Karolinska University Hospital

Difficult-to-treat systemic lupus erythematosus: from refractory disease to a multidimensional clinical trajectory

Difficult-to-treat (D2T) systemic lupus erythematosus (SLE) is increasingly recognised in clinical practice but is still conceptually underdeveloped. In contrast to rheumatoid arthritis and psoriatic arthritis, for which formal D2T frameworks have been proposed, SLE still lacks a...

Efficacy of dolutegravir or bictegravir-containing therapy in a real-life cohort of people with HIV-1 sub-subtype A6

OBJECTIVE: The objective of the study was to establish whether HIV-1 sub-subtype A6 (HIV-1A6) is a risk factor for virological failure in people with HIV (PWH) treated with the high genetic barrier integrase strand transfer inhibitors (INSTIs) dolutegravir (DTG) or bictegravir (B...

The Impact of Out-of-Hours Liver Transplantation on Outcomes

Objectives: This national, multicenter retrospective study of 764 adult liver transplantations (LT) in Sweden (2019–2023) employed a data-driven approach to identify the out-of-hours (OOH) high-risk window and evaluate its impact on patient outcomes and health care costs. Summary...

Food choices and beliefs in adults with inflammatory bowel disease in Sweden

Abstract Objectives Diet is a recognised risk factor for inflammatory bowel disease (IBD) and a management strategy. Concerns persist regarding the adverse effects of restrictive diets, including nutritional deficiencies and selective eating. The impact of IBD on patients’ belief...

Low-Voltage Ablation in Persistent Atrial Fibrillation

Importance Pulmonary vein isolation remains the foundational ablation approach for atrial fibrillation (AF), yet outcomes in persistent AF remain suboptimal. Targeting low-voltage zones identified by electroanatomical mapping offers a promising strategy for enhancing ablation suc...

Genomic characterization of ER-positive primary tumors and corresponding relapses identifies potentially targetable alterations

The majority of breast cancer patients have tumors expressing estrogen receptor α (ER) and receive endocrine therapy. However, around one-third relapse in their disease, predominantly with retained ER expression. Molecular alterations are proposed to be contributors to the resist...

Blunt versus penetrating trauma: differences in early physiology, coagulopathy, and outcomes in a Scandinavian trauma centre

Abstract Background Blunt and penetrating trauma differ in injury patterns, management, and outcomes, but data comparing early physiological and haemostatic responses within Scandinavian trauma systems remain limited. We aimed to investigate differences in clinical characteristic...

Incident psoriasis in atopic dermatitis: a large-scale cohort study of disease- and treatment-associated risks

Abstract Background Clinical and genetic evidence on the association between atopic dermatitis (AD) and subsequent psoriasis remains conflicting, and it is unclear whether this risk is modified by systemic treatments. Recent reports suggest type 2-targeted biologics may unmask ps...

Preferential Retention of the LMP-1 Promoter at EBV Integration Sites in Lymphomas: Evidence from Cartilage Hair Hypoplasia and Controls

Abstract Purpose Cartilage-Hair Hypoplasia (CHH), a rare ribosomopathy characterized by immune deficiency, carries a markedly increased risk of early-onset malignancy, particularly lymphoma. However, the molecular drivers of malignant transformation in CHH, and the contribution o...

Comparison of Methods for Incorporating Related Data When Developing Clinical Prediction Models: A Simulation Study

Clinical Prediction Models (CPMs) compute an individual's risk of an outcome, given a set of predictors. Guidance states CPMs should be constructed using data sampled from the target population. However, researchers might have access to ancillary data sets from different time poi...

Delivery mode and maternal health conditions before and after childbirth: A population‐based cohort study from Estonia

INTRODUCTION: Cesarean section (CS) is the most common gynecological surgery globally, with rates increasing in many developed countries. In Estonia, the CS rate rose from 6.4% in 1992 to 20.6% in 2021. While CS can be lifesaving when medically necessary, its rising use without c...

Early life predictors of subjective cognitive function in older age: Emerging longitudinal associations over six decades

Abstract Objectives Self-rated memory impairment is common in older age and has been related to objective cognitive decline and dementia. Recently, there has been growing interest in early-life predictors of late-life cognition, but research has been limited due to the absence of...

Plasma proteome reflects tissue damage and clinical manifestations in patients with inflammatory myopathies

OBJECTIVE: Tissue-specific biomarkers that are reliable and associated with clinical manifestations of idiopathic inflammatory myopathy (IIM) are lacking. The blood circulation in individuals serves as a central conduit, allowing communication between tissues and facilitating cle...

Naïve adaptive immune receptor repertoires in celiac disease assessed by machine learning; impact of the HLA-DQ2.5 allotype on the TCR repertoire

Abstract The adaptive immune receptor repertoire (AIRR) - the collection of an individual’s B-cell and T-cell receptors (BCRs and TCRs, respectively) - encodes cumulative immune history and is shaped by both germline genetics and environmental exposures. Skewed repertoires have b...

Machine Learning-Based First-Trimester Antenatal Risk Prediction for Adverse Maternal and Neonatal Outcomes: Multicenter Model Development Study.

Background: Maternal outcomes remain inequitable worldwide. Severe morbidity persists, and current risk assessment tools are largely arbitrary, focusing on biomedical factors while overlooking social determinants of health. There is a need for data-driven AI models to improve ear...

Effects of mandibular advancement device versus continuous positive airway pressure on cardiac remodeling in obstructive sleep apnea: a randomized CMR substudy

Obstructive sleep apnea (OSA) is associated with adverse cardiac remodeling, including diffuse myocardial fibrosis. Continuous positive airway pressure (CPAP) is the standard treatment for OSA, while mandibular advancement devices (MAD) may represent an alternative. However, thei...

Hormonal Responses to a Short Daytime Fast in Children With Beta‐Oxidation Disorders

ABSTRACT Fasting‐induced cellular energy deficiency and hypoglycemia are well‐known complications of beta‐oxidation disorders. The changes in energy homeostasis during fasting are under hormonal regulation. This aspect of fasting metabolism in beta‐oxidation disorders is not full...

P1.004. Cryoablation of Barrett´s Esophagus in Patients not Suitable for Treatment With Radiofrequency Ablation

Abstract Topic Benign Disease: Barrett’s Esophagus: Pathology and Pathophysiology; Non-invasive Neoplasia Background Radiofrequency ablation (RFA) is the gold standard for ablation of the esophagus. However, there are occasions when RFA is not suitable, for example if the patient...

OA03-RF01.05. The Safety and Efficacy of Endoscopic Submucosal Dissection for Early Esophageal Squamous Cell Carcinoma in Scandinavia (SEES-Study)

Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – early outcomes and complications Background Endoscopic submucosal dissection (ESD) is recommended for early-stage esophageal squamous cell carcinoma (ESCC). Most data on the efficacy of ESD for ESCC comes...

Trajectories of refraction and strabismus from 2.5 to 12 years in a national cohort of extremely preterm children‐ the Extremely Preterm Infants in Sweden Study (EXPRESS)

Abstract Purpose To investigate the longitudinal development of refraction and strabismus in a national cohort of children born extremely preterm (EPT) and find relations to perinatal events and neurodevelopmental outcomes. Methods All surviving children born <27‐gestation wee...