| 1. |
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| 2. |
- Strömbeck, Johan, et al.
(författare)
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Outcome of a Multi-modal CBT-based Treatment Program for Chronic School Refusal
- 2021
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Ingår i: GLOBAL PEDIATRIC HEALTH. - : Sage Publications. - 2333-794X. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- School refusal (SR) can have several negative consequences, but effective treatments are available. When chronic, school absence requires comprehensive treatment. This study evaluates an intervention for SR based on a Cognitive Behavioral Therapy (CBT) model, Hemmasittarprogrammet (HSP). Attendance, anxiety, depression, quality of life, and emotional and behavioral symptoms were measured at pre-treatment, post-treatment, and follow-up. The participants (n = 84; 69% male) were SR students between 10 and 17 years old and their parents. School attendance increased after treatment and at follow-up. The proportion of students totally absent from school decreased and the number of students with an acceptable level of school attendance increased. Levels of anxiety and depression were lower both post-treatment and at follow-up for the youths and their parents. HSP, a promising treatment program for school refusal, builds on the literature of CBT-based programs, which has been shown to be effective for SR treatment. However, more research about the effectiveness of the program is needed. Future studies should have a stronger research design, include a measure of fidelity, and be evaluated independent of the founders of the program under investigation.
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| 3. |
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| 4. |
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| 5. |
- Ahrné, Karin, et al.
(författare)
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Tillstånd och trender för arter och deras livsmiljöer – rödlistade arter i Sverige 2015
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- 2015 års upplaga av den svenska rödlistan är den fjärde i ordningen. Den är baserad på IUCN:s rödlistningskriterier och revideras vart femte år. I rödlistan bedöms risken som enskilda arter av djur, växter och svampar löper att försvinna från Sverige. Bedömningen utförs av ArtDatabankens medarbetare i samverkan med över 100 externa experter, indelade i 14 expertkommittéer för olika organismgrupper. Under arbetet med 2015 års rödlista har tillstånd och trender bedömts för 21 600 arter och 1 318 lägre taxa (apomiktiska arter, underarter och varieteter), sammanlagt ca 22 900 taxa. Av de bedömda arterna klassificerades 2 029 som hotade (kategorierna CR, EN och VU) och 4 273 som rödlistade (inkluderar även kategorierna NT, RE och DD). Förhållandet mellan antalet rödlistade och antalet bedömda arter ar 19,8 %, vilket är ungefär samma värde som 2010 och 2005. I denna rapport jämförs antalet och andelen rödlistade arter mellan olika organismgrupper, biotoper, substrat och påverkansfaktorer. Texten ar indelad i en allmän del och åtta kapitel inriktade på olika landskapstyper. Landskapstyperna utgör en grov indelning av landets miljöer enligt följande kategorier: Skog, Jordbrukslandskap, Urbana miljöer, Fjäll, Våtmarker, Sötvatten, Havsstränder och Havsmiljöer. Skogen och jordbrukslandskapet är de artrikaste landskapstyperna med 1 800 respektive 1 400 arter som har en stark anknytning dit, och ytterligare flera hundra arter som förekommer där mer sporadiskt. De faktorer som påverkar flest rödlistade arter i Sverige är skogsavverkning och igenväxning, som båda utgör ett hot mot vardera ca 30 % av de rödlistade arterna. Avverkning minskar arealen av skog där naturliga strukturer och naturlig dynamik upprätthålls, och den orsakar därmed förlust av livsmiljöer. Igenväxning orsakas av ett antal faktorer, bland annat upphörande hävd (bete och slåtter), gödsling, trädplantering och brist på naturliga störningsregimer som t.ex. regelbundna översvämningar kring vattendrag och sjöar. Andra viktiga påverkansfaktorer är fiske, torrläggning av våtmarker, tillbakagång hos värdarter (främst alm och ask som drabbats av invasiva svampsjukdomar), klimatförändringar och konkurrens från invasiva arter. IUCN:s rödlisteindex beräknas för ett urval av de bedömda organismgrupperna. Rödlisteindex visar att skillnaderna mellan rödlistorna från 2000, 2005, 2010 och 2015 är små. Ett par undantag finns dock. Groddjur och stora däggdjur har fått en något förbättrad situation sedan 2000. Totalt förefaller det ändå som att trycket mot Sveriges artstock har förblivit relativt konstant under de senaste 15 åren.
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| 6. |
- Gunnarsson, Carina, et al.
