayo, Oladimeji M.
    Afarideh, Mohsen
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Vos, Theo
    Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 20172020Ingår i: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 395, nr 10225, s. 709-733Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and induded incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017,1.2 million (95% uncertainty interval [UI] 1.2 to 1.3) people died from CKD. The global all-age mortality rate from CKD increased 41.5% (95% UI 35.2 to 46.5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2.8%, -1.5 to 6.3). In 2017,697.5 million (95% UI 649.2 to 752.0) cases of all-stage CKD were recorded, for a global prevalence of 9.1% (8.5 to 9.8). The global all-age prevalence of CKD increased 29.3% (95% UI 26.4 to 32.6) since 1990, whereas the age-standardised prevalence remained stable (1.2%, -1.1 to 3.5). CKD resulted in 35.8 million (95% UI 33.7 to 38.0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1.4 million (95% UI 1.2 to 1.6) cardiovascular disease-related deaths and 25.3 million (22.2 to 28.9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.

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  • 31. Bjerre, M.
    et al.
    Hilden, J.
    Winkel, P.
    Jensen, G. B.
    Kjøller, E.
    Sajadieh, A.
    Kastrup, J.
    Kolmos, H. J.
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Karolinska Institute.
    Gluud, C.
    Serum osteoprotegerin as a long-term predictor for patients with stable coronary artery disease and its association with diabetes and statin treatment: A CLARICOR trial 10-year follow-up substudy2020Ingår i: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 301, s. 8-14Artikel i tidskrift (Refereegranskat)
  • 32.
    Blessborn, Daniel
    et al.
    Högskolan Dalarna, Akademin Industri och samhälle, Kemiteknik.
    Römsing, Susanne
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Kemi.
    Bergqvist, Yngve
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Lindegardh, Niklas
    Assay for screening for six antimalarial drugs and one metabolite using dried blood spot sampling, sequential extraction and ion-trap detection2010Ingår i: Bioanalysis, ISSN 1757-6180, E-ISSN 1757-6199, Vol. 2, nr 11, s. 1839-1847Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: More parasites are becoming resistant to antimalarial drugs, and in many areas a change in first-line drug treatment is necessary. The aim of the developed assay is to help determine drug use in these areas and also to be a complement to interviewing patients, which will increase reliability of surveys.

    Results: This assay detects quinine, mefloquine, sulfadoxine, pyrimethamine, lumefantrine, chloroquine and its metabolite desethylchloroquine in a 100-mu l dried blood spot. Most of the drugs also have long half-lives that make them detectable at least 7 days after administration. The drugs are extracted from the dried blood spot with sequential extraction (due to the big differences in physicochemical properties), solid-phase extraction is used as sample clean-up and separation is performed with gradient-LC with MS ion-trap detection.

    Conclusion: Detection limits (S/N > 5:1) at 50 ng/ml or better were achieved for all drugs except lumefantrine (200 ng/ml), and thus can be used to determine patient compliance. A major advantage of using the ion-trap MS it that it will be possible to go back into the data and look for other drugs as needed.

  • 33. Blomberg, Jonas
    et al.
    Blomberg, Fredrik
    Sjösten, Anna
    Sheikholvaezin, Ali
    Bolin-Wiener, Agnes
    Elfaitouri, Amal
    Hessel, Sanna
    Gottfries, Carl-Gerhard
    Zachrisson, Olof
    Ohrmalm, Christina
    Jobs, Magnus
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Pipkorn, Ruediger
    No evidence for xenotropic murine leukemia-related virus infection in Sweden using internally controlled multiepitope suspension array serology2012Ingår i: Clinical and Vaccine Immunology, ISSN 1556-6811, E-ISSN 1556-679X, Vol. 19, nr 9, s. 1399-1410Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Many syndromes have a large number of differential diagnoses, a situation which calls for multiplex diagnostic systems. Myalgic encephalomyelitis (ME), also named chronic fatigue syndrome (CFS), is a common disease of unknown etiology. A mouse retrovirus, xenotropic murine leukemia-related virus (XMRV), was found in ME/CFS patients and blood donors, but this was not corroborated. However, the paucity of serological investigations on XMRV in humans prompted us to develop a serological assay which cover many aspects of XMRV antigenicity. It is a novel suspension array method, using a multiplex IgG assay with nine recombinant proteins from the env and gag genes of XMRV and 38 peptides based on known epitopes of vertebrate gamma-retroviruses. IgG antibodies were sought in 520 blood donors and 85 ME/CFS patients and in positive-and negative-control sera from animals. We found no differences in seroreactivity between blood donors and ME/CFS patients for any of the antigens. This did not support an association between ME/CFS and XMRV infection. The multiplex serological system had several advantages: (i) biotinylated protein G allowed us to run both human and animal sera, which is essential because of a lack of XMRV-positive humans; (ii) a novel quality control was a pan-peptide positive-control rabbit serum; and (iii) synthetic XMRV Gag peptides with degenerate positions covering most of the variation of murine leukemia-like viruses did not give higher background than nondegenerate analogs. The principle may be used for creation of variant tolerant peptide serologies. Thus, our system allows rational large-scale serological assays with built-in quality control.

