| 1. |
- Groenning, Minna, et al.
(författare)
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Thermodynamic stability and denaturation kinetics of a benign natural transthyretin mutant identified in a Danish kindred
- 2011
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Ingår i: AMYLOID-JOURNAL OF PROTEIN FOLDING DISORDERS. - : Informa Healthcare. - 1350-6129. ; 18:2, s. 35-46
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Tidskriftsartikel (refereegranskat)abstract
- The disease phenotype of transthyretin (TTR) is dramatically influenced by single point mutations in the TTR gene. Herein, we report on a novel mutation D99N (Asp99Asn) in TTR found in a Danish kindred. None of the family members carrying this mutation have so far shown any clinical signs of amyloidosis. One carrier found compound heterozygous for TTR D99N and L111M (Leu111Met) associated with cardiac amyloid is asymptomatic (42 years). Disease severity can often be linked to both the kinetics of fibril formation and the degree of destabilisation of the native state. In this study, we show that the thermodynamic stability and rate of tetramer dissociation of the variant TTR D99N is unchanged or slightly more stable than wild type (WT) TTR. Furthermore, the in vitro fibrillation kinetics of the variant reveals an unchanged or slightly suppressed tendency to form fibrils compared to WT. Thus, the in vitro experiments support the lack of clinical symptoms observed so far for the TTR D99N carriers. In line with this, studies on kinetic stability and fibrillation kinetics reveal indistinguishable stability of TTR heterotetramers D99N/L111M compared to the heterotetramers WT/L111M. In conclusion, TTR D99N is predicted to be a non-pathogenic benign mutation with WT properties.andlt;/.
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| 2. |
- Martinsson, Gunilla, et al.
(författare)
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Being altruistically egoistic : Nursing aides’ experiences of caring for older persons with mental disorders
- 2011
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 6:4, s. 7530-
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Tidskriftsartikel (refereegranskat)abstract
- Older persons with mental disorders, excluding dementia disorders, constitute a vulnerable group of people. With the future international increase in the older population, mental disorders will increase as well, thus entailing new challenges for their caregivers. These older persons often remain in their own homes, and in Sweden they are cared for by nursing aides. With little previous research, an increased workload and facing new strenuous situations, it is important to make use of the knowledge the nursing aides possess and to deepen the understanding of their experiences. The study aimed at illuminating the meaning of caring for older persons with mental disorders as experienced by nursing aides in the municipal home help service. Interviews with nine female nursing aides were performed and analysed with a phenomenological hermeneutical research method inspired by the philosophy of Paul Ricoeur. Being altruistically egoistic emerged as a main theme in the nursing aides’ narratives. The nursing aides’ experiences could be interpreted as a movement between being altruistic and egoistic. The findings revealed a continuous distancing by the nursing aides and their struggle to redress the balance between their altruistic and egoistic actions. Caring for these older persons constitutes a complex situation where distancing functions as a recourse to prioritize oneself and to diminish the value of caring. The study suggests that an increased knowledge base on older persons with mental disorders, followed by continuous supervision, is necessary for the nursing aides to improve the quality of the care given
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| 3. |
- Martinsson, Gunilla, et al.
(författare)
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Mental disorders affect older persons in Sweden : a register-based study
- 2011
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 26:3, s. 277-283
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The study aimed to estimate the prevalence of mental disorders based on pharmaceutical use among the old (age >/= 65) in Sweden for the years 2006-2008. METHODS: Data on the mental health of older persons were approximated on the basis of recommended prescriptions for pharmaceuticals, gathered from the Swedish Register on Prescribed Pharmaceuticals (SRPP). Each disorder (ICD-10, F20-F42, and F60-F61) was analyzed to identify associated recommended pharmaceuticals. Anatomical Therapeutic Chemical Classification codes were applied. The data covered 188 024 individuals who received 2 013 079 prescriptions for pharmaceuticals for mental disorders during a 3-year period. Persons with pharmaceuticals for dementia disorders were excluded from the calculations of the prevalence of mental disorders. RESULTS: The prevalence of mental disorders among the old in Sweden, measured on the basis of pharmaceutical use, was 6.6% in 2006, 2007, and 2008, respectively. Men constituted one-third of cases and women two-thirds. Prevalence was lowest in the age group 65-69 and increased subsequently with age. CONCLUSIONS: This fundamental register-based study included a great number of older persons and shows that mental disorders affect every fifteenth older person in Sweden. The prevalence of mental disorders increases with increasing age. The results highlight the extent of mental disorders among older persons, which is important to know when planning care for these patients. This study, by investigating a large population, provides a solid basis for general planning as well as for future mental disorder research.
