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  • Knudsen, Kati, et al. (författare)
  • The best method to predict easy intubation : a quasi-experimental pilot study
  • 2014
  • Ingår i: Journal of Perianesthesia Nursing. - 1089-9472. ; 29:4, s. 292-297
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE:To facilitate evaluation of the airway before endotracheal intubation, different scores have been developed, mainly to predict difficult airways. However, in anesthesia clinical practice in Sweden, scores would be more useful if they could also predict an easy airway, so that the correct category of anesthesia personnel can be allocated. Therefore, we evaluated whether scoring systems commonly used to predict difficult airways could also predict easy endotracheal intubation.DESIGN:This prospective observational study included patients who were scheduled for general anesthesia and required endotracheal intubation.METHODS:Airways were evaluated preoperatively by two independent variables, namely Mallampati classification and thyromental distance. After anesthesia induction, the Cormack and Lehane grade was assessed.FINDING:Mallampati scores yielded the highest specificity in predicting easy intubation, and Cormack and Lehane grades yielded the highest positive predictive value for predicting easy intubation.CONCLUSIONS:Mallampati classification is an appropriate screening test for predicting easy intubation.
  • Carlsson, Axel C, et al. (författare)
  • Association between circulating endostatin, hypertension duration, and hypertensive target-organ damage
  • 2013
  • Ingår i: Hypertension. - 0194-911X. ; 62:6, s. 1146-1151
  • Tidskriftsartikel (refereegranskat)abstract
    • Our aim is to study associations between circulating endostatin, hypertension duration, and hypertensive target-organ damage. Long-term hypertension induces cardiovascular and renal remodeling. Circulating endostatin, a biologically active derivate of collagen XVIII, has been suggested to be a relevant marker for extracellular matrix turnover and remodeling in various diseases. However, the role of endostatin in hypertension and hypertensive target-organ damage is unclear. Serum endostatin was measured in 2 independent community-based cohorts: the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS; women 51%; n=812; mean age, 75 years) and the Uppsala Longitudinal Study of Adult Men (ULSAM; n=785; mean age, 77.6 years). Retrospective data on blood pressure measurements and antihypertensive medication (PIVUS >5 years, ULSAM >27 years), and cross-sectional data on echocardiographic left ventricular mass, endothelial function (endothelium-dependent vasodilation assessed by the invasive forearm model), and urinary albumin/creatinine ratio were available. In PIVUS, participants with ≥5 years of history of hypertension portrayed 0.42 SD (95% confidence interval, 0.23-0.61; P<0.001) higher serum endostatin, compared with that of normotensives. This association was replicated in ULSAM, in which participants with 27 years hypertension duration had the highest endostatin (0.57 SD higher; 95% confidence interval, 0.35-0.80; P<0.001). In addition, higher endostatin was associated with higher left ventricular mass, worsened endothelial function, and higher urinary albumin/creatinine ratio (P<0.03 for all) in participants with prevalent hypertension. Circulating endostatin is associated with the duration of hypertension, and vascular, myocardial, and renal indices of hypertensive target-organ damage. Further studies are warranted to assess the prognostic role of endostatin in individuals with hypertension.