  • 34.
    Borg, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Commentary on selection of assistive technology in a context with limited resources2019Ingår i: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 14, nr 8, s. 753-754Artikel i tidskrift (Refereegranskat)
  • 35. Bozkurt Ahman, H
    et al.
    Giedraitis, V
    Cedervall, Y
    Berglund, L
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Rosendahl, E
    Ingelsson, M
    Åberg, Anna Cristina
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Correlations Between Dual-Task Performance and Alzheimer’s Disease Cerebrospinal Fluid Biomarkers2018Konferensbidrag (Refereegranskat)
  • 36. Bozkurt Åhman, H
    et al.
    Cedervall, Y
    Giedraitis, V
    Berglund, L
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Rosendahl, E
    Ingelsson, M
    Åberg, Anna Cristina
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Combining Two Dual-Task Tests to Discriminate Between People with Dementia Disorder, Mild Cognitive Impairment, Subjective Cognitive Impairment, and Healthy Controls2019Konferensbidrag (Refereegranskat)
  • 37. Bozkurt Åhman, H
    et al.
    Giedraitis, V
    Cedervall, Y
    Berglund, L
    Kilander, L
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Rosendahl, E
    Ingelsson, M
    Åberg, Anna Cristina
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Correlations Between Dual-Task Performance and Alzheimer’s Disease Cerebrospinal Fluid Biomarkers2018Konferensbidrag (Refereegranskat)
  • 38. Bozkurt Åhman, H
    et al.
    Giedraitis, V
    Cedervall, Y
    Berglund, L
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Rosendahl, E
    Ingelsson, M
    Åberg, Anna Cristina
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Correlations Between Dual-Task Performance and Alzheimer’s Disease Cerebrospinal Fluid Biomarkers2019Konferensbidrag (Refereegranskat)
  • 39. Bozkurt Åhman, H
    et al.
    Giedraitis, V
    Cedervall, Y
    Berglund, L
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Rosendahl, E
    Ingelsson, M
    Åberg, Anna Cristina
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Correlations between Dual-Task Performance and Alzheimer’s Disease Cerebrospinal Fluid Biomarkers2019Konferensbidrag (Refereegranskat)
  • 40. Britting, Sabine
    et al.
    Artzi-Medvedik, Rada
    Fabbietti, Paolo
    Tap, Lisanne
    Mattace-Raso, Francesco
    Corsonello, Andrea
    Lattanzio, Fabrizia
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala University; Karolinska Institutet.
    Carlsson, Axel C
    Freiberger, Ellen
    Kidney function and other factors and their association with falls: The screening for CKD among older people across Europe (SCOPE) study.2020Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 20, nr Suppl 1, artikel-id 320Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Reduced kidney function has become a major public health concern, especially among older people, as Chronic Kidney Disease (CKD) is associated with increased risk of end stage renal disease and mortality. Falls are a serious negative health outcome in older persons with one third of people aged 65 years experiencing a fall per year and increasing fall rates with increasing age. The impact of CKD on falls in older community-dwelling persons is not well investigated. Additionally, lower urinary tract symptoms (LUTS) may also increase the risk of falls. Therefore, our aim was to investigate the impact of CKD and LUTS on falls as well as on injurious falls.

    METHODS: The SCOPE study is an observational, multinational, multicenter, prospective cohort study involving community-dwelling older persons aged 75 years and more recruited from August 2016 to March 2018 in seven European countries. The main outcomes of the present study were any falls and any injurious falls during the 12 months before enrolment. The cross-sectional association of estimated glomerular filtration rate (eGFR) and LUTS with study outcomes was investigated by logistic regression analysis adjusted for baseline characteristics of enrolled subjects.

