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Upsala Journal of Medical Sciences

Tomas Snäckerström, Christian Johansen
Over the last decades the advent of digital documentation has provided research communities with valuable resources of information for clinical research. To utilize the potential of information about patients, their health care, and its outcome that is already available in different registers, the possibility to cross-reference information from different registers is inevitably required. When performing linkage, we are currently forced to disclose information of participating subjects either to the administration of the other register(s) or to the researcher...
February 7, 2019: Upsala Journal of Medical Sciences
Karl Nyberg, Peter Hedman
During the last decade Sweden has invested in a national infrastructure for collection of structured clinical data in the form of healthcare registries (in Sweden known as Kvalitetsregister). These data can be combined with other public data using the national personal identifiers that are issued to Swedish citizens. The healthcare registries have an almost complete coverage of Swedish healthcare, and a large network of clinicians is involved in the quality assurance and continuous improvement of healthcare using these registries...
February 6, 2019: Upsala Journal of Medical Sciences
Anna Beskow
A biobank is generally in an international setting considered as a sample collection with linked data. In Sweden we have a lot of sample collections, but the definition of a biobank has changed, and it has become an organization that administrates many sample collections as well as an infrastructure to support research. Uppsala Biobank was started in September 2008 as a joint biobank organization between Uppsala County Council and Uppsala University. At the start there were 138 registered biobanks in Uppsala for these two principals...
February 1, 2019: Upsala Journal of Medical Sciences
Thomas Cars, Lars Lindhagen, Johan Sundström
In order to monitor the net public health benefit of new drugs, especially in the light of recent stepwise approval approaches, there is a need to optimize real-time post-marketing evaluation of new drugs using data collected in routine care. Sweden, with its unique possibilities for observational research, can provide these data. We herein propose a framework for continuous monitoring of the effectiveness, safety, and cost-effectiveness of new drugs, using prospectively determined protocols designed in collaboration between all relevant stakeholders...
January 28, 2019: Upsala Journal of Medical Sciences
Johan Sundström, Cecilia Björkelund, Vilmantas Giedraitis, Per-Olof Hansson, Marieann Högman, Christer Janson, Ilona Koupil, Margareta Kristenson, Ylva Trolle Lagerros, Jerzy Leppert, Lars Lind, Lauren Lissner, Ingegerd Johansson, Jonas F Ludvigsson, Peter M Nilsson, Håkan Olsson, Nancy L Pedersen, Andreas Rosenblad, Annika Rosengren, Sven Sandin, Tomas Snäckerström, Magnus Stenbeck, Stefan Söderberg, Elisabete Weiderpass, Anders Wanhainen, Patrik Wennberg, Isabel Fortier, Susanne Heller, Maria Storgärds, Bodil Svennblad
We herein outline the rationale for a Swedish cohort consortium, aiming to facilitate greater use of Swedish cohorts for world-class research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on rare exposures and outcomes, leading to better utilization of study participants' data, better return of funders' investments, and higher benefit to patients and populations. We motivate the proposed infrastructure partly by lessons learned from a pilot study encompassing data from 21 cohorts...
January 8, 2019: Upsala Journal of Medical Sciences
Axel Åkerblom, Jonas Oldgren, Aino Latva-Rasku, Lars Johansson, Vera Lisovskaja, Cecilia Karlsson, Jan Oscarsson, Pirjo Nuutila
BACKGROUND: Diabetes increases the risk for cardiovascular (CV) events. It has recently been shown that the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors leads to a reduction in CV outcomes in patients with type 2 diabetes mellitus (T2DM), including mortality and heart failure hospitalization. The exact mechanisms of how SGLT2 inhibitors lead to this CV risk reduction remain incompletely understood. The study of DAPAgliflozin on CARDiac substrate uptake, myocardial efficiency and myocardial contractile work in type 2 diabetes patients (DAPACARD) (NCT03387683) explores the possible effects of dapagliflozin, an SGLT2 inhibitor, on cardiac work, metabolism, and biomarker levels...
January 8, 2019: Upsala Journal of Medical Sciences
Maja Bodin, Tanja Tydén, Lisa Käll, Margareta Larsson
BACKGROUND: Many men have limited knowledge about reproductive health and fertility. The aim of the study was to evaluate if Reproductive Life Plan (RLP)-based counselling during a sexual health visit could increase men's fertility awareness. MATERIAL AND METHODS: The study was a randomized controlled trial including 201 men aged 18-50 who visited either of two participating sexual health clinics in Sweden for sexually transmitted infection testing during 2014-2016...
December 13, 2018: Upsala Journal of Medical Sciences
Lisa Ekselius
Personality disorders (PDs) can be described as the manifestation of extreme personality traits that interfere with everyday life and contribute to significant suffering, functional limitations, or both. They are common and are frequently encountered in virtually all forms of health care. PDs are associated with an inferior quality of life (QoL), poor health, and premature mortality. The aetiology of PDs is complex and is influenced by genetic and environmental factors. The clinical expression varies between different PD types; the most common and core aspect is related to an inability to build and maintain healthy interpersonal relationships...
December 12, 2018: Upsala Journal of Medical Sciences
Randi Sylvest, Emily Koert, Ida Vittrup, Kathrine Birch Petersen, Anders Nyboe Andersen, Anja Pinborg, Lone Schmidt
INTRODUCTION: Over the past 50 years women and men have postponed family formation in high-income societies. Fertility assessment and counselling has been suggested as a method to reduce delayed childbearing and its consequences. This study explored women's perceptions of how attending a fertility assessment intervention influenced their decisions and choices regarding family formation and childbearing. MATERIAL AND METHODS: Follow-up data from a longitudinal semi-structured qualitative interview study including 20 women aged 35-40 years seeking individual fertility counselling at the Fertility Assessment and Counselling Clinic at Rigshospitalet, Copenhagen, Denmark...
