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- Bobbio, Emanuele, et al.
(author)
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Association between central haemodynamics and renal function in advanced heart failure: a nationwide study from Sweden.
- 2022
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In: ESC heart failure. - : Wiley. - 2055-5822. ; 9:4, s. 2654-2663
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Journal article (peer-reviewed)abstract
- Renal dysfunction in patients with heart failure (HF) has traditionally been attributed to declining cardiac output and renal hypoperfusion. However, other central haemodynamic aberrations may contribute to impaired kidney function. This study assessed the relationship between invasive central haemodynamic measurements from right-heart catheterizations and measured glomerular filtration rate (mGFR) in advanced HF.All patients referred for heart transplantation work-up in Sweden between 1988 and 2019 were identified through the Scandiatransplant organ-exchange organization database. Invasive haemodynamic variables and mGFR were retrieved retrospectively. A total of 1001 subjects (49±13years; 24% female) were eligible for the study. Analysis of covariance adjusted for age, sex, and centre revealed that higher right atrial pressure (RAP) displayed the strongest relationship with impaired GFR [β coefficient -0.59; 95% confidence interval (CI) -0.69 to -0.48; P<0.001], followed by lower mean arterial pressure (MAP) (β coefficient 0.29; 95% CI 0.14-0.37; P<0.001), and finally reduced cardiac index (β coefficient 3.51; 95% CI 2.14-4.84; P<0.003). A combination of high RAP and low MAP was associated with markedly worse mGFR than any other RAP/MAP profile, and high renal perfusion pressure (RPP, MAP minus RAP) was associated with superior renal function irrespective of the degree of cardiac output.In patients with advanced HF, high RAP contributed more to impaired GFR than low MAP. A higher RPP was more closely related to GFR than was high cardiac index.
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| 2. |
- Bartfay, Sven-Erik, et al.
(author)
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Durable circulatory support with a paracorporeal device as an option for pediatric and adult heart failure patients.
- 2021
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In: The Journal of thoracic and cardiovascular surgery. - : Elsevier BV. - 1097-685X .- 0022-5223. ; 161:4
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Journal article (peer-reviewed)abstract
- Not all patients in need of durable mechanical circulatory support are suitable for a continuous-flow left ventricular assist device. We describe patient populations who were treated with the paracorporeal EXCOR, including children with small body sizes, adolescents with complex congenital heart diseases, and adults with biventricular failure.Information on clinical data, echocardiography, invasive hemodynamic measurements, and surgical procedures were collected retrospectively. Differences between various groups were compared.Between 2008 and 2018, a total of 50 patients (21 children and 29 adults) received an EXCOR as bridge to heart transplantation or myocardial recovery. The majority of patients had heart failure compatible with Interagency Registry for Mechanically Assisted Circulatory Support profile 1. At year 5, the overall survival probability for children was 90%, and for adults 75% (P=.3). After we pooled data from children and adults, the survival probability between patients supported by a biventricular assist device was similar to those treated with a left ventricular assist device/ right ventricular assist device (94% vs 75%, respectively, P=.2). Patients with dilated cardiomyopathy had a trend toward better survival than those with other heart failure etiologies (92% vs 70%, P=.05) and a greater survival free from stroke (92% vs 64%, P=.01). Pump house exchange was performed in nine patients due to chamber thrombosis (n=7) and partial membrane rupture (n=2). There were 14 cases of stroke in eleven patients.Despite severe illness, patient survival on EXCOR was high, and the long-term overall survival probability following heart transplantation and recovery was advantageous. Treatment safety was satisfactory, although still hampered by thromboembolism, mechanical problems, and infections.
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| 4. |
- Ekelund, Alexander, 1979-
(author)
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Kampen om vetenskapen : Politisk och vetenskaplig formering under den svenska vänsterradikaliseringens era
- 2017
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Doctoral thesis (other academic/artistic)abstract
- This thesis examines the relation between politics and science in Sweden during the era of political radicalization in the sixties and seventies. Rooted in the Bourdieuan tradition of cultural sociology the main analysis focuses on relations between different cultural fields. Studying social movements and the political debate as well as the scientific fields makes it possible to identify habitus and strategies that formed the radical student generation. In addition to efforts to understand the historical background of the radicalisation, like the changes within the Education system and the general tendencies of the political debate, certain parts of the Swedish student movement are studied in-depth, like Unga filosofer in Stockholm and other autonomous groups organizing students and young teachers at the university departments. Of particular interest are the collective struggles to gain influence within the academic structures and the alternative forms of education that were initiated in the late sixties and early seventies.Since the young generation of radical academics were not prone to follow the traditional paths – the established order of succession – they had to find ways to compensate for the academic capital that they renounced by challenging their professors or other influential actors. To understand how this came to effect the Social Sciences and Humanities – or in this case more precisely the fields of philosophy, sociology and literary criticism – the other studies focus on analysing three politically motivated projects that were formed at intersections between a movement-context and academia: the first centred on the critique of positivism, the second engaged in the development of the ideas of scientific socialism – inspired by the reception of the philosophy of Louis Althusser – and the third a later feminist project that evolved in the field of literary criticism with the reception of Julia Kristeva’s theories. One thing the three projects had in common was that they created opportunities to channel political engagement in academic strategies by occupying homological positions in the political-intellectual field and the scientific fields – in some cases confronting the same antagonists in the different arenas. Some of the preconditions that made these strategies possible, which are discussed on the basis of the studies of the different fields, are the intellectual infrastructure that enabled conversion of symbolical assets, like magazines and other arenas for theoretical debate, the creation of social networks and the fact that the political radicalization encouraged transnational theoretical investments.
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| 6. |
- Ekelund, Göran, et al.
(author)
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Bruno Samenius
- 2008
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In: Svensk Kirurgi. - 0346-847X. ; 66:1, s. 23-24
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Journal article (pop. science, debate, etc.)
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| 7. |
- Ekelund, Göran, et al.
(author)
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För tidigt att rekommendera allmän screening för kolorektal cancer
- 2003
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In: Läkartidningen. - 0023-7205. ; 100:38, s. 2922-2926
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Journal article (peer-reviewed)abstract
- Randomised controlled trials have shown that screening may significantly reduce mortality in coloretcal cancer. In the present evaluation it is shown that the reported reduction of 15 per cent, or higher, is given in relative figures. With absolute figures the reduction is only 0.15 per cent or lower. The number of individuals needed to invite for screening (NNT) biannually for 10 years to prevent one death in colorectal cancer is 1,173 (confidence interval 741-2,807). Side-effects, costs and ethical issues are seldom, or never, discussed. Postopeative follow-up may be regardes as the screening of a high-risk group. The reduced mortality seen in the metaanalysis of randomised controlled trials is here regarded as small and should also be weighed against the drawbacks of follow-up before any recommendation for more active surveillance is given.
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