| 1. |
- Bauer, A, et al.
(författare)
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How COVID-19 changed clinical research strategies: a global survey
- 2022
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Ingår i: The Journal of international medical research. - : SAGE Publications. - 1473-2300 .- 0300-0605. ; 50:4, s. 3000605221093179-
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Tidskriftsartikel (refereegranskat)abstract
- Clinical research has faced new challenges during the COVID-19 pandemic, leading to excessive operational demands affecting all stakeholders. We evaluated the impact of COVID-19 on clinical research strategies and compared different adaptations by regulatory bodies and academic research institutions in a global context, exploring what can be learned for possible future pandemics. Methods We conducted a cross-sectional online survey and identified and assessed different COVID-19-specific adaptation strategies used by academic research institutions and regulatory bodies. Results All 19 participating academic research institutions developed and followed similar strategies, including preventive measures, manpower recruitment, and prioritisation of COVID-19 projects. In contrast, measures for centralised management or coordination of COVID-19 projects, project preselection, and funding were handled differently amongst institutions. Regulatory bodies responded similarly to the pandemic by implementing fast-track authorisation procedures for COVID-19 projects and developing guidance documents. Quality and consistency of the information and advice provided was rated differently amongst institutions. Conclusion Both academic research institutions and regulatory bodies worldwide were able to cope with challenges during the COVID-19 pandemic by developing similar strategies. We identified some unique approaches to ensure fast and efficient responses to a pandemic. Ethical concerns should be addressed in any new decision-making process.
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| 2. |
- Diwan, Salwan, et al.
(författare)
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Nudging strategies to influence prescribers' behavior toward reducing opioid prescriptions : a systematic scoping review
- 2024
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Ingår i: Journal of international medical research. - : Sage Publications. - 0300-0605 .- 1473-2300. ; 52:9
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: This systematic scoping review aimed to map the literature on the use of various nudging strategies to influence prescriber behavior toward reducing opioid prescriptions across diverse healthcare settings.METHODS: A systematic database search was conducted using seven electronic databases. Only articles published in English were included. A total of 2234 articles were identified, 35 of which met the inclusion criteria. Two independent dimensions were used to describe nudging strategies according to user action and the timing of their implementation.RESULTS: Six nudging strategies were identified. The most common strategy was default choices, followed by increasing salience of information or incentives and providing feedback. Moreover, 32 studies used the electronic health record as an implementation method, and 29 reported significant results. Most of the effective interventions were multicomponent interventions (i.e., combining nudge strategies and non-nudge components).CONCLUSIONS: Most nudging strategies used a passive approach, such as defaulting prescriptions to generics and requiring no action from the prescriber. Although reported as effective, this approach often operates under the prescriber's radar. Future research should explore the ethical implications of nudging strategies.INPLASY registration number: 202420082.
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| 3. |
- Duberg, Anna, 1976-, et al.
(författare)
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The effects of a dance intervention on somatic symptoms and emotional distress in adolescent girls : A randomized controlled trial
- 2020
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Ingår i: Journal of international medical research. - : Sage Publications. - 0300-0605 .- 1473-2300. ; 48:2
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate whether a dance intervention for adolescent girls reduces stressrelated symptoms.Methods: This was a randomized controlled trial of an after-school intervention. Participants were 112 girls aged 13 to 18 years with stress-related somatic symptoms and emotional distress. The intervention comprised twice-weekly dance sessions for 8 months with a focus on enjoyment and socialization. A questionnaire was administered at baseline and after 8, 12 and 20 months. Participants rated the frequency with which they had experienced somatic symptoms and emotional distress during the previous 3 months.Results: After the intervention, there was a significantly greater reduction in somatic symptoms and emotional distress in the dance intervention group than in the control group. The difference in the mean score change on a 5-point scale was 0.26 (95% confidence interval [CI]: 0.04 to 0.47) for somatic symptoms and 0.30 (95% CI: 0.04 to 0.58) for emotional distress.Conclusion: Dance interventions may reduce somatic symptoms and emotional distress in adolescent girls, and may constitute a nonpharmacological complement to school health services. However, continued participation is needed for long-term sustainable results. Additional randomized studies are required to further evaluate the effect of this type of intervention in different settings.
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| 4. |
- Edvinsson, Marie, et al.
