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- Palm, A., et al.
(författare)
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Outcomes of CPAP therapy in Down syndrome - the population-based DISCOVERY study
- 2022
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Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 60:Suppl. 66
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Obstructive sleep apnoea (OSA) is overrepresented in patients with Down syndrome (DS). We aimed to compare patient characteristics and outcomes of CPAP treatment for OSA between persons with DS and people without DS from the general population.Methods: Population-based, longitudinal study on patients initiating CPAP therapy between July 2010 and March 2018 in Sweden, with crosslinked data from the National Patient Registry and the Prescribed Drug Registry. Each DS patient was sex- and age matched with 5 controls. Hospitalization free survival was analyzed with Cox´s proportional hazard regression, and association between having DS and adherence to CPAP treatment with logistic and linear regression.Results: DS patients initiating CPAP (n=64) had higher apnoea-hypopnea index (AHI) (51.7±30.3 vs 36.8±29.1, p<0.001), Epworth sleepiness scale (ESS) score (13.7±5.9 vs 11.0±4.9, p=0.001), rate of surgery of tonsils and/or adenoids (21.9% vs 8.2%, p=0.001), more thyroid replacement hormones therapy (45.3% vs 7.8%, p<0.001), but lower use of cardiovascular drugs (7.8% vs 22.3%, p=0.003) compared to controls. Outcomes were similar between groups in terms of nocturnal CPAP usage time (5.6±2.4 vs 5.5±2.0 hours, p=0.77), adherence ≥4 hours/night (62% vs 65%, p=0.93), improved ESS score (-5.4±6.8 vs -5.0±2.0, p=0.84). Patients with DS were more often hospitalized during the study period (34.4% vs 17.9%, p=0.003).Conclusion: When starting CPAP for OSA, patients with DS have more severe sleep apnea and had more often undergone tonsil/adenoid surgery but have similar adherence to CPAP therapy and effect on daytime sleepiness as patients without DS.
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- Asplund, M., et al.
(författare)
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Therapist-Guided Internet-Delivered Acceptance-Enhanced Behavior Therapy for Skin-Picking Disorder : A Randomized Controlled Trial
- 2024
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Ingår i: Behavior Therapy. - : Elsevier BV. - 0005-7894 .- 1878-1888.
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Tidskriftsartikel (refereegranskat)abstract
- Despite its high prevalence, individuals suffering from skin-picking disorder (SPD) face limited access to treatment due to several factors, including geographical and economic barriers, as well as a shortage of properly trained therapists. Offering Internet-delivered therapy could be a solution to these barriers. This study aimed to evaluate the efficacy of therapist-guided Internet-delivered acceptance-enhanced behavior therapy (iBT) for SPD compared to a wait-list control condition. Participants randomized to the intervention group received 10 weeks of iBT (n = 35), while those in the control group were placed on a wait-list (n = 35). The primary outcome was the Skin Picking Scale—Revised (SPS-R). Mixed-model regression analyses demonstrated a significantly greater improvement in SPD symptoms in the iBT group compared to the control group at posttreatment (between-group difference −5.1 points, F = 9.69, p <.001). The between-group effect size was in the large range, with a bootstrapped d of 1.3 (95% CI [0.92, 1.69]). At posttreatment, 43% of the participants in the iBT group were classified as responders, and 31% were in remission, compared to 0% responders and 3% in remission in the control group. At the 6-month follow-up, the SPD symptoms had increased compared to posttreatment. However, the improvement from pretreatment remained significant. Participants reported a high level of satisfaction and credibility of the treatment, and a perceived good level of working alliance. Compared to wait-list control, iBT is an efficacious treatment for SPD at posttreatment and follow-up, with the potential to substantially increase the availability and access to evidence-based treatment for this disorder. Replication studies, particularly those comparing iBT to an active control, are warranted.
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- de Gelder, Stefan, et al.
(författare)
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Transepithelial transfer of phenanthrene, but not of benzo[a]pyrene, is inhibited by fatty acids in the proximal intestine of rainbow trout (Oncorhynchus mykiss)
- 2018
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Ingår i: Comparative Biochemistry and Physiology Part C: Toxicology and Pharmacology. - : Elsevier BV. - 1532-0456 .- 1878-1659. ; 204, s. 97-105
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 Elsevier Inc. The inclusion of vegetable oils in aquafeeds introduces contaminating polycyclic aromatic hydrocarbons (PAHs) in salmonids. Since lipophilic PAHs solubilize in micelles composed of lipids, bile salts and fatty acids, dietary lipid composition can alter intestinal transepithelial PAH transfer. We studied the uptake of two PAHs, viz. benzo[a]pyrene (BaP) and phenanthrene (PHE), in rainbow trout (Oncorhynchus mykiss) intestine. We also investigated the effects of two fatty acids, viz. fish oil-derived eicosapentaenoic acid (EPA, 20:5n-3) and vegetable oil-derived oleic acid (18:1n-9) on intestinal uptake. Radiolabeled PAHs were solubilized in micelles composed of tritiated EPA and oleic acid, respectively, and administrated to intestinal segments mounted in Ussing chambers. In the absence of micelles, PHE accumulation was two times higher than BaP in the mucosal and serosal layers of proximal and distal intestine. Administration of PHE in micelles composed of oleic acid resulted in a 50% lower accumulation of PHE in the mucosal layers of the proximal intestine compared to EPA-composed micelles. Accumulation of EPA and oleic acid in the proximal intestinal mucosa correlated negatively with the transepithelial transfer of these fatty acids across the proximal intestinal epithelium. Transepithelial PHE transfer across the proximal intestine was reduced by 30% in co-exposure with EPA-composed micelles compared to 80% with oleic acid micelles. BaP was not transferred across the intestine. We conclude that the lipid composition of an aquafeed is an important determinant of PAH bioavailability. Therefore, lipid composition should be an important consideration in choosing vegetable oils as alternatives for fish oil in aquafeeds.
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