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  • 1.
    Bylund, Dan
    et al.
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Natural Sciences.
    Henriksson, Anders E.
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Natural Sciences. Sundsvalls sjukhus.
    Proteomic approaches to identify circulating biomarkers in patients with abdominal aortic aneurysm2015In: American Journal of Cardiovascular Disease, ISSN 2160-200X, Vol. 5, no 3, p. 140-145Article, review/survey (Refereed)
    Abstract [en]

    Abdominal aortic aneurysm (AAA) is a common condition with high mortality when ruptured. Most clinicians agree that small AAAs are best managed by ultrasonographic surveillance. However, it has been stated in recent reviews that a serum/plasma biomarker that predicts AAA rupture risk would be a powerful tool in stratifying patients with small AAAs. Identification of such circulating biomarkers with traditional hypothesis driven studies has been unsuccessful. In this review we summarize six studies using different proteomic approaches to find new, potential plasma AAA biomarker candidates. In conclusion, by using proteomic approaches novel potential plasma biomarkers for AAA have been identified.

  • 2.
    Fransson, Maria
    et al.
    Department of Surgery, Sundsvall County Hospital, Sundsvall, Sweden.
    Rydningen, Hans
    Department of Surgery, Sundsvall County Hospital, Sundsvall, Sweden.
    Henriksson, Anders E.
    Department of Laboratory Medicine, Sundsvall County Hospital, SE-851 86 Sundsvall, Sweden .
    Early coagulopathy in patients with ruptured abdominal aortic aneurysm.2012In: Clinical and applied thrombosis/hemostasis, ISSN 1076-0296, E-ISSN 1938-2723, Vol. 18, no 1, p. 96-9Article in journal (Refereed)
    Abstract [en]

    Ruptured abdominal aortic aneurysm (AAA) is associated with a high mortality despite surgical management. Earlier reports indicate that a major cause of immediate intraoperative death in patients with ruptured AAA is related to hemorrhage due to coagulopathy. Acidosis is, besides hypothermia and hemodilution, a possible cause of coagulopathy. The aim of the present study was to investigate the incidence of coagulopathy and acidosis preoperatively in patients with ruptured AAA in relation to the clinical outcome with special regard to the influence of shock. For this purpose, 95 consecutive patients who underwent surgery for AAA (43 ruptured with shock, 12 ruptured without shock, and 40 nonruptured) were included. Coagulopathy was defined as prothrombin time (international normalized ratio [INR]) ≥1.5 and acidosis was defined as base deficit ≥6 mmol/L. Mortality and postoperative complications were recorded. The present study shows a state of acidosis at the start of surgery in 30 of 55 patients with ruptured AAA. However, only in 7 of 55 patients with ruptured AAA a state of preoperative coagulopathy was demonstrated. Furthermore, in our patients with shock due to ruptured AAA only 2 of 12 deaths were due to coagulopathy and bleeding. Indeed, our results show a relatively high incidence of thrombosis-related causes of death in patients with ruptured AAA, indicating a relation to an activated coagulation in these patients. These findings indicate that modern emergency management of ruptured AAA has improved in the attempt to prevent fatal coagulopathy.

  • 3.
    Hambraeus, K.
    et al.
    Falun Cent Hosp, Dept Cardiol, Falun, Sweden .
    Burell, G.
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden .
    Johansson, P.
    Heart & Lung Patients Assoc, Stockholm, Sweden .
    Karlsson, R.
    Karlstad Hosp, Karlstad, Sweden .
    Lisspers, Jan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Perk, J.
    Linnaeus Univ, Sch Hlth & Caring Sci, Kalmar, Sweden.
    Cardiac rehabilitation: demands from elderly patients after percutaneous coronary intervention2012In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 33, no Supp 1, p. 450-450Article in journal (Other academic)
  • 4.
    Jideus, Lena
    et al.
    Dept. Surg. Sci., Thorac. C., University Hospital, Uppsala.
    Ericson, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Stridsberg, Mats
    Nilsson, Leif
    Blomström, Per
    Dept. Surg. Sci., Thorac. C., University Hospital, Uppsala.
    Blomström-Lundqvist, Carina
    University Hospital, Uppsala.
    Diminished circadian variation in heart rate variability before surgery in patients developing postoperative atrial fibrillation2001In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 35, no 4, p. 238-244Article in journal (Refereed)
    Abstract [en]

    Objective - To evaluate the role of the autonomic nervous system for the development of atrial fibrillation (AF) after coronary artery bypass Surgery. Design - Eighty patients without a previous history of AF were included. The sympathetic and parasympathetic activity were evaluated by the analysis of heart rate variability (HRV) in the frequency domain from 24-h Holter recordings and by measuring neuropeptides (neuropeptide Y, chromogranin A, chromogranin B, and pancreatic polypeptide (PP)) and catecholamines, obtained pre- and postoperatively. Results - Preoperatively, patients (36.3%) developing AF postoperatively showed a statistically significant less circadian variation in the HRV variables, the hi gh-f requency (HF) component (p = 0.013) and the low-frequency (LF)/HF ratio (p = 0.007), than patients remaining in sinus rhythm. The HF component and PP, both reflecting parasympathetic activity, and all other variables in the frequency domain, decreased significantly after surgery in both patient groups (p < 0.0001). Although catecholamines increased significantly postoperatively in both patient groups, neither catecholamines nor neuropeptides expressing sympathetic activity, differed between the two g PP groups. PP was, however, significantly higher in patients with postoperative AF than in those with sinus rhythm postoperatively on day 1. Conclusion - The diminished circadian variation in HRV before surgery and the indirect signs of a higher parasympathetic activity in patients developing postoperative AF compared with patients remaining in sinus rhythm, may indicate a propensity for AF.

