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| 2. |
- Gustavsson, A., et al.
(författare)
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Pharmaceutical treatment patterns for patients with a diagnosis related to chronic pain initiating a slow-release strong opioid treatment in Sweden
- 2012
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Ingår i: Pain. - : Ovid Technologies (Wolters Kluwer Health). - 1872-6623 .- 0304-3959. ; 153:12, s. 2325-2331
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Tidskriftsartikel (refereegranskat)abstract
- Slow-release strong opioids (SRSO) are indicated in patients with severe chronic pain. Side effects, lack of efficacy and risk of dependency limit their use in clinical practice. The aim of this study was to explore prescription patterns of SRSO in Swedish real-world data on patients with a diagnosis related to chronic pain (DRCP). Patient-level data were extracted from the national prescriptions register and a regional register with diagnosis codes. The prescription sequences, switches, co-medications, and strengths over time were analyzed for cancer and noncancer patients. Of 840,000 patients with a DRCP, 16,257 initiated treatment with an SRSO in 2007 to 2008. They were 71 years old on average; 60% were female and 34% had cancer. The most common first prescription was oxycodone (54%) followed by fentanyl (19%), buprenorphine (14%), and morphine (13%). 63% refilled their prescription within 6 months, and 12% switched to another SRSO, most commonly fentanyl. After 3 years, 51% of cancer and 27% of noncancer patients still being in contact with health care remained on any SRSO. Of noncancer patients, 35% had a psychiatric co-medication (SSRI or benzodiazepine). In conclusion, fewer patients remain on SRSO in the long-term in clinical practice than reported in previous clinical trials. Oxycodone is the most common first SRSO prescription and one-third of patients get a prescription indicating psychiatric comorbidity. Our interpretation of these findings are that there is need for better treatment options for these patients, and that more effort is needed to improve treatment guidelines and to ascertain that these guidelines are followed. (c) 2012 International Association for the Study of Pain. Published by Elsevier B. V. All rights reserved.
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| 3. |
- Gustavsson, A., et al.
(författare)
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Socio-economic burden of patients with a diagnosis related to chronic pain : Register data of 840,000 Swedish patients
- 2012
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Ingår i: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 16:2, s. 289-299
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic pain constitutes a substantial socio-economic challenge but little is known about its actual cost.Aim: To estimate the direct and indirect costs of patients with a diagnosis related to chronic pain (DRCP), to determine variation in these costs across different diagnosis groups, and to identify what resources constitute the most important components of costs.Methods: Patient level data from three administrative registries in Vastra Gotalandsregionen in Sweden including inpatient and outpatient care, prescriptions, long-term sick-leaves, and early retirement were extracted. Patients with a DRCP between January 2004 and November 2009 were selected.Results: In total, 840,000 patients with a DRCP were identified. The mean total costs per patient and year were estimated at 6400 EUR but were higher for patients with cancer (10,400 EUR). Patients on analgesic drugs had more than twice as high costs as patients without analgesic drugs, on average. Indirect costs (sick-leaves and early retirement) constituted the largest cost component (59%) followed by outpatient (21%) and inpatient care (14%), whereas analgesic drug prescriptions constituted less than 1 percent of the total.Conclusions: The socio-economic burden of patients with a diagnosis related to chronic pain amounts to 32 billion EUR per year, when findings from Vastra Gotalandsregionen are extrapolated to the whole of Sweden. This compares to a fifth of the total Swedish tax burden in 2007 or about a tenth of Swedish GDP. This study does not provide evidence on what costs are caused by chronic pain per se. However, the higher costs of patients on analgesic drugs might indicate that the consequences of pain are of major importance.
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- Hultman, L, et al.
