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- Jönsson, Karin, et al.
(författare)
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Evaluation of the degradation of desamino1,D-arginine8-vasopressin by nasal mucosa.
- 1992
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Ingår i: Acta Endocrinologica. - : Oxford University Press (OUP). - 0001-5598 .- 0804-4643 .- 1479-683X. ; 127:1, s. 27-32
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Tidskriftsartikel (refereegranskat)abstract
- The nasal route is a convenient and simple way to administer peptides to humans. Absorption of the drug, however, requires passage of the substance through the nasal mucosa. This is a possible site of enzymatic degradation of the peptide. It is shown that rabbit nasal mucosa homogenates rapidly degrade the synthetic anti-diuretic hormone analogue desamino1,D-arginine8-vasopressin in vitro. The metabolite formed has been identified as des-(amino,arginine8,glycineamide9)-vasopressin, which is stable under the prevalent in vitro incubation conditions. It is proposed that this process is catalyzed by intracellular post-proline cleavage enzyme. Reversed phase chromatography in combination with immunological detection has been used to study the possible presence of this metabolite in the circulation after intranasal administration to humans. The metabolite des-(amino,arginine8,glycineamide9)-vasopressin could not be detected in plasma following intranasal administration, possibly indicating a paracellular absorption of desamino1,D-arginine8-vasopressin or absence of this enzymatic activity in humans.
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| 2. |
- Serenius, Fredrik, et al.
(författare)
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Neurodevelopmental Outcomes Among Extremely Preterm Infants 6.5 Years After Active Perinatal Care in Sweden
- 2016
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Ingår i: Jama Pediatrics. - Chicago : American Medical Association (AMA). - 2168-6203 .- 2168-6211. ; 170:10, s. 954-963
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Active perinatal care increases the rate of survival of extremely preterm infants, but there are concerns that improved survival might increase the rate of disabled survivors. OBJECTIVE To determine the neurodevelopmental outcomes of a national cohort of children 6.5 years of age who had been born extremely preterm (<27 weeks' gestational age) in Sweden. DESIGN, SETTING, AND PARTICIPANTS Population-based prospective cohort study of consecutively born extremely preterm infants. All of these infants were born in Sweden during the period from April 1, 2004, to March 31, 2007. Of 707 live-born extremely preterm infants, 486 (68.7%) survived to 6.5 years of age. These children were assessed and compared with matched controls who had been born at term. Comparison estimates were adjusted for demographic differences. Assessments ended in February 2014, and analysis started thereafter. MAIN OUTCOMES AND MEASURES Cognitive ability was measured with the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV), and the mean (SD) scores of the children who had been born extremely preterm were compared with those of the controls. Clinical examinations and parental questionnaires were used for diagnosis of cerebral palsy, hearing and vision impairments, and cognition for the children who were not assessed with the WISC-IV. RESULTS Of 486 eligible infants who were born extremely preterm, 441 (90.7%) were assessed at 6.5 years of age (59 by medical record review only) alongside 371 controls. The adjusted mean (SD) full-scale WISC-IV score was 14.2 (95% CI, 12.1-16.3) points lower for children who had been born extremely preterm than for controls. Cognitive disability was moderate for 18.8% of extremely preterm children and 2.2% of controls (P < .001), and it was severe for 11.1% of extremely preterm children and 0.3% of controls (P < .001). Cerebral palsy was observed in 9.5% of extremely preterm children and 0.0% of controls (P < .001), blindness was observed in 2.0% of extremely preterm children and 0.0% of controls (P < .001), and hearing impairment was observed in 2.1% of extremely preterm children and 0.5% of controls (P = .07). Overall, 36.1%(95% CI, 31.7%-40.6%) of extremely preterm children had no disability, 30.4%(95% CI 26.3%-34.8%) had mild disability, 20.2%(95% CI, 16.6%-24.2%) had moderate disability, and 13.4%(95% CI, 10.5%-16.9%) had severe disability. For extremely preterm children, moderate or severe overall disability decreased with gestational age at birth (adjusted odds ratio per week, 0.65 [95% CI, 0.54-0.79]; P < .001) and increased from 26.6% to 33.5%(P = .01) for children assessed both at 2.5 and 6.5 years. CONCLUSIONS AND RELEVANCE Of the 441 extremely preterm infants who had received active perinatal care, 293 (66.4%) had no or mild disability at 6.5 years; of the 371 controls, 11 (3.0%) had moderate or severe disability. Disability rates at 6.5 years increased relative to the rates at 2.5 years. Results are relevant for health care professionals and planners, and for clinicians counseling families facing extremely preterm births.
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| 7. |
- Brorson, Håkan, et al.
