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| 2. |
- Laukka, Erika J, 1986-, et al.
(författare)
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Olfactory impairment and domain‐specific cognitive decline : A 12‐year population‐based study
- 2023
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Ingår i: Alzheimer's & Dementia. - : John Wiley & Sons. - 1552-5260 .- 1552-5279. ; 19:S18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Olfactory impairment has been associated with both cognitive impairment and dementia and Alzheimer’s disease (AD). This study aimed to investigate the association between olfactory dysfunction (OD) and change trajectories in different cognitive domains in aging. Method: Participants (n = 2473, mean age = 72 years, 61% female) from the population-based Swedish National study on Aging and Care-Kungsholmen (SNAC-K) were repeatedly assessed with tasks measuring episodic memory, semantic memory, verbal fluency, and perceptual speed across 12 years. OD was measured at baseline and participants were categorized as normosmic, hyposmic, or anosmic based on the Sniffin’ Sticks odor identification task. Linear mixed-effects models were used to assess the associations between baseline OD and rates of cognitive decline. Result: OD was related to poorer baseline performance and faster rates of decline during follow-up in all examined domains, as well as in global cognition. Associations were generally more pronounced for anosmia compared to hyposmia. Conclusion: Olfactory impairment is associated with accelerated decline in aging across a wide range of cognitive domains.
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| 3. |
- Arvidsson, Eva, 1959-, et al.
(författare)
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Vägen framåt
- 2013
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Ingår i: Att välja rättvist. - Lund : Studentlitteratur AB. ; , s. 207-214
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Som vi visat har utvecklingen av metoder och strukturer för öppna prioriteringar i Sverige kommit långt. Många frågor återstår likväl. Under vårt arbete med denna bok har vi identifierat ett antal förbättringsområden och utmaningar som vi avslutningsvis vill lyfta fram. Det rör sig om vilka som ska delta i prioriteringarna, tydliggörande av värdegrunden, behov av bättre kunskap, baserad på både vetenskaplig metod och erfarenhet, och fortsatt utveckling av prioriteringsprocesser på olika nivåer och i olika sammanhang. Även om vi i Sverige skulle nå en god enighet kring principer och kriterier för prioriteringar så kommer vi alltid finna många olika sätt att praktiskt lösa specifika prioriteringsproblem.
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| 4. |
- Bellander, M, et al.
(författare)
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Preliminary evidence that allelic variation in the LMX1A gene influences training-related working memory improvement
- 2011
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Ingår i: NEUROPSYCHOLOGIA. - : Elsevier BV. - 0028-3932 .- 1873-3514. ; 49:7, s. 1938-1942
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Tidskriftsartikel (refereegranskat)abstract
- LMX1A is a transcription factor involved in the development of dopamine (DA)-producing neurons in midbrain. Previous research has shown that allelic variations in three LMX1A single nucleotide polymorphisms (SNPs) were related to risk of Parkinson's disease (PD), suggesting that these SNPs may influence the number of mesencephalic DA neurons. Prompted by the established link between striatal DA functions and working memory (WM) performance, we examined two of these SNPs in relation to the ability to benefit from 4 weeks of WM training. One SNP (rs4657412) was strongly associated with the magnitude of training-related gains in verbal WM. The allele linked to larger gains has previously been suggested to be associated with higher dopaminergic nerve cell density. No differential gains of either SNP were observed for spatial WM, and the genotype groups were also indistinguishable in tests of attention, interference control, episodic memory, perceptual speed, and reasoning for both SNPs. This pattern of data is in agreement with previous findings from our group, suggesting that cognitive effects of DA-related genes may be more easily detected in a training context than for single-assessment performance scores.
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| 5. |
- Forsberg, Anna, 1969, et al.
(författare)
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Experiencing liver transplantation: a phenomenological approach.
- 2000
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Ingår i: Journal of advanced nursing. - 0309-2402. ; 32:2, s. 327-34
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Tidskriftsartikel (refereegranskat)abstract
- In order to promote health, nurses and other health care professionals need to discover and articulate the meaning that is implicit in experiencing life after liver transplantation. From such an understanding, appropriate nursing interventions can be based. The aim of this study was to investigate the subjective experiences of the meaning of having a liver transplant, 1 year after the transplantation. After approval from the ethics committee at Goteborg University, 12 patients, nine women and three men, were interviewed. The study sample was chosen strategically to represent common diagnoses preceding liver transplantation. A phenomenological approach was chosen for the study. Analyses of the interviews were based on a modified version of a phenomenological method by Karlsson. Seven categories emerged: facing the inevitable; recapturing the body; emotional chaos; leaving the experts; family and friends; the threat of graft rejection; and honouring the donor. Having undergone a liver transplant meant living in a paradoxical situation. Knowing that you survived, it was a struggle to regain physical strength under great emotional stress. The recipients had to self-administer life-long medication, recognize symptoms indicating a potential problem and monitor for the possibility of graft rejection. Social support was essential for recovery. Meeting others with the same experience helped liver-transplanted patients to deal with their identity crises as well as undergo a transformation from being utterly unique to a survivor among others. The clinical implications from this study are that interventions, such as patient education, and social and mental support, are important tools to optimize both self-care capacity and the ability to maintain a healthy perception of identity after having a liver transplant at least up to 12 months post-transplant.
