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- Brodin, Daniel, et al.
(författare)
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Inhaled ciclesonide in adults hospitalised with COVID-19 : a randomised controlled open-label trial (HALT COVID-19)
- 2023
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:2
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess the efficacy of inhaled ciclesonide in reducing the duration of oxygen therapy (an indicator of time to clinical improvement) among adults hospitalised with COVID-19.DESIGN: Multicentre, randomised, controlled, open-label trial.SETTING: 9 hospitals (3 academic hospitals and 6 non-academic hospitals) in Sweden between 1 June 2020 and 17 May 2021.PARTICIPANTS: Adults hospitalised with COVID-19 and receiving oxygen therapy.INTERVENTION: Inhaled ciclesonide 320 µg two times a day for 14 days versus standard care.MAIN OUTCOME MEASURES: Primary outcome was duration of oxygen therapy, an indicator of time to clinical improvement. Key secondary outcome was a composite of invasive mechanical ventilation/death.RESULTS: Data from 98 participants were analysed (48 receiving ciclesonide and 50 receiving standard care; median (IQR) age, 59.5 (49-67) years; 67 (68%) men). Median (IQR) duration of oxygen therapy was 5.5 (3-9) days in the ciclesonide group and 4 (2-7) days in the standard care group (HR for termination of oxygen therapy 0.73 (95% CI 0.47 to 1.11), with the upper 95% CI being compatible with a 10% relative reduction in oxygen therapy duration, corresponding to a <1 day absolute reduction in a post-hoc calculation). Three participants in each group died/received invasive mechanical ventilation (HR 0.90 (95% CI 0.15 to 5.32)). The trial was discontinued early due to slow enrolment.CONCLUSIONS: In patients hospitalised with COVID-19 receiving oxygen therapy, this trial ruled out, with 0.95 confidence, a treatment effect of ciclesonide corresponding to more than a 1 day reduction in duration of oxygen therapy. Ciclesonide is unlikely to improve this outcome meaningfully.TRIAL REGISTRATION NUMBER: NCT04381364.
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| 5. |
- Bertram, Michael, et al.
(författare)
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Evidence of the impacts of pharmaceuticals on aquatic animal behaviour: a systematic map protocol
- 2021
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Ingår i: Environmental Evidence. - : Springer Science and Business Media LLC. - 2047-2382. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Globally, there is growing concern over the impacts of pharmaceuticals and drug manufacturing on aquatic animals, and pharmaceuticals are now recognized as contaminants of emerging environmental concern. In recent years, scientists, environmental managers, and policymakers have been interested in using behavioural endpoints for chemical regulation, given their importance for ftness and survival. The body of research on whether and how pharmaceutical exposure alters the behaviour of aquatic animals has grown exponentially, making it diffcult to get an overview of the results. With an international spotlight on the management of these environmental threats, synthesizing the currently available data is vital to inform managers and policymakers, as well as highlighting areas where more research is needed. This is a protocol for a systematic evidence map (SEM) and serves as an a priori record of our objectives and methodological decisions. Our objectives are to identify, catalogue, and present primary research articles on the efects of human and veterinary pharmaceuticals on aquatic animal behaviour.Methods: The literature search will be conducted using two electronic databases: Web of Science and Scopus, and we will supplement these searches with additional sources. The search string has been developed using a Population–Exposure–Comparison–Outcome (PECO) framework, to capture articles that used an aquatic organism (P, population) to test the efects of a pharmaceutical (E, exposure) on behaviour (O, outcome). Eligible articles must also have a control group (C, comparison). Articles will be screened in two stages, title and abstract, followed by full-text screening before data extraction. Decision trees have been designed a priori to appraise articles for eligibility at both stages of screening. At both stages, screening each article will be completed by two independent reviewers. Study validity will be appraised but not used as a basis for article inclusion. The information extracted from the eligible articles, along with bibliometric data, will be mapped and displayed. All data associated with this SEM will be publicly available through the Open Science Framework (OSF) and a future project webpage.
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| 6. |
- Bertram, Michael G., et al.
