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Träfflista för sökning "hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) hsv:(Annan klinisk medicin) "

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51.
  • Gustafsson, Patrik, et al. (författare)
  • Muscle oxygenation in Type 1 diabetic and non-diabetic patients with and without chronic compartment syndrome
  • 2017
  • Ingår i: PLoS Medicine. - Public library science. - 1549-1277. ; 12:10
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Type 1 diabetic patients and non-diabetic patients were referred for evaluation for chronic exertional compartment syndrome (CECS) based on clinical examination and complaints of activity-related leg pain in the region of the tibialis anterior muscle. Previous studies using near-infrared spectroscopy (NIRS) showed greater deoxygenation during exercise for CECS patients versus healthy controls; however, this comparison has not been done for diabetic CECS patients. Methods: We used NIRS to test for differences in oxygenation kinetics for Type 1 diabetic patients diagnosed with (CECS-diabetics, n = 9) versus diabetic patients without (CON-diabetics, n = 10) leg anterior chronic exertional compartment syndrome. Comparisons were also made between non-diabetic CECS patients (n = 11) and healthy controls (CON, n = 10). The experimental protocol consisted of thigh arterial cuff occlusion (AO, 1-minute duration), and treadmill running to reproduce symptoms. NIRS variables generated were resting StO(2)%, and oxygen recovery following AO. Also, during and following treadmill running the magnitude of deoxygenation and oxygen recovery, respectively, were determined. Results: There was no difference in resting StO2% between CECS-diabetics (78.2 +/- 12.6%) vs. CON-diabetics (69.1 +/- 20.8%), or between CECS (69.3 +/- 16.2) vs. CON (75.9 +/- 11.2%). However, oxygen recovery following AO was significantly slower for CECS (1.8 +/- 0.8%/sec) vs. CON (3.8 +/- 1.7%/sec) (P = 0.002); these data were not different between the diabetic groups. StO2% during exercise was lower (greater deoxygenation) for CECS-diabetics (6.3 +/- 8.6%) vs. CON-diabetics (40.4 +/- 22.0%), and for CECS (11.3 +/- 16.8%) vs. CON (34.1 +/- 21.2%) (P<0.05 for both). The rate of oxygen recovery post exercise was faster for CECS-diabetics (3.5 +/- 2.6%/sec) vs. CON-diabetics (1.4 +/- 0.8%/sec) (P = 0.04), and there was a tendency of difference for CECS (3.1 +/- 1.4%/sec) vs. CON (1.9 +/- 1.3%/sec) (P = 0.05). Conclusion: The greater deoxygenation during treadmill running for the CECS-diabetics group (vs. CON-diabetics) is in line with previous studies (and with the present study) that compared non-diabetic CECS patients with healthy controls. Our findings could suggest that NIRS may be useful as a diagnostic tool for assessing Type 1 diabetic patients suspected of CECS.
52.
  • Hesse, Camilla, et al. (författare)
  • The N-terminal domain of α-dystroglycan is released as a 38kDa protein and is increased in cerebrospinal fluid in patients with Lyme neuroborreliosis.
  • 2011
  • Ingår i: Biochemical and biophysical research communications. - 1090-2104. ; 412:3
  • Tidskriftsartikel (refereegranskat)abstract
    • α-Dystroglycan is an extracellular adhesion protein that is known to interact with different ligands. The interaction is thought to stabilize the integrity of the plasma membrane. The N-terminal part of α-dystroglycan may be proteolytically processed to generate a small 38kDa protein (α-DG-N). The physiological significance of α-DG-N is unclear but has been suggested to be involved in nerve regeneration and myelination and to function as a potential biomarker for neurodegenerative and neuromuscular diseases. In this report we show that α-DG-N is released into different body fluids, such as lachrimal fluid, cerebrospinal fluid (CSF), urine and plasma. To investigate the significance of α-DG-N in CSF we examined the levels of α-DG-N and known neurodegenerative markers in CSF from patients diagnosed with Lyme neuroborreliosis (LNB) and healthy controls. In untreated acute phase LNB patients, 67% showed a significant increase of CSF α-DG-N compared to healthy controls. After treatment with antibiotics the CSF α-DG-N levels were normalized in the LNB patients.
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53.
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54.
  • Kronvall, Erik, et al. (författare)
  • Metylprednisolon allt mer ifrågasatt vid behandling av akut ryggmärgsskada
  • 2005
  • Ingår i: Läkartidningen. - Swedish Medical Association. - 0023-7205. ; 102:24-25, s. 8-1890
  • Tidskriftsartikel (refereegranskat)abstract
    • Methylprednisolone (MP) has, through the results from the clinical multi-center studies National Acute Spinal Cord Injury Study II and III, during the 1990's become standard treatment in acute spinal cord injury (ASCI). Critical reappraisals of the data have later shown that analyses have been made on subgroups of the study-populations and argue that the results are based on statistical artefacts. This, combined with the failure to show improved functional recovery, puts into question earlier conclusions drawn on the efficacy of MP on ASCI. This review of the recent literature on the subject concludes that there is no scientific evidence to support MP as standard treatment in ASCI.
