| 1. |
- Fava, Cristiano, et al.
(författare)
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Novel mutations in the SLC12A3 gene causing Gitelman's syndrome in Swedes
- 2007
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Ingår i: DNA Sequence. - : Informa UK Limited. - 1029-2365 .- 1042-5179. ; 18:5, s. 395-399
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Gitelman's syndrome (GS) is an inherited autosomal recessive disorder due to loss of function mutations in the SLC12A3 gene encoding the Na-Cl co-transporter (NCCT), the target of thiazide diuretics. The defective function of the NCCT, which normally is expressed in the apical membrane of the distal convolute tubule in the kidney, leads to mild hypotension, hypokalemia, hyperreninemic hyperaldosteronism, mild metabolic alkalosis, hypomagnesemia and hypocalciuria. Up to now, more than 100 mutations of the SLC12A3 gene have been described in GS patients. METHODS: We have collected 30 patients from Sweden with a clinical diagnosis of GS and undertaken a mutation screening by SSCP and successive sequencing of the 26 exons and intronic boundaries. Both mutations were identified in most (n = 28, 93%) and at least one mutation was identified in all patients. RESULTS: We found 22 different mutations evenly distributed throughout the gene, 11 of which have not been described previously. The new variants include 8 missense mutations (Glu68Lys, His69Asn, Argl45His, Vall53Met, Gly230Asp, Gly342Ala, Val677Leu and Gly867Ser), 1 insertion (c.834_835insG on exon 6) and 2 splice-site mutations (c.2667 + lT>G substitution in splicing donor site after exon 22, c.1569-1G>A substitution in the splicing acceptor site before exon 13). CONCLUSION: In Swedish patients with the clinical features of GS, disease-causing mutations in the SLC12A3 gene were identified in most patients. The spectrum of GS mutations is wide making full mutation screening of the SLC12A3 gene necessary to confirm the diagnosis.
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| 2. |
- Dautovic Bergh, Cecilia, 1972-, et al.
(författare)
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Protein S100B after cardiac surgery: An indicator of long-term anxiety?
- 2007
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 41:2, s. 109-113
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. The aim of the study was to assess long-term state and trait anxiety in cardiac surgical risk patients. Design. Thirty two patients with serum S100B > 0.3 µg/l 48 hours after cardiac surgery with cardiopulmonary bypass were matched according to age, gender, type, date and length of surgery with 35 operated patients without elevated S100B. They completed Spielberger's Anxiety Inventory (STAI). Results. Patients with elevated S100B reported more state anxiety and trait anxiety. S100B was an independent predictor of both state and trait anxiety when controlling for perioperative variables. Conclusions. Patients with elevated S100B reported more anxiety 3–6 years after cardiac surgery. A postoperative blood sample can identify risk patients and facilitate appropriate follow-up.
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| 3. |
- Krigsman, Kristin, et al.
(författare)
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Refill non-adherence to repeat prescriptions leads to treatment gaps or to high extra costs.
- 2007
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Ingår i: Pharmacy World & Science. - : Springer Netherlands. - 0928-1231 .- 1573-739X. ; 29:1, s. 19-24
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine the nature and extent of undersupply and the economic consequences of oversupply of medication among non-adherent patients. METHODS: This study used copies of repeat prescriptions (= multiple dispensations), collected during 1 week in 2002 at 16 Swedish community pharmacies. For patients with a refill adherence below 80%, treatment gaps were defined as the number of days they had no drug available. The cost of drug oversupply (i.e., refill adherence > 120%) was calculated from the prices of the drug packages dispensed. RESULTS: The number of collected repeat prescriptions was 3,636. The median of treatment gaps among patients with a refill adherence below 80% was 53 days per 90-100 days treatment period and the corresponding median for oversupply was 40 days. The cost of oversupply for exempt patients (i.e., patients who have paid 1,800 SEK (Euro 196; US$ 243) per year for medicines) was 32,000 SEK (Euro 3,500; US$ 4,300) higher than for non-exempt patients. An extrapolation to all Sweden indicates that exemption from charges leads to an additional oversupply of about 142 million SEK (Euro 15 million; US$ 19 million) per year above that of non-exempt patients. CONCLUSION: Both undersupply and oversupply of prescribed medicines are common in Sweden. Patients with a refill adherence below 80% seem to have less than half of the prescribed treatment available. Oversupply or drug stockpiling occurs more frequently among exempt than among non-exempt patients, and this oversupply leads to high unnecessary costs.
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| 4. |
- Bäsckström, M., et al.
