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Upsala Journal of Medical Sciences

Ammar Al-Mashhadi, Michael Häggman, Göran Läckgren, Sam Ladjevardi, Tryggve Nevéus, Arne Stenberg, A Erik G Persson, Mattias Carlström
BACKGROUND: As much as 20% of all cases of hypertension are associated with kidney malfunctions. We have previously demonstrated in animals and in pediatric patients that hydronephrosis causes hypertension, which was attenuated by surgical relief of the ureteropelvic junction (UPJ) obstruction. This retrospective cohort study aimed to investigate: (1) the proposed link between hydronephrosis, due to UPJ obstruction, and elevated arterial pressure in adults; and (2) if elevated blood pressure in patients with hydronephrosis might be another indication for surgery...
October 8, 2018: Upsala Journal of Medical Sciences
Lars Lind
The first population-based cohort study in Uppsala with the aim to study cardiovascular disease was initiated in 1970 (ULSAM). This cohort of 2300 middle-aged men has since then been followed in a longitudinal fashion for almost 50 years. This study has been followed by the PIVUS study, investigating 1000 men and women at ages 70, 75, and 80. A very detailed examination has also been performed in 500 subjects aged 50 years, the POEM study. In recent years, a high-throughput study conducted in 13000 subjects has also been performed, named EpiHealth...
October 3, 2018: Upsala Journal of Medical Sciences
Jack Lysholm, Bertil Lindahl
The aim of the present paper is to describe how the use of national quality registries (NQRs) for research has evolved over the past decade in Sweden. All Swedish NQRs have reported their scientific activity (publications per year in peer-reviewed scientific journals) to the Swedish Association of Local Authorities and Regions since 2009, and the present report is based on available data from 2009-2016. The yearly number of publications of the 69 registries active in 2009 has increased from 121 to 496 in 2016...
October 1, 2018: Upsala Journal of Medical Sciences
Gorav Batra, Anders Ahlsson, Bertil Lindahl, Lars Lindhagen, Anders Wickbom, Jonas Oldgren
BACKGROUND: The aim was to determine the association between atrial fibrillation (AF) and outcome in patients undergoing coronary artery bypass grafting (CABG). METHODS: All patients undergoing CABG between January 2010 and June 2013 were identified in the Swedish Heart Surgery Registry. Outcomes studied were all-cause mortality, cardiovascular mortality, myocardial infarction, congestive heart failure, ischemic stroke, and recurrent AF. Patients with history of AF prior to surgery (preoperative AF) and patients without history of AF but with AF episodes post-surgery (postoperative AF) were compared to patients with no AF using adjusted Cox regression models...
September 28, 2018: Upsala Journal of Medical Sciences
Johan Sundström, Lars Lind, Shamim Nowrouzi, Per Lytsy, Kerstin Marttala, Inger Ekman, Patrik Öhagen, Ollie Östlund
High blood pressure is the leading risk factor for premature deaths and a major cost to societies worldwide. Effective blood pressure-lowering drugs are available, but patient adherence to them is low, likely partly due to side effects. To identify patient-specific differences in treatment effects, a repeated cross-over design, where the same treatment contrasts are repeated within each patient, is needed. Such designs have been surprisingly rarely used, given the current focus on precision medicine. The Precision HYpertenSIon Care (PHYSIC) study aims to investigate if there is a consistent between-person variation in blood pressure response to the common blood pressure-lowering drug classes of a clinically relevant magnitude, given the within-person variation in blood pressure...
September 28, 2018: Upsala Journal of Medical Sciences
Bing-Qiang Li, Yu-Cheng Zhong, Xiang Wang
BACKGROUND: High-density lipoprotein (HDL) particles exert many beneficial actions that may help protect against cardiovascular disease. However, recent work has demonstrated that HDL can be oxidized and glycated under certain circumstances and may become pro-atherogenic. The present study investigated the impact of oxidized high-density lipoprotein (ox-HDL) and glycated apolipoprotein A-I (gly-ApoA-I) in patients presenting with ST-elevation myocardial infarction (STEMI). METHODS: We assessed 55 consecutive patients with STEMI...
September 27, 2018: Upsala Journal of Medical Sciences
Lars Berglund, Ulf Risérus, Kristina Hambraeus
AIMS: Weight loss is recommended for myocardial infarction (MI) patients with overweight or obesity. It has, however, been suggested that obese patients have better prognosis than normal-weight patients have, but also that central obesity is harmful. The aim of this study was to examine associations between repeated measures of body mass index (BMI) and waist circumference (WC), and all-cause mortality. METHODS AND RESULTS: A total of 14,224 MI patients aged <75 years in Sweden between the years 2004 and 2013 had measurements of risk factors at hospital discharge...
