| 1. |
- Bengtsson, Kristofer, 1979, et al.
(författare)
-
Emergency department overview - Improving the dynamic capabilities using an event-driven information architecture
- 2016
-
Ingår i: IEEE International Conference on Emerging technologies and factory automation (ETFA) 2016.
-
Konferensbidrag (refereegranskat)abstract
- It is challenging to get an overview and understand- ing of what is going on at an emergency department (ED). This is due to the sometimes turbulent work environment and a large variation in patient processes. To increase the dynamic capability and responsiveness of an ED, it is important that the staff and patients have an overview of what is going on and what will happen in the coming hours. This paper presents a smart online support software that shows the current state of the ED as well as a prediction of the coming hours. The software has been developed as a case study of using agile development ideas when developing new systems for hospitals. The result shows that the use of the event-driven information architecture for healthcare (EVAH) enabled a rapid development of a successful running application, helping the nurses getting an overview of current situation and the coming hours.
|
|
| 2. |
|
|
| 3. |
- Lindelöf, Linnea, et al.
(författare)
-
62 Acquired ficolin-3 deficiency in patients with Systemic Lupus Erythematosus
- 2023
-
Ingår i: Immunobiology. - : Elsevier. - 0171-2985 .- 1878-3279. ; 228:5, s. 152515-152515
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Ficolin-3 is the main initiator of the lectin pathway in humans. Case reports of ficolin-3 deficient patients have suggested that ficolin-3 deficiency may be enriched in patients with Systemic Lupus Erythematosus (SLE), a systemic autoimmune disease where complement plays an important role. Therefore, this study aimed to investigate the activity levels of ficolin-3 and to identify potential ficolin-3 deficient individuals in two Swedish SLE cohorts.Methods: Serum or plasma samples from SLE patients (n=810) and matched controls (n=566) were collected from the Karolinska Institute (KI) and Umeå University Hospital. The ficolin-3 activity levels were measured by an in-house developed functional ELISA with a pooled normal human serum sample as a reference. Serial samples were analyzed for ficolin-3 deficient patients when available. Sequencing data were analyzed for FCN3 frame-shift mutation +1637delC (rs532781899) and other potential loss-of-function (LoF) variants.Results: This screening revealed that the level of ficolin-3 activity varies largely in patients with SLE. The activity levels also show that SLE patients seem to generally have elevated ficolin-3 activity compared to the control group (p<0.0001). Out of 810 patients with SLE, four patients were determined to be ficolin-3 deficient. For two of these patients, the ficolin-3 activity was at normal levels at the time of diagnosis and thereafter depleted over time, indicating an acquired deficiency. For deficient patients, no or very low ficolin-3 protein levels and no lectin pathway-dependent complement activation could be detected. Autoantibodies against ficolin-3 were not detectable. No patients were homozygous for the +1637delC frameshift mutation, whereas in total 10 patients were determined to be heterozygous carriers. These heterozygous patients displayed lower levels of ficolin-3 activity but did not include the deficient patients. Additional possible LoF variants were analyzed but none were enriched in either patients or controls.Conclusions: Contrary to the classical pathway of the complement system we show that genetic ficolin-3 deficiency is not a risk factor for SLE. Instead, acquired ficolin-3 deficiency was observed in a subgroup of SLE patients, possibly due to a potent activation of the lectin pathway that depleted ficolin-3 plasma levels in these individuals.
|
|
| 4. |
- Lindelöf, Linnea, et al.
(författare)
-
A survey of ficolin-3 activity in Systemic Lupus Erythematosus reveals a link to hematological disease manifestations and autoantibody profile
- 2024
-
Ingår i: Journal of Autoimmunity. - : Elsevier. - 0896-8411 .- 1095-9157. ; 143
-
Tidskriftsartikel (refereegranskat)abstract
- The complement system plays a central role in the pathogenesis of Systemic Lupus Erythematosus (SLE), but most studies have focused on the classical pathway. Ficolin-3 is the main initiator of the lectin pathway of complement in humans, but its role in systemic autoimmune disease has not been conclusively determined. Here, we combined biochemical and genetic approaches to assess the contribution of ficolin-3 to SLE risk and disease manifestations. Ficolin-3 activity was measured by a functional assay in serum or plasma samples from Swedish SLE patients (n = 786) and controls matched for age and sex (n = 566). Genetic variants in an extended 300 kb genomic region spanning the FCN3 locus were analyzed for their association with ficolin-3 activity and SLE manifestations in a Swedish multicenter cohort (n = 985). Patients with ficolin-3 activity in the highest tertile showed a strong enrichment in an SLE cluster defined by anti-Sm/DNA/nucleosome antibodies (OR 3.0, p < 0.001) and had increased rates of hematological disease (OR 1.4, p = 0.078) and lymphopenia (OR = 1.6, p = 0.039). Genetic variants associated with low ficolin-3 activity mapped to an extended haplotype in high linkage disequilibrium upstream of the FCN3 gene. Patients carrying the lead genetic variant associated with low ficolin3 activity had a lower frequency of hematological disease (OR 0.67, p = 0.018) and lymphopenia (OR 0.63, p = 0.031) and fewer autoantibodies (p = 0.0019). Loss-of-function variants in the FCN3 gene were not associated with SLE, but four (0.5 %) SLE patients developed acquired ficolin-3 deficiency where ficolin-3 activity in serum was depleted following diagnosis of SLE. Taken together, our results provide genetic and biochemical evidence that implicate the lectin pathway in hematological SLE manifestations. We also identify lectin pathway activation through ficolin-3 as a factor that contributes to the autoantibody response in SLE.