  • 5.
    Junehag, Lena
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Svedlund, Marianne
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    A qualitative study: Perceptions of the psychosocial consequences and access to support after an acute myocardial infarction2014In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, no 1, p. 22-30Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to describe individuals' perceptions of the psychosocial consequences of an acute myocardial infarction (AMI) and of their access to support one year after the event. Methods: The study included 20 participants (14 men and six women) who lived in rural areas and had experienced their first AMI. Eleven were offered contact with a mentor. The participants were interviewed one year after their AMI. Results: The findings are presented in three themes: having a different life, having to manage the situation and having access to support, with 11 subthemes. During their recovery, the participants experienced psychosocial consequences, consisting of anxiety and the fear of being afflicted again. Most mentees appreciated their mentor and some of those without mentors wished they had received organised support. Participants were often more dissatisfied than satisfied with the follow-up provided during recovery. Conclusions: After an AMI, follow-up is important during recovery, but the standardised information provided is inadequate. During recovery, people need help dealing with existential crises. After discharge, receiving peer support from lay people with similar experiences could be valuable. The knowledge gleaned from this study could be used in education at coronary care units and in health care outside the hospital setting. © 2013 Elsevier Ltd.

  • 6.
    Kivimäki, M.
    et al.
    Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
    Nyberg, S. T.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Batty, G. D.
    Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
    Fransson, E. I.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Heikkilä, K.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Alfredsson, L.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Bjorner, J. B.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Borritz, M.
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
    Burr, H.
    Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany.
    Casini, A.
    School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
    Clays, E.
    Department of Public Health, Ghent University, Ghent, Belgium.
    De Bacquer, D.
    Department of Public Health, Ghent University, Ghent, Belgium.
    Dragano, N.
    Department of Medical Sociology, University of Düsseldorf, Düsseldorf, Germany.
    Ferrie, J. E.
    Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
    Geuskens, G. A.
    TNO, Hoofddorp, Netherlands.
    Goldberg, M.
    Versailles-Saint Quentin University, Versailles, France.
    Hamer, M.
    Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
    Hooftman, W. E.
    TNO, Hoofddorp, Netherlands.
    Houtman, I. L.
    TNO, Hoofddorp, Netherlands.
    Joensuu, M.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Jokela, M.
    Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
    Kittel, F.
    School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Koskenvuo, M.
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Koskinen, A.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Kouvonen, A.
    School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, United Kingdom.
    Kumari, M.
    Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
    Madsen, I. E. H.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Marmot, M. G.
    Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
    Nielsen, M. L.
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
    Nordin, M.
    Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
    Oksanen, T.
    Finnish Institute of Occupational Health, Turku, Finland.
    Pentti, J.
    Finnish Institute of Occupational Health, Turku, Finland.
    Rugulies, R.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Salo, P.
    Finnish Institute of Occupational Health, Turku, Finland.
    Siegrist, J.
    Department of Medical Sociology, University of Düsseldorf, Düsseldorf, Germany.
    Singh-Manoux, A.
    Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
    Suominen, S. B.
    Department of Public Health, University of Turku, Turku, Finland.
    Väänänen, A.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Vahtera, J.
    Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
    Virtanen, M.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Westerholm, P. J. M.
    Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
    Westerlund, H.
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Zins, M.
    Versailles-Saint Quentin University, Versailles, France.
    Steptoe, A.
    Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
    Theorell, T.
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Job strain as a risk factor for coronary heart disease: A collaborative meta-analysis of individual participant data2012In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 380, no 9852, p. 1491-1497Article in journal (Refereed)
    Abstract [en]

