| 1. |
- Bosnic-Anticevich, S, et al.
(författare)
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ARIA pharmacy 2018 "Allergic rhinitis care pathways for community pharmacy"
- 2019
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Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : Wiley. - 0105-4538 .- 1398-9995. ; 74:7, s. 1219-1236
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Forskningsöversikt (refereegranskat)abstract
- Pharmacists are trusted health professionals. Many patients use over-the-counter (OTC) medications and are seen by pharmacists who are the initial point of contact of allergic rhinitis management in most countries. The role of pharmacists in integrated care pathways (ICPs) for allergic diseases is important. This paper builds on existing studies and provides tools intended to help pharmacists provide optimal advice/interventions/strategies to patients with rhinitis. The ARIA-pharmacy ICP includes a diagnostic questionnaire specifically focusing attention on key symptoms and markers of the disease, a systematic Diagnosis Guide (including differential diagnoses) and a simple flowchart with proposed treatment for rhinitis and asthma multimorbidity. Key prompts for referral within the ICP are included. The use of technology is critical to enhance the management of AR. However, the ARIA-pharmacy ICP should be adapted to local health care environments/situations as regional (national) differences exist in pharmacy care.
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| 2. |
- Wilking, N., et al.
(författare)
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Long-term follow-up of the SBG 9401 study comparing tailored FEC-based therapy versus marrow-supported high-dose therapy
- 2007
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Ingår i: Annals of Oncology. - : Elsevier BV. - 0923-7534 .- 1569-8041. ; 18:4, s. 694-700
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Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose was to investigate adjuvant marrow-supportive high-dose chemotherapy compared with an equitoxicity-tailored comparator arm. Patients and methods: Five hundred and twenty-five women below theage of 60 years with operated high-risk primary breast cancer were randomised to nine cycles of granulocyte colony-stimulating factor supported and individually tailored FEC (5-fluorouracil, epirubicin, cyclophosphamide), (n = 251) or standard FEC followed by marrow-supported high-dose therapy with CTCb (cyclophosphamide, thiotepa, carboplatin) therapy (n = 274), followed by locoregional radiotherapy and tamoxifen for 5 years. Results: There were 104 breast cancer relapses in the tailored FEC group versus 139 in the CTCb group (double triangular method by Whitehead, P = 0.046), with a median follow-up of all included patients of 60.8 months. The event-free survival demonstrated 121 and 150 events in the tailored FEC- and CTCb group, respectively [P = 0.074, hazard ratio (HR) 0.804, 95% confidence interval (CI) 0.633-1.022]. Ten patients in the tailored FEC regimen developed acute myeloid leukaemia (AML)/myelodysplasia (MDS). One hundred deaths occurred in the tailored FEC group and 121 in the CTCb group (P = 0.287, HR 0.866, 95% CI 0.665-1.129). Conclusion: The update of this study shows an improved outcome linked to the tailored FEC treatment in relation to breast cancer relapse, but also an increased incidence of AML/MDS. © 2007 Oxford University Press.
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| 3. |
- Hayes, A., et al.
(författare)
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A European multicentre evaluation of detection and typing methods for human enteroviruses and parechoviruses using RNA transcripts
- 2020
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Ingår i: Journal of Medical Virology. - : Wiley. - 0146-6615 .- 1096-9071. ; 92:8, s. 1065-1074
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Tidskriftsartikel (refereegranskat)abstract
- Polymerase chain reaction (PCR) detection has become the gold standard for diagnosis and typing of enterovirus (EV) and human parechovirus (HPeV) infections. Its effectiveness depends critically on using the appropriate sample types and high assay sensitivity as viral loads in cerebrospinal fluid samples from meningitis and sepsis clinical presentation can be extremely low. This study evaluated the sensitivity and specificity of currently used commercial and in-house diagnostic and typing assays. Accurately quantified RNA transcript controls were distributed to 27 diagnostic and 12 reference laboratories in 17 European countries for blinded testing. Transcripts represented the four human EV species (EV-A71, echovirus 30, coxsackie A virus 21, and EV-D68), HPeV3, and specificity controls. Reported results from 48 in-house and 15 commercial assays showed 98% detection frequencies of high copy (1000 RNA copies/5 µL) transcripts. In-house assays showed significantly greater detection frequencies of the low copy (10 copies/5 µL) EV and HPeV transcripts (81% and 86%, respectively) compared with commercial assays (56%, 50%; P = 7 × 10−5). EV-specific PCRs showed low cross-reactivity with human rhinovirus C (3 of 42 tests) and infrequent positivity in the negative control (2 of 63 tests). Most or all high copy EV and HPeV controls were successfully typed (88%, 100%) by reference laboratories, but showed reduced effectiveness for low copy controls (41%, 67%). Stabilized RNA transcripts provide an effective, logistically simple and inexpensive reagent for evaluation of diagnostic assay performance. The study provides reassurance of the performance of the many in-house assay formats used across Europe. However, it identified often substantially reduced sensitivities of commercial assays often used as point-of-care tests.
