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Book ; Thesis: The infected knee arthroplasty

Stefánsdóttir, Anna

(Doctoral dissertation series ; 2011,)

2011

Author's details	Anna Stefánsdóttir
Series title	Doctoral dissertation series ; 2011,
Collection
Language	English ; Swedish
Size	Getr. Zählung : Ill., graph. Darst.
Publishing country	Sweden
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Lund, Univ., Diss., 2011
Note	Zsfassung in schwed. Sprache
HBZ-ID	HT017106589
ISBN	978-91-86671-31-0 ; 91-86671-31-6
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Increased short- and long-term mortality amongst patients with early periprosthetic knee joint infection.

Thompson, Olof / W-Dahl, Annette / Stefánsdóttir, Anna

BMC musculoskeletal disorders

2022 Volume 23, Issue 1, Page(s) 1069

Abstract: Background: Periprosthetic joint infection (PJI) following total knee arthroplasty (TKA) is a severe complication in terms of disability, morbidity, and cost. We performed a study to investigate whether early PJI (within 90 days of primary TKA) is ... ...

Abstract	Background: Periprosthetic joint infection (PJI) following total knee arthroplasty (TKA) is a severe complication in terms of disability, morbidity, and cost. We performed a study to investigate whether early PJI (within 90 days of primary TKA) is associated with increased mortality. Secondary aims were to compare mortality rates over time and between surgical treatment methods. Methods: Patients with suspected PJI were identified by linkage of the Swedish Knee Arthroplasty Register (SKAR) and the Swedish Prescribed Drug Register (SPDR) in 2007-2008 and 2012-2013. Medical records of patients receiving more than 4 weeks of continuous antibiotic therapy were subsequently reviewed to verify the PJI diagnosis. Information on mortality was obtained through the SKAR which is updated daily from the tax agency and patients with PJI were compared to patients without PJI. Results: Four hundred sixty-six patients were diagnosed with PJI within 90 days and compared to 40,362 patients without PJI. Mortality rates were significantly higher for PJI patients in both short- and long term: 2.6% vs. 0.8% at 1 year, 4.9% vs. 1.9% at 2 years, 15.7% vs. 7.1% at 5 years, and 38% vs. 21.4% at 10 years. The difference in mortality rate remained after adjusting for sex, age, diagnosis, and time period for surgery with Hazard Ratio 1.8 (95% CI:1.6-2.1). Mortality rates did not differ between time periods, and we found no correlation to surgical treatment. Conclusion: Patients with early PJI after primary TKA have an increased mortality rate compared to TKA patients without PJI. Improvements in surgical treatment strategy has not resulted in better survival. Long term difference in mortality rates indicates that PJI is not the sole reason for mortality suggesting a general frailty in PJI patients.
MeSH term(s)	Humans ; Knee Joint
Language	English
Publishing date	2022-12-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2041355-5
ISSN	1471-2474 ; 1471-2474
ISSN (online)	1471-2474
ISSN	1471-2474
DOI	10.1186/s12891-022-06024-y
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Article ; Online: Anti-rheumatic treatment and prosthetic joint infection: an observational study in 494 elective hip and knee arthroplasties.

Borgas, Ylva / Gülfe, Anders / Kindt, Mikael / Stefánsdóttir, Anna

BMC musculoskeletal disorders

2020 Volume 21, Issue 1, Page(s) 410

Abstract: Background: Surgical site infections are more frequent among patients with rheumatic disease. To what extent this is related to immunosuppressive antirheumatic drugs is unclear, as is the value of discontinuing medication perioperatively. The aim of ... ...

Abstract	Background: Surgical site infections are more frequent among patients with rheumatic disease. To what extent this is related to immunosuppressive antirheumatic drugs is unclear, as is the value of discontinuing medication perioperatively. The aim of study was to assess the rate of surgical site infections after knee and hip replacement in patients with inflammatory joint disease, with an emphasis on periprosthetic joint infection, and to investigate the influence of treatment with disease-modifying antirheumatic drugs (DMARDs) in this regard. Methods: Data were collected from 494 primary elective hip (51.4%) and knee arthroplasties, along with demographic and medication data. The primary outcome was surgical site infection during the first year after surgery. Results: In 78% (n = 385) of the cases the patient used 1 to 3 disease-modifying antirheumatic drugs perioperatively. Thirty-two percent (n = 157) of patients used a TNF-alpha inhibitor. The rate of surgical site infection was 3.8% (n = 19). The rate of periprosthetic joint infection was 1.4% (n = 7), all of which occurred after knee arthroplasty. Periprosthetic joint infection occurred in only 1 patient medicating perioperatively with a TNF-alpha inhibitor. Conclusion: Surgical site infections were not associated with ongoing medication with disease-modifying antirheumatic drugs. Due to the low event rate this should be interpreted with caution, but our center will maintain its routine of continuing treatment with TNF-alpha inhibitors perioperatively.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antirheumatic Agents/therapeutic use ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Elective Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Perioperative Care ; Prosthesis-Related Infections/epidemiology ; Retrospective Studies ; Rheumatic Diseases/drug therapy ; Surgical Wound Infection/epidemiology ; Tumor Necrosis Factor Inhibitors/therapeutic use ; Young Adult
Chemical Substances	Antirheumatic Agents ; Tumor Necrosis Factor Inhibitors
Language	English
Publishing date	2020-06-29
Publishing country	England
Document type	Journal Article ; Observational Study
ISSN	1471-2474
ISSN (online)	1471-2474
DOI	10.1186/s12891-020-03459-z
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Article ; Online: Similar periprosthetic joint infection rates after and before a national infection control program: a study of 45,438 primary total knee arthroplasties.

