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  • Resultat 1275601-1275610 av 1637242
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1275601.
  • Farsky, Pedro S, et al. (författare)
  • Optimal medical therapy with or without surgical revascularization and long-term outcomes in ischemic cardiomyopathy.
  • 2022
  • Ingår i: The Journal of thoracic and cardiovascular surgery. - : Elsevier BV. - 1097-685X .- 0022-5223. ; 164:6, s. 1890-1899.e4
  • Tidskriftsartikel (refereegranskat)abstract
    • Optimal medical therapy in patients with heart failure and coronary artery disease is associated with improved outcomes. However, whether this association is influenced by the performance of coronary artery bypass grafting is less well established. Thus, the aim of this study was to determine the possible relationship between coronary artery bypass grafting and optimal medical therapy and its effect on the outcomes of patients with ischemic cardiomyopathy.The Surgical Treatment for Ischemic Heart Failure trial randomized 1212 patients with coronary artery disease and left ventricular ejection fraction 35% or less to coronary artery bypass grafting with medical therapy or medical therapy alone with a median follow-up over 9.8 years. For the purpose of this study, optimal medical therapy was collected at baseline and 4 months, and defined as the combination of 4 drugs: angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, beta-blocker, statin, and 1 antiplatelet drug.At baseline and 4 months, 58.7% and 73.3% of patients were receiving optimal medical therapy, respectively. These patients had no differences in important parameters such as left ventricular ejection fraction and left ventricular volumes. In a multivariable Cox model, optimal medical therapy at baseline was associated with a lower all-cause mortality (hazard ratio, 0.78; 95% confidence interval, 0.66-0.91; P = .001). When landmarked at 4 months, optimal medical therapy was also associated with a lower all-cause mortality (hazard ratio, 0.82; 95% confidence interval, 0.62-0.99; P = .04). There was no interaction between the benefit of optimal medical therapy and treatment allocation.Optimal medical therapy was associated with improved long-term survival and lower cardiovascular mortality in patients with ischemic cardiomyopathy and should be strongly recommended.
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1275602.
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1275603.
  • Fartash, Bahman (författare)
  • Single crystal sapphire dental implants : experimental and clinical studies
  • 1996
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aim of this project was to evaluate single synthetic sapphire crystals as dental implants, with special reference to correlation of clinical and in vitro/in vivo methods of research. The laboratory studies confirmed chemical stability. The nontoxic properties were confirmed by in vitro tests showing no disruption to normal cell function in cell cultures of human oral epithelial cells and fibroblasts. Tissue-implant interactions were studied in animal experiments: thirty Sprague-Dawley rats were used for subcutaneous implantation and two inbred beagle dogs for mandibular bone implantation. The subcutaneously implanted sapphire rods showed a minimal foreign body reaction after 4-12 weeks in situ. In the intraosseous implantation experiment the implants and surrounding tissues were removed after 6 months in situ: for histological and histometric analysis. Showed that bone contact to the implants was appr. 62% and the peri-implant mucosa closely resembled the mucosa surrounding the tooth. In the clinical studies, conducted in one Swedish and one Norwegian specialist clinic, 86 patients with edentulous mandibular were treated with overdentures supported by sapphire implants. To determine implant success, clinical evaluation and radiographic features were monitored. Of the initial 324 implants, 28 implants were lost during the first 42 months. For the remaining implants, the cumulative implant success rates, based on radiographic and clinical criteria varied from 95.2% at the end of the prosthetic treatment to 91.3% at the twelve year follow-up. The radiographic analysis of the remaining implants showed no statistically significant changes in the bone implant score index (BIS), measured from baseline to the five year follow-up. Correlation of the experimental and clinical data indicate that the single synthetic sapphire crystal dental implant system is an appropriate method for rehabilitation of mandibular edentulism.
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1275604.
  • Farup, Per G, et al. (författare)
  • Irritable bowel syndrome.
  • 2012
  • Ingår i: Gastroenterology research and practice. - : Hindawi Limited. - 1687-630X .- 1687-6121. ; 2012
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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1275605.