  • Knudsen, Kati, et al. (författare)
  • A nationwide postal questionnaire survey:
  • 2014
  • Ingår i: BMC Anesthesiology. - 1471-2253. ; 14, s. 25
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundIn Sweden, airway guidelines aimed toward improving patient safety have been recommended by the Swedish Society of Anaesthesia and Intensive Care Medicine. Adherence to evidence-based airway guidelines is known to be generally poor in Sweden. The aim of this study was to determine whether airway guidelines are present in Swedish anaesthesia departments.MethodsA nationwide postal questionnaire inquiring about the presence of airway guidelines was sent out to directors of Swedish anaesthesia departments (n = 74). The structured questionnaire was based on a review of the Swedish Society of Anaesthesia and Intensive Care voluntary recommendations of guidelines for airway management. Mean, standard deviation, minimum/maximum, percentage (%) and number of general anaesthesia performed per year as frequency (n), were used to describe, each hospital type (university, county, private). For comparison between hospitals type and available written airway guidelines were cross tabulation used and analysed using Pearson’s Chi-Square tests. A p- value of less than 0 .05 was judged significant.ResultsIn total 68 directors who were responsible for the anaesthesia departments returned the questionnaire, which give a response rate of 92% (n 68 of 74). The presence of guidelines showing an airway algorithm was reported by 68% of the departments; 52% reported having a written patient information card in case of a difficult airway and guidelines for difficult airways, respectively; 43% reported the presence of guidelines for preoperative assessment; 31% had guidelines for Rapid Sequence Intubation; 26% reported criteria for performing an awake intubation; and 21% reported guidelines for awake fibre-optic intubation. A prescription for the registered nurse anaesthetist for performing tracheal intubation was reported by 24%. The most frequently pre-printed preoperative elements in the anaesthesia record form were dental status and head and neck mobility.ConclusionsDespite recommendations from the national anaesthesia society, the presence of airway guidelines in Swedish anaesthesia departments is low. From the perspective of safety for both patients and the anaesthesia staff, airway management guidelines should be considered a higher priority.
  • Ärnlöv, Johan, et al. (författare)
  • Serum endostatin and risk of mortality in the elderly : findings from 2 community-based cohorts
  • 2013
  • Ingår i: Arteriosclerosis, Thrombosis and Vascular Biology. - 1079-5642. ; 33:11, s. 2689-2695
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE:Experimental data imply that endostatin, a proteolytically cleaved fragment of collagen XVIII, could be involved in the development of cardiovascular disease and cancer. Prospective data concerning the relation between circulating endostatin and mortality are lacking. Accordingly, we aimed to study associations between circulating endostatin and mortality risk.APPROACH AND RESULTS:Serum endostatin was analyzed in 2 community-based cohorts: the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS; women 50%, n=931; mean age, 70 years; median follow-up, 7.9 years) and the Uppsala Longitudinal Study of Adult Men (ULSAM; n=748; mean age, 77 years; median follow-up, 9.7 years). During follow-up, 90 participants died in PIVUS (1.28/100 person-years at risk), and 417 participants died in ULSAM (6.7/100 person-years at risk). In multivariable Cox regression models adjusted for age and established cardiovascular risk factors, 1 SD higher ln(serum endostatin level) was associated with a hazard ratio of mortality of 1.39 and 95% confidence interval, 1.26 to 1.53, on average in both cohorts. In the ULSAM cohort, serum endostatin was also associated with cardiovascular mortality (177 deaths; hazard ratio per SD of ln[endostatin] 1.45, 95% confidence interval [1.25-1.71]) and cancer mortality (115 deaths; hazard ratio per SD of ln[endostatin] 1.35, 95% confidence interval [1.10-1.66]).CONCLUSIONS:High serum endostatin was associated with increased mortality risk in 2 independent community-based cohorts of the elderly. Our observational data support the importance of extracellular matrix remodeling in the underlying pathophysiology of cardiovascular disease and cancer.
  • Lindholm, Åsa, et al. (författare)
  • Effect of sibutramine on weight reduction in women with polycystic ovary syndrome : a randomized, double-blind, placebo-controlled trial
  • 2008
  • Ingår i: Fertility and Sterility. - 0015-0282. ; 89:5, s. 1221-1228
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To examine the efficacy of sibutramine together with brief lifestyle modification for weight reduction in obese women with polycystic ovary syndrome (PCOS). DESIGN: Investigator-initiated, multicenter, double-blind, randomized, parallel-group clinical trial. SETTING: Departments of Obstetrics and Gynecology in primary care, referral centers, and private practice. PATIENT(S): Forty-two patients with confirmed PCOS were included in the study, and 34 patients completed the study. INTERVENTION: Sibutramine 15 mg once daily together with brief lifestyle modification was compare with placebo together with brief lifestyle modification. MAIN OUTCOME MEASURE(S): The primary endpoint was to assess weight loss. Secondary endpoints included the efficacy of sibutramine for treatment of menstrual pattern and cardiovascular risk factors. RESULT(S): After 6 months the sibutramine group had lost 7.8 +/- 5.1 kg compared with a weight loss of 2.8 +/- 6.2 kg in the placebo group. Sibutramine treatment resulted in significant decreases in apolipoprotein B, apolipoprotein B/apolipoprotein A ratio, triglycerides, and cystatin C levels. CONCLUSION(S): Sibutramine in combination with lifestyle intervention results in significant weight reduction in obese patients with PCOS. In addition to the weight loss, sibutramine seems to have beneficial effects on metabolic and cardiovascular risk factors.
