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- Cronberg, Tobias
(författare)
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Neuroprognostication of Cardiac Arrest Patients : Outcomes of Importance
- 2017
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Ingår i: Seminars in Respiratory and Critical Care Medicine. - : Georg Thieme Verlag KG. - 1069-3424 .- 1098-9048. ; 38:6, s. 775-784
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Forskningsöversikt (refereegranskat)abstract
- During the last two decades, survival rates after cardiac arrest have increased while the fraction of patients surviving with a severe neurological disability or vegetative state has decreased in many countries. While improved survival is due to improvements in the whole chain of survival, improved methods for prognostication of neurological outcome may be of major importance for the lower disability rates. Patients who are resuscitated and treated in intensive care will die mainly from the withdrawal of life-sustaining (WLST) therapy due to presumed poor chances of meaningful neurological recovery. To ensure high-quality decision-making and to reduce the risk of premature withdrawal of care, implementation of local protocols is crucial and should be guided by international recommendations. Despite rigorous neurological prognostication, cognitive impairment and related psychological distress and reduced participation in society will still be relevant concerns for cardiac arrest survivors. The commonly used outcome measures are not designed to provide information on these domains. Follow-up of the cardiac arrest survivor needs to consider the cardiovascular burden as an important factor to prevent cognitive difficulties and future decline.
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- Fischer, A, et al.
(författare)
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Genetics of sarcoidosis
- 2014
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Ingår i: Seminars in respiratory and critical care medicine. - : Georg Thieme Verlag KG. - 1098-9048 .- 1069-3424. ; 35:3, s. 296-306
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Tidskriftsartikel (refereegranskat)
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- Johnsson, Åse (Allansdotter), 1966, et al.
(författare)
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Chest tomosynthesis: technical and clinical perspectives.
- 2014
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Ingår i: Seminars in respiratory and critical care medicine. - : Georg Thieme Verlag KG. - 1098-9048 .- 1069-3424. ; 35:1, s. 17-26
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Tidskriftsartikel (refereegranskat)abstract
- The recent implementation of chest tomosynthesis is built on the availability of large, dose-efficient, high-resolution flat panel detectors, which enable the acquisition of the necessary number of projection radiographs to allow reconstruction of section images of the chest within one breath hold. A chest tomosynthesis examination obtains the increased diagnostic information provided by volumetric imaging at a radiation dose comparable to that of conventional chest radiography. There is evidence that the sensitivity of chest tomosynthesis may be at least three times higher than for conventional chest radiography for detection of pulmonary nodules. The sensitivity increases with increasing nodule size and attenuation and decreases for nodules with subpleural location. Differentiation between pleural and subpleural lesions is a known pitfall due to the limited depth resolution in chest tomosynthesis. Studies on different types of pathology report increased detectability in favor of chest tomosynthesis in comparison to chest radiography. The technique provides improved diagnostic accuracy and confidence in the diagnosis of suspected pulmonary lesions on chest radiography and facilitates the exclusion of pulmonary lesions in a majority of patients, avoiding the need for computed tomography (CT). However, motion artifacts can be a cumbersome limitation and breathing during the tomosynthesis image acquisition may result in severe artifacts significantly affecting the detectability of pathology. In summary, chest tomosynthesis has been shown to be superior to chest conventional radiography for many tasks and to be able to replace CT in selected cases. In our experience chest tomosynthesis is an efficient problem solver in daily clinical work.
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- Karakaya, B, et al.
(författare)
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Löfgren's Syndrome: Diagnosis, Management, and Disease Pathogenesis
- 2017
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Ingår i: Seminars in respiratory and critical care medicine. - : Georg Thieme Verlag KG. - 1098-9048 .- 1069-3424. ; 38:4, s. 463-476
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Tidskriftsartikel (refereegranskat)abstract
- Löfgren's syndrome (LS), first described in 1946 by Swedish Professor of Medicine Sven Löfgren, is a clinically distinct phenotype of sarcoidosis. Patients typically experience an acute disease onset, usually with fever, and characteristic symptoms of bilateral hilar lymphadenopathy, erythema nodosum, and/or bilateral ankle arthritis or periarticular inflammation. LS patients are well documented to have a good prognosis, which is especially true for HLA-DRB1*03+ individuals. The presence of this allele correlates closely with an accumulation of clonal CD4+ T-cell populations in the lung, suggestive of local antigen recognition. Moreover, LS differs markedly from “non-LS” sarcoidosis regarding immune cell activation, differentiation, and regulation, which may influence clinical outcome and spontaneous disease resolution.This review offers an overview of the clinical characteristics, genetic background, and immunological characteristics of LS, as well as patient management, and reflections on future scientific challenges, emphasizing the concept of LS as a disease in its own right.
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- Petersson, J, et al.
(författare)
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Gas Exchange in the Lung
- 2023
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Ingår i: Seminars in respiratory and critical care medicine. - 1098-9048. ; 44:055, s. 555-568
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Tidskriftsartikel (refereegranskat)
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