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A cluster of multiple sclerosis cases in Lysvik in the Swedish county of Värmland.

https://arctichealth.org/en/permalink/ahliterature179821
Source
Acta Neurol Scand. 2004 Jul;110(1):14-22
Publication Type
Article
Date
Jul-2004
Author
M. Callander
A-M Landtblom
Author Affiliation
Department of Neuroscience and Locomotion, Division of Neurology, Faculty of Health Sciences, University of Linköping, Linköping, Sweden. margarita.callander@lio.se
Source
Acta Neurol Scand. 2004 Jul;110(1):14-22
Date
Jul-2004
Language
English
Publication Type
Article
Keywords
Cluster analysis
Consanguinity
Emigration and Immigration
Female
Finland - ethnology
Genetic Diseases, Inborn - epidemiology - ethnology - genetics
Genetic Predisposition to Disease - genetics
Humans
Male
Mortality
Multiple Sclerosis - epidemiology - ethnology - genetics
Pedigree
Prevalence
Sweden - epidemiology
Abstract
When surveying the county of Värmland in Sweden in order to determine the prevalence of multiple sclerosis (MS), we observed an aggregation of MS cases originating from the parish of Lysvik in the local region called Fryksdalen. Our intention was to analyse this cluster thoroughly, confirming the MS diagnosis and seeing if a hereditary or environmental background was plausible.
The medical files were studied and the cases were classified by a neurologist according to Poser's criteria. Hereditary factors were analysed.
Sixteen living cases of MS were found, either living in the parish (n = 6) or born or raised there and had later moved to another place (n = 10). All patients had clinically definite MS. Eleven patients had relatives with MS, all of these being descendants of the Suhoinen family. Another two cases were Suhoinen descendants who did not have relatives with MS. Other common ancestors were also identified. Two cases were adopted. Eleven deceased MS patients from Lysvik were found, 10 of them had Suhoinen ancestry.
We report a cluster of MS cases with a common ancestry indicating heredity for MS in 85% of the cases. Lysvik is a parish where Finnish immigration was pronounced in the 17th century and there has been inbreeding to a certain extent through marriage between cousins. Thus, we interpret this aggregation as possibly being genetically based, and neurogenetic studies are now being performed. However, as two of the cases were adopted environmental factors must also be considered.
PubMed ID
15180802 View in PubMed
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Cytokine mapping in cerebrospinal fluid and blood in multiple sclerosis patients without oligoclonal bands.

https://arctichealth.org/en/permalink/ahliterature130806
Source
Mult Scler. 2012 May;18(5):669-73
Publication Type
Article
Date
May-2012
Author
M. Vrethem
M. Kvarnström
J. Stenstam
P. Cassel
M. Gustafsson
A M Landtblom
J. Ernerudh
Author Affiliation
Department of Neurology, Division of Neuroscience, Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden. magnus.vrethem@lio.se
Source
Mult Scler. 2012 May;18(5):669-73
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Biological Markers - blood - cerebrospinal fluid
Case-Control Studies
Cells, Cultured
Chi-Square Distribution
Cytokines - blood - cerebrospinal fluid
Female
Humans
Inflammation Mediators - blood - cerebrospinal fluid
Leukocytes, Mononuclear - immunology
Male
Middle Aged
Multiple Sclerosis - blood - cerebrospinal fluid - classification - diagnosis - immunology
Oligoclonal Bands - cerebrospinal fluid
Regression Analysis
Sweden
Young Adult
Abstract
Since there are clinical and genetic differences between MS patients with intrathecal oligoclonal bands (OCB+) in the cerebrospinal fluid (CSF) compared with those without (OCB-), the aim was to find out if OCB- patients showed a different pattern of cytokine immune activation compared with OCB+ patients.
The study included 25 MS patients (10 OCB- and 15 OCB+) and 13 controls. A panel of cytokines was measured; IL-1ß, IL-6, IL-8/CXCL8, IL-10, TNF and GM-CSF in serum, CSF and in supernatants from polyclonally stimulated blood mononuclear cells, where also levels of IL-12p40, IL-13, IL-15, IL-17 and IFN-? were measured. The concentrations of soluble (s) VCAM-1 and sCD14 were measured in serum and CSF.
In general, there were no extensive differences in cytokine concentrations between the OCB- and OCB+ groups.
OCB- MS patients do not seem to constitute a separate entity concerning inflammatory parameters measured as cytokine concentrations in CSF and blood.
PubMed ID
21965416 View in PubMed
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[Did Saint Birgitta suffer from epilepsy?].

