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- Amundson, Emily, et al.
(författare)
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Genetiska, somatiska och hormoners effekter på livskvalitet vid Turners syndrom.
- 2008
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Ingår i: Poster vid Svenska Läkaresällskapets Riksstämma 2008.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Livskvalitet var inte relaterad till längd, karyotyp eller hormonbehandling men påverkades negativt av social isolering, osteoporos och dålig balans vid Turners syndrom. Det är viktigt med en aktiv livsstil redan från barnsben för att få enbra muskel- och balansfunktion och därigenom en god livskvalitet.
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2. |
- Amundson, Emily, et al.
(författare)
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Impact of growth hormone therapy on quality of life in adults with turner syndrome.
- 2010
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 95:3, s. 1355-9
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Tidskriftsartikel (refereegranskat)abstract
- Context: GH and/or oxandrolone are used to promote growth in Turner syndrome (TS). Objective: The aim of this study was to compare quality of life (QoL) in TS women with controls and determine the impact of growth promoting therapy on QoL in TS women. Design: This was a cross-sectional, case-control study. Setting: The study was conducted at an outpatient clinic at Sahlgrenska University Hospital, Göteborg, Sweden. Patients: Patients included 111 TS women (age range 18-59 yr) and 111 randomly selected, age-matched women (25-54 yr) from the World Health Organization Monitoring Trends and Determinants for Cardiovascular Disease project (Göteborg, Sweden) served as controls. Main Outcome Measures: QoL was estimated by the Psychological General Well-Being scale (anxiety, depressed mood, positive well-being, self-control, general health and vitality) and the Nottingham Health Profile (physical mobility, pain, sleep, energy, social isolation, and emotional reactions). Results: TS women reported more social isolation than controls (P < 0.001). After age adjustment, significantly less pain (<0.05) was reported attributable to GH treatment within TS. No significant difference in any other subscales used could be shown. In TS, QoL was negatively affected by higher current age and age at diagnosis and positively affected by better body balance, fine motor function, and higher bone mineral density. Conclusions: Social isolation was more commonly reported in the whole TS cohort than in the population. Except for less pain, no significant impact on QoL attributable to GH treatment could be found, despite the mean +5.1 cm final height.
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4. |
- Edvinsson, Marie, et al.
(författare)
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Chlamydophila pneumoniae changes iron homeostasis in infected tissues
- 2008
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Ingår i: International Journal of Medical Microbiology. - : Elsevier BV. - 1438-4221 .- 1618-0607. ; 298:7-8, s. 635-44
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Tidskriftsartikel (refereegranskat)abstract
- Many bacteria, including Chlamydophila pneumoniae (C. pneumoniae), are dependent on iron (Fe) for their growth. However, it is not known whether bacterial infections affect gastrointestinal uptake and uptake of trace elements in infected tissues. A human C. pneumoniae strain adapted to C57BL/6J mice was used to study hepcidin gene expression in the liver and divalent metal transporter 1 (DMT1) content in the liver and intestine and whether Fe is concomitantly changed in serum, liver, and intestine. The copper/zinc (Cu/Zn) ratio in the serum was used as a marker for infection. Bacterial DNA, mRNA, and hepcidin were measured by real-time PCR, DMT1 by Western blot, and trace elements by ICP-MS on days 2, 5, and 8 of the infection. C. pneumoniae DNA was found in the liver on all days but the number of viable bacteria peaked on day 8. Hepcidin expression increased on days 2 and 5, whereas DMT1 content in the liver increased on day 8. Fe decreased in serum, increased in the liver but was not changed in the intestine during the disease. In the serum, the Cu/Zn ratio peaked on day 5. The peak of viable bacteria in the liver was associated with increased DMT1 and Fe contents and increased hepcidin expression, but this did not affect intestinal Fe uptake. Thus, growth of C. pneumoniae in tissues parallels a redistribution of Fe to those tissues resulting in a changed body homeostasis of Fe.
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5. |
- Forsell, Erik, et al.