55.
  • Lindstedt Ingemansson, Sandra, et al. (författare)
  • Evaluation of continuous and intermittent myocardial topical negative pressure.
  • 2008
  • Ingår i: Journal of Cardiovascular Medicine. - Lippincott Williams and Wilkins. - 1558-2027. ; 9:8, s. 813-819
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Topical negative pressure, commonly used in wound therapy, has been shown to increase blood flow and stimulate angiogenesis in subcutaneous tissue and skeletal muscle. In wound therapy, intermittent negative pressure is often preferred to continuous negative pressure as tissue exposed to intermittent therapy shows twice as much granulation tissue formation than that exposed to continuous pressure after 2 weeks of therapy. The present study was designed to elucidate the differences in microvascular blood flow in the left anterior descending artery area between continuous and intermittent myocardial topical negative pressure of -50 mmHg. METHODS: Six pigs underwent median sternotomy. Laser Doppler probes were inserted horizontally into the heart muscle in the left anterior descending artery area at depths of approximately 5-6 mm. Measurements of microvascular blood flow were performed in normal myocardium and ischemic myocardium during 20 min of countinuous and intermittent topical negative pressure at -50 mmHg. RESULTS: Both continuous and intermittent topical negative pressure of -50 mmHg significantly increased microvascular blood flow in the underlying myocardium: from 56.2 +/- 13.1 perfusion units (PU) before to 132.8 +/- 7.4 PU during countinuous topical negative pressure application (P < 0.05) and from 75.8 +/- 12.1 PU before to 153.6 +/- 4.7 PU during intermittent topical negative pressure application (P < 0.05). CONCLUSION: No statistically significant difference was found between microvascular blood flow during 20 min of continuous and intermittent topical negative pressure at -50 mmHg in this porcine model.
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56.
  • Lindstedt Ingemansson, Sandra, et al. (författare)
  • Impact of different topical negative pressure levels on myocardial microvascular blood flow.
  • 2008
  • Ingår i: Cardiovascular Revascularization Medicine. - Elsevier Inc.. - 1878-0938. ; 9:1, s. 29-35
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: We have previously shown that a myocardial topical negative pressure (TNP) of -50 mmHg significantly increases microvascular blood flow in the underlying myocardium in normal, ischemic, and reperfused porcine myocardium. The present study was designed to elucidate the effect of different TNP levels between -50 and -150 mmHg on microvascular flow in normal and ischemic myocardium. MATERIALS AND METHODS: Seven pigs underwent median sternotomy. The microvascular blood flow in the myocardium was recorded, before and after the application of TNP, using laser Doppler velocimetry. Analyses were performed before left anterior descending artery (LAD) occlusion (normal myocardium) and after 20 min of LAD occlusion (ischemic myocardium). RESULTS: A TNP of -50 mmHg significantly increased microvascular blood flow in both normal (from 320.0+/-56.1 PU before TNP application to 435.7+/-65.5 PU after TNP application, P=.028) and ischemic myocardium (from 110.0+/-36.7 PU before TNP application to 194.3+/-56.2 PU after TNP application, P=.012). TNP between -75 and -150 mmHg showed no significant increase in microvascular blood flow in normal or ischemic myocardium. CONCLUSIONS: Of pressures between -50 and -150 mmHg, a TNP of -50 mmHg seems to be the most effective negative pressure concerning significant increase in microvascular blood flow in both normal and ischemic myocardium.
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57.
  • Lindstedt Ingemansson, Sandra, et al. (författare)
  • Topical negative pressure effects on coronary blood flow in a sternal wound model.
  • 2008
  • Ingår i: International Wound Journal. - Wiley-Blackwell. - 1742-481X. ; 5:4, s. 503-509
  • Tidskriftsartikel (refereegranskat)abstract
    • Several studies have suggested that mediastinitis is a strong predictor for poor long-term survival after coronary artery bypass surgery (CABG). In those studies, several conventional wound-healing techniques were used. Previously, we have shown no difference in long-term survival between CABG patients with topical negative pressure (TNP)-treated mediastinitis and CABG patients without mediastinitis. The present study was designed to elucidate if TNP, applied over the myocardium, resulted in an increase of the total amount of coronary blood flow. Six pigs underwent median sternotomy. The coronary blood flow was measured, before and after the application of TNP (-50 mmHg), using coronary electromagnetic flow meter probes. Analyses were performed before left anterior descending artery (LAD) occlusion (normal myocardium) and after 20 minutes of LAD occlusion (ischaemic myocardium). Normal myocardium: 171.3 +/- 14.5 ml/minute before to 206.3 +/- 17.6 ml/minute after TNP application, P < 0.05. Ischaemic myocardium: 133.7 +/- 18.4 ml/minute before to 183.2 +/- 18.9 ml/minute after TNP application, P < 0.05. TNP of -50 mmHg applied over the LAD region induced a significant increase in the total coronary blood flow in both normal and ischaemic myocardium.
