| 1. |
- Aas, Wenche, et al.
(författare)
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Trends in Air Pollution in Europe, 2000–2019
- 2024
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Ingår i: Aerosol and Air Quality Research. - 2071-1409 .- 1680-8584. ; 24:4
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Tidskriftsartikel (refereegranskat)abstract
- This paper encompasses an assessment of air pollution trends in rural environments in Europe over the 2000–2019 period, benefiting from extensive long-term observational data from the EMEP monitoring network and EMEP MSC-W model computations. The trends in pollutant concentrations align with the decreasing emission patterns observed throughout Europe. Annual average concentrations of sulfur dioxide, particulate sulfate, and sulfur wet deposition have shown consistent declines of 3–4% annually since 2000. Similarly, oxidized nitrogen species have markedly decreased across Europe, with an annual reduction of 1.5–2% in nitrogen dioxide concentrations, total nitrate in the air, and oxidized nitrogen deposition. Notably, emission reductions and model predictions appear to slightly surpass the observed declines in sulfur and oxidized nitrogen, indicating a potential overestimation of reported emission reductions. Ammonia emissions have decreased less compared to other pollutants since 2000. Significant reductions in particulate ammonium have however, been achieved due to the impact of reductions in SOx and NOx emissions. For ground level ozone, both the observed and modelled peak levels in summer show declining trends, although the observed decline is smaller than modelled. There have been substantial annual reductions of 1.8% and 2.4% in the concentrations of PM10 and PM2.5, respectively. Elemental carbon has seen a reduction of approximately 4.5% per year since 2000. A similar reduction for organic carbon is only seen in winter when primary anthropogenic sources dominate. The observed improvements in European air quality emphasize the importance of comprehensive legislations to mitigate emissions.
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| 2. |
- Hansson, Jeanette, 1972, et al.
(författare)
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Randomized clinical trial of antibiotic therapy versus appendicectomy as primary treatment of acute appendicitis in unselected patients.
- 2009
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Ingår i: The British journal of surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; 96:5, s. 473-81
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A trial in selected men suggested that antibiotic therapy could be an alternative to appendicectomy in appendicitis. This study aimed to evaluate antibiotic therapy in unselected men and women with acute appendicitis. METHODS: Consecutive patients were allocated to study (antibiotics) or control (surgery) groups according to date of birth. Study patients received intravenous antibiotics for 24 h and continued at home with oral antibiotics for 10 days. Control patients had a standard appendicectomy. Follow-up at 1 and 12 months was carried out according to intention and per protocol. RESULTS: Study and control patients were comparable at inclusion; 106 (52.5 per cent) of 202 patients allocated to antibiotics completed the treatment and 154 (92.2 per cent) of 167 patients allocated to appendicectomy had surgery. Treatment efficacy was 90.8 per cent for antibiotic therapy and 89.2 per cent for surgery. Recurrent appendicitis occurred in 15 patients (13.9 per cent) after a median of 1 year. A third of recurrences appeared within 10 days and two-thirds between 3 and 16 months after hospital discharge. Minor complications were similar between the groups. Major complications were threefold higher in patients who had an appendicectomy (P < 0.050). CONCLUSION: Antibiotic treatment appears to be a safe first-line therapy in unselected patients with acute appendicitis. Registration number: NCT00469430 (http://www.clinicaltrials.gov).
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| 3. |
- Solberg, Anna, 1961, et al.
(författare)
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A local imbalance between MMP and TIMP may have an implication on the severity and course of appendicitis.