(författare)
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No evidence of Chlamydia pneumoniae in the synovia of patients with osteoarthritis
- 2019
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Ingår i: Journal of international medical research. - : Sage Publications. - 0300-0605 .- 1473-2300. ; 47:2, s. 635-640
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Osteoarthritis (OA) is a common cause of disability affecting millions of people of all ages worldwide. The pathogenesis involves an inflammatory component, but the cause of the inflammation remains incompletely understood. The intracellular bacteria Chlamydia trachomatis and C. pneumoniae have been demonstrated in patients with reactive arthritis. Both of these microorganisms can cause chronic and persistent infections, with C. trachomatis being the most common cause of reactive arthritis. This study was performed to investigate the presence of C. pneumoniae in a large number of patients with primary OA.METHODS: The study included 75 patients who underwent total knee arthroplasty. During surgery, a synovial biopsy was performed and synovial fluid drawn. Real-time polymerase chain reaction (PCR) of C. pneumoniae was run on all patients, and real-time PCR of bacterial 16S rDNA was conducted on 30 of the 75 patients to screen for the presence of other bacteria.RESULTS: Real-time PCR showed no evidence of the presence of C. pneumoniae in the patients' specimens, nor were other bacteria detected.CONCLUSIONS: Although an inflammatory component is part of the pathogenesis of OA, we found no evidence indicating that C. pneumoniae is a stimulator of that inflammation.
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| 5. |
- Eriksson, Hannah K., MD, et al.
(författare)
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Low accuracy in preoperative tissue biopsies for diagnosing chronic periprosthetic joint infection : an observational retrospective single-centre study
- 2023
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Ingår i: Journal of international medical research. - : Sage Publications. - 0300-0605 .- 1473-2300. ; 51:6
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Tidskriftsartikel (refereegranskat)abstract
- Objective Diagnosing periprosthetic joint infection (PJI) can be challenging. The ability to distinguish between septic and aseptic failure of a joint prosthesis is crucial for treatment strategy optimisation and prognosis prediction. Preoperative tissue cultures are included in many diagnostic algorithms; however, studies report different degrees of concordance (63%-85%) with intraoperative cultures. This study aimed to investigate the diagnostic performance of tissue biopsies in the preoperative diagnostic process with the 2018 International Consensus Meeting criteria as a reference and to describe the concordance between microbiological findings in pre- and intraoperative biopsies.Methods This observational retrospective study included 44 patients requiring revision surgery of a total hip or knee arthroplasty, where the diagnostic workup included biopsies of periprosthetic tissue. The accuracy of preoperative biopsies was calculated, and concordance between microbiological findings in pre- and intraoperative biopsies was described.Results The accuracy was 59%, with a sensitivity of 50% and specificity of 79%. Full concordance between microbiological findings in pre- and intraoperative biopsies was found in 64% of the cases.Conclusion An open biopsy of periprosthetic tissue cannot reliably confirm or exclude PJI, and, therefore, should not be performed.
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| 6. |
- Farrants, Kristin, et al.
(författare)
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Sick leave before and after the age of 65 years among those in paid work in Sweden in 2000 or 2005 : a register-based cohort study
- 2018
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Ingår i: Journal of international medical research. - : SAGE Publications. - 0300-0605 .- 1473-2300. ; 46:2, s. 564-577
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Tidskriftsartikel (refereegranskat)abstract
- Objective With pressure for older people to remain in work, research is needed on how people aged over 65 years fare in the labour market. However, few studies have focused on sick leave among older workers, especially those over the standard retirement age. This study investigated changes in sick-leave patterns among people aged over 65 years still in work.Methods All individuals in Sweden who turned 65 years old in 2000 or 2005 were followed from 1995 to 2010. The mean number of sick-leave days per year was measured for those who remained in paid work past the age of 65 years.Results Those over 65 years still working had fewer sick-leave days before the age of 65 years than those who retired. They also had fewer sick-leave days after 65 years than before. There were fewer socioeconomic differences after 65 years than before, but these differences were greater for workers over 65 years in the 2005 cohort.Conclusions Although there were more people over 65 years in paid work in 2005, sick-leave days and socioeconomic differences in sick leave were lower in this age group. Sick-leave days and socioeconomic differences in sick leave were greater in the 2005 cohort.