(författare)
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Ökad användning av restströmmar från spannmålsodling för en svensk biobaserad ekonomi
- 2022
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Det finns ett stort intresse att använda halm i bioraffinaderiprocesser för att producera förnybara material, kemikalier och drivmedel, men mängden halm är begränsad och aktuella processer är ofta storskaliga. Målet med detta projekt var att bidra till ökad användning av tillgängliga restströmmar från spannmålsproduktion och därmed bidra till ökad andel inhemsk råvara till den svenska biobaserade industrin. Projektet undersökte tre restströmmar från spannmålsproduktionen: halm, rensverksfraktion (från tröskans rensverk som normalt sprids ut på fältet och inte samlas in) samt avrens från rensmaskiner och aspiratörer på spannmålsmottagningar. Arbetet innefattade att karakterisera olika sorters halm, utvärdera tekniker för att öka insamlingsgraden vid skörd, lagringsförsök samt modellering av leveranssäkerhet och skördestrategier. Ett speciellt fokus var att utvärdera materialet med avseende på biogasproduktion. Den grundläggande karakteriseringen som gjordes av halm och rensverksfraktion från höstvete, korn, havre, höstråg och höstraps visade vissa skillnader i innehåll av cellulosa, hemicellulosa, lignin, oorganiska ämnen samt extraktivämnen, men inga som kunde förklara skillnaderna i metanproduktionen mellan proverna. Råghalm hade den högsta metanproduktionen, medan halm från höstraps hade signifikant lägre metanproduktion än de andra halmsorterna. Metanproduktionen från rensverksfraktionerna visade samma tendens som för halmen. För att försöka hitta förklaringar till den lägre metanproduktionen för halm och rensverksfraktion från höstraps gjordes kompletterande analyser av biomassans struktur och sammansättning. Inga tydliga skillnader i cellullosakristallinitet kunde ses som skulle kunna förklara den lägre biogasproduktionen. De fördjupade analyserna kunde visa att det finns skillnader i ligninstruktur, det skulle dock behöva undersökas vidare om dessa bidrar till skillnaderna i metanproduktionen. En hypotes som inte kunde bekräftas är att höstrapshalmen innehåller glukosinulater som när de bryts ner kan verka hämmande på bakterierna i jäsningsprocessen. Detta behöver utredas vidare i kommande studier. I projektet utvärderades två olika tekniker för att förutom halm även samla in rensverksfraktion och därigenom öka mängden bärgat material. Vid skörd av spannmål samlas kärnan i en tank, medan halmen och övriga överjordiska delar av spannmålsplantan som återstår matas ut efter skördetröskan. Utvärderingen visade att total insamlad mängd biomassa ökade när även rensverksfraktionen samlades in. Även halmbalarnas densitet ökade vid inblandning av rensverksfraktionen i halmen, vilket är fördelaktigt för transporteffektiviteten. Ökningen av insamlad mängd och baldensitet var dock signifikant i endast ett av de två försöken. Mellan 36 % och 41 % av den teoretiskt bärgningsbara mängden biomassa samlades inte in och kan betraktas som förluster i systemet. Vissa av förlusterna går att åtgärda med val av maskiner som är väl anpassade till varandra medan andra kräver ett helt annat skördesystem. Potentialen för utveckling av nya och förbättrade tekniska system som möjliggör att en större andel biomassa kan tillvaratas är därför stor. Tillgången på halm för användning i bioraffinaderier kan även ökas genom att använda halm av olika kvalitet, tex fuktig halm. I tre olika lagringsförsök undersöktes under vilka förutsättningar det finns risk för förluster under aeroba förhållanden. Försöken utvärderades med avseende på effekten på förluster och kvalitet samt metanproduktion. Respirometerförsök genomfördes på halm och rensverksfraktion från höstvete och korn vid två olika vattenaktiviteter (vattenhalter) under ca 2 månader. Resultaten visade att förlusterna hos höstvetehalm troligen kan hållas låga om den lagras vid en vattenhalt under 20-23 %. Kornhalm verkar vara något känsligare och kan behöva vara några procentenheter torrare, medan rensverksfraktionen verkar vara något mer motståndskraftig mot mikrobiell tillväxt. I vetehalm ökade metanpotentialen under lagringen, medan den minskade för halm och rensverksfraktion från korn. Den stora minskningen i metanpotential för kornproverna kan ha orsakats av de högre kvävehalterna och lägre C/N kvot som gynnar mikrobiell aktivitet. Resultaten tyder på att fuktig aerob lagring av vetehalm kan fungera som ett förbehandlingssteg där cellulosanedbrytande mögelsvampar bryter ned cellulosan och därmed gör kolet mer tillgänglig för de metangasproducerande mikroorganismerna. Studien tyder på att denna process går snabbare med kornhalm. Dessa resultat behöver följas upp och fördjupas. Genom att utnyttja lagringstiden till biologisk förbehandling inför användning i bioraffinaderiet kan