1.
De Basso, Rachel, et al.
(författare)
Increased carotid plaque burden in men with the fibrillin-1 2/3 genotype
2014
Ingår i: Clinical and Experimental Pharmacology and Physiology. - : Wiley. - 1440-1681 .- 0305-1870. ; 41:9, s. 637-642
Tidskriftsartikel (refereegranskat) abstract
Fibrillin-1 (FBN1) is an important constituent of the vascular wall and earlier studies have indicated an effect of the FBN1 2/3 genotype on blood pressure as well as aortic stiffness in men. The aim of the present study was to determine whether the FBN1 2/3 genotype was associated with the presence of carotid plaque and incident cardiovascular morbidity and mortality in middle-aged subjects. The FBN1 genotype was characterized in 5765 subjects (2424 men, 3341 women; age 45-69years) recruited from the Malmo Diet and Cancer Study Cardiovascular Cohort, Sweden. Plaque occurrence and intima-media thickness (IMT) of the carotid artery were assessed by ultrasound. The incidence of first cardiovascular events (myocardial infarction and stroke) and cause-specific mortality were monitored over a mean follow-up period of 13.2years. The most common FBN1 genotypes were 2/2, 2/3 and 2/4, which accounted for 92.2% (n=5317) of subjects. There were no differences between the three genotypes regarding age, blood pressure, glucose, lipids, smoking habits, common carotid artery diameter and intima-media thickness in men and women. The presence of plaque in the carotid artery was higher in men with the 2/3 genotype compared with the 2/2 and 2/4 genotypes (55% vs 46% and 50%, respectively; P=0.007). No similar differences were observed in women. No significant relationship was observed between FBN1 genotypes and the incidence of cardiovascular disease or all-cause mortality. The increased prevalence of plaque in the carotid artery of middle-aged men with the FBN1 2/3 genotype indicates pathological arterial wall remodelling with a more pronounced atherosclerotic burden.
2.
Ernsth Bravell, Marie, 1973-, et al.
(författare)
How to assess frailty and the need for care? Report from the Study of Health and Drugs in the Elderly (SHADES) in community dwellings in Sweden
2011
Ingår i: Archives of Gerontology and Geriatrics. - : Elsevier BV. - 1872-6976 .- 0167-4943. ; 53:1, s. 40-45
Tidskriftsartikel (refereegranskat) abstract
Knowledge about the need for care of elderly individuals in community dwellings and the factors affecting their needs and support is limited. The aim of this study was to characterize the frailty of a population of elderly individuals living in community dwellings in Sweden in relation to co-morbidity, use of drugs, and risk of severe conditions such as malnutrition, pressure ulcers, and falls. In 2008, 315 elderly individuals living in community dwellings were interviewed and examined as part of the SHADES-study. The elderly demonstrated co-morbidity (a mean of three diseases) and polypharmacy (an average of seven drugs). More than half the sample was at risk for malnutrition, one third was at risk for developing pressure ulcers, and nearly all (93%) had an increased risk of falling and a great majority had cognitive problems. Age, pulse pressure, body mass index, and specific items from the modified Norton scale (MNS), the Downton fall risk index (DFRI), and the mini nutritional assessment (MNA-SF) were related to different outcomes, defining the need for care and frailty. Based on the results of this study, we suggest a single set of items useful for understanding the need for care and to improve individual based care in community dwellings. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
3.
De Basso, Rachel, et al.