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58.
  • Malmsjö, Malin, et al. (författare)
  • Negative-pressure wound therapy using gauze or open-cell polyurethane foam: similar early effects on pressure transduction and tissue contraction in an experimental porcine wound model.
  • 2009
  • Ingår i: Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society. - Wiley-Blackwell. - 1524-475X. ; 17:2, s. 200-205
  • Tidskriftsartikel (refereegranskat)abstract
    • Negative-pressure wound therapy (NPWT), also known as topical negative-pressure therapy, is widely used to manage wounds and accelerate healing. NPWT has so far been delivered mainly via open-cell polyurethane foam, but increasing interest has been directed toward delivering NPWT via gauze. In the present study, the early effects of NPWT on pressure transduction and wound contraction were examined in wounds filled with either polyurethane foam or gauze. An experimental setup of a porcine wound model was used, in which the animals were anesthetized for 12-14 hours. Negative pressures between -50 and -175 mmHg were applied in -25 mmHg increments. Wound bed pressure was measured using a saline filled catheter sutured to the bottom of the wound. The contraction of the wound edges was also determined. The recordings were performed upon reaching steady state, which typically occurred within 1 minute. For both fillers, wound bed negative pressure increased linearly with delivered vacuum with little deviation from set pressure (correlation coefficient 0.99 in both cases). Similar tissue contraction was observed when using foam and gauze. The most prominent contraction was observed in the range of 0 to -50 mmHg with greater vacuum only producing minor further movement of the wound edge. In conclusion, the present experimental study shows that gauze and foam are equally effective at delivering negative pressure and creating mechanical deformation of the wound.
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59.
  • Midlöv, Patrik, et al. (författare)
  • Medication report reduces number of medication errors when elderly patients are discharged from hospital
  • 2008
  • Ingår i: PHARMACY WORLD & SCIENCE. - Springer. - 0928-1231. ; 30:1, s. 92-98
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective To investigate whether a Medication Report can reduce the number of medication errors when elderly patients are discharged from hospital. Method We conducted a prospective intervention with retrospective controls on patients at three departments at Lund University Hospital, Sweden that where transferred to primary care. The intervention group, where patients received a Medication Report at discharge, was compared with a control group with patients of the same age, who were not given a Medication Report when discharged from the same ward one year earlier. Main outcome measures The main outcome measure was the number of medication errors when elderly patients were discharged from hospital. Results Among 248 patients in the intervention group 79 (32%) had at least one medication error as compared with 118 (66%) among the 179 patients in the control group. In the intervention group 15% of the patients had errors that were considered to have moderate or high risk of clinical consequences compared with 32% in the control group. The differences were statistically significant (P < 0.001). Conclusion Medication errors are common when elderly patients are discharged from hospital. The Medication Report is a simple tool that reduces the number of medication errors.
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60.
  • Minthon, Lennart, et al. (författare)
  • Somatostatin and neuropeptide Y in cerebrospinal fluid: correlations with severity of disease and clinical signs in Alzheimer's disease and frontotemporal dementia
  • 1997
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - Karger. ; 8:4, s. 232-239
  • Tidskriftsartikel (refereegranskat)abstract
    • Alzheimer's disease (AD) and frontotemporal dementia (FTD) are the most common types of progressive neurodegenerative disorder in our catchment area. The distribution of cortical degeneration in FTD is mainly the reverse of that in AD, while there are both differences and similarities in the clinical characteristics. Somatostatin and neuropeptide Y (NPY) are neuropeptides with a widespread distribution in the human cerebral cortex. Somatostatin is involved in the regulation of hormone release from the anterior pituitary and may act as a neurotransmitter-modulator. NPY is a potent anxiolytic neuropeptide. Somatostatin and NPY coexist in the cerebral cortex, basal ganglia and in amygdaloid complexes. The present study of AD (n = 34) and FTD (n = 22) analyses the cerebrospinal-fluid (CSF) levels of somatostatin-like immunoreactivity and NPY-like immunoreactivity and correlates their levels to 54 different clinical items, such as restlessness, anxiety, irritability and depression. The CSF levels of the two neuropeptides somatostatin and NPY were significantly correlated in FTD (p < 0.02), but not in AD. Several significant correlations to the clinical signs were found: in AD disorientation and dyspraxia, and in FTD agitation, irritability and restlessness. Somatostatin showed a significant negative correlation with severity of dementia in AD (p < 0.013).
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