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  • Pundziute-Lycka, A, et al. (författare)
  • The incidence of Type I diabetes has not increased but shifted to a younger age at diagnosis in the 0-34 years group in Sweden 1983 to 1998
  • 2002
  • Ingår i: Diabetologia. - 0012-186X. ; 45:6, s. 783-791
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims/hypothesis. To analyse the incidence of Type I (insulin-dependent) diabetes mellitus in the 0-34 years age group in Sweden 1983-1998. Methods. Incidence and cumulative incidence per 100 000 and Poisson regression analysis of age-period effects was carried out using 11 751 cases from two nation-wide prospective registers. Results. Incidence (95%-CI) was 21.4 (20.8-21.9) in men and 17.1 (16.6-17.5) in women between 0 and 34 years of age. In boys aged 0-14 and girls aged 0-12 years the incidence increased over time, but it tended to decrease at older age groups, especially in men. Average cumulative incidence at 35 years was 748 in men and 598 in women. Cumulative incidence in men was rather stable during four 4-year periods (736, 732, 762, 756), while in women it varied more (592, 542, 617, 631). In males aged 0-34 years, the incidence did not vary between the 4-year periods (p=0.63), but time changes among the 3-year age groups differed (p<0.001). In females the incidence between the periods varied (p<0.001), being lower in 1987-1990 compared to 1983-1986, but time changes in the age groups did not differ (p=0.08). For both sexes median age at diagnosis was higher in 1983-1986 than in 1995-1998 (p<0.001) (15.0 and 12.5 years in males, 11.9 and 10.4 in females, respectively). Conclusion/interpretation. During a 16-year period the incidence of Type I diabetes did not increase in the 0-34 years age group in Sweden, while median age at diagnosis decreased. A shift to younger age at diagnosis seems to explain the increasing incidence of childhood Type I diabetes.
  • Olsson-Strömberg, Ulla, et al. (författare)
  • Comparison of busulphan, hydroxyurea and allogeneic bone marrow transplantation (BMT) in chronic myeloid leukaemia : BMT prolongs survival.
  • 2004
  • Ingår i: Hematol J. - 1466-4860. ; 5:6, s. 462-6
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Whether busulphan-treated patients develop blastic transformation earlier than hydroxyurea treated has been a controversial issue. In a randomised prospective study, we examined the busulphan versus hydroxyurea influence on time to blast crisis and on survival. When we opened our study in 1984, the clinical benefit of allogeneic bone marrow transplantation (BMT) was not well known, to follow up the long-time outcome of this treatment was therefore of great interest. Materials and methods: Previously untreated CML patients were randomly started on either hydroxyurea (30 mg/kg/day) or busulphan (0.1 mg/kg/day). The end points of the study were overall survival and time to blast crisis. A total of 26 patients subsequently underwent BMT. Results: A total of 179 patients were randomised, 90 to hydroxyurea, and 89 to busulphan treatment. There was no significant difference in survival between hydroxyurea- and busulphan-treated patients (P = 0.46), median survival was 3.5 and 3.2 years, respectively. In all, 85 of the patients were subsequently diagnosed with blast crisis, 41 in the busulphan and 44 in the hydroxyurea group. There was no significant difference between the two groups (P=0.91). The 26 patients who were allotransplanted survived significantly longer than those who were not transplanted (P=0.0001). The 5-year-survival rates were 50 and 22% and the 10-year-survival rates were 46 and 2%, respectively. The median survival was 4.7 years for the transplanted and 3.3 years for the nontransplanted patients. Conclusion: We did not find any difference between hydroxyurea and busulphan treatment, either in overall survival or in blast crisis-free survival, transplanted patients survived significantly longer than nontransplanted patients. © 2004 The European Hematology Association All rights reserved.
  • Tuvemo, T, et al. (författare)
  • Final height after combined growth hormone and GnRH analogue treatment in adopted girls with early puberty
  • 2004
  • Ingår i: Acta Paediatrica. - 0803-5253. ; 93:11, s. 1456-1462
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Girls adopted from developing countries often have early or precocious puberty, requiring treatment with gonadotrophin-releasing hormone (GnRH) analogues. During such treatment, decreased growth velocity is frequent. Aim: To study whether the addition of growth hormone (GH) to GnRH analogue treatment improves final height in girls with early or precocious puberty. Methods: Forty-six girls with early or precocious puberty (age ≤9.5 y) adopted from developing countries were randomized for treatment for 2-4 y with GnRH analogue, or with a combination of GH and GnRH analogue. Results: During treatment, the mean growth velocity in the GH/GnRH analogue group was significantly higher compared to the control group. Combined GH/GnRH analogue treatment resulted in a higher final height: 158.9 cm compared to 155.8 cm in the GnRH analogue-treated group. Three out of 24 girls (13%) in the combined group and nine of the 22 girls (41%) treated with GnRH analogue alone attained a final height below -2 standard deviation scores (SDS). Conclusion: The difference between the two groups is statistically significant, and possibly of clinical importance. A future challenge is to identify a subgroup with clinically significant advantage of GH addition to GnRH analogue treatment. Being very short on arrival in Sweden and being short and young at start of treatment are possible indicators.