September 26, 2018: Upsala Journal of Medical Sciences
Torbjörn Karlsson, Honar Cherif
AIM: The aim of this retrospective single-centre study was to evaluate whether mutations in the ENG, ACVRL1, and SMAD4 genes were associated with different phenotypes in hereditary haemorrhagic telangiectasia (HHT). METHODS: The case records of 21 HHT patients with verified mutations in ENG, ACVRL1, or SMAD4 genes were reviewed. The numbers of HHT diagnostic criteria fulfilled for the three genotypes were compared, as was the prevalence of complications such as iron deficiency anaemia, gastrointestinal haemorrhage, stroke, and cerebral abscess...
September 25, 2018: Upsala Journal of Medical Sciences
Tomasz Baron, Anna Beskow, Stefan James, Bertil Lindahl
High-quality biobanking within routine health services, through the use of existing health-care practices and infrastructure, with respect to safety and integrity of patients in line with the Swedish Biobank Act, enables large-scale collection of biological material at reasonable costs. Complementing the extensive information on myocardial infarction patients from a national registry gives unique opportunities for research focusing on better understanding of cardiovascular disease occurrence and prognosis, developing of new diagnostic methods, and personalized treatments with greater efficacy and fewer side effects...
September 25, 2018: Upsala Journal of Medical Sciences
Rolf Gedeborg, Charles Cline, Björn Zethelius, Tomas Salmonson
The pragmatic clinical trial addresses scientific questions in a setting close to routine clinical practice and sometimes using routinely collected data. From a regulatory perspective, when evaluating a new medicine before approving marketing authorization, there will never be enough patients studied in all subgroups that may potentially be at higher risk for adverse outcomes, or sufficient patients to detect rare adverse events, or sufficient follow-up time to detect late adverse events that require long exposure times to develop...
September 25, 2018: Upsala Journal of Medical Sciences
Xueshuang Mei, Francesca Atturo, Karin Wadin, Sune Larsson, Sumit Agrawal, Hanif M Ladak, Hao Li, Helge Rask-Andersen
BACKGROUND: The Uppsala collection of human temporal bones and molds is a unique resource for education and international research collaboration. Micro-computerized tomography (micro-CT) and synchrotron imaging are used to investigate the complex anatomy of the inner ear. Impaired microcirculation is etiologically linked to various inner ear disorders, and recent developments in inner ear surgery promote examination of the vascular system. Here, for the first time, we present three-dimensional (3D) data from investigations of the major vascular pathways and corresponding bone channels...
September 11, 2018: Upsala Journal of Medical Sciences
Emil Jansson, Tryggve Nevéus
OBJECTIVES: Detrusor overactivity and constipation often co-exist in children with enuresis. Constipation is known to be linked to detrusor overactivity. The voiding chart is the best non-invasive way to investigate bladder function, whereas the ultrasonographical detection of rectal dilatation is the best way to objectify constipation. We wanted to investigate a possible relationship between the rectal diameter and voiding chart data in enuretic children. METHODS: Children with therapy-resistant enuresis were retrospectively evaluated...
September 4, 2018: Upsala Journal of Medical Sciences
Gianluigi Savarese, Peter Vasko, Åsa Jonsson, Magnus Edner, Ulf Dahlström, Lars H Lund
Heart failure (HF) represents a global pandemic. Although in HF with reduced ejection fraction (HFrEF) randomized controlled trials have provided effective treatments, prognosis still remains poor, with signals of undertreatment. HF with mid-range EF (HFmrEF) has no evidence-based therapy, and its characterization is ongoing. Trials in HF with preserved EF (HFpEF) have failed to provide any effective treatment, but there are several concerns about their design. Thus, current challenges in the HF field are: 1) optimizing the use of existing treatments in HFrEF; 2) developing and proving efficacy of new treatments, and of new use of existing treatments in HFpEF and HFmrEF...
