383 results match your criteria: "Academic Primary Health Care Centre[Affiliation]"

Background/aim: Two retrospective studies of prospective cohorts showed doubled odds of birth asphyxia among women with low plasma vitamin D levels, and another study reported a four-fold increased risk of stillbirth. It was not known whether this was related to low sun exposure or to insufficient vitamin D per se. We aimed to assess if it was due to vitamin D status.

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Introduction: Recurrent pregnancy loss (RPL), defined as two or more pregnancy losses, might be associated with elevated obstetrical and perinatal risks in the following pregnancies. RPL and pregnancy problems related to placental development may have similar etiological features. This study explores the incidences of pregnancy and perinatal outcomes in women with RPL.

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Background: Higher circulating levels of tumor necrosis factor (TNF) alpha receptors 1 (TNFR1) and 2 (TNFR2) are associated with increased long-term mortality and impaired kidney function.

Aim: To study associations between levels of TNFR1 and TNFR2 and all-cause mortality as well as estimated glomerular filtration rate (eGFR) decline.

Population And Methods: Patients with chronic kidney disease (CKD) stages 3-5 in the Salford Kidney Study were included.

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Exercise in primary care after robot-assisted radical cystectomy for urinary bladder cancer - effects on postoperative complications: a secondary analysis of a randomised controlled trial.

Scand J Urol

December 2024

Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden; Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden.

Objective: An exercise programme in primary care soon after radical cystectomy for urinary bladder cancer was previously evaluated regarding its effects on physical function. A secondary aim, presented herein, was to evaluate the programme in terms of its effect on postoperative complications.

Materials And Methods: Patients who were planned for robot-assisted radical cystectomy for urinary bladder cancer at Karolinska University Hospital between September 2019 and October 2022 were invited to participate.

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Lithium Use During Pregnancy in 14 Countries.

JAMA Netw Open

December 2024

Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.

Importance: In pregnancy, the benefits of lithium treatment for relapse prevention in psychiatric conditions must be weighed against potential teratogenic effects. Currently, there is a paucity of information on how and when lithium is used by pregnant women.

Objective: To examine lithium use in the perinatal period.

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Article Synopsis
  • The study analyzed the impact of alcohol control policies on health outcomes related to alcohol in Nordic countries from 1990 to 2019.
  • More restrictive alcohol policies were generally linked to lower levels of alcohol-attributed harm, especially in Sweden and Norway, while Denmark, with the least restrictive policies, had higher harm levels.
  • Findings suggest that while stricter policies can reduce alcohol-related disease burdens, other factors like sex and specific locations also play crucial roles, indicating that policy effectiveness is context-dependent.
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Background: Plasma osteopontin (pOPN) is a promising aging-related biomarker among individuals with and without kidney disease. The interaction between sex, pOPN levels, and global and cardiorenal outcomes among older individuals was not previously evaluated.

Methods: In this study we investigated the association of pOPN with 24-month global mortality, major cardiovascular events (MACEs), MACEs + cardiovascular (CV) mortality, and renal decline among older individuals; we also evaluated whether sex modified observed associations.

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Exhaustion disorder (ED) was introduced to the Swedish version of the International Classification of Diseases, 10th edition (ICD-10) 2005. Primarily characterized by general fatigue and cognitive deficits, ED has become one of the most common mental health diagnoses in Sweden. Little is still known regarding the discriminative validity of the ED diagnosis and how it relates to other diagnostic constructs.

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Article Synopsis
  • - Children born to mothers with polycystic ovary syndrome (PCOS) show a greater likelihood of developing cardiovascular risk factors and subclinical cardiovascular disease compared to those born to mothers without PCOS.
  • - A large cohort study in Denmark and Sweden, tracking over 6 million live births, reveals that offspring of mothers with PCOS have an increased risk of cardiovascular diseases, regardless of other health conditions.
  • - The study's results suggest that if confirmed by further research, there may be a need for early cardiovascular prevention strategies for children born to women with PCOS.
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All-cause mortality and death by aortic dissection in women with Turner syndrome: A national clinical cohort study.