    RESULTS: Our series consisted of 2256 SCOPE participants (median age = 79.5 years, 55.7% female). Of them, 746 participants experienced a fall and 484 reported an injurious fall in the 12 months prior to baseline assessment. CKD was not significantly associated with falls (OR = 0.95, 95%CI = 0.79-1.14 for eGFR< 60; OR = 1.02, 95%CI = 0.81-1.28 for eGFR< 45; OR = 1.08, 95%CI = 0.74-1.57 for eGFR< 30) or injurious falls (OR = 0.91, 95%CI = 0.67-1.24 for eGFR< 60; OR = 0.93, 95%CI = 0.63-1.37 for eGFR< 45; OR = 1.19, 95%CI = 0.62-2.29 for eGFR< 30). LUTS were found significantly associated with both falls (OR = 1.56, 95%CI = 1.29-1.89) and injurious falls (OR = 1.58, 95%CI = 1.14-2.19), and such associations were confirmed in all multivariable models.

    CONCLUSIONS: Cross-sectional data suggest that CKD may not be associated with history of falls or injurious falls, whereas LUTS is significantly associated with the outcomes.

    TRIAL REGISTRATION: This study was registered on 25th February 2016 at clinicaltrials.gov ( NCT02691546 ).

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  • 41. Brück, Katharina
    et al.
    Jager, Kitty J
    Dounousi, Evangelia
    Kainz, Alexander
    Nitsch, Dorothea
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala university.
    Rothenbacher, Dietrich
    Browne, Gemma
    Capuano, Vincenzo
    Ferraro, Pietro Manuel
    Methodology used in studies reporting chronic kidney disease prevalence: a systematic literature review2015Ingår i: Nephrology, Dialysis and Transplantation, ISSN 0931-0509, E-ISSN 1460-2385, Vol. 30, nr Supp. 4, s. iv6-iv16Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Many publications report the prevalence of chronic kidney disease (CKD) in the general population. Comparisons across studies are hampered as CKD prevalence estimations are influenced by study population characteristics and laboratory methods.

    METHODS: For this systematic review, two researchers independently searched PubMed, MEDLINE and EMBASE to identify all original research articles that were published between 1 January 2003 and 1 November 2014 reporting the prevalence of CKD in the European adult general population. Data on study methodology and reporting of CKD prevalence results were independently extracted by two researchers.

    RESULTS: We identified 82 eligible publications and included 48 publications of individual studies for the data extraction. There was considerable variation in population sample selection. The majority of studies did not report the sampling frame used, and the response ranged from 10 to 87%. With regard to the assessment of kidney function, 67% used a Jaffe assay, whereas 13% used the enzymatic assay for creatinine determination. Isotope dilution mass spectrometry calibration was used in 29%. The CKD-EPI (52%) and MDRD (75%) equations were most often used to estimate glomerular filtration rate (GFR). CKD was defined as estimated GFR (eGFR) <60 mL/min/1.73 m(2) in 92% of studies. Urinary markers of CKD were assessed in 60% of the studies. CKD prevalence was reported by sex and age strata in 54 and 50% of the studies, respectively. In publications with a primary objective of reporting CKD prevalence, 39% reported a 95% confidence interval.

    CONCLUSIONS: The findings from this systematic review showed considerable variation in methods for sampling the general population and assessment of kidney function across studies reporting CKD prevalence. These results are utilized to provide recommendations to help optimize both the design and the reporting of future CKD prevalence studies, which will enhance comparability of study results.