(författare)
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Frontiers in quantifying wildlife behavioural responses to chemical pollution
- 2022
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Ingår i: Biological Reviews. - : John Wiley & Sons. - 1464-7931 .- 1469-185X. ; 97:4
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Tidskriftsartikel (refereegranskat)abstract
- Animal behaviour is remarkably sensitive to disruption by chemical pollution, with widespread implications for ecological and evolutionary processes in contaminated wildlife populations. However, conventional approaches applied to study the impacts of chemical pollutants on wildlife behaviour seldom address the complexity of natural environments in which contamination occurs. The aim of this review is to guide the rapidly developing field of behavioural ecotoxicology towards increased environmental realism, ecological complexity, and mechanistic understanding. We identify research areas in ecology that to date have been largely overlooked within behavioural ecotoxicology but which promise to yield valuable insights, including within- and among-individual variation, social networks and collective behaviour, and multi-stressor interactions. Further, we feature methodological and technological innovations that enable the collection of data on pollutant-induced behavioural changes at an unprecedented resolution and scale in the laboratory and the field. In an era of rapid environmental change, there is an urgent need to advance our understanding of the real-world impacts of chemical pollution on wildlife behaviour. This review therefore provides a roadmap of the major outstanding questions in behavioural ecotoxicology and highlights the need for increased cross-talk with other disciplines in order to find the answers.
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| 7. |
- Bohlooly-Yeganeh, Mohammad, 1966, et al.
(författare)
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Growth hormone overexpression in the central nervous system results in hyperphagia-induced obesity associated with insulin resistance and dyslipidemia.
- 2005
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Ingår i: Diabetes. - 0012-1797 .- 1939-327X. ; 54:1, s. 51-62
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Tidskriftsartikel (refereegranskat)abstract
- It is well known that peripherally administered growth hormone (GH) results in decreased body fat mass. However, GH-deficient patients increase their food intake when substituted with GH, suggesting that GH also has an appetite stimulating effect. Transgenic mice with an overexpression of bovine GH in the central nervous system (CNS) were created to investigate the role of GH in CNS. This study shows that overexpression of GH in the CNS differentiates the effect of GH on body fat mass from that on appetite. The transgenic mice were not GH-deficient but were obese and showed increased food intake as well as increased hypothalamic expression of agouti-related protein and neuropeptide Y. GH also had an acute effect on food intake following intracerebroventricular injection of C57BL/6 mice. The transgenic mice were severely hyperinsulinemic and showed a marked hyperplasia of the islets of Langerhans. In addition, the transgenic mice displayed alterations in serum lipid and lipoprotein levels and hepatic gene expression. In conclusion, GH overexpression in the CNS results in hyperphagia-induced obesity indicating a dual effect of GH with a central stimulation of appetite and a peripheral lipolytic effect.
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| 8. |
- Bose, Aneesh, et al.
(författare)
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Pharmaceutical pollution disrupts the behaviour and predator–prey interactions of two widespread aquatic insects
- 2022
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Ingår i: iScience. - : Elsevier BV. - 2589-0042. ; 25
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Tidskriftsartikel (refereegranskat)abstract
- Pharmaceutical pollution represents a rapidly growing threat to ecosystems worldwide. Drugs are now commonly detected in the tissues of wildlife and have the potential to alter the natural expression of behavior, though relatively little is known about how pharmaceuticals impact predator-prey interactions. We conducted parallel laboratory experiments using larval odonates (dragonfly and damselfly nymphs) to investigate the effects of exposure to two pharmaceuticals, cetirizine and citalopram, and their mixture on the outcomes of predator-prey interactions. We found that exposure to both compounds elevated dragonfly activity and impacted their predation success and efficiency in complex ways. While exposure to citalopram reduced predation efficiency, exposure to cetirizine showed varied effects, with predation success being enhanced in some contexts but impaired in others. Our findings underscore the importance of evaluating pharmaceutical effects under multiple contexts and indicate that these compounds can affect predator-prey outcomes at sublethal concentrations.
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| 9. |
- Bose, Aneesh, et al.
