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Tapering of prescribed opioids in patients with long-term non-malignant pain (TOPIO)-efficacy and effects on pain, pain cognitions, and quality of life : a study protocol for a randomized controlled clinical trial with a 12-month follow-up

BACKGROUND: Opioids are still widely prescribed to long-term pain patients although they are no longer recommended for long-term treatments due to poor evidence for long-term efficacy, risks of serious side effects, and the possibility of inducing opioid hyperalgesia. In a Cochrane study from 2017, the authors identified an urgent need for more randomized controlled trials investigating the effici

Association of germline genetic variants with breast cancer-specific survival in patient subgroups defined by clinic-pathological variables related to tumor biology and type of systemic treatment

BACKGROUND: Given the high heterogeneity among breast tumors, associations between common germline genetic variants and survival that may exist within specific subgroups could go undetected in an unstratified set of breast cancer patients. METHODS: We performed genome-wide association analyses within 15 subgroups of breast cancer patients based on prognostic factors, including hormone receptors, t

Patterns of Lifetime Criminality in Mentally Disordered Offenders – Findings From a Nationally Representative Cohort

Background: Treatment of mentally disordered offenders (MDOs) is challenging as their behavior and clinical conditions can be traced to a complex constellation of major mental disorders, substance use and antisocial lifestyle. Finding subgroups of these offenders, which could guide treatment and risk assessment, is desirable. There are few long-term, prospective studies of risk factors for persist

Development of MRI-defined structural tissue damage after anterior cruciate ligament injury over 5 Years : The KANON Study

Background: MRI is used to evaluate structural joint changes after anterior cruciate ligament (ACL) injury, but no long-term data are available for comparing different treatment approaches. Purpose: To describe structural joint damage with MRI over a 5-year period in the Knee Anterior Cruciate Ligament, Nonsurgical versus Surgical Treatment (KANON) study and to compare frequencies of such tissue d

Second Primary Cancers After Kidney Cancers, and Kidney Cancers as Second Primary Cancers

Background: Second primary cancers (SPCs) are increasing due to improving survival in first primary cancers. Previous studies on SPCs in renal cell carcinoma (RCC) have focused on treatment and other risk factors, but data of RCC as an SPC are scarce. Objective: In this study, we want to elucidate the risk for any SPC after RCC, and in reverse order, for RCC as an SPC after any cancer. We addition

Copeptin as a predictive marker of incident heart failure

AIMS: Heart failure (HF) is a common disease with increasing prevalence and poor prognosis. The vasopressin (VP) marker copeptin predicts development of diabetes mellitus, diabetic heart disease, coronary artery disease, and premature mortality. Copeptin is elevated in HF patients and predicts a worse outcome. This study aims to investigate whether copeptin can predict HF development.METHODS: Cope

Perspectives on a Way Forward to Implementation of Precision Medicine in Patients With Diabetic Kidney Disease; Results of a Stakeholder Consensus-Building Meeting

Aim: This study aimed to identify from different stakeholders the benefits and obstacles of implementing precision medicine in diabetic kidney disease (DKD) and to build consensus about a way forward in order to treat, prevent, or even reverse this disease. Methods: As part of an ongoing effort of moving implementation of precision medicine in DKD forward, a two-day consensus-building meeting was

Who benefits from multimodal rehabilitation – an exploration of pain, psychological distress, and life impacts in over 35,000 chronic pain patients identified in the swedish quality registry for pain rehabilitation

Background: Chronic pain patients frequently suffer from psychological symptoms. There is no consensus concerning the prevalence of severe anxiety and depressive symptoms and the strength of the associations between pain intensity and psychological distress. Although an important aspect of the clinical picture is understanding how the pain condition impacts life, little is known about the relative

Association of Short-Term Mortality of Venous Thromboembolism with Family History of Venous Thromboembolism and Charlson Comorbidity Index

Studies on short-term prognosis of venous thromboembolism (VTE) that take family history of VTE and Charlson Comorbidity Index (CCI) into account are sparse. The aim was to investigate the importance of family history of VTE and CCI for short-term mortality after a first episode of VTE. Using Swedish medical databases, we conducted a 90-day nationwide cohort study of 41,700 Swedish born patients w

Microbial Preparations (Probiotics) for the Prevention of Clostridium difficile Infection in Adults and Children : An Individual Patient Data Meta-analysis of 6,851 Participants

OBJECTIVE: To determine whether probiotic prophylaxes reduce the odds of Clostridium difficile infection (CDI) in adults and children. DESIGN: Individual participant data (IPD) meta-analysis of randomized controlled trials (RCTs), adjusting for risk factors. METHODS: We searched 6 databases and 11 grey literature sources from inception to April 2016. We identified 32 RCTs (n=8,713); among them, 18