(författare)
Increased cardiovascular risk without generalized arterial dilating diathesis in persons who do not have abdominal aortic aneurysm but who are first-degree relatives of abdominal aortic aneurysm patients
2015
Ingår i: Clinical and Experimental Pharmacology and Physiology. - : Wiley. - 1440-1681 .- 0305-1870. ; 42:6, s. 576-581
Tidskriftsartikel (refereegranskat) abstract
There is a strong genetic predisposition towards abdominal aortic aneurysm (AAA), but it is unknown whether persons without AAA but with first-degree relatives who are AAA patients have a generalized dilating diathesis, defect arterial wall mechanics, or increased cardiovascular risk. The aim of the study was to investigate arterial diameters and wall mechanics at multiple arterial sites in these subjects and compare them with controls without a family history of AAA. This study included 118 first-degree relatives of patients with AAA and 66 controls (age: 40-80years). The abdominal aorta, common carotid artery, common femoral artery, and popliteal artery were investigated by echo-tracking ultrasound. The relatives had no arterial dilatation, but they did tend to have smaller diameters than controls. Relatives had a higher heart rate, diastolic blood pressure, and mean arterial pressure than controls. The distensibility coefficient and the compliance coefficient were decreased in all arteries in male relatives, adjusted for age and smoking; these coefficients were normalized after adjustment for mean arterial pressure and heart rate. Female relatives had a lower compliance coefficient in the abdominal aorta, adjusted for age and smoking. After adjustment for mean arterial pressure and heart rate, the difference disappeared. No general arterial dilatation in relatives without AAA was found, supporting the hypothesis that the dilating diathesis is linked to the aneurysmal manifestation in the abdominal aorta. Although the threat of aneurysmal dilatation and rupture seems to be lacking in these subjects, heart rate, blood pressure, and arterial wall stiffness were all increased, which may indicate a higher risk of developing cardiovascular morbidity and mortality.
4.
Ekström, Jörgen, 1944, et al.
(författare)
Neural- and Hormonal-induced Protein Synthesis and Mitotic Activity in the Rat Parotid Gland and the Dependence on NO-generation
2007
Ingår i: Journal of Oral Biosciences. - : Elsevier. - 1349-0079 .- 1880-3865. ; 49:1, s. 31-38
Tidskriftsartikel (refereegranskat) abstract
Nitric oxide (NO) is a likely parasympathetic nonadrenergic, noncholinergic transmitter in parotid glands, since parasympathetic nerves contain NO-synthase. Parasympathetic stimulation (30 min, atropine + phentolamine + propranolol) increased the protein synthesis ([3H] leucine uptake) by 142% (10 Hz) and 200% (40 Hz). Surprisingly, neither the neuronal type NO-synthase inhibitor N-PLA, nor the unspecific inhibitor L-NAME reduced the response. Moreover, the parasympathetic nonadrenergic, noncholinergic (40 Hz, 30 min)-evoked increase (65%) in mitotic activity ([3H] thymidine uptake) was unaffected by the NO-synthase inhibitors. Sympathetic nerves lack NO-synthase, yet inhibition of NO-generation reduced the β-adrenoceptor mediated response to sympathetic stimulation. Whereas the protein synthesis increased by 192% to stimulation (50 Hz, 1s every tenth s for 30 min) under just α-adrenoceptor blockade, the response was more than halved in the presence of N-PLA to 86%) or L-NAME to 91%). Furthermore, the β-adrenoceptor mediated increase in mitotic activity 122%) to sympathetic stimulation 20 Hz, 4 min every fifth min for 30 min), under α-adrenoceptor blockade, was reduced to 49% N-PLA) and 47% (L-NAME). Pentagastrin (20 µg/kg, I. V. infused for one h) increased the protein synthesis by 17%. N-PLA prevented this increase but did not affect the basal protein, while cholecystokinin receptor blockers reduced both the basal protein synthesis (by 20%), and the pentagastrin-induced increase. Thus, implying that strong rather than weak stimuli of the cholecystokinin receptors activate neuronal type NO-synthase. Despite being of the neuronal type, the NO-synthase generating NO in response to stimulation of β-adrenoceptors or cholecystokinin receptors was probably of parenchymal origin.
5.
Karlsson, Sandra, et al.
