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Featured researches published by Lina Bergman.


American Journal of Hypertension | 2014

Plasma Levels of S100B in Preeclampsia and Association With Possible Central Nervous System Effects

Lina Bergman; Tansim Akhter; Anna-Karin Wikström; Johan Wikström; Tord Naessen; Helena Åkerud

BACKGROUND S100B is supposed to be a peripheral biomarker of central nervous system (CNS) injury. The purpose of this study was to compare levels of S100B in women with preeclampsia with levels in healthy pregnant control subjects and furthermore to analyze levels of S100B in relation to possible CNS effects. METHODS A cross-sectional case–control study in antenatal care centers in Uppsala, Sweden, was performed. Fifty-three women with preeclampsia and 58 healthy pregnant women were recruited at similar gestational length; women with preeclampsia were recruited at time of diagnosis, and control subjects were recruited during their routine visit to an antenatal clinic. Plasma samples were collected, and levels of S100B were analyzed with an enzyme-linked immunosorbent assay. Information about demographic and clinical characteristics, including symptoms related to CNS affection, was collected from the medical records. The main outcome measures were plasma levels of S100B and possible CNS effects. RESULTS Levels of S100B were significantly higher among women with preeclampsia than among control subjects (0.12 µg/L vs. 0.07 µg/L; P < 0.001). In preeclampsia, there was a significant association between high levels of S100B and visual disturbances (P < 0.05). CONCLUSIONS S100B is increased among women with preeclampsia, and high levels of S100B associate with visual disturbances, which might reflect CNS affection in women with preeclampsia.


American Journal of Hypertension | 2017

Cerebral Magnesium Levels in Preeclampsia; A Phosphorus Magnetic Resonance Spectroscopy Study

Maria Nelander; Jan Weis; Lina Bergman; Anders Larsson; Anna-Karin Wikström; Johan Wikström

BACKGROUND Magnesium sulfate (MgSO4) is used as a prophylaxis for eclamptic seizures. The exact mechanism of action is not fully established. We used phosphorus magnetic resonance spectroscopy (31P-MRS) to investigate if cerebral magnesium (Mg2+) levels differ between women with preeclampsia, normal pregnant, and nonpregnant women. METHODS This cross-sectional study comprised 28 women with preeclampsia, 30 women with normal pregnancies in corresponding gestational week (range: 23-41 weeks) and 11 nonpregnant healthy controls. All women underwent 31P-MRS from the parieto-occipital region of the brain and were interviewed about cerebral symptoms. Differences between groups were assessed by analysis of variance and Tukeys post-hoc test. Correlations between Mg2+ levels and specific neurological symptoms were estimated with Spearmans rank test. RESULTS Mean maternal cerebral Mg2+ levels were lower in women with preeclampsia (0.12 mM ± 0.02) compared to normal pregnant controls (0.14 mM ± 0.03) (P = 0.04). Nonpregnant and normal pregnant women did not differ in Mg2+ levels. Among women with preeclampsia, lower Mg2+ levels correlated with presence of visual disturbances (P = 0.04). Plasma levels of Mg2+ did not differ between preeclampsia and normal pregnancy. CONCLUSIONS Women with preeclampsia have reduced cerebral Mg2+ levels, which could explain the potent antiseizure prophylactic properties of MgSO4. Within the preeclampsia group, women with visual disturbances have lower levels of Mg2+ than those without such symptoms.


Reproductive Sciences | 2016

Plasma Levels of the Cerebral Biomarker, Neuron-Specific Enolase, are Elevated During Pregnancy in Women Developing Preeclampsia

Lina Bergman; Helena Åkerud

Objectives: Neuron-specific enolase (NSE) is considered to be a peripheral biomarker of central nervous system injury. The aim of this study was to compare levels of NSE throughout pregnancy, in healthy pregnant women and in women developing preeclampsia. Methods: A nested case–control study within a longitudinal study cohort was performed. Four hundred sixty nine healthy pregnant women were enrolled, and plasma samples were collected at gestational weeks 10, 25, 28, 33, and 37. Levels of NSE were analyzed in 16 women with preeclampsia and 36 controls throughout pregnancy with an enzyme-linked immunosorbent assay. Results: In gestational week 37, women who developed preeclampsia had significantly higher plasma levels of NSE than healthy pregnant controls (P < .001). The levels of NSE did not change between gestational weeks 10 and 37 in women who developed preeclampsia, but the levels decreased significantly in healthy pregnant controls (P < .001). Conclusion: In pregnant women developing preeclampsia, the levels of NSE remained high throughout pregnancy, whereas in healthy women, these tended to decline over time, especially at the 2 last time points. The result might be confounded in early pregnancy by extracerebral sources of NSE, such as the corpus luteum. Findings need to be confirmed in a larger prospective study.