(författare)
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Breast Cancer-Related Chronic Arm Lymphedema Is Associated with Excess Adipose and Muscle Tissue.
- 2009
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Ingår i: Lymphatic Research and Biology. - : Mary Ann Liebert Inc. - 1539-6851 .- 1557-8585.
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background: Arm lymphedema is a common complication after breast cancer treatment. Although conservative treatment can be used to reduce swelling, treatment often fails, possibly due to chronic edema being transformed from lymph fluid to subcutaneous fat, a condition called nonpitting lymphedema. It is currently unknown if the excess volume is solely due to excess in fat. This study evaluated whether dual energy X-ray absorptiometry (DXA) could be used to estimate the excess fat, muscle, and bone tissue in patients with arm lymphedema. Methods and Results: Eighteen women with arm lymphedema were investigated. Measurements were converted to volume values and compared with values obtained using plethysmography (PG). Linear regression equations and correlation equations were used to compare the DXA and the PG techniques in regard to total volume and excess volume in the lymphedematous arm. DXA was used to estimate excess fat, muscle, and bone volume in the lymphedematous arm. Both DXA and PG provided similar total arm volume and excess volume measurements for the lymphedematous arm. The lymphedematous arm showed 73% more fat, 47% more muscle, and 7% more bone by volume in the lymphedematous arm. Conclusions: Both excess fat and muscle volume contributed to the total excess volume in nonpitting arm lymphedema; excess soft tissue developed the first few years after breast cancer surgery. DXA can be used to identify patients with excess fat in their arms and thus unsuitable for conservative treatment and may be useful in estimating the amount of fat to remove in patients scheduled for liposuction.
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| 8. |
- Brorson, Håkan, et al.
(författare)
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Role of Compression after Liposuction
- 2016
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Ingår i: Veins and Lymphatics. - : PAGEPress Publications. - 2279-7483. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Liposuction, which is a very effective treatment modality to reduce lymphedema, can be performed as soon as the pitting component had been corrected by a phase of initial compression (Figure 1). Just like after conservative treatment, the use of compression garments after liposuction is very important to maintain the outcome.Garments should be prescribed in such numbers so that the edema does not recur. A common mistake is that the patient receive one, or if lucky two, garments, after treatment. When the arm or leg is swollen again the patient comes back to the therapist and treatment starts again, and so on. Instead the patient must be followed up at his needs in order to prevent recurrence. This means that treatment must be individualized. An elderly woman may need two garments every 6 months, while a young active patient with a heavy work may need two garments every month. One can draw a parallel to the dosage of insulin to a patient with diabetes that in the same way must be individualized. Nobody prescribes two vials of insulin for 6 months, when the patient needs that same amount for one month.The purpose of compression therapy is to increase the interstitial pressure so that the capillary filtration is decreased. When treated with standard compression garments a study showed a reduction of the excess volume (1680 mL; range 670-3320) after two weeks with 20% (range 5-37) corresponding to 338 ml (range 95-1225).1 Studies of treatment for 6 months have shown a reduction of excess volume of 17% (range 16-52), corresponding to a volume of 139 mL (range 150-345).2Compression garments can be used at the onset of symptoms to possibly prevent the development of lymphedema. Garments that are used throughout the day (15 years’ follow-up)3 as well as only daytime (6 months follow-up)2 prevent the edema to recur.Compression garments must be ordered by a qualified and experienced lymphedema team, consisting of a lymph therapist with a basic education in physiotherapy or occupational therapy and a physician. The team should have vast knowledge regarding various compression trademarks and how to take measurements for ordering of garments. In order to increase compliance and feedback, the team should never let the patient have the measurements for ordering of garments taken by a retailer outside of the team.
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| 9. |
- Brorson, Håkan, et al.
(författare)
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Suction-assisted lipectomy
- 2015
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Ingår i: Lymphedema : Presentation, Diagnosis, and Treatment - Presentation, Diagnosis, and Treatment. - Cham : Springer International Publishing. - 9783319144924 - 9783319144931 ; , s. 313-324
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Bokkapitel (refereegranskat)abstract
- 39.Brorson H, Svensson B, Ohlin K. Suction-Assisted Lipectomy. In: Greene AK, Slavin S, Brorson H, editors, Lymphedema - Presentation, Diagnosis, and Treatment. Cham, Switzerland: Springer; 2015: p. 313-324.
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| 10. |
- Brorson, Håkan, et al.
(författare)
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Volume measurements and follow-up
- 2015
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Ingår i: Lymphedema : Presentation, Diagnosis, and Treatment - Presentation, Diagnosis, and Treatment. - Cham : Springer International Publishing. - 9783319144924 - 9783319144931 ; , s. 115-122
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Bokkapitel (refereegranskat)
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