August 9, 2018: Upsala Journal of Medical Sciences
Erik M G Olsson, Fredrika Norlund, Ronnie Pingel, Gunilla Burell, Mats Gulliksson, Anders Larsson, Bo Karlsson, Kurt Svärdsudd, Claes Held
BACKGROUND: The Secondary Prevention in Uppsala Primary Healthcare Project (SUPRIM) is a prospective randomized controlled trial of a group-based cognitive behavioral therapy (CBT) stress management program for coronary heart disease (CHD) patients. The intervention reduced the risk of fatal or non-fatal first recurrent cardiovascular (CV) events. The aim of the present study was to analyze if the positive effects of the CBT program on clinical outcomes could have been mediated by changes in biomarkers for inflammation...
August 8, 2018: Upsala Journal of Medical Sciences
Jeltje Boer, Ellen Ederveen, Birgitta Grundmark
OBJECTIVE: Desloratadine, a third-generation antihistamine, is claimed to cause fewer central nervous system (CNS) adverse drug reactions (ADRs) than antihistamines of the first- and second-generation. While literature is inconclusive regarding the possible CNS effects, symptoms like somnolence and hallucinations are acknowledged ADRs of desloratadine, indeed suggesting some passage of this drug across the blood-brain barrier. Depression is currently not described as an ADR in the approved desloratadine product labelling...
August 7, 2018: Upsala Journal of Medical Sciences
Robert Wålinder, Roma Runeson-Broberg, Erebouni Arakelian, Tobias Nordqvist, Andreas Runeson, Anna Rask-Andersen
BACKGROUND: Shortage of health-care workers e.g. in operating theatres is a global problem. A shortage of staff negatively affects patient outcomes, making it important to keep the employees from quitting. The aim of this survey was to study if well-being, zest for work, and thoughts about leaving work in an operating theatre can be related to the psychosocial work environment, as described by the job demand-control-support (JDCS) model. METHODS: A questionnaire was provided to personnel in operating theatres of seven Swedish hospitals (n = 1405, with a response rate of 68%) that included the JDCS model, personal factors, work ability, well-being, zest for work, and thoughts about leaving their position...
August 7, 2018: Upsala Journal of Medical Sciences
Karin E Lindgren, Fatma Gülen Yaldir, Julius Hreinsson, Jan Holte, Karin Kårehed, Inger Sundström-Poromaa, Helena Kaihola, Helena Åkerud
OBJECTIVES: The aim of this study was to assess different patterns of the human embryo secretome analysed as protein levels in culture media. Furthermore, analyses to correlate protein levels with quality and timing to development of human embryos were performed. MATERIAL AND METHODS: Human day-2 cryopreserved embryos were cultured for four days in an EmbryoScope® with a time-lapse camera, and embryo quality was evaluated retrospectively. After culture, the media were collected and relative levels of secreted proteins were analysed using Proseek Multiplex Assays...
September 2018: Upsala Journal of Medical Sciences
Juliana Pedro, Tânia Brandão, Lone Schmidt, Maria E Costa, Mariana V Martins
INTRODUCTION: Recent evidence indicates that reproductive-age people have inadequate fertility awareness (FA) concerning fertility, infertility risk factors, and consequences of delaying childbearing. However, no study has tried to summarize these studies and to clarify the variables associated with FA, namely the role of gender, age, education, and reproductive status on FA. METHODS: A literature search up to February 2017 was conducted using the EBSCO, Web of Science, Scielo, and Scopus electronic databases with combinations of keywords and MeSH terms (e...
June 2018: Upsala Journal of Medical Sciences
Victor C Kok, Han-Wei Zhang, Chin-Teng Lin, Shih-Chung Huang, Ming-Feng Wu
INTRODUCTION: We hypothesized that hypertensive patients harbor a higher risk of urinary bladder (UB) cancer. MATERIAL AND METHODS: We performed a population-based cohort study on adults using a National Health Insurance Research Database (NHIRD) dataset. Hypertension and comparison non-hypertensive (COMP) groups comprising 39,618 patients each were propensity score-matched by age, sex, index date, and medical comorbidities. The outcome was incident UB cancer validated using procedure codes...
June 2018: Upsala Journal of Medical Sciences
Maria Ekstrand Ragnar, Jenny Niemeyer Hultstrand, Tanja Tydén, Margareta Larsson
INTRODUCTION: Many women and men lack knowledge about fertility, including timing of the fertile window, age-related decline, and lifestyle factors that may impair fertility. The Internet has become an important source of information, but evidence-based information on fertility and reproduction in Swedish on the Internet is limited. The present study aimed to develop and evaluate an evidence-based fertility awareness website, '', to increase awareness of fertility and provide guidance for improved preconception health and care among individuals and healthcare providers...
June 2018: Upsala Journal of Medical Sciences
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