  • Niedomsyl, Thomas, et al. (författare)
  • Learning Benefits of Using 2D Versus 3D Maps: Evidence from a Randomized Controlled Experiment
  • 2013
  • Ingår i: Journal of geography. - 0022-1341. ; 112:3, s. 87-96
  • Tidskriftsartikel (refereegranskat)abstract
    • The traditional important role of maps used for educational purposes has gained further potential with recent advances in GIS technology. But beyond specific courses in cartography this potential seems little realized in geography teaching. This article investigates the extent to which any learning benefits may be derived from the use of such technologies. A controlled experiment was conducted to examine whether information recall is improved when cartographic information on population distribution is presented in 2D versus 3D form. The results show statistically significant differences in learning benefits between the two formats, largely in favor of 2D representation. These findings suggest that learning benefits can be derived from paying greater attention to map format in educational settings.
  • Sundelöf, Johan, et al. (författare)
  • Cystatin C Levels are Positively Correlated with both Aβ42 and Tau Levels in Cerebrospinal Fluid in Persons with Alzheimer's Disease, Mild Cognitive Impairment, and Healthy Controls
  • 2010
  • Ingår i: Journal of Alzheimer's Disease. - 1387-2877. ; 21:2, s. 471-478
  • Tidskriftsartikel (refereegranskat)abstract
    • Cystatin C is suggested to be involved in neurodegeneration and the development of Alzheimer's disease (AD) by binding to soluble amyloid-beta (Abeta) peptides. Studies of cystatin C levels in cerebrospinal fluid (CSF) in relation to risk of AD are conflicting and relations between cystatin C, Abeta42, and tau levels in CSF in AD, mild cognitive impairment (MCI), and healthy controls are unknown. The objective of this study was to investigate cystatin C, Abeta42, and tau levels in CSF in AD, MCI, and controls. As a secondary aim, the relationships between cystatin C, Abeta42, and tau levels across disease groups were investigated. Cystatin C, Abeta42, total tau, and phosphorylated tau levels in CSF were analyzed by turbidimetry (cystatin C) and xMAP Luminex technology (Abeta and tau) in persons with AD (n=101), MCI (n=84), and healthy control subjects (n=28). Mean cystatin C levels were similar in cases of AD (5.6 mumol/L +/- 1.7), MCI (5.4 mumol/L +/- 1.48), and controls (5.6 mumol/L +/- 1.6). However, CSF cystatin C levels were strongly and positively correlated with total tau and phosphorylated tau levels (r=0.61-0.81, p< 0.0001) and Abeta42 (r=0.35-0.65, p< 0.001) independent of age, gender, and APOE genotype. Mean CSF cystatin C levels did not differ between patients with AD and MCI and healthy controls. Interestingly, cystatin C levels were positively correlated with both tau and Abeta42 levels in CSF independent of age, gender, and APOE genotype.