Thompson, Olof / W-Dahl, Annette / Lindgren, Viktor / Gordon, Max / Robertsson, Otto / Stefánsdóttir, Anna

Acta orthopaedica

2022 Volume 93, Page(s) 3–10

Abstract: Background and purpose - Strenuous efforts to minimize postoperative infection rates have been made, including the Swedish nationwide initiative Prosthesis Related Infections Shall be Stopped (PRISS). This study calculated the incidence rate of ... ...

Abstract	Background and purpose - Strenuous efforts to minimize postoperative infection rates have been made, including the Swedish nationwide initiative Prosthesis Related Infections Shall be Stopped (PRISS). This study calculated the incidence rate of periprosthetic joint infection (PJI) following primary total knee arthroplasty (TKA) before and after PRISS. Patients and methods - All 45,438 primary TKAs registered in the Swedish Knee Arthroplasty Register (SKAR) during 2007-2008 and 2012-2013 were included. Matched data on antibiotic prescriptions were obtained from the Swedish Prescribed Drug Register (SPDR). All patients with ≥ 28 days of continuous antibiotic treatment within 2 years of primary surgery had their medical charts reviewed to identify cases of PJI. The incidence rate was calculated by dividing the number of PJIs by the total time at risk during each time period and presented as percentages with 95% confidence interval (CI). Results - 644 PJIs were identified, equaling a 2-year incidence rate of 1.45% (CI 1.34-1.57). The incidence rate was 1.44% (CI 1.27-1.61) before PRISS and 1.46% (CI 1.31-1.61) after. Diagnosis was made within 30 days of primary TKA in 52%, and within 90 days in 73% of cases. 603 cases were reoperated on or revised. Median time from operation to diagnosis was 29 days (1-716), for both time periods. Debridement with exchange of the insert was performed in 32% and 63% of cases before and after PRISS, respectively. Interpretation - We found similar incidence rates before and after the PRISS initiative without any statistically significant difference. Time to diagnosis was similar during both time periods. The project may have contributed to increased compliance with treatment protocols.
MeSH term(s)	Aged ; Anti-Bacterial Agents/therapeutic use ; Arthroplasty, Replacement, Knee/methods ; Female ; Humans ; Incidence ; Infection Control/methods ; Male ; Middle Aged ; Prosthesis-Related Infections/drug therapy ; Prosthesis-Related Infections/epidemiology ; Sweden/epidemiology
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2022-01-03
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	2180677-9
ISSN	1745-3682 ; 1745-3674
ISSN (online)	1745-3682
ISSN	1745-3674
DOI	10.1080/17453674.2021.1977532
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Article ; Online: Repetitive focal seizures evolving into ictal asystole: a case report with 18 seizures during video-EEG monitoring.

Stefánsdóttir, Anna / Sabers, Anne / Sidaros, Annette / Rásonyi, György / Becser Andersen, Noémi / Kløvgaard, Marius

Epileptic disorders : international epilepsy journal with videotape

2021 Volume 23, Issue 6, Page(s) 937–939

MeSH term(s)	Electroencephalography ; Heart Arrest/etiology ; Humans ; Seizures/complications ; Seizures/physiopathology
Language	English
Publishing date	2021-10-12
Publishing country	France
Document type	Case Reports
ZDB-ID	2086797-9
ISSN	1950-6945 ; 1294-9361
ISSN (online)	1950-6945
ISSN	1294-9361
DOI	10.1684/epd.2021.1336
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Article: A population-based study on the treatment and outcome of enterococcal prosthetic joint infections. A consecutive series of 55 cases.

Thompson, Olof / Rasmussen, Magnus / Stefánsdóttir, Anna / Christensson, Bertil / Åkesson, Per

Journal of bone and joint infection

2019 Volume 4, Issue 6, Page(s) 285–291

Abstract: Aim: Enterococci cause 2-11% of all prosthetic joint infections (PJI) and are generally considered difficult to treat. However, study-results are not consistent. In this study we present a population-based case series of 55 cases with enterococcal PJI, ... ...