- 2008
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Ingår i: International journal of colorectal disease. - : Springer Science and Business Media LLC. - 0179-1958 .- 1432-1262. ; 23:6, s. 611-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Matrix metalloproteinases (MMPs) and the tissue inhibitors of MMPs (TIMPs) have been demonstrated to be involved in inflammatory conditions in the intestine. The purpose of this study was to investigate whether the alterations of the MMP/TIMP balance might reflect the course of the inflammatory process in acute appendicitis and if the expression and localisation of MMPs and TIMP is variable in the various clinical manifestations of appendicitis. MATERIALS AND METHODS: The study comprises 40 patients (26 men and 14 women) having emergency appendectomy and a control group constituting of 10 patients (5 men and 5 women) having a hemicolectomy for other reasons. MMP and TIMP expressions were assessed and compared in tissue specimens from phlegmonous (n = 15), gangrenous (n = 7), perforated appendicitis (n = 11) and controls with noninflamed appendices (n = 10) by means of enzyme-linked immunosorbent assay technique. Localisation of the enzymes was performed by immunohistochemistry. RESULTS: MMP-1 was significantly higher in gangrenous and perforated appendicitis compared with phlegmonous appendicitis and controls (p < 0.05) while MMP-2 was significantly lower in gangrenous appendicitis compared with phlegmonous appendicitis and controls. MMP-2 was also lower in perforated appendicitis when compared with controls (p < 0.01). Elevated expression of MMP-9 was demonstrated in all groups of appendicitis compared with the controls (p < 0.001). CONCLUSIONS: MMP-9 is the most abundantly expressed MMP of those investigated in inflamed appendix. We postulate that a local imbalance between MMP-9 and TIMP-1 may trigger a perforation. These results suggest that MMPs might be useful as biomarkers of appendices prone to perforation.
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| 4. |
- Solberg, Anna, 1961
(författare)
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Extracellular matrix remodelling proteases in acute appendicitis and their impact on appendiceal perforation
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Abstract Background Appendicitis is associated with varying degradation of extracellular matrix involved in tissue injury. The principal aim of this study was to investigate whether immunoreactive techniques could illustrate the course and severity of appendicitis and separate the different inflammatory grades, phlegmonous, gangrenous and perforated appendicitis, from each other and from uninflamed appendix. This could lead to early identification of patients with appendicitis that have or are at risk of a perforation, thereby improving their treatment and outcome. Materials and Methods In Papers I-II, tissue biopsies were taken from 40 appendectomized patients. Ten patients who had a hemicolectomy served as controls. In Paper III, proteolysis from tissue biopsies at and adjacent to the perforation was studied in 15 patients operated on for perforated appendicitis. In Paper IV, plasma samples taken prior to surgery and 4 weeks postoperatively and biopsies from the appendix were taken in 57 patients operated on for suspected appendicitis. Protein levels of matrix metalloproteinase (MMP) -1, -2, -3, -9 and tissue inhibitor of metalloproteinase (TIMP-1) (Papers I, III and IV), urokinase plasminogen activator (uPA) and plasminogen activator inhibitor type 1 (PAI-1) (Papers II, III and IV) were determined by ELISA and localised by immunohistochemistry. Results MMP-9 was the most abundant protease in all groups of appendicitis compared with controls. The expression of MMP-1 and PAI-1 was significantly higher in perforated appendicitis compared with phlegmonous appendicitis and controls while MMP-2 showed an opposite pattern. uPA was twice as high in all groups of appendicitis compared with controls while no differences were found in MMP-3 and TIMP-1 expression between the groups. Immunohistochemically a scattered distribution of MMP-9 and TIMP-1 was demonstrated in the appendiceal wall in gangrenous and perforated appendicitis. When investigating the proteases in relation to the sites of perforation, MMP-9 and PAI-1 were found to be highest at the perforation sites while MMP-1 was higher close to them and MMP-2 decreased gradually away from them. No difference was seen in TIMP-1 and uPA. The individual differences in plasma for TIMP-1 were higher in patients with perforated appendicitis than in them who had phlegmonous and gangrenous appendicitis. Conclusions ECM remodelling proteases and anti-proteases could be demonstrated in appendicitis. A local imbalance between MMP-9 and TIMP-1 in combination with an over-expression of PAI-1 participated in the ECM degradation, leading to tissue injury in appendiceal perforation. TIMP-1 in plasma could be an inflammatory diagnostic marker for patients with appendicitis and at risk for perforation. Keywords; Appendicitis, Perforation, Extracellular matrix, MMP-9, TIMP-1, uPA, PAI-1
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| 5. |
- Solberg, Anna, 1961, et al.
(författare)
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Local and systemic expressions of MMP-9, TIMP-1 and PAI-1 in patients undergoing surgery for clinically suspected appendicitis.
