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  • 1.
    Sundbaum, Johanna
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Hepatitis B: is the risk increased in patients with rheumatois arthritis?2012Conference paper (Refereed)
  • 2.
    Sundbaum, Johanna
    et al.
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Arkema, Elizabeth
    Enheten för klinisk epidemiologi, Karolinska universitetssjukhuset/institutet.
    Feltelius, Nils
    Läkemdelsverket, Enheten för reumatologi, Institutionen för medicin, Karolinska universitetssjukhuset/institutet.
    Baecklund, Eva
    Enheten för reumatologi, Institutionen för medicinska vetenskaper, Uppsala universitet.
    Askling, Johan
    Enheten för klinisk epidemiologi, Karolinska universitetssjukhuset/ Karolinska Institutet.
    Hepatit B infektion hos patienter behandlade med biologiska läkemedel för reumatisk sjukdom: svenska fall 1999-20112011Conference paper (Refereed)
  • 3.
    Sundbaum, Johanna
    et al.
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Back, Johan
    Institutionen för medicinska vetenskaper, Uppsala Universitet.
    Lehto, Niklas
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Vikman, Irene
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Baecklund, Eva
    Institutionen för medicinska vetenskaper, Uppsala Universitet.
    Kontrollprovtagning vid metotrexatebehandling av RA patienter: Erfarenheter från en reumatologklinik2014Conference paper (Other academic)
  • 4.
    Sundbaum, Johanna
    et al.
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Berglund, V.
    Uppsala University, Dermatologic Section, Department of Medical Science.
    Back, Johan
    Institutionen för medicinska vetenskaper, Uppsala Universitet.
    Lehto, Niklas
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Vikman, Irene
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Rollman, O.
    Uppsala University, Dermatologic Section, Department of Medical Science.
    Baecklund, Eva
    Enheten för reumatologi, Institutionen för medicinska vetenskaper, Uppsala universitet, Institutionen för medicinska vetenskaper, Uppsala Universitet.
    Methotrexate in rheumatoid arthritis and psoriasis/psoriatic arthritis: a comparative study of hepatotoxicity2014In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 43, p. 29-Article in journal (Refereed)
  • 5.
    Sundbaum, Johanna
    et al.
    Luleå University of Technology, Department of Health Sciences, Medical Science. Department of Medical Sciences, Rheumatology, Uppsala University, Uppsala, Sweden.
    Eriksson, Niclas
    Department of Medical Sciences, Clinical Pharmacology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
    Hallberg, Pär
    Department of Medical Sciences, Clinical Pharmacology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
    Lehto, Niklas
    Luleå University of Technology, Department of Engineering Sciences and Mathematics, Material Science. Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
    Wadelius, Mia
    Department of Medical Sciences, Clinical Pharmacology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
    Baecklund, Eva
    Department of Medical Sciences, Rheumatology, Uppsala University, Uppsala, Sweden.
    Methotrexate treatment in rheumatoid arthritis and elevated liver enzymes: A long‐term follow‐up of predictors, surveillance, and outcome in clinical practice2019In: International Journal of Rheumatic Diseases, E-ISSN 1756-185X, Vol. 22, no 7, p. 1226-1232Article in journal (Refereed)
    Abstract [en]

    Aim

    To assess predictors of alanine aminotransferase (ALT) elevation in methotrexate (MTX) treated rheumatoid arthritis (RA) patients, and to describe the monitoring of liver enzymes, including handling and outcome of elevated ALT.

    Methods

    All RA patients starting MTX in January, 2005 to April, 2013 at a rheumatology clinic, (Uppsala University Hospital, Sweden) were identified from electronic medical records. Clinical and laboratory data were obtained from medical records, supplemented by telephone interviews. Predictors for ALT >1.5× over the upper limit of normal (ULN) were identified by multiple regression analysis.

    Results

    The study comprised 213 RA patients starting MTX. During a mean follow‐up of 4.3 years, 6288 ALT tests were performed; 7% of tests with ALT were >ULN. ALT >1.5× ULN was observed in 44 (21%) patients and the strongest predictor was a pre‐treatment elevation of ALT (adjusted odds ratio = 6.8, 95% CI 2.2‐20.5). Recurrent elevations occurred in 70% of patients who continued treatment, and the proportion was similar in those with and without interventions, for example MTX dose reduction (67% vs 73%, P = 0.43). Seven patients (3%) permanently stopped MTX due to ALT elevation, and two were eventually diagnosed with non‐alcoholic fatty liver disease. No patient developed hepatic failure.

    Conclusion

    Only a small number of ALT tests performed during MTX therapy in RA capture an elevation. A pre‐treatment elevation of ALT was the strongest predictor for early and recurrent ALT elevations during therapy. This study supports a more individualized approach to monitoring and handling of ALT elevations during MTX therapy in RA than recommended in current guidelines.

  • 6.
    Söderberg, Anja
    et al.
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Sundbaum, Johanna
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Nursing students' perceptions of learning through complex meetings with standard psychatric patients2016Conference paper (Other academic)
  • 7.
    Söderberg, Anja
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sundbaum, Johanna
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Nursing students' reflections after meetings with patients and their relatives enacted by professional actors: Being touched and feeling emphaty2017In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 38, no 2, p. 139-144Article in journal (Refereed)
    Abstract [en]

    When professional actors have been used in mental health simulations with nursing students, the experiencehas been regarded as a meaningful contribution to their education and described as a safe way ofexperiencing challenging situations that can occur in clinical settings. The aim was to study nursing students’reflections aftermeetings with nursing patients and their relatives, as enacted by professional actors,in psychiatric/elderly care. The design was a qualitative descriptive research approach. Gibbs’s (1988) reflectivecycle was the basis for the questions thatwere asked.Written reflections with 60 nursing studentswereanalysed using qualitative thematic content analysis. The analysis produced the theme “being touched andfeeling empathy,”with four categories: “becoming aware of what knowledge and skills are needed,” “wantingto dowell and to have the right answer,”“daring to get close and being present,”and “knowledge comesalive.” Simulation with real people who act as patients or relatives in vulnerable situations creates feelingsof empathy. To talk with them, experience eye contact, and see how they react on touch makes nursingstudents feel they have experienced closeness and their knowledge has become alive

1 - 7 of 7
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