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| 7. |
- Fransson, Torbjörn, et al.
(författare)
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Drug-eluting balloon (DEB) versus plain old balloon angioplasty (POBA) in the treatment of failing dialysis access : A prospective randomized trial
- 2022
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Ingår i: Journal of International Medical Research. - : SAGE Publications. - 0300-0605 .- 1473-2300. ; 50:3
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare the efficacy of angioplasty using drug-eluting balloons (DEB) compared with plain old balloon angioplasty (POBA) to reduce the rate of restenosis. Methods: This prospective, single-centre, single-blinded, 1:1 randomized, clinical trial enrolled patients that had primary or restenotic lesions in native upper extremity arteriovenous (AV) fistulas or at the graft-venous anastomosis. Patients were randomized to angioplasty with a POBA or a DEB. The primary effectiveness endpoints were freedom from target lesion revascularization (TLR) and functional status of access circuit at 12 months. Results: A total of 42 (28 male, 14 female; age range, 42–83 years) patients were enrolled. Patients were followed for 12 months. No significant differences were detected between the POBA and DEB groups regarding total number of TLR procedures (31 versus 36, respectively), freedom from TLR (3 versus 4, respectively) and functional status of the access circuit at 12 months (14 of 20 patients [70%] versus 17 of 22 patients [77%], respectively). Conclusion: This clinical trial did not demonstrate any significant differences between DEB angioplasty and standard balloon angioplasty when treating dysfunctional haemodialysis access.
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| 8. |
- Garmy, Pernilla, 1973-, et al.
(författare)
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Is sleep duration associated with self-reported overall health, screen time, and nighttime texting among adolescents?
- 2019
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Ingår i: Journal of international medical research. - 0300-0605 .- 1473-2300.
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesWe aimed to investigate whether sleep duration is associated with self-reported overall health, screen time, and nighttime texting among Swedish adolescents.MethodsThis was a cross-sectional survey of students (n = 1518) aged 13 to 15 years (50.7% girls) in southern Sweden.ResultsFewer than 8 hours sleep duration before a school day was reported by 31% of students. The median time spent watching television and/or at the computer was 3 hours, and 43% of students reported texting at night one or more times per week. Sleeping fewer than 8 hours was significantly associated with poorer self-reported overall health, often being tired at school, increased screen time, and a habit of nighttime texting.ConclusionsShort sleep duration (<8 hours) was associated with poor self-reported health, increased screen time, and nighttime texting among respondents. These results provide information for parents, educators, and school health professionals to encourage young people to adopt healthy screen habits and sleep hygiene.
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| 9. |
- Garmy, Pernilla, et al.
(författare)
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Is sleep duration associated with self-reported overall health, screen time, and nighttime texting among adolescents?
- 2020
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Ingår i: Journal of International Medical Research. - : SAGE Publications. - 1473-2300 .- 0300-0605. ; 48:3, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: We aimed to investigate whether sleep duration is associated with self-reported overall health, screen time, and nighttime texting among Swedish adolescents.METHODS: This was a cross-sectional survey of students (n = 1518) aged 13 to 15 years (50.7% girls) in southern Sweden.RESULTS: Fewer than 8 hours sleep duration before a school day was reported by 31% of students. The median time spent watching television and/or at the computer was 3 hours, and 43% of students reported texting at night one or more times per week. Sleeping fewer than 8 hours was significantly associated with poorer self-reported overall health, often being tired at school, increased screen time, and a habit of nighttime texting.CONCLUSIONS: Short sleep duration (<8 hours) was associated with poor self-reported health, increased screen time, and nighttime texting among respondents. These results provide information for parents, educators, and school health professionals to encourage young people to adopt healthy screen habits and sleep hygiene.
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| 10. |
- Hansson, Erika, et al.
