| 1. |
- Subramaniyam, Devipriya, et al.
(författare)
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TNF-alpha-induced self expression in human lung endothelial cells is inhibited by native and oxidized alpha 1-antitrypsin
- 2008
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Ingår i: International Journal of Biochemistry & Cell Biology. - : Elsevier BV. - 1878-5875 .- 1357-2725. ; 40:2, s. 258-271
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Tidskriftsartikel (refereegranskat)abstract
- Endothelial cells are among the main physiological targets of the pro-inflammatory cytokine tumor necrosis factor-alpha (TNF-alpha). In endothelial cells TNF-alpha elicits a broad spectrum of biological effects including differentiation, proliferation and apoptosis. alpha 1-antitrypsin (AAT), an endogenous inhibitor of serine proteases plays a vital role in protecting host tissue from proteolytic injury at sites of inflammation. Recently, it has been shown that AAT can be internalized by pulmonary endothelial cells, raising speculation that it may modulate endothelial cell function in addition to suppressing protease activity. Using Affymetrix microarray technology, real time PCR and ELISA methods we have investigated the effects of AAT on un-stimulated and TNF-alpha stimulated human primary lung microvascular endothelial cell gene expression and protein secretion. We find that AAT and TNF-alpha generally induced expression of distinct gene families with AAT exhibiting little activity in terms of inflammatory gene expression. Approximately 25% of genes up regulated by TNF-alpha were inhibited by co-administration of AAT including TNF-alpha-induced self expression. Surprisingly, the effects of AAT on TNF-alpha-induced self expression was inhibited equally well by oxidized AAT, a modified form of AAT, which lacks serine protease inhibitor activity. Overall, the pattern of gene expression regulated by native and oxidized AAT was similar with neither inducing pro-inflammatory gene expression. These findings suggest that inhibitory effects of native and oxidized forms of AAT on TNF-alpha stimulated gene expression may play an important role in limiting the uncontrolled endothelial cell activation and vascular injury in inflammatory disease.
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| 2. |
- Östlund, Gunnel, 1956-, et al.
(författare)
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Emotions related to participation restrictions as experienced by patients with early rheumatoid arthritis : A qualitative interview study (The Swedish TIRA project)
- 2014
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Ingår i: Clinical Rheumatology. - : Springer Science and Business Media LLC. - 0770-3198 .- 1434-9949. ; 33:10, s. 1403-1413
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Tidskriftsartikel (refereegranskat)abstract
- Background: Psychological distress is a well-known complication in rheumatoid arthritis (RA), but knowledge regarding emotions, and their relationship to participation restrictions, is scarce.Objectives: To explore emotions related to participation restrictions by patients with early RA. Method: In this study, 48 patients with early RA, aged 20-63 years, were interviewed about participation restrictions using Critical Incident Technique. Information from transcribed interviews was converted into dilemmas and linked to ICF participation codes. The emotions described were condensed and categorized.Results: Hopelessness and sadness were described when trying to perform daily activities such as getting up in the mornings, getting dressed, or not being able to perform duties at work. Sadness was experienced in relation to not being able to continue leisure activities or care for children. Examples of fear descriptions were found in relation to deteriorating health and fumble fear, which made the individual withdraw from activities as a result of mistrusting the body. Anger and irritation were described in relation to domestic and employed work, but also in social relations where the individual felt unable to continue valued activities. Shame or embarrassment was described when participation restrictions became visible in public.Conclusions: Feelings of grief, aggressiveness, fear and shame are emotions closely related to participation restrictions in everyday life in early RA. Emotions related to disability need to be addressed both in clinical settings in order to optimize rehabilitative multi-professional interventions and in research to achieve further knowledge.
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| 3. |
- Waldheim, Eva, et al.