  • Nystedt, Astrid, et al. (författare)
  • Epidural analgesia for pain relief in labour and childbirth - a review with a systematic approach.
  • 2004
  • Ingår i: Journal of Clinical Nursing. - 0962-1067. ; 13:4, s. 455-66
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Clinical ambiguity concerning effects of epidural analgesia for pain relief in labour seems to reflect a need for evidence-based knowledge for midwives. AIMS: This study aimed to review, with a systematic approach, the literature about effects and risks associated with the use of epidural analgesia for pain relief in labour and childbirth. DESIGN: A structured question was formulated and used for deriving search terms, establishing the inclusion of certain criteria and retrieving articles, i.e. what are the effects of epidural analgesia for pain relief in labour and childbirth? References were obtained through searches using MeSH-terms in Medline and Subheadings (SH) in CINAHL (e.g. Obstetrical Analgesia combined either with psychology or adverse effects and together with, Dystocia, Caesarean Section, Infant Newborn and Breastfeeding). The articles were divided into prospective randomized trials (C), non-randomized prospective studies (P) and retrospective studies (R). Scientific quality of the studies was assessed on a three-grade scale: high scientific quality (I), moderate scientific quality (II) or low scientific quality (III). RESULTS: Twenty-four articles were retrieved and systematically assessed. Seven studies were judged as high quality, 15 as moderate quality and two as low quality. The majority of studies appraised in this review failed to obtain or establish a cause and effect relationship. According to the data, it seems clear that the use of epidural analgesia is considered to be an effective method of pain relief during labour and childbirth from the perspective of women giving birth. RELEVANCE TO CLINICAL PRACTICE: Midwives and doctors can recommend this form of pain relief. However, information about possible associations with adverse effects in mothers and infants must be provided to expectant couples.
  • Andersson, P L, et al. (författare)
  • Bioaccumulation of selected PCBs in zebrafish, three-spined stickleback, and arctic char after three different routes of exposure.
  • 2001
  • Ingår i: Arch Environ Contam Toxicol. - 0090-4341. ; 40:4, s. 519-30
  • Tidskriftsartikel (refereegranskat)abstract
    • The uptake and elimination of 20 structurally diverse tetra- to heptachlorinated biphenyls were studied in zebrafish (Danio rerio), three-spined stickleback (Gasterosteus aculeatus), and Arctic char (Salvelinus alpinus). The polychlorinated biphenyls (PCBs) were administered to the fish through food, intraperitoneal injection of peanut oil, or intraperitoneal implantation of silicone capsules. The retention of the PCBs in fish exposed through their diet was related with the substitution patterns of the compounds. Ortho-substituted congeners with no unsubstituted meta-para positions had high biomagnification potential. PCBs with low biomagnification all had adjacent vicinal hydrogens, indicating that congeners with this feature may have been metabolically eliminated. The retention characteristics of the PCBs in the diet-exposed and the injected zebrafish were similar. The pattern of congeners in Arctic char indicates that they have a lower capacity to metabolize PCBs compared to three-spined sticklebacks and zebrafish. The levels in the fish exposed to the PCBs through a silastic implant were negatively correlated with the hydrophobicity of the congeners. Most probably congener-specific release rates of the PCBs from the implants mask their retention characteristics. It is suggested that food, mimicking the natural intake route, should be used in PCB exposure studies to validate extrapolations to natural situations.
  • Jonsson, Isak, et al. (författare)
  • Recursive Blocked Algorithms for Solving Triangular Systems - Part I: : One-Sided and Coupled Sylvester-Type Matrix Equations
  • 2002
  • Ingår i: ACM Transactions on Mathematical Software. - 0098-3500 ; 28:4, s. 392-415
  • Tidskriftsartikel (refereegranskat)abstract
    • Triangular matrix equations appear naturally in estimating the condition numbers of matrix equations and different eigenspace computations, including block-diagonalization of matrices and matrix pairs and computation of functions of matrices. To solve a triangular matrix equation is also a major step in the classical Bartels-Stewart method for solving the standard continuous-time Sylvester equation (AX-XB=C). We present novel recursive blocked algorithms for solving one-sided triangular matrix equations, including the continuous-time Sylvester and Lyapunov equations, and a generalized coupled Sylvester equation. The main parts of the computations are performed as level-3 general matrix multiply and add (GEMM) operations. In contrast to explicit standard blocking techniques, our recursive approach leads to an automatic variable blocking that has the potential of matching the memory hierarchies of today's HPC systems. Different implementation issues are discussed, including when to terminate the recursion, the design of new optimized superscalar kernels for solving leaf-node triangular matrix equations efficiently, and how parallelism is utilized in our implementations. Uniprocessor and SMP parallel performance results of our recursive blocked algorithms and corresponding routines in the state-of-the-art libraries LAPACK and SLICOT are presented. The performance improvements of our recursive algorithms are remarkable, including 10-fold speedups compared to standard algorithms.