(författare)
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Bullying, health complaints, and self-rated health among school-aged children and adolescents
- 2020
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Ingår i: Journal of International Medical Research. - : SAGE Publications. - 0300-0605 .- 1473-2300. ; 48:2
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the current study was to examine whether health complaints and self-reported health were associated with bullying victimization in a large cohort of Icelandic children and adolescents. Methods: In this study, we used data from a school-based cross-sectional survey, specifically, the Icelandic contribution to the international research network Health Behavior in School-aged Children (HBSC). The study population included all students throughout Iceland in grades 6, 8, and 10 (mean age 13 years, standard deviation 1.61). The participation rate was 84% (N = 11,018). Participating students completed an anonymous standardized questionnaire in their classrooms. Results: Bullying victimization was associated with feeling depressed (odds ratio 2.61), having difficulty falling asleep, dizziness, and low self-reported health. No differences were found between sex and age groups. Conclusions: Children and adolescents who are bullied appear to more often experience depression, difficulties falling asleep, dizziness, and poor health; however, health complaints were also relatively high among non-bullied children and adolescents. Bullying prevention measures must be implemented in children’s and adolescents’ social environments. In addition to assessing bullying interventions, further research should focus on methods of enhancing resilience in this population.
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| 11. |
- Jildenstål, Pether, 1970-, et al.
(författare)
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Spectral edge frequency during general anaesthesia : A narrative literature review.
- 2022
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Ingår i: Journal of international medical research. - : Sage Publications. - 0300-0605 .- 1473-2300. ; 50:8
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Forskningsöversikt (refereegranskat)abstract
- Previous studies have attempted to determine the depth of anaesthesia with different anaesthetic agents using electroencephalogram (EEG) measurements with variable success. Measuring depth of anaesthesia is confounded by the complexity of the EEG and the fact that different agents create different pattens. A narrative review was undertaken to examine the available research evidence on the effect and reliability of spectral edge frequency (SEF) for assessing the depth of anaesthesia in adult patients under general anaesthesia. A systematic search of the PubMed®, Scopus®, CINAHL and Cochrane databases identified six randomized controlled trials and five observational studies. The findings of these studies suggest that SEF varies according to the anaesthetic drugs used. Remifentanil and age are two factors that can affect SEF, while other opioids and benzodiazepine (administered separately) seem to have no effect. No patients experienced intraoperative awareness. However, this does not indicate that SEF can provide full protection against it and the number of articles in which intraoperative awareness was studied was too small to afford any certainty. None of the studies demonstrated a reliable SEF interval associated with adequate general anaesthesia. SEF must be adapted to the anaesthetic drug used, the patient's age and state while under general anaesthesia.
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| 12. |
- KANDER, THOMAS, et al.
(författare)
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Dose-response effects of omega-3 on platelet aggregation: an observational study
- 2018
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Ingår i: Journal of International Medical Research. - : SAGE Publications. - 1473-2300 .- 0300-0605. ; 46:12, s. 5074-5082
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThis study aimed to evaluate the dose-response effects of supplemental omega-3 fatty acids on platelet function in healthy volunteers.MethodsTwelve healthy volunteers ingested a normal supplemental dose of 1260 mg omega-3 fatty acids daily for 5 days, followed by a high dose of 2520 mg daily for another 5 days. Multiple electrode aggregometry (MEA) with four different agonists was used to measure platelet aggregation before and after the normal- and high-dose regimes. In vitro spiking using physiological doses of omega-3 fatty acids was also performed to determine whether MEA is capable of detecting a platelet-inhibiting effect due to omega-3 fatty acids.ResultsThere were no differences in platelet aggregation measured by the MEA assay in healthy volunteers after intake of either the normal or high dose of omega-3 fatty acids. In the in vitro experiment, a platelet-inhibiting effect of omega-3 fatty acids was shown by an arachidonic acid agonist in MEA .ConclusionsSupplemental omega-3 fatty acids do not evoke their positive health effects through inhibition of platelet aggregation measurable with MEA.
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| 13. |
- KANDER, THOMAS, et al.
(författare)
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Effect of hypothermia on haemostasis and bleeding risk : a narrative review
- 2019
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Ingår i: Journal of International Medical Research. - : SAGE Publications. - 0300-0605 .- 1473-2300. ; 47:8, s. 3559-3568
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Forskningsöversikt (refereegranskat)abstract
- It must be remembered that clinically important haemostasis occurs in vivo and not in a tube, and that variables such as the number of bleeding events and bleeding volume are more robust measures of bleeding risk than the results of analyses. In this narrative review, we highlight trauma, surgery, and mild induced hypothermia as three clinically important situations in which the effects of hypothermia on haemostasis are important. In observational studies of trauma, hypothermia (body temperature <35°C) has demonstrated an association with mortality and morbidity, perhaps owing to its effect on haemostatic functions. Randomised trials have shown that hypothermia causes increased bleeding during surgery. Although causality between hypothermia and bleeding risk has not been well established, there is a clear association between hypothermia and negative outcomes in connection with trauma, surgery, and accidental hypothermia; thus, it is crucial to rewarm patients in these clinical situations without delay. Mild induced hypothermia to ≥33°C for 24 hours does not seem to be associated with either decreased total haemostasis or increased bleeding risk.