American Journal of Hypertension | 2016

Cerebral Biomarkers in Women With Preeclampsia Are Still Elevated 1 Year Postpartum

Lina Bergman; Helena Åkerud; Anna Karin Wikström; Marita Larsson; Tord Naessen; Tansim Akhter

BACKGROUND There is evidence of cerebral involvement among women with preeclampsia. Levels of the cerebral biomarkers neuron-specific enolase (NSE) and S100B are elevated during pregnancy in women developing preeclampsia. It is although not known if these biomarkers return to normal range postpartum. The aim with this study was to compare levels of S100B and NSE during pregnancy and 1 year postpartum in women who have had preeclampsia to women with normal pregnancies. METHODS This study was a longitudinal study of cases (n = 53) with preeclampsia and controls (n = 58) consisted of normal pregnant women in matched gestational weeks. Plasma samples were collected at inclusion during pregnancy and 1 year postpartum. Plasma samples were analyzed for levels of S100B and NSE by enzyme-linked immunosorbent assays kits. RESULTS Levels of NSE and S100B in women with preeclampsia were higher during pregnancy than in women with normal pregnancies. One year postpartum, women who have had preeclampsia still had a higher median level of both NSE (5.07 vs. 4.28 µg/l, P < 0.05) and S100B (0.07 vs. 0.06 µg/l, P < 0.05) compared to women with previous normal pregnancies. High levels of NSE and S100B postpartum remained associated with previous preeclampsia after adjustment for confounding factors. Levels of NSE correlated to S100B during pregnancy and postpartum. CONCLUSIONS Levels of NSE and S100B are still elevated 1 year postpartum in women who have had preeclampsia in contrast to women with previous normal pregnancies. We hypothesize that there might be a persistent cerebral involvement among women with preeclampsia even 1 year postpartum.


PLOS ONE | 2018

Blood-based cerebral biomarkers in preeclampsia: Plasma concentrations of NfL, tau, S100B and NSE during pregnancy in women who later develop preeclampsia - A nested case control study

Lina Bergman; Henrik Zetterberg; Helena Kaihola; Henrik Hagberg; Kaj Blennow; Helena Åkerud

Objective To evaluate if concentrations of the neuronal proteins neurofilament light chain and tau are changed in women developing preeclampsia and to evaluate the ability of a combination of neurofilament light chain, tau, S100B and neuron specific enolase in identifying neurologic impairment before diagnosis of preeclampsia. Methods A nested case-control study within a longitudinal study cohort was performed. 469 healthy pregnant women were enrolled between 2004–2007 and plasma samples were collected at gestational weeks 10, 25, 28, 33 and 37. Plasma concentrations of tau and neurofilament light chain were analyzed in 16 women who eventually developed preeclampsia and 36 controls throughout pregnancy with single molecule array (Simoa) method and compared within and between groups. S100B and NSE had been analyzed previously in the same study population. A statistical model with receiving characteristic operation curve was constructed with the four biomarkers combined. Results Plasma concentrations of neurofilament light chain were significantly increased in women who developed preeclampsia in gestational week 33 (11.85 ng/L, IQR 7.48–39.93 vs 6.80 ng/L, IQR 5.65–11.40) and 37 (22.15 ng/L, IQR 10.93–35.30 vs 8.40 ng/L, IQR 6.40–14.30) and for tau in gestational week 37 (4.33 ng/L, IQR 3.97–12.83 vs 3.77 ng/L, IQR 1.91–5.25) in contrast to healthy controls. A combined model for preeclampsia with tau, neurofilament light chain, S100B and neuron specific enolase in gestational week 25 displayed an area under the curve of 0.77, in week 28 it was 0.75, in week 33 it was 0.89 and in week 37 it was 0.83. Median week for diagnosis of preeclampsia was at 38 weeks of gestation. Conclusion Concentrations of both tau and neurofilament light chain are increased in the end of pregnancy in women developing preeclampsia in contrast to healthy pregnancies. Cerebral biomarkers might reflect cerebral involvement before onset of disease.