(författare)
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Growth and electronic properties of epitaxial TiN thin films on 3C-SiC(001) and 6H-SiC(0001) substrates by reactive magnetron sputtering
- 1996
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Ingår i: Journal of Materials Research. - 0884-2914. ; 11:10, s. 2458-2462
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Tidskriftsartikel (refereegranskat)abstract
- Epitaxial TiN films were grown on cubic (3C)-SiC(001) and hexagonal (6H)-SiC(0001) substrates by ultrahigh vacuum reactive magnetron sputtering from a Ti target in a mixed Ar and N2 discharge at a substrate temperature of 700°C. Cross-sectional transmission electron microscopy, including high-resolution imaging, showed orientational relationships TiN(001) ∥ 3C-SiC(001), and TiN[110] ∥ 3C-SiC[110], and TiN(111) ∥ 6H-SiC(0001) and TiN[110],[101] ∥ 6H-SiC[1210]. In the latter case, twin-related TiN domains formed as the result of nucleation on SiC terraces with an inequivalent stacking sequence of Si and C. The TiN/SiC interface was locally atomically sharp for both SiC polytypes. Defects in the TiN layers consisted of threading double positioning domain boundaries in TiN(111) on 6H-SiC. Stacking faults in 3C-SiC did not propagate upon growth of TiN. Room-temperature resistivity of TiN films was ρ = 14 μΩ cm for 6H-SiC(0001) and ρ = 17 μΩ cm for 3C-SiC(001) substrates. Specific contact resistance of TiN to 6H-SiC(0001) was 1.3 × 10-3 Ω cm2 for a 6H-SiC substrate with an n-type doping of 5 × 1017 cm-3.
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| 5. |
- Mulholland, Megan, et al.
(författare)
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Interleukin-1 receptor accessory protein blockade limits the development of atherosclerosis and reduces plaque inflammation
- 2024
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Ingår i: Cardiovascular Research. - : Oxford University Press. - 0008-6363 .- 1755-3245. ; 120:6, s. 581-595
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The interleukin-1 receptor accessory protein (IL1RAP) is a co-receptor required for signalling through the IL-1, IL-33, and IL-36 receptors. Using a novel anti-IL1RAP-blocking antibody, we investigated the role of IL1RAP in atherosclerosis.Methods and results: Single-cell RNA sequencing data from human atherosclerotic plaques revealed the expression of IL1RAP and several IL1RAP-related cytokines and receptors, including IL1B and IL33. Histological analysis showed the presence of IL1RAP in both the plaque and adventitia, and flow cytometry of murine atherosclerotic aortas revealed IL1RAP expression on plaque leucocytes, including neutrophils and macrophages. High-cholesterol diet fed apolipoprotein E-deficient (Apoe-/-) mice were treated with a novel non-depleting IL1RAP-blocking antibody or isotype control for the last 6 weeks of diet. IL1RAP blockade in mice resulted in a 20% reduction in subvalvular plaque size and limited the accumulation of neutrophils and monocytes/macrophages in plaques and of T cells in adventitia, compared with control mice. Indicative of reduced plaque inflammation, the expression of several genes related to leucocyte recruitment, including Cxcl1 and Cxcl2, was reduced in brachiocephalic arteries of anti-IL1RAP-treated mice, and the expression of these chemokines in human plaques was mainly restricted to CD68+ myeloid cells. Furthermore, in vitro studies demonstrated that IL-1, IL-33, and IL-36 induced CXCL1 release from both macrophages and fibroblasts, which could be mitigated by IL1RAP blockade.Conclusion: Limiting IL1RAP-dependent cytokine signalling pathways in atherosclerotic mice reduces plaque burden and plaque inflammation, potentially by limiting plaque chemokine production.
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| 6. |
- Rester, M., et al.
(författare)
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Annealing studies of nanocomposite Ti-Si-C thin films with respect to phase stability and tribological performance
- 2006
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Ingår i: Materials Science & Engineering. - : Elsevier BV. - 0921-5093 .- 1873-4936. ; 429:1-2, s. 90-95
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Tidskriftsartikel (refereegranskat)abstract
- Nanocomposite Ti-Si-C thin films were deposited by dc magnetron sputtering from a Ti3SiC2 target onto Si(1 0 0) and high-speed steel substrates at 300 °C. The as-deposited films consisted of nanocrystalline (nc-) TiCx and amorphous (a-) SiCx, as determined by X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS). Annealing in vacuum up to 1450 °C resulted in improved crystallinity and a decreased volume fraction of the amorphous phase. Additionally, differential scanning calorimetry (DSC) was used to monitor heat flows connected to the respective reactions in the material, where a broad exothermic peak attributed to grain growth of crystalline TiCx appeared, while an exothermic reaction related to the formation of Ti3SiC2 was not detected. Tribological testing in a ball-on-disk setup was conducted at room temperature, 500 and 700 °C against an alumina counterpart. The room temperature measurement resulted in a coefficient of friction value of 0.8, at elevated temperatures the coefficient of friction decreased to 0.4. © 2006 Elsevier B.V. All rights reserved.
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