Drugresistance in parascaris equorum

Litteraturstudien sammanfattar rapporter om sviktande behandlingsresultat efter behandling med avmaskningsmedel mot Parascaris equorum, hästens spolmask. De olika substanserna med indikation spolmask på häst, som är godkända för behandling i Sverige jämförs. Vidare belyses alternativa metoder för att hålla smittrycket av hästens spolmask nere. Gällande avmasknings och beteshygiensrekommendationer i Sverige jämförs med hur detta genomförs ute i landet. Studien visar på att kunskap om de faktorer som påverkar resistensutveckling och spolmaskens livscykel är av yttersta vikt för att det skall vara möjligt att förvalta den resurs som läkemedlen är på bästa sätt. Förekomst av läkemedelsresistens påvisas, framförallt mot ivermektin, hos hästens spolmask baserat på studier från USA, Canada och Europa

Kongenital intestinal lymfangiektasi hos hund

Intestinal lymfangiektasi (IL) är en ovanlig gastrointestinal sjukdom som karaktäriseras av patologisk dilatation av tarmens lymfkärl. Sjukdomen drabbar både hundar och människor men behandlingen divergerar inom human- respektive veterinärmedicinen. Etiologin är ännu inte fullständigt belyst. Sannolikt finns ärftliga komponenter och gener essentiella för lymfangiogenes har isolerats. Patogenesen är relativt väl undersökt och behandlingen syftar till att reducera förlusten av plasmaproteiner. Det centrala i behandlingen är att minimera mängden triglycerider med långa fettsyror (LCT) i dieten, då absorption av dessa stimulerar det intestinala lymfflödet. Dieten bör även kompensera för förluster av protein, energi och vitaminer genom hög näringstäthet och rikligt med högvärdigt protein. Immunosupprimerande läkemedel har länge varit en del av behandlingen, inom veterinärmedicinen, trots att IL i många fall helt saknar inflammatoriska inslag och att bieffekterna av dessa preparat är kontraproduktiva vid IL. Ett antal hundar svarar bra på behandling med kortikosteroider. Supplementering med triglycerider bestående av medellånga fettsyror (MCT-olja) är omdiskuterat och både oljans smaklighet och absorption har ifrågasatts. I denna mastersuppsats har en litteraturstudie, en journalstudie och ett smaktest av MCT-olja gjorts. Resultatet visar att MCT-olja, i motsatts till tidigare påståenden, accepteras väl av hundar. Sammanställningen av tidigare studier visar att absorptionen av MCT-olja är komplex. Utöver fettsyrornas längd spelar även triglyceridmolekylens interna struktur, mängden MCT samt mängden övrigt fett in i absorptionen av MCT. Trots att en liten andel absorberas via lymfkärlen kan supplementering med MCT vara av nytta i fall med hundar som inte klarar att hålla vikten på endast fettreducerad diet.Intestinal lymphangiectasia (IL) is a rare gastrointestinal disease that is characterized by marked dilatation of the intestinal lymphatic network. The disease affects both dogs and humans but the treatment differs between humans and dogs. Genetics of IL is not yet fully understood, heritability is likely and some genes essential for lymphangiogenesis have been isolated. The pathogenesis is relatively well studied. The treatment aim is to reduce the loss of plasma proteins. The essential of treatment is to minimize the amount of triglycerides with long chain fatty acids (LCT) in the diet since absorption of these stimulate the intestinal lymph and subsequent protein loss. The diet must also compensate for the loss of protein, energy and vitamins by having a high nutrient density and contain plenty of high-quality protein. Immunosuppressive drugs have long been a part of the treatment in veterinary medicine, although IL in many cases lacks an inflammatory component and the side effects of these drugs are counterproductive in IL. Some, but not all dogs respond to medical treatment in the form of corticosteroids. Supplementation with medium chain triglyceride (MCT-oil) is controversial and both oil palatability and absorption has been questioned. This master thesis includes a case report, study and a palatability test of MCT-oil. The results show that MCT-oil, in contrast to previous claims, is well accepted by dogs. A review of earlier studies shows that the absorption of MCT-oil is complex. In addition to the length of the fatty acids, the internal structure of the triglyceride molecule, the amount of MCT and the total fat content in the diet plays a role in the absorption of MCT. Although a small percentage is absorbed by 2 the lymphatic vessels supplementation with MCT can be of benefit in cases of dogs who cannot manage to keep the weight of only fat-reduced diet

