| 1. |
- Jacobsson, Ewa, et al.
(författare)
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Källkritisk granskning av skolpersonals anmälningar till socialtjänsten
- 2004
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Kritisk prövning av 107 anmälningar från skolor i 18 kommuner under oktober 2004. Precisionen var låg. Det saknades angiven tidpunkt (85 fall), namn på närvarande personer (80 fall) och fanns opreciserade uppgifter (85 fall). Anmälningarna klarar alltså inte en källkritisk granskning.
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| 2. |
- Laudanski, Piotr, et al.
(författare)
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Plasma C16-Cer levels are increased in patients with preterm labor.
- 2016
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Ingår i: Prostaglandins & other lipid mediators. - : Elsevier BV. - 1098-8823. ; 123, s. 40-5
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Tidskriftsartikel (refereegranskat)abstract
- The pathogenesis of preterm labor is fragmentarily explained. The most widely accepted theory points out to infection and inflammation as possible causes, which can be mediated by potentially different factors, including sphingolipid mediators. Sphingolipids are a class of lipids that have been shown as important mediators in various cell processes such as: proliferation, growth, apoptosis, stress response, necrosis and inflammation. The aim of the study was to assess plasma concentrations of selected sphingolipids in patients with preterm labor.We used ultra-high performance liquid chromatography with triple mass spectrometry (UHPLC-ESI-MS/MS) to assess plasma concentrations of the 11 sphingolipids in patients presenting with symptoms of preterm labor (n=61) and threatened preterm labor (n=40).We observed a statistically significant increase (p-value<0.004) in plasma concentrations of C16-Cer in patients with preterm labor as compared to the control group. We also found C16-Cer to be the best predictor of preterm labor in the group of patients with symptoms occurring after 32 weeks of gestation.Our findings show a possible involvement of selected sphingolipids, especially C16-Cer, in the pathogenesis of preterm labor. Their role as predictors of preterm delivery needs to be validated in the future on larger group of patients.
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| 3. |
- Silander, Ewa M, 1952, et al.
(författare)
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Energy intake and sources of nutritional support in patients with head and neck cancer-a randomised longitudinal study.
- 2013
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Ingår i: European journal of clinical nutrition. - : Springer Science and Business Media LLC. - 1476-5640 .- 0954-3007. ; 67, s. 47-52
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Tidskriftsartikel (refereegranskat)abstract
- Background/objectives:Malnutrition decreases the cancer patient's ability to manage treatment, affects quality of life and survival, and is common among head and neck (HN) cancer patients due to the tumour location and the treatment received. In this study, advanced HN cancer patients were included and followed during 2 years in order to measure their energy intake, choice of energy sources and to assess problems with dysphagia. The main purpose was to explore when and for how long the patients had dysphagia and lost weight due to insufficient intake and if having a PEG (percutaneous endoscopic gastrostomy) in place for enteral nutrition made a difference.Subjects/methods:One hundred thirty-four patients were included and randomised to either a prophylactic PEG for early enteral feeding or nutritional care according to clinical praxis. At seven time points weight, dysphagia and energy intake (assessed as oral, nutritional supplements, enteral and parenteral) were measured.Results:Both groups lost weight the first six months due to insufficient energy intake and used enteral nutrition as their main intake source; no significant differences between groups were found. Problems with dysphagia were vast during the 6 months. At the 6-, 12- and 24-month follow-ups both groups reached estimated energy requirements and weight loss ceased. Oral intake was the major energy source after 1 year.Conclusions:HN cancer patients need nutritional support and enteral feeding for a long time period during and after treatment due to insufficient energy intake. A prophylactic PEG did not significantly improve the enteral intake probably due to treatment side effects.European Journal of Clinical Nutrition advance online publication, 21 November 2012; doi:10.1038/ejcn.2012.172.
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| 4. |
- Thorstensson, Carina A., et al.
