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- Bravo, L, et al.
(författare)
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- 2021
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swepub:Mat__t
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2. |
- Tabiri, S, et al.
(författare)
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- 2021
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swepub:Mat__t
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3. |
- Niemi, MEK, et al.
(författare)
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- 2021
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swepub:Mat__t
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4. |
- Kanai, M, et al.
(författare)
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- 2023
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swepub:Mat__t
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5. |
- Eklund, Michael, 1988-, et al.
(författare)
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Effect of spironolactone on vascular stiffness in hemodialysis patients : a randomized crossover trial
- 2022
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Ingår i: Upsala Journal of Medical Sciences. - : Upsala Medical Society. - 0300-9734 .- 2000-1967. ; 127:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The role of spironolactone treatment in hemodialysis patients is debated, but a survival benefit is suggested. Mineralocorticoids and chronic kidney disease have been linked to cardiovascular fibrosis. Therefore, we hypothesized that spironolactone would affect vascular stiffness, cardiac systolic, and diastolic function in hemodialysis patients.Methods: This was a randomized crossover study in hemodialysis patients supplemented with an echocardiographic case series. All outcomes reported here were secondary in the trial and were assessed without blinding. Block randomization and allocation determined treatment order. Participants received 50 mg spironolactone daily for 12 weeks and untreated observation for another 12 weeks. Pulse wave velocity (PWV) was measured before and after treatment and observation. Doppler-echocardiography was conducted before and after treatment. Systemic arterial compliance indexed to body surface area (SACi), left ventricular ejection fraction (LVEF), the peak early diastolic mitral inflow velocity (E), the peak late diastolic mitral inflow velocity (A), and the peak early diastolic myocardial lengthening velocity (E') were measured. E/A and E/E' were then calculated. Statistical analyses were conducted per protocol. A generalized linear mixed model with random participant effects was used for PWV. The Wilcoxon signed-rank test was used for echocardiographic variables.Results: Thirty participants were recruited, 18 completed follow-up, and 17 were included in PWV-analyses. Spironolactone treatment showed a tendency toward an increase in PWV of 1.34 (95% confidence interval: -0.11 to 2.78) m/s, which was not statistically significant (P = 0.07). There were no significant changes in any of the other variables (LVEF, E/A, E/E', or SACi).Conclusions: We found no evidence supporting an effect of 12-week administration of spironolactone 50 mg daily on vascular stiffness, cardiac systolic, or diastolic function in hemodialysis patients.
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6. |
- Parsmo, Rasmus, et al.
(författare)
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BRAVE ECO – Benchmark for Reduction of Anchoring Vessels’ Emissions – Enabling Change of Operation
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This feasibility study aims to evaluate the possibilities to reduce air emissions from ships anchored in port areas and, then especially the Port of Gothenburg. For this purpose, the study uses two main approaches. Firstly, it analyses the reasons and legal/business aspects for anchoring. Secondly, this study develops a reproducible calculation model for anchored vessels' CO2 emissions. Regulation of anchoring sites are not entirely clear since international regulation partly applies, also it is not clear who is responsible for the anchoring sites. This implies that the port´s scope of action is limited mainly to the ships that are calling the port. However, also emission from other ships at in the port area has been evaluated in this study to get a broader perspective. This pre-study provides both qualitative and quantitative findings and it is produced using mixed methods, including workshops with relevant port stakeholders. It also involves different scientific disciplines and several authors from the Port of Gothenburg Authority, IVL Swedish Environmental Research Institute, Maritime Studies at Chalmers University of Technology and the School of Business, Economics and Law at the University of Gothenburg. Furthermore, in connection to this study, one bachelor's thesis and two master's theses have been carried out. The results show that it is mainly tanker ships that are anchoring in Gothenburg and that their main reasons for anchoring are related to awaiting Laycan or waiting for an available berth. The companies involved in the study generally combine time charter and voyage charter contracts to access vessel capacity. The inputs from the workshops, the interviews conducted with stakeholders and the international literature are “rather” consistent: combining just in time arrival with slow steaming has a great potential for making a business case and to reduce fuel