| 1. |
- Arnoldsson, Kristina, 1961-, et al.
(författare)
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Retention and maternal transfer of environmentally relevant polybrominated dibenzo-p-dioxins and dibenzofurans, polychlorinated dibenzo-p-dioxins and dibenzofurans, and polychlorinated biphenyls in zebrafish (Danio rerio) after dietary exposure
- 2012
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Ingår i: Environmental Toxicology and Chemistry. - : John Wiley & Sons. - 0730-7268 .- 1552-8618. ; 31:4, s. 804-812
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Tidskriftsartikel (refereegranskat)abstract
- High levels of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), mono- and non-ortho polychlorinated biphenyls (PCBs), and polybrominated dibenzo-p-dioxins (PBDDs) are found in fish from coastal areas in the Baltic Sea, which may cause ecotoxicological effects. To increase our understanding of the persistency of the emerging pollutants polybrominated dibenzo-p-dioxins and dibenzofurans (PBDD/Fs), fish feed was spiked with 21 PBDD/Fs, 17 PCDD/Fs, and 30 PCBs and fed to zebrafish. Concentrations in fish and eggs were examined during a six- or twelve-week uptake period, and a six-week elimination period. Steady-state was reached for 2, 3, 7, and/or 8-substituted tri- and tetra-BDD/Fs, with 2,3,7,8-tetra-BDD (2,3,7,8-TeBDD) being the most strongly retained. Steady-state was not reached for tetra- to hexa-CDDs. Non-2,3,7,8-congeners showed little of or no retention. Most PCBs had high retention and did not reach steady-state. Half-lives decreased in the order: PCBs > PCDD/Fs > PBDD/Fs. Concentrations of 2,3,7,8-penta- to octa-CDD/Fs decreased with their degree of chlorination suggesting that the rate-limiting factor for uptake is low bioavailability. Maternal transfer was observed for all retained compounds, with most transfer factors < 1, indicating that transfer rates are affected by the poor water solubility of the compounds. The limited retention of the major PBDD congeners found in Baltic Sea fish suggests that they are exposed to high or very high concentrations via either food or water.
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| 2. |
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| 3. |
- Austeng, Dordi, et al.
(författare)
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Incidence of and risk factors for neonatal morbidity after active perinatal care : extremely preterm infants study in Sweden (EXPRESS)
- 2010
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 99:7, s. 978-992
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of this study was to determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotizing enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage >= 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusion: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted.
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| 4. |
- Barazzoni, Rocco, et al.
(författare)
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Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition
- 2022
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Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 41:6, s. 1425-1433
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Tidskriftsartikel (refereegranskat)abstract
- The Global Leadership Initiative on Malnutrition (GLIM) provides consensus criteria for the diagnosis of malnutrition that can be widely applied. The GLIM approach is based on the assessment of three phenotypic (weight loss, low body mass index, and low skeletal muscle mass) and two etiologic (low food intake and presence of disease with systemic inflammation) criteria, with diagnosis confirmed by any combination of one phenotypic and one etiologic criterion fulfilled. Assessment of muscle mass is less commonly performed than other phenotypic malnutrition criteria, and its interpretation may be less straightforward, particularly in settings that lack access to skilled clinical nutrition practitioners and/or to body composition methodologies. In order to promote the widespread assessment of skeletal muscle mass as an integral part of the GLIM diagnosis of malnutrition, the GLIM consortium appointed a working group to provide consensus-based guidance on assessment of skeletal muscle mass. When such methods and skills are available, quantitative assessment of muscle mass should be measured or estimated using dual-energy x-ray absorptiometry, computerized tomography, or bioelectrical impedance analysis. For settings where these resources are not available, then the use of anthropometric measures and physical examination are also endorsed. Validated ethnic-and sex-specific cutoff values for each measurement and tool are recommended when available. Measurement of skeletal muscle function is not advised as surrogate measurement of muscle mass. However, once malnutrition is diagnosed, skeletal muscle function should be investigated as a relevant component of sarcopenia and for complete nutrition assessment of persons with malnutrition. (c) 2022 Elsevier Ltd. and European Society for Clinical Nutrition and Metabolism and American Society for Parenteral and Enteral Nutrition. All rights reserved.
