| 1. |
- Chaireti, Roza, et al.
(författare)
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Increased thrombin generation in splanchnic vein thrombosis is related to the presence of liver cirrhosis and not to the thrombotic event
- 2014
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Ingår i: Thrombosis Research. - : Elsevier BV. - 0049-3848 .- 1879-2472. ; 134:2, s. 455-461
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Tidskriftsartikel (refereegranskat)abstract
- Background: In recent years there have been increasing evidence associating liver disease with hypercoagulability, rather than bleeding.Aims: To evaluate the haemostatic potential in patients with liver disease.Methods: We measured thrombin generation in the presence and absence of thrombomodulin in patients with portal vein thrombosis (PVT, n=47), Budd-Chiari syndrome (BCS, n=15) and cirrhosis (n=24) and compared the results to those obtained from healthy controls (n=21). Fifteen patients with PVT and 10 patients with BCS were treated with warfarin and were compared with an equal number of patients with atrial fibrillation matched for prothrombin time-international normalized ratio. We assessed resistance to thrombomodulin by using ratios [marker measured in the presence]/[marker measured in the absence of thrombomodulin].Results: There were no differences between patients with BCS, patients on warfarin treatment and controls. Cirrhotic patients generated more thrombin in the presence of thrombomodulin and exhibited thrombomodulin resistance compared with controls [p=0.006 for endogenous thrombin potential (ETP) and p<0.001 for peak thrombin. P<0.001 for both ratios ETP and peak] and patients with non-cirrhotic PVT (p=0.001, p=0.006, p<0.001, p<0.001 for ETP, peak, ratio ETP, ratio peak). The patients with cirrhotic PVT exhibited higher ETP (p=0.044) and peak (p=0.02) in the presence of thrombomodulin than controls, as well as thrombomodulin resistance (ETP ratio: p=0.001, peak ratio: p=0.001).Conclusions: Hypercoagulability and thrombomodulin resistance in patients with cirrhosis were independent of the presence of splanchnic vein thrombosis. The hypercoagulability in patients with cirrhotic PVT could have implications for considering longer treatment with anticoagulants in this group.
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| 2. |
- Melin, Martin, Universitetslektor, 1977-, et al.
(författare)
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Facilitating transformative innovations in sustainability education
- 2022
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Ingår i: Open Research Europe. - : F1000 Research Ltd. - 2732-5121. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Educational strategies globally are changing from an authoritative, top-down model to one focused on greater student and stakeholder participation in planning and implementation of research and educational activities. In addition to emphasis on student-centered education, strategies currently evolve to encompass learning organizations and multistakeholder learning networks. These are essential to address the complexity and scope of tomorrow’s challenges, involving issues that could be called ’wicked problems’ not easily addressed by single disciplines nor resulting in solutions that please all the players. In this study we describe how a transformative innovation – the NEXTFOOD educational approach – may contribute substantially to a transition of agricultural and food education and how it can be developed and diffused within and between teaching institutions. The method was action research informed by several workshops organized at annual consortium conferences during the first three years of the project. The findings show that a successful transformation involves learning both within and across innovation projects repeated at various organisations in a network. The action research model presented in this paper may be useful as an instrument to support the facilitation of transformative innovations. The transition process resulted in substantial changes in mindset, educational practices and organisational structures at the teaching institutions. However, scaling-up promising educational initiatives may encounter several barriers that need to be overcome at individual, group and institutional levels, and we provide insight on how this can be accomplished in a multi-national consortium of universities.
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| 3. |
- Melin, Martin, Universitetslektor, 1977-, et al.