vi på ett positivt sätt utnyttja faktorer som normalt har negativ inverkan på kvalitet, såsom hög fukthalt och temperatur samt långa lagringstider. I fullskaliga försök som upprepades under två år vid Gasum AB biogasanläggning i Jordberga utvärderades avrenslagring under praktiska förhållande i stora plansilor utan täckning. Lagringsförsöket genomfördes med avrensat material (avrens) från i spannmålshandelns mottagningsanläggningar. Lagringsprocessen övervakades på olika djup genom mätningar av gassammansättning och temperatur och lagringsförlusterna bestämdes. Förlusterna av torrsubstans under lagringen varierade mellan 1,5 och 3 %, dock med undantag från ytprovet år två där förlusterna uppgick till 63 %. De höga förlusterna i ytprovet beror sannolikt på en längre lagringstid i kombination med direkt exponering mot atmosfäriska förhållanden och därmed nederbörd. Detta resulterade i en omfattande tillväxt av mögelsvampar. Metanpotentialen i proverna från ytan var båda åren signifikant lägre (8 % respektive 62 %) än i proverna från inläggningen. Mellan djupare liggande prover fanns ingen signifikant skillnad i metanpotential sinsemellan eller jämfört med inläggningsprovet. Låg vattenhalt, syrefattiga förhållanden och höga temperaturer hämmade mikrobiell tillväxt i djupare liggande prover. Den modelleringsstudie baserad på väderdata som genomfördes med syftet att under-söka hur leveranssäkerheten av halm påverkas av väderleken visade att mängden torr halm som kan bärgas varierar stort mellan år. Andelen av den tillgängliga mängden halm som i genomsnitt över flera år är möjlig att bala (pressningskoefficient) beräknades till 84, 86, 82 och 80 % för Västmanland, Östergötland, Västra Götaland respektive Skåne vid maximalt 18% vattenhalt vid pressning. Den varierade även över skördesäsongen. Den tillgängliga pressningstiden minskade från över 50 % i den andra halvan av juli till under 30 % i de första veckorna i oktober beroende på område. De genomsnittliga andelarna pressad halm varierade för de enskilda grödorna: den var högst för höstvete, ca 90 % för gårdarna belägna i Västmanland, Östergötland och Västra Götaland, och 80 % i Skåne. Andelarna för vårvete var lägst, 67–75 % beroende på område.
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| 7. |
- Matheson, Gordon O, et al.
(författare)
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Prevention and management of non-communicable disease : the IOC consensus statement, Lausanne 2013.
- 2013
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 47:16, s. 1003-11
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Tidskriftsartikel (refereegranskat)abstract
- Morbidity and mortality from preventable, non-communicable chronic disease (NCD) threatens the health of our populations and our economies. The accumulation of vast amounts of scientific knowledge has done little to change this. New and innovative thinking is essential to foster new creative approaches that leverage and integrate evidence through the support of big data, technology and design thinking. The purpose of this paper is to summarise the results of a consensus meeting on NCD prevention sponsored by the IOC in April 2013. Within the context of advocacy for multifaceted systems change, the IOC's focus is to create solutions that gain traction within healthcare systems. The group of participants attending the meeting achieved consensus on a strategy for the prevention and management of chronic disease that includes the following: (1) Focus on behavioural change as the core component of all clinical programmes for the prevention and management of chronic disease. (2) Establish actual centres to design, implement, study and improve preventive programmes for chronic disease. (3) Use human-centred design in the creation of prevention programmes with an inclination to action, rapid prototyping and multiple iterations. (4) Extend the knowledge and skills of Sports and Exercise Medicine (SEM) professionals to build new programmes for the prevention and treatment of chronic disease focused on physical activity, diet and lifestyle. (5) Mobilise resources and leverage networks to scale and distribute programmes of prevention. True innovation lies in the ability to align thinking around these core strategies to ensure successful implementation of NCD prevention and management programmes within healthcare. The IOC and SEM community are in an ideal position to lead this disruptive change. The outcome of the consensus meeting was the creation of the IOC Non-Communicable Diseases ad hoc Working Group charged with the responsibility of moving this agenda forward.
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| 8. |
- Matheson, Gordon O, et al.
(författare)
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Prevention and Management of Non-Communicable Disease : The IOC Consensus Statement, Lausanne 2013.