(författare)
Inhibition of CYP27B1 and CYP24 Increases the Anti-proliferative Effects of 25-Hydroxyvitamin D 3 in LNCaP Cells
2021
Ingår i: Anticancer Research. - : Anticancer Research USA Inc.. - 0250-7005 .- 1791-7530. ; 41:10, s. 4733-4740
Tidskriftsartikel (refereegranskat) abstract
Background/Aim: Growing evidence suggests that vitamin D3 exerts anticancer effects. The present study aimed to evaluate 25-hydroxyvitamin D3(25(OH)D3) as a potential endocrine factor regulating proliferation and vitamin D receptor expression in LNCaP prostate cancer cells. Materials and Methods: Cell counting after treatment was utilized to assess the effect of 25(OH)D3on cell proliferation. Changes in mRNA expression of the vitamin D receptors, VDR and PDIA3, were evaluated using droplet digital polymerase chain reaction (ddPCR). Results: 25(OH)D3inhibited cell proliferation in a dose- and time-dependent manner. The inhibitory effect of 25(OH)D3on cell proliferation was potentiated after inhibition of CYP17B1 and CYP24 by genistein, preventing further metabolism of 25(OH)D3to 1,25-dihydroxyvitamin D3(1,25(OH)2D3) and 24,25-dihydroxyvitamin D3(24,25(OH)2D3). Expression of PDIA3 and VDR mRNA increased after treatment with 25(OH)D3, whereas the ratio between PDIA3 and VDR mRNA remained unchanged. Conclusion: 25(OH)D3has a direct inhibitory effect on cell proliferation, which is enhanced and accelerated when the metabolism of 25(OH)D3to 1,25(OH)2D3and 24,25(OH)2D3was inhibited by the CYP17B1 and CYP24 inhibitor genistein. Furthermore, treatment with 25(OH)D3increased receptor transcript expression, suggesting an increased VDR stability and sensibility of the treated cells.
6.
Lindström, Kjell, 1946-, et al.
(författare)
Can selective serotonin inhibitor drugs in elderly patients in nursing homes be reduced?
2007
Ingår i: Scandinavian Journal of Primary Health Care. - London : Informa Healthcare. - 0281-3432 .- 1502-7724. ; 25:1, s. 3-8
Tidskriftsartikel (refereegranskat) abstract
OBJECTIVE: To investigate whether treatment with selective serotonin reuptake inhibitors (SSRIs) could be withdrawn for elderly residents who had been on treatment for at least one year and to evaluate a method for systematic drug review. DESIGN: Open, prospective, interventional study. SETTING: Four counties in Sweden. SUBJECTS: Elderly residents at 19 nursing homes, with ongoing treatment with SSRIs for more than one year. MAIN OUTCOME MEASURES: Clinical evaluation, registration of drugs used and rating with Montgomery-Asberg Depression Rating Scale (MADRS). A semi-structured telephone interview with 15 participating physicians and 19 nurses. RESULTS: About one-third of all 822 residents in the nursing homes had ongoing antidepressant treatment, predominantly with SSRIs; 75% of them had been treated with SSRIs for at least one year and 119 (60%) of these were considered eligible for the study. The intervention was judged successful in 52% of these residents of whom 88% had a MADRS rating of less than 20 points. The GPs and the nurses experienced the method as practicable. CONCLUSIONS: Withdrawal of SSRI treatment was successful in the majority of cases. The MADRS may be a valuable addition to clinical evaluation when deciding whether to end or continue SSRI treatment.
7.
Seidel, Pia, et al.
