| 1. |
- Serra, J., et al.
(författare)
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European society of neurogastroenterology and motility guidelines on functional constipation in adults
- 2020
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Ingår i: Neurogastroenterology and Motility. - : Wiley. - 1350-1925 .- 1365-2982. ; 32:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Chronic constipation is a common disorder with a reported prevalence ranging from 3% to 27% in the general population. Several management strategies, including diagnostic tests, empiric treatments, and specific treatments, have been developed. Our aim was to develop European guidelines for the clinical management of constipation. Design After a thorough review of the literature by experts in relevant fields, including gastroenterologists, surgeons, general practitioners, radiologists, and experts in gastrointestinal motility testing from various European countries, a Delphi consensus process was used to produce statements and practical algorithms for the management of chronic constipation. Key Results Seventy-three final statements were agreed upon after the Delphi process. The level of evidence for most statements was low or very low. A high level of evidence was agreed only for anorectal manometry as a comprehensive evaluation of anorectal function and for treatment with osmotic laxatives, especially polyethylene glycol, the prokinetic drug prucalopride, secretagogues, such as linaclotide and lubiprostone and PAMORAs for the treatment of opioid-induced constipation. However, the level of agreement between the authors was good for most statements (80% or more of the authors). The greatest disagreement was related to the surgical management of constipation. Conclusions and Inferences European guidelines on chronic constipation, with recommendations and algorithms, were developed by experts. Despite the high level of agreement between the different experts, the level of scientific evidence for most recommendations was low, highlighting the need for future research to increase the evidence and improve treatment outcomes in these patients.
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| 2. |
- Keller, J., et al.
(författare)
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Advances in the diagnosis and classification of gastric and intestinal motility disorders
- 2018
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Ingår i: Nature Reviews Gastroenterology & Hepatology. - : Springer Science and Business Media LLC. - 1759-5045 .- 1759-5053. ; 15:5, s. 291-308
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Tidskriftsartikel (refereegranskat)abstract
- Disturbances of gastric, intestinal and colonic motor and sensory functions affect a large proportion of the population worldwide, impair quality of life and cause considerable health-care costs. Assessment of gastrointestinal motility in these patients can serve to establish diagnosis and to guide therapy. Major advances in diagnostic techniques during the past 5-10 years have led to this update about indications for and selection and performance of currently available tests. As symptoms have poor concordance with gastrointestinal motor dysfunction, clinical motility testing is indicated in patients in whom there is no evidence of causative mucosal or structural diseases such as inflammatory or malignant disease. Transit tests using radiopaque markers, scintigraphy, breath tests and wireless motility capsules are noninvasive. Other tests of gastrointestinal contractility or sensation usually require intubation, typically represent second-line investigations limited to patients with severe symptoms and are performed at only specialized centres. This Consensus Statement details recommended tests as well as useful clinical alternatives for investigation of gastric, small bowel and colonic motility. The article provides recommendations on how to classify gastrointestinal motor disorders on the basis of test results and describes how test results guide treatment decisions.
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| 3. |
- Elming, Sten-åke, et al.
(författare)
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Palaeomagnetism and AR-40/AR-39 age determinations of the Ediacaran traps from the southwestern margin of the East European Craton, Ukraine : relevance to the Rodinia break-up
- 2007
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Ingår i: Journal of the Geological Society. - : Geological Society of London. - 0016-7649 .- 2041-479X. ; 164:5, s. 969-982
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Tidskriftsartikel (refereegranskat)abstract
- A palaeomagnetic study and age determinations have been performed on Ediacaran basalts from the northwestern Ukraine. Whole-rock ^sup 40^Ar/^sup 39^Ar age determination revealed plateau ages at 590-560 Ma and 393 Ma, the latter probably reflecting a resetting of the radiometric system. Palaeomagnetic poles have been calculated from five basalt flows, two of which (A poles) are considered reliable with ages that range from 580 to 560 Ma. Tentative poles (B poles), calculated from most probably primary magnetizations, have ages estimated at 580-545 Ma. Secondary magnetizations, possibly of late Ediacaran or Devonian age, have also been isolated (C poles). Based on the new poles, Baltica drifted together with Laurentia from an equatorial position at c. 750 Ma to occupy high southern latitude positions at c. 580 Ma. Baltica during that time period was joined to Laurentia in a similar relative position to that at 750 Ma. The two shields then split up from each other and from c. 550 Ma Baltica drifted at moderately high latitudes and rotated some 180° during the final opening of the Iapetus ocean. This reconstruction suggests that during the Ediacaran glaciation Baltica occupied high-latitude positions, which contradicts the high-obliquity model to explain low-latitude Neoproterozoic glaciations
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| 5. |
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| 6. |
- Tack, J., et al.