- 2013
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Ingår i: Sports Medicine. - : Springer Science and Business Media LLC. - 0112-1642 .- 1179-2035. ; 43:11, s. 1075-88
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Tidskriftsartikel (refereegranskat)abstract
- Morbidity and mortality from preventable, non-communicable chronic disease (NCD) threatens the health of our populations and our economies. The accumulation of vast amounts of scientific knowledge has done little to change this. New and innovative thinking is essential to foster new creative approaches that leverage and integrate evidence through the support of big data, technology, and design thinking. The purpose of this paper is to summarize the results of a consensus meeting on NCD prevention sponsored by the International Olympic Committee (IOC) in April, 2013. Within the context of advocacy for multifaceted systems change, the IOC's focus is to create solutions that gain traction within health care systems. The group of participants attending the meeting achieved consensus on a strategy for the prevention and management of chronic disease that includes the following: 1. Focus on behavioural change as the core component of all clinical programs for the prevention and management of chronic disease. 2. Establish actual centres to design, implement, study, and improve preventive programs for chronic disease. 3. Use human-centered design in the creation of prevention programs with an inclination to action, rapid prototyping and multiple iterations. 4. Extend the knowledge and skills of Sports and Exercise Medicine (SEM) professionals to build new programs for the prevention and treatment of chronic disease focused on physical activity, diet and lifestyle. 5. Mobilize resources and leverage networks to scale and distribute programs of prevention. True innovation lies in the ability to align thinking around these core strategies to ensure successful implementation of NCD prevention and management programs within health care. The IOC and SEM community are in an ideal position to lead this disruptive change. The outcome of the consensus meeting was the creation of the IOC Non-Communicable Diseases ad-hoc Working Group charged with the responsibility of moving this agenda forward.
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| 9. |
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| 10. |
- Sanchez, Vera Victoria, et al.
(författare)
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Autophagy is required for gamete differentiation in the moss Physcomitrella patens
- 2017
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Ingår i: Autophagy. - : Informa UK Limited. - 1554-8627 .- 1554-8635. ; 13:11, s. 1939-1951
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Tidskriftsartikel (refereegranskat)abstract
- Autophagy, a major catabolic process in eukaryotes, was initially related to cell tolerance to nutrient depletion. In plants autophagy has also been widely related to tolerance to biotic and abiotic stresses (through the induction or repression of programmed cell death, PCD) as well as to promotion of developmentally regulated PCD, starch degradation or caloric restriction important for life span. Much less is known regarding its role in plant cell differentiation. Here we show that macroautophagy, the autophagy pathway driven by engulfment of cytoplasmic components by autophagosomes and its subsequent degradation in vacuoles, is highly active during germ cell differentiation in the early diverging land plant Physcomitrella patens. Our data provide evidence that suppression of ATG5-mediated autophagy results in reduced density of the egg cell-mediated mucilage that surrounds the mature egg, pointing toward a potential role of autophagy in extracellular mucilage formation. In addition, we found that ATG5- and ATG7-mediated autophagy is essential for the differentiation and cytoplasmic reduction of the flagellated motile sperm and hence for sperm fertility. The similarities between the need of macroautophagy for sperm differentiation in moss and mouse are striking, strongly pointing toward an ancestral function of autophagy not only as a protector against nutrient stress, but also in gamete differentiation.
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| 11. |
- Sundberg, Sebastian, et al.
(författare)
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Havsstränder
- 2015
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Ingår i: Tillstånd och trender för arter och deras livsmiljöer - rödlistade arter i Sverige 2015. - 9789187853135 ; :17, s. 51-56
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Sveriges mångformiga kust - med sand-, grus- och klippstränder, dyner och strandängar - hyser drygt 270 rödlistade arter för vilka havsstränderna är viktiga livsmiljöer. Här ingår många arter av fåglar, kärlväxter, spindeldjur, skalbaggar, fjärilar och groddjur. Havsstrandängar och sandiga miljöer är särskilt artrika. Havsstrandsarterna hotas främst av igenväxning, exploatering, mänsklig störning av häckningsplatser och livsmiljöer samt nedskräpning. De viktigaste åtgärderna är att återskapa blottade sandstränder och dyner, att säkerställa en välanpassad hävd av strandängar samt att minska föroreningar och marin nedskräpning.
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| 12. |
- Ali, Abdulemir, et al.