Am Heart J

November 2024

Department of Internal Medicine and Clinical Nutrition, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Internal Medicine, Section for Endocrinology, Sahlgrenska University Hospital Gothenburg, Sweden.

Background: Turner syndrome (TS) is a complex genetic disorder with raised mortality. Our objective was to investigate mortality and causes of death in TS.

Methods: A matched retrospective observational study of women with TS recruited from the Turner centers in Sweden were conducted.

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Background: Patients with chronic pain often struggle to engage in physical activity despite its health benefits. The eVISualisation of physical activity and pain intervention (eVIS) was developed to support adherence to physical activity plans in Interdisciplinary Pain Rehabilitation Programs (IPRPs) by visualising activity, pain levels, pain interference, and pharmacological use. This pilot study assesses the feasibility and acceptability of trial design and trial conduct of a registry-based randomised clinical trial (R-RCT).

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In this study we examined the effect of simultaneously elevated levels of parathyroid hormone (PTH) (≥ 65 ng/mL) and high levels of insulin-like growth factor-binding protein 1 (IGFBP-1) on the 10-year risk of all-cause mortality and hip fractures. Blood tests for levels of PTH and IGFBP-1 was collected at baseline in 338 community-dwelling women in Stockholm aged between 69 and 79 years. Data on hip fractures and all-cause mortality over the next 10 years were retrieved from healthcare registers.

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Measurement Properties of the Patient Health Questionnaire-15 and Somatic Symptom Scale-8: A Systematic Review and Meta-Analysis.

JAMA Netw Open

November 2024

Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.

Article Synopsis
  • The study evaluates the reliability and validity of two common self-reported measures for somatic symptoms: the Patient Health Questionnaire-15 (PHQ-15) and the Somatic Symptom Scale-8 (SSS-8).
  • Extensive data was extracted from 305 studies involving over 361,000 participants, focusing primarily on routine care and the general population.
  • Results indicated that both scales measure specific symptom domains and overall symptom burden, with the PHQ-15 showing good reliability (α = 0.81) while certain items had low correlations, and the SSS-8 also showing strong reliability (α = 0.80).
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The aim was to study if nurse-managed hypertension care was associated with differences in pharmacotherapy, lifestyle counseling, and prevalence of comorbid cardiometabolic diseases among patients receiving care at primary health care centers. To assess the extent of nurses' involvement in the hypertension care, a questionnaire was distributed to all primary health care centers in Region Stockholm. Age-adjusted logistic regression models were used to analyze the results, odds ratios with 99% confidence intervals.

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Article Synopsis
  • Asthma, the most common chronic disease during pregnancy, may lead to various negative outcomes for both mothers and their offspring, including neurodevelopmental disorders.
  • A study involving over 1.2 million mother-child pairs in Finland revealed that children of mothers with asthma had slightly higher rates of neurodevelopmental disorders compared to those without asthma, although the absolute differences were small.
  • Specific disorders noted include ADHD, autism, motor and language disorders, and learning disabilities, with ADHD showing the strongest association, though overall risk percentages were low.
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Introduction: Although perinatal death rates in the Nordic countries are among the lowest in the world, the risk of perinatal death is unevenly distributed across the Nordic countries, despite similarity in health care systems and pregnancy care. Birth registration practices across countries may explain some of the differences. We investigated differences in national registration of perinatal mortality within the Nordic countries and its impact on perinatal mortality according to gestational age.