Abstract	Aim: Enterococci cause 2-11% of all prosthetic joint infections (PJI) and are generally considered difficult to treat. However, study-results are not consistent. In this study we present a population-based case series of 55 cases with enterococcal PJI, investigating treatment and outcome, as well as describing the affected patient population regarding demography and co-morbidities. Methods: We identified all enterococcal PJIs in the Region of Skåne, Sweden, during a five-year period (2011-2015) and reviewed the patients' medical records. Results: Fifty-five enterococcal PJIs were found. Enterococcus faecalis was the most frequently isolated species (84%), and poly-microbial infections were common (64%). Treatment with intention to cure was given to 43 (78%) cases. Debridement with retention of the implant and antibiotics (DAIR) was the most common surgical treatment strategy (71%), with a cure-rate of 72%. Overall cure-rate was 67%, and in cases where cure was intended, this was achieved in 80%. Conclusions: When cure is aimed for, the prognosis for enterococcal PJI is not so poor, and DAIR treatment can provide adequate results in many cases.
Language	English
Publishing date	2019-11-07
Publishing country	Germany
Document type	Journal Article
ISSN	2206-3552
ISSN	2206-3552
DOI	10.7150/jbji.35683
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Article ; Online: Increased body fat content in horses alters metabolic and physiological exercise response, decreases performance, and increases locomotion asymmetry.

Jansson, Anna / Gunnarsson, Vikingur Þ / Ringmark, Sara / Ragnarsson, Sveinn / Söderroos, Denise / Ásgeirsson, Einar / Jóhannsdóttir, Tanja R / Liedberg, Charlotta / Stefánsdóttir, Guðrún J

Physiological reports

2021 Volume 9, Issue 11, Page(s) e14824

Abstract: This study examined the effect of altered body weight (BW) and body fat content on exercise performance and recovery. Nine horses were divided into two groups, and changes in BW and fat content were induced by feeding a high (HA) or restricted (RA) ... ...

Abstract	This study examined the effect of altered body weight (BW) and body fat content on exercise performance and recovery. Nine horses were divided into two groups, and changes in BW and fat content were induced by feeding a high (HA) or restricted (RA) energy allowance for 36 days in a cross-over design. In the last week of each treatment, BW and body condition score (BCS) were recorded, body fat percentage was estimated using ultrasound, and a standardized incremental treadmill exercise test (SET) and competition-like field test were performed (scored by judges blinded to treatments). Blood samples were collected, and heart rate (HR), rectal temperature (RT), and respiratory rate (RR) were also recorded. Objective locomotion analyses were performed before and after the field test. Body weight, body fat percentage, and BCS were higher (5-8%) in HA than in RA horses (p < 0.05). In SET, HA horses showed higher HR, plasma lactate concentration, RR, and RT than RA horses (p < 0.05), and lower V
MeSH term(s)	Adipose Tissue/physiology ; Animals ; Body Temperature/physiology ; Heart Rate/physiology ; Horses/metabolism ; Horses/physiology ; Locomotion/physiology ; Male ; Physical Conditioning, Animal/physiology ; Respiratory Rate/physiology
Language	English
Publishing date	2021-06-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2724325-4
ISSN	2051-817X ; 2051-817X
ISSN (online)	2051-817X
ISSN	2051-817X
DOI	10.14814/phy2.14824
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Article ; Online: Plasma insulin concentration increases linearly with body condition in Icelandic horses.

Jansson, Anna / Stéfansdóttir, Gudrun J / Ragnarsson, Sveinn

Acta veterinaria Scandinavica

2016 Volume 58, Issue 1, Page(s) 76

Abstract: Background: This study investigated the variation in plasma insulin concentration (PIC) in a group of Icelandic horses in training, considered to be healthy and examined possible relationships between PIC and gender, age, body size, body condition score ...

Abstract	Background: This study investigated the variation in plasma insulin concentration (PIC) in a group of Icelandic horses in training, considered to be healthy and examined possible relationships between PIC and gender, age, body size, body condition score and management factors such as feed allowance and subjective level of fitness. Results: Plasma insulin concentration ranged from 0.2 to 13.9 mU/l, body condition score from 2.3 to 4.0 and concentrate allowance from 0 to 4 kg. There was a significant effect of concentrate allowance (P = 0.0007) and body condition score (P = 0.004) on PIC. For every 1 kg increase in the concentrate allowance, log-PIC increased by 0.26 mU/l. For every 1 unit increase in body condition score, log-PIC increased by 0.45 mU/l. There was no effect of hay allowance, level of fitness, transport time, body size and age on insulin concentration. Conclusion: Owners of Icelandic horses should be aware that increased body condition elevates PIC, and thereby potentially the risk of laminitis. However, in the group of horses studied, the concentrations were within the range considered normal.
MeSH term(s)	Animal Feed/analysis ; Animal Feed/standards ; Animals ; Body Constitution/physiology ; Diet/veterinary ; Female ; Horses/blood ; Horses/physiology ; Insulin/blood ; Male
Chemical Substances	Insulin
Language	English
Publishing date	2016-11-09
Publishing country	England
Document type	Journal Article
ZDB-ID	40137-7
ISSN	1751-0147 ; 0044-605X
ISSN (online)	1751-0147
ISSN	0044-605X
DOI	10.1186/s13028-016-0258-8
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Article ; Online: Why are antiepileptic drugs continued after successful epilepsy surgery in adults?

