Search

Your search keyword '"Posserud, Iris"' showing total 33 results
Start Over Author "Posserud, Iris"

Refine your results

more »

more »

more »

more »
33 results on '"Posserud, Iris"'

2. Morbidity, risk of cancer and mortality in 3645 HFE mutations carriers

Author

Hagström, Hannes, Ndegwa, Nelson, Jalmeus, Molly, Ekstedt, Mattias, Posserud, Iris, Rorsman, Fredrik, Nyhlin, Nils, Klintman, Daniel, Werner, Mårten, Marschall, Hanns-Ulrich, Askling, Johan, Stål, Per, Hagström, Hannes, Ndegwa, Nelson, Jalmeus, Molly, Ekstedt, Mattias, Posserud, Iris, Rorsman, Fredrik, Nyhlin, Nils, Klintman, Daniel, Werner, Mårten, Marschall, Hanns-Ulrich, Askling, Johan, and Stål, Per

Abstract

Background & Aims Mutations in the HFE gene can lead to hereditary haemochromatosis (HH) and have been suggested to increase the risk of extra-hepatic diseases, especially breast and colorectal cancer. Here we investigated long-term outcomes of Swedish patients with HFE mutations. Methods We identified 3645 patients with a homozygous p.C282Y (62%) or a compound heterozygous p.C282Y/p.H63D (38%) mutation from eight centres in Sweden between 1997 and 2017. These were matched 1:10 by age, sex and county of residence to reference individuals from the general population. We ascertained incident outcomes until the end of 2017 by linkage to national registers. Studied outcomes were HH, cirrhosis, hepatocellular carcinoma (HCC), breast cancer (in women), colorectal cancer, type 1 and 2 diabetes, hypothyroidism, Parkinson's disease and mortality. Cox proportional hazards regression was used to estimate hazard ratios for these outcomes. Results Median age at diagnosis was 52 years, 44% were females. During a mean follow-up of 7.9 years, we found an increased risk for HCC, HH, cirrhosis, type 2 diabetes, osteoarthritis and death. Excess mortality was only seen in men. No increased risk was seen for colorectal or breast cancer. Liver-related outcomes were rare, with a cumulative incidence of HFE mutation carriers in a university hospital setting had an increased risk for mortality in men, along with increased risks of cirrhosis, HCC, diabetes type 2, and osteoarthritis. In general, the absolute risk for adverse outcomes was low and no increased risk for colon or breast cancer was observed.

Published
2021
Full Text
View/download PDF

9. Peripheral and central factors in the pathophysiology of irritable bowel syndrome

Author

Posserud, Iris

Subjects
stress, visceral perception, gastrointestinal symptoms, rectal barostat, hypervigilance, visceral hypersensitivity, selective attention, small intestinal bacterial overgrowth, small bowel motility, rectal perception, gastrointestinal dysmotility, irritable bowel syndrome (IBS)
Abstract

Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder characterized by abdominal pain and/or discomfort together with abnormal bowel habits. The pathophysiology is complex and incompletely understood. Potential important factors are altered brain-gut interactions, visceral hypersensitivity, psychosocial factors, disturbed GI motility, inflammatory changes, and bacterial overgrowth. Our aim was to investigate some of the different pathophysiological factors in IBS. Altered rectal perception was found in 62% of IBS patients. These subjects more frequently reported moderate or severe abdominal pain, bloating, diarrhea, satiety, and anxiety. Symptoms of abdominal pain and bloating were associated with altered rectal perception in a multivariate analysis. Moderate or severe symptoms overall were also associated with female gender and anxiety. Stress decreased visceral sensory thresholds in controls, probably due to distraction. In IBS patients, sensory thresholds remained stable during stress, indicating a disability to suppress signals from the bowel during stress in these patients. Compared with controls, IBS patients had altered neuroendocrine hormones both in the basal state and in response to stress. In an experimental setting, investigation of memory and attention showed that compared with patients with organic GI disease, IBS patients were faster at identifying words, especially words representing GI symptoms and negative affects. There were no group differences regarding levels of anxiety or depression, but in IBS patients these levels were correlated with memory processing of GI words. Small intestinal bacterial overgrowth investigated with proximal jejunal cultures, was present in 4% of IBS subjects, which was not different from healthy controls. However, mildly elevated counts of bacteria were more common in IBS patients than in controls. Patients with bacterial overgrowth tended to have fewer phase IIIs, and enteric dysmotility was twice as common in these subjects. There was no relation between mildly elevated counts of bacteria and small bowel motility. Conclusions: The pathophysiology of IBS is complex and multifactorial. Altered visceral perception is associated with symptom severity, and stress induces an altered visceral and neuroendocrine response in IBS patients, which could explain why stress is sometimes associated with the onset and worsening of symptoms. IBS patients seem to be hypervigilant regarding GI symptoms through memory processing connected to psychological state. Small intestinal bacterial overgrowth is not common in IBS, but of uncertain relevance, a proportion of IBS patients have elevated counts of bacteria in the proximal jejunum.

Published
2007

Catalog

Books, media, physical & digital resources
See catalog results