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Visby, Sweden

Stokkeland K.,Visby Hospital | Stokkeland K.,Karolinska Institutet | Ebrahim F.,Karolinska Institutet | Ekbom A.,Karolinska Institutet
Alcoholism: Clinical and Experimental Research | Year: 2010

Background and Aims: During the last decades, a multitude of different treatments for chronic liver disease have been introduced. New surveillance programs have been established to detect esophageal varices and liver cancer. The aims of our study were to assess whether the prognosis for patients hospitalized with liver diseases between 1969 and 2006 had improved and to study the differences in mortality and complications between patients with alcoholic liver disease and nonalcoholic liver diseases.Methods: We used the Swedish Hospital Discharge Register and Cause of Death Register at the National Board of Health and Welfare in Sweden between 1969 and 2006 to identify and follow-up a cohort of patients with liver disease according to the International Classification of Diseases-8, -9, and -10.Results: There were 36,462 patients hospitalized with alcoholic and 95,842 with nonalcoholic liver diseases. The main finding was that patients hospitalized with alcoholic liver disease had an increased mortality risk, compared to patient with nonalcoholic liver disease, 1.89 (1.85 to 1.92). In addition, the patients with alcoholic liver disease had an increased risk for esophageal varices and liver cancer. There was a reduced risk for hospitalization with esophageal varices for patients with nonalcoholic liver disease up to 1998.Conclusions: We found that the prognosis for patients hospitalized with chronic liver diseases had not improved. Patients with alcoholic liver disease have an increased risk of complications, which suggest that the disease is more aggressive and are in need of closer follow-up than other chronic liver diseases. © 2010 by the Research Society on Alcoholism. Source

Osterberg S.A.,Linnaeus University | Baigi A.,Research and Development Unit | Baigi A.,Gothenburg University | Bering C.,Visby Hospital | And 2 more authors.
British Journal of Nursing | Year: 2010

Background Participation in cardiac rehabilitation programmes (CRPs) allows patients to increase their knowledge of the importance of established risk factors to help them maintain healthy lifestyle changes after coronary heart disease (CHD). Aim To explore perceived importance and knowledge of known risk factors for CHD among non-attendees in CRPs. Method Consecutive non-attendees in CRPs (n=106) answered a questionnaire focusing on patients' attitudes towards risk factors and cardiac rehabilitation. Results The non-attendees lacked knowledge of non-physical characteristics such as depression and social isolation. They also had poor knowledge about biological causes and hereditary factors. However, those who said they knew enough about CHD to prevent recurrent illness did have sufficient knowledge about the established risk factors. Conclusion There is a lack of knowledge about social isolation and depression and their importance in the development of CHD among the non-attendees. They show greater knowledge about biological risk factors than the importance of companionship, joy and happiness. CHD and loneliness are intimately correlated, so creating a sense of belonging must not be underestimated as a measure to prevent CHD. Source

Garland A.,Visby Hospital | Garland A.,Uppsala University Hospital | Rolfson O.,Swedish Hip Arthroplasty Register | Rolfson O.,Gothenburg University | And 7 more authors.
BMC Musculoskeletal Disorders | Year: 2015

Background: Approximately a fifth of all total hip arthroplasty (THA) patients suffers from bilateral osteoarthritis of the hip. It is unclear whether mortality risks differ between simultaneous bilateral THA and staged bilateral THA. We investigated mortality after simultaneous THA compared with staged bilateral THA in the largest cohort hitherto reported. Methods: The 42,238 patients reported to have received bilateral primary THA from 1992 to 2012 in the Swedish Hip Arthroplasty Register were included. Tumours and fractures as underlying diagnoses were excluded. The time interval between the first and second THA was divided into four categories or treated as a continuous variable. Unadjusted survival was calculated according to Kaplan-Meier and adjusted Cox regression models were fitted in order to calculate crude and adjusted hazard ratios (HR) for the risk of death within different time frames. Results: Patients selected for simultaneous bilateral surgery were younger, more often male, and had lower ASA (American Society of Anesthesiologists) class than patients receiving staged procedures. The adjusted 90-day mortality after the second procedure did not differ between the four investigated groups (simultaneous bilateral [HR 1.3, CI 0.5-3.3], surgeries within 6 months [HR 1.1, CI 0.6-2.0], surgeries between 7 and 12 months [HR 0.7, CI 0.4-1.2], with second surgery after >12 months as the reference group). For patients older than 75 years, men, patients with ASA class 3 or above, and for patients with rheumatoid arthritis (RA) the 90-day mortality was increased. The unadjusted risk of implant revision of any hip was slightly higher for patients with simultaneous bilateral THA compared to those with staged procedure within one year, but after adjustment for age, gender, diagnosis and implant fixation these differences were no longer statistically significant. Conclusion: There were no clinically relevant differences in early postoperative mortality between simultaneous and staged bilateral surgery in healthy patients. Advanced age, RA, a high ASA class and male sex increased the risk of death within 90 days. There may be an issue with enhanced risk of implant revision in patients with simultaneous bilateral THA that needs to be explored further. © 2015 Garland et al.; licensee BioMed Central. Source