  • Sundelöf, Johan, et al. (författare)
  • Higher Cathepsin B Levels in Plasma in Alzheimer's Disease Compared to Healthy Controls
  • 2010
  • Ingår i: Journal of Alzheimer's Disease. - 1387-2877. ; 22:4, s. 1223-1230
  • Tidskriftsartikel (refereegranskat)abstract
    • Cathepsin B is suggested to be involved in amyloid-β (Aβ) processing and Alzheimer's disease (AD). Studies of cathepsin B levels in plasma and cerebrospinal fluid (CSF) have not been previously performed. We examined cathepsin B levels in plasma and CSF samples in persons with AD, mild cognitive impairment (MCI), and healthy controls in order to test the hypothesis that cathepsin B levels can discriminate persons with AD or MCI from healthy controls. Cathepsin B, Cystatin C, Aβ1-40 and Aβ1-42, total tau, phosphorylated tau, and albumin levels in plasma and CSF were analyzed by ELISA (Cathepsin B) turbidimetry (cystatin C), xMAP Luminex technology (Aβ1-40 and Aβ1-42 and tau), and Cobas C501 analyzer (albumin) in persons with AD (n=101), MCI (n=84), and healthy control subjects (n=28). Plasma cathepsin B levels were higher in persons with AD compared to healthy controls, both in unadjusted models and in multivariable models adjusting for age, gender, APOE genotype, cystatin C, and albumin levels: Odds ratio (OR) for AD per 1 SD of plasma cathepsin B; 2.04, 95% confidence interval (CI); 1.01-4.14, p= 0.05. There was no difference between diagnostic groups in cathepsin B levels in CSF: OR for AD per 1 SD of CSF cathepsin B; 0.93, 95% CI; 0.37-2.30, p= 0.87. Plasma cathepsin B levels were higher in persons with AD compared to healthy controls whereas there was no difference between diagnostic groups in cathepsin B levels in CSF. Further investigation of cathepsin B as a predictor of AD is warranted.
  • Appelgren, Patrik, et al. (författare)
  • Experimental Study of Electromagnetic Effects on Solid Copper Jets
  • 2010
  • Ingår i: Journal of applied mechanics. - 0021-8936. ; 77:1, s. 011010
  • Tidskriftsartikel (refereegranskat)abstract
    • In this paper we present a study of the interaction between all electric current pulse and a solid copper jet. Experiments were performed using a dedicated pulsed power supply delivering a current pulse of such amplitude, rise little, and duration that the jet is efficiently affected. The copper jet was created by using a shaped charge warhead. All electrode configuration consisting of two aluminum plates with a separation distance of 150 mm was used. The discharge current pulse and the voltages at the capacitors and at the electrodes were measured to obtain data oil energy deposition in and the resistance of the jet and electrode contact region. X-ray diagnostics were used to radiograph the jet, and by analyzing the radiograph, the degree of disruption of the electrified jet could be obtained. It was found that a current pulse with an amplitude of 200-250 kA and a rise time of 16 mu s could strongly enhance the natural fragmentation of the jet. In this case, the initial electric energy was 100 kJ and about 90% of the electric energy was deposited in the jet and electrodes. At the exit of the electrode region, the jet fragments formed rings with a radial velocity of up to 200 m/s, depending oil the initial electric energy in the pulsed power supply. [DOI: 10.1115/1.3172251]
  • Appelgren, Patrik, et al. (författare)
  • Modeling of a small helical magnetic flux compression generator
  • 2008
  • Ingår i: IEEE Transactions on Plasma Science. - 0093-3813. ; 36:5, s. 2662-2672
  • Tidskriftsartikel (refereegranskat)abstract
    •  In order to gain experience in explosive pulsed power and to provide experimental data as the basis for computer modeling, a small high-explosive-driven helical magnetic flux-compression generator (FCG) was designed at the Swedish Defence Research Agency. The generator, of which three have been built, has an overall length of 300 mm and a diameter of 70 mm. It could serve as the energy source in a pulse-forming network to generate high-power pulses for various loads. This paper presents a simulation model of this helical FCG. The model, which was implemented in Matlab-Simulink, uses analytical expressions for the generator inductance. The model of resistive losses takes into account the heating of the conductors and the diffusion of the magnetic field into the conductors. The simulation results are compared with experimental data from two experiments with identical generators but with different seed currents, influencing the resistive losses. The model is used to analyze the performance of the generator.
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