(författare)
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An expert consensus definition of failure of a treatment to provide adequate relief (F-PAR) for chronic constipation - an international Delphi survey
- 2017
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Ingår i: Alimentary Pharmacology & Therapeutics. - : Wiley. - 0269-2813. ; 45:3, s. 434-442
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Tidskriftsartikel (refereegranskat)abstract
- Background As treatments for constipation become increasingly available, it is important to know when to progress along the treatment algorithm if the patient is not better. To establish the definition of failure of a treatment to provide adequate relief (F-PAR) to support this management and referral process in patients with chronic constipation. We conducted an international Delphi Survey among gastroenterologists and general practitioners with a special interest in chronic constipation. An initial questionnaire based on recognised rating scales was developed following a focus group. Data were collected from two subsequent rounds of questionnaires completed by all authors. Likert scales were used to establish a consensus on a shorter list of more severe symptoms. The initial focus group yielded a first round questionnaire with 84 statements. There was good consensus on symptom severity and a clear severity response curve, allowing 67 of the symptom-severity pairings to be eliminated. Subsequently, a clear consensus was established on further reduction to eight symptom statements in the final definition, condensed by the steering committee into five diagnostic statements (after replicate statements had been removed). We present an international consensus on chronic constipation, of five symptoms and their severities, any of which would be sufficient to provide clinical evidence of treatment failure. We also provide data representing an expert calibration of commonly used rating scales, thus allowing results of clinical trials expressed in terms of those scales to be converted into estimates of rates of provision of adequate relief.
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| 7. |
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| 8. |
- Elming, Sten-åke, et al.
(författare)
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A palaeomagnetic study and age determinations of Tertiary rocks in Nicaragua, Central America
- 2001
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Ingår i: Geophysical Journal International. - : Oxford University Press (OUP). - 0956-540X .- 1365-246X. ; 147:2, s. 294-309
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Tidskriftsartikel (refereegranskat)abstract
- Palaeomagnetic, K-Ar and Ar40/Ar39 measurements have been made to elucidate Nicaragua's plate tectonic history. These show that the Nicaraguan Highland rotated 90° counterclockwise between 30 and 18 Myr ago, but the Pacific Coastal Plain has not rotated.A lack of data has prevented a direct comparison with the tectonic history of adjacent areas, in particular, the Chortis Block, which is the part of the Caribbean Plate that is geologically most closely related to the Nicaraguan Highland. However, our data suggest that the Caribbean Plate in this part of Central America was not consolidated until c. 15 Ma.
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| 9. |
- Elming, Sten-åke, et al.
