1. |
- Andersson, Karin, 1972, et al.
(författare)
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Inflammation in the hippocampus affects IGF1 receptor signaling and contributes to neurological sequelae in rheumatoid arthritis.
- 2018
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 1091-6490. ; 115:51
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Tidskriftsartikel (refereegranskat)abstract
- Rheumatoid arthritis (RA) is an inflammatory joint disease with a neurological component including depression, cognitive deficits, and pain, which substantially affect patients' quality of daily life. Insulin-like growth factor 1 receptor (IGF1R) signaling is one of the factors in RA pathogenesis as well as a known regulator of adult neurogenesis. The purpose of this study was to investigate the association between IGF1R signaling and the neurological symptoms in RA. In experimental RA, we demonstrated that arthritis induced enrichment of IBA1+ microglia in the hippocampus. This coincided with inhibitory phosphorylation of insulin receptor substrate 1 (IRS1) and up-regulation of IGF1R in the pyramidal cell layer of the cornus ammoni and in the dentate gyrus, reproducing the molecular features of the IGF1/insulin resistance. The aberrant IGF1R signaling was associated with reduced hippocampal neurogenesis, smaller hippocampus, and increased immobility of RA mice. Inhibition of IGF1R in experimental RA led to a reduction of IRS1 inhibition and partial improvement of neurogenesis. Evaluation of physical functioning and brain imaging in RA patients revealed that enhanced functional disability is linked with smaller hippocampus volume and aberrant IGF1R/IRS1 signaling. These results point to abnormal IGF1R signaling in the brain as a mediator of neurological sequelae in RA and provide support for the potentially reversible nature of hippocampal changes.
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2. |
- Arvidsson, Eva, et al.
(författare)
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Primary care patients' attitudes to priority setting in Sweden
- 2009
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 27:2, s. 123-128
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To analyse attitudes to priority setting among patients in Swedish primary healthcare. Design. A questionnaire was given to patients comprising statements on attitudes towards prioritizing, on the role of politicians and healthcare staff in prioritizing, and on patient satisfaction with the outcome of their contact with primary healthcare (PHC). Settings. Four healthcare centres in Sweden, chosen through purposive sampling. Participants. All the patients in contact with the health centres during a two-week period in 2004 (2517 questionnaires, 72% returned). Main outcomes. Patient attitudes to priority setting and satisfaction with the outcome of their contact. Results. More than 75% of the patients agreed with statements like Public health services should always provide the best possible care, irrespective of cost. Almost three-quarters of the patients wanted healthcare staff rather than politicians to make decisions on priority setting. Younger patients and males were more positive towards priority setting and they also had a more positive view of the role of politicians. Less than 10% of the patients experienced some kind of economic rationing but the majority of these patients were satisfied with their contact with primary care. Conclusions. Primary care patient opinions concerning priority setting are a challenge for both politicians and GPs. The fact that males and younger patients are less negative to prioritizing may pave the way for a future dialogue between politicians and the general public.
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3. |
- Arvidsson, Eva, 1959-, et al.