(författare)
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Adverse drug reaction reporting by nurses in Sweden
- 2007
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Ingår i: European Journal of Clinical Pharmacology. - Berlin : Springer. - 0031-6970 .- 1432-1041. ; 63, s. 613-618
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate whether nurses could be a useful tool for improving the reporting rate of adverse drug reactions (ADRs). Furthermore, we wanted to study how physicians working at the study departments would respond to nurses as reporters of ADRs and if the reporting from the nurses affected the reporting rate from the physicians.METHOD: Three departments of internal medicine and one unit for orthopaedics were selected for the study. Nurses with special drug responsibilities were invited to participate. At the start of the study period, the nurses received an introduction with background, objective, method and other practical issues concerning the study. After this, an education programme about ADR reporting, definitions, and ADR classification according to mechanism and organ system was given. To study their knowledge about and attitude towards ADRs, a questionnaire was handed out to the nurses. A questionnaire was also handed out to all physicians at the participating departments in order to investigate their attitude towards nurses as reporters of ADRs.RESULTS: Fifty-four nurses participated in the study. During the study period, a total number of 23 reports with 39 ADRs were sent to the regional centres by the nurses. Seventeen (74%) of the reports were assessed as serious. Eight of the 39 ADRs were unlabelled and all reports were considered appropriate. The reporting rate from the physicians during the study period was similar to the previous year, indicating that the nurses contributed with additional reports. At the end of the study, the nurses thought that they had enough knowledge to report ADRs. Sixty-eight percent of the physicians did not object to nurses being included as reporters of suspected ADRs.CONCLUSION: Adverse drug reaction reporting by nurses could improve the overall safety of drugs.
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| 5. |
- Fagerström, Cecilia, et al.
(författare)
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Feeling hindered by health problems and functional capacity at 60 years and above
- 2007
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 44:2, s. 181-201
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Tidskriftsartikel (refereegranskat)abstract
- It is common to use activities of daily living (ADL) rating scales to identify the impact of health problems such as diseases, impaired eyesight or hearing on daily life. However, for various reasons people with health problems might feel hindered in daily life before limitations in ability to perform ADL have occurred. In addition, there is sparse knowledge of what makes people feel hindered by health problems in relation to their ADL capacity. The aim was to investigate feeling hindered by health problems among 1297 people aged 60–89 living at home in relation to ADL capacity, health problems, life satisfaction, self-esteem, and social and financial resources, using a self-reported questionnaire, including questions from OARS (Older Americans’ Resources and Services schedule), Rosenberg’s self-esteem and Life Satisfaction Index Z. People feeling greatly hindered by health problems rarely had anyone who could help when they needed support, had lower life satisfaction and self-esteem than those not feeling hindered. Feeling hindered by health problems appeared to take on a different meaning depending on ADL capacity, knowledge that seems essential to include when accomplishing health promotion and rehabilitation interventions, especially at the early stages of reduced ADL capacity.
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| 6. |
- Fagerström, Cecilia
(författare)
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LIFE SATISFACTION AND FEELING HINDERED BY HEALTH PROBLEMS AT 60 YEARS AND ABOVE
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to investigate how older people's capacity to perform activities of daily living (ADL), health, social and financial resources, and self-esteem can be related to their life satisfaction. The aim was also to investigate how people feel hindered by health problems in relation to their ADL capacity, health problems, social and financial resources, self-esteem, sense of coherence, and life satisfaction. The thesis focused on people 60?96 years of age in six European countries, living at home. The data were collected in two cross-sectional studies, using standardised self-reported questionnaires and a medical examination. The first study (papers I, II and III) included people in six European countries (Sweden, the UK, the Netherlands, Luxembourg, Austria, and Italy) who participated in the European Study of Adult Well-being (ESAW) in 2001 to 2002. Paper I included people (n = 7699) aged 60?89 in all six countries, Paper II included people with reduced ADL capacity (n = 2195), and Paper III included people living in Sweden (n = 1297) with at least one health problem. In the ESAW, questions from the Older Americans Resources and Services schedule, (OARS), the Life Satisfaction Index Z (LSIZ) and Rosenberg's Self-Esteem Scale were used. The other study (Paper IV) included people (n = 958) aged 60?96 years of age who participated in a baseline survey in one of the four centres (Blekinge) of the longitudinal multi-centre cohort study named The Swedish National study on Aging and Care (SNAC) in 2001. Established questions and instruments were used to collect the data, and quantitative descriptive statistics, comparative statistics and multiple regressions were used when analysing the data. In all ESAW country samples, factors such as feeling hindered by health problems, low social and financial resources, and low self-esteem played a crucial role in creating conditions for low life satisfaction. It is also possible to identify both common and country-specific factors influential for life satisfaction in the six European countries. The analysis furthermore revealed that personal as well as environmental factors were important, though personal factors were more important for life satisfaction than environmental factors among people with impaired ADL capacity. Among those with impaired ADL capacity in the six national samples, people afflicted by poor overall health and people who were feeling worried and had low self-esteem suffered an increased risk of low life satisfaction in all countries. At the same time, social and financial resources had an impact on life satisfaction in four countries. Results suggest that self-esteem and perceived health are of universal importance for life satisfaction irrespective of ADL capacity, and these phenomena are thus essential to target in health care interventions. Furthermore, feeling hindered by health problems in daily living, rather than the impairment in ADL capacity, appears to increase the risk for low life satisfaction. In addition to this, people felt hindered by their problems although they had excellent ADL capacity. Several factors contributed to people feeling hindered, and the importance of these factors differed according to the level of the ADL capacity of the individual. The results suggest that people seemingly re-evaluate the importance of their resources when health declines, making certain activities in daily life more important than others.