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| 14. |
- Laine, MK, et al.
(författare)
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Drug purchases prior to conception and the risk of gestational diabetes mellitus
- 2022
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Ingår i: The Journal of international medical research. - : SAGE Publications. - 1473-2300 .- 0300-0605. ; 50:11, s. 3000605221138455-
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Tidskriftsartikel (refereegranskat)abstract
- Some drugs have adverse effects on glucose metabolism, but it is unknown whether prescription drugs used prior to conception influence the future risk of gestational diabetes mellitus (GDM). Our study evaluated whether the purchase of prescription drugs 6 months prior to conception was associated with the occurrence of GDM. Methods This cohort study enrolled women with a Finnish background who delivered between 2009 and 2015 in the city of Vantaa, Finland (N = 10,455). Data on maternal characteristics and prescription drug purchases were obtained from national health registers. The use of a unique personal identification number enabled us to combine the register data on an individual level. Results Six months prior to conception, women who had pregnancies complicated by GDM purchased more prescription drugs than women without GDM (1.38 ± 2.04 vs. 1.11 ± 1.80). The GDM risk was higher in women with higher numbers of prescription purchases and those with more than three deliveries. Conclusions Multiparous women who purchase several prescription drugs should be given personalized counseling to prevent GDM.
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| 15. |
- Liang, HD, et al.
(författare)
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A case report: Non-alcoholic Wernicke encephalopathy associated with polyneuropathy
- 2017
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Ingår i: The Journal of international medical research. - : SAGE Publications. - 1473-2300 .- 0300-0605. ; 45:6, s. 1794-1801
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Tidskriftsartikel (refereegranskat)abstract
- We report a rare case of non-alcoholic Wernicke encephalopathy (WE) with polyneuropathy. A 24-year-old woman who had recently served a 4-month prison sentence and underwent a short period of dieting manifested slow response, weakness, language disorder and amnesia. Brain magnetic resonance imaging (MRI) revealed typical lesions of WE. Examination of nerve conduction velocity revealed sensory-motor axonal polyneuropathy. The patient was immediately treated with thiamine. Neurological symptoms were alleviated in a few days and abnormal signals were markedly decreased in a follow-up MRI 1 week later. Polyneuropathy symptoms ameliorated during hospital therapy and significantly improved after 4 months. This case suggests that WE may be associated with polyneuropathy in non-alcoholic patients. Early thiamine treatment in symptomatic patients may improve prognosis.
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| 16. |
- Oelerich, Ole, et al.
(författare)
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Temporomandibular disorders among Ehlers-Danlos syndromes : a narrative review
- 2024
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Ingår i: Journal of international medical research. - : Sage Publications. - 0300-0605 .- 1473-2300. ; 52:4
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Tidskriftsartikel (refereegranskat)abstract
- This narrative review aims to demonstrate and summarize the complex relationship between Ehlers-Danlos syndromes (EDS) and temporomandibular disorders (TMD) by reviewing the results of observational studies and case reports. EDS are a set of hereditary connective tissue disorders, where generalized joint hypermobility (GJH), especially in the hypermobile subtype (hEDS), is a key symptom. Mutations have been identified in genes that impact the production or assembly of collagen for all subtypes except hEDS. While the correlation between GJH and TMD has been analysed in various studies, fewer studies have examined TMD in patients with EDS, with most showing an increased prevalence of TMD. In case–control studies, an elevated prevalence of myalgia, arthralgia and disc-related disorders was found in individuals with EDS. Various therapeutic interventions have been reported within the literature in the form of case reports and observational studies, but there are no long-term clinical trials with results on the efficacy of different therapeutic approaches to date. This review demonstrates the high prevalence of different TMDs in different subtypes of EDS, but also shows that little is known about the success of treatment thus far. Further clinical research is necessary to provide adequate guidance on targeted treatment.
