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1.
  • Berg, Thomas, 1975- (författare)
  • Medical Treatment and Grading of Bell's Palsy
  • 2009
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>The main aim of this thesis was to evaluate the effect of prednisolone and valaciclovir in a large number of Bell's palsy patients. The incidence and intensity of pain around the ear, in the face or in the neck during the first two months of palsy, and its prognostic value, was also assessed. We also investigated how study design and choice of analysis method affect the rate of facial recovery. Furthermore, the agreement between the Sunnybrook, House-Brackmann and Yanagihara facial grading systems was evaluated.</p> <p>From May 2001 to September 2007, a prospective, randomised, double-blind, placebo-controlled, multicentre trial with 12-month follow-up was performed in patients with Bell's palsy. Of 839 randomised patients, 829 were included in the intention-to-treat analysis; 206 received placebo plus placebo, 210 prednisolone plus placebo, 207 valaciclovir plus placebo, and 206 prednisolone plus valaciclovir. Time to recovery was significantly shorter in the 416 patients who received prednisolone compared with the 413 who did not (p&lt;0.0001). At 12 months, 300 of 416 patients (72%) in the prednisolone group had recovered compared with 237 of 413 patients (57%) in the no prednisolone group (p&lt;0.0001). Valaciclovir was not found to affect time to facial recovery or outcome at 12 months. Prednisolone and/or valaciclovir did not affect the incidence or intensity of pain. Presence of pain at day 11 to 17 indicated a worse prognosis for facial recovery at 12 months. We also found that recovery rates in a Bell's palsy trial are substantially affected by the choice of analysis method and definition of facial recovery.</p> <p>We used weighted Kappa statistics in 100 examinations of patients with facial palsy to assess the agreement between the Sunnybrook, House-Brackmann and Yanagihara scales. The highest agreement was found between the regional Sunnybrook and Yanagihara scales. An evaluative difference between the Sunnybrook and House-Brackmann systems was observed.</p>
2.
  • Sahlstrand-Johnson, Pernilla, et al. (författare)
  • Does the oral steroid treatment of patients with nasal polyposis cause osteopenia or osteoporosis?
  • ????
  • Ingår i: Clinical Otolaryngology. - Wiley-Blackwell. - 1749-4478.
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: We aimed to investigate the bone mineral density (BMD) in a group of Swedish patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) with or without asthma, as well as to evaluate whether the treatment of this patient group is in accordance with the EPOS recommendations. Design, settings and participants: Adult patients with a diagnosis of CRSwNP, and a history of at least two courses of oral corticosteroids (OCS) during the last year, were consecutively included in this study at five centres. Main outcome measures: The BMD of the patients was measured by Dual-energy X-ray absorptiometry (DXA), which is the only technology for classifying BMD according to the criteria established by WHO. Results: A total of 51 patients, with an average number of 7 years with OCS treatment, were enrolled. During the last 12 months, the mean number of OCS courses was 2.76, and the total mean intake was 891 mg of Prednisone equivalents. According to the T-scores, 17 patients were measured to have ≤−1 SD T-score lumbar spine, which is considered to be osteopenia, and five patients had <−2.5 SD T-score, considered as osteoporosis. However, when taking age and gender into account and analysing the Z-scores, only 2 patients had a reduced density of the spine and none in the hip, which is no difference compared to a matched Swedish population. Conclusions: This prospective study shows that 2-3 moderate courses of OCS annually may be used without high risk of causing osteopenia/osteoporosis in patients with CRSwNP.
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3.
