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  • 1.
    Axelsson, Bertil
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    What is the Place for an Effect of Surgery to Prevent And/or to Treat Cancer Pain2011In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 47, p. S45-S45Article in journal (Other academic)
  • 2. Dérand, Per
    et al.
    Rännar, Lars-Erik
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Engineering and Sustainable Development.
    Hirsch, Jan-M
    Imaging, virtual planning, design and production of patient specific implants and clinical validation in cranio-maxillo-facial surgery2012In: Cranial maxillofacial Trauma and Reconstruction, ISSN 1943-3875, Vol. 5, no 3, p. 137-144Article in journal (Refereed)
  • 3.
    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.

  • 4.
    Henriksson, Anders E.
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Natural Sciences.
    The impact of blood component transfusion practices on patient survival after abdominal aortic aneurysm surgery2013In: Vascular and Endovascular Surgery, ISSN 1538-5744, Vol. 47, no 1, p. 38-41Article in journal (Refereed)
    Abstract [en]

    Background: The aim of the present study was to investigate the blood transfusion practice in patients operated for abdominal aortic aneurysm (AAA) with special emphasis on massive transfusion in cases with rupture. Material and methods: From a database, 504 patients operated for AAA were stratified into 2 groups; an early transfusion period (1992-1999) and a late transfusion period (2000-2008) to evaluate the changes in transfusion practices over the course of time. Results: Patients operated for nonruptured AAA (n = 330) showed a decreased mortality rate from 4% (early transfusion period) to 1% (late transfusion period) without significant changes in the transfusion practices. In patients operated for ruptured AAA (n = 174) an unexpected low mortality rate was found compared to the 30-day mortality reported in earlier studies. The transfusion practices in ruptured AAA surgery showed a significant increase in platelet use and change of fresh frozen plasma: red blood cell ratio from 0.8 to 0.9 between the early and the late transfusion period. Conclusion: The present database study shows that the operating mortality for AAA surgery has declined during the past decades. The cause of the decline in mortality in patients with ruptured AAA was interpreted as partly due to a modern blood component therapy. © The Author(s) 2012.

  • 5. Hirsch, Jan-M
    et al.
    Rännar, Lars-Erik
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Engineering and Sustainable Development.
    Gamstedt, Kristofer
    Virtual planning of reconstructions, production of individualized implants and transfer of the plan to the operating room in CMF surgery2012Conference paper (Other academic)
  • 6.
    Hirsch, Jan-Michael
    et al.
    Uppsala university.
    Dérand, Per
    University hospital of Lund.
    Gamstedt, Kristofer
    Uppsala university.
    Huo, Jinxing
    Uppsala university.
    Omar, Omar
    Gothenburg university.
    Palmquist, Anders
    Gothenburg university.
    Thor, Andreas
    Uppsala university.
    Nysjö, Fredrik
    Uppsala university.
    Nysjö, J
    Uppsala university.
    Nyström, Ingela
    Uppsala university.
    Rännar, Lars-Erik
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Technology and Management, Mechanical Engineering and Mathematics.
    3D printed titanium implants i Maxillofacial surgery2016Conference paper (Refereed)
  • 7.
    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.

  • 8.
    Lindqvist, Markus
    et al.
    Sundsvall Cty Hosp, Dept Clin Chem, SE-85186 Sundsvall, Sweden.
    Wallinder, Jonas
    Department of Surgery, Sundsvall County Hospital, Sweden.
    Henriksson, Anders E.
    Mid Sweden University, Faculty of Science, Technology and Media, Department of applied science and design.
    Soluble urokinase plasminogen activator receptor in patients with abdominal aortic aneurysm2012In: Thrombosis Research, ISSN 0049-3848, E-ISSN 1879-2472, Vol. 130, no 3, p. 511-513Article in journal (Refereed)
    Abstract [en]

    Introduction: In the present study we investigated the impact of soluble urokinase plasminogen activator receptor (suPAR) as a biomarker in patients with abdominal aortic aneurysm (AAA) in relation to conventional inflammatory markers, aneurysm size, and rupture. Methods: suPAR and conventional inflammatory markers were measured in 119 patients with AAA and 36 controls without aneurysm matched by age, gender and smoking habit. Results: The results support earlier studies suggesting a state of activated inflammatory response in patients with nonruptured AAA as expressed by elevated CRP and IL-6 compared with the controls. In contrast, suPAR showed similar levels in patients with nonruptured AAA compared with the controls. Unexpectedly, all follow-up patients (n = 16) have significant (p<0.001) elevated suPAR levels three years postoperatively compared preoperatively. Conclusions: suPAR does not seem to be a useful biomarker in the AAA disease. The role of the postoperative elevation of suPAR needs to be further elucidated. (C) 2012 Elsevier Ltd. All rights reserved.

  • 9.
    Swarén, Mikael
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Danvind, Jonas
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Engineering and Sustainable Development.
    Holmberg, Hans-Christer
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Acceleration of the head during alpine skiing2010In: Proceedings for the fifth international conference on Science and Skiing / [ed] Erich Mueller, Salzburg, 2010, p. 82-Conference paper (Refereed)
  • 10. Viklander, Gertrud
    et al.
    Wallinder, Jonas
    Henriksson, Anders E
    ABO blood groups and abdominal aortic aneurysm.2012In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 47, no 3, p. 351-3Article in journal (Refereed)
    Abstract [en]

    Earlier studies have indicated an association between blood group non-O and atherosclerosis related vascular diseases. Abdominal aortic aneurysm (AAA) is traditionally regarded as a consequence of atherosclerosis. The aim of the present study was to investigate the association between ABO blood groups and AAA with special regard to a relation to AAA rupture. Prospectively, 504 patients operated on for AAA were investigated. Patients operated on for AAA have similar ABO blood group distributions as a population based control group. Furthermore, there was no significant difference in distribution of ABO blood group between patients operated on for ruptured AAA (n=174) and non-ruptured AAA (n=330). In conclusion, this study fails to demonstrate an association between ABO blood groups and AAA.

  • 11.
    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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