| 1. |
- Andersen, Niels S., et al.
(författare)
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Pre-Emptive Treatment With Rituximab of Molecular Relapse After Autologous Stem Cell Transplantation in Mantle Cell Lymphoma
- 2009
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Ingår i: Journal of Clinical Oncology. - 0732-183X .- 1527-7755. ; 27:26, s. 4365-4370
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Minimal residual disease (MRD) is predictive of clinical progression in mantle-cell lymphoma (MCL). According to the Nordic MCL-2 protocol we prospectively analyzed the efficacy of pre-emptive treatment using rituximab to MCL patients in molecular relapse after autologous stem cell transplantation (ASCT). Patients and Materials MCL patients enrolled onto the study, who had polymerase chain reaction (PCR) detectable molecular markers and underwent ASCT, were followed with serial PCR assessments of MRD in consecutive bone marrow and peripheral blood samples after ASCT. In case of molecular relapse with increasing MRD levels, patients were offered pre-emptive treatment with rituximab 375 mg/m(2) weekly for 4 weeks. Results Of 160 MCL patients enrolled, 145 underwent ASCT, of whom 78 had a molecular marker. Of these, 74 were in complete remission (CR) and four had progressive disease after ASCT. Of the CR patients, 36 underwent a molecular relapse up to 6 years (mean, 18.5 months) after ASCT. Ten patients did not receive pre-emptive treatment mainly due to a simultaneous molecular and clinical relapse, while 26 patients underwent pre-emptive treatment leading to reinduction of molecular remission in 92%. Median molecular and clinical relapse-free survival after pre-emptive treatment were 1.5 and 3.7 years, respectively. Of the 38 patients who remain in molecular remission for now for a median of 3.3 years (range, 0.4 to 6.6 years), 33 are still in clinical CR. Conclusion Molecular relapse may occur many years after ASCT in MCL, and PCR based pre-emptive treatment using rituximab is feasible, reinduce molecular remission, and may prevent clinical relapse.
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| 2. |
- Carlström, Eric, 1957, et al.
(författare)
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The first single responders in Sweden : Evaluation of a pre-hospital single staffed unit
- 2017
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Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X .- 1878-013X. ; 32:S1, s. 15-19
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Single responder (SR) systems have been implemented in several countries. When the very first SR system in Sweden was planned, it was criticised because of concerns about sending single emergency nurses out on alerts. In the present study, the first Swedish SR unit was studied in order to register waiting times and assess the working environment.METHOD: Quantitative data were collected from the ambulance dispatch register. Data on the working environment were collected using a questionnaire sent to the SR staff.RESULTS: The SR system reduced the average patient waiting time from 26 to 13min. It also reduced the number of ambulance transports by 35% following triage of patient(s) priority determined by the SR. The staff perceived the working environment to be adequate.CONCLUSION: The SR unit was successful in that it reduced waiting times to prehospital health care. Contrary to expectations, it proved to be an adequate working environment. There is good reason to believe that SR systems will spread throughout the country. In order to enhance in depth the statistical analysis, additional should be collected over a longer time period and from more than one SR unit.
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| 3. |
- Dahlborg Lyckhage, Elisabeth, et al.
(författare)
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Gränshinder : en kvalitativ och kvantitativ studie av samverkandesjukvård
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The project "Health care interaction" among different care providers was introduced as a trial activity in the municipalities of Strömstad and Tanum in the spring of 2010. The aim of health care interaction is to provide citizens health care adapted to their specific need within shortest possible time frame; Is emergency care not needed, the aim is to avoid that the care seeker ends up in an emergency room at the hospital. In this study experiences from health care interaction is described with quantitative as well as qualitative data. Empirical data is based on available medical statistics, focus group interviews with nurses with long experience from pre-hospital emergency care and home health care, questionnaires data gathered from other health professionals involved in the activity, individual interviews with nurses and physicians at call centers for medical information, primary health care centers, home health care, pre-hospital health care and elderly care. The analysis of the data reveal opportunities and expectations among the personnel as well as their willingness to develop and improve the health care. It's also evident that the general impression among health care personnel is that increased interaction among health care providers improves the quality of the health care given. Health care interaction also contributes to improved opportunities for person-centered care with an increased degree of continuity and participation for the patient. The study also reveals that collaboration between colleagues promotes development of individual and collective knowledge. Conclusions drawn from the study is that the documentation and information system used in health care interaction needs to strengthen the participation of the care seekers as well as to improve in accessibility for the personnel involved. In order for health care interaction to evolve and develop through close follow-up and evaluation, a more transparent and uniform system for documentation is recommended. It's also concluded from the study that the call center for medical information (1177) as one of the major actors in the health care interaction program has the best potential to instigate an expansion and development of the health care interaction among care providers.
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| 4. |
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| 5. |
- Forsman, Anna K., et al.
(författare)
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Contribution of the Nordic School of Public Health to the public mental health research field : a selection of research initiatives, 2007-2014
- 2015
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 43, s. 66-72
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Tidskriftsartikel (refereegranskat)abstract
- The field of public mental health has been defined by an expert group convened by the Nordic School of Public Health (NHV) as encompassing the experience, occurrence, distribution and trajectories of positive mental health and mental health problems and their determinants; mental health promotion and prevention of mental disorders; as well as mental health system policies, governance and organization. The mental health priorities of the Nordic Council of Ministers in 2010 signalled a mutual Nordic exchange of knowledge in the following thematic areas: child and adolescent mental health; working life and mental health; mental health in older people; strengthening the role of primary care in mental health service provision; stronger involvement of users and carers; and reduction of use of coercion in psychiatric care. Efforts to realize these priorities included commissioning the Nordic Research Academy for Mental Health, an NHV-based network of research institutions with a common interest in mental health research across the Nordic countries, to develop, organize and follow-up projects on public mental health. The research initiatives included mental health policy analysis, register-based research and research focused on the users' perspective in a Nordic context, as well as EU-level research policy analysis. The public mental health research conducted at the NHV highlighted the complexity of mental health and emphasized that the broad determinants of mental health need to be increasingly addressed in both public health research and practice. For example, health promotion actions, improved access to health care, a healthy alcohol policy and prevention of suicides and violence are all needed to reduce the life expectancy gap - a red flag indicator of public health inequalities. By exchanging knowledge and best practice, the collaboration between the Nordic countries contributes to the welfare of the region. The expertise and traditions developed at the NHV are of significant importance in this work.