  • Åhman, Mats, et al. (författare)
  • Nasal symptoms and pathophysiology in farmers
  • 2001
  • Ingår i: International Archives of Occupational and Environmental Health. - 0340-0131 .- 1432-1246. ; 74:4, s. 279-84
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>OBJECTIVES: Increased morbidity and mortality in lower airway diseases have been reported among farmers. The aim of this study was to assess upper airway problems in farmers. SUBJECTS AND METHODS: Twenty-five dairy farmers, 20 pig farmers, 21 grain farmers and 19 control subjects were studied, by use of questionnaire, skin-prick test, dynamic spirometry, nasal inspection, acoustic rhinometry (before and after a decongestant) as well as by determinations of the olfactory threshold and nasal lavage (NAL) concentrations of eosinophil cationic protein (ECP), myeloperoxidase (MPO) and albumin. RESULTS: Compared with the control group, farmers had more complaints of work-related symptoms from the lower airways, and symptoms of smell impairment, and more often had nasal polyps and hyperaemia of the nasal mucosa. They also had higher levels of MPO in NAL (especially dairy farmers and pig farmers), and a tendency to more swollen nasal mucosa and lower olfactory threshold (especially grain farmers). CONCLUSIONS: The farmers had more pathological findings in their nasal mucosa, possibly indicating effects of allergens and irritants in their work environment. More studies are needed to evaluate work environment factors causing these pathological findings in farmers.</p>
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4.
  • Ahlgren, Karin, et al. (författare)
  • De stora restaureringarna Från Uppsala domkyrka till Skokloster
  • 2004
  • Rapport (populärvet., debatt m.m.)abstract
    • <p>De stora restaureringarna har varit årets tema. Genom att dokumentera och analysera teori och praktik i några av 1800- och 1900-talets största restaureringar - från genomgripande stilrestaureringar till ett mer återhållsamt och tekniskt skon­samt synsätt. Därmed får vi också ett bättre underlag även för dagens ställningsta­gande.Föremål för våra studier är Uppsala domkyrka, Gripsholms slott, Vreta kloster­kyrka, Gustav 11I:s paviljong i Haga, Kungapalatset i Vadstena och Skoklosters slott. Vi hoppas att denna utställning skall bidra till en kritisk hållning och en ökad kunskap om restaureringskonsten, som kvalificerad yrkesuppgift, tidsspegel för historiesyn och som gestaltningsideal.</p>
5.
  • Asplund, Monika Stenkvist, et al. (författare)
  • Chemotherapy in severe nasal polyposis - a possible beneficial effect? : A report of three cases
  • 2010
  • Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 48:3, s. 374-376
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background: Nasal polyposis is an inflammatory process of the nasal mucosa. Treatment has changed from surgery to an anti-inflammatory approach, but neither of these treatments addresses the underlying cause. Topical steroids and occasional use of systemic steroids in patients with nasal polyposis can frequently control the polypoid disease. In a few cases, when the disease is more aggressive, the repeated application of systemic steroids together with sinus surgery is required. Material and Methods: We present our experience with one case of rheumatoid arthritis and two cases with malignant diseases, all of which were treated with chemotherapy and were also accompanied by severe nasal polyposis. All of our patients had eosinophilic polypoid disease. Various chemotherapeutic treatment schemes were utilized. Results: During chemotherapy all three patients were markedly improved symptomatically including olfaction along with a significant reduction in their nasal polyposis. Duration of remission lasted for a few months in two cases and for three years, in a third case. Conclusion: This is the first report describing the successful treatment of severe nasal polyposis with chemotherapy. Based on this experience, we suggest a phase II trial with chemotherapy, preferably "low dose" methotrexate, in patients with severe nasal polyposis.</p>
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6.
  • Austeng, Dordi, et al. (författare)
  • Incidence of and risk factors for neonatal morbidity after active perinatal care : extremely preterm infants study in Sweden (EXPRESS)
  • 2010
  • Ingår i: Acta Paediatrica. - 0803-5253 .- 1651-2227. ; 99:7, s. 978-992
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Aims: The aim of this study was to determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotizing enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage &gt;= 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusion: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted.</p>
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7.
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8.
  • Barck, Charlotte, et al. (författare)
  • Does nitrogen dioxide affect inflammatory markers after nasal allergen challenge?