(författare)
Drug information sources in professional work-a questionnaire study on physicians' usage and preferences (the drug information study)
2023
Ingår i: European Journal of Clinical Pharmacology. - : Springer Nature. - 0031-6970 .- 1432-1041. ; 79
Tidskriftsartikel (refereegranskat) abstract
PurposeThis study aimed to explore physicians' use of drug information in professional work, with special focus on those working in primary care, and also in relation to personal characteristics of physicians.MethodsA web-based questionnaire was distributed by e-mail to physicians in five regions in Sweden. The questions concerned drug-related queries at issue when searching for information, sources used, and factors of importance for the choice of source, as well as responder characteristics.ResultsA total of 3254 (85%) out of 3814 responding physicians stated that they searched for drug information every week. For physicians working in primary health care, the corresponding number was 585 (96%). The most common drug-related issues searched for by 76% of physicians every week concerned pharmacotherapeutic aspects (e.g., dosing), followed by adverse drug reactions (63%). For 3349 (88%) physicians, credibility was the most important factor for the choice of sources of drug information, followed by easy access online (n = 3127, 82%). Further analyses among physicians in primary care showed that some personal characteristics, like seniority, sex, and country of education, as well as research experience, were associated with usage and preferences of drug information sources.ConclusionsThis study confirms that physicians often use drug information sources in professional work, in particular those who work in primary health care. Credibility and easy access are key factors for usage. Among physicians in primary care, personal factors influenced the choice of drug information sources.
8.
Westerlind, Björn, 1961-, et al.
(författare)
Use of non-benzodiazepine hypnotics is associated with falls in nursing home residents : a longitudinal cohort study
2019
Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 31:8, s. 1078-1095
Tidskriftsartikel (refereegranskat) abstract
BackgroundFalls and related injuries are common among older people, and several drug classes are considered to increase fall risk.AimsThis study aimed to investigate the association between the use of certain drug classes and falls in older nursing home residents in Sweden, and relate these to different age groups.MethodsInformation on falls that occurred in the previous year and regular use of possible fall risk drugs including non-benzodiazepine hypnotics (zopiclone and zolpidem) was collected from 331 nursing home residents during 2008–2011. Over the following 6 months, the occurrence of serious falls, requiring a physician visit or hospital care, was registered. Association between serious falls and drug use was compared between an older (≥ 85 years) and a younger group.ResultsAn increased fall risk (Downton Fall Risk Index ≥ 3) was found in 93% of the study subjects (aged 65–101 years). Baseline data indicated an association between falls that occurred in the previous year and regular use of non-benzodiazepine hypnotics (p = 0.005), but not with the other studied drug classes. During the following 6 months, an association between use of non-benzodiazepine hypnotics and serious falls in the older group (p = 0.017, odds ratio 4.311) was found. No association was found between the other studied drug classes and serious falls.DiscussionThese results indicate an association between falls and the use of non-benzodiazepine hypnotics, compounds that previously have been considered generally well-tolerated in older people.ConclusionsCaution is advocated when using non-benzodiazepine hypnotics regularly in older people living in nursing homes.
9.
Cuomo, Belinda M., et al.
(författare)
Effectiveness of Sleep-Based Interventions for Children with Autism Spectrum Disorder : A Meta-Synthesis
2017
Ingår i: Pharmacotherapy. - : John Wiley & Sons. - 0277-0008 .- 1875-9114. ; 37:5, s. 555-578
Forskningsöversikt (refereegranskat) abstract
Sleep problems are common in children with autism spectrum disorder (ASD). This meta-synthesis collated eight previously published systematic reviews examining the efficacy of sleep interventions in children with ASD in an attempt to present a clear analysis of trialed interventions. The collated reviews consider five major groups of sleep interventions for children with ASD: melatonin therapy, pharmacologic treatments other than melatonin, behavioral interventions, parent education/education programs, and alternative therapies (massage therapy, aromatherapy, and multivitamin and iron supplementation). These eight reviews were based on 38 original studies and address the efficacy of interventions across 17 sleep problem domains. The results of this meta-synthesis suggest that no single intervention is effective across all sleep problems in children with ASD. However, melatonin, behavioral interventions, and parent education/education program interventions appear the most effective at ameliorating multiple domains of sleep problems compared with other interventions. Due to the heterogeneous causative factors and presentations of disordered sleep, further research into the effectiveness of sleep interventions may target specific phenotypic subgroups rather than a broad analysis across the general ASD population. Similarly, future research needs to consider the efficacy of different polytherapeutic approaches in order to provide clinicians with evidence to inform best practice. In the meantime, this review supports clinicians' decision making for a majority of the identified sleep problems in the ASD population.
10.