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  • 42. Brück, Katharina
    et al.
    Stel, Vianda S
    Gambaro, Giovanni
    Hallan, Stein
    Völzke, Henry
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala universitet.
    Kastarinen, Mika
    Guessous, Idris
    Vinhas, José
    Stengel, Bénédicte
    CKD prevalence varies across the European general population2016Ingår i: Journal of the American Society of Nephrology, ISSN 1046-6673, E-ISSN 1533-3450, Vol. 27, nr 7, s. 2135-2147Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    CKD prevalence estimation is central to CKD management and prevention planning at the population level. This study estimated CKD prevalence in the European adult general population and investigated international variation in CKD prevalence by age, sex, and presence of diabetes, hypertension, and obesity. We collected data from 19 general-population studies from 13 European countries. CKD stages 1-5 was defined as eGFR<60 ml/min per 1.73 m(2), as calculated by the CKD-Epidemiology Collaboration equation, or albuminuria >30 mg/g, and CKD stages 3-5 was defined as eGFR<60 ml/min per 1.73 m(2). CKD prevalence was age- and sex-standardized to the population of the 27 Member States of the European Union (EU27). We found considerable differences in both CKD stages 1-5 and CKD stages 3-5 prevalence across European study populations. The adjusted CKD stages 1-5 prevalence varied between 3.31% (95% confidence interval [95% CI], 3.30% to 3.33%) in Norway and 17.3% (95% CI, 16.5% to 18.1%) in northeast Germany. The adjusted CKD stages 3-5 prevalence varied between 1.0% (95% CI, 0.7% to 1.3%) in central Italy and 5.9% (95% CI, 5.2% to 6.6%) in northeast Germany. The variation in CKD prevalence stratified by diabetes, hypertension, and obesity status followed the same pattern as the overall prevalence. In conclusion, this large-scale attempt to carefully characterize CKD prevalence in Europe identified substantial variation in CKD prevalence that appears to be due to factors other than the prevalence of diabetes, hypertension, and obesity.

  • 43. Burgaz, A.
    et al.
    Byberg, L.
    Rautiainen, S.
    Orsini, N.
    Hakansson, N.
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Sundstrom, J.
    Lind, L.
    Melhus, H.
    Michaelsson, K.
    Wolk, A.
    Confirmed hypertension and plasma 25(OH)D concentrations amongst elderly men2011Ingår i: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 269, nr 2, s. 211-218Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives. The results of experimental studies suggest that vitamin D deficiency activates the renin-angiotensin system and predisposes to hypertension. Results of previous epidemiological studies investigating the association between 25-hydroxyvitamin D [25(OH)D] status and hypertension have not been consistent, perhaps because of their sole reliance on office blood pressure (BP) measurements leading to some misclassification of hypertension status. No previous studies have examined the association between 25(OH)D status and confirmed hypertension assessed with both office and 24-h BP measurements.

    Design. In this cross-sectional study, we investigated 833 Caucasian men, aged 71 +/- 0.6 years, to determine the association between plasma 25(OH)D concentrations, measured with high-pressure liquid chromatography mass spectrometry, and the prevalence of hypertension. We used both supine office and 24-h BP measurements for classifying participants as normotensive or confirmed hypertensive; participants with inconsistent classifications were excluded.

    Results. In a multivariable adjusted logistic regression model, men with 25(OH)D concentrations < 37.5 nmol L-1 had a 3-fold higher prevalence of confirmed hypertension compared to those with >= 37.5 nmol L-1 25(OH)D (odds ratio = 3.3, 95% CI: 1.0-11.0).

    Conclusions. Our results show that low plasma 25(OH)D concentration is associated with a higher prevalence of confirmed hypertension.

  • 44.
    Bäckvik, Victoria
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Näslund, Ingela
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Patientutbildning i ergonomi för gravida kvinnor med bäckensmärta: en single-subject design studie2020Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Graviditetsrelaterad bäckensmärta (PGP) är vanligt förekommande hos gravida. Punktprevalensen har uppgetts till cirka 20 %. Bäckensmärtan utlöses av belastning och inverkar negativt på det dagliga livets aktiviteter såsom att bära, lyfta och förflytta sig. Det finns få studier på effekten av hållningskorrigering och ergonomi vid PGP.

    Syfte: Syftet med studien var att undersöka om en patientutbildning i ergonomi med fokus på praktisk träning av aktiviteterna gång, vändning i säng och uppresning hade effekt på smärta och aktivitetsbegränsning hos gravida kvinnor med bäckensmärta.

    Metod: En single-subject experimental design studie med AB design genomfördes med sex gravida deltagare med PGP. Interventionen bestod av praktisk träning av rörelsetekniker vid gång, vändning i säng och uppresning i kombination med information om PGP. Som utfallsmått för smärta användes Numeric Rating Scale, för aktivitetsbegränsning användes Timed Up and Go samt Pelvic Girdle Questionnaire. Två standardavvikelser-metoden (2SD-metoden) användes för att analysera data.

