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- Bjerselius, Rickard, et al.
(författare)
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Persistenta organiska miljöföroreningar i fisk från Östersjöregionen 2000-2002
- 2004
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/DFs) are still an environmental problem in Sweden, although the use and production of PCBs have been banned for decades and the release of PCDD/DFs have decreased significantly. In general, the concentrations in food have declined since the 1970s. However, in fish from some parts of the Baltic Sea, the decline of PCBs and PCDD/DFs appears to have ceased in the 1990s (Bignert, 2002). For risk assessment purposes, the Swedish National Food Administration has conducted a fish survey 2000-2002 of levels of selected persistent organic pollutants (POPs), PCBs, PCDD/DFs and persistent pesticides, in fish from the Baltic Sea region. Also polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecane (HBCD), ubiquitously used flame retardants, have been added to this list because of results suggesting the PBDE group as candidate for a new environmental hazard. The aim is to get relevant data to be used in the continuous evaluation of the dietary recommendations and to follow changes in the levels of these environmental contaminants in fish. The ambition is to use the data as a basis for intake estimations for human body burdens and compare with internationally established tolerable weekly intakes (TWI). In addition, in November 2001, the European Commission (EC) published legislation aimed at achieving a reduction in human exposure to PCDD/DFs and PCBs (Council Regulation 2375/01/EC). One of the strategies to reduce the human exposure for PCDD/DFs and dioxin-like PCBs has been to set maximum levels for PCDD/DFs in foodstuffs. Sweden and Finland currently have a derogation from the Council regulation that allows national marketing of fish that exceed the maximum level for PCDD/DF. The legislation came into force from 1 July 2002. The Council Regulation also carries with it an obligation for Member States to monitor the levels of dioxin-like PCBs and PCDD/DFs in foodstuffs and to report the levels to the EC. These data will ultimately be used to both review the maximum limits and measure the effectiveness of the reduction strategy and set new maximum limits. For example, during 2004 the Commission is planning to set maximum levels for dioxin-like PCBs based on reported background levels from the member states. The following report includes results from parts of the sampling carried out in the Baltic Sea area in 2000-2002. Only results of PCBs, persistent pesticides, PBDEs and HBCD are reported here. The corresponding PCDD/DF levels are reported on www.slv.se in three interim reports.
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- Bodin, Ingrid, 1944-
(författare)
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Impairment of intra-oral sensation, discrimination ability, and swallowing function following radiotherapy and surgery for oral and pharyngeal cancer
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Oral and pharyngeal cancer is commonly treated with a combination of radiotherapy and surgery. It is a clinical knowledge that patients often experience severe swallowing disorders following treatment. Since surgical sequelae are instantaneous and obvious, little attention has been paid to other concurrent effects of the treatment. To shed light on this subject, the aim of this thesis was twofold (i) to make a retrospective inventory of the sequelae following treatment and (ii) to perform a prospective, inceptive examination at diagnosis, and to follow-up after radiotherapy, six months and 12 months after surgery. The files of ninety-nine patients revealed that following treatment one-third had to use gastric fistulas and more than nine of ten patients had restricted swallowing capacity. Every second patient could only swallow puréed or liquid food. Adequate intra-oral sensation and discrimination ability is essential for bolus preparation and bolus control, for appropriate elicitation of the swallowing reflex and, hence, for the oral phase of swallowing. At the inceptive examination, the prospective part of the study demonstrated intra-oral discrimination ability in patients was equal to that in healthy controls but was impaired six months after treatment and there was no significant improvement after 12 months. It had been expected that the patient’s healthy, non-tumor side would compensate but it did not. An explanation was found when it was revealed that radiotherapy induced a delayed decline in intra-oral sensation. Sensory decline was not demonstrated within a month after radiotherapy but was manifest six months later. Since the radiotherapy field includes the neck, because of the risk for metastasis, it is highly plausible that pharyngeal sensation declines in a manner corresponding to that found intra-orally when the healthy side is irradiated. In accord with this presumption, pharyngeal swallowing function deteriorated in patents with oral tumors. Cineradiographic evaluation of oral and pharyngeal swallowing function disclosed a significant association between the degree of swallowing dysfunction and the degree of sensory decline and with the degree of impairment of shape recognition. Conclusions: Delayed intra-oral sensory decline, found to be induced by radiotherapy, can be expected to appear in the entire radiation field, including the oral cavity and the pharynx, with adverse effect on swallowing. Testing intra-oral sensation close to the last radiotherapy session is not advisable, because sensory decline does not develop immediately after radiotherapy but manifests after six months. Spontaneous sensory rehabilitation cannot be expected after six months. The significant association between degree of swallowing dysfunction and degree of intra-oral sensory decline and impaired discrimination ability must be considered in the quest for functional rehabilitation of patients treated for oral or pharyngeal cancer.