(författare)
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Så resonerar läkare och sjuksköterskor vid prioriteringar av patienter i primärvård
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Studier av prioriteringar i primärvården är särskilt intressanta eftersom det är där de allra flesta av oss kommer i kontakt med hälso- och sjukvården. Det är också i primärvården prioriteringar och olika former av ransonering på grund av begränsade resurser är vanliga. De allra flesta av oss förstår och accepterar att vi inte omedelbart kan få träffa en läkare om det inte rör sig om akuta och allvarliga sjukdomstillstånd. Vi finner många gånger ett råd om egenvård som en tillfredställande lösning för tillfället. Hur olika prioriteringar görs ”bakom kulisserna” är dock många gånger oklart för oss. Vi kan ibland t.ex. undra varför vi får betala för vissa vårdtjänster medan andra är gratis. Osäkerhet om på vilka grunder prioriteringar sker gäller inte bara för patienter utan även sjukvårdspersonal. Erfarenheter från flera olika håll i Sverige pekar på att de etiska riktlinjer som utgör kärnan i riksdagens prioriteringsprinciper är svåra att använda i praktiken. Det är därför angeläget att få mer kunskap om hur prioriteringsprinciper och begrepp uppfattas av sjukvårdspersonalen för att utveckla arbetsformer som är begripliga och förenliga med rådande rutiner.Distriktsläkare, mottagningssköterskor och distriktssköterskor vid fyra vårdcentraler som tidigare deltagit i en prioriteringsstudie har inbjudits att diskutera prioriteringar utifrån ett antal frågeställningar. Resultaten från dessa diskussioner visar bland att olika begrepp tolkas på många olika sätt. En framgångsrik implementering av den etiska plattformen kräver antagligen betydligt mer av öppna diskussioner om prioriteringar och principer i det dagliga vårdarbetet.Två allmänläkare Eva Arvidsson från Kalmar och Malin André från Falun har bidragit med den största insatsen i projektet som för övrigt inbegriper Lars Borgquist från Avdelningen för allmänmedicin vid Linköpings universitet och Kjell Lindström från Primärvårdens utvecklingsenhet i Jönköping. Studien har finansierats av Forskningsrådet för sydöstra sjukvårdsregionen (FORSS).Jag vill på projektgruppens vägnar tacka alla medverkande från vårdcentralerna Lindsdal och Borgholm i Kalmar läns landsting, Öxnehaga i Jönköpings läns landsting och Ryds vårdcentral i Landstinget i Östergötland.Linköping 2007-07-24Per Carlsson
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4. |
- Axelsson, Malin, 1964-, et al.
(författare)
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Personality, adherence, asthma control and health-related quality of life in young adult asthmatics
- 2009
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Ingår i: Respiratory Medicine. - : Elsevier. - 0954-6111 .- 1532-3064. ; 103:7, s. 1033-1040
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundStriving for improved adherence and asthma control is of vital concern in today's asthma management. Several influential factors have been identified, but the importance of personality traits has been insufficiently explored. The aim was first to determine whether personality traits in young adult asthmatics are related to asthma control and health-related quality of life (HRQL), and second to examine the influences of personality traits on adherence to regular asthma medication treatment.MethodsYoung adult asthmatics, 22 years of age (n = 268) completed questionnaires. Statistical analyses were performed.ResultsThe personality traits Negative Affectivity and Impulsivity correlated negatively with asthma control, whereas in women Hedonic Capacity correlated positively with asthma control. Negative Affectivity, Impulsivity, Hedonic Capacity, Alexithymia and asthma control predicted the mental dimension of HRQL. Asthma control and physical activity predicted the physical dimension of HRQL. Among respondents with regular asthma medication (n = 109), Impulsivity correlated negatively with adherence. In men, Antagonism and Alexithymia were associated with low adherence. Additionally, Alexithymia, Hedonic Capacity and Negative Affectivity showed non-linear relationships with adherence, meaning that initially increased scores on these personality traits scales were associated with increased adherence but higher scores did not increase adherence. Respondents who were prescribed a single inhaler combining ICS and LABA reported higher adherence than those with monotherapies.ConclusionThese data suggest that personality can influence how asthma patients adhere to asthma medication treatment, and report their control and HRQL. Tools determining personality traits may be useful in the future in individualizing management of asthma patients.
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5. |
- Beecham, Ashley H, et al.
(författare)
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Analysis of immune-related loci identifies 48 new susceptibility variants for multiple sclerosis.
- 2013
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Ingår i: Nature genetics. - : Springer Science and Business Media LLC. - 1546-1718 .- 1061-4036. ; 45:11, s. 1353-60
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Tidskriftsartikel (refereegranskat)abstract
- Using the ImmunoChip custom genotyping array, we analyzed 14,498 subjects with multiple sclerosis and 24,091 healthy controls for 161,311 autosomal variants and identified 135 potentially associated regions (P < 1.0 × 10(-4)). In a replication phase, we combined these data with previous genome-wide association study (GWAS) data from an independent 14,802 subjects with multiple sclerosis and 26,703 healthy controls. In these 80,094 individuals of European ancestry, we identified 48 new susceptibility variants (P < 5.0 × 10(-8)), 3 of which we found after conditioning on previously identified variants. Thus, there are now 110 established multiple sclerosis risk variants at 103 discrete loci outside of the major histocompatibility complex. With high-resolution Bayesian fine mapping, we identified five regions where one variant accounted for more than 50% of the posterior probability of association. This study enhances the catalog of multiple sclerosis risk variants and illustrates the value of fine mapping in the resolution of GWAS signals.
