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1.
  • Frisk, Fredrik, et al. (författare)
  • Pulp exposures in adults--choice of treatment among Swedish dentists.
  • 2013
  • Ingår i: Swedish dental journal. - 0347-9994. ; 37:3, s. 153-60
  • Tidskriftsartikel (refereegranskat)abstract
    • This study comprises a survey of Swedish dentists treatment preferences in cases of carious exposure of the dental pulp in adults. The survey was conducted as part of a comprehensive report on methods of diagnosis and treatment in endodontics, published in 2010 by the Swedish Council on Health Technology Assessment. A questionnaire was mailed to a random subsample of 2012 dental offices where one dentist at each office was requested to answer all questions. Each questionnaire contained one of three sets of questions about endodontic practice routines. Thus around one-third of the subsample received case-specific questions about treating carious exposure. Only general practitioners aged below 70 years were included. The final study sample comprised 412 participants. The dentists were presented with two case scenarios. In Case a 22-year old patient had a deep carious lesion in tooth 36 and in Case 2 a 50-year old patient had a deep carious lesion in tooth 14. The participants were asked to nominate their treatment of choice: pulp capping, partial pulpotomy or pulpectomy. For Case 1, 17 per cent of the respondents selected pulpectomy; the corresponding rate for Case 2 was 47 per cent. Female gender and age group 25-49 years were predictive of selection of less invasive treatment options. However, according to recent guidelines (2011) from the National Board of Health and Wellfare, Swedish dentists are recommended to elect pulpectomy prior to pulp capping/partial pulpotomy when confronted with a tooth having a cariously exposed pulp in adults.
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2.
  • Ketelhuth, Daniel, et al. (författare)
  • Identification of a danger-associated peptide from apolipoprotein B100 (ApoBDS-1) that triggers innate proatherogenic responses
  • 2011
  • Ingår i: Circulation. - 1524-45390009-7322. ; 124:22, s. 2433-431-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Background- Subendothelial deposited low-density lipoprotein particles are a known inflammatory factor in atherosclerosis. However, the causal components derived from low-density lipoprotein are still poorly defined. Apolipoprotein B100 (ApoB100) is the unexchangeable protein component of low-density lipoprotein, and the progression of atherosclerosis is associated with immune responses to ApoB100-derived peptides. In this study, we analyzed the proinflammatory activity of ApoB100 peptides in atherosclerosis. Methods and Results- By screening a peptide library of ApoB100, we identified a distinct native peptide referred to as ApoB100 danger-associated signal 1 (ApoBDS-1), which shows sequence-specific bioactivity in stimulation of interleukin-8, CCL2, and interleukin-6. ApoBDS-1 activates mitogen-activated protein kinase and calcium signaling, thereby effecting the expression of interleukin-8 in innate immune cells. Ex vivo stimulation of carotid plaques with ApoBDS-1 enhances interleukin-8 and prostaglandin E(2) release. Furthermore, we demonstrated that ApoBDS-1-positive peptide fragments are present in atherosclerotic lesions using immunoassays and that low-molecular-weight fractions isolated from plaque show ApoBDS-1 activity inducing interleukin-8 production. Conclusions- Our data show that ApoBDS-1 is a previously unrecognized peptide with robust proinflammatory activity, contributing to the disease-promoting effects of low-density lipoprotein in the pathogenesis of atherosclerosis.
3.
  • Hultin, Margareta, et al. (författare)
  • Oral Rehabilitation of Tooth Loss: A Systematic Review of Quantitative Studies of OHRQoL
  • 2012
  • Ingår i: International Journal of Prosthodontics. - 0893-2174. ; 25:6, s. 543-552
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: This study aimed to review published quantitative studies for evidence regarding the influence of oral rehabilitation following total or partial tooth loss on self-perceived oral health–related quality of life (OHRQoL). Materials and Methods: Three databases were searched using specified indexing terms. The reference lists of relevant publications were also searched manually. Quality of evidence was classified according to GRADE guidelines as high, moderate, low, or very low. Results: The search yielded 2,138 titles and abstracts, 2,102 of which were of a quantitative study design. Based on pre-established criteria, the full-text versions of 322 articles were obtained. After data extraction and interpretation, 5 publications of high or moderate study quality remained. The results of these 5 studies showed positive effects of oral rehabilitation on OHRQoL. Two studies showed substantial improvements. Conclusions: This is a relatively new field of research; there are very few quantitative studies of how patients perceive OHRQoL following tooth loss and subsequent rehabilitation. While this review indicates that treatment has positive effects on quality of life, the scientific basis is insufficient to support general conclusions about the influence of various interventions on the OHRQoL of patients who have experienced total or partial tooth loss. To achieve a more comprehensive analysis, it is recommended that future studies be based on a combination of quantitative and qualitative methods, ie, questionnaires and semi-structured interviews. The follow-up period must also be appropriate for the specific intervention studied.