  • 2005
  • Ingår i: American Journal of Rhinology. - 1050-6586 .- 1539-6290. ; 19:6, s. 560-566
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>BACKGROUND: Exposure to high ambient levels of nitrogen dioxide (NO2) enhances the bronchial inflammatory reaction to allergen in humans. We tested whether this NO2 effect occurs also in the upper airways.</p> <p>METHODS: Sixteen allergic subjects with rhinitis and mild asthma were exposed at rest to either purified air or 500 microg/m3 NO2 for 30 minutes, followed 4 hours later by a nasal allergen challenge. Nasal lavage was performed before air/NO2 exposure, before allergen challenge, and 1, 4 and 18 hours after allergen challenge. Symptoms were recorded.</p> <p>RESULTS: The percentage of eosinophils and neutrophils, eosinophil cationic protein, and myeloperoxidase were similar after exposure to air + allergen and to NO2 + allergen. We noticed a tendency to increased sneezing the day after exposure to NO2 + allergen.</p> <p>CONCLUSION: The priming effect of an ambient brief NO2 exposure on subsequent allergic response was not noticeable in activation of inflammatory cells and mediators in the upper airways.</p>
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9.
  • Behar, Etienne, et al. (författare)
  • Mass-loading of the solar wind at 67P/Churyumov-Gerasimenko Observations and modelling
  • 2016
  • Ingår i: Astronomy and Astrophysics. - EDP Sciences. - 0004-6361 .- 1432-0746. ; 596
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>Context.</strong> The first long-term in-situ observation of the plasma environment in the vicinity of a comet, as provided by the European Rosetta spacecraft.</p><p><strong>Aims.</strong> Here we offer characterisation of the solar wind flow near 67P/Churyumov-Gerasimenko (67P) and its long term evolution during low nucleus activity. We also aim to quantify and interpret the deflection and deceleration of the flow expected from ionization of neutral cometary particles within the undisturbed solar wind.</p><p><strong>Methods.</strong> We have analysed in situ ion and magnetic field data and combined this with hybrid modeling of the interaction between the solar wind and the comet atmosphere.</p><p><strong>Results.</strong> The solar wind deflection is increasing with decreasing heliocentric distances, and exhibits very little deceleration. This is seen both in observations and in modeled solar wind protons. According to our model, energy and momentum are transferred from the solar wind to the coma in a single region, centered on the nucleus, with a size in the order of 1000 km. This interaction affects, over larger scales, the downstream modeled solar wind flow. The energy gained by the cometary ions is a small fraction of the energy available in the solar wind.</p><p><strong>Conclusions.</strong> The deflection of the solar wind is the strongest and clearest signature of the mass-loading for a small, low-activity comet, whereas there is little deceleration of the solar wind. </p>
10.
  • Behar, Etienne, et al. (författare)
  • Mass-loading of the solar wind at 67P/Churyumov-Gerasimenko : Observations and modelling
  • 2016
  • Ingår i: Astronomy and Astrophysics. - 0004-6361 .- 1432-0746. ; 596
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Context. The first long-term in-situ observation of the plasma environment in the vicinity of a comet, as provided by the European Rosetta spacecraft. Aims. Here we offer characterisation of the solar wind flow near 67P/Churyumov-Gerasimenko (67P) and its long term evolution during low nucleus activity. We also aim to quantify and interpret the deflection and deceleration of the flow expected from ionization of neutral cometary particles within the undisturbed solar wind. Methods. We have analysed in situ ion and magnetic field data and combined this with hybrid modeling of the interaction between the solar wind and the comet atmosphere. Results. The solar wind deflection is increasing with decreasing heliocentric distances, and exhibits very little deceleration. This is seen both in observations and in modeled solar wind protons. According to our model, energy and momentum are transferred from the solar wind to the coma in a single region, centered on the nucleus, with a size in the order of 1000 km. This interaction affects, over larger scales, the downstream modeled solar wind flow. The energy gained by the cometary ions is a small fraction of the energy available in the solar wind. Conclusions. The deflection of the solar wind is the strongest and clearest signature of the mass-loading for a small, low-activity comet, whereas there is little deceleration of the solar wind</p>
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