| 1271. |
- Kumlien, Eva, et al.
(författare)
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Treatment with neurostimulation and ketogenic diet for people with medically refractory epilepsy : Andra behandlingsalternativ vid svårbehandlad epilepsi.
- 2018
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Ingår i: Läkartidningen. - 1652-7518. ; 115:Maj
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Forskningsöversikt (refereegranskat)abstract
- For some people with medically refractory epilepsy adjunct treatment with neurostimulation and ketogenic diet can be an option. Vagal nerve stimulation, VNS, consists of chronic intermittent electrical stimulation of the vagus nerve. VNS is effective and well tolerated in adolescents and adults. There is insufficient evidence on the efficacy of deep brain stimulation, DBS, and brain-responsive neurostimulation, RNS. Ketogenic diet is an established treatment in epilepsy with an increased number of indications, especially in neurometabolic diseases, where dietary therapy can completely eliminate epilepsy and improve cognitive and motor development. Ketogenic diet is a calculated diet consisting of a high amount of fat, the daily need of protein and a minimum of carbohydrates. The fat is converted to ketone bodies and transported across the blood-brain barrier to be used as an alternative energy source in the brain. Strictly calculated menus, regular monitoring and support from a team of dietician, nurse and physician are required.
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| 1272. |
- Kumlin, Urban, et al.
(författare)
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Sialic acid tissue distribution and influenza virus tropism
- 2008
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Ingår i: Influenza and Other Respiratory Viruses. - : Wiley. - 1750-2640 .- 1750-2659. ; 2:5, s. 147-154
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Forskningsöversikt (refereegranskat)abstract
- Avian influenza A viruses exhibit a strong preference for using alpha 2,3-linked sialic acid as a receptor. Until recently, the presumed lack of this receptor in human airways was believed to constitute an efficient barrier to avian influenza A virus infection of humans. Recent zoonotic outbreaks of avian influenza A virus have triggered researchers to analyse tissue distribution of sialic acid in further detail. Here, we review and extend the current knowledge about sialic acid distribution in human tissues, and discuss viruses with ocular tropism and their preference for a2,3-linked sialic acid.
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| 1273. |
- Kunze, K. N., et al.
(författare)
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A guide to appropriately planning and conducting meta-analyses: part 2-effect size estimation, heterogeneity and analytic approaches
- 2023
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Ingår i: Knee Surgery Sports Traumatology Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 31:5, s. 1629-1634
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Forskningsöversikt (refereegranskat)abstract
- Meta-analyses by definition are a subtype of systematic review intended to quantitatively assess the strength of evidence present on an intervention or treatment. Such analyses may use individual-level data or aggregate data to produce a point estimate of an effect, also known as the combined effect, and measure precision of the calculated estimate. The current article will review several important considerations during the analytic phase of a meta-analysis, including selection of effect estimators, heterogeneity and various sub-types of meta-analytic approaches.
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| 1274. |
- Kunze, K. N., et al.
(författare)
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A guide to appropriately planning and conducting meta-analyses: part 3. Special considerations-the network meta-analysis
- 2023
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Ingår i: Knee Surgery Sports Traumatology Arthroscopy. - 0942-2056. ; 31:7, s. 2544-2549
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Forskningsöversikt (refereegranskat)abstract
- The meta-analysis has become one of the predominant studies designs in orthopaedic literature. Within recent years, the network meta-analysis has been implicated as a powerful approach to comparing multiple treatments for an outcome of interest when conducting a meta-analysis (as opposed to two competing treatments which is typical of a traditional meta-analysis). With the increasing use of the network meta-analysis, it is imperative for readers to possess the ability to independently and critically evaluate these types of studies. The purpose of this article is to provide the necessary foundation of knowledge to both properly conduct and interpret the results of a network meta-analysis.
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| 1275. |
- Kurz, Adrian, et al.
(författare)
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Credibility and quality of meta-analyses addressing graft choice in anterior cruciate ligament reconstruction: a systematic review.