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6. |
- Berggrund, Malin, et al.
(författare)
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Identification of candidate plasma protein biomarkers for cervical cancer using the multiplex proximity extension assay
- 2019
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Ingår i: Molecular & Cellular Proteomics. - 1535-9476 .- 1535-9484. ; 18:4, s. 735-743
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Tidskriftsartikel (refereegranskat)abstract
- Human papillomavirus (HPV) is recommended as the primary test in cervical cancer screening, with co-testing by cytology for HPV-positive women to identify cervical lesions. Cytology has low sensitivity and there is a need to identify biomarkers that could identify dysplasia that are likely to progress to cancer. We searched for plasma proteins that could identify women with cervical cancer using the multiplex proximity extension assay (PEA). The abundance of 100 proteins were measured in plasma collected at the time of diagnosis of patients with invasive cervical cancer and in population controls using the Olink Multiplex panels CVD II, INF I, and ONC II. Eighty proteins showed increased levels in cases compared to controls. We identified a signature of 11 proteins (PTX3, ITGB1BP2, AXIN1, STAMPB, SRC, SIRT2, 4E-BP1, PAPPA, HB-EGF, NEMO and IL27) that distinguished cases and controls with a sensitivity of 0.96 at a specificity of 1.0. This signature was evaluated in a prospective replication cohort with samples collected before, at or after diagnosis and achieved a sensitivity of 0.78 and a specificity 0.56 separating samples collected at the time of diagnosis of invasive cancer from samples collected prior to diagnosis. No difference in abundance was seen between samples collected prior to diagnosis or after treatment as compared to population controls, indicating that this protein signature is mainly informative close to time of diagnosis. Further studies are needed to determine the optimal window in time prior to diagnosis for these biomarker candidates.
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7. |
- Björk, Göran, 1956, et al.
(författare)
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Seasonal oxygen depletion in a shallow sill fjord on the Swedish west coast
- 2017
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Ingår i: Journal of Marine Systems. - : Elsevier BV. - 0924-7963 .- 1879-1573. ; 175, s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- During the summer of 2008, oxygen depleted water, between 5 and 12 m depth, was discovered in Sannasfjord on the Swedish west coast. The resulting sediments were black, benthic macrofauna were absent and Beggiatoa bacterial mats were a characteristic feature. This phenomenon, which was observed several years in a row, appears to be a relatively new phenomenon starting in the mid-1980s. In this study we attempt to find the underlying causes by investigating climatic effects (temperature, wind and precipitation), the local supply of nutrients from land, ecosystem change and the supply of organic material from the open Skagerrak. An analysis of long meteorological time series indicates that climatic effects are contributory, but probably not a dominating factor leading to hypoxia. Results from an advection-diffusion model solving for oxygen show that the observed increase in the river supply of nutrients has a high potential to generate hypoxia. Although complex and more difficult to quantify, it appears that ecosystem changes, with higher abundance of filamentous algae, may have played an important role. It is also possible that an enhanced supply of organic material from the open Skagerrak has contributed. (C) 2017 Elsevier B.V. All rights reserved.
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8. |
- Ekerljung, Linda, 1979, et al.
(författare)
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Five-fold increase in use of inhaled corticosteroids over 18 years in the general adult population in West Sweden.
- 2014
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Ingår i: Respiratory medicine. - : Elsevier BV. - 1532-3064 .- 0954-6111. ; 108:5, s. 685-693
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Tidskriftsartikel (refereegranskat)abstract
- Asthma medication was increasingly used during the second part of the past century. There are few detailed data from population studies on use of asthma medication. The current study aimed to determine the use and determinants of asthma medication in West Sweden and to assess changes during the last two decades.