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| 17. |
- Rivano Fischer, Marcelo, et al.
(författare)
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Do quality of life, anxiety, depression and acceptance improve after interdisciplinary pain rehabilitation? A multicentre matched control study of acceptance and commitment therapy-based versus cognitive–behavioural therapy-based programmes
- 2021
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Ingår i: Journal of International Medical Research. - : SAGE Publications. - 0300-0605 .- 1473-2300. ; 49:7
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Interdisciplinary pain rehabilitation (IPR) usually employs a cognitive–behavioural therapeutic (CBT) approach. However, there is growing support for chronic pain treatments based on acceptance and commitment therapy (ACT). Most studies of ACT and CBT for chronic pain have evaluated their effects after psychological interventions, not after IPR. We compared the results of an ACT-based IPR programme with two CBT-based IPR programmes. Methods: We used a retrospective multicentre pretest–posttest design with matched patient groups at three centres. Data were collected from the Swedish Quality Registry for Pain Rehabilitation before and after IPR participation. Participants completed the EQ-5D health-related quality of life questionnaire, the Chronic Pain Acceptance Questionnaire, (CPAQ) and the Hospital Anxiety and Depression Scale (HADS). Analyses were performed to compare the effects of the different interventions. Results: Neither EQ-5D nor HADS depression scores were affected by the psychological approach used. The score changes on both CPAQ subscales (activity engagement and pain willingness) indicated significant improvements between admission and discharge at all centres. Conclusions: These findings indicate the effectiveness of using psychological approaches to manage chronic pain. Both CBT and ACT had a beneficial effect on most of the assessed health-related parameters.
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| 18. |
- Rot, U, et al.
(författare)
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Impression of clinical worsening fails to predict interferon-beta neutralizing antibody status
- 2008
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Ingår i: The Journal of international medical research. - : SAGE Publications. - 0300-0605 .- 1473-2300. ; 36:6, s. 1418-1425
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Tidskriftsartikel (refereegranskat)abstract
- The development of neutralizing antibodies (NAbs) against interferon-β (IFNβ) reduces clinical efficacy and markers of bioactivity in patients with multiple sclerosis (MS), although it has also been shown that a poor response to IFNβ coincided with unexpectedly low NAb levels. To try and resolve this incoherency, this study investigated 2822 patients referred to a NAb testing facility. The reason for NAb testing was indicated for 2506 patients: routine testing (76%), worsening of disease (14%) and other reasons (10%). Overall, 31% of patients were NAb positive and 17% had titres high enough to obliterate IFNβ bioactivity. The frequency of NAbs was similar in patients in the routine testing group compared with the worsening group. Samples showing high titres failed to be associated with worsening of symptoms. The study failed to show low NAb levels in patients responding poorly to IFNβ. It is concluded that it is not possible to predict NAb status by clinical impression of treatment response. This is likely to be an effect of the partial efficacy of IFNβ. Thus routine testing for NAbs must be carried out in order to identify NAb status in patients with MS.
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| 19. |
- Sollerhed, Ann-Christin, 1954-, et al.
(författare)
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Adolescent physical activity-related injuries in school physical education and leisure-time sports
- 2020
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Ingår i: Journal of international medical research. - 0300-0605 .- 1473-2300. ; 48:9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aims of this study were to investigate the prevalence of sports injuries in school physical education (PE) and leisure-time sports among 1011 15- to 16-year-old adolescents in relation to physical activity, and to examine goal orientation.METHODS: A survey was used with additional narrative descriptions.RESULTS: There was a higher prevalence of injuries in leisure time (645/993 = 65%) than in PE (519/998 = 52%). Two groups with high PE injury rates were identified: a) highly active (258/998 = 26%) in both school PE and leisure-time sports and b) highly inactive (180/998 = 18%) in both contexts. There were no differences between girls and boys. Task-oriented adolescents were more prone to injury.CONCLUSIONS: The high prevalence of injuries in PE appears to have two mechanisms: renewed inadequately recovered leisure-time injuries among highly active adolescents, and injuries among fragile inactive adolescents unfamiliar with exercise. PE educators of these two groups with different injury patterns have a considerable didactic challenge. Knowledge of inadequately recovered injuries and consideration of the high volume and intensity of early sport-specific training in children and adolescents are important parameters in the design of lesson plans for PE.