- 2012
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Ingår i: European surgical research. Europäische chirurgische Forschung. Recherches chirurgicales européennes. - : S. Karger AG. - 1421-9921. ; 48:2, s. 99-105
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Tidskriftsartikel (refereegranskat)abstract
- To examine, compare and correlate the expressions of matrix metalloproteinase 9 (MMP-9), tissue inhibitor of metalloproteinase 1 (TIMP-1) and plasminogen activator inhibitor type 1 (PAI-1) in appendiceal tissue and pre- and postoperative blood samples in patients undergoing surgery for clinically suspected appendicitis.
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| 6. |
- Solberg, Anna, 1961, et al.
(författare)
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Progress of tissue injury in appendicitis involves the serine proteases uPA and PAI-1.
- 2009
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Ingår i: Scandinavian journal of gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 44:5, s. 579-84
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Serine proteases and the matrix metalloproteinases (MMPs) are key factors in the proteolytic cascade and participate in extracellular matrix (ECM) degradation. Fibrinolytic activators and inhibitors may have an effect on inflammatory cells, thereby modulating the inflammatory response. It is reasonable to assume that they may be implicated in the tissue injury in acute appendicitis that subsequently leads to appendix perforation. The purpose of this study was to investigate the expression and distribution of urokinase-type plasminogen activator (uPA) and plasminogen-activator inhibitor type 1 (PAI-1) in appendicitis. MATERIAL AND METHODS: Expression of uPA and expression of PAI-1 were measured in tissue specimens from patients with appendicitis (n=30) and in control specimens (n=9), using the quantitative ELISA technique. Distribution of enzymes was studied with immunohistochemistry. The uPA and PAI-1 levels in the subgroups of appendicitis and controls were compared. RESULTS: The overall expressions of uPA and PAI-1 were greater in appendicitis than in control specimens (p <0.001 and p<0.0001, respectively). Expressions of uPA and PAI-1 in phlegmonous (n=15), gangrenous (n=6) and perforated appendicitis (n=9) were all higher than those in controls (n=9), (p<0.01). Moreover, the PAI-1 level was elevated in perforated appendicitis compared with phlegmonous appendicitis (p<0.01). uPA staining was observed in connection with vascular endothelial cells and the serosa stained intensely in specimens from perforated appendicitis. CONCLUSIONS: The expression of uPA and especially the over-expression of PAI-1 seem to correlate to the progression of local inflammatory response in acute appendicitis.
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| 7. |
- Solberg, Anna, 1961, et al.
(författare)
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Tissue Proteolysis in Appendicitis with Perforation
- 2011
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Ingår i: Journal of Surgical Research. - : Elsevier BV. - 0022-4804 .- 1095-8673. ; 169:2, s. 194-201
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Matrix metalloproteinases (MMPs) and serine proteases are able to degrade the extracellular matrix (ECM) and modulate immune responses in the gastrointestinal tract. The purpose of this study was to investigate local proteolysis in perforated appendicitis and its association with the appendix perforation. MATERIALS AND METHODS: Biopsies were taken at the sites of perforation (n = 15) and with a gradually increased distance from it. The expression and distribution of MMP-1, -2, and -9, the tissue inhibitor of metalloproteinases type (TIMP-1), plasminogen activator inhibitor type1 (PAI-1), and urokinase plasminogen activator (uPA) were measured by ELISA. The distribution of MMP-9, TIMP-1, uPA, and PAI-1 in perforated, nonperforated, and uninflamed appendix was investigated by immunohistochemistry with monoclonal antibody technique. RESULTS: MMP-1 expression was highest close to the perforation and was gradually decreased in biopsies in more distal locations (P < 0.01). MMP-9 showed a similar pattern being highest at the sites of perforation (P < 0.05), while MMP-2 expression showed a trend in the opposite direction without statistically significance. The expression of TIMP-1 trended lower at the sites of perforation. PAI-1 was highest at the sites of perforation (P < 0.01) and the uPA expression was similarly elevated close to and at the perforation. CONCLUSIONS: These data indicate a key role of MMP in the pathogenesis of appendix perforation. A local imbalance between MMP-9 and the inhibitor TIMP-1 could potentially contribute to the tissue injury leading to an appendix perforation. The overexpression of PAI-1 at the sites of perforation may also contribute to tissue damage.
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