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Sökning: WFRF:(Brodin Lars Åke)

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2.
  • Bratel, Tomas, et al. (författare)
  • Ventilation-perfusion relationships in pulmonary arterial hypertension : Effect of intravenous and inhaled prostacyclin treatment
  • 2007
  • Ingår i: Respiratory Physiology & Neurobiology. - 1569-9048 .- 1878-1519. ; 158:1, s. 59-69
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>In seven patients with idiopathic or secondary pulmonary arterial hypertension (PAH), ventilation-perfusion (V-A/Q) relationships were measured during a right heart catheterization using the multiple inert-gas elimination technique before and during intravenous infusion with epoprostenol (EPO), and following 5 months of 20 mu g inhaled iloprost taken three times daily (ILO). Pre-treatment pulmonary vascular resistance (PVR) was 9.3 +/- 5.0 mmHg/l/min and the dispersion of perfusion and ventilation for V-A/Q-ratios was increased. EPO reduced PVR by 20%, and increased cardiac output, shunt, and mixed venous oxygenation (Sv(O2)) The arterial oxygen tension (Pa-O2) remained unchanged. Basal central haemodynamics did not change after 5 months of ILO. Fifteen minutes after ILO, PVR decreased by 20%, and the shunt, Sv(O2), and Pa-O2 remained unaltered. Conclusions: In secondary PAH with normal lung volumes, significant V-A/Q mismatching occurred. The PVR was reduced to a similar degree during EPO and after ILO, but only EPO increased the shunt and Sv(O2). EPO and ILO did not significantly affect the Pa-O2.</p>
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  • Carlsson, Lars, et al. (författare)
  • Enhanced systolic myocardial function in elite endurance athletes during combined arm-and-leg exercise
  • 2011
  • Ingår i: European Journal of Applied Physiology. - 1439-6319. ; 111:6, s. 905-913
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim here was to employ color tissue velocity imaging (TVI), to test the hypothesis that highly trained endurance athletes exhibit enhanced systolic function of the left ventricular (LV) myocardium both at rest and during combined arm-and-leg exercise in comparison with untrained subjects. For each of the ten elite male (EG) and ten matched control participants (CG), LV dimensions and systolic function were assessed at rest using echocardiography. Subsequently, these subjects exercised continuously on a combined arm-and-leg cycle ergometer for 3 min each at 50, 60, 70, 80, 90 and 100% of VO2max. Oxygen uptake, heart rate, systolic blood pressure (SBP) and peak contraction systolic velocities of the LV myocardium (PSV) were recorded in the end of each level. At rest, the trained and untrained groups differed with respect to LV dimensions, but not systolic function. At 60–100% VO2max, the EG group demonstrated both higher PSV and SBP. The observation that the EG athletes had higher PSV than CG during exercise at 60–100% VO2max, but not at rest or at 50% of VO2max, suggested an enhanced systolic capacity. This improvement is likely to be due to an enhanced inotropic contractility, which only becomes apparent during exercise.
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5.
  • Carlsson, Lars, et al. (författare)
  • Enhanced systolic myocardial function in elite endurance athletes during combined arm-and-leg exercise
  • 2011
  • Ingår i: European Journal of Applied Physiology. - 1439-6319 .- 1439-6327. ; 111:6, s. 905-913
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>The aim here was to employ color tissue velocity imaging (TVI), to test the hypothesis that highly trained endurance athletes exhibit enhanced systolic function of the left ventricular (LV) myocardium both at rest and during combined arm-and-leg exercise in comparison with untrained subjects. For each of the ten elite male (EG) and ten matched control participants (CG), LV dimensions and systolic function were assessed at rest using echocardiography. Subsequently, these subjects exercised continuously on a combined arm-and-leg cycle ergometer for 3 min each at 50, 60, 70, 80, 90 and 100% of VO2max. Oxygen uptake, heart rate, systolic blood pressure (SBP) and peak contraction systolic velocities of the LV myocardium (PSV) were recorded in the end of each level. At rest, the trained and untrained groups differed with respect to LV dimensions, but not systolic function. At 60-100% VO2max, the EG group demonstrated both higher PSV and SBP. The observation that the EG athletes had higher PSV than CG during exercise at 60-100% VO2max, but not at rest or at 50% of VO2max, suggested an enhanced systolic capacity. This improvement is likely to be due to an enhanced inotropic contractility, which only becomes apparent during exercise.</p>
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7.