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| 20. |
- Sollerhed, Ann-Christin, et al.
(författare)
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Adolescent physical activity-related injuries in school physical education and leisure-time sports
- 2020
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Ingår i: Journal of International Medical Research. - : SAGE Publications Inc.. - 0300-0605 .- 1473-2300. ; 48:9
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aims of this study were to investigate the prevalence of sports injuries in school physical education (PE) and leisure-time sports among 1011 15- to 16-year-old adolescents in relation to physical activity, and to examine goal orientation. METHODS: A survey was used with additional narrative descriptions. RESULTS: There was a higher prevalence of injuries in leisure time (645/993 = 65%) than in PE (519/998 = 52%). Two groups with high PE injury rates were identified: a) highly active (258/998 = 26%) in both school PE and leisure-time sports and b) highly inactive (180/998 = 18%) in both contexts. There were no differences between girls and boys. Task-oriented adolescents were more prone to injury. CONCLUSIONS: The high prevalence of injuries in PE appears to have two mechanisms: renewed inadequately recovered leisure-time injuries among highly active adolescents, and injuries among fragile inactive adolescents unfamiliar with exercise. PE educators of these two groups with different injury patterns have a considerable didactic challenge. Knowledge of inadequately recovered injuries and consideration of the high volume and intensity of early sport-specific training in children and adolescents are important parameters in the design of lesson plans for PE.
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| 21. |
- Syvalahti, EKG, et al.
(författare)
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Citalopram causes no significant alterations in plasma neuroleptic levels in schizophrenic patients
- 1997
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Ingår i: The Journal of international medical research. - : SAGE Publications. - 0300-0605 .- 1473-2300. ; 25:1, s. 24-32
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Tidskriftsartikel (refereegranskat)abstract
- Steady-state plasma concentrations of commonly used neuroleptic drugs were measured in 90 schizophrenic patients before and after adding placebo or citalopram (40 mg/day) to their treatment regimen. Plasma concentrations of citalopram and its main metabolite, desmethylcitalopram, were also measured. In addition, patients with exceptionally high neuroleptic levels or an increase in adverse effects during the 12-week study period were evaluated for their debrisoquine/sparteine hydroxylase (CYP2D6) genotype, an enzyme responsible for oxidative metabolism of several neuroleptics and selective serotonin re-uptake inhibitors. There were no significant changes in plasma concentrations of haloperidol, chlorpromazine, zuclopenthixol, levomepromazine, thioridazine or perphenazine during the study. Plasma concentrations of citalopram and desmethylcitalopram were well within the levels reported previously with monotherapy, and remained stable throughout the study. None of the 15 patients analysed for the CYP2D6 genotype was a poor metabolizer. It is concluded that clinically important pharmacokinetic drug interactions do not play a crucial role when citalopram is used as an augmentation therapy in neuroleptic-treated schizophrenic patients.
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| 22. |
- Thurm, Mascha, et al.
(författare)
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Spinal anaesthesia with clonidine: pain relief and earlier mobilisation after open nephrectomy – a randomised clinical trial
- 2022
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Ingår i: Journal of international medical research. - : Sage Publications. - 0300-0605 .- 1473-2300. ; 50:9, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Early mobilisation and effective pain management after open nephrectomy for renal cell carcinoma often include epidural analgesia (EDA), requiring an infusion pump and a urinary catheter, thus impeding mobilisation. Spinal anaesthesia (SpA) may be an alternative. This randomised clinical trial evaluated whether SpA improves analgesia and facilitates mobilisation over EDA and which factors influence mobilisation and length of stay (LOS).Methods: Between 2012 and 2015, 135 patients were randomised and stratified by surgical method to either SpA with clonidine or EDA. Mobility index score (MobIs), pain scale, patient satisfaction questionnaire, and LOS were the main outcome measures.Results: SpA patients exhibited an increase in MobIs significantly earlier than EDA patients. Among SpA patients >50% reached MobIs ≥13 by postoperative day 3, while 29% of EDA patients never reached MobIs ≥13 before discharge. SpA patients had higher maximum pain scores on postoperative days 1 and 2, but both groups had similar patient satisfaction. One day before discharge, 36/64 SpA versus 22/67 EDA patients (56% and 33%, respectively) were opioid-free. SpA patients were discharged significantly earlier than EDA patients.Conclusions: SpA facilitates postoperative pain management and is associated with faster mobilisation and shorter LOS.The trial was registered at ClinicalTrials.org (ID-NCT02030717).