(författare)
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Reduced functional performance in the lower extremity predicted radiographic knee osteoarthritis five years later
- 2004
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 63:4, s. 402-407
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reduced quadriceps strength is an early finding in subjects with knee osteoarthritis, but it is not clear whether it is a cause or a consequence of knee osteoarthritis.Objective: To determine whether reduced functional performance in the lower extremity predicts the incidence or progression of radiographic knee osteoarthritis.Design: Prospective, epidemiological, population based cohort study.Patients: 148 subjects (62 women), aged 35–54 (mean 44.8), with chronic knee pain from a population based cohort.Measurements: Predictors analysed were age, sex, body mass index, baseline knee pain, and three tests of lower extremity functional performance: maximum number of one-leg rises from sitting, time spent walking 300 m, and timed standing on one leg. Weightbearing tibiofemoral knee radiographs were obtained at baseline and after 5 years (median 5.1, range 4.2–6.1), and classified according to Kellgren and Lawrence as no osteoarthritis (Kellgren and Lawrence = 0, n = 94) or prevalent osteoarthritis (Kellgren and Lawrence ⩾1, n = 54).Results: Fewer one-leg rises (median 17 v 25) predicted incident radiographic osteoarthritis five years later (OR 2.6, 95% CI 1.1 to 6.0). The association remained significant after controlling for age, sex, body mass index, and pain. No significant predictor of radiographic progression in the group with prevalent osteoarthritis was found.Conclusion: Reduced functional performance in the lower extremity predicted development of radiographic knee osteoarthritis 5 years later among people aged 35–55 with chronic knee pain and normal radiographs at baseline. These findings suggest that a test of one-leg rises may be useful, and interventions aimed at improving functional performance may be protective against development of knee osteoarthritis.
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| 5. |
- Thorstensson, Carina
(författare)
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Exercise and Functional Performance in Middle-aged Patients with Knee Osteoarthritis
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall purpose of this thesis was to explore the impact of exercise and functional performance on development and treatment of knee osteoarthritis in the middle aged. In this thesis, I have studied a population based cohort of middle-aged subjects (35-54 years, 42 % women) with chronic knee pain at baseline, to evaluate the longitudinal effect of muscle weakness on knee osteoarthritis development, the relationship between muscle function and joint load and the effects of exercise on joint load. I have also studied the effect of exercise on pain and function in another middle-aged cohort (36-65 years, 51 % women) with moderate to severe knee osteoarthritis, and explored their conceptions of exercise as treatment. In the first study, 148 subjects with chronic knee pain underwent radiographic examination and tests of functional performance at baseline. 94 of them had no radiographic signs of knee osteoarthritis. Five years later they had new radiographs taken and 41/94 (44 %) had developed incident knee osteoarthritis. I found that reduced functional performance, assessed by maximum number of one-leg rises from a stool, predicted knee osteoarthritis development. The result was controlled for the previously known risk factors of age, BMI and pain. In the second study, I used 3-dimensional motion analysis to explore the possibility of altering joint load by exercise. The medial compartment joint load (peak adduction moment) during maximum number of one-leg rises was assessed in 13 subjects with early radiographic signs of knee osteoarthritis from the cohort in study one, before and after 8 weeks of exercise. Two subjects were lost to follow up for reasons not related to the knee. The peak adduction moment could be reduced by exercise, and a high maximum number of one-leg rises was associated with lower levels of peak adduction moment. The third study included 61 subjects with moderate to severe radiographic knee osteoarthritis. They were randomized to 6 weeks of intensive exercise or to a control group. The effects of exercise were assessed using questionnaires. No effects were seen on pain or self estimated function, however, the quality of life improved. The individual response to exercise ranged from clinically significant improvement to clinically significant worsening. As an attempt to understand this large inter individual response to exercise, I designed the fourth study, where I interviewed 16 of the 30 patients in the exercise group about their conceptions of exercise as treatment. The interviews were analysed using qualitative methodology, and it was revealed that all patients were aware of the general health benefits of exercise, but had doubts about exercise as treatment of osteoarthritis even if they had perceived pain relief and improvement in physical function from the exercise intervention. The pain experienced during exercise caused the patients to believe that exercise was harmful to their knees, and some of them would prefer not to exercise at all. They thought that exercise should be introduced early during the course of the disease, and all of them expressed the need of continuous encouragement and support to adhere to exercise. From this thesis I conclude that reduced muscle function is a risk factor of knee osteoarthritis development among middle aged subjects with knee pain. Reduced muscle function is associated with increased joint load, which seem to be modifiable by exercise. Initial pain when starting exercise, or occasional pain from exercise, should be treated by combining exercise with pain relief such as analgesics or acupuncture. Pain contributes to the difficulty patients have determining the degree of benefit or damage related to exercise, and thus causes feelings of anxiety and helplessness (paper IV). Pain also seems to interfere with the possibility of achieving increased functional performance (paper II, III, IV).
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| 6. |
- Wandzioch, Ewa, et al.
