Increased rate of abdominal surgery both before and after diagnosis of celiac disease

BACKGROUND: The detection of celiac disease (CD) is suboptimal. AIMS: We hypothesized that misdiagnosis is leading to diagnostic delays, and examine this assertion by determining if patients have increased risk of abdominal surgery before CD diagnosis. METHODS: Through biopsy reports from Sweden's 28 pathology departments we identified all individuals with CD (Marsh stage 3; n=29,096). Using hospital-based data on inpatient and outpatient surgery recorded in the Swedish Patient Register, we compared abdominal surgery (appendectomy, laparotomy, biliary tract surgery, and uterine surgery) with that in 144,522 controls matched for age, sex, county and calendar year. Conditional logistic regression estimated odds ratios (ORs). RESULTS: 4064 (14.0%) individuals with CD and 15,760 (10.9%) controls had a record of earlier abdominal surgery (OR=1.36, 95% CI=1.31-1.42). Risk estimates were highest in the first year after surgery (OR=2.00; 95% CI=1.79-2.22). Appendectomy, laparotomy, biliary tract surgery, and uterine surgery were all associated with having a later CD diagnosis. Of note, abdominal surgery was also more common after CD diagnosis (hazard ratio=1.34; 95% CI=1.29-1.39). CONCLUSIONS: There is an increased risk of abdominal surgery both before and after CD diagnosis. Surgical complications associated with CD may best explain these outcomes. Medical nihilism and lack of CD awareness may be contributing to outcomes

Patients With Celiac Disease Have an Increased Risk for Pancreatitis

Background & Aims Patients with celiac disease have been reported to be at increased risk for pancreatitis and pancreatic insufficiency, but the risk might have been overestimated because of patient selection and limited numbers of patients for analysis. Furthermore, no distinction has been made between patients with gallstone-related and non–gallstone-related pancreatitis. We performed a nationwide study to determine the risk for any pancreatitis or subtype of pancreatitis among patients with biopsy-verified celiac disease. Methods We analyzed data from patients in Sweden with celiac disease (n = 28,908) who were identified on the basis of small intestinal biopsy records from 28 pathology departments (those with villous atrophy, Marsh 3). Biopsies were performed from 1969 to 2008, and biopsy report data were collected from 2006 to 2008. Patients with pancreatitis were identified on the basis of diagnostic codes in the Swedish Patient Register and records of pancreatic enzyme use in the Swedish Prescribed Drug Register. Data were matched with those from 143,746 individuals in the general population; Cox regression was used to estimate hazard ratios (HRs) for pancreatitis. Results We identified 406 patients with celiac disease who were later diagnosed with pancreatitis (and 143 with expected pancreatitis) (HR, 2.85; 95% confidence interval [CI], 2.53–3.21). The absolute risk of any pancreatitis among patients with celiac disease was 126/100,000 person-years, with an excess risk of 81/100,000 person-years. The HR for gallstone-related acute pancreatitis was 1.59 (95% CI, 1.06–2.40), for non–gallstone-related acute pancreatitis HR was 1.86 (95% CI, 1.52–2.26), for chronic pancreatitis HR was 3.33 (95% CI, 2.33–4.76), and for supplementation with pancreatic enzymes HR was 5.34 (95% CI, 2.99–9.53). The risk of any pancreatitis within 5 years of diagnosis was 2.76 (95% CI, 2.36–3.22). Conclusions Based on an analysis of medical records from Sweden, patients with celiac disease have an almost 3-fold increase in risk of developing pancreatitis, compared with the general population

Televising the Famine : An Audiovisual Representation of the Famine in Northern Sweden, 1867-1868

In the 1970s, historical documentarists Olle Häger and Hans Villius at the Swedish Broadcasting Corporation made both a documentary and a dramatic television production about the famine years of the 1860s. The productions indicate that a class perspective dominated popular culture at the time. Yet, not least the documentary (“Ett satans år,” [One Year of Satan] 1977) is evidence of how media producers sought to communicate seriously about famine in the past, at the same time relating to contemporary issue

Democracy in Timor-Leste

Timor-Leste has since 1999 been going through one of the most extensive processes of post-conflict peacebuilding undertaken by the United Nations up till today. Post-conflict peacebuilding entails comprehensive rebuilding of states emerging from violent conflict and aims to establish democracy and market economy. This thesis examines the state of democracy in Timor-Leste today, after almost ten years of post-conflict peacebuilding. The analysis is based on the theory of the five arenas of consolidated democracies by Linz and Stepan, and Diamond. The findings of the thesis are that the current Timorese society suffers from many problems related to democracy. All five arenas, political society, civil society, rule of law, bureaucracy and economic society are quite frail and are still in much need of support from the United Nations and others. The fragility of the rule of law poses a major obstacle to further democratic development, as do the lack of a functioning bureaucracy and economic growth. Although the presidential and legislative elections held since 1999 have been somewhat successful the political society suffers from problems to adapt to democratic norms of government

Exclusive breastfeeding of Swedish children and its possible influence on the development of obesity: a prospective cohort study