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| 23. |
- Toft Morén, Amelie, 1994, et al.
(författare)
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Remarkable effects of infliximab on severe radiation-induced side effects in a patient with uterine cervical cancer: a case report
- 2023
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Ingår i: Journal of International Medical Research. - 0300-0605 .- 1473-2300. ; 51:12
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Tidskriftsartikel (refereegranskat)abstract
- Pelvic radiotherapy is a powerful treatment for a broad range of cancers, including gynecological, prostate, rectal, and anal cancers. Despite improvements in the delivery of ionizing beams, damage to non-cancerous tissue can cause long-term effects that are potentially severe, affecting quality of life and daily function. There is an urgent need for new strategies to treat and reverse the side effects of pelvic radiotherapy without compromising the antitumor effect. A woman with severe radiation-induced intestinal side effects was treated with the tumor necrosis factor-alpha inhibitor infliximab with a dose of 3 mg/kg every 4 to 6 weeks. With infliximab treatment, a remarkable improvement in her bowel health was observed. The patient’s late bowel toxicity was reduced from Grade 2 to Grade 0 (RTOG/EORTC Late Radiation Morbidity Scale). Although it is necessary to proceed cautiously because of the risk of serious side effects from immunosuppressants, our case suggests that infliximab can be used to treat symptoms of chronic bowel dysfunction after radiotherapy.
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| 24. |
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| 25. |
- Kafkasi, A., et al.
(författare)
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Clinical correlation between adenosine deaminase activity and pre-eclampsia severity
- 2006
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Ingår i: Journal of International Medical Research. - 1473-2300. ; 34:3, s. 247-255
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated the relationship between the activity of the inflammatory indicator adenosine deaminase (ADA) in placental tissue and maternal and fetal (umbilical cord) plasma and the severity of pre-eclampsia. Maternal and umbilical vein whole blood and placental tissue samples were collected from women with normal pregnancies (n = 33) and patients with mild (n = 12) or severe (n = 17) pre-eclampsia. ADA activity was measured spectrophotometrically. Significantly increased ADA activity was detected in maternal and fetal plasma, and placental tissue in patients with mild and severe pre-eclampsia compared with normal pregnancies; there were no significant differences between the mild and severe cases. The presence of increased ADA activity in pre-eclampsia is consistent with activation of the inflammatory system in this condition. The increased ADA activity was related to the presence of the disease but not the severity of clinical symptoms. Neonatal outcome did not significantly correlate with observed ADA activity.
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| 26. |
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| 27. |
- Gerhardsson, Lars, 1952, et al.
(författare)
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Cerebrospinal fluid/plasma quotients of essential and non-essential metals in patients with Alzheimer's disease.
- 2011
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Ingår i: Journal of neural transmission (Vienna, Austria : 1996). - : Springer Science and Business Media LLC. - 1435-1463 .- 0300-9564. ; 118:6, s. 957-62
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Tidskriftsartikel (refereegranskat)abstract
- In this study, the quotients (Q) between metal concentrations in cerebrospinal fluid (CSF) and plasma were studied in subjects with Alzheimer's disease (AD) and referents to investigate if the leakage through the blood-CSF barrier (BCB) increased with increased duration and severity of the disease. Concentrations of 18 metals (Mg, Ca, Mn, Fe, Co, Ni, Cu, Zn, Se, Rb, Sr, Mo, Cd, Sn, Sb, Cs, Hg, and Pb) were determined by ICP-MS in plasma and cerebrospinal fluid in 264 patients with AD, and in 54 healthy referents. The quotients Q (Mn), Q (Rb), Q (Sb), Q (Pb) and Q (Hg) were significantly lower (p≤0.003) and Q (Co) significantly higher (p≤0.001) in subjects with AD as compared with the controls. Subjects in a subgroup with more severe AD, showed the same pattern. The metal leakage into CSF did not increase with increased duration and/or severity of the disease. The permeability of BCB varied considerably between the studied metals with low median quotients (Q≤0.02) for Cd, Cu, Sb, Se and Zn and higher median quotients for Ca (Q~0.5