(författare)
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Network learning and transitional change in a global project for transforming sustainability education
- 2022
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Ingår i: Open Research Europe. - : F1000 Research Ltd. - 2732-5121. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Educational strategies globally are changing from an authoritative, top-down model to one focused on greater student and stakeholder participation in planning and implementation of research and educational activities. In addition to emphasis on student-centered education, strategies currently evolve to encompass learning organizations and multistakeholder learning networks. These are essential to address the complexity and scope of tomorrow’s challenges, involving issues that could be called ’wicked problems’ not easily addressed by single disciplines nor resulting in solutions that please all the players. In this study we describe how a transformative innovation – the NEXTFOOD educational approach – may contribute substantially to a transition of agricultural and food education and how it can be developed and diffused within and between teaching institutions. The method was action research informed by several workshops organized at annual consortium conferences during the first three years of the project. The findings show that a successful transformation involves learning both within and across innovation projects repeated at various organisations in a network. The action research model presented in this paper may be useful as an instrument to support the facilitation of transformative innovations. The transition process resulted in substantial changes in mindset, educational practices and organisational structures at the teaching institutions. However, scaling-up promising educational initiatives may encounter several barriers that need to be overcome at individual, group and institutional levels, and we provide insight on how this can be accomplished in a multi-national consortium of universities.
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| 4. |
- Melin, Tor, et al.
(författare)
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Absorption and metabolism of orally fed arachidonic acid and linoleic acid in the rat.
- 1988
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Ingår i: American Journal of Physiology: Gastrointestinal and Liver Physiology. - 1522-1547. ; 255:5 Pt 1, s. 612-618
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Tidskriftsartikel (refereegranskat)abstract
- [3H]arachidonic [( 3H]20:4) and [14C]linoleic acid [14C]18:2) were fed to rats in Intralipid or cream. Later (30-240 min) the stomach, small intestine, plasma, and liver were analyzed for radioactivity in different lipid classes. [3H]20:4 and [14C]18:2 were emptied from the stomach and absorbed by the intestine at similar rates. The [3H]20:4:[14C]18:2 ratio of the lipids in the small intestinal wall increased, however, with time. This was due to a higher retention of [3H]20:4 than [14C]18:2 in intestinal phospholipids. In contrast, more of the [14C]18:2 was in triacylglycerol of the small intestine and plasma. The highest 3H:14C ratios were found in phosphatidylethanolamine and phosphatidylinositol. The 3H:14C ratio of intestinal phosphatidylcholine varied with the type of fat vehicle used, being highest in the Intralipid experiments. After feeding Intralipid (30-60 min), significantly more of the plasma [3H]20:4 than plasma [14C]18:2 was in diacylglycerol, the 3H:14C ratio of which was much higher than that of plasma free fatty acids. [3H]20:4 and [14C]18:2 of chyle triacylglycerol are thus metabolized differently.
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| 5. |
- Melin, Tor
(författare)
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Early steps of Eicosanoid precursor absorption and tissue distribution.
- 1997
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Eicosanoids are important for a wide range of physiological and pathophysiological processes.How their essential fatty acid precursors are absorbed and tissue distributed is not well charactherized. When given orally to rats, arachidonic acid (20:4) was retained in the small intestine to a larger extent than linoleic acid (18:2).More 20:4 than 18:2 was incorporated in phospholipids (PL) of the small intestine, with the strongest preference for phosphatidyl ethanolamine and phosphatidyl inositol. More of the 20:4 than of 18:2 was directed to the liver. Essential fatty acid deficient (EFAD) rats had an increased incorporation of 18:2 in all tissues, and an increased PL incorporation of both 20:4 and 18:2 compared to controls. EFAD human HepG2 cells had an increased delta-6- and delta-5-desaturase activity. Both enzymes had a rate limiting function.Chylomicron 20:4- and 20:5-diacylglycerol esters were resistant to in vitro incubations with lipoprotein lipase (LPL) but not to hepatic lipase.18:2 and other shorterchain fatty acid esters were not LPL resistant. When 20:4 was injected intravenously to rats, 8% of the dose was secreted in the bile during 24h. Diverting the bile with a drain decreased the recovery of small intestinal 20:4 by 75%, but did not decrease the recovery in stomach and colon. The pools of 20:4 injected i.v. in albumin bound form and injected esterified in chylomicrons did not equilibrate even after 96 h. The selective chanelling of 20:4 to the liver via chylomicrons, and biliary secretion, points to an enterohepatic circulation of 20:4.
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| 6. |
- Rajani, Rupesh, et al.