    Background Published work assessing psychosocial stress (job strain) as a risk factor for coronary heart disease is inconsistent and subject to publication bias and reverse causation bias. We analysed the relation between job strain and coronary heart disease with a meta-analysis of published and unpublished studies. Methods We used individual records from 13 European cohort studies (1985-2006) of men and women without coronary heart disease who were employed at time of baseline assessment. We measured job strain with questions from validated job-content and demand-control questionnaires. We extracted data in two stages such that acquisition and harmonisation of job strain measure and covariables occurred before linkage to records for coronary heart disease. We defined incident coronary heart disease as the first non-fatal myocardial infarction or coronary death. Findings 30 214 (15%) of 197 473 participants reported job strain. In 1•49 million person-years at risk (mean follow-up 7•5 years [SD 1•7]), we recorded 2358 events of incident coronary heart disease. After adjustment for sex and age, the hazard ratio for job strain versus no job strain was 1•23 (95% CI 1•10-1•37). This effect estimate was higher in published (1•43, 1•15-1•77) than unpublished (1•16, 1•02-1•32) studies. Hazard ratios were likewise raised in analyses addressing reverse causality by exclusion of events of coronary heart disease that occurred in the first 3 years (1•31, 1•15-1•48) and 5 years (1•30, 1•13-1•50) of follow-up. We noted an association between job strain and coronary heart disease for sex, age groups, socioeconomic strata, and region, and after adjustments for socioeconomic status, and lifestyle and conventional risk factors. The population attributable risk for job strain was 3•4%. Interpretation Our findings suggest that prevention of workplace stress might decrease disease incidence; however, this strategy would have a much smaller effect than would tackling of standard risk factors, such as smoking. Funding Finnish Work Environment Fund, the Academy of Finland, the Swedish Research Council for Working Life and Social Research, the German Social Accident Insurance, the Danish National Research Centre for the Working Environment, the BUPA Foundation, the Ministry of Social Affairs and Employment, the Medical Research Council, the Wellcome Trust, and the US National Institutes of Health.

  • 7.
    Perk, J.
    et al.
    Linnaeus Univ, Sch Hlth & Caring Sci, Kalmar, Sweden.
    Burell, G.
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden .
    Hambraeus, K.
    Falun Cent Hosp, Dept Cardiol, Falun, Sweden .
    Johansson, P.
    Heart & Lung Patients Assoc, Stockholm, Sweden .
    Karlsson, R.
    Karlstad Hosp, Karlstad, Sweden .
    Lisspers, Jan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Harvesting the benefits of a cardioprotective lifestyle after coronary angioplasty2012In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 33, no Supp 1, p. 446-446Article in journal (Other academic)
  • 8.
    Sjödin, Christina
    et al.
    Mid Sweden University. Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Wall Dahlberg, Malin
    Mid Sweden University. Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Livet för patienter med hjärtsvikt: En litteraturöversikt2010Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Patients with heart failure is a patient group growing in numbers, the most common treatment focuses on reliving symptoms and the only cure is heart transplantation. Objective: Aim of the study was to illuminate patients' experiences of living with heart failure at his home. Method: Qualitative design, with a manifest content analysis. The results are based on 12 scientific articles.  Results: Patients with heart failure find that the disease is limited to their daily lives through mental illness and physical symptoms. The short comings of given information to the Patients are a necessary element to include in the planning for Patients future life. The Patients are experiencing that their lives are hanging on a thread as their life is running out, giving anxiety and worries. The need for palliative care is great, but is experienced by patients as containing large gaps. Discussion: Heart failure is a hidden disease, where patients with heart failure often feel like a burden on the environment. Dependence on other people gives a feeling of hope and hopelessness. Conclusion: information plays a large role in how patients with heart failure are able to live with their everyday lives.

  • 9.
    Wallinder, Jonas
    et al.
    Departments of Surgery, Sundsvall County Hospital, Sweden .
    Bergqvist, David
    Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University Hospital, Sweden .
    Henriksson, Anders E.
    Laboratory Medicine, Sundsvall County Hospital, Sweden.
    Haemostatic markers in patients with abdominal aortic aneurysm and the impact of aneurysm size2009In: Thrombosis Research, ISSN 0049-3848, E-ISSN 1879-2472, Vol. 124, no 4, p. 423-6Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Abdominal aortic aneurysm is a common condition with high mortality when rupturing. However, the condition is also associated with nonaneurysmal cardiovascular mortality. A possible contributing mechanism for the thrombosis related cardiovascular mortality is an imbalance between the activation of the coagulation system and the fibrinolytic system. The aim of the present study was to investigate haemostatic markers in patients with nonruptured abdominal aortic aneurysm with special regard to the influence of aneurysm size and smoking habits.

    METHODS: Seventy-eight patients with infrarenal aortic aneurysm and forty-one controls without aneurysm matched by age, gender and smoking habits were studied. Thrombin-antithrombin (TAT), prothrombin fragment 1+2 (F 1+2)--markers of thrombin generation, and von Willebrand factor antigen (vWFag)--considered as a reliable marker of endothelial dysfunction--were measured. Plasma levels of tissue plasminogen activator antigen (tPAag), and plasminogen activator inhibitor type 1 (PAI-1) were measured as markers of fibrinolytic activity. D-dimer, a marker of fibrin turnover, was also measured.

    RESULTS: There were significantly higher levels of TAT and D-dimer in patients with abdominal aortic aneurysm. The highest level of TAT and D-dimer were detected in patients with large compared to small AAA.

    CONCLUSIONS: The present data indicate a state of activated coagulation in patients with abdominal aortic aneurysm which is dependent by aneurysm size. The activated coagulation in AAA patients could contribute to an increased cardiovascular risk in patients also with small AAA. The possible impact of secondary prevention apart from smoking cessation has to be further evaluated and is maybe as important as finding patients at risk of rupture.

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