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Article Synopsis
  • * Results showed significant symptom improvement, with 60% of participants achieving reliable change and 44% in remission after 12 weeks of treatment.
  • * Higher adherence to treatment modules correlated with better outcomes, indicating ICBT's potential as a widely accessible therapy for health anxiety.
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Article Synopsis
  • - Restless legs syndrome (RLS) disrupts sleep and lowers quality of life, leading researchers to develop the RLS-Self-care Behaviour questionnaire (RLS-ScBq) to measure self-care activities for patients with this condition.
  • - The study with 788 patients assessed the questionnaire's validity and reliability, finding it useful for evaluating physical and mental self-care actions in managing RLS.
  • - Results indicated a two-factor solution with decent internal consistency, suggesting the RLS-ScBq could help healthcare professionals understand and promote self-care in RLS patients.
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Article Synopsis
  • Gestational diabetes mellitus (GDM) is identified through abnormal results in an oral glucose tolerance test (OGTT), with a lack of clear understanding about how the number of abnormal values relates to negative birth outcomes.
  • A study involving 4869 pregnant women in Finland analyzed the connection between the quantity of abnormal OGTT values and adverse perinatal and neonatal results, taking into account various health and social factors.
  • Results indicated that women with two or more abnormal OGTT values had significantly higher rates of negative perinatal (35.0% vs. 27.5%) and neonatal outcomes (31.1% vs. 18.9%) compared to those with fewer or no abnormal values.
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A prevailing belief among researchers is that burnout is a work-specific syndrome induced by intractable job stress. The validity of this belief, however, remains unclear. This cross-sectional study compared burnout with two general conditions, nonspecific psychological distress (NSPD) and exhaustion, in terms of (a) causal attributions to work and (b) associations with 11 job variables (e.

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Background: Physical activity is thought to be a key component in reducing postoperative complications following major abdominal surgery. The available literature on exercise interventions following radical cystectomy in patients with bladder cancer is scarce but suggests that physical activity and exercise might improve physical function and health-related quality of life, thus calling for further investigation. The CanMoRe-trial is a single-blinded randomised controlled trial (Clinicals Trials NCT03998579 25/06/2019), aimed at evaluating the impact of an exercise intervention in primary care following robot-assisted radical cystectomy.

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Kidney function, uric acid, and risk of atrial fibrillation: experience from the AMORIS cohort.

BMC Cardiovasc Disord

October 2024

Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobelsväg 13, Stockholm, 17177, Sweden.

Background: Uric acid closely relates to both kidney disease and atrial fibrillation (AF), yet the extent to which it influences the kidney-AF association remains uncertain. We examined the relationship between kidney function and risk of AF, accounting for uric acid levels.

Methods: A total of 308,509 individuals in the Swedish Apolipoprotein-Related Mortality Risk (AMORIS) cohort were included and their serum creatinine and uric acid were measured during 1985-1996.

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Proportion of normal deliveries is decreasing worldwide. This study analysed operative vaginal deliveries (OVD) and Caesarean sections (CS) with some background factors in Estonia and Finland from 1992 to 2016. Data on all deliveries from 1992 to 2016 were obtained from the Finnish Medical Birth Registry (1 481 160 births) and the Estonian Medical Birth Registry (356 063 births).

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A machine learning tool for identifying newly diagnosed heart failure in individuals with known diabetes in primary care.

ESC Heart Fail

October 2024

Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Solna, Sweden.

Aims: We aimed to create a predictive model utilizing machine learning (ML) to identify new cases of congestive heart failure (CHF) in individuals with diabetes in primary health care (PHC) through the analysis of diagnostic data.

Methods: We used a sex- and age-matched case-control design. Cases of new CHF were identified across all outpatient care settings 2015-2022 (n = 9098).

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Article Synopsis
  • The study aimed to investigate the relationship between phase angle (PhA), a marker of hydration and nutritional status, and the development of sarcopenia in older adults.
  • It involved 696 participants aged 75 and older, assessing them for sarcopenia and related physical capabilities over 24 months using various tests and methods.
  • While lower baseline PhA was observed in those who developed sarcopenia, it was not confirmed as a significant predictor after accounting for other related factors, raising questions about its practical use as an early marker for sarcopenia risk.
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