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| 6. |
- Forsberg, Anna, 1969, et al.
(författare)
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Liver transplant recipients' ability to cope during the first 12 months after transplantation--a prospective study.
- 2002
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Ingår i: Scandinavian journal of caring sciences. - 0283-9318 .- 1471-6712. ; 16:4, s. 345-52
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about the coping style and coping strategies among liver transplant recipients. The aim of this study was to evaluate the change in the sense of coherence and coping strategies among liver transplant recipients before and during the first year after liver transplantation. The aim was also to study whether or not there was any relationship between the sense of coherence and the coping strategies. Thirty-five patients met the inclusion criteria. Twenty-six-patients gave their verbal consent to participate in this longitudinal study and 21 patients (80%) completed the follow-up study. The Sense of Coherence scale (SOC) was used for investigation of coping style. The Jalowiec Coping Scale (JCS-40) was used to assess general coping behaviour. The Ethics Committee gave approval to perform this study. The group was heterogeneous regarding the change in the sense of coherence with pronounced individual changes in meaningfulness during the first 3 months and in comprehensibility 6-12 months after liver transplantation. The group showed a homogeneous pattern of change in coping strategies. Confrontational coping strategy was commonly used during the period. A relationship was found between comprehensibility and palliative coping. This prospective study indicated that coping style, assessed by the SOC scale, changed primarily at an individual level during the first year after liver transplantation while changes in coping strategies, according to JSC-40, were in common for the group. The usual coping strategy during the first posttransplant year was confrontational coping.
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| 7. |
- Herlenius, Gustaf, 1961, et al.
(författare)
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Conversion From Calcineurin Inhibitor to Either Mycophenolate Mofetil or Sirolimus Improves Renal Function in Liver Transplant Recipients With Chronic Kidney Disease : Results of a Prospective Randomized Trial
- 2010
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Ingår i: Transplantation Proceedings. - : Elsevier BV. - 0041-1345 .- 1873-2623. ; 42:10, s. 4441-4448
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Tidskriftsartikel (refereegranskat)abstract
- Background. Chronic kidney disease (CKD) has emerged as a significant cause of morbidity and a risk factor for mortality after orthotopic liver transplantation (OLT). The use of calcineurin inhibitor (CNI)-based immunosuppression is an important etiologic factor for developing CKD. CNI discontinuation or minimization protocols with replacement of the CNI with non-nephrotoxic drugs, such as mycophenolate mofetil (MMF) or sirolimus (SRL), may have the potential to preserve or recover renal function. Patients and Methods. In this prospective, randomized, single-center study with CNI discontinuation, OLT recipients with CKD (measured glomerular filtration rate [GFRm] 15-45 mL/min/1.73 m(2)) were randomized to either SRL or MMF-based immunosuppression. The main objective was to study the effect of CNI discontinuation on renal function. Secondary aims were to assess the frequency of biopsy-proven acute rejection episodes (BPAR) and adverse events (AE). Renal function was followed with GFRm using 51-Chromium EDTA clearance at baseline, 3 months, and 1 year. Patients were stratified according to baseline GFRm > versus <30 mL/min/1.73 m(2). The 25 patients were enrolled for MMF (n = 13) or SRL (n = 12). The median age at inclusion was 59 years (range, 25-66) and the median number of years after OLT was 4.4 (range, 1-13). Twenty-two patients were followed up for a year; MMF (n = 12) and SRL (n = 10). Results. Mean GFRm for the whole cohort (n = 25) was 31+/-8 mL/min/1.73 m(2) at baseline. After 3 months the GFRm (n = 23) increased to 40+/-10 mL/min/1.73 m(2) (P = .0001) and at 1 year 42 +/- 11 mL/min/1.73 m(2) (n = 22). There was not significant difference between the MMF and the SRL study arms. The cohort (n = 8) with baseline GFRm <30 mL showed a 63% (P = .003) increased filtration after 1 year. There was no significant difference in the frequency or severity of AE between the study arms with the exception of oral ulcerations and persistent hypertriglyceridemia in the SRL group. Two deaths occurred, 1 in each study arm, both probably unrelated to the change in immunosuppression. There were no BPAR episodes. Conclusion. CNI discontinuation and replacement with either MMF or SRL resulted in a significant improvement in renal function even in those patients with severe CKD. The protocol was effective with no acute rejection episodes. The SRL arm showed a higher frequency of oral apthous ulcerations and hypertriglyceridemia. Future studies addressing long-term renal function after CNI discontinuation are needed.