https://arctichealth.org/en/permalink/ahliterature195829
Source
Lakartidningen. 2000 Dec 20;97(51-52):6044-8
Publication Type
Article
Date
Dec-20-2000
Author
A M Landtblom
Author Affiliation
LAH-kliniken, Lasarettet i Motala, institutionen för nervsystem och rörelseorgan, sektion neurologi, Hälsouniversitetet, Linköping.
Source
Lakartidningen. 2000 Dec 20;97(51-52):6044-8
Date
Dec-20-2000
Language
Swedish
Publication Type
Article
Keywords
Cephalometry - history
Epilepsy - history
Female
History, Medieval
History, Modern 1601-
Humans
Medicine in Art
Religion and Medicine
Saints - history
Sculpture - history
Sweden
PubMed ID
11195443 View in PubMed
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Does the changing sex ratio of multiple sclerosis give opportunities for intervention?

https://arctichealth.org/en/permalink/ahliterature269046
Source
Acta Neurol Scand. 2015;132(199):42-5
Publication Type
Article
Date
2015
Author
I. Boström
A-M Landtblom
Source
Acta Neurol Scand. 2015;132(199):42-5
Date
2015
Language
English
Publication Type
Article
Keywords
Adult
Environment
Female
Humans
Male
Multiple Sclerosis - epidemiology - therapy
Sex ratio
Sweden - epidemiology
Abstract
In several international studies, an increasing women-to-men (w/m) ratio in patients with multiple sclerosis (MS) has been reported. Such sex ratios have been analysed by year of onset or by year of birth. In a Swedish study, data from the Swedish MS register (SMSreg) were used to analyse the w/m ratio in Sweden. The sex ratio was analysed both by year of birth (8834 patients) and by year of onset (9098 patients). No increased w/m ratio was seen in this study. The age-specific sex ratio did not demonstrate any significant changes. However, a new investigation of the sex ratio in Sweden, based on data from all available data sources (19,510 patients), showed a significantly increased w/m ratio of MS in Sweden from 1.70 to 2.67. Environmental factors such as cigarette smoking, hormonal factors and nutrition are of interest in this context, but the cause of the increasing w/m ratio in MS is yet not possible to explain.
PubMed ID
26046558 View in PubMed
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Further considerations on the distribution of multiple sclerosis in Sweden.

https://arctichealth.org/en/permalink/ahliterature29875
Source
Acta Neurol Scand. 2005 Apr;111(4):238-46
Publication Type
Article
Date
Apr-2005
Author
A-M Landtblom
T. Riise
J F Kurtzke
Author Affiliation
Division of Neurology, University Hospital, Linköping, Sweden. anne-marie.landtblom@lio.se
Source
Acta Neurol Scand. 2005 Apr;111(4):238-46
Date
Apr-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Child
Child, Preschool
Cross-Sectional Studies
Disabled persons - statistics & numerical data
Epidemiologic Studies
Female
Geography
Hospitals - statistics & numerical data
Humans
Infant
Infant, Newborn
Male
Middle Aged
Mortality - trends
Multiple Sclerosis - epidemiology
Prevalence
Retrospective Studies
Sweden - epidemiology
Abstract
OBJECTIVES: The geographic distribution of multiple sclerosis (MS) in Sweden over time was compared in order to analyze homogeneity. METHODS: The distribution of MS was compared among three nationwide resources: 1301 hospital cases 1925-1934; 5425 deaths 1952-1992; and 11,371 disability pension recipients 1971-1994. RESULTS: Distributions by county (lan) were markedly non-homogenous, with greatest variations in the early prevalence series (16-232% of the national mean), less within the death data (75-170%), and least for the disability series (87-128%). Maximal rates for MS in the early prevalence series were found for the cluster of seven counties surrounding the two major lakes of south central Sweden, as well as for one region on the northern shore of the Bay of Bothnia, and another also off the Bay north of Stockholm. CONCLUSION: Though the epidemiologic sources are quite different, they are internally consistent and thus provide three consecutive cross-sectional views of the distribution over time. When considered together the data may be compatible with a thesis of the origin and spread of MS within Sweden from the south-central inland lake regions of the country. Such spread within a half century is too rapid for a genetic cause, including HLA patterns.
PubMed ID
15740575 View in PubMed
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Genome-wide TDT analysis in a localized population with a high prevalence of multiple sclerosis indicates the importance of a region on chromosome 14q.