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| 4. |
- Martinsson, Gunilla, et al.
(författare)
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Specialist prescribing of psychotropic drugs to older persons in Sweden : a register-based study of 188 024 older persons
- 2012
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Ingår i: BMC Psychiatry. - 1471-244X. ; 12:197
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe situation for older persons with mental disorders other than dementia disorders has scarcely been studied. The older population is increasing worldwide and along with this increase the prevalence of mental disorders will also rise. The treatment of older persons with mental disorders entails complex challenges, with drugs constituting the major medical treatment. Knowledge of geriatric psychiatry is essential for providing older persons with appropriate treatment and care. This study aimed to evaluate the prescription of drugs for mental disorders to older persons (>=65) in Sweden, focused on the medical specialties of the prescribing physicians.MethodsData concerning drug treatment for older persons from 2006 to 2008 was gathered from the Swedish Prescribed Drug Register. Mental disorders, defined as affective, psychotic and anxiety disorders (ICD-10 F20-42) were evaluated in order to identify associated drugs. Included was a total of 188 024 older individuals, who collectively filled 2 013 079 prescriptions for the treatment of mental disorders. Descriptive analyses were performed, including frequency distribution and 95% CI. The competence of the prescribers was analyzed by subdividing them into five groups: geriatricians, psychiatrists, general practitioners (GPs), other specialists, and physicians without specialist education.ResultsGPs represented the main prescribers, whereas geriatricians and psychiatrists rarely prescribed drugs to older persons. Benzodiazepines and tricyclic antidepressants were the most commonly prescribed drugs. Women were prescribed drugs from geriatricians and psychiatrists to a greater extent than men.ConclusionsThis study examined the prescription of psychotropic drugs to older persons. Physicians specialized in older persons' disorders and mental health were rarely the prescribers of these drugs. Contrary to clinical guidelines, benzodiazepines and tricyclic antidepressants were commonly prescribed to older persons, emphasizing the need for continuous examination of pharmaceutical treatment for older persons. The results indicate a future need of more specialists in geriatrics and psychiatry.
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| 5. |
- Martinsson, Gunilla, et al.
(författare)
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Struggling for existence : - Life situation experiences of older persons with mental disorders
- 2012
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 7:Art. nr. 18422
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Tidskriftsartikel (refereegranskat)abstract
- Older persons with mental disorders represent a vulnerable group of people with extensive and complex needs. The older population is rapidly increasing worldwide and, as a result of deinstitutionalization in mental health care, older persons are remaining at home to a greater extent. Although they constitute a large proportion of the population, older persons with mental disorders have been neglected in research as well as in care organizations. As there is little previous knowledge concerning older persons’ experiences of their own situations, this study aimed to illuminate the meaning of the life situation as experienced by older persons with mental disorders (excluding dementia disorders). Interviews were conducted with seven older persons and the text was analyzed using a phenomenological hermeneutical research method, inspired by the philosophy of Paul Ricoeur. ‘‘Struggling for existence’’ emerged as a main theme in the older persons’ narratives, understood as a loss of dignity of identity and involving being troubled and powerless as well as yearning for respect. The older persons fought to master their existence and to be seen for who they are. The study highlights the importance for caregivers, both formal and informal, to avoid focusing on the diagnoses and rather acknowledge the older persons and their lifeworld, be present in the relation and help them rebuild their dignity of identity. This study brings a new understanding about older persons with mental disorders that may help reduce stigma and contribute to planning future mental health care
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| 6. |
- Nyberg, Annette, 1967, et al.
(författare)
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Pulmonary net release of tissue-type plasminogen activator during porcine primary and secondary acute lung injury.