|
|
| 5. |
|
|
| 6. |
- Myrberg, Tomi, et al.
(författare)
-
Effect of pre-operative fluid therapy on hemodynamic stability during anesthesia induction : a randomized study
- 2019
-
Ingår i: Acta Anaesthesiologica Scandinavica. - : John Wiley & Sons. - 0001-5172 .- 1399-6576. ; 63:9, s. 1129-1136
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Preserving perfusion pressure during anesthesia induction is crucial. Standardized anesthesia methods, alert fluid therapy and vasoactive drugs may help maintain adequate hemodynamic conditions throughout the induction procedure. In this randomized study, we hypothesized that a pre-operative volume bolus based on lean body weight would decrease the incidence of significant blood pressure drops (BPD) after induction with target-controlled infusion (TCI) or rapid sequence induction (RSI).METHODS: Eighty individuals scheduled for non-cardiac surgery were randomized to either a pre-operative colloid fluid bolus of 6 ml kg-1 lean body weight or no bolus, and then anesthetized by means of TCI or RSI. The main outcome measure was blood pressure drops below the mean arterial pressure 65 mm Hg during the first 20 minutes after anesthesia induction. ClinicalTrials.com Identifier: NCT03394833.RESULTS: Pre-operative fluid therapy decreased the incidence of BPDs fivefold, from 23 of 40 (57.5%) individuals without fluids to 5 of 40 (12.5%) with fluid management, P < .001. The mean BPD was greater in the groups without pre-operative fluids compared to the groups with fluid management; 53 ± 18 mm Hg vs 43 ± 14 mm Hg, P = .007. The overall mean volume of pre-operative fluid bolus infused was 387 ± 52 ml. There was no difference in hemodynamic stability between TCI and RSI. No correlation was shown between incidence of BPDs and increasing age, medication, hypertension, diabetes, renal failure, or low physical capacity.CONCLUSIONS: Pre-operative fluid bolus decreased the incidence of significant blood pressure drops during TCI and RSI induction of general anesthesia.
|
|
| 7. |
- Stenberg, Ylva, et al.
(författare)
-
Pre-operative transthoracic echocardiography in ambulatory surgery : a cross sectional study
- 2020
-
Ingår i: Acta Anaesthesiologica Scandinavica. - : John Wiley & Sons. - 0001-5172 .- 1399-6576. ; 64:8, s. 1055-1062
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cardiac disease and aberrations in central volume statusare risk factors for perioperative complications,and should be identified prior to surgery. This study investigatedthe benefit of transthoracic echocardiography for preoperative identification of cardiac disease andhypovolemia in ambulatory surgery.METHODS: Ninety-six patients, with a mean age of 63.5±12.2 years and body mass index of 27.0±4.3 kg/m2 , scheduled for ambulatorysurgery (breast, thyroid, minor gastrointestinal), were consecutively enrolled in this prospective observational study. Preoperative comprehensive transthoracic echocardiographywas performed in order to assess heart failure, asymptomatic left ventricular dysfunction, valvular disease and aberrations incentral volume status.RESULTS: Preoperative transthoracic echocardiography identified a total of 28 cases of heart failure; thirteen cases of heart failure with reduced, or moderately reduced, ejection fraction and fifteen cases of heart failure with preserved ejection fraction. Furthermore, forty-six cases of asymptomatic left ventricular dysfunction were identified. 44/96 patients were hypovolemic, 16 of whom in severe hypovolemia.Seven cases of previously unknown obstructive valvular or myocardial diseaseand six cases of right ventricular systolic dysfunction were identified.A total of 24% (23/96) were classified as potential critical hemodynamic findings. The number needed to treat for preoperative TTE in order to find one critical finding was 4.2.CONCLUSION: In this ambulatory surgical cohort, a high prevalence of preoperative LV dysfunction and aberrations in volume status was observed. The results demonstrate that preoperative TTE contributed valuable hemodynamic information. The standard preoperative assessment for this cohort might need to be revised.
|
|