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| 4. |
- Skoglund, Karin, et al.
(författare)
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In vivo CYP3A activity and pharmacokinetics of imatinib in relation to therapeutic outcome in chronic myeloid leukemia patients
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The hepatic enzymes CYP3A4 and CYP3A5 metabolize the tyrosine kinase inhibitor imatinib into a large number of metabolites including the pharmacologically active N-desmethyl imatinib (CGP74588). Because the metabolic activity of CYP3A varies considerably between individuals and a previous pilot study suggested an inverse association between in vivo CYP3A metabolic activity and therapeutic outcome of imatinib, the primary aim of this study was to investigate the influence of CYP3A metabolic activity on the outcome of imatinib therapy in chronic myeloid leukemia patients.Methods: Fifty-five patients were included and CYP3A activity was estimated in vivo using quinine as a probe drug. Imatinib and CGP74588 trough concentrations in the plasma were determined at steady state in 34 patients. Cytogenetic and molecular responses after 12 months of first-line imatinib were retrospectively collected from patients’ medical records.Results: Patients with optimal response to imatinib (complete cytogenetic response (CCgR) or molecular response of BCR-ABL <1%) did not have different levels of CYP3A activity compared to non-optimal responders. Similar results were found when analyzing the molecular response and CCgR separately. Neither the imatinib trough concentration nor the CGP74588/imatinib ratio were significantly associated with CYP3A activity.Conclusion: CYP3A enzyme activity, as measured by quinine metabolic ratio, does not correlate with the plasma concentrations of imatinib or CGP74588 and is not predictive of imatinib therapeutic outcome. These results indicate that even though imatinib is metabolized by CYP3A enzymes, this activity is not the ratelimiting step in imatinib metabolism and excretion. Future studies should focus on other pharmacokinetic processes such as plasma protein binding or transport protein activity to look for the major contributor to patient variability in imatinib plasma concentration.
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| 5. |
- Matikainen, N., et al.
(författare)
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Minor contribution of endogenous GLP-1 and GLP-2 to postprandial lipemia in obese men
- 2016
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Context. Glucose and lipids stimulate the gut-hormones glucagon-like peptide (GLP)-1, GLP-2 and glucose-dependent insulinotropic polypeptide (GIP) but the effect of these on human postprandial lipid metabolism is not fully clarified. Objective. To explore the responses of GLP-1, GLP-2 and GIP after a fat-rich meal compared to the same responses after an oral glucose tolerance test (OGTT) and to investigate possible relationships between incretin response and triglyceride-rich lipoprotein (TRL) response to a fat-rich meal. Design. Glucose, insulin, GLP-1, GLP-2 and GIP were measured after an OGTT and after a fat-rich meal in 65 healthy obese (BMI 26.5-40.2 kg/m2) male subjects. Triglycerides (TG), apoB48 and apoB100 in TG-rich lipoproteins (chylomicrons, VLDL1 and VLDL2) were measured after the fat-rich meal. Main Outcome Measures. Postprandial responses (area under the curve, AUC) for glucose, insulin, GLP-1, GLP-2, GIP in plasma, and TG, apoB48 and apoB100 in plasma and TG-rich lipoproteins. Results. The GLP-1, GLP-2 and GIP responses after the fat-rich meal and after the OGTT correlated strongly (r = 0.73, p<0.0001; r = 0.46, p<0.001 and r = 0.69, p<0.001, respectively). Glucose and insulin AUCs were lower, but the AUCs for GLP-1, GLP-2 and GIP were significantly higher after the fat-rich meal than after the OGTT. The peak value for all hormones appeared at 120 minutes after the fat-rich meal, compared to 30 minutes after the OGTT. After the fat-rich meal, the AUCs for GLP-1, GLP-2 and GIP correlated significantly with plasma TG- and apoB48 AUCs but the contribution was very modest. Conclusions. In obese males, GLP-1, GLP-2 and GIP responses to a fat-rich meal are greater than following an OGTT. However, the most important explanatory variable for postprandial TG excursion was fasting triglycerides. The contribution of endogenous GLP-1, GLP-2 and GIP to explaining the variance in postprandial TG excursion was minor. Copyright © 2016 Matikainen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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| 6. |
- Salminen, J., et al.