(författare)
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Lhx2-/- mice develop liver fibrosis
- 2004
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 101:47, s. 16549-16554
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Tidskriftsartikel (refereegranskat)abstract
- Liver fibrosis is a wound-healing response to chronic injury of any type and is characterized by a progressive increase in deposition of extracellular matrix (ECM) proteins, the major source of which are activated hepatic stellate cells (HSCs). Because the LIM homeobox gene Lhx2 is expressed in HSCs and liver development in Lhx2 –/– mice is disrupted, we analyzed liver development in Lhx2 –/– embryos in detail. Lhx2 –/– embryos contain numerous activated HSCs and display a progressively increased deposition of the ECM proteins associated with liver fibrosis, suggesting that Lhx2 inhibits HSC activation. Transfection of Lhx2 cDNA into a human HSC line down-regulates expression of genes characteristic of activated HSCs. Moreover, the Lhx2 –/– liver display a disrupted cellular organization and an altered gene expression pattern of the intrahepatic endodermal cells, and the increased deposition of ECM proteins precedes these abnormalities. Collectively these results show that Lhx2 negatively regulates HSC activation, and its inactivation in developing HSCs appears therefore to mimic the signals that are triggered by the wound-healing response to chronic liver injury. This study establishes a spontaneous and reproducible animal model for hepatic fibrosis and reveals that Lhx2 expression in HSCs is important for proper cellular organization and differentiation of the liver.
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| 7. |
- Wikström, Ingegerd, et al.
(författare)
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Reliability, validity and responsiveness of a new leisure index : The Patient-Specific Leisure Scale (PSLS)
- 2009
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Ingår i: Musculoskeletal Care. - London : Whurr Publishers. - 1478-2189 .- 1557-0681. ; 7:3, s. 178-193
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Tidskriftsartikel (refereegranskat)abstract
- Objectives:To investigate the reliability, validity and responsiveness of a new Patient-Specific Leisure Scale (PSLS), constructed to identify goals and outcomes for individual patients with rheumatoid arthritis (RA).Methods:Forty-nine patients with RA were used to evaluate test-retest reliability, and 100 consecutive RA patients were used for construct validity. Twenty-five RA patients, commencing with treatment on tumour necrosis factor (TNF) inhibitors, were evaluated before the start and after three months of therapy, to test responsiveness. The most important leisure activity (as judged by the patients) was used when evaluating reliability and validity. The perceived difficulty with each activity was scored from 0 to 10 (0 = able to perform activity without difficulty, 10 = unable to perform activity).Results: Test-retest reliability indicated a good agreement (0.62-0.87) using weighted kappa. Construct validity was demonstrated by modest positive correlation between leisure activity and Health Assessment Questionnaire (HAQ) (rs = 0.27, p = 0.005) visual analogue scale (VAS) pain (rs = 0.28, p = 0.004) VAS global (rs = 0.22, p = 0.027), VAS fatigue (rs = 0.24, p = 0.013), joint index of 28 swollen joints (rs = 0.22, p = 0.027) and negative correlations with short-form-36 (SF-36) physical functioning (rs = -0.18, p = 0.008), bodily pain (rs = -0.31, p < 0.001), general health (rs = -0.23, p = 0.019), vitality (rs = -0.31, p < 0.001), social function (rs = -0.24, p = 0.016) and role-emotional (rs = -0.28, p = 0.005). Mean improvement for the most important leisure activity was 1.36, (p = 0.036, 95% confidence interval 0.10-2.62). Standardized response mean and effect size for the most important activity in PSLS was 1.05 and 0.72, respectively, and for HAQ 0.34 and 0.28, respectively.Conclusions:PSLS appears to be feasible, reliable, valid and responsive for measuring leisure activities in RA. It provides both an individual result which is useful in clinical work, and results at a group level.
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| 8. |
- Wressle, Ewa, 1953-, et al.
(författare)
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Evaluation of occupational therapy interventions for elderly patients in Swedish acute care : A pilot study
- 2006
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 13:4, s. 203-210
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to evaluate whether occupational therapy interventions in acute care could improve the elderly patient's perception of ability to manage at home after discharge. A pilot study was performed, including 22 patients in the experimental group and 19 in the control group. Occupational therapy interventions were conducted in the experimental group concerning personal care, information, prescription of assistive devices, planning of discharge, and reporting to primary care or community care. The control group was given no occupational therapy interventions. Structured interviews were performed on discharge and at a follow-up in about 14 weeks after discharge. The two groups were comparable concerning gender, age, days of care, and diagnoses. Patients in the experimental group scored lower on mental health and were more anxious on discharge. However, there was no difference between the groups in managing at home after discharge. Patients in the control group had greater need of further contacts with healthcare after discharge. Due to the small sample interpretations must be made with caution. The findings indicate that occupational therapy interventions in acute care might have a positive effect from the perspective of the elderly patient. These results need to be confirmed in a larger study.
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