(författare)
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Predicting Treatment Failure in Regular Care Internet-Delivered Cognitive Behavior Therapy for Depression and Anxiety Using Only Weekly Symptom Measures
- 2020
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Ingår i: Journal of Consulting and Clinical Psychology. - : American Psychological Association (APA). - 0022-006X .- 1939-2117. ; 88:4, s. 311-321
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Therapist guided Internet-Delivered Cognitive Behavior Therapy (ICBT) is effective, but as in traditional CBT, not all patients improve, and clinicians generally fail to identify them early enough. We predict treatment failure in 12-week regular care ICBT for Depression, Panic disorder and Social anxiety disorder, using only patients' weekly symptom ratings to identify when the accuracy of predictions exceed 2 benchmarks: (a) chance, and (b) empirically derived clinician preferences for actionable predictions. Method: Screening, pretreatment and weekly symptom ratings from 4310 regular care ICBT-patients from the Internet Psychiatry Clinic in Stockholm, Sweden was analyzed in a series of regression models each adding 1 more week of data. Final score was predicted in a holdout test sample, which was then categorized into Success or Failure (failure defined as the absence of both remitter and responder status). Classification analyses with Balanced Accuracy and 95% Confidence intervals was then compared to predefined benchmarks. Results: Benchmark 1 (better than chance) was reached 1 week into all treatments. Social anxiety disorder reached Benchmark 2 (>65%) at week 5, whereas Depression and Panic Disorder reached it at week 6. Conclusions: For depression, social anxiety and panic disorder, prediction with only patient-rated symptom scores can detect treatment failure 6 weeks into ICBT, with enough accuracy for a clinician to take action. Early identification of failing treatment attempts may be a viable way to increase the overall success rate of existing psychological treatments by providing extra clinical resources to at-risk patients, within a so-called Adaptive Treatment Strategy.
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- Gustafson, Torbjörn, 1953-
(författare)
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Causes and treatment of chronic respiratory failure : experience of a national register
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Long-term oxygen therapy (LTOT) or home mechanical ventilation (HMV) can improve survival time in chronic respiratory failure. A national quality register could be an aid to identifying risk markers and optimizing therapy for respiratory failure. Aims: ▪To identify risk markers for chronic respiratory failure, especially when triggered by chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF). ▪To predict sex-related differences in the future need of LTOT for COPD and to study sex related survival rate in COPD patients starting LTOT. ▪To investigate if HMV is more effective than LTOT alone in treating chronic respiratory failure caused by kyphoscoliosis. ▪To evaluate the use of quality indicators in LTOT. Methods: Swedish national registers for LTOT and HMV were established in 1987 and 1996 respectively. They were reconstructed in 2004 to form the web-based register Swedevox. Indications for LTOT were based on the guidelines from the Swedish Society for Respiratory Medicine. The incidence and prevalence of LTOT for COPD were measured annually from 1987 to 2000, and the future need for LTOT was estimated on the basis of the frequency of ever smoking in Sweden in 2001 in different age groups. A postal questionnaire on occupational exposures was completed by 181 patients with severe pulmonary fibrosis who started LTOT between 1997 and 2000, and by 757 controls. Odds ratios (ORs) were calculated. Time to death was evaluated in kyphoscoliotic patients starting HMV or LTOT alone in 1996-2004. Ten quality indicators were defined and evaluated based on data from patients starting LTOT in 1987-2005. Results: The incidence each year of LTOT in COPD patients increased more rapidly in women than in men (from 2.0 and 2.8/100,000 in 1987 to 7.6 and 7.1/100,000 in 2000 respectively, (p < 0.001)). Women ran a 1.9 times higher risk than men to develop chronic hypoxemia from COPD and had a higher survival rate during LTOT. In men, IPF was associated with exposure to birch dust with an OR 2.7, (95% confidence interval (CI) 1.30–5.65) and with hardwood dust, OR 2.7 (95% CI 1.14–6.52). Patients with kyphoscoliosis showed a better survival rate with HMV than with LTOT alone with a hazard ratio of 0.30 (95%CI 0.18-0.51), adjusted for age, sex, concomitant respiratory diseases, and blood gas levels. There were improvements in the following eight quality indicators for LTOT: access to LTOT, PaO2 ≤ 7.3 kPa without oxygen, no current smoking, low number of thoracic deformity patients without concomitant HMV, LTOT > 16 hours of oxygen/day, mobile oxygen equipment, reassessment of hypoxemia when LTOT was not started in a stable state COPD, and avoidance of continuous oral steroids in COPD. There was a decline in the indicator PaO2 > 8 kPa on oxygen. First-year survival rate in COPD was unchanged. Conclusions: The incidence and prevalence of LTOT increase more rapidly in women than in men. Survival rate during LTOT in COPD is better in women than in men. Exposure to birch and hardwood dust may contribute to the risk of IPF in men. Survival rate in patients with kyphoscoliosis was three times better with HMV than with LTOT alone. The national quality register for LTOT showed improvements in eight out of ten quality indicators. Levels for excellent quality in the indicators are suggested.
