| 1. |
- Jung, Christian, et al.
(author)
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A comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention
- 2019
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In: Journal of critical care. - : W B SAUNDERS CO-ELSEVIER INC. - 0883-9441 .- 1557-8615. ; 52, s. 141-148
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Journal article (peer-reviewed)abstract
- Background: We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed.Methods: In total, 5063 VIPs were induded in this analysis, 922 were admitted after elective surgery or intervention, 4141 acutely, with 402 after acute surgery. Differences were calculated using Mann-Whitney-U test and Wilcoxon test. Univariate and multivariable logistic regression were used to assess associations with mortality.Results: Compared patients admitted after acute surgery, patients admitted after elective surgery suffered less often from frailty as defined as CFS (28% vs 46%; p < 0.001), evidenced lower SOFA scores (4 +/- 5 vs 7 +/- 7; p < 0.001). Presence of frailty (CFS >4) was associated with significantly increased mortality both in elective surgery patients (7% vs 12%; p = 0.01), in acute surgery (7% vs 12%; p = 0.02).Conclusions: VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery.
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| 2. |
- Eriksson, Mats, et al.
(author)
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Biotic dynamics and carbonate microfacies of the conspicuous Darriwilian (Middle Ordovician) 'Taljsten' interval, south-central Sweden
- 2012
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In: Palaeogeography, Palaeoclimatology, Palaeoecology. - : Elsevier BV. - 1872-616X .- 0031-0182. ; 367, s. 89-103
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Journal article (peer-reviewed)abstract
- Enclosed in the Darriwilian (Middle Ordovician) part of the reddish 'orthoceratite limestone' of Baltoscandia is a conspicuous c. 1.5 m thick unit colloquially known as the 'Taljsten' interval. It has a wide geographical distribution in the Baltoscandian paleocontinent but is particularly well exposed in south-central Sweden. The unit is characterized by its deviant gray color and beds with a mass occurrence of cystoid echinoderms. Moreover, the recent discovery of an anomalous abundance of extraterrestrial chromite grains and micrometeorites in the 'Taljsten' and immediately adjacent strata bear witness of a time of deposition correlating to an increased influx of extraterrestrial matter to Earth. In this study we analyze the faunal dynamics, based primarily on microfossils and carbonate microfacies, across this intriguing interval. Generally known as a macrolithologically monotonous succession, the 'Taljsten' proved more heterogeneous than previously believed in terms of fossil content and preservation, as well as mineral content and composition. The general texture is wackestone/packstone, but local heterogeneities are frequent. A microfaunal reorganization occurred with a transition from a trilobite- and brachiopod-dominated community to one dominated by echinoderms, which is mirrored also macroscopically by the cystoids. The latter pelmatozoans seem to have flourished and might even have aided in the formation of the numerous hardgrounds. The increase in echinoderms is linked to a Volkhovian increase in echinoderms in eastern Baltica. In the immediate post-'Taljsten' strata there is no distinct change back to the pre-'Taljsten' biota. Conodont and ostracod faunal diversity data reveal peak values in the 'Taljsten' compared to the enclosing strata, suggesting that the paleoenvironment was more suitable for higher diversity faunas of these metazoan groups. All data collectively support a regression in the beginning of the 'Taljsten', likely followed by transgression in its upper part. (C) 2012 Elsevier B.V. All rights reserved.
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| 3. |
- Sjöwall, Johanna, et al.
(author)
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Innate immune responses in Lyme borreliosis : Enhanced tumour necrosis factor-a and interleukin-12 in asymptomatic individuals in response to live spirochetes
- 2005
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In: Clinical and Experimental Immunology. - : Oxford University Press (OUP). - 0009-9104 .- 1365-2249. ; 141:1, s. 89-98
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Journal article (peer-reviewed)abstract
- Innate immunity is important for early defence against borrelia spirochetes and should play a role in the clinical outcome of the infection. In order to study early cytokine responses, in vitro differentiated dendritic cells (DCs) and whole blood cells from 21 patients with different clinical outcomes of Lyme neuroborreliosis were stimulated with live borrelia spirochetes. The borrelia-induced secretion of interleukin (IL)-4, IL-10, IL-12p70, Interferon (INF)-? and tumour necrosis factor (TNF)-a in DCs and IL-1ß, IL-6, IL-8, IL-10, IL-12p70, TNF-a, regulated upon activation normal T cell expressed and secreted (RANTES), monocyte chemoattractant protein (MCP)-1, macrophage inflammatory protein (MIP)-1a, MIP-1ß and eotaxin in whole blood cells was measured by enzyme-linked immunospot (ELISPOT) and multiplex arrays, respectively. We found increased numbers of TNF-a-secreting DCs (P = 0.018) in asymptomatic seropositive individuals compared to patients with subacute neuroborreliosis and seronegative controls. Asymptomatic individuals were also found to have elevated levels of IL-12p70 (P = 0.031) in whole blood cell supernatants compared to seronegative controls. These results are in line with previous experiments using cells of the adaptive immune response, indicating that strong T helper type 1 (Th1) proinflammatory responses might be associated with a successful resolution of Lyme disease. © 2005 British Society for Immunology.
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