Stokkeland K.,Visby Hospital | Stokkeland K.,Karolinska Institutet | Ebrahim F.,National Board of Health and Welfare | Hultcrantz R.,Karolinska Institutet | Ekbom A.,Karolinska Institutet
Liver International | Year: 2013

Background: Pregnancy in women with liver disease may increase the risk of fetal complication. Data on disease frequencies in children born to mothers with alcoholic liver disease do not exist, although we do know that prenatal alcohol exposure may affect the fetus negatively. Aims: The aim of this study was to assess the relative risk of neuropsychiatric diseases in children who were born to mothers with chronic liver diseases. Methods: We linked the Hospital Discharge Register, Medical Birth Register and Pharmaceutical Register in Sweden between 1969 and 2009 to identify women with liver disease. We identified their children, up to the age of 16 in the Medical Birth Register, born between 1973 and 2009. Between 2005 and 2009, we identified every prescription that was dispensed to these children. Results: We identified 5 124 children of mothers with alcoholic liver disease. There were 22 960 children of mothers with non-alcoholic liver disease. For controls, we used 10 sex-, age- and birthplace-matched children. There were more children born to mothers with alcoholic liver disease before the birth who had been dispensed antiepileptics (n = 11, RR = 3.2 (1.6-6.4)), neuroleptics (n = 7, RR = 5.0 (2.0-12.5)) and drugs to treat attention deficit hyperactivity disorders (n = 22, RR = 5.9 (3.7-9.4)) compared with sex-, age- and regionally adjusted controls. Children born to mothers with non-alcoholic liver disease had significantly increased risk of being dispensed drugs to treat attention deficit disorders (RR = 2.2 (1.8-2.6)). Conclusions: Mothers with alcoholic liver disease have increased risks of having children with severe neurological and psychiatric disorders. © 2012 John Wiley & Sons A/S. Source

Nyegaard M.,University of Aarhus | Overgaard M.T.,University of Aalborg | Sondergaard M.T.,University of Aalborg | Vranas M.,University of Aarhus | And 10 more authors.
American Journal of Human Genetics | Year: 2012

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a devastating inherited disorder characterized by episodic syncope and/or sudden cardiac arrest during exercise or acute emotion in individuals without structural cardiac abnormalities. Although rare, CPVT is suspected to cause a substantial part of sudden cardiac deaths in young individuals. Mutations in RYR2, encoding the cardiac sarcoplasmic calcium channel, have been identified as causative in approximately half of all dominantly inherited CPVT cases. Applying a genome-wide linkage analysis in a large Swedish family with a severe dominantly inherited form of CPVT-like arrhythmias, we mapped the disease locus to chromosome 14q31-32. Sequencing CALM1 encoding calmodulin revealed a heterozygous missense mutation (c.161A>T [p.Asn53Ile]) segregating with the disease. A second, de novo, missense mutation (c.293A>G [p.Asn97Ser]) was subsequently identified in an individual of Iraqi origin; this individual was diagnosed with CPVT from a screening of 61 arrhythmia samples with no identified RYR2 mutations. Both CALM1 substitutions demonstrated compromised calcium binding, and p.Asn97Ser displayed an aberrant interaction with the RYR2 calmodulin-binding-domain peptide at low calcium concentrations. We conclude that calmodulin mutations can cause severe cardiac arrhythmia and that the calmodulin genes are candidates for genetic screening of individual cases and families with idiopathic ventricular tachycardia and unexplained sudden cardiac death. © 2012 The American Society of Human Genetics. Source

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