Life events as predictors for disability pension due to musculoskeletal diagnoses : a cohort study of Finnish twins

Purpose Musculoskeletal diagnoses (MSD) are one of the largest diagnostic groups for disability pensions (DP). This study investigated the associations between life events and DP due to MSD, considering sociodemographic, health, and familial factors. Methods The study sample included 18,530 Finnish twins, 24-64 years old at baseline, who responded to a questionnaire in 1981 including a 21-item life event inventory. Information on DP with diagnosis codes (ICD codes: M00-M99) were obtained from the official national pension registers. Life events were divided into family- and work-related events. "Positive change in life" was analyzed separately. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI). Results During the follow-up of 23 years, 1273 (7%) individuals were granted DP due to MSD. In discordant pair analysis, family-related events (>= 4 events) increased (HR 1.63, 95% CI 1.31, 2.03) and the absence of such events decreased (HR 0.68, 95% CI 0.48, 0.95) the risk of DP due to MSD. For work-related events (>= 3 events), the risk estimates were non-significant when controlling for familial factors. Having had a positive change in life decreased the risk of DP due to MSD (HR 0.79, 95% CI 0.65, 0.96) while controlling for familial confounding, but were non-significant in the full model controlling for various covariates (HR 0.91, 95% CI 0.75, 1.12). Conclusions The associations between life events and the risk of DP due to MSD are complex and potentially affected by familial and other confounding factors including sociodemographics and health.Peer reviewe

The role of familial confounding in the associations of physical activity, smoking and alcohol consumption with early exit from the labour market

We investigated the associations between health behaviors and sustainable working life outcomes including allcause disability pension, disability pensions due to musculoskeletal and mental diagnoses and unemployment. The role of familial factors behind these associations was studied by analysing discordant twin pairs. Our data included Swedish twins born in 1925-1986 (51891 twin individuals). Baseline data based on two independent surveys in 1998-2003 and 2005-2006 for health behaviors were linked to national registers on disability pension and unemployment until 2016. Cox proportional hazards models for hazard ratios (HR) with 95% confidence intervals (CI) were estimated for the whole sample adjusting for covariates. Analyses of health behavior discordant twin pairs (n = 5903 pairs) were conducted using conditional Cox models. In the whole cohort, the combination of healthy behaviors was associated with lower risk for all-cause disability pension, disability pension due to musculoskeletal diagnoses or mental diagnoses, and for unemployment (HRs 0.56-0.86, 95% CIs 0.51-0.92) as did being physically active (HRs 0.69-0.87, 95% CI 0.65-0.92). The discordant pair analyses confirmed the lower risk among those having healthy behaviors (HR 0.70-0.86) or being physically active (HR 0.86-0.87) for all-cause disability pension, disability pension due to musculoskeletal diagnoses, and for unemployment. To conclude, controlling the effects of covariates or familial confounding (i.e. discordant twin pair analyses) shows that being physically active or having several healthy behaviors predict better working life outcomes. This points towards independent association between healthy behavior and longer working life.Peer reviewe

Sustainable Working Life in a Swedish Twin Cohort—A Definition Paper with Sample Overview