- 2017
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Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 25:2, s. 538-551
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Forskningsöversikt (refereegranskat)abstract
- This systematic review examined the methodological credibility and quality of reporting of all meta-analyses which have compared bone-patellar tendon-bone (BPTB) versus hamstring tendon (HT) for anterior cruciate ligament (ACL) reconstruction (ACLR).EMBASE, MEDLINE, and The Cochrane Library were systematically searched, and two reviewers independently assessed eligibility, credibility according to the Users' Guide to medical literature, and completeness of reporting according to the preferred reporting items for systematic review and meta-analyses (PRISMA) checklist. Inter-rater agreement was quantified using Kappa, and we used Pearson's correlation coefficient to evaluate potential associations.Seventeen meta-analyses were identified comparing BPTB versus HT for ACLR. The majority of meta-analyses were published in 2011 (5; 29%), and North America was the most common continent of publication (6; 35%). The three most commonly reported outcomes were stability (82%), complications (76%), and function (return to sport, IKDC score) (71%). The median number of satisfactorily reported items in the Users' Guide was three out of seven (IQR 2-4). The median number of satisfactorily reported items in PRISMA for the meta-analyses was 20 out of 27 (IQR 19-22).The credibility of the meta-analyses comparing BPTB versus HT autograft for ACLR although limited is improving with time. Earlier studies had limited methodological rigour; however, the more recent studies have shown promise in improved methodology. The study findings suggest that decisions should be made on a case-to-case basis with coordination of patient factors and preferences as well as surgeon experience on the background of the best available evidence.IV.
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| 1276. |
- Kvarnemo, Charlotta, 1963
(författare)
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Why do some animals mate with one partner rather than many? A review of causes and consequences of monogamy.
- 2018
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Ingår i: Biological Reviews of the Cambridge Philosophical Society. - : Wiley. - 1469-185X. ; 93, s. 1795-1812
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Forskningsöversikt (refereegranskat)abstract
- Why do some animals mate with one partner rather than many? Here, I investigate factors related to (i) spatial constraints (habitat limitation, mate availability), (ii) time constraints (breeding synchrony, length of breeding season), (iii) need for parental care, and (iv) genetic compatibility, to see what support can be found in different taxa regarding the importance of these factors in explaining the occurrence of monogamy, whether shown by one sex (monogyny or monandry) or by both sexes (mutual monogamy). Focusing on reproductive rather than social monogamy whenever possible, I review the empirical literature for birds, mammals and fishes, with occasional examples from other taxa. Each of these factors can explain mating patterns in some taxa, but not in all. In general, there is mixed support for how well the factors listed above predict monogamy. The factor that shows greatest support across taxa is habitat limitation. By contrast, while a need for parental care might explain monogamy in freshwater fishes and birds, there is clear evidence that this is not the case in marine fishes and mammals. Hence, reproductive monogamy does not appear to have a single overriding explanation, but is more taxon specific. Genetic compatibility is a promising avenue for future work likely to improve our understanding of monogamy and other mating patterns. I also discuss eight important consequences of reproductive monogamy: (i) parentage, (ii) parental care, (iii) eusociality and altruism, (iv) infanticide, (v) effective population size, (vi) mate choice before mating, (vii) sexual selection, and (viii) sexual conflict. Of these, eusociality and infanticide have been subject to debate, briefly summarised herein. A common expectation is that monogamy leads to little sexual conflict and no or little sexual selection. However, as reviewed here, sexual selection can be substantial under mutual monogamy, and both sexes can be subject to such selection. Under long-term mutual monogamy, mate quality is obviously more important than mate numbers, which in turn affects the need for pre-mating mate choice. Overall, I conclude that, despite much research on genetic mating patterns, reproductive monogamy is still surprisingly poorly understood and further experimental and comparative work is needed. This review identifies several areas in need of more data and also proposes new hypotheses to test.
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| 1277. |
- Kvernebo-Sunnergren, Kjersti, 1974, et al.