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| 6. |
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| 7. |
- Fredén, Lars, et al.
(författare)
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Vilken inriktning och kvalitet har examensarbeten i svenska folkhälsovetenskapliga utbildningar?
- 2017
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Ingår i: Socialmedicinsk tidskrift. - 0037-833X. ; 94:3, s. 293-300
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Tidskriftsartikel (refereegranskat)abstract
- Den andra nationella utvärderingen av samtliga 23 utbildningsprogram på kandidat-, magister- och masternivå i folkhälsovetenskap genomfördes 2011-2012. Här presenteras en översikt av de examensarbeten som utvärderingen baserades på. Det är 218 slumpmässigt utvalda uppsatser, 67 från kandidatnivå, 55 från magisternivå och 76 från mastersnivå. Högskoleverkets hårt reglerade format medgav inte någon innehållsmässig analys av hur folkhälsovetenskapen speglades i uppsatserna. Vi åtta i bedömargruppen var dock eniga om att vidga ramarna. Vår fördjupning kom att fokuseras på vilka tillämpningsområden som studenterna valde, vilka forskningsdesigner som tillämpades och hur kvaliteten bedömdes i relation till ämne, metod och fakultetsområde. Av de nio folkhälsovetenskapliga områden som förekommer i uppsatserna var de vanligaste Hälsofrämjande och Hälsans bestämningsfaktorer. Ämnesinnehåll och olika examensnivåer varierade stort mellan de olika lärosätena. En slutsats är att utbildningen i folkhälsovetenskap har svårigheter att balansera det flervetenskapliga med att nå ett fördjupat kunskapsinnehåll.
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| 8. |
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| 9. |
- Hjelmgren, Ola, et al.
(författare)
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A study of plaque vascularization and inflammation using quantitative contrast-enhanced US and PET/CT
- 2014
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Ingår i: European Journal of Radiology. - : Elsevier BV. - 0720-048X .- 1872-7727. ; 83:7, s. 1184-1189
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Tidskriftsartikel (refereegranskat)abstract
- Background: Contrast-enhanced ultrasound (CEUS) is an in vivo methodology to quantify carotid plaque vascularization. Increased metabolism in plaques, measured as FDG uptake in PET/CT examination, has been associated with markers of inflammation in histological samples. In this study, we tested the association between FDG uptake and vascularization measured by CEUS to assess whether CEUS can be used as an in vivo marker of plaque vulnerability. Methods: After informed consent, subjects aged >60 years with carotid plaque height exceeding 2.5 mm were recruited. CEUS was performed and analyzed using earlier described protocol and software, Contrast Quantification Program, which calculates the fraction of the plaque being contrast positive (CQP value). PET/CT examination was performed within 3 months of CEUS (median time 7 days). PET/CT images were acquired 90 min after FDG injection (2.7 MBq/kg). FDG uptake was measured as tissue background index (TBI), calculated using Spearman's rho as mean standard uptake value (SUV) of the plaque divided by mean Shy in the jugular vein (mean of 7 measuring points). Local ethics committee approved the study. Results: We recruited 13 subjects (5 women) with a mean age of 71 years, 6 had a history of stroke or TIA, 1 had a history of ipsilateral stroke. CQP values showed a significant, positive correlation with TBI of carotid plaques, r= 0.67, p <0.02. Conclusions: Plaque vascularization measured by CEUS correlates positively with FDG uptake measured by PET/CT in humans. This indicates an association between vascularization and inflammation and/or hypoxia, supporting the use of CEUS as a non-invasive method to detect plaque vulnerability. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
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| 10. |
- Kullberg, Joel, et al.
(författare)
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Gastric bypass promotes more lipid mobilization than a similar weight loss induced by low-calorie diet
- 2011
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Ingår i: Journal of Obesity. - : Hindawi Limited. - 2090-0708 .- 2090-0716. ; 2011, s. 959601-
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Tidskriftsartikel (refereegranskat)abstract
- Background.Recently, we found large reductions in visceral and subcutaneous fat one month after gastric bypass (GBP), without any change in liver fat content.Purpose.Firstly to characterize weight loss-induced lipid mobilization after one month with preoperative low-calorie diet (LCD) and a subsequent month following GBP, and secondly, to discuss the observations with reference to our previous published findings after GBP intervention alone.Methods.15 morbidly obese women were studied prior to LCD, at GBP, and one month after GBP. Effects on metabolism were measured by magnetic resonance techniques and blood tests.Results.Body weight was similarly reduced after both months (mean: -8.0 kg, n = 13). Relative body fat changes were smaller after LCD than after GBP (-7.1 ± 3.6% versus -10 ± 3.2%, P = .029, n = 13). Liver fat fell during the LCD month (-41%, P = .001, n = 13) but was unaltered one month after GBP (+12%).Conclusion.Gastric bypass seems to cause a greater lipid mobilization than a comparable LCD-induced weight loss. One may speculate that GBP-altered gastrointestinal signalling sensitizes adipose tissue to lipolysis, promoting the changes observed.
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