(författare)
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Paleomagnetic and geochronological studies on Paleoproterozoic diabase dykes of Karelia, East Finland-Key for testing the Superia supercraton
- 2014
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Ingår i: Precambrian Research. - : Elsevier BV. - 0301-9268. ; 244, s. 87-99
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Tidskriftsartikel (refereegranskat)abstract
- Paleomagnetic results are presented for two Paleoproterozoic mafic dykes in the Taivalkoski area in northern Karelia Province of the Fennoscandian shield where, based on K-Ar data, the crust has seen minimal effects of the otherwise pervasive 1.8-1.9 Ga Svecofennian orogeny. Within this study a new U-Pb baddeleyite age of 2339 +/- 18 Ma has been determined for one of the E-W trending dykes (dyke AD13). The paleomagnetic results show that a strong Svecofennian overprinting is pervasive in the area. Upon thermal or AF demagnetization four remanence directions were obtained. Most typical are the secondary Svecofennian remanence direction A (intermediate down to the NNW) and remanence direction B (intermediate down to the NNE). Component D (D = 115.4 degrees, 1=50.5 degrees, alpha(95) =2.6 degrees) yielding a virtual geomagnetic pole (VGP) D (Plat= -19.5 degrees N, Plon= 263.3 degrees, A95 = 3.1 degrees) is obtained from baked rocks for dyke WD, and based on a positive baked contact test is interpreted to represent the primary magnetization dating from about 2.4 Ga. Dyke AD13 carries only secondary A and B components, its unbaked host migmatites carry reversed A (A(R)) component, and the baked host rock carries a component D' (D = 134.5 degrees, 1= -7.3 degrees, alpha(95) = 8.8 degrees), which yields a VGP pole D' (Plat= -20.4 degrees N, Plon = 257.3 degrees, A(95) = 7.6 degrees), possibly representing magnetization at 2.3 Ga. The new paleomagnetic data from the Karelia Province compared to similar-aged paleomagnetic data from the Superior Province does not support the recently proposed Superia configuration, based upon dyke swarm trajectories. (c) 2013 Elsevier B.V. All rights reserved.
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| 7. |
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| 8. |
- Cramer, Bradley D., et al.
(författare)
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U-Pb (zircon) age constraints on the timing and duration of Wen lock (Silurian) paleocommunity collapse and recovery during the "Big Crisis"
- 2012
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Ingår i: Geological Society of America Bulletin. - 0016-7606. ; 124:11-12, s. 1841-1857
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Tidskriftsartikel (refereegranskat)abstract
- High-precision isotope-dilution U-Pb (zircon) dating was conducted on three volcanic ash fall (bentonite) samples from the Swedish island of Gotland, and on a fourth bentonite from the West Midlands, England. Zircons from the Ireviken, Grotlingbo, Djupvik (Gotland), and Wren's Nest Hill-15 (West Midlands) bentonites yielded weighted mean Pb-206/U-238 ages of 431.83 +/- 0.23/0.67 Ma, 428.45 +/- 035/0.73 Ma, 428.06 +/- 0.2110.66 Ma, and 427.86 +/- 032/0.71 Ma, respectively (analytical/total uncertainties). These biostratigraphically well-controlled age dates effectively bracket the Wenlock Epoch of the Silurian Period and provide control for the duration of one of the major Paleozoic biotic events and associated perturbations to the global carbon cycle (the "Big Crisis" or lundgreni event- graptolites; the NIulde Event-conodonts; the Mulde excursion-carbon isotopes). These new data suggest an older and shorter duration for the recalibration of the Wenlock Series and demonstrate that the cascade of biological and chemical events that took place during the Big Crisis happened on time scales of tens to hundreds of thousands of years.