    Resultat: En deltagare upplevde sig helt återställd vid studiens slut och hade signifikant minskad smärta vid gång och vändning i säng samt signifikant minskad aktivitetsbegränsning. En deltagare upplevde sig mycket försämrad och hade signifikant ökad smärta vid uppresning samt signifikant ökad aktivitetsbegränsning. Övriga deltagare hade överlag oförändrade resultat vad gäller smärta och aktivitetsbegränsning.

    Slutsats: Det kunde inte ses någon positiv effekt på smärta och aktivitetsbegränsning förutom för en deltagare. Fyra av deltagarna upplevde en förbättring av sina bäckenbesvär vid studiens slut.

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  • 45. Böger, Carsten A
    et al.
    Chen, Ming-Huei
    Tin, Adrienne
    Olden, Matthias
    Köttgen, Anna
    de Boer, Ian H
    Fuchsberger, Christian
    O'Seaghdha, Conall M
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala universitet.
    Kao, W. H. L
    CUBN is a gene locus for albuminuria2011Ingår i: Journal of the American Society of Nephrology, ISSN 1046-6673, E-ISSN 1533-3450, Vol. 22, nr 3, s. 555-70Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Identification of genetic risk factors for albuminuria may alter strategies for early prevention of CKD progression, particularly among patients with diabetes. Little is known about the influence of common genetic variants on albuminuria in both general and diabetic populations. We performed a meta-analysis of data from 63,153 individuals of European ancestry with genotype information from genome-wide association studies (CKDGen Consortium) and from a large candidate gene study (CARe Consortium) to identify susceptibility loci for the quantitative trait urinary albumin-to-creatinine ratio (UACR) and the clinical diagnosis microalbuminuria. We identified an association between a missense variant (I2984V) in the CUBN gene, which encodes cubilin, and both UACR (P = 1.1 × 10−11) and microalbuminuria (P = 0.001). We observed similar associations among 6981 African Americans in the CARe Consortium. The associations between this variant and both UACR and microalbuminuria were significant in individuals of European ancestry regardless of diabetes status. Finally, this variant associated with a 41% increased risk for the development of persistent microalbuminuria during 20 years of follow-up among 1304 participants with type 1 diabetes in the prospective DCCT/EDIC Study. In summary, we identified a missense CUBN variant that associates with levels of albuminuria in both the general population and in individuals with diabetes

  • 46. Capiau, Sara
    et al.
    Veenhof, Herman
    Koster, Remco
    Bergqvist, Yngve
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Boettcher, Michael
    Halmingh, Otto
    Keevil, Brian
    Koch, Birgit
    Linden, Rafael
    Alffenaar, Jan-Willem
    Official International Association for Therapeutic Drug Monitoring and Toxicology guideline: Development and Validation of Dried Blood Spot-based Methods for Therapeutic Drug Monitoring2019Ingår i: Therapeutic Drug Monitoring, ISSN 0163-4356, E-ISSN 1536-3694, Vol. 41, nr 4, s. 409-430Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Dried blood spot (DBS) analysis has been introduced more and more into clinical practice to facilitate Therapeutic Drug Monitoring (TDM). To assure the quality of bioanalytical methods, the design, development and validation needs to fit the intended use. Current validation requirements, described in guidelines for traditional matrices (blood, plasma, serum), do not cover all necessary aspects of method development, analytical- and clinical validation of DBS assays for TDM. Therefore, this guideline provides parameters required for the validation of quantitative determination of small molecule drugs in DBS using chromatographic methods, and to provide advice on how these can be assessed. In addition, guidance is given on the application of validated methods in a routine context. First, considerations for the method development stage are described covering sample collection procedure, type of filter paper and punch size, sample volume, drying and storage, internal standard incorporation, type of blood used, sample preparation and prevalidation. Second, common parameters regarding analytical validation are described in context of DBS analysis with the addition of DBS-specific parameters, such as volume-, volcano-and hematocrit effects. Third, clinical validation studies are described, including number of clinical samples and patients, comparison of DBS with venous blood, statistical methods and interpretation, spot quality, sampling procedure, duplicates, outliers, automated analysis methods and quality control programs. Lastly, cross-validation is discussed, covering changes made to existing sampling- and analysis methods. This guideline of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology on the development, validation and evaluation of DBS-based methods for the purpose of TDM aims to contribute to high-quality micro sampling methods used in clinical practice.