Foged, Mette Thrane / Stefánsdóttir, Anna / Brændgaard, Mette / Holm, Emil / Pinborg, Lars H / Sabers, Anne

Epilepsy & behavior : E&B

2019 Volume 100, Issue Pt A, Page(s) 106452

Abstract: Objective: Studies have demonstrated that a substantial number of patients continue treatment with antiepileptic drugs (AEDs) for many years after epilepsy surgery despite seizure freedom. In this study, we aimed to investigate why AED treatment is ... ...

Abstract	Objective: Studies have demonstrated that a substantial number of patients continue treatment with antiepileptic drugs (AEDs) for many years after epilepsy surgery despite seizure freedom. In this study, we aimed to investigate why AED treatment is maintained in patients three and seven years after successful epilepsy surgery. To our knowledge, an analysis of this specific subgroup of completely seizure-free patients has not been done before. Material and methods: Danish patients with medically refractory epilepsy and histopathologically proven hippocampal sclerosis operated between 1995 and 2014 who were reported seizure-free at one-year postsurgery were contacted by telephone in 2017 and retrospectively asked about the reasons to continue or taper AED at three and seven years after the operation. Results: Fifty patients were completely seizure-free three years after the operation. Of those, 31 (62%) were still taking AEDs at three years, thereof 10 (20%) in the same dose and number and half of those on their own wish. At seven years, nine patients were still taking AEDs, two in unchanged number and dose, both on their own wish. Fear of relapse was the most common reason not to withdraw medication. Presurgery seizure frequency for patients taking AEDs at three and seven years was not higher than for those who had discontinued taking AEDs. Conclusions: A large portion of completely seizure-free patients still take AEDs even seven years after epilepsy surgery. This seems to be largely due to the patients' own wishes and fear of relapse, and unrelated to presurgery seizure frequency. Our results could aid in counseling patients on the decision to withdraw AEDs after successful epilepsy surgery.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anticonvulsants/therapeutic use ; Anxiety/etiology ; Anxiety/psychology ; Combined Modality Therapy ; Denmark ; Drug Administration Schedule ; Drug Resistant Epilepsy/drug therapy ; Drug Resistant Epilepsy/psychology ; Drug Resistant Epilepsy/surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Patient Preference/psychology ; Patient Preference/statistics & numerical data ; Practice Patterns, Physicians'/statistics & numerical data ; Recurrence ; Retrospective Studies ; Treatment Outcome ; Withholding Treatment/statistics & numerical data ; Young Adult
Chemical Substances	Anticonvulsants
Language	English
Publishing date	2019-10-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/j.yebeh.2019.106452
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Article: A Patients' Perspective Towards the Injection Devices for Humira® and Imraldi® in a Nationwide Switching Program.

Karlsdottir, Kristin / Gunnarsdottir, Anna I / Grondal, Gerdur / Love, Thorvardur J / Stefansdottir, Elinborg / Davidsdottir, Loa G / Thorleifsdottir, Ragna H / Gudbjornsson, Bjorn

Frontiers in medicine

2022 Volume 9, Page(s) 799494

Abstract: Objective: Due to a tender process in Iceland, all patients on Humira® were switched nationwide to its biosimilar Imraldi® in March 2019. The study aimed to explore the patient's perspective of the Humira® and Imraldi® injection devices.: Methods: A ... ...

Abstract	Objective: Due to a tender process in Iceland, all patients on Humira® were switched nationwide to its biosimilar Imraldi® in March 2019. The study aimed to explore the patient's perspective of the Humira® and Imraldi® injection devices. Methods: A standard telephone interview was carried out among patients with inflammatory arthritis, inflammatory bowel disease and psoriasis, who underwent this nationwide switching program a few months earlier. Results: The response rate was 84.5% ( Conclusion: Patients with inflammatory disorders who have been treated regularly with adalimumab preferred the Humira® injection device over the Imraldi® device, according to our results. After all, these injection devices' structure and content are not the same, although both contain the same active ingredient, i.e. adalimumab. Our results highlight the importance of thorough information, not only with an information letter but also with the possibilities for individualized introduction in planning switching to biosimilars.
Language	English
Publishing date	2022-01-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.799494
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