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| 9. |
- Fraenkel, C. J., et al.
(författare)
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Risk factors for hospital norovirus outbreaks : impact of vomiting, genotype, and multi-occupancy rooms
- 2018
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Ingår i: Journal of Hospital Infection. - : Elsevier BV. - 0195-6701. ; 98:4, s. 398-403
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Tidskriftsartikel (refereegranskat)abstract
- Background: Norovirus is frequently introduced to the hospital and is a frequent cause of hospital outbreaks. Recognition of the factors that facilitate or impede norovirus transmission is an important step to effectively prevent hospital outbreaks. Aim: To investigate risk factors for norovirus outbreaks in hospital settings. Methods: Clinical data, ward setting, and norovirus genotype were collected from all 65 norovirus-positive index cases in outbreaks and all 186 sporadic norovirus cases at 192 wards in southern Sweden during 2010–2012 in a nested case–control study. Uni- and multivariate statistical analyses were conducted. Findings: Outbreak was independently associated with the number of patients sharing a room with the norovirus case (odds ratio (OR): 1.9 per additional patient in the room; P < 0.01), vomiting (OR: 2.6; P = 0.04), age >80 years (OR: 3.2; P < 0.01), comorbidity (OR: 2.3; P = 0.05), and onset of symptoms after admission to the ward (OR: 3.5; P < 0.01) in the multivariate analysis. Infection with genotype GII.4 was found to be strongly associated with outbreak in the univariate analysis (OR: 5.7; P < 0.01). Moreover, associations between GII.4 and vomiting (OR: 2.5; P = 0.01) and old age (OR: 4.3: P < 0.01) were found. Conclusion: This is the first study to investigate clinical, ward and genotype risk factors for norovirus hospital outbreaks. Recognition of these factors may help direct and prioritize infection control actions based on the outbreak risk. The results also suggest that the outbreak association with GII.4 partly may be explained by an enhanced ability to induce vomiting.
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| 10. |
- Gaytán, Álvaro, 1988-, et al.
(författare)
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Changes in the foliar fungal community between oak leaf flushes along a latitudinal gradient in Europe
- 2022
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Ingår i: Journal of Biogeography. - : Wiley. - 0305-0270 .- 1365-2699. ; 49:12, s. 2269-2280
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Leaves support a large diversity of fungi, which are known to cause plant diseases, induce plant defences or influence leaf senescence and decomposition. To advance our understanding of how foliar fungal communities are structured and assembled, we assessed to what extent leaf flush and latitude can explain the within- and among-tree variation in foliar fungal communities.Location: A latitudinal gradient spanning c. 20 degrees in latitude in Europe.Taxa: The foliar fungal community associated with a foundation tree species, the pedunculate oak Quercus robur.Methods: We examined the main and interactive effects of leaf flush and latitude on the foliar fungal community by sampling 20 populations of the pedunculate oak Quercus robur across the tree's range. We used the ITS region as a target for characterization of fungal communities using DNA metabarcoding.Results: Species composition, but not species richness, differed between leaf flushes. Across the latitudinal gradient, species richness was highest in the central part of the oak's distributional range, and foliar fungal community composition shifted along the latitudinal gradient. Among fungal guilds, the relative abundance of plant pathogens and mycoparasites was lower on the first leaf flush, and the relative abundance of plant pathogens and saprotrophs decreased with latitude.Conclusions: Changes in community composition between leaf flushes and along the latitudinal gradient were mostly a result of species turnover. Overall, our findings demonstrate that leaf flush and latitude explain 5%–22% of the small- and large-scale spatial variation in the foliar fungal community on a foundation tree within the temperate region. Using space-for-time substitution, we expect that foliar fungal community structure will change with climate warming, with an increase in the abundance of plant pathogens and mycoparasites at higher latitudes, with major consequences for plant health, species interactions and ecosystem dynamics.
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