(författare)
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Health-related quality of life, fatigue and mood in patients with SLE and high levels of pain compared to controls and patients with low levels of pain
- 2013
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Ingår i: Lupus. - London : Sage Publications. - 0961-2033 .- 1477-0962. ; 22:11, s. 1118-1127
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The objective of this paper is to investigate health-related quality of life (HRQoL), fatigue, anxiety and depression in patients with systemic lupus erythematosus (SLE) and higher levels of pain and to compare them to patients with lower levels of pain and controls.Method: Patients were dichotomized into two groups based on SLE-related pain score on the visual analog scale (VAS): low-pain group (76%, n=64, VAS 0-39 mm) and high-pain group (24%, n=20, VAS 40-100 mm). Sex- and age-matched controls were randomly selected from the general population. Participants were asked to complete questionnaires regarding self-reported pain, HRQoL, fatigue, anxiety and depression. Medical assessments also were recorded.Result: Fatigue score in the high-pain group (median, 36.5; interquartile range (IQR), 32.5-39.7) was significantly higher (p<0.001) compared to the low-pain group (median, 23; IQR, 14.6-34.1), as well as scores for anxiety (median, 9; IQR, 6.5-11.5) and depression (median, 7.5; IQR, 5.5-9) (p<0.001). The high-pain group had significantly lower scores compared to the low-pain group in all dimensions in the SF-36 (p ≤ 0.001-0.007). No statistical differences were detected between the low-pain group and controls in any measurement except for the dimensions physical function, general health, vitality and social function in SF-36. Conclusion Patients with SLE scoring higher degrees of pain were burdened with more fatigue, anxiety and depression and lower levels of HRQoL compared to patients with lower levels of pain who did not differ significantly from the general population in most dimensions. These results elucidate the importance of identifying patients with higher degrees of pain who are probably in need of more extensive multidimensional interventions to decrease symptom burden.
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| 4. |
- Berg, Stefan, 1959, et al.
(författare)
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Long Episodes of Rash and Fever : Chapter 100
- 2019
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Ingår i: Pediatric Immunology : A Case-Based Collection with MCQs, Volume 2. Rezaei, N. (red.). - Switzerland AG : Springer Nature. - 9783030212629 ; , s. 527-531
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 5. |
- Firth, Karl, et al.
(författare)
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Psychological Stress in Postural Orthostatic Tachycardia Syndrome : A Pilot Pre‑COVID Survey
- 2023
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Ingår i: Heart and Mind. - 2468-6476. ; 7:4, s. 246-254
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Postural orthostatic tachycardia syndrome (POTS) is a chronic condition in which patients show a marked increase in heart rate on standing, but also suffer from a range of additional symptoms, which may include fatigue and difficulty in concentration. This study’s aim was to investigate the role of psychological stress, resilience, and lifestyle as possible contributing factors in POTS onset and symptomatology. Methods: Sixty patients diagnosed with POTS at a tertiary investigation center were contacted by mail. A 64-item, online survey was developed in five sections to explore stressful events at symptom onset, present lifestyle factors, and perceptions of stress and resilience. A link was provided for the online survey to those who accepted study participation. Results: Twenty-four POTS patients completed the survey. The average age at onset of symptoms was 20 years and 4 months, with patients waiting an average of 9 years and 5 months for a POTS diagnosis. Respondents reported 54 stressful events in the 12 months leading up to the onset of their symptoms, an average of 2.48 (standard deviation [SD] = 3.24) events per person. However, the modal response was zero events. Patients with POTS had a statistically significant higher score for perceived stress (M = 19.38, SD = 8.88, P < 0.01) than the general population of Sweden (M = 13.96, SD = 5.63). However, there was no correlation between perceptions of stress and symptom severity measured by the orthostatic hypotension questionnaire. Conclusions: Swedish POTS patients have higher levels of perceived stress, similar to other disease states like chronic pain. However, no correlation between perceptions of stress and symptom severity was found. While some respondents reported many stressful events in the lead up to symptom onset, their role is unclear. Further study is required.
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| 6. |
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| 7. |
- Rydenman, Karin, 1982, et al.