(författare)
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Mini review shows that a testicular volume of 3 mL was the most reliable clinical sign of pubertal onset in males
- 2023
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Ingår i: Acta Paediatrica. - 0803-5253. ; 112:11, s. 2300-06
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Forskningsöversikt (refereegranskat)abstract
- AimWe aimed to evaluate aspects of pubertal development to identify the most reliable clinical sign of pubertal onset in males. MethodsWe performed a mini review of the literature. ResultsIn 1951 Reynolds and Wines categorised pubic hair growth and genital development in five stages by visual inspection. Today the Tanner scale is used to assess the five stages of pubertal development, The second genital stage, characterised by enlargement of the scrotum defines pubertal onset in males. Testicular volume may be evaluated by using a calliper or by ultrasound scan. The Prader orchidometer, described in 1966, offers a method for evaluating testicular growth by palpation. Pubertal onset is commonly defined as testicular volume >3 or & GE;4 mL. The development of sensitive laboratory methods has enabled studies analysing hormonal activity in the hypothalamus-pituitary-gonadal axis. We review the relationships between physical and hormonal signs of puberty. We also discuss the results of studies assessing different aspects of pubertal development with a focus on identifying the most reliable clinical sign of pubertal onset in males. ConclusionA substantial amount of evidence supports testicular volume of 3 mL as the most reliable clinical sign of male pubertal onset.
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| 1278. |
- Kvist, Thomas, 1959, et al.
(författare)
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Clinical decision making of post-treatment disease
- 2023
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Ingår i: International Endodontic Journal. - : Wiley. - 0143-2885 .- 1365-2591. ; 56:Suppl 2, s. 154-168
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Forskningsöversikt (refereegranskat)abstract
- Root-filled teeth presenting with signs of post-treatment disease is a common finding in virtually every dental practice. There is both empirical and experimental evidence that, as long as the condition is asymptomatic, it is often left untreated. Professional judgements and decision making in endodontics as in any medical discipline are based on qualified estimations of the probability and the value of relevant outcomes. In this paper we describe various aspects of clinical decision making in general, from a descriptive as well as a normative point of view, but with a particular focus on the condition of the root-filled tooth with post-treatment disease. We review how attention to various types of uncertainties are relevant for the decision-making process. Additionally, we discuss the nature of value judgements and different concepts of health and disease which are important for understanding the complexity of the clinical decision-making process. We also refer to a set of principal rules that can guide the clinician's decision making in every-day practice in front of a case with endodontic post-treatment disease. Finally, we provide some aspects on the sometime cumbersome decision whether to go for a non-surgical or surgical method, whenever a decision on retreatment has been made.
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| 1279. |
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| 1280. |
- Kvitne, Kine Eide, et al.
(författare)
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Oral Drug Dosing After Gastric Bypass and Diet-Induced Weight Loss: Simpler Than We Think? Lessons Learned From the COCKTAIL Study
- 2024
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Ingår i: CLINICAL PHARMACOLOGY & THERAPEUTICS. - 0009-9236 .- 1532-6535. ; 116:3, s. 647-652
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Forskningsöversikt (refereegranskat)abstract
- This article summarizes the lessons learned from the COCKTAIL study: an open, three-armed, single-center study including patients with obesity scheduled for treatment with Roux-en-Y gastric bypass (RYGB) or nonsurgical calorie restriction, and a normal- to overweight control group. The clinical implications of the results from multiple peer-reviewed articles describing the effects of RYGB, severe caloric restriction, weight loss, and type 2 diabetes on the in vivo activity and protein expression of drug-metabolizing enzymes (cytochrome P450 (CYP) 1A2, 2C9, 2C19, and 3A) and transporters (DMETs; organic anion-transporting polypeptide (OATP) 1B1 and P-glycoprotein (P-gp)) are discussed in the perspective of three clinically relevant questions: (1) How should clinicians get the dose right in patients after RYGB? (2) Will drug disposition in patients with obesity be normalized after successful weight loss? (3) Are dose adjustments needed according to obesity and diabetes status? Overall, RYGB seems to have a lower impact on drug disposition than previously assumed, but clinicians should pay close attention to drugs with a narrow therapeutic range or where a high maximum drug concentration may be problematic. Whether obesity-related alterations of DMETs normalize with substantial weight loss depends on the DMET in question. Obesity and diabetes downregulate the in vivo activity of CYP2C19 and CYP3A (only obesity) but whether substrate drugs should be dose adjusted is also dependent on other factors that influence clearance, that is, liver blood flow and protein binding. Finally, we recommend frequent and individualized follow-up due to high inter- and intraindividual variability in these patients, particularly following RYGB.
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