Background: A unified or consensus definition of “sustainable working life” remains lacking, although studies investigating risk factors for labour market exit are numerous. In this study, we aimed (1) to update the information and to explore a definition of “sustainable working life” via a systematic literature review and (2) to describe the working life trajectories via the prevalence of sickness absence (SA), disability pension (DP), and unemployment in a Swedish twin cohort to provide a sample overview in our Sustainable Working Life-project. Methods: A systematic literature review was conducted to explore the studies with the search phrase “sustainable working life” in PubMed, PsycInfo, and the Web of Science Database of Social Sciences in January 2021, resulting in a total of 51 references. A qualitative synthesis was performed for the definitions and the measures of “sustainable working life.” Based on the Swedish Twin project Of Disability pension and Sickness absence (STODS), the current dataset to address sustainable working life includes 108 280 twin individuals born between 1925 and 1990. Comprehensive register data until 2016 for unemployment, SA and DP were linked to all individuals. Using STODS, we analysed the annual prevalence of SA, DP, and unemployment as working life trajectories over time across education and age groups. Results: The reviewed 16 full articles described several distinct definitions for sustainable working life between 2007 and 2020 from various perspectives, i.e., considering workplaces or employees, the individual, organizational or enterprise level, and the society level. The definition of “sustainable working life” appearing most often was the swAge-model including a broad range of factors, e.g., health, physical/mental/psychosocial work environment, work motivation/satisfaction, and the family situation and leisure activities. Our dataset comprised of 81%–94% of individuals who did not meet SA, DP, or unemployment during the follow-up in 1994–2016, being indicative for “sustainable working life.” The annual prevalence across years had a decreasing trend of unemployment over time, whereas the prevalence of SA had more variation, with DP being rather stable. Both unemployment and DP had the highest prevalence among those with a lower level of education, whereas in SA, the differences in prevalence between education levels were minor. Unemployment was highest across the years in the youngest age group (18–27 years), the age group differences for SA were minor, and for DP, the oldest age group (58–65 years) had the highest prevalence. Conclusions: No consensus exists for a “sustainable working life,” hence meriting further studies, and we intend to contribute by utilising the STODS database for the Sustainable Working Life project. In the upcoming studies, the existing knowledge of available definitions and frameworks will be utilised. The dataset containing both register data and self-reports enables detailed follow-up for labour market participation for sustainable working life

Sustainable Working Life in a Swedish Twin Cohort—A Definition Paper with Sample Overview

Background: A unified or consensus definition of “sustainable working life” remains lacking, although studies investigating risk factors for labour market exit are numerous. In this study, we aimed (1) to update the information and to explore a definition of “sustainable working life” via a systematic literature review and (2) to describe the working life trajectories via the prevalence of sickness absence (SA), disability pension (DP), and unemployment in a Swedish twin cohort to provide a sample overview in our Sustainable Working Life-project. Methods: A systematic literature review was conducted to explore the studies with the search phrase “sustainable working life” in PubMed, PsycInfo, and the Web of Science Database of Social Sciences in January 2021, resulting in a total of 51 references. A qualitative synthesis was performed for the definitions and the measures of “sustainable working life.” Based on the Swedish Twin project Of Disability pension and Sickness absence (STODS), the current dataset to address sustainable working life includes 108 280 twin individuals born between 1925 and 1990. Comprehensive register data until 2016 for unemployment, SA and DP were linked to all individuals. Using STODS, we analysed the annual prevalence of SA, DP, and unemployment as working life trajectories over time across education and age groups. Results: The reviewed 16 full articles described several distinct definitions for sustainable working life between 2007 and 2020 from various perspectives, i.e., considering workplaces or employees, the individual, organizational or enterprise level, and the society level. The definition of “sustainable working life” appearing most often was the swAge-model including a broad range of factors, e.g., health, physical/mental/psychosocial work environment, work motivation/satisfaction, and the family situation and leisure activities. Our dataset comprised of 81%–94% of individuals who did not meet SA, DP, or unemployment during the follow-up in 1994–2016, being indicative for “sustainable working life.” The annual prevalence across years had a decreasing trend of unemployment over time, whereas the prevalence of SA had more variation, with DP being rather stable. Both unemployment and DP had the highest prevalence among those with a lower level of education, whereas in SA, the differences in prevalence between education levels were minor. Unemployment was highest across the years in the youngest age group (18–27 years), the age group differences for SA were minor, and for DP, the oldest age group (58–65 years) had the highest prevalence. Conclusions: No consensus exists for a “sustainable working life,” hence meriting further studies, and we intend to contribute by utilising the STODS database for the Sustainable Working Life project. In the upcoming studies, the existing knowledge of available definitions and frameworks will be utilised. The dataset containing both register data and self-reports enables detailed follow-up for labour market participation for sustainable working life

Association between long-term smoking and leisure-time physical inactivity : a cohort study among Finnish twins with a 35-year follow-up