- 2004
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Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 48:7, s. 845-50
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Tissue-type plasminogen activator (tPA) is a key mediator of fibrinolysis. Matching of pulmonary perfusion and ventilation is a critical denominator of oxygenation in acute lung injury (ALI). This study investigates pulmonary venoarterial plasma tPA gradients in association with acute ALI induced by bronchoalveolar lavage (BAL) and endotoxinemia (ETX). METHODS: Twenty-one anaesthetized, ventilated pigs were allocated to control (CTRL, n=5), bronchoalveolar saline lavage (BAL, n=8) or infusion of Escherichia coli endotoxin (ETX, n=8). Total tPA was analyzed in plasma (ELISA calibrated for porcine tPA). The inflammatory response was assessed by TNFa levels (ELISA). All variables were assessed at baseline and 2 h following ALI. RESULTS: Bronchoalveolar lavage and ETX induced similar increases in pulmonary shunt whereas pulmonary vascular resistance was significantly more increased in ETX animals. Cardiac output remained stable in BAL animals but decreased in ETX animals. The pulmonary venoarterial tPA plasma gradient increased in ETX animals, yielding a positive pulmonary net flux of tPA, which was absent in BAL animals. TNFalpha levels increased in ETX, but not in BAL, animals. A significant correlation was observed between TNFalpha and tPA plasma levels in ETX animals. All variables remained unchanged in CTRL animals. CONCLUSION: Plasma changes of tPA levels support a pulmonary release of tPA in early experimental ALI induced by acute ETX but not lavage, and are related to the inflammatory response. Despite increased vascular fibrinolytic capacity in ETX animals, pulmonary dysfunction was not different from BAL animals. The results demonstrate the close relation between inflammation and coagulation in early ALI.
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| 7. |
- Pauli, Nina, et al.
(författare)
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Temporomandibular disorder as risk factor for radiation-induced trismus in patients with head and neck cancer
- 2022
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Ingår i: Clinical and Experimental Dental Research. - : Wiley. - 2057-4347. ; 8:1, s. 123-129
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to investigate if patients with temporomandibular disorders (TMD) prior to head and neck cancer (HNC) treatment are at higher risk of developing trismus after oncological treatment. Materials and Methods: Eighty-three study patients underwent detailed dental examination prior oncological treatment and 6 months after radiotherapy completion, including evaluation of temporomandibular jaw function, palpation of the jaw muscles, and measurement of mouth opening capacity. TMD criteria were based on both clinical examination findings and patient-reported symptoms. TMD at baseline was used in regression analysis in order to predict restricted mouth opening. Results: At the 6 months follow-up more than a third of the patients (35%) were examined with reduced mouth opening of >20% compared to baseline. A majority of the patients had bilateral tenderness of both the temporal and the masseter muscle. At the 6 months follow-up, 42% of the study patients reported mouth opening problems. About one-third of the patients suffered from fatigue and stiffness of the jaw as well as pain when mowing the jaw. Two questions from the validated symptom-specific Gothenburg Trismus Questionnaire were found to be related to a statistically significant increased risk of restricted mouth opening after radiotherapy; "During the last week, have you felt: Pain on moving the jaw?" (OR [95% CI] 5.9 (1.2-29.4) [p = 0.030]) and "During the last week, have you felt pain and tenderness in the muscles of mastication?" (OR [95% CI] 5.90 [1.19-29.40] [p = 0.030]). Conclusions: TMD is common amongst HNC patients. Patients who suffer from pain in the jaw muscles and pain when moving the jaw before start of treatment are at higher risk of radiation-induced trismus after 6 months. Clinicians should strive for optimizing the patients pain treatment and oral health before, during, and after radiotherapy.
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| 8. |
- Pauli, Nina, et al.
(författare)
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Temporomandibular disorder in head and neck cancer patients undergoing radiotherapy: Clinical findings and patient-reported symptoms
- 2019
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Ingår i: Head and Neck-Journal for the Sciences and Specialties of the Head and Neck. - : Wiley. - 1043-3074. ; 41:10, s. 3570-3576
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Tidskriftsartikel (refereegranskat)abstract
- Background The aim of this study was to investigate how common temporomandibular disorder (TMD) symptoms are among head and neck cancer (HNC) patients before and after oncological treatment. Methods Eighty-nine patients with HNC receiving radiotherapy were enrolled in the study. Patients were examined before radiotherapy and at 6 and 12 months after radiotherapy to evaluate the function and tenderness of the temporomandibular jaw and the muscles of mastication as well as the patient-reported symptoms. Results At 6 months after radiotherapy, there was a large increase in the number of patients reporting problems with opening their mouth, fatigue, stiffness, and pain of the jaw. Sixty-eight percent of the patients had symptoms of TMD before oncological treatment and 94% and 81% had symptoms at the 6- and 12-month follow-up, respectively. Conclusion The signs and symptoms of TMD escalate after radiotherapy, with symptoms peaking at 6 months after radiotherapy. Most commonly, patients suffer from restricted mouth opening, stiffness, fatigue, and pain of the jaw.
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