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4.
  • Lindgren, Helena, et al. (författare)
  • Changing attitudes - Women's experiences of negative reactions to their decision for home birth: A population-based study.
  • 2012
  • Ingår i: Sexual & reproductive healthcare. - Elsevier. - 1877-5764. ; 3:1, s. 55-56
  • Tidskriftsartikel (refereegranskat)abstract
    • Being confronted with negative attitudes influences the self-concept of pregnant women. Few women in Sweden give birth at home, and Sweden does not have national home birth guidelines. This study describes women's experiences concerning reactions to their decision to give birth at home. One in five women experienced negative attitudes to a high extent from health care staff during the study period (1992-2005). Fewer women reported this during the latter part of the period compared to the earlier part. The change in attitudes may be related to the introduction in 2002 of guidelines for planned home births in Stockholm County Council.
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5.
  • Sjöblom, Ingela, et al. (författare)
  • A provoking choice-Swedish women's experiences of reactions to their plans to give birth at home
  • 2012
  • Ingår i: Women and Birth. - Elsevier Science BV. - 1871-5192. ; 25:3, s. E11-E18
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The home birth rate in Sweden is less than 1 in 1000, and home birth is not included within the health care system. This study describes women's experiences concerning reactions to their decision to give birth at home. Design and setting: A nationwide survey (SHE - Swedish Homebirth Experience) in Sweden was conducted between 1992 and 2005 whereas 735 women had given birth to 1038 children. Of 1038 questionnaires 1025 were returned. Measurements: In the questionnaires an open-ended question asked women to report their experience of reactions to their decision to give birth at home The question was answered by 594 women, and data were analysed using content analysis. Findings: The analysis yielded one overarching theme; "To be faced with fear for life and death'' including being exposed to reactions about risks. This describes attitudes of professionals and family towards life and death and suggests perceptions of risk and fear of unexpected events. Four main categories were identified; Seen as an irresponsible person, Met with emotional arguments, Exposed to persuasion and Alienation. Conclusion: Women who plan for a home birth were confronted with negative attitudes and persuasion to make them change their mind. This made them feel alienated, and they searched for support among like-minded. Negative attitudes from health care professionals may erode their confidence in conventional health services and turn them towards other options. Implication for practice: Women who want to give birth at home should be given evidence-based information about risks and benefits. Enhanced knowledge among public and professionals about home births would improve the options for respectful encounters. (C) 2011 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.
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6.
  • Albrektsson, Tomas, et al. (författare)
  • On crestal/marginal bone loss around dental implants.
  • 2012
  • Ingår i: The International journal of prosthodontics. - 0893-2174. ; 25:4, s. 320
  • Tidskriftsartikel (populärvet., debatt m.m.)abstract
    • Recently published reports(1-5) as well as a consensus statement(6) have suggested an alarming increase in inflammatory responses around dental implants that are accompanied by variable levels of marginal bone loss. These responses are popularly referred to as an escalating disease entity-so-called "peri-implantitis." This emerging mindset poses serious questions for the long-term viability of the osseointegration technique if the condition indeed exists in a primary form. However, the bulk of the existing literature related to osseointegration has not described peri-implant gingivitis with accompanying marginal bone changes in such dramatic terms. In fact, it has been well documented that failure to induce and maintain long-term osseointegration actually occurs in less than 5% of treated patients. Moreover, clinical outcome studies have not routinely described complications related to progressive soft or hard tissue deterioration. Consequently, the current emphasis on the significance of peri-implant bone loss represents either an ignored phenomenon or is an overtly pessimistic interpretation of or emphasis on a somewhat rarely occurring event. In an effort to determine which of these dichotomous occurrences more closely resembles the truth, an independent initiative sought to evaluate questions related to soft and hard tissue damage adjacent to dental implants.
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7.
  • Andersson, Bodil T., et al. (författare)
  • Radiographers' areas of professional competence related to good nursing care
  • 2008
  • Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 22:3, s. 401-409
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Radiographers' ability and competence is a matter of vital importance for patients. Nursing care is an integral part of the radiographer's work. The demand for high competence in clinical activities has increased in diagnostic radiology and has had an impact on the development of the profession.AIM: The aim was to describe the radiographer's areas of professional competence in relation to good nursing care based on critical incidents that occur in the course of radiological examinations and interventions.METHOD: A descriptive design with a qualitative approach, using the Critical Incident Technique was employed. Interviews were conducted with a strategic sample of registered radiographers (n = 14), based at different hospitals in Sweden.ETHICAL ISSUES: The appropriate ethical principles were followed. All the participants provided informed consent, and formal approval for conducting the research was obtained according to national and local directives.RESULTS: The data analysis resulted in two main areas; direct and indirect patient-related areas of competence, which describe the radiographers' skills that either facilitate or hinder good nursing care. In the direct patient-related area of competence, four categories emerged, which illustrate good nursing care in the patient's immediate surroundings. In the indirect patient-related area of competence, four categories illuminated good nursing care that is provided without direct contact with the patient.CONCLUSIONS: The study highlights the different areas of the radiographer's unique professional competence. The findings provide insight into the radiographer's profession, on one hand as a carer and on the other as a medical technologist as well as highlighting the importance of each role. The radiographer's work encompasses a variety of components--from caring for the patient to handling and checking the technical equipment.