(författare)
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Chapter 104. Recurrent Fever and Sore Throat
- 2019
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Ingår i: Pediatric Immunology. A Case-Based Collection with MCQs. Rezaei N. (red.). - Cham : Springer. - 9783030212612 ; , s. 553-559
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Munthe, Christian, 1962, et al.
(författare)
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Time-lapse in reproductive medicine: ethical prospects and challenges
- 2015
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Ingår i: ESHRE Annual Meeting, Lisbon, June 14-17, 2015.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Study question: What are the ethical prospects and challenges of using time-lapse (TL) for different purposes in research, clinical service, care and commercial marketing in the assisted reproductive context? What possible professional or public policy implications follow from these? Summary answer: The ethics of TL depends on its more exact use. Current knowledge indicates possible clinical benefits, but premature clinical application should be resisted. TL opens for, e.g., patient demands regarding embryo selection and implementation of TL involving display to patients mandates extra caution regarding care, counseling and marketing exploits. What is known already: Using TL to capture the process of in vitro embryo development has quickly entered reproductive medicine, with prospective uses in research and clinical service. It has also been picked up as a possible marketing tool by commercial providers, and as an add-on of patient care and counseling. Assessment of the effects and efficiency of TL is ongoing and, as yet, displaying complex and partly unclear or contradictory results. care and counseling aspects remain uncharted. Study design, size, duration: Explorative theoretical analytical applied ethics study. Participants/materials, setting, methods: Systematic analysis of ethical aspects using literature on TL and relevant aspects of the ethics of assisted reproduction and reproductive medicine. Main results and the role of chance: TL is valuable for research, but trials of TL-interventions aiming at improved IVF should not be launched prematurely or allowed to sneak into routine practice. Offering display of TL documentation of embryo development to patients during ongoing treatment has unclear benefits and risks from a care and counseling perspective and arises the issue of what to display. It may be a vehicle for increasing patient involvement, but may also create conflict between patients and clinicians regarding embryo selection, and will introduce care and counselling challenges as patients form their own reactions. Retrospective offers appear less risky, but may fuel into uncertainty about the outcome. Marketing services with such offers risks biasing patients towards an “entertainment” view and away from more important considerations counseling wise. Limitations, reason for caution: There are many unknowns regarding the more detailed effects on patient experience of incorporating TL display as part of assisted reproductive services. Such additions also have unknown cultural dimensions by making the living in vitro embryo more widely and intimately visible and acquaintable. Wider implications of the findings: Besides the need to structure, monitor and limit attempts at using TL to boost IVF results, the idea of displaying TL output to patients is in need of much probing, not least regarding patient experience and structural effects on the perception of assisted reproductive services, but also clinical policy and counseling requirements. Professional and scientific organizations should act to prevent premature and reckless clinical use.
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| 9. |
- Aggestam, Lena, et al.
(författare)
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The Development and Evaluation of an Animated Video for Pre- and Postoperative Instructions for Patients with Osteoarthritis : A Design Science Research Approach
- 2024
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Ingår i: Geriatrics. - 2308-3417. ; 9:19, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Osteoarthritis (OA) is a condition in the hip or knee joints that develops during a long period of time and sometimes needs hip or knee joint replacement surgery when pain gets too intense for the patient. This paper describes how an animated video for pre- and postoperative instructions for patients with osteoarthritis was designed. The design science research (DSR) approach was followed by creating a web-based animated video. The web-based animated video is used to support surgical departments with education for patients suffering from OA. In the web-based animated video, information about OA surgical treatment and its pre- and post-arrangements was included. The relevance, the rigor, and the design cycles were focused on, with some iterations of and improvements in the animations. Even after implementation, there was a feedback-loop with comments from the surgeons and their patients. Moreover, as more departments will use the web-based animated video, they want to make their special mark on it, so that further changes will be made. This paper presents the design and successful implementation of an animated video for pre- and postoperative instructions for patients with osteoarthritis, tightly linked to the patient journey and the workflow of healthcare professionals. The animated video serves not only as a tool to improve care but also as a basis for further scientific research studies.
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| 10. |
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