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1,045 results on '"Granath, Fredrik"'

20. Surgical strategy in lithium‐associated hyperparathyroidism: A population‐based study.

Author

Nilsson, I.‐L., Thorsteinsson, D., Nylén, C., Koman, A., Granath, Fredrik, and Bränström, R.

Subjects
THERAPEUTIC use of lithium, HYPERPARATHYROIDISM, REGRESSION analysis, LITHIUM carbonate, OPERATIVE surgery, DESCRIPTIVE statistics
Abstract

Background: The extent of parathyroidectomy (PTX) recommendation in patients with lithium‐associated hyperparathyroidism (LAH) remains controversial. The primary objectives of this study were to analyze extent of surgery, complications, and long‐term outcomes. Methods: A population‐based study, including all primary hyperparathyroidism (PHPT) patients who underwent PTX in Sweden between 2008 and 2017. Data on exhibited lithium prescriptions, morbidity, surgical approach, and outcomes were collected from relevant national registers and the Scandinavian Quality Register of Thyroid, Parathyroid, and Adrenal Surgery. Patients with lithium exposure before PTX were defined as having LAH. Descriptive summary statistics and regression models were used to evaluate differences in comorbidities, surgical approach, and outcomes between LAH and PHPT not exposed to lithium (non‐LAH). Results: Lithium exposure was significantly more common among PHPT (n = 202, 2.3%) than in controls (n = 416, 0.5%); OR 5.0 (95% CI 4.2–5.9). The risk of LAH correlated to the length of lithium exposure. In the LAH‐group, the surgical procedures were more extensive and associated with a higher risk of postoperative bleeding, wound infections, persistent hypercalcemia, and hypocalcemia that remained after adjustment for the higher percentage of multiglandular disease. However, the cumulative risk of re‐admission for PHPT was similar the first years after PTX and primarily elevated for patients with >5 years duration of lithium exposure prior to surgery. Conclusions: The findings support the perception of LAH as a complex entity. We recommend a functionally oriented approach, aimed to obtain and maintain normocalcemia for as long as possible, minimizing the risk of permanent hypoparathyroidism, and accepting some risk of recurrence. [ABSTRACT FROM AUTHOR]

Published
2024
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27. Nosocomial SARS-CoV-2 Infections and Mortality During Unique COVID-19 Epidemic Waves

Author

Epi Infectieziekten, Dave, Nishi, Sjöholm, Daniel, Hedberg, Pontus, Ternhag, Anders, Granath, Fredrik, Verberk, Janneke D M, Johansson, Anders F, van der Werff, Suzanne D, Nauclér, Pontus, Epi Infectieziekten, Dave, Nishi, Sjöholm, Daniel, Hedberg, Pontus, Ternhag, Anders, Granath, Fredrik, Verberk, Janneke D M, Johansson, Anders F, van der Werff, Suzanne D, and Nauclér, Pontus

Published
2023

39. Reply

Author

Remaeus, Katarina, primary, Johansson, Kari, additional, Granath, Fredrik, additional, Stephansson, Olof, additional, and Hellgren, Karin, additional

Published
2022
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42. Risk of pre-eclampsia and impact of disease activity and antirheumatic treatment in women with rheumatoid arthritis, axial spondylarthritis and psoriatic arthritis:a collaborative matched cohort study from Sweden and Denmark

Author

Secher, Anne Emilie Pape, Granath, Fredrik, Glintborg, Bente, Rom, Ane, Hetland, Merete Lund, Hellgren, Karin, Secher, Anne Emilie Pape, Granath, Fredrik, Glintborg, Bente, Rom, Ane, Hetland, Merete Lund, and Hellgren, Karin