  • Farzad, Payam, 1973 (författare)
  • On tissue reactions to dentin as a bone substitute material
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background Reconstruction of the jaws due to resorption of the alveolar crest may require bone augmentation prior to installation of endosseous implants. Active research on new bone graft materials with bone regeneration ability equivalent to autogenous bone but without the limitations of allogenic, xenogenic and synthetic bone are constantly ongoing. From clinical and experimental studies, it has been demonstrated that replanted teeth without a viable periodontal membrane will ankylose with the bone. The dentin of such teeth is fused with the bone, and will be gradually replaced by bone, also called replacement resorption or osseous replacement. In order to possibly modify treatment protocols and also exploring possible cost-benefit alternatives to commercially available bone replacement materials, there has been an increased interest to explore the use of human dentin as a source for graft material. Aims The aim of the first study was to evaluate and compare the host tissue response to autogenous and xenogenic non-demineralized dentin blocks implanted in non-osteogenic areas, the abdominal connective tissue and femoral muscle of rabbits. The objective of the second study was primarily to evaluate the healing pattern of xenogenic non-demineralized dentin granules and dentin blocks grafted to maxillary bone of rabbits and secondarily to study integration of titanium micro-implants installed in grafted areas. In paper III, we sought to evaluate the healing pattern of xenogenic demineralized dentin granules and dentin blocks grafted to cavities created in tibial bone of rabbits, secondarily to study integration of titanium micro-implants installed in grafted areas and thirdly to investigate the morphological appearances and differences between demineralized and non-demineralized dentin by means of Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray (EDX). Finally, the objective of study IV was to compare the host tissue response and remodelling of onlay grafts of demineralized dentin in comparison to onlay bone grafts transplanted to the native tibial cortical bone wall. Material and methods In study I, fifteen 6-month old New Zealand male white rabbits were used. Dentin autografts taken from the same rabbit and dentin xenografts taken from human premolars were implanted in abdominal connective tissue and femoral muscles. All rabbits were sacrificed after 12 weeks for light microscopic analysis. In study II, fifteen 6-months old New Zealand male rabbits were used. Dentin blocks and dentin granules from human premolars were implanted in cavities prepared on either side of the maxilla (n=15x2). After a healing period of 6 months, one micro implant (5 mm long, 2 mm in diameter) was installed in each surgical site. All rabbits were sacrificed 24 weeks after implant installation. The specimens were studied by light microscopic and histomorphometrical analysis. Study III included twelve 6-month old New Zealand male, white rabbits. Dentin blocks and dentin granules from human premolars were implanted in cavities prepared on both tibial bones. Twelve hours prior to grafting the dentin grafts were rinsed in saline and demineralized on its surface by being placed in 24% EDTA neutral, pH7, for 12 hours. After a healing period of 24 weeks, one micro implant was installed in each surgical site. To characterize the grafts, twelve additional dentin blocks were prepared in standardized sizes. All samples were conditioned in 24% EDTA neutral, pH7, for 12 hours followed by a second x-ray analysis. Four samples were chosen for conventional SEM and energy dispersive X-ray analysis (EDX), both image mode and element analysis mode. In study IV, we used eight 6-months old New Zealand male rabbits. Standardized sized dentin blocks from human premolars and similar autogenous bone blocks, harvested from tibia were grafted as onlay blocks on each tibia (n=8x2). All animals were sacrificed after a healing period of 12 weeks. Descriptive histology as well as histomorphometrical analysis of the remaining dentin, bone graft and soft tissue was determined using light microscopy. Results Study I showed only minor signs of heterotopic bone formation. There were no significant differences between autografts and xenografts or grafts implanted in connective tissue or muscle with regards to tissue reactions except for a significant difference (P = 0.018) in findings of more local inflammatory cells in relation to grafts placed in connective tissue in the autograft group. In study II, no statistically significant difference could be observed in BIC and BA between dentin and native bone. Overall the BIC and percentage of new bone fill of the block specimens were higher than the same parameters for the particulate graft. Study III showed a tendency towards higher BIC and BA for the EDTA conditioned dentin in conjunction with installed implants, but the difference was not statistically significant. In addition, on the demineralized dentin surface the organic marker element C dominated, as revealed by EDX image mode. The hydroxyapatite constituents Ca, P and O were close to devoid on the dentin surface. A similar pattern was discerned from the semi-quantitative data analysis where the organic markers C and N dominated. Study IV showed that in general, both the dentin and bone block grafts were fused to the bone, resorbed and replaced by bone and connective tissue to a varying degree. Resorption cavities could be seen in the dentin with bone formation. Zones of osseous replacement resorption of the dentin could be noted. In both graft types, higher rate of bone formation was seen at the interface between graft and recipient site. Conclusion Non-demineralized dentin, whether autogenous or xenogenic did not have the potential to induce bone formation when implanted in non-osteogenic areas such as the abdominal wall and abdominal muscle of rabbits. Limited or no bone contact between micro-implants and xenogenic non-demineralized dentin grafts could be seen. Demineralized xenogenic dentin onlay grafts showed similar resorption characteristics as autogenous bone onlay grafts, being resorbed in a similar rate during 12 weeks. New bone formation occurred mainly in terms of replacement resorption in the interface between dentin/bone graft and native bone. The bone inductive capacity of the dentin material seemed limited although demineralization by means of EDTA indicated a higher BIC and BA value in conjunction with installed implants in the area. Keywords Grafted dentin, tissue reaction, bone blocks, dental implants, experimental study
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1275606.