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7. |
- Williams, Kirk L., et al.
(författare)
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Demonstration of microcoil heaters for microthrusters
- 2007
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Ingår i: Journal of Propulsion and Power. - : American Institute of Aeronautics and Astronautics (AIAA). - 0748-4658 .- 1533-3876. ; 23:4, s. 881-884
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Tidskriftsartikel (refereegranskat)abstract
- The resilience and performance of carbon microcoil heaters made by laser-induced chemical vapor deposition (LCVD) to be used as an efficient means for increasing the specific impulse of cold/hot gas microthrusters were investigated. Two naked carbon coils and two tungsten coated carbon coils coated through LCVD were used in this experiment. Each pair of coated and uncoated carbon coils were heated resistively in a thermal cycling between 300-1173K and 973-1173K for 2 h in 0.000003 mbar and 2 bar N. The results show that at these temperatures the carbon microcoils and nitrogen propellant were compatible while the tungsten coated microcoils started degrading. It was observed that LVCD-deposited carbon and tungsten-coated carbon microcoils can withstand low to medium-high temperatures for extended periods of time during thermal cycling without showing signs of degradation.
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8. |
- Williams, Kirk L., et al.
(författare)
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Electrothermal characterization of tungsten-coated carbon microcoils for micropropulsion systems
- 2007
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Ingår i: Carbon. - : Elsevier BV. - 0008-6223 .- 1873-3891. ; 45:3, s. 484-492
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Tidskriftsartikel (refereegranskat)abstract
- Laser-induced chemical vapor deposition is used to deposit tungsten-coated carbon microcoils from the gas phase. Because the microcoils are used as heating elements in cold/hot gas microthrusters in nanosatellites, it is important to characterize their electrothermal behavior so that the performance of the thruster may be predicted. The coils are deposited using an argon-ion laser (wavelength 514.5 nm) at 360 mW and 930 mbar of C2H4. Bent arms are then deposited at the ends of the 1 mm long coils using 600 mW of laser power and 700 mbar of C2H4. The arms serve as electrical contacts and as mechanical supports to hold the coils in the thruster by a locking mechanism. A layer of tungsten is then applied to the carbon coils by the hydrogen-reduction of WF6 using a 20 : 1 (H2 : WF6) pressure ratio at a total pressure of 105 mbar and 400 mW of laser power. High-resolution scanning electron microscopy analysis showed the tungsten coating to be 1.5–3.5 μm thick on the body of the coil and less than 2 μm on the contact arms. The tungsten coating reduced the resistance of the carbon coils by an order of magnitude and reached higher temperatures at lower voltages. In vacuum, the tungsten coating is the dominant current carrier below 1300–1700 °C; above this range carbon dominates. Peak temperatures for the tungsten-coated coils are 2050 °C in vacuum and 1940 °C in N2 – several hundred degrees higher than the non-coated coils.
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