consumption and thereby emissions. However, there are many barriers which needs to be addressed, such as: lack of trust, improving information sharing (actors now communicate via phone or email), loss of income (due to demurrage), attitudes in the industry, the “first come, first serve” concept, risk of missing estimated time of arrival and port infrastructure. Even if there are many barriers, several actors in the port already have experience of combining just in time arrival and slow steaming. In this study, we develop a reproducible emission calculation model that calculates CO2eq emissions. The emissions are partly calculated by using the ships’ positions (AIS-data) from 2019, to extract the time spent at anchor. The emission model calculates the anchored vessels' total CO2eq emissions, but the model also calculates the theoretical potential for avoiding emission by using the time at anchor to slow steam. The results show that all tanker ships that anchored outside the port in 2019, could theoretically have reduced their emissions with about 30 ktonnes CO2eq, if they would have been notified of delays 24 hours before arrival and then reduced their speed to 10 knots. The results also show that using time to slow steam have a much greater potential to reduce emissions than if the ships would only reduce the time at anchor (by using fewer ships to perform the same transport work). This is especially true for the initial speed reductions (10-14 knots). This study also evaluates the emission calculation methods and assesses the uncertainties, by comparing different sources and underlying assumptions with real world data. The study argues that it is problematic to just use default values proposed in the global emission inventory issued by the International Maritime Organization (IMO). Using default values for estimating emission makes it harder to estimate the real effect of a new policy, regulation, or incentive in the port. However, a better emission inventory requires that on-board visits are made or that data is obtained digitally. The largest calculation uncertainties now are for boiler fuel consumption and bunker ships fuel consumption at the anchorage areas.
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7. |
- Rådegran, Göran, et al.
(författare)
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Characteristics and survival of adult Swedish PAH and CTEPH patients 2000-2014
- 2016
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Ingår i: Scandinavian Cardiovascular Journal. - : Taylor & Francis. - 1401-7431 .- 1651-2006. ; 50:4, s. 243-250
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The Swedish Pulmonary Arterial Hypertension Register (SPAHR) is an open continuous register, including pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) patients from 2000 and onwards. We hereby launch the first data from SPAHR, defining baseline characteristics and survival of Swedish PAH and CTEPH patients.DESIGN: Incident PAH and CTEPH patients 2008-2014 from all seven Swedish PAH-centres were specifically reviewed.RESULTS: There were 457 PAH (median age: 67 years, 64% female) and 183 CTEPH (median age: 70 years, 50% female) patients, whereof 77 and 81%, respectively, were in functional class III-IV at diagnosis. Systemic hypertension, diabetes, ischaemic heart disease and atrial fibrillation were common comorbidities, particularly in those >65 years. One-, 3- and 5-year survival was 85%, 71% and 59% for PAH patients. Corresponding numbers for CTEPH patients with versus without pulmonary endarterectomy were 96%, 89% and 86% versus 91%, 75% and 69%, respectively. In 2014, the incidence of IPAH/HPAH, associated PAH and CTEPH was 5, 3 and 2 per million inhabitants and year, and the prevalence was 25, 24 and 19 per million inhabitants.CONCLUSION: The majority of the PAH and CTEPH patients were diagnosed at age >65 years, in functional class III-IV, and exhibiting several comorbidities. PAH survival in SPAHR was similar to other registers.
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10. |
- Wall, Kent, et al.
(författare)
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Thirty-year electrocardiographic follow-up after repair of tetralogy of Fallot or atrial septal defect
- 2007
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Ingår i: Journal of Electrocardiology. - South Burlington, Vt. : Research in Electrocardiology, Inc.. - 0022-0736 .- 1532-8430. ; 40:2, s. 214-217
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Knowledge about long-term electrocardiographic changes after surgery for congenital heart disease is limited. METHODS: Eleven patients with corrected tetralogy of Fallot (ToF) and 14 with corrected atrial septal defect (ASD) were followed up at 20 and 30 years after surgery. RESULTS: Approximately 50% of the ASD group developed prolonged QRS duration. In the ToF group, 7 increased QRS duration by more than 20 milliseconds. Nearly all had right bundle-branch block, and 30% of them also had bifascicular block. Two in the ASD group developed first grade atrioventricular block. Five ASD and 6 ToF had prolonged corrected QT duration in the late postoperative phase. CONCLUSIONS: Even after primarily good results of surgery in congenital heart disease, unknown late effects may occur not only in complex lesions such as ToF but also after ASD correction. Regular medical checkups are important after surgical correction in congenital heart disease.
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