  • 47. Carlsson, A. C.
    et al.
    Riserus, U.
    Engstrom, G.
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Melander, O.
    Leander, K.
    Gigante, B.
    Hellenius, M-L
    de Faire, U.
    Novel and established anthropometric measures and the prediction of incident cardiovascular disease: a cohort study2013Ingår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 37, nr 12, s. 1579-1585Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The aim of this study was to compare novel and established anthropometrical measures in their ability to predict cardiovascular disease (CVD), and to determine whether they improve risk prediction beyond classical risk factors in a cohort study of 60-year-old men and women. We also stratified the results according to gender to identify possible differences between men and women. Furthermore, we aimed to replicate our findings in a large independent cohort (The Malmo Diet and Cancer study-cardiovascular cohort).

    METHODS: This was a population-based study of 1751 men and 1990 women, aged 60 years and without CVD at baseline, with 375 incident cases of CVD during 11 years of follow-up. Weight, height, waist circumference (WC), hip circumference and sagittal abdominal diameter (SAD) were measured at baseline. Body mass index (BMI), waist-hip ratio (WHR), waist-hip-height ratio (WHHR), WC-to-height ratio (WCHR) and SAD-to-height ratio (SADHR) were calculated.

    RESULTS: All anthropometric measures predicted CVD in unadjusted Cox regression models per s.d. increment (hazard ratios, 95% confidence interval), while significant associations after adjustments for established risk CVD factors were noted for WHHR 1.20 (1.08-1.33), WHR 1.14 (1.02-1.28), SAD 1.13 (1.02-1.25) and SADHR 1.17 (1.06-1.28). WHHR had higher increases in C-statistics, and model improvements (likelihood ratio tests (P<0.001)). In the replication study (MDC-CC, n = 5180), WHHR was the only measure that improved Cox regression models in men (P = 0.01).

    CONCLUSION: WHHR, a new measure reflecting body fat distribution, showed the highest risk estimates after adjustments for established CVD risk factors. These findings were verified in men but not women in an independent cohort.

  • 48.
    Carlsson, A C
    et al.
    Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden ; Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Riserus, Ulf
    Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Department of Public Health and Caring Sciences/Section of Geriatrics Uppsala University, Uppsala, Sweden.
    Borné, Y
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Leander, K
    Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Gigante, B
    Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden ; Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Hellénius, M-L
    Cardiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Bottai, M
    Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institute, Sweden.
    de Faire, U
    Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden ; Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
    Prediction of cardiovascular disease by abdominal obesity measures is dependent on body weight and sex: results from two community based cohort studies2014Ingår i: NMCD. Nutrition Metabolism and Cardiovascular Diseases, ISSN 0939-4753, E-ISSN 1590-3729, Vol. 24, nr 8, s. 891-899Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To study waist-hip ratio (WHR), waist circumference (WC), sagittal abdominal diameter (SAD), and waist-hip-height ratio (WHHR) as predictors of CVD, in men and women stratified by BMI (cut-off ≥25).

    METHODS AND RESULTS: A cohort of n = 3741 (53% women) 60-year old individuals without CVD was followed for 11-years (375 CVD cases). To replicate the results, we also assessed another large independent cohort; The Malmö Diet and Cancer study - cardiovascular cohort (MDCC, (n = 5180, 60% women, 602 CVD cases during 16-years). After adjustment for established risk factors in normal-weight women, the hazard ratio (HR) per one standard deviation (SD) were; WHR; 1.91 (95% confidence interval (CI) 1.35-2.70), WC; 1.81 (95% CI 1.02-3.20), SAD; 1.25 (95% CI 0.74-2.11), and WHHR; 1.97 (95% CI 1.40-2.78). In men the association with WHR, WHHR and WC were not significant, whereas SAD was the only measure that significantly predicted CVD in men (HR 1.19 (95% CI 1.04-1.35). After adjustments for established risk factors in overweight/obese women, none of the measures were significantly associated with CVD risk. In men, however, all measures were significant predictors; WHR; 1.24 (955 CI 1.04-1.47), WC 1.19 (95% CI 1.00-1.42), SAD 1.21 (95% CI 1.00-1.46), and WHHR; 1.23 (95% CI 1.05-1.44). Only the findings in men with BMI ≥ 25 were verified in MDCC.