  • Farzadfar, Farshad, et al. (författare)
  • National, regional, and global trends in serum total cholesterol since 1980:systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3.0 million participants
  • 2011
  • Ingår i: Lancet. - 0140-6736. ; 377:9765, s. 578-86
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Data for trends in serum cholesterol are needed to understand the effects of its dietary, lifestyle, and pharmacological determinants; set intervention priorities; and evaluate national programmes. Previous analyses of trends in serum cholesterol were limited to a few countries, with no consistent and comparable global analysis. We estimated worldwide trends in population mean serum total cholesterol. Methods We estimated trends and their uncertainties in mean serum total cholesterol for adults 25 years and older in 199 countries and territories. We obtained data from published and unpublished health examination surveys and epidemiological studies (321 country-years and 3·0 million participants). For each sex, we used a Bayesian hierarchical model to estimate mean total cholesterol by age, country, and year, accounting for whether a study was nationally representative. Findings In 2008, age-standardised mean total cholesterol worldwide was 4·64 mmol/L (95% uncertainty interval 4·51–4·76) for men and 4·76 mmol/L (4·62–4·91) for women. Globally, mean total cholesterol changed little between 1980 and 2008, falling by less than 0·1 mmol/L per decade in men and women. Total cholesterol fell in the high-income region consisting of Australasia, North America, and western Europe, and in central and eastern Europe; the regional declines were about 0·2 mmol/L per decade for both sexes, with posterior probabilities of these being true declines 0·99 or greater. Mean total cholesterol increased in east and southeast Asia and Pacific by 0·08 mmol/L per decade (−0·06 to 0·22, posterior probability=0·86) in men and 0·09 mmol/L per decade (−0·07 to 0·26, posterior probability=0·86) in women. Despite converging trends, serum total cholesterol in 2008 was highest in the high-income region consisting of Australasia, North America, and western Europe; the regional mean was 5·24 mmol/L (5·08–5·39) for men and 5·23 mmol/L (5·03–5·43) for women. It was lowest in sub-Saharan Africa at 4·08 mmol/L (3·82–4·34) for men and 4·27 mmol/L (3·99–4·56) for women. Interpretation Nutritional policies and pharmacological interventions should be used to accelerate improvements in total cholesterol in regions with decline and to curb or prevent the rise in Asian populations and elsewhere. Population-based surveillance of cholesterol needs to be improved in low-income and middle-income countries.
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1275607.
  • Fasano, A., et al. (författare)
  • Gaps, Controversies, and Proposed Roadmap for Research in Normal Pressure Hydrocephalus
  • 2020
  • Ingår i: Movement Disorders. - : Wiley. - 0885-3185 .- 1531-8257. ; 35:11, s. 1945-1954
  • Tidskriftsartikel (refereegranskat)abstract
    • Idiopathic normal pressure hydrocephalus is considered common but remains underinvestigated. There are no uniformly accepted diagnostic criteria and therapeutic guidelines. We summarize the accumulated evidence regarding the definition, pathophysiology, diagnosis, and treatment of idiopathic normal pressure hydrocephalus, highlighting the many gaps and controversies, including diagnostic challenges, the frequent association with neurodegeneration and vascular disease, and the many unknowns regarding patient selection and outcome predictors. A roadmap to fill these gaps and solve the controversies around this condition is also proposed. More evidence is required with respect to diagnostic criteria, the value of ancillary testing, prospective population-based studies and novel trial designs. Furthermore, a need exists to develop new advanced options in shunt technology. (c) 2020 International Parkinson and Movement Disorder Society
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1275608.
  • Fast, Karin, et al. (författare)
  • Prevalence of attention-deficit/hyperactivity disorder and autism in 12-year-old children: A population-based cohort
  • 2023
  • Ingår i: Developmental Medicine and Child Neurology. - 0012-1622.
  • Tidskriftsartikel (refereegranskat)abstract
    • AimTo investigate the prevalence of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in a population-based birth cohort and correlate the findings with prenatal and perinatal factors. We hypothesized that children born preterm, having experienced preeclampsia or maternal overweight, would have an increased risk of ADHD or ASD.MethodA Swedish cohort of 2666 children (1350 males, 1316 females) has been followed from birth with parental and perinatal data. The National Board of Health and Welfare's registries were used to collect data regarding perinatal status and assigned diagnoses at the age of 12 years.ResultsThe prevalence of ADHD and ASD was 7.6% and 1.1% respectively. Maternal obesity early in pregnancy resulted in a three-fold increased risk of ADHD in the child. Similarly, paternal obesity resulted in a two-fold increased risk. The association was significant also when adjusted for sex, preterm birth, smoking, and lower educational level. The prevalence of ASD was too low for statistically relevant risk factor analyses.InterpretationOur results corroborate earlier findings regarding prevalence and sex ratio for both ADHD and ASD. Maternal body mass index and preterm birth were correlated with an ADHD diagnosis at the age of 12 years.
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1275609.
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1275610.
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