(författare)
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Dissatisfied patients after total knee arthroplasty
- 2014
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 85:3, s. 229-233
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - In 2003, an enquiry by the Swedish Knee Arthroplasty Register (SKAR) 2-7 years after total knee arthroplasty (TKA) revealed patients who were dissatisfied with the outcome of their surgery but who had not been revised. 6 years later, we examined the dissatisfied patients in one Swedish county and a matched group of very satisfied patients. Patients and methods - 118 TKAs in 114 patients, all of whom had had their surgery between 1996 and 2001, were examined in 2009-2010. 55 patients (with 58 TKAs) had stated in 2003 that they were dissatisfied with their knees and 59 (with 60 TKAs) had stated that they were very satisfied with their knees. The patients were examined clinically and radiographically, and performed functional tests consisting of the 6-minute walk and chair-stand test. All the patients filled out a visual analog scale (VAS, 0-100 mm) regarding knee pain and also the Hospital and Anxiety and Depression scale (HAD). Results - Mean VAS score for knee pain differed by 30 mm in favor of the very satisfied group (p < 0.001). 23 of the 55 patients in the dissatisfied group and 6 of 59 patients in the very satisfied group suffered from anxiety and/or depression (p = 0.001). Mean range of motion was 11 degrees better in the very satisfied group (p < 0.001). The groups were similar with regard to clinical examination, physical performance testing, and radiography. Interpretation - The patients who reported poor response after TKA continued to be unhappy after 8-13 years, as demonstrated by VAS pain and HAD, despite the absence of a discernible objective reason for revision.
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| 13. |
- Ali, Abdulemir, et al.
(författare)
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Doubtful effect of continuous intraarticular analgesia after total knee arthroplasty.
- 2015
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 86:3, s. 373-377
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Local infiltration analgesia (LIA) is well established for effective postoperative pain relief in total knee arthroplasty (TKA). To prolong the effect of LIA, infusion pumps with local intraarticular analgesia can be used. We evaluated the effect of such an infusion pump for the first 48 h postoperatively regarding pain, knee function, length of stay (LOS) in hospital, and complications. Patients and methods - 200 patients received peroperative LIA and a continuous intraarticular elastomeric infusion pump set at 2 mL/h. The patients were randomized either to ropivacaine (7.5 mg/mL) or to NaCl (9 mg/mL) in the pump. Visual analog scale (VAS) pain (0-100 mm), analgesic consumption, side effects of medicine, range of motion (ROM), leg-raising ability, LOS, and complications during the first 3 months were recorded. Results - On the first postoperative day, the ropivacaine group had lower VAS pain (33 vs. 40 at 12 noon and 36 vs. 43 at 8 p.m.; p = 0.02 and 0.03, respectively), but after that all recorded variables were similar between the groups. During the first 3 months, the ropivacaine group had a greater number of superficial and deep surgical wound infections (11 patients vs. 2 patients, p = 0.02). There were no other statistically significant differences between the groups. Interpretation - Continuous intraarticular analgesia (CIAA) with ropivacaine after TKA has no relevant clinical effect on VAS pain and does not affect LOS, analgesic consumption, ROM, or leg-raising ability. There may, however, be a higher risk of wound-healing complications including deep infections.
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| 14. |
- Ali, Abdulemir, et al.
(författare)
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Preoperative Anxiety and Depression Correlate With Dissatisfaction After Total Knee Arthroplasty : A Prospective Longitudinal Cohort Study of 186 Patients, With 4-Year Follow-Up
- 2017
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Ingår i: Journal of Arthroplasty. - : Elsevier BV. - 0883-5403. ; 32:3, s. 767-770
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: After more than 4 decades experience of total knee arthroplasty (TKA), there is still a group of patients who are not satisfied with the outcome. In spite of the improvement of many aspects around the procedure, for unexplainable reasons, patient dissatisfaction is still approximately the same. We conducted this study to analyze correlations between preoperative psychological aspects and dissatisfaction after TKA.METHODS: A total of 186 patients were operated with a primary TKA. Patients filled out the Hospital Anxiety and Depression Scale, Visual Analog Pain Scale (0-100), and Knee injury and Osteoarthritis Outcome Score preoperatively and 4 years postoperatively. Four years postoperatively, the patients also scored their satisfaction degree with the outcome of the surgery.RESULTS: Of 186 patients, 27 (15%) reported that they were dissatisfied or uncertain with the result of their TKA 4 years postoperatively. Sixteen of those 27 patients had reported anxiety/depression preoperatively compared with 11 of 159 (7%) in the satisfied or very satisfied groups. Patients with preoperative anxiety or depression had more than 6 times higher risk to be dissatisfied compared with patients with no anxiety or depression (P < .001). Patients with deep prosthetic infection had 3 times higher risk to be dissatisfied with the operation outcome (P = .03). Dissatisfied patients had 1-day longer hospital stay compared with the satisfied group (P < .001).CONCLUSION: Preoperative anxiety and/or depression is an import predictor for dissatisfaction after TKA. Psychological assessment and treatment preoperatively might improve degree of satisfaction.