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- Brattström, Daniel, et al.
(författare)
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Serum VEGF and bFGF adds prognostic information in patients with normal platelet counts when sampled before, during and after treatment for locally advanced non-small cell lung cancer
- 2003
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Ingår i: Lung Cancer. - : Elsevier BV. - 0169-5002 .- 1872-8332. ; 43:1, s. 55-62
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Tidskriftsartikel (refereegranskat)abstract
- Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) have both been implicated to have roles in tumour angiogenesis. In the present retrospective study, serum VEGF and bFGF from patients with locally advanced non-small cell lung cancer (NSCLC) were analysed before, during and after treatment. Seventy-three patients and a total of 460 serum samples were analysed for VEGF and 443 serum samples were analysed for bFGF. Pre-treatment bFGF levels in patients with normal platelet counts, were correlated to poorer survival, P-value = 0.047. During chemotherapy, each rise of one unit bFGF corresponded to a hazard ratio of 4.06 (P=0.022). In patients with normal platelet counts, VEGF levels after radiotherapy significantly correlated to good prognosis (P=0.023), during radiotherapy VEGF levels indicated the same correlation (P=0.085). We conclude that serum VEGF and especially bFGF are of clinical interest as prognostic factors, especially in patients presenting with normal platelet counts.
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- Bylund, Nicklas, et al.
(författare)
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Enhanced engineering design practice using knowledge enabled engineering with simulation methods
- 2004
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Ingår i: Design 2004. - Zabreb : University of Zagreb. - 9536313596
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Konferensbidrag (refereegranskat)abstract
- The objective of this paper is to discuss how Knowledge Enabled Engineering, when combined with simulation methods is a development step for product development processes, engineering design methods and evaluation support systems. The paper opens the discussion on how these approaches, i.e. work methods, simulation support and Knowledge Enabled Engineering (KEE) methods affects best practice in engineering design (ED) by adding synthesis support to the already existing analysis support. In the presented work the authors discuss the actual state of industrial applications, with challenges and opportunities, at Volvo Car Corporation, automotive manufacturer, and Volvo Aero Corporation, jet engine component manufacturer, both operating in Sweden.
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- Ivarsson, Bodil, et al.
(författare)
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Patient reactions to cancelled or postponed heart operations.
- 2002
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 10:2, s. 75-81
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim was to survey the rate and cause of cancellations of planned cardiac operations at a Swedish clinic during 1999, and to study how the patients were affected. Design Questionnaires were distributed to 74 patients who had their operations cancelled. Their mood after discharge was measured with The Hospital Anxiety and Depression scale. Ninety-three patients, who were operated on without postponement, served as controls. Results Sixty-one percent of the patients in the cancellation group reacted negatively, especially if the reason for cancellation was organizational (P = 0.03). The women in the cancellation group had a significantly higher degree of depression than men (P = 0.01) and both women (P = 0.02) and men (P = 0.003) in the control group. Most of the patients, however, were satisfied with the nursing staff's reception and information. Conclusions The patients reacted negatively to the cancellation, especially if it had organizational reasons. Women subjected to cancellation had a significantly higher degree of depression than other patients. To be avoided, organizational and medical problems must be identified in time. One way to do this is to introduce a preadmission nurse clinic.
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