Abstract

Objective To explore the risk of pre-eclampsia in rheumatoid arthritis (RA), axial spondyloarthritis (AxSpA) and psoriatic arthritis (PsA), focusing on the impact of treatment and disease activity. Methods We identified RA, AxSpA and PsA singleton pregnancies (2006-2018) by linking medical birth registers to Swedish (SRQ) and Danish (DANBIO) rheumatology registers. Control pregnancies from the medical birth registers were matched 1:10 on maternal age, parity and birth year. We obtained information on antirheumatic treatment before and during pregnancy and disease activity during pregnancy. Risks of pre-eclampsia in RA, AxSpA and PsA pregnancies, compared with control pregnancies, were estimated overall and by antirheumatic treatment (conventional synthetic disease-modifying antirheumatic drug (DMARD)/biological DMARD/corticosteroids, as monotherapy or combination therapy) and disease load (Health Assessment Questionnaire≥1/C-reactive protein≥10/Disease Activity Score in 28 joints≥3.2) through logistic regression (adjusted ORs (aORs) with 95% CI). Results We observed 69, 34, and 26 pre-eclampsia events among RA (n=1739), AxSpA (n=819) and PsA (n=489), resulting in a risk of pre-eclampsia of, respectively, aOR 1.27 (95% CI 0.96 to 1.67), 1.17 (0.76 to 1.78) and 1.85 (1.10 to 3.12), compared with controls. For RA, maternal combination therapy before and during pregnancy was associated with increased risk (1.59; 1.07 to 2.37 and 1.53; 0.97 to 2.39, respectively). For PsA, maternal monotherapy before pregnancy was associated with pre-eclampsia (2.72; 1.4 to 5.13). In RA pregnancies with available information (43%), high disease load was associated with doubled risk of pre-eclampsia (aOR 1.96; 1.26 to 3.04). Conclusion PsA pregnancies, but not AxSpA pregnancies, were at increased risk of pre-eclampsia. For RA, combination therapy (potentially a surrogate for high disease activity both before and during pregnancy) and high disease load during pregnancy might be a risk f

Published
2022

43. Pregnancy outcomes in relation to disease activity and anti-rheumatic treatment strategies in women with rheumatoid arthritis:a matched cohort study from Sweden and Denmark

Author

Hellgren, Karin, Secher, Anne Emilie, Glintborg, Bente, Rom, Ane Lilleøre, Gudbjornsson, Bjorn, Michelsen, Brigitte, Granath, Fredrik, Hetland, Merete Lund, Hellgren, Karin, Secher, Anne Emilie, Glintborg, Bente, Rom, Ane Lilleøre, Gudbjornsson, Bjorn, Michelsen, Brigitte, Granath, Fredrik, and Hetland, Merete Lund

Abstract

OBJECTIVES: To explore the association of maternal RA to pregnancy outcomes, especially preterm birth (PTB) and small for gestational age (SGA), in relation to disease activity and anti-rheumatic treatment before and during pregnancy. METHODS: By linking prospective clinical rheumatology registers (CRR) in Sweden (the Swedish Rheumatology Quality Register, SRQ) and Denmark (the Danish clinical quality register, DANBIO) with medical birth registers, we identified 1739 RA-pregnancies and 17 390 control-pregnancies (matched 1:10 on maternal age, birth year, parity) with delivery 2006-18. Disease activity (DAS28, CRP, HAQ score) and anti-rheumatic treatment 9 months before and during pregnancy were identified through CRR and prescribed drug registers. Using logistic regression, we estimated adjusted odds ratios (aOR) with 95% CI for PTB and SGA overall and stratified by disease activity and anti-rheumatic treatment before and during pregnancy, adjusting for maternal characteristics. RESULTS: We found increased aOR of PTB [1.92 (1.56-2.35)] and SGA [1.93 (1.45-2.57)] in RA-pregnancies vs control-pregnancies. For RA-pregnancies with DAS28-CRP ≥4.1 vs <3.2 during pregnancy, aOR was 3.38 (1.52-7.55) for PTB and 3.90 (1.46-10.4) for SGA. Use of oral CS (yes/no) during pregnancy resulted in an aOR of 2.11 (0.94-4.74) for PTB. The corresponding figure for biologics was 1.38 (0.66-2.89). Combination therapy, including biologics before pregnancy, was a marker of increased risk of both PTB and SGA. CONCLUSION: During pregnancy, disease activity rather than treatment seems to be the most important risk factor for PTB and SGA in RA. Women with RA should be carefully monitored during pregnancy, especially if they have moderate to high disease activity or/and are treated with extensive anti-rheumatic treatment.

Published
2022

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