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8.
  • Hammarfjord, Oscar, et al. (författare)
  • Surgical treatment of recurring ameloblastoma, are there options?
  • 2013
  • Ingår i: British Journal of Oral & Maxillofacial Surgery. - 0266-4356. ; 51:8, s. 762-766
  • Tidskriftsartikel (refereegranskat)abstract
    • Our aim was to evaluate the treatment given to patients with intraosseus ameloblastomas with special emphasis on recurrence and the outcomes of primary and secondary resection. Forty-eight patients who were treated for intraosseous ameloblastoma at 8 centres across Sweden met the inclusion criteria. They showed typical distribution of age, sex, site of lesion, and characteristic presenting features. Eleven of the 48 were initially treated with radical resection and none recurred. Twenty-two of the remaining 37 who were initially treated by conservative resection presented with recurrences. Sixteen of the 22 then had conservative secondary resections, which resulted in further recurrence in 6 patients. Initial radical resection is therefore superior to conservative management as far as recurrences are concerned. We argue, however, that a conservative surgical approach is adequate for many intraosseous ameloblastomas with limited extension, because relapse can be followed by radical resection if clinically indicated in selected cases.
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9.
  • Hultin, Margareta, et al. (författare)
  • Treatment of Adult Patients with Partial Edentulism: A Systematic Review
  • 2012
  • Ingår i: International Journal of Prosthodontics. - 0893-2174. ; 25:6, s. 568-581
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The purpose of this systematic review was to identify and critically appraise published studies of treatment methods used in general practice to rehabilitate adult patients with single tooth loss or partial edentulism, with special emphasis on outcomes reported after at least 5 years of follow-up. MATERIALS AND METHODS: Three databases were searched using specified indexing terms. Publications were included if the study design, research questions, and sample size satisfied pre-established criteria. Reference lists of relevant publications and systematic reviews were also searched. The quality of evidence was classified according to the GRADE system as high, moderate, low, or very low. RESULTS: The search yielded 7,675 titles, of which 1,130 were read in full text. A final total of 15 publications were deemed eligible for inclusion: 5 of moderate quality and 10 of low quality. The five studies of moderate quality were all related to implant-based treatment. The 5-year survival rates for implant-supported single crowns and prostheses were 91% and 94.7%, respectively (implant survival rates: 98.5% and 94.9%, respectively). The underlying scientific evidence was low in quality. No relevant publications were identified regarding the economic aspects of treatment. CONCLUSION: Due to the low scientific evidence of the included studies, it was not possible to compare various treatment methods used for rehabilitation of single tooth loss or partial edentulism.
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10.
  • Rohlin, M., et al. (författare)
  • Treatment of Adult Patients with Edentulous Arches: A Systematic Review
  • 2012
  • Ingår i: International Journal of Prosthodontics. - 0893-2174. ; 25:6, s. 553-567
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: This study aimed to evaluate the outcomes of treatment methods used to rehabilitate adult patients with maxillary and/or mandibular edentulism after at least 5 years of follow-up. The risks, adverse effects, and cost effectiveness of these methods were also evaluated. Materials and Methods: Three databases as well as the reference lists of included publications were searched using specified indexing terms. Publications that met the inclusion criteria were read and interpreted using pre-established protocols. Quality of evidence was classified according to the GRADE system (high, moderate, low, or very low). Results: The search yielded 2,130 titles and abstracts. Of these, the full-text versions of 488 publications were obtained. After data extraction and interpretation, 10 studies with moderate study quality of evidence and 1 study with low quality of evidence regarding outcomes, risks, and adverse effects remained. Three studies on the economic aspects of treatment were also included (1 with moderate quality and 2 with low quality). Low-quality evidence showed that the survival rate of implant-supported fixed prostheses is 95% after 5 years in patients with maxillary edentulism and 97% after 10 years in patients with mandibular edentulism. The survival rate of implant-supported overdentures is 93% after 5 years (low-quality evidence). In implant-supported fixed prostheses, 70 of every 1,000 implants are at risk of failing in the maxilla after 5 years and 17 of every 1,000 implants in the mandible are at risk after 10 years. Regarding economic aspects, the evidence was insufficient to provide reliable results. Conclusions: Due to the low quality of evidence found in the included studies, further research with a higher quality of evidence is recommended to better understand the outcomes of treatment for patients with maxillary and/or mandibular edentulism.
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