To investigate longitudinal associations of smoking and a change in smoking status with leisure-time physical inactivity. In addition, to control whether familial confounding (genetics and shared environment) influences the associations. Data were based on the population-based Finnish Adult Twin Cohort of 5254 twin individuals born in 1945-1957 (41% men) and who participated in all four surveys over a 35-year follow-up (1975-2011). Logistic and conditional logistic regression models with multiple covariates were used for analyses. Compared to never-smokers, long-term daily smokers (1975-1990) had the highest likelihood for both long-term inactivity and to change into inactive by 2011. Recurrent smoking was associated with long-term inactivity. Instead, in comparison to persistent daily smokers, quitting smoking decreased the likelihood of becoming physically inactive at leisure time. The associations remained in the analyses which accounted for multiple covariates and/or familial confounding. Daily smoking increases the likelihood of remaining or becoming physically inactive over the decades. Our results emphasize not only the importance of preventing smoking initiation, but also to support early smoking cessation in promotion of lifelong physical activity.Peer reviewe

Stability and change of body mass index as a predictor of disability

AIMS: To investigate whether stability or change in body mass index (BMI) predict disability pension (DP) due to musculoskeletal diagnosis (MSD) when controlling for familial confounding. METHODS: Our study cohort consisted of 17,169 Finnish twins born before 1958. Data on BMI and multiple covariates from questionnaires in 1975 and 1981 were included and DPs were collected from the national pension registers until the end of 2004. Cox proportional hazards regression models with Hazard Ratios (HR) and 95% Confidence Intervals (CI) were used for statistical analyses. RESULTS: General DP was granted to 2853 individuals and DP due to MSD to 1143 individuals during the 23-year follow-up. A one-unit increase in BMI in both 1975 (HR 1.08, 95% CI 1.05, 1.10) and 1981 (HR 1.06, 95% CI 1.04, 1.07), as well as the stability of and change in BMI from 1975 to 1981 were all associated with an increased risk of DP. These associations held in the analyses controlling for multiple covariates (age, sex, socioeconomic status, education, marital status, leisure-time physical activity, and musculoskeletal pain), and mainly also familial confounding, that is, genetics and shared environment. HR for stable obesity was 2.28 (95% CI 1.69, 3.08) for DP due to MSD, and 1.91 (95% CI 1.56, 2.34) for general DP in the fully adjusted models. CONCLUSIONS: BMI is an early predictor of general DP and also of DP due to MSD. Owing to the independency of various covariates and potentially also familial confounding, BMI may possibly have a direct effect on the risk of DP.Peer reviewe

Sustainable Working Life Patterns in a Swedish Twin Cohort: Age-Related Sequences of Sickness Absence, Disability Pension, Unemployment, and Premature Death during Working Life

We aimed to investigate sustainable working life via age-related sequences of sickness absence (SA), disability pension (DP), unemployment (UE), premature death, and the influence of individual characteristics, accounting for familial confounding. The sample included monozygotic (MZ) and dizygotic (DZ) same-sexed twin pairs with register data (n = 47,450) that were followed for 10 years in four age cohorts: 26–35 (n = 9892), 36–45 (n = 10,620), 46–55 (n = 12,964) and 56–65 (n = 13,974). A sequence analysis was done in a 7-element state space: 1. “Sustainable working life”: SA/DP 0–30 days and UE 0–90 days; 2. “Unemployment >90 days”: SA/DP 0–30 days and UE > 90 days; 3. “Moderate SA/DP”: SA/DP 30–180 days; 4. “Almost full year of SA/DP”: SA/DP 180–365 days; 5. “Full year of SA/DP”: SA/DP ≥ 365 days; 6. Death; 7. Old-age pension. The largest cluster had a sustainable working life and never experienced states 2–6 (34–59%). Higher education and being married predicted a lower likelihood of experiencing states 2–6. The MZ twin pairs (vs. DZ) were more often in the same cluster suggesting the role of genetic factors. To conclude, the sustainable working life was the largest cluster group. Few individuals had prolonged periods of interruptions of sustainable working life meriting actions, especially in early adulthood for interventions to support workability