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| 6. |
- Compher, Charlene, et al.
(författare)
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Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition diagnosis of malnutrition
- 2022
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Ingår i: JPEN - Journal of Parenteral and Enteral Nutrition. - : John Wiley & Sons. - 0148-6071 .- 1941-2444. ; 46:6, s. 1232-1242
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Tidskriftsartikel (refereegranskat)abstract
- The Global Leadership Initiative on Malnutrition (GLIM) provides consensus criteria for the diagnosis of malnutrition that can be widely applied. The GLIM approach is based on the assessment of three phenotypic (weight loss, low body mass index, and low skeletal muscle mass) and two etiologic (low food intake and presence of disease with systemic inflammation) criteria, with diagnosis confirmed by any combination of one phenotypic and one etiologic criterion fulfilled. Assessment of muscle mass is less commonly performed than other phenotypic malnutrition criteria, and its interpretation may be less straightforward, particularly in settings that lack access to skilled clinical nutrition practitioners and/or to body composition methodologies. In order to promote the widespread assessment of skeletal muscle mass as an integral part of the GLIM diagnosis of malnutrition, the GLIM consortium appointed a working group to provide consensus-based guidance on assessment of skeletal muscle mass. When such methods and skills are available, quantitative assessment of muscle mass should be measured or estimated using dual-energy x-ray absorptiometry, computerized tomography, or bioelectrical impedance analysis. For settings where these resources are not available, then the use of anthropometric measures and physical examination are also endorsed. Validated ethnic- and sex-specific cutoff values for each measurement and tool are recommended when available. Measurement of skeletal muscle function is not advised as surrogate measurement of muscle mass. However, once malnutrition is diagnosed, skeletal muscle function should be investigated as a relevant component of sarcopenia and for complete nutrition assessment of persons with malnutrition.
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| 7. |
- Gomes, Filomena, et al.
(författare)
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ESPEN guidelines on nutritional support for polymorbid internal medicine patients
- 2018
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Ingår i: Clinical Nutrition. - : CHURCHILL LIVINGSTONE. - 0261-5614 .- 1532-1983. ; 37:1, s. 336-353
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Polymorbidity (also known as multimorbidity)-defined as the co-occurrence of at least two chronic health conditions - is highly prevalent, particularly in the hospitalized population. Nonetheless, clinical guidelines largely address individual diseases and rarely account for polymorbidity. The aim of this project was to develop guidelines on nutritional support for polymorbid patients hospitalized in medical wards.Methods: The methodology used for the development of the current project follows the standard operating procedures for ESPEN guidelines. It started with an initial meeting of the Working Group in January 2015, where twelve key clinical questions were developed that encompassed different aspects of nutritional support: indication, route of feeding, energy and protein requirements, micronutrient requirements, disease-specific nutrients, timing, monitoring and procedure of intervention. Systematic literature searches were conducted in three different databases (Medline, Embase and the Cochrane Library), as well as in secondary sources (e.g. published guidelines), until April 2016. Retrieved abstracts were screened to identify relevant studies that were used to develop recommendations, which were followed by submission to Delphi voting rounds.Results: From a total of 4532 retrieved abstracts, 38 relevant studies were analyzed and used to generate a guideline draft that proposed 22 recommendations and four statements. The results of the first online voting showed a strong consensus (agreement of >90%) in 68% of recommendations and 75% of statements, and consensus (agreement of >75-90%) in 32% of recommendations and 25% of statements. At the final consensus conference, a consensus greater than 89% was reached for all of the recommendations.Conclusions: Despite the methodological difficulties in creating non-disease specific guidelines, the evidence behind several important aspects of nutritional support for polymorbid medical inpatients was reviewed and summarized into practical clinical recommendations. Use of these guidelines offer an evidence-based nutritional approach to the polymorbid medical inpatient and may improve their outcomes.