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| 15. |
- Ali, Abdulemir, et al.
(författare)
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Similar patient-reported outcomes and performance after total knee arthroplasty with or without patellar resurfacing : A randomized study of 74 patients with 6 years of follow-up
- 2016
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Ingår i: Acta Orthopaedica. - : Informa UK Limited. - 1745-3674 .- 1745-3682. ; 87:3, s. 274-279
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose — Knee pain after total knee arthroplasty (TKA) is not uncommon. Patellar retention in TKA is one cause of postoperative knee pain, and may lead to secondary addition of a patellar component. Patellar resurfacing in TKA is controversial. Its use ranges from 2% to 90% worldwide. In this randomized study, we compared the outcome after patellar resurfacing and after no resurfacing. Patients and methods — We performed a prospective, randomized study of 74 patients with primary osteoarthritis who underwent a Triathlon CR TKA. The patients were randomized to either patellar resurfacing or no resurfacing. They filled out the VAS pain score and KOOS questionnaires preoperatively, and VAS pain, KOOS, and patient satisfaction 3, 12, and 72 months postoperatively. Physical performance tests were performed preoperatively and 3 months postoperatively. Results — We found similar scores for VAS pain, patient satisfaction, and KOOS 5 subscales at 3, 12, and 72 months postoperatively in the 2 groups. Physical performance tests 3 months postoperatively were also similar in the 2 groups. No secondary resurfacing was performed in the group with no resurfacing during the first 72 months Interpretation — Patellar resurfacing in primary Triathlon CR TKA is of no advantage regarding pain, physical performance, KOOS 5 subscales, or patient satisfaction compared to no resurfacing. None of the patients were reoperated with secondary addition of a patellar component within 6 years. According to these results, routine patellar resurfacing in primary Triathlon TKA appears to be unnecessary.
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| 16. |
- Alwis, Gayani, et al.
(författare)
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Normative Calcaneal Quantitative Ultrasound Data as an Estimation of Skeletal Development in Swedish Children and Adolescents.
- 2010
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Ingår i: Calcified Tissue International. - : Springer Science and Business Media LLC. - 1432-0827 .- 0171-967X. ; 87, s. 493-506
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Tidskriftsartikel (refereegranskat)abstract
- We present age- and gender-specific normative bone status data evaluated by quantitative ultrasound (QUS) in the calcaneus with the Lunar Achilles device and compare these estimates with bone mineral content (BMC) and bone mineral density (BMD) estimated by dual X-ray absorptiometry (DXA). Included were a sample of 518 population-based collected Swedish girls and 558 boys aged 6-19 years. QUS measurements included speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness index (SI) in the calcaneus. DXA measurements included BMC and BMD in the femoral neck (FN), lumbar spine (L2-L4), and total body (TB). Height and weight were measured with standard equipment. Age, height, and weight were significantly associated with SOS, BUA, and SI. Compared to SOS, in both girls and boys there was a higher correlation between BUA and FN BMC (r = 0.71 and r = 0.73, respectively), FN BMD (r = 0.68 and r = 0.67, respectively), L2-L4 BMC (r = 0.70 and r = 0.64, respectively), L2-L4 BMD (r = 0.69 and r = 0.64, respectively), TB BMC (r = 0.76 and r = 0.75, respectively), and TB BMD (r = 0.74 and r = 0.74, respectively). The correlations between SOS and FN BMC (r = 0.38 and r = 0.52, respectively), FN BMD (r = 0.41 and r = 0.52, respectively), L2-L4 BMC (r = 0.31 and r = 0.40, respectively), L2-L4 BMD (r = 0.32 and r = 0.41, respectively), TB BMC (r = 0.42 and r = 0.49, respectively), and TB BMD (r = 0.48 and r = 0.54, respectively) were lower, although still significant (all P < 0.001). BUA seems to be the QUS parameter that best resembles the changes in BMC during growth.
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| 17. |
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| 18. |
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| 19. |
- Andersson, Håkan S., 1967-, et al.
(författare)
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The toxicity of ribbon worms: alpha-nemertides or tetrodotoxin, or both?