(författare)
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Uptake, depuration, and behavioural effects of oxazepam on activity and foraging in a tropical snail (Melanoides tuberculata)
- 2022
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Ingår i: Environmental advances. - : Elsevier BV. - 2666-7657. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Pharmaceuticals are increasingly being detected in surface waters around the globe, giving rise to concerns that they may alter the physiology and behaviour of aquatic organisms exposed in the wild. Invertebrates represent important components of many ecosystems and bear a high potential for transmitting pharmaceutical contaminants to higher trophic levels. Here, we present a laboratory study in which we exposed a freshwater tropical snail, Melanoides tuberculata, to a serial dilution of the benzodiazepine oxazepam ranging from 50 ng/L to 5 mg/L. We tested for subsequent behavioural effects, including locomotor activity and foraging propensity, at two diurnal time points (day and night), and across three days. We found that the snails displayed a high level of behavioural tolerance to all treatments of oxazepam except at the highest exposure, where locomotor and foraging activity declined. We also detected a weak non-monotonic response curve suggestive of behavioural disinhibition at moderate exposure levels. Regardless of treatment, the snails were also less active after three days of exposure and more active during nighttime observations. We measured the uptake of oxazepam in tissues across treatments, showing that it bioconcentrated at up to 29 times the water exposure level (BCF range: 7 - 29). Finally, we characterized the uptake/depuration pharmacokinetics of oxazepam in snail tissues across time, which revealed that the snails reach a steady state equilibrium in < 8 hours of exposure and depurate at a similar rate. Overall, our study suggests that snails such as M. tuberculata, due to their behavioural resilience and high bioconcentration potential, could act as vectors for pharmaceutical transfer throughout the food web in pharmaceutical-polluted habitats (e.g., wastewater outfalls).
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| 10. |
- Brattström, Daniel, 1966-
(författare)
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Angiogenesis Related Markers In Non-Small Cell Lung Cancer
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis investigated the predictive and the prognostic powers of angiogenesis related markers in both operable and inoperable non-small cell lung cancer (NSCLC) patients.In the first and second study, we investigated the serological fractions of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in 2 cohorts of patients with either operable or inoperable NSCLC. Regarding operable NSCLC, we demonstrated significant correlations between VEGF and tumour volume and overall survival. Regarding bFGF, significant correlations with recurrent disease and survival were demonstrated. VEGF and bFGF correlated to each other and with platelet counts. In multivariate analysis, bFGF proved to be a significantly independent prognostic factor.Regarding inoperable NSCLC, we demonstrated that patients with elevated bFGF levels before any treatment and during chemotherapy had a significantly poorer survival. During chemotherapy, each rise of one unit of bFGF (ng/L) corresponded to a 4 times increased risk of death. Regarding VEGF, elevated levels after radiotherapy corresponded with better survival. All prognostic information demonstrated in this study concerned patients with a, co-sampled, normal platelet count.In the third study, three putative markers, HER-2, EGFR and COX-2, suitable for targeted therapies in resected NSCLC were investigated in a panel of 53 tumours and further investigated for a possible correlation with microvessel density. We demonstrated that HER-2 and COX-2 were mainly expressed in adenocarcinomas, whereas EGFR was only expressed in squamous cell carcinomas. COX-2 showed a trend towards a correlation with microvesssel density. The expression profile, HER-2+/EGFR-, was significantly correlated to poorer survival. In the fourth study, a predictive model for recurrences consisting of p53, CD34 and CD105, and circulating serum fractions of VEGF and bFGF, was investigated. The two endothelial markers correlated with each other. CD105 expression correlated with p53 expression. No other significant correlations between markers could be demonstrated. A significant correlation between p53 overexpression and recurrent disease was demonstrated. The mutational status could not confirm the immunohistochemical correlation between p53 and recurrences. In conclusion, the present thesis demonstrates that the angiogenic factors VEGF and bFGF analysed in sera have both predictive and prognostic information when measured in operable and inoperable NSCLC. Since HER-2 is overexpressed in NSCLC and linked with prognostic information, this marker might be a suitable target for therapy in NSCLC. Furthermore, in patients with operable NSCLC, p53 expression status was linked with recurrent disease and mean MVD.
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