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| 8. |
- Gustafsson, Mats, 1966-, et al.
(författare)
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Optidrift : optimerad vinter- och barmarksdrift för bättre luftkvalitet
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Drift av gator och vägar påverkar, förutom framkomlighet och säkerhet, även miljöaspekter som luftkvalitet. Åtgärder som sandning och saltning påverkar halten av inandningsbara partiklar (PM10) i luften. Driftåtgärder som görs för att minska uppvirvlingen av partiklar på våren kan å andra sidan ha effekt på vinterdriften, genom att de saltlösningar som används också fungerar som halkbekämpningsmedel. Projektet har undersökt möjligheterna att optimera gatudriften ur dessa aspekter, med ett fokus på luftkvalitet. I olika aktiviteter inhämtades synpunkter och erfarenheter kring problembild och lösningar från bransch, väghållare och praktiker. En provtagare för vägdamm, WDS II, vidareutvecklades. Utvärderingar av olika spol- och städvarianters effekt på dammförrådet visade att en positiv effekt av metoderna kräver att det finns förhållandevis mycket damm på vägytan. Optimeringstester visade att god prognosstyrning av insatserna är viktigt för ett bra resultat. En kriteriebaserad analys visade att ingen optimering av dammbindningen skett under projektperioden. Sammantaget har projektets ursprungliga mål att kunna föreslå en optimerad gatudrift i en stadsdel i Stockholm inte nåtts, främst beroende av gällande driftkontrakt och av miljökvalitetsmålets (PM10) och framkomlighetens höga prioritet i staden. Däremot har Optidrift identifierat framgångsfaktorer och problem med gatudriften, resulterat i ökad kunskap om gatudriftens effekter på dammförråd och luftkvalitet samt tagit fram användbara utvärderingsmetoder och scenarioanalyser användbara i fortsatt arbete med att förbättra och optimera vinter- och barmarksdrift.
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| 9. |
- Kleberg, Agneta, et al.
(författare)
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Lower stress responses after newborn individualized developmental care and assessment program care during eye screening examinations for retinopathy of prematurity : A randomized study
- 2008
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 121:5, s. E1267-E1278
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE. Screening examination for retinopathy of prematurity is distressing and painful. The aim of the present study was to investigate whether a Newborn Individualized Developmental Care and Assessment Program intervention during a retinopathy of prematurity examination results in less adverse behavioral, pain, and stress responses as compared with standard care. METHODS. The first 2 eye examinations in 36 preterm infants were evaluated. The infants were randomly assigned at the first eye examination to receive either Newborn Individualized Developmental Care and Assessment Program care or standard care. At the second examination, crossover of subject assignment was performed. The assessments included behavioral responses, recordings of heart rate, respiration, and oxygenation, pain scores (premature infant pain profile), and salivary cortisol at defined time points up to 4 hours after the eye examination. The nursing support given during the eye examinations (intervention score) were scored using predefined criteria. RESULTS. Altogether, 68 examinations were evaluated. Newborn Individualized Developmental Care and Assessment Program care was associated with better behavioral scores during the examination but there was no difference in heart rate, respiratory rate, oxygenation, or premature infant pain profile score between the 2 care strategies before or after the eye examination. Salivary cortisol increased from baseline to 30 minutes after the eye examination independent of care strategy and decreased significantly between 30 and 60 minutes when infants were subjected to Newborn Individualized Developmental Care and Assessment Program care but not after standard care. During the study period the intervention score for standard care increased and approached the score for Newborn Individualized Developmental Care and Assessment Program care at the later eye examinations. CONCLUSION. A Newborn Individualized Developmental Care and Assessment Program-based intervention during eye examination does not decrease pain responses but results in faster recovery, as measured by lower salivary cortisol 60 minutes after the examination. The differences were seen despite the influence from the Newborn Individualized Developmental Care and Assessment Program intervention on the standard care treatment that occurred during the study period.
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