- 2016
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Ingår i: Planta Medica. - : Georg Thieme Verlag KG. - 0032-0943 .- 1439-0221. ; 82:Supplement 1
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The marine ribbon worms (nemerteans) are predators which capture their prey by everting a proboscis carrying a mixture of toxins which brings on rapid paralysis [1]. Moreover, ribbon worms have a thick layer of epidermal mucus of similar constitution. Tetrodotoxin (TTX) has been identified as one of these toxins [2]. The extreme toxicity of TTX (lethal by ingestion of 0.5-2 mg) is due to its ability to block voltage-gated sodium channels. Although several bacterial species (among these Vibrio sp.) have been linked to its synthesis, the biogenic origin and biosynthesis is unclear. One hypothesis is that TTX production occurs in a symbiotic relationship with its host, in this case the ribbon worm [3]. We have made significant effort to identify TTX in a setup for production through the cultivation of Vibrio alginolyticus in nutrient broth infused with mucus from the ribbon worm Lineus longissimus. Toxicity was demonstrated by fraction injections into shore crabs, but no TTX was found, and it could be shown conclusively that toxicity was unrelated to TTX and the Vibrio culture itself, and rather a constituent of the ribbon worm mucus [4]. The following studies led us to the discovery of a new class of peptides, the alpha-nemertides, in the mucus of the ribbon worms, which could be directly linked to the toxic effects. A literature review of the available evidence for TTX in ribbon worms show that the evidence in most cases are indirect, although notable exceptions exist. This points to the necessity to further investigate the presence and roles of TTX and alpha-nemertides in ribbon worms.
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| 20. |
- Atroshi, I, et al.
(författare)
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Quality of life after hip revision with impaction bone grafting on a par with that 4 years after primary cemented arthroplasty
- 2004
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 75:6, s. 677-683
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Tidskriftsartikel (refereegranskat)abstract
- Background There have been few studies evaluating patient-reported quality of life outcomes after hip revision with impaction bone grafting. Patients and methods The inclusion criteria were aseptic loosening after primary arthroplasty performed for osteoarthrosis, and first-time revision with impacted morselized allograft bone and cemented Exeter stem. During a 4-year period, 35 patients were eligible and all were included. The Nottingham Health Profile (NHP) was completed by the patients and the Charnley hip scores recorded by the examining surgeon preoperatively, after 6 months and yearly up to 4 years (28 patients) postoperatively. For comparison, 35 osteoarthrotic patients completed the NHP 4 years after cemented Exeter primary arthroplasty. Results At 4 years, the NHP scores for the revision patients did not differ significantly from those recorded in the primary arthroplasty group. Among the revision patients, mixed model analysis showed improvement in NHP pain (p < 0.001) and physical mobility scores (p = 0.002). The effect size at 4 years was large for pain (1.2) and moderate for physical mobility (0.6). The major improvement was recorded at 6 months, with no further substantial change observed. The correlations between the NHP and Charnley scores were weak or moderate (r, -0.15 to -0.67). Interpretation Hip revision with impaction bone grafting leads to substantially improved quality of life, similar to that 4 years after primary arthroplasty.
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| 21. |
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| 22. |
- Belfrage, Ola, et al.
(författare)
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Local treatment of cancellous bone grafts with BMP-7 and zoledronate increases both the bone formation rate and bone density.
- 2011
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 82:2, s. 228-233
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose The remodeling of morselized bone grafts in revision surgery can be enhanced by an anabolic substance such as a bone morphogenetic protein (BMP). On the other hand, BMPs boost catabolism and might cause a premature resorption, both of the graft and of the new-formed bone. Bisphosphonates inactivate osteoclasts and can be used to control the resorption. We studied a combination of both drugs as a local admix to a cancellous allograft. Methods Cancellous bone allografts were harvested and freeze-dried. Either saline, BMP-7, the bisphosphonate zoledronate, or a combination of BMP-7 and zoledronate were added in solution. The grafts were placed in bone conduction chambers and implanted in the proximal tibia of 34 rats. The grafts were harvested after 6 weeks and evaluated by histomorphometry. Results Bone volume/total volume (BV/TV) was 50% in the grafts treated with the combination of BMP-7 and zoledronate and 16% in the saline controls (p < 0.001). In the zoledronate group BV/TV was 56%, and in the BMP group it was 14%. The ingrowth distance of new bone into the graft was 3.5 mm for the combination of BMP-7 and zoledronate and 2.6 mm in the saline control (p = 0.002). The net amount of retained remodeled bone was more than 4 times higher when BMP-7 and zoledronate were combined than in the controls. Interpretation An anabolic drug like BMP-7 can be combined with an anti-catabolic bisphosphonate as local bone graft adjunct, and the combination increases the amount of remaining bone after remodeling is complete.