Inter-rater agreement of the Quality of Life-Alzheimer's Disease (QoL-AD) self-rating and proxy rating scale : Secondary analysis of RightTimePlaceCare data

Background: To assess the quality of life of people with dementia, measures are required for self-rating by the person with dementia, and for proxy rating by others. The Quality of Life in Alzheimer's Disease scale (QoL-AD) is available in two versions, QoL-AD-SR (self-rating) and QoL-AD-PR (proxy rating). The aim of our study was to analyse the inter-rater agreement between self- and proxy rating

Impact of heart failure and other comorbidities on mortality in patients with chronic obstructive pulmonary disease : A register-based, prospective cohort study

Background: Multimorbidity has already become common in primary care and will be a challenge in the future. Primary care in Sweden participates to a great extent in the care of patients with two severe, chronic conditions: chronic obstructive pulmonary disease (COPD) and heart failure. Both conditions are characterized by high mortality and often coexist. Age, sex, heart failure and other comorbid

Deep learning for segmentation of 49 selected bones in CT scans : First step in automated PET/CT-based 3D quantification of skeletal metastases

Purpose: The aim of this study was to develop a deep learning-based method for segmentation of bones in CT scans and test its accuracy compared to manual delineation, as a first step in the creation of an automated PET/CT-based method for quantifying skeletal tumour burden. Methods: Convolutional neural networks (CNNs) were trained to segment 49 bones using manual segmentations from 100 CT scans.

Long-term exposure to air pollution and road traffic noise in relation to dispensed antidepressant medications : A Swedish cohort study

Background: The impact of air pollution and road traffic noise on depression remains inconclusive. This study examined long-term residential exposure to air pollutants and road traffic noise in relation to dispensed antidepressant medications. Methods: A cohort study was conducted using the Swedish Malmö Diet and Cancer Study, with the outcome defined as a first dispensed antidepressant (ATC: N06A

Asthma and extrapulmonary comorbidities in a middle-aged general population : results from the SCAPIS study

Introduction Asthma may increase the risk of comorbidities and systemic inflammation, but population data are scarce. This study aimed to compare comorbidities and systemic inflammation between those with and without current asthma and to identify characteristics linked to comorbidities and biomarkers. Methods In a cross-sectional analysis of 28 828 people aged 50–64 in the Swedish CArdioPulmonary

Patterns of sex-specific and age-specific risk indicators of suicide : a population-nested case-control study

Background Suicide is more common among males and in older age, but the understanding of sex-specific and age-specific risk indicators is limited. Objective To describe the sex-specific and age-specific prevalence of 25 suicide risk indicators in the year preceding suicide and estimate their associations with suicide. Methods Register-based population-nested case-control study in Sweden, 2009–2021

Human papillomavirus-related squamous cell carcinomas after blood or marrow transplantation - a Blood or Marrow Transplant Survivor Study report

Background Human papillomavirus (HPV) is associated with an increased risk for a variety of squamous cell carcinomas in the general population. The risk for subsequent squamous cell carcinomas in blood or marrow transplantation survivors that are potentially related to HPV (cervical, oropharyngeal, vulvar, vaginal, anal, and penile cancer; HPV-related squamous cell carcinomas) remains unknown. Met

Common Designs of Custom-Made Fenestrated Arch Devices and Applicability of an Off-the-Shelf Design

Objectives: To analyze device designs, similarities and overlaps of custom-made fenestrated arch endografts intended for mid/distal arch thoracic endovascular aortic repair. Materials and Methods: A multicenter cross-sectional study analyzing custom-made anonymized graft plans was performed. Graft plans were included from a cohort of mid/distal aortic arch repairs using custom-made fenestrated aor

Multiple System Atrophy Without Dysautonomia : An Autopsy-Confirmed Study

BACKGROUND AND OBJECTIVES: Multiple system atrophy (MSA) is a neurodegenerative disorder characterized by 3 core symptom complexes: parkinsonism, cerebellar syndrome, and dysautonomia. Recent Movement Disorder Society (MDS) criteria allow for the clinical diagnosis of MSA based solely on motor symptoms, without requiring dysautonomia. This study aimed to evaluate the frequency and disease trajecto

Associations of intraoperative end-tidal CO2 levels with postoperative outcome-secondary analysis of a worldwide observational study

BACKGROUND: Patients receiving intraoperative ventilation during general anesthesia often have low end-tidal CO2 (etCO2). We examined the association of intraoperative etCO2 levels with the occurrence of postoperative pulmonary complications (PPCs) in a conveniently-sized international, prospective study named 'Local ASsessment of Ventilatory management during General Anesthesia for Surgery' (LAS