https://arctichealth.org/en/permalink/ahliterature182585
Source
Genes Immun. 2003 Dec;4(8):559-63
Publication Type
Article
Date
Dec-2003
Author
V. Giedraitis
H. Modin
M. Callander
A M Landtblom
R. Fossdal
K. Stefansson
J. Hillert
J. Gulcher
Author Affiliation
Division of Neurology, Huddinge University Hospital, Karolinska Institute, Huddinge, Sweden.
Source
Genes Immun. 2003 Dec;4(8):559-63
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Chromosomes, Human, Pair 14 - genetics
Genetic Markers - genetics
Genetic Predisposition to Disease
Genome, Human
Haplotypes - genetics
Humans
Linkage Disequilibrium
Microsatellite Repeats - genetics
Multiple Sclerosis - genetics
Pedigree
Sweden
Abstract
Epidemiological studies show that susceptibility to multiple sclerosis (MS) has a strong genetic component, but apart from the HLA gene complex, additional genetic factors have proven difficult to map in the general population. Thus, localized populations, where MS patients are assumed to be more closely related, may offer a better opportunity to identify shared chromosomal regions. We have performed a genome-wide scan with 834 microsatellite markers in a data set consisting of 54 MS patients and 114 healthy family members. A group of families from a small village were possible to track back to common ancestors living in the 17th century. We used single marker- and haplotype-based transmission disequilibrium test (TDT) analysis and nonparametric linkage analysis to analyze genotyping data. Regions on chromosomes 2q23-31, 6p24-21, 6q25-27, 14q24-32, 16p13-12 and 17q12-24 were found to be in transmission disequilibrium with MS. Strong transmission disequilibrium was detected in 14q24-32, where several dimarker haplotypes were in transmission disequilibrium in affected individuals. Several regions showed modest evidence for linkage, but linkage and TDT were both clearly positive only for 17q12-24. All patients and controls were also typed for HLA class II genes; however, no evidence for a gene-gene interaction was observed.
PubMed ID
14647195 View in PubMed
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Multiple sclerosis and exposure to solvents, ionizing radiation and animals.

https://arctichealth.org/en/permalink/ahliterature219752
Source
Scand J Work Environ Health. 1993 Dec;19(6):399-404
Publication Type
Article
Date
Dec-1993
Author
A M Landtblom
U. Flodin
M. Karlsson
S. Pålhagen
O. Axelson
B. Söderfeldt
Author Affiliation
Department of Neurology, University Hospital, Linköping, Sweden.
Source
Scand J Work Environ Health. 1993 Dec;19(6):399-404
Date
Dec-1993
Language
English
Publication Type
Article
Keywords
Adult
Animal Population Groups
Animals
Female
Humans
Male
Middle Aged
Multiple Sclerosis - etiology
Occupational Diseases - etiology
Radiation Injuries - etiology
Risk factors
Solvents - adverse effects
Sweden
Welding
Abstract
Earlier studies have indicated an association between multiple sclerosis and environmental factors, especially occupational exposure to solvents. The present study examined such relationships further. From medical files of hospitals in Kalmar and Jönköping, 91 cases of multiple sclerosis, diagnosed in 1983-1988, were identified from population registers corresponding to the catchment areas of the hospitals, and 348 referents were randomly drawn. The cases and referents answered a questionnaire concerning occupational exposure and animal contacts. The men had significantly elevated risks, determined from logistic odds ratios, for solvent exposure, occupational contact with dogs or cats, and leisure-time contact with caged birds. X-ray treatment and previous diseases were risk indicators among the women. For the men and women together, solvent exposure, radiological work, and previous diseases were associated with clearly elevated risks. Although the study concerned rather few subjects, the findings indicate that several exogenous factors might contribute to the development of multiple sclerosis.
Notes
Comment In: Scand J Work Environ Health. 1995 Apr;21(2):1507618061
PubMed ID
8153592 View in PubMed
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Multiple sclerosis in nurse anaesthetists.

https://arctichealth.org/en/permalink/ahliterature71471
Source
Occup Environ Med. 2003 Jan;60(1):66-8
Publication Type
Article
Date
Jan-2003
Author
U. Flodin
A-M Landtblom
O. Axelson
Author Affiliation
Division of Occupational and Environmental Medicine, Department of Health and Environment, Linköping University, S-581 85 Linköping, Sweden. ulf.flodin@lio.se
Source
Occup Environ Med. 2003 Jan;60(1):66-8
Date
Jan-2003
Language
English
Publication Type
Article
Keywords
Adult
Anesthetics - adverse effects
Female
Humans
Middle Aged
Multiple Sclerosis - chemically induced
Nurse Anesthetists
Occupational Diseases - chemically induced
Occupational Exposure - adverse effects
Risk assessment
Abstract
BACKGROUND: Volatile anaesthetics are chemically related to organic solvents used in industry. Exposure to industrial solvents may increase the incidence of multiple sclerosis (MS). AIM: To examine the risk among nurse anaesthetists of contracting MS. METHODS: Nurses with MS were identified by an appeal in the monthly magazine of the Swedish Nurse Union and a magazine of the Neurological Patients Association in Sweden. Ninety nurses with MS responded and contacted our clinic. They were given a questionnaire, which was filled in by 85 subjects; 13 of these were nurse anaesthetists. The questionnaire requested information about work tasks, exposure, diagnosis, symptoms, and year. The number of active nurse anaesthetists was estimated based on information from the National Board of Health and Welfare and The Nurse Union. Incidence data for women in the region of Gothenburg and Denmark were used as the reference to estimate the risk by calculation of the standardised incidence ratio (SIR). RESULTS: Eleven of the 13 nurse anaesthetists were exposed to anaesthetic gases before onset of MS. Mean duration of exposure before diagnosis was 14.4 years (range 4-27 years). Ten cases were diagnosed in the study period 1980-99, resulting in significantly increased SIRs of 2.9 and 2.8 with the Gothenburg and the Danish reference data, respectively. CONCLUSION: Although based on crude data and a somewhat approximate analysis, this study provides preliminary evidence for an excess risk of MS in nurse anaesthetists. The risk may be even greater than observed, as the case ascertainment might have been incomplete because of the crude method applied. Further studies in this respect are clearly required to more definitely assess the risk.
PubMed ID
12499460 View in PubMed
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Organic solvents and multiple sclerosis: a synthesis of the current evidence.