  • Linnersjö, Anette, et al. (författare)
  • Low mortality and myocardial infarction incidence among flying personnel during working career and beyond
  • 2011
  • Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 37:3, s. 219-226
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Objective The aim of this study was to evaluate mortality and acute myocardial infarction (AM!) incidence among commercial and military flying personnel in Sweden. Methods Flying personnel, employed at the Swedish part of Scandinavian Airlines and/or the Swedish Armed Forces at some point between 1957-1994, were included. The cohort was followed regarding mortality and AMI incidence using national registers of hospital discharges and deaths. The observed mortality and AMI incidence was compared with the expected rate in the general Swedish population through standardized mortality ratios (SMR) and standardized incidence ratios (SIR) taking age, gender, and calendar year into account. Results Swedish flying personnel, except male cabin crew, had a lower-than-expected all-cause mortality (SMR ranging from 0.57 among female cabin crew to 0.79 among navigators and mechanics; male cabin crew 0.89) and cardiovascular mortality (SMR from 0.31 among female cabin crew to 0.79 among navigators and mechanics). We observed an elevated mortality in aircraft accidents (SMR ranging from 23.87 among commercial pilots to 165.68 among military pilots). Male cabin attendants had a higher-than-expected mortality for alcohol-related death causes and acquired immunodeficiency syndrome (AIDS). AMI incidence was reduced in all groups and across the lifespan (SIR between 0.13 among female cabin crew and 0.61 among navigators and mechanics). Conclusions Swedish flying personnel have a low all-cause mortality. This is mostly due to a reduced cardiovascular mortality reflecting a low AMI incidence during the working life as well as after retirement.</p>
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8.
  • Ressner, Marcus, 1967-, et al. (författare)
  • Effects of ultrasound contrast agents on doppler tissue velocity estimation
  • 2006
  • Ingår i: Journal of the American Society of Echocardiography. - 0894-7317 .- 1097-6795. ; 19:2, s. 154-164
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>The combination of Doppler tissue imaging and myocardial contrast echocardiography has the potential to provide information about motion and perfusion of the myocardium in a single examination. The purpose of this study was to establish how the presence of ultrasound contrast agent (UCA) affects measurements of Doppler tissue velocities in vivo and in vitro. We performed echocardiography in 12 patients with ischemic heart disease before and immediately after a slow intravenous infusion of the UCA Optison, using color Doppler tissue imaging to examine the effect of contrast agents in vivo. The myocardial peak systolic velocities and their integrals were analyzed in digitally stored cineloops before and after contrast administration. To distinguish between methodologic and physiologic factors affecting the measurement of tissue velocity in vitro, experiments with a rotating disk and a flow cone phantom were also carried out for the 3 contrast agents: Optison, Sonovue, and Sonazoid. In vivo results show that the values for peak systolic velocity increased by about 10% during contrast infusion, from mean 5.2 ± 1.8 to 5.7 ± 2.3 cm/s (P = .02, 95% confidence interval 2%-16%). The increase in myocardial peak systolic velocities was verified in experimental models in which the UCA increased the estimated mean velocity in the order of 5% to 20% for the motion interval of 5 to 7 cm/s, corresponding to the myocardial velocities studied in vivo. The response was similar for all 3 contrast agents and was not affected by moderate variations in concentration of the agent. We have shown that the presence UCA will affect Doppler tissue measurements in vivo and in vitro. The observed bias is presumed to be an effect of harmonic signal contribution from rupturing contrast agent microbubbles and does not indicate biologic or physiologic effects. Copyright 2006 by the American Society of Echocardiography.</p>
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10.
  • Andersson, Agneta, et al. (författare)
  • Domiciliary liquid oxygen versus concentrator treatment in chronic hypoxaemia: a cost-utility analysis
  • 1998
  • Ingår i: European Respiratory Journal. - 1399-3003. ; 12:6, s. 1284-1289
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Whether long-term oxygen therapy (LTOT) improves quality of life in chronic hypoxaemia has been questioned. LTOT with an oxygen concentrator (C/C) and gas cylinders for ambulation is considered cumbersome compared to mobile liquid oxygen equipment (L). The hypothesis for this study was that LTOT with liquid oxygen treatment (L) improves patients' health-related quality of life, but that it is also more expensive compared to concentrator (C/C) treatment. A prospective, randomized multicentre trial comparing C/C with L for LTOT was conducted during a six-month period. Fifty-one patients (29 on L and 22 on C/C) with chronic hypoxaemia, regularly active outside the home, participated in the study initially. Costs for oxygen were obtained from the pharmacies. Patient diaries and telephone contacts with members of the healthcare sector were used to estimate costs. Health-related quality of life was measured by the Sickness Impact Profile (SIP) and the EuroQol, instruments at the start and after 6 months. The average total cost per patient for group C/C for the six-month period was US$1,310, and for group L it was US$4,950. Health-related quality of life measured by the SIP instrument showed significant differences in favour of group L in the categories/dimensions of physical function, body care, ambulation, social interaction and total SIP score. In conclusion, liquid-oxygen treatment was more expensive compared to concentrator treatment. However, treatment effects showed that liquid oxygen had a better impact on quality of life.</p>
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