(författare)
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Budd-Chiari syndrome in Sweden : epidemiology, clinical characteristics and survival - an 18-year experience
- 2009
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Ingår i: Liver international (Print). - Oxford : Blackwell Munksgaard. - 1478-3223 .- 1478-3231. ; 29:2, s. 253-259
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The exact incidence and prevalence of Budd-Chiari syndrome (BCS) is unknown in the general population. Published reports differ in terms of the clinical characteristics, effects of therapy and survival. AIMS: To investigate the epidemiology, clinical presentation and survival in patients with BCS. METHODS: Retrospective multicentre study in Sweden reviewing the medical records of all patients with BCS 1986-2003, identified from the computerised diagnosis database of 11 hospitals, including all university hospitals and liver transplantation centres. RESULTS: Forty-three patients with BCS were identified, of whom nine (21%) had concomitant portal vein thrombosis. The mean age-standardised incidence and prevalence rates in 1990-2001 were calculated to be 0.8 per million per year and 1.4 per million inhabitants respectively. Myeloproliferative disorders (38%), thrombophilic factors (31%) and oral contraceptives (30%) were common aetiological factors. Two or more risk factors were present in 44%. In 23%, no risk factor was evident. The median follow-up time was 2.7 years. Seventy-two percent were on anticoagulant therapy during follow-up. Transjugular intrahepatic portosystemic shunting, surgical shunting procedures and liver transplantation were performed in 4, 6 and 18 patients respectively. Nineteen patients died. The overall transplantation-free survival at 1, 5 and 10 years was 47, 28 and 17% respectively. CONCLUSIONS: Budd-Chiari syndrome is a rare disorder; the mean age-standardised incidence and prevalence rates in Sweden in 1990-2001 were calculated to be 0.8 per million per year and 1.4 per million inhabitants respectively. The presence of a myeloproliferative disorder was a common aetiological factor in our cohort and about half of the patients had a multifactorial aetiology. The transplantation-free survival was poor.
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| 7. |
- Rajani, Rupesh, et al.
(författare)
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High prevalence of the germline JAK2 46/1 haplotype and V617-mutationin Swedish patients with Budd-Chiari syndrome and Portal Vein Thrombosis
- 2010
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background & Aims: To determine the prevalence of the somatic JAK2 V617F mutation and distribution of the germline JAK2 46/1 haplotype in Budd-Chiari Syndrome (BCS) and portal vein thrombosis (PVT). Methods: Real-time PCR was performed to genotype for the JAK2V 617F mutation and the 46/1 haplotype (tag-SNPs rs12343867, T>C and rs12340895, C>G) in blood samples of 19 BCS and 91 PVT patients (without intra-abdominal malignancy), and 283 controls from a background population. Results: The prevalence of JAK2 V617F-mutation was 63% in BCS and 14% in PVT patients. 10% in BCS and 2% in PVT had V617F negative MPD. Conversely, V617F positive subjects without known MPD was found in 5% of the BCS and in 1% of PVT patients. The frequency of the JAK2 46/1 haplotype was significantly higher in BCS (53%) and PVT (36%) patients compared to controls (27%) (p=0.02; OR=3.0; 95% CI 1.5-5.9 and OR=1.51; 95% CI 1.1-2.1, respectively). In PVT patients the JAK2 haplotype was highly enriched in non-cirrhotic patients (41%) (p <0.01 ; OR=1.8; 95% CI 1.2-2.6) but not in cirrhotic patients (23%) (p=0.53 ; OR= 0.8; 95% CI 0.4-1.7). An increased JAK2 46/1 haplotype frequency was evident only in V617F mutation positive patients. Conclusions: The prevalence of JAK2 V617F was high in BCS (63%) and non-cirrhotic PVT (14%), facilitating detection of latent MPD. A negative result dose not rule out MPD. The occurrence of the JAK2 46/1 haplotype was significantly higher in V617F mutation positive patients but not in mutation negative patients, suggesting that the haplotype may not have an independent role separated from the V617F mutation in BCS and PVT patients.
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