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| 23. |
- Belfrage, Ola, et al.
(författare)
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Locally administered bisphosphonate in hip stem revisions using the bone impaction grafting technique : a randomised, placebo-controlled study with DXA and five-year RSA follow-up
- 2019
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Ingår i: HIP International. - : SAGE Publications. - 1120-7000 .- 1724-6067. ; 29:1, s. 26-34
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bisphosphonates have previously been shown to increase the density of impacted graft bone. In the present study we hypothesise that bisphosphonates also reduce early stem subsidence. We examined the effect of locally applied bisphosphonate to allografts on prosthetic micromotion and bone density in femoral stem revision with impaction grafting. Methods: 37 patients were randomised to either clodronate or saline as local adjunct to the morsellised allograft bone. 24 patients were finally analysed per protocol and evaluated by dual-energy x-ray absorptiometry (DXA) during the first year and with radiostereometric analysis (RSA) for 5 years. Results: There were no significant differences neither in bone density, nor in migratory behaviour between the groups. The femoral stems had subsided 3.6 mm in both groups (p = 0.99) at 5 years and there was no difference as measured over time with mixed models analysis. The clinical outcome was good in both groups. Conclusion: Clodronate as a local addendum to allograft bone in hip revision did not increase bone density or reduce micromotion of the implant.
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| 24. |
- Belfrage, Ola, et al.
(författare)
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Preserved periprosthetic bone stock at 5 years post-operatively with uncemented short hip stem in both collared and collarless version
- 2022
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Ingår i: Archives of Orthopaedic and Trauma Surgery. - : Springer Science and Business Media LLC. - 0936-8051 .- 1434-3916. ; 142:11, s. 3489-3496
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Previous bone density studies have generally shown bone resorption around both cemented and uncemented total hip arthroplasty (THA) stems. This is presumed to be due to stress shielding. Short stems have been introduced partly to preserve bone in the proximal femur by a more physiological loading of the bone. The purpose of this study was to evaluate bone remodeling around a short, fully hydroxyapatite-coated titanium stem that comes in a collared and collarless version. Patients and methods: A prospective cohort of 50 patients included in a study evaluating the Furlong Evolution stem has been followed for 5 years. Examination was done with dual energy X-ray absorptiometry (DXA) postoperatively, at 1, 2 and 5 years. Clinical outcome was followed with radiography and both general and hip specific outcome measures. Results: The two versions of the stem behaved similarly regarding bone remodeling. After an initial decrease up to 1 year, bone mineral density (BMD) increased in all Gruen zones up to 2 years and at 5 years bone stock was still preserved compared with postoperatively (net BMD + 1.2% (95% CI − 0.4 to 2.8)). Increase in BMD occurred mainly in the greater trochanter and distally around the stem with a decrease in the calcar area. Both versions showed excellent clinical outcome up to 5 years. Conclusion: This short stem seems to preserve proximal bone stock up to 5 years, exhibiting similar behaviour both with and without a collar. Trial registration number and date of registration: ClinicalTrials.gov, (identifier: NCT01894854). July 10, 2013.
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| 25. |
- Berg, Urban, et al.
(författare)
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Fast-Track Programs in Total Hip and Knee Replacement at Swedish Hospitals-Influence on 2-Year Risk of Revision and Mortality
- 2021
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Ingår i: Journal of Clinical Medicine. - : MDPI AG. - 2077-0383. ; 10:8
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: We aimed to study the influence of fast-track care programs in total hip and total knee replacements (THR and TKR) at Swedish hospitals on the risk of revision and mortality within 2 years after the operation. Methods: Data were collected from the Swedish Hip and Knee Arthroplasty Registers (SHAR and SKAR), including 67,913 THR and 59,268 TKR operations from 2011 to 2015 on patients with osteoarthritis. Operations from 2011 to 2015 Revision and mortality in the fast-track group were compared with non-fast-track using Kaplan-Meier survival analysis and Cox regression analysis with adjustments. Results: The hazard ratio (HR) for revision within 2 years after THR with fast-track was 1.19 (CI: 1.03-1.39), indicating increased risk, whereas no increased risk was found in TKR (HR 0.91; CI: 0.79-1.06). The risk of death within 2 years was estimated with a HR of 0.85 (CI: 0.74-0.97) for TKR and 0.96 (CI: 0.85-1.09) for THR in fast-track hospitals compared to non-fast-track. Conclusions: Fast-track programs at Swedish hospitals were associated with an increased risk of revision in THR but not in TKR, while we found the mortality to be lower (TKR) or similar (THR) as compared to non-fast track.
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