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| 8. |
- Herlenius, Gustaf, 1961, et al.
(författare)
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Early renal function post-liver transplantation is predictive of progressive chronic kidney disease.
- 2008
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Ingår i: Scandinavian journal of gastroenterology. - 0036-5521. ; 43:3, s. 344-9
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Tidskriftsartikel (refereegranskat)abstract
- With improvements in long-term results after liver transplantation, chronic kidney disease (CKD) has become a highly relevant problem. The early measurement of the glomerular filtration rate (GFR) can identify those patients who are at risk of developing CKD years after liver transplantation. The aims of this study were to describe the prevalence of CKD 5 years after liver transplantation, to study the correlation between measured GFR early after transplantation and late renal function and to identify patients at risk of developing late CKD after liver transplantation.
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| 9. |
- Melum, Espen, et al.
(författare)
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Hepatitis C impairs survival following liver transplantation irrespective of concomitant hepatocellular carcinoma.
- 2007
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Ingår i: Journal of hepatology. - : Elsevier BV. - 0168-8278 .- 1600-0641. ; 47:6, s. 777-83
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIMS: Liver transplantation (LTX) is the only curative treatment for end-stage liver disease caused by hepatitis C (HCV). Hepatocellular carcinoma (HCC) is common in patients with HCV cirrhosis. METHODS: Two hundred and eighty-two HCV patients listed for LTX in the Nordic countries in a 17-year period were included. For comparison a group of patients with non-viral chronic liver disease (n=1552) was used. RESULTS: Two hundred and fifty-three (90%) patients received a first liver allograft. HCC was found in 38% of the explanted livers. Survival at 1, 3 and 5years was 82%, 69% and 61% vs. 85%, 80% and 76% for the comparison group (p<0.0001), this survival difference was also evident when excluding patients with HCC (p=0.007). HCV patients with HCC had 1, 3 and 5year survival of 73%, 52% and 46% compared with 88%, 80% and 71% for the HCV patients without HCC (p=0.0005). In an intention-to-treat analysis (from time of acceptance to the waiting list) HCV was also associated with an impaired survival. CONCLUSIONS: HCV cirrhosis, which is now also an important indication for LTX in the Nordic countries, and significantly impairs survival following LTX. Concomitant HCC and donor age are the two most important factors contributing to an impaired survival.
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| 10. |
- Söderdahl, G., et al.
(författare)
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A prospective, randomized, multi-centre trial of systemic adjuvant chemotherapy versus no additional treatment in liver transplantation for hepatocellular carcinoma
- 2006
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Ingår i: Transplant international. - : Frontiers Media SA. - 0934-0874. ; 19:4, s. 288-94
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Tidskriftsartikel (refereegranskat)abstract
- The role of adjuvant systemic chemotherapy in liver transplantation (LT) for hepatocellular carcinoma (HCC) is controversial. Here, we report the results of a Nordic prospective, randomized, multi-centre trial of systemic low-dose doxorubicin in patients with HCC. Between February 1996 and April 2004, 46 patients were randomized to receive either neoadjuvant doxorubicin in combination with LT (chemo group; n = 19) or LT alone (control group; n = 27). In the chemo group, doxorubicin was administered intravenously, 10 mg/m(2) weekly, starting from acceptance onto the waiting list for LT. One intraoperative dose of 15 mg/m(2) was given, and postoperatively doxorubicin was given weekly at a dose of 10 mg/m(2), depending on the clinical course, up to a cumulative dose of 400 mg/m(2). Actuarial, 3-year overall survival (OS) and disease-free survival (DFS) in the control group were 70% and 50%, respectively. In the chemo group, both OS and DFS were 63%. Freedom from recurrence at 3 years was 55% in the control group and 74% in the chemo group. None of the differences was statistically significant. Neoadjuvant treatment with systemic low-dose doxorubicin seems not to improve either survival or freedom from recurrence in patients with HCC undergoing LT.
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