American Journal of Hypertension | 2018

Cerebral osmolytes and plasma osmolality in pregnancy and preeclampsia : a proton magnetic resonance spectroscopy study

Maria Nelander; Anna-Karin Wikström; Jan Weis; Lina Bergman; Anders Larsson; Inger Sundström-Poromaa; Johan Wikström

BACKGROUND Cerebral complications contribute substantially to mortality in preeclampsia. Pregnancy calls for extensive maternal adaptations, some associated with increased propensity for seizures, but the pathophysiology behind the eclamptic seizures is not fully understood. Plasma osmolality and sodium levels are lowered in pregnancy. This could result in extrusion of cerebral organic osmolytes, including the excitatory neurotransmitter glutamate, but this remains to be determined. The hypothesis of this study was that cerebral levels of organic osmolytes are decreased during pregnancy, and that this decrease is even more pronounced in women with preeclampsia. METHODS We used proton magnetic resonance spectroscopy to compare levels of cerebral organic osmolytes, in women with preeclampsia (n = 30), normal pregnancy (n = 32), and nonpregnant controls (n = 16). Cerebral levels of organic osmolytes were further correlated to plasma osmolality and plasma levels of glutamate and sodium. RESULTS Compared to nonpregnant women, women with normal pregnancy and preeclampsia had lower levels of the cerebral osmolytes, myo-inositol, choline and creatine (P = 0.001 or less), and all these metabolites correlated with each other (P < 0.05). Women with normal pregnancies and preeclampsia had similar levels of osmolytes, except for glutamate, which was significantly lower in preeclampsia. Cerebral and plasma glutamate levels were negatively correlated with each other (P < 0.008), and myo-inositol, choline and creatine levels were all positively correlated with both plasma osmolality and sodium levels (P < 0.05). CONCLUSIONS Our results indicate that pregnancy is associated with extrusion of cerebral organic osmolytes. This includes the excitatory neurotransmitter glutamate, which may be involved in the pathophysiology of seizures in preeclampsia.


Acta Obstetricia et Gynecologica Scandinavica | 2018

Risk of fistula formation and long-term health effects after a benign hysterectomy complicated by organ injury: A population-based register study

Susanne Hesselman; Lina Bergman; Ulf Högberg; Maria Jonsson

There is a paucity of data on the impact of organ injury on long‐term outcomes after a hysterectomy for benign indications. The aim of this study was to investigate fistula formation and patient‐reported long‐term health outcomes after organ injury at the time of a hysterectomy.


Acta Obstetricia et Gynecologica Scandinavica | 2018

Assessment of cerebral perfusion and edema in preeclampsia with intravoxel incoherent motion MRI

Maria Nelander; Daniel Hannsberger; Inger Sundström-Poromaa; Lina Bergman; Jan Weis; Helena Åkerud; Johan Wikström; Anna-Karin Wikström

Cerebral complications are the main reasons for morbidity and mortality in preeclampsia and eclampsia. As yet, we do not know whether the pathophysiology entails hypo‐ or hyperperfusion of the brain, or how and when edema emerges, due to the difficulty of examining the cerebral circulation.


BMJ Leader | 2017

36 Involving patients and families in tracheostomy care and quality improvement initiatives: a global perspective

Arif Manji; Lina Bergman; Chloe Swords; Erin Ward; Michael McCormick; Asit Arora

Aim Previous work describing patient and family outcomes after tracheostomy indicated that patients do not feel prepared at the time of discharge. The aim of our work was threefold: i. To assess the current provision of tracheostomy care within hospitals in the global community. ii. To improve hospital provision of tracheostomy quality improvement projects. iii. To champion clinician-patient interactions to improve the future of tracheostomy care. Methods An electronic survey was developed to review the perspective of healthcare professionals with respect to tracheostomy care. Confidence levels were assessed using a 5-point Likert scale. Surveys were disseminated via email. Following completion, participants participated in a free online webinar and completed a post-webinar survey. Participant confidence was compared pre-and post-webinar using Mann-Whitney. Results Only 23% of institutions provided elective patients with the opportunity to meet a tracheostomy patient prior to surgery. 52% of participants’ institutions participated in tracheostomy quality improvement initiatives and fewer than one quarter involved patients in quality improvement projects. Following the webinar, participant confidence regarding discussing emergency and home nursing tracheostomy care improved (p=0.025, p=0.001). Importantly, participants reported increased confidence in their ability to involve patients and their families in quality improvement interventions (p=0.001). Conclusions Current hospital and discharge provision of tracheostomy care can be improved. Educational interventions, such as webinars, act as an aid to improve confidence and provide professionals with strategies to change their practice. The current practice of clinician-led audit is becoming less viable. Future initiatives should focus upon patient-centred and patient-led outcomes to ensure excellence in deliverance of healthcare.


RCOG world congress 2017 20th-22nd of March 2017 | 2017

Effect of Experimental Preeclampsia, Seizure and MgSO4 Treatment in a Rat Model on Serum Levels of S100B and Neuron Specific Enolase

Lina Bergman; Abbie Chapman Johnson; Sarah M. Tremble; Helena Åkerud; Marilyn J. Cipolla

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