December 12, 2018: Upsala Journal of Medical Sciences
Gustav Ullenhag
No abstract text is available yet for this article.
December 11, 2018: Upsala Journal of Medical Sciences
Sandra Halldorsdottir, Hanna Dahlstrand, Karin Stålberg
BACKGROUND: Prolonged survival in ovarian and endometrial cancer patients increases the importance of paying attention to quality of life. Hormone replacement therapy (HRT) after gynecologic cancer has been controversial. With this survey, we sought to describe Swedish gynecologists' and gynecologic oncologists' attitudes towards prescribing HRT to these cancer survivors and see if prescribing practice is consistent with the available evidence and national guidelines. MATERIAL AND METHODS: A web-based survey containing three hypothetical cases with a total of 15 questions was distributed to gynecologists and gynecologic oncologists in Sweden...
December 10, 2018: Upsala Journal of Medical Sciences
Lars Wallentin, Bertil Lindahl
Uppsala Clinical Research Center (UCR) is a non-profit organization that provides service for clinical research aiming for development and improvement of health care in Sweden and worldwide. UCR was started in 2001 with the ambition to shift the focus of clinical research from new medications or devices launched by the industry to problem-based research on issues identified in clinical reality, for example through the national quality registries. In order to accomplish these goals, UCR has established services in: 1) clinical trials of new and old methods in health care; 2) quality development of the health care system supported by internet-based national quality registries; 3) biostatistics, epidemiology, and data management; 4) biobanking of biological materials (Uppsala Biobank); 5) high-throughput biochemical analyses (UCR laboratory); and 6) academic leadership by the members of the UCR research faculty...
December 4, 2018: Upsala Journal of Medical Sciences
Arne Andersson, Joey Lau Börjesson
No abstract text is available yet for this article.
December 4, 2018: Upsala Journal of Medical Sciences
Ola Winsö, Josef Kral, Wanzhong Wang, Ivana Kralova, Pernilla Abrahamsson, Göran Johansson, Per-Jonas Blind
AIMS: The activity of the sympathetic nervous system (SNS) is crucial at an early stage in the development of an inflammatory reaction. A study of metabolic events globally and locally in the early phase of acute pancreatitis (AP), implying hampered SNS activity, is lacking. We hypothesized that thoracic epidural anaesthesia (TEA) modulates the inflammatory response and alleviates the severity of AP in pigs. MATERIAL AND METHODS: The taurocholate (TC) group (n = 8) had only TC AP...
November 23, 2018: Upsala Journal of Medical Sciences
Kristina Beijer, Erik Lampa, Johan Sundström, Peter M Nilsson, Sölve Elmståhl, Nancy L Pedersen, Lars Lind
BACKGROUND: Regular exercise reduces pulse rate, but it is less clear how prolonged sitting time affects pulse rate. Our hypothesis was that high physical activity could compensate for prolonged sitting time regarding the pulse rate. METHODS: Regression analysis was performed on cross-sectional data including 47,457 men and women based on two Swedish cohort studies, EpiHealth (18-45 years) and LifeGene (45-75 years). Self-reported leisure time physical activity was given in five levels, from low (level 1) to vigorous (level 5), and television time was used as a proxy of sitting time...
November 23, 2018: Upsala Journal of Medical Sciences
Claes Held
Clinical endpoint adjudication (CEA) is a standardized process for assessment of safety and efficacy of pharmacologic or device therapies in clinical trials. CEA plays a key role in many large clinical trials with the aim of achieving consistency and accuracy of the study results, by applying independent and blinded evaluation of suspected clinical events reported by investigators. However, due to high costs there are different opinions regarding the use of central adjudication versus more simplified strategies or site-based assessments and whether the final results differ significantly...
November 14, 2018: Upsala Journal of Medical Sciences
Magdalena Mattebo, Tanja Tydén, Elisabet Häggström-Nordin, Kent W Nilsson, Margareta Larsson
BACKGROUND: The aims of this longitudinal study were to identify predictors for continued pornography consumption and to investigate pornography consumption in relation to psychosomatic and depressive symptoms among a group of adolescents in Sweden. METHODS AND MATERIALS: A longitudinal study in classroom environment in 53 randomly selected senior high school classes in mid-Sweden in years 2011 and 2013. Out of 477 participating boys and 400 girls in 2011, 224 boys (47%) and 238 girls (60%) participated in 2013...
November 9, 2018: Upsala Journal of Medical Sciences
Ioannis Kouros, Niklas Hörberg, Lisa Ekselius, Mia Ramklint
OBJECTIVE: The aim of this study was to examine the psychometric properties and diagnostic accuracy of the Swedish version of the Wender Utah Rating Scale (WURS) in psychiatric patients with similar symptoms but diagnosed with either attention deficit hyperactivity disorder (ADHD), bipolar disorder (BP), and/or borderline personality disorder (BPD). METHODS: A total of 121 patients from an outpatient psychiatric clinic for young adults (18-25 years) were diagnosed using the Structured Clinical Interview for DSM Axis I and Axis II (SCID-I and SCID-II), and ADHD was diagnosed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS)...
October 29, 2018: 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
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