    CONCLUSION: In normal weight individuals, WHHR and WHR were the best predictors in women, whereas SAD was the only independent predictor in men. Among overweight/obese individuals all measures failed to predict CVD in women, whereas WHHR was the strongest predictor after adjustments for CVD risk factors in men.

  • 49. Carlsson, A. C.
    et al.
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala universitet.
    Sundström, J.
    Michaëlsson, K.
    Byberg, L.
    Lind, L.
    Physical activity, obesity and risk of cardiovascular disease in middle-aged men during a median of 30 years of follow-up2016Ingår i: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 23, nr 4, s. 359-365Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: We aimed to investigate associations between combinations of body mass index (BMI)-categories, levels of physical activity and long-term risk of cardiovascular disease.

    Method and results: At age 50 years, cardiovascular risk factors were assessed in 2196 participating men of the ULSAM-study. This investigation was repeated at age 60, 70, 77 and 82 years. Being physically active (PA) was defined as three hours of recreational or hard physical training per week. The men were categorized according to BMI/PA-status, as PA/normal weight (n = 593 at baseline), non-PA/normal weight (BMI &lt; 25 kg/m2, n = 580), PA/overweight (n = 418), non-PA/overweight (BMI 25-30 kg/m2, n = 462), PA/obese (n = 62), non-PA/obese (BMI &gt;30 kg/m2, n = 81). We used updated data on BMI and physical activity obtained at all examinations. During follow-up (median 30 years) 850 individuals suffered a cardiovascular disease (myocardial infarction, stroke or heart failure). Using updated data on BMI/PA categories, an increased risk for cardiovascular disease was seen with increasing BMI, but a high physical activity was associated with a lower risk of cardiovascular disease within each BMI category: non-PA/normal weight (hazard ratio (HR) 1.31, 95% confidence interval (CI) 1.04-1.66), PA/overweight (HR 1.52, 95% CI 1.20-1.94), non-PA/overweight (HR 1.65, 95% CI 1.31-2.07) PA/obese (HR 2.05, 95% CI 1.44-2.92) and non-PA/obese (HR 2.39, 95% CI 1.74-3.29), using PA/normal weight men as referent.

    Conclusions: Although physical activity was beneficial at all levels of BMI regarding the risk of future cardiovascular disease, there was still a substantial increased risk associated with being overweight or obese during 30 years of follow-up. 

  • 50. Carlsson, A C
    et al.
    Östgren, C J
    Länne, T
    Larsson, A
    Nystrom, F H
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala universitet.
    The association between endostatin and kidney disease and mortality in patients with type 2 diabetes2016Ingår i: Diabetes & Metabolism, ISSN 1262-3636, E-ISSN 1878-1780, Vol. 42, nr 5, s. 351-357Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: Circulating endostatin, a biologically active derivate of collagen XVIII, is considered to be a marker of kidney disease and a risk factor for its related mortality. However, less is known of the role of endostatin in diabetes and the development of diabetic nephropathy. For this reason, our study investigated the associations between circulating endostatin and the prevalence and progression of kidney disease, and its mortality risk in patients with type 2 diabetes (T2D).

    METHODS: This was a cohort study of 607 patients with T2D (mean age: 61 years, 44% women). Estimated glomerular filtration rate (eGFR), calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation, was used to assess the patients' kidney function decline and mortality.

    RESULTS: Of the total study cohort, 20 patients declined by ≥20% in eGFR over 4 years, and 44 died during the follow-up (mean duration: 6.7 years). At baseline, participants with diabetic nephropathy (defined as eGFR<60mL/min/1.73m(2)) and/or microalbuminuria [defined as a urinary albumin-to-creatinine ratio (ACR)>3g/mol] had higher median levels of endostatin than those without nephropathy (62.7μg/L vs 57.4μg/L, respectively; P=0.031). In longitudinal analyses adjusted for age, gender, baseline eGFR and ACR, higher endostatin levels were associated with a higher risk of decline (≥20% in eGFR, OR per 1 SD increase: 1.73, 95% CI: 1.13-2.65) and a higher risk of mortality (HR per 1 SD increase: 1.57, 95% CI: 1.19-2.07).

    CONCLUSION: In patients with T2D, circulating endostatin levels can predict the progression of kidney disease and mortality independently of established kidney disease markers. The clinical usefulness of endostatin as a risk marker in such patients merits further studies.

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