<p>Abstract</p> <p>Background</p> <p>Overweight and obesity are increasing among children all over the world. Socio-economic factors may influence the development of overweight and obesity in childhood, and it has been proposed that breastfeeding may protect against obesity. The aim of our study was to examine the relationship between exclusive breastfeeding and obesity when potential confounders, such as socioeconomic factors, are considered.</p> <p>Methods</p> <p>The data analyzed was from ABIS (All Babies in Southeast Sweden), a prospective cohort study. All parents with children born between October 1, 1997 and October 1, 1999 in Southeast Sweden (n = 21,700) were asked to participate. Parents were asked to answer periodic questionnaires from the time of the child's birth (n = 16,058) until he/she was five years of age (n = 7,356). Cutoffs for overweight and obesity were defined according to Cole et al, age and gender adjusted. Short-term exclusive breastfeeding was defined as < 4 months of exclusive breastfeeding. Multiple logistic regressions were used to identify variables that predict the child's BMI (Body Mass Index) at five years of age.</p> <p>Results</p> <p>At five years of age, 12.9% of the children in the study wereoverweight and 4.3% were obese. At the age of three months, 78.4% of the children were being breastfed exclusively. The median exclusive breastfeeding duration was four months. High maternal BMI > 30 (AOR = 1.07; CI = 1.05–1.09; P < 0.001), maternal smoking (AOR = 1.43; CI = 1.05–1.95; P = 0.023) and being a single parent (AOR = 2.10; CI = 1.43–3.09; P < 0.001) were associated with short-term exclusive breastfeeding (less than 4 months). Short-term exclusive breastfeeding was less common if one of the parents had a university degree (Mother: AOR = 0.74; CI = 0.61–0.90; P = 0.003 Father: AOR = 0.73; CI = 0.58–0.92; P = 0.008) or if the father was more than 37 years old (AOR = 0.74; CI = 0.55–0.99; P = 0.045). Short-term exclusive breastfeeding was associated with obesity in five-year-old children (simple logistic regression: OR = 1.44; CI = 1.00–2.07; P = 0.050), but when including other independent factors in the analysis, short-term exclusive breastfeeding did not attain statistical significance.</p> <p>Conclusion</p> <p>We cannot exclude the possibility that exclusive breastfeeding influences weight development, but it does not seem to protect against obesity at five years of age.</p

A Population-Based Study of the Risk of Diabetic Retinopathy in Patients With Type 1 Diabetes and Celiac Disease

Objective: Celiac disease (CD) is associated with type 1 diabetes (T1D). In the current study, we examined whether CD affects the risk of diabetic retinopathy (DRP) in patients with T1D. Research design and methods: This was a population-based cohort study. Through the Swedish National Patient Register, we identified 41,566 patients diagnosed with diabetes in 1964–2009 and who were ≤30 years of age at diagnosis. CD was defined as having villous atrophy (Marsh stage 3) according to small intestinal biopsies performed between 1969 and 2008, with biopsy reports obtained from Sweden’s 28 pathology departments. During follow-up, 947 T1D patients had a diagnosis of CD. We used Cox regression analysis with CD as a time-dependent covariate to estimate adjusted hazard ratios (aHRs) for DRP in patients with T1D and CD and compared them with patients with T1D but no CD. Results: Duration of CD correlated with the risk of DRP. When results were stratified by time since CD diagnosis, individuals with T1D and CD were at a lower risk of DRP in the first 5 years after CD diagnosis (aHR 0.57 [95% CI 0.36–0.91]), followed by a neutral risk in years 5 to <10 (1.03 [0.68–1.57]). With longer follow-up, coexisting CD was a risk factor for DRP (10 to <15 years of follow-up, aHR 2.83 [95% CI 1.95–4.11]; ≥15 years of follow-up, 3.01 [1.43–6.32]). Conclusions: Having a diagnosis of CD for >10 years is a risk factor for the development of DRP in T1D. Long-standing CD in patients with T1D merits intense monitoring of DRP

An overview of EFB usage in Scandinavia - discrepancies between EASA’s recommendations and operators’ implementation

The use of Electronic Flight Bags (EFBs) have become widespread and common among a majority of commercial airlines in Scandinavia and the United States in recent years. This development was enabled by modernized rules and regulations and the availability of suitable and affordable commercial-off-the-shelf (COTS) devices. This bachelor thesis studied EFB usage and user experience among pilots in commercial airlines in Scandinavia and identified if there were any discrepancies between usage and associated recommended best practices issued by the European Aviation Safety Agency (EASA). Focus areas were EFB training, performance calculations and documentation. Over 500 pilots from 11 airlines in Scandinavia responded to an online survey consisting of 42 questions. The survey showed that a large majority of the pilots used their EFB for mission critical purposes such as performance calculations. The results revealed discrepancies between recommendations by EASA and operators’ implementation regarding EFB training and procedures for performance calculations. Furthermore, the new technology must be implemented in a structured way. Information shall be made available based on the needs and abilities of the pilots within their various roles and not based solely on available software features

High-order numerical methods for 2D parabolic problems in single and composite domains

In this work, we discuss and compare three methods for the numerical approximation of constant- and variable-coefficient diffusion equations in both single and composite domains with possible discontinuity in the solution/flux at interfaces, considering (i) the Cut Finite Element Method; (ii) the Difference Potentials Method; and (iii) the summation-by-parts Finite Difference Method. First we give a brief introduction for each of the three methods. Next, we propose benchmark problems, and consider numerical tests-with respect to accuracy and convergence-for linear parabolic problems on a single domain, and continue with similar tests for linear parabolic problems on a composite domain (with the interface defined either explicitly or implicitly). Lastly, a comparative discussion of the methods and numerical results will be given.Comment: 45 pages, 12 figures, in revision for Journal of Scientific Computin

Generic Web Server in Embedded Control Systems

The goal for this master thesis was to investigate the possibility of using an existing web server and modify it so it can be used in ABB controllers. The work has resulted in two different versions of a web server. The basic functionality is the same for both versions. The web servers are able to present a number of controller-related information. For example: hardware, which control programs that are executing in the controller, information about the firmware, and also system information like heap memory usage. It can also be used for changing different parameters. The two versions use different techniques for presenting the information. They are also implemented in different ways. The first version has a more user-friendly interface but requires more memory, 71 kb. The second version requires less memory, 48 kb, but does not have the same user-friendly interface