  • Laurell, Katarina, et al. (författare)
  • Headache in schoolchildren:agreement between different sources of information
  • 2003
  • Ingår i: Cephalalgia. - Blackwell. - 0333-1024. ; 23:6, s. 420-428
  • Tidskriftsartikel (refereegranskat)abstract
    • The level of agreement between different sources of information, i.e. questionnaires, interviews and diaries, was evaluated in a sample of 129 schoolchildren, 69 girls and 60 boys, ranging in age from 7 to 17 years. Headache diagnoses and headache features showed high agreement between questionnaires and subsequent interviews. The concordance between questionnaires and interviews for headache diagnoses increased, and the number of unclassified headaches decreased, when the International Headache Society (IHS) duration criterion was excluded. When comparing headache frequency reported in questionnaires and interviews with diary recordings, the agreement was low and the frequency higher in the diaries. Overall, the agreement between questionnaires, interviews and diaries was not related to age or gender. The questionnaire may serve as a valid source of information in studies of headache in schoolchildren. Prospective recordings in diaries provide additional information, in particular of low-intensity headache. In children, the IHS duration criterion should be modified or excluded.
  • Laurell, Katarina, et al. (författare)
  • Prevalence of headache in Swedish schoolchildren, with a focus on tension-type headache
  • 2004
  • Ingår i: Cephalalgia. - Blackwell. - 0333-1024. ; 24:5, s. 380-388
  • Tidskriftsartikel (refereegranskat)abstract
    • To estimate the prevalence of tension-type headache, migraine and other headaches, 1850 schoolchildren, age 7-15 years, from the city of Uppsala, were invited to complete a questionnaire. The response rate was 74.1%. To validate the information from the questionnaires, 131 children and their parents were interviewed. Using the criteria of the International Headache Society, the 1-year prevalence of tension-type headache and migraine was 9.8 and 11.0%, respectively. However, these prevalence rates increased considerably, to 23.0 and 17.0%, respectively, when excluding the criteria defining the number of earlier episodes and duration of headache. The prevalence of headache increased with age, similarly in girls and boys up to 11 years, and thereafter only in girls. The preponderance in teenage girls was even more pronounced for tension-type headache than for migraine. Our results indicate an increase over time in headache prevalence when compared with findings in a study conducted in the same city in 1955.
  • Lin, W. W., et al. (författare)
  • Perturbation analysis for the eigenproblem of periodic matrix pairs
  • 2001
  • Ingår i: Linear Algebra and Its Applications. - 0024-3795 ; 337, s. 157-187
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper is devoted to perturbation analysis for the eigenproblem of periodic matrix pairs {(A(j), E-j)}(j=1)(K). We first study perturbation expansions of periodic deflating subspaces and eigenvalue pairs. Then, we derive explicit expressions of condition numbers, perturbation bounds and backward errors for eigenvalue pairs and periodic deflating subspaces. (C) 2001 Elsevier Science Inc. All rights reserved.
  • Lugina, Helen I, et al. (författare)
  • Assessing mothers' concerns in the postpartum period : methodological issues.
  • 2004
  • Ingår i: J Adv Nurs. - 0309-2402. ; 48:3, s. 279-90
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: This paper reports a study evaluating the sensitivity of a semi-structured interview schedule and card sort methods in assessing postpartum concerns of women. BACKGROUND: Several methods have been used to assess postpartum maternal concerns and the process of becoming a mother, but few studies have evaluated the methods with respect to their sensitivity for obtaining information. METHOD: A cohort of mothers was followed-up at one (n = 110) and 6 weeks (n = 83) after childbirth in Dar es Salaam, Tanzania. Women with a minimum of 7 years of primary education were interviewed and they also sorted cards. Those with less fewer than 7 years of primary education were interviewed only. The methods were used in alternate order to assess method interaction. RESULTS: In the interviews at 1 week, mothers more often expressed worry and interest related to the baby or themselves when they had sorted cards first. The extent to which women expressed worry and interest about specific baby- and mother-related topics was generally higher for women who had sorted cards before the interview at both 1 and 6 weeks. Independent of whether they were interviewed only, interviewed after sorting cards or before, mothers more often expressed a higher degree of interest than of worry about the baby and self at both 1 and 6 weeks. The order of the data collection methods did not influence the way women sorted cards as being worries and interests. CONCLUSION: Compared to interview using a semi-structured interview schedule, our findings suggest that the card sort is more sensitive in obtaining information about women's concerns. Although the interview method has the advantage of reaching less educated people, the card sort is a technique that is associated with fewer barriers and is a more participatory method for those who can use it.
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