https://arctichealth.org/en/permalink/ahliterature211603
Source
Epidemiology. 1996 Jul;7(4):429-33
Publication Type
Article
Date
Jul-1996
Author
A M Landtblom
U. Flodin
B. Söderfeldt
C. Wolfson
O. Axelson
Author Affiliation
Department of Clinical Neuroscience, University Hospital, Linköping, Sweden.
Source
Epidemiology. 1996 Jul;7(4):429-33
Date
Jul-1996
Language
English
Publication Type
Article
Keywords
Case-Control Studies
Cross-Sectional Studies
Humans
Meta-Analysis as Topic
Multiple Sclerosis - chemically induced - epidemiology
Prevalence
Retrospective Studies
Risk factors
Solvents - adverse effects
Sweden - epidemiology
Abstract
To evaluate the possible relation between exposure to organic solvents and the development of multiple sclerosis, we carried out a best-evidence synthesis of the available information. We found 13 studies with varying methodology that included information on solvent exposure. In 10 of the studies, there were indications of an increased risk of multiple sclerosis in relation to solvent exposure. We made three selections of studies for both pooled analyses and meta-analyses. The relative risk point estimates that we obtained varied from 1.7 to 2.6. Our evaluation is consistent with the hypothesis that organic solvents may be a cause of multiple sclerosis.
PubMed ID
8793371 View in PubMed
Less detail

Patterns of antiepileptic drug prescription in Sweden: A register-based approach.

https://arctichealth.org/en/permalink/ahliterature291612
Source
Acta Neurol Scand. 2017 Nov; 136(5):521-527
Publication Type
Journal Article
Date
Nov-2017
Author
K Bolin
F Berggren
P Berling
S Morberg
H Gauffin
A-M Landtblom
Author Affiliation
Department of Economics, University of Gothenburg, Gothenburg, Sweden.
Source
Acta Neurol Scand. 2017 Nov; 136(5):521-527
Date
Nov-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Anticonvulsants - administration & dosage - therapeutic use
Carbamazepine - administration & dosage - therapeutic use
Drug Prescriptions - statistics & numerical data
Epilepsy - drug therapy
Female
Humans
Male
Middle Aged
Registries
Sweden
Triazines - administration & dosage - therapeutic use
Valproic Acid - administration & dosage - therapeutic use
Abstract
To determine drug utilization pathways from the incident healthcare visit due to epilepsy and three years onward.
Anti-epileptic drug utilization was calculated using individual information on inpatient- and outpatient care utilization and drug sales. Throughout, we used national register information pertaining to pharmaceutical sales linked to diagnosis-related healthcare utilization. Information on pharmaceutical sales was collected for the 2007-2013 period.
For the entire studied period, a majority of new patients with epilepsy were initiated on anti-epileptic drug treatment with a monotherapy (98%); most of these patients remained on that first treatment (64%). The three most frequently prescribed drugs accounted for 72% of the initiated AED treatments. Patients with epilepsy (ICD-10: G40/41) were most commonly prescribed carbamazepine, lamotrigine and valproate. The most common second-line monotherapy was levetiracetam. About 12% of new patients with epilepsy who were initiated on AED treatment during the period eventually switched to an add-on therapy. The proportion of patients who were initiated on treatment with carbamazepine or valproate decreased, and the proportion of patients who remained on their initial monotherapy increased between 2007 and 2013.
A limited number of anti-epileptic drugs accounted for the treatment of a majority of new patients with epilepsy (carbamazepine, lamotrigine and valproate accounted for more than 70%). Add-on therapies showed the same pattern, as the most frequently prescribed add-on regimens were the same ones that accounted for most of the monotherapies. There was a tendency towards fewer patients being initiated on AED treatment with either carbamazepine or valproate.
PubMed ID
28585316 View in PubMed
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19 records – page 1 of 2.