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9. |
- Florentzson, Malin, et al.
(författare)
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Low gastric acid and high plasma gastrin in high-anxiety Wistar Kyoto rats
- 2009
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 44:4, s. 401-407
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Wistar Kyoto (WKY) rats are more susceptible to stress-evoked ulcerations than Sprague-Dawley (SPD) rats. We have already demonstrated that gastrin cells are more active and ghrelin cells less active in WKY rats than in SPD rats. The purpose of this study was to compare endocrine cell activity and gastric acid output in WKY and SPD rats. Material and methods. Gastric acid output was determined in conscious rats with gastric fistula. Plasma gastrin and ghrelin levels were measured after an overnight fast. Acid secretagogues (gastrin, histamine and carbachol) were given by continuous subcutaneous infusion. Results. The volume of gastric juice, and the acidity and acid output were all significantly lower (p 0.05) in fasted WKY rats than in fasted SPD rats. Gastrin evoked a 4-fold (p 0.01) and 3-fold (p 0.05) increase in gastric acid output in SPD rats and WKY rats, respectively. Histamine raised the acid output 1.6-fold in SPD rats (p=0.06) and 3-fold in WKY rats (p 0.05), while carbachol failed to affect the acid output (weak increase, p 0.05). Fasting plasma ghrelin levels were 2-fold higher in SPD rats than in WKY rats (p 0.01) while fasting gastrin levels were 10-fold higher in WKY rats than in SPD rats (p 0.05). Neither the parietal-cell density nor the oxyntic mucosal thickness differed between the two strains. Conclusions. The results of the present study suggest that a high gastrin cell activity in WKY rats is secondary to a low gastric acidity. Whether the high gastrin cell activity is linked to susceptibility to stress ulcer in WKY rats warrants further investigation.
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10. |
- Fuxe, Kjell, et al.
(författare)
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From the Golgi-Cajal mapping to the transmitter-based characterization of the neuronal networks leading to two modes of brain communication: wiring and volume transmission.
- 2007
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Ingår i: Brain research reviews. - : Elsevier BV. - 0165-0173. ; 55:1, s. 17-54
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Tidskriftsartikel (refereegranskat)abstract
- After Golgi-Cajal mapped neural circuits, the discovery and mapping of the central monoamine neurons opened up for a new understanding of interneuronal communication by indicating that another form of communication exists. For instance, it was found that dopamine may be released as a prolactin inhibitory factor from the median eminence, indicating an alternative mode of dopamine communication in the brain. Subsequently, the analysis of the locus coeruleus noradrenaline neurons demonstrated a novel type of lower brainstem neuron that monosynaptically and globally innervated the entire CNS. Furthermore, the ascending raphe serotonin neuron systems were found to globally innervate the forebrain with few synapses, and where deficits in serotonergic function appeared to play a major role in depression. We propose that serotonin reuptake inhibitors may produce antidepressant effects through increasing serotonergic neurotrophism in serotonin nerve cells and their targets by transactivation of receptor tyrosine kinases (RTK), involving direct or indirect receptor/RTK interactions. Early chemical neuroanatomical work on the monoamine neurons, involving primitive nervous systems and analysis of peptide neurons, indicated the existence of alternative modes of communication apart from synaptic transmission. In 1986, Agnati and Fuxe introduced the theory of two main types of intercellular communication in the brain: wiring and volume transmission (WT and VT). Synchronization of phasic activity in the monoamine cell clusters through electrotonic coupling and synaptic transmission (WT) enables optimal VT of monoamines in the target regions. Experimental work suggests an integration of WT and VT signals via receptor-receptor interactions, and a new theory of receptor-connexin interactions in electrical and mixed synapses is introduced. Consequently, a new model of brain function must be built, in which communication includes both WT and VT and receptor-receptor interactions in the integration of signals. This will lead to the unified execution of information handling and trophism for optimal brain function and survival.
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