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| 7. |
- Hovbrandt, Pia, et al.
(författare)
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Very old people´s experience of occupational performance outside the home; : Possibilities and limitations
- 2007
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Ingår i: Scand J Occup Ther. - : Informa UK Limited. ; 14:2, s. 77-85
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Tidskriftsartikel (refereegranskat)abstract
- To support occupations outside the home for older people with functional limitations it is important to understand how the person, environment, and occupations influence performance. Therefore the purpose of this study was to describe how very old people experience occupational performance outside the home. Twenty-one single-living, very old persons, above 80 years, were strategically selected and interviewed. A phenomenographic approach was used for this study and the interviews were analyzed using contextual analysis. The findings showed a variation in the experience of occupational performance described in three referential aspects: keeping on doing as before, drawing on available resources, and living in constrained circumstances. Referring to everyday occupations the participants described how they continued to do what they had done before, but decline in functional capacity made it more difficult to overcome environmental barriers. They also described how they sometimes could put functional limitations aside and use their utmost capacity to reach their goals. When they could not do that any more, they had to find possibilities for occupations close to home. In order to support very old people's occupational performance outside the home, outdoor mobility has to be facilitated, including the design of the physical environment as well as possibilities for social interaction.
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| 8. |
- Samuelson, Karin, et al.
(författare)
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Stressful experiences in relation to depth of sedation in mechanically ventilated patients.
- 2007
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Ingår i: Nursing in critical care. - : Wiley. - 1478-5153 .- 1362-1017. ; 12:2, s. 93-104
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Tidskriftsartikel (refereegranskat)abstract
- n mechanically ventilated patients, sedatives and analgesics are commonly used to ensure comfort, but there is no documented knowledge about the impact of depth of sedation on patients' perception of discomfort. The aim of this study was, therefore, to investigate the relationship between stressful experiences and intensive care sedation, including the depth of sedation. During 18 months, 313 intubated mechanically ventilated adults admitted to two general intensive care units (ICU) for more than 24 h were included. Patients (n= 250) were interviewed on the general ward 5 days after ICU discharge using the ICU Stressful Experiences Questionnaire. Patient data including sedation scores as measured by the Motor Activity Assessment Scale (MAAS) were collected from hospital records after the interview. Of the 206 patients with memories of the intensive care, 82% remembered at least one experience as quite a bit or extremely bothersome. Multivariate analyses showed that higher proportion of MAAS score 3 (indicating more periods of wakefulness), longer ICU stay and being admitted emergent were factors associated with remembering stressful experiences of the ICU as more bothersome. The findings indicate that the depth of sedation has an impact on patients' perception of stressful experiences and that light sedation compared with heavy seems to increase the risk of perceiving experiences in the ICU as more bothersome. In reducing discomfort, depth of sedation and patient comfort should be assessed regularly, non-pharmacological interventions taken into account and the use of sedatives and analgesics adapted to the individual requirements of the patient
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| 9. |
- Waldenström, Jonas, et al.
(författare)
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Migrating birds and tickborne encephalitis virus
- 2007
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Ingår i: Emerging Infectious Diseases. - : Centers for Disease Control and Prevention (CDC). - 1080-6040 .- 1080-6059. ; 13:8, s. 1215-8
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Tidskriftsartikel (refereegranskat)abstract
- During spring and autumn 2001, we screened 13,260 migrating birds at Ottenby Bird Observatory, Sweden, and found 3.4% were infested with ticks. Four birds, each a different passerine species, carried tickborne encephalitis virus (TBEV)-infected ticks (Ixodes ricinus). Migrating birds may play a role in the geographic dispersal of TBEV-infected ticks.
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| 10. |
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