(författare)
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Proterozoic Basic dykes in the Ukrainian Shield: A palaeomagnetic, geochronologic and geochemical study-The accretion of the Ukrainian Shield to Fennoscandia
- 2010
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Ingår i: Precambrian Research. - : Elsevier BV. - 0301-9268 .- 1872-7433. ; 178:1-4, s. 119-135
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Tidskriftsartikel (refereegranskat)abstract
- A palaeomagnetic, geochronologic and geochemical study of basic dykes in the Ukrainian Shield has been undertaken with the purpose of testing a hypothesis for timing of accretion of the Ukrainian Shield with Fennoscandia. On the basis of geological data it has been suggested that the two shields amalgamated at ca. 1900-1800 Ma. With this study of 11 basic dykes the palaeomagnetic database for the Ukrainian Shield is extended. The palaeomagnetic data indicate three generations of dykes. This is supported by the age data and the difference in geochemical compositions. Ages of two ca. 25 m wide dykes (Susly) in the North-Western Block of the shield have been determined, one for which a positive palaeomagnetic field test is demonstrated. The lower of the two Ar-40/Ar-39 hornblende ages of this dyke, 2061 +/- 20 Ma, is similar to the U-Pb, zircon age of the granitic host rock (ca. 2067 Ma, U-Pb, zircon), which suggests that the dyke intruded shortly after crystallization of the granite. Combined with the magnetization of the baked contact and that of another dyke a new ca 2060 Ma pole is presented (Plat. = 15.7 degrees, Plon. = 182.9 degrees, A(95) = 13.7 degrees). which may be regarded as a VGP. An U-Pb age of 1722 +/- 12 Ma of baddeleyite from the Khmelnik dyke, which yields a well-defined VGP, is similar to the age of nearby anorthosite complexes. A new 1740-1770 Ma key pole for the Ukranian Shield is also presented (Plat. = 26.5 degrees, Plon. = 169.1 degrees, A(95) = 3.9 degrees). On the basis of palaeomagnetic and geochronological data a 2060-1720 Ma apparent polar wander for the Ukrainian Shield is defined. This apparent polar wander is significantly different from that of Fennoscandia during the same time interval and indicates that the two shields were not in their present relative positions at ca. 1770 Ma. A scenario is here proposed where the Ukrainian Shield (and Sarmatia) collided with Fennoscandia at ca. 1900-1800 Ma and after that event, at ca. 1720-1660 Ma, it rotated approximately 43 degrees into its present position. (C) 2010 Elsevier B.V. All rights reserved.
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| 10. |
- Elming, Sten-Åke, et al.
(författare)
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Uplift deduced from remanent magnetization of a proterozoic basic dyke and the baked country rock in the Hoting area, Central Sweden: a palaeomagnetic and Ar-40/Ar-39 study
- 2009
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Ingår i: Geophysical Journal International. - 0956-540X .- 1365-246X. ; 179:1, s. 59-78
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Tidskriftsartikel (refereegranskat)abstract
- Remanent magnetization in dyke contact zones in the Hoting area of the Fennoscandian Shield in the central part of Sweden has been studied in order to establish the ambient temperature of the host rock and the depth of burial of the present erosion surface at the time of intrusion. A positive baked contact test for two Subjotnian dykes demonstrates the primary nature of the dyke magnetization. From the magnetic properties and the palaeomagnetic data, it can be concluded that the overprinting in the hybrid zone of one of the basic dykes is a partial thermoremanent magnetization. Reliable results were also obtained from a palaeointensity study of samples from the hybrid zone in the baked host rock. The study was performed in the laboratories at Luleå and at Scripps and a mean intensity of the Earth's magnetic field of 5.8 ± 1.9 μT was determined. The maximum temperature due to the dyke intrusion in the hybrid zone has been defined and from that an ambient temperature of 375 °C in the host rock at the time of intrusion has been calculated. This calculated temperature is not contradicted by the 40Ar/39Ar data. A palaeothermal gradient in the crust at ca. 1.6 Ga is calculated at ca. 34 °C km-1 and yields a depth of burial of the present erosion surface at ca. 10.4 km. This implies an uplift rate of 0.65 km (100 Ma)-1. A slow cooling of the gabbroic host rock (ca. 3.5 °C Ma-1) has been calculated from the difference in the U-Pb age of zircon (1.786 ± 0.010 Ga) and the 40Ar/39Ar biotite ages (1.648 ± 0.012 Ga; 1614 ± 0.024 Ga) of this study. This slow cooling resulted in a palaeomagnetic age of ca. 1.7 Ga for the gabbro, which is also the age of the determined palaeointensity. The calculated ca. 1.614 Ga palaeomagnetic pole from the basic dykes fulfils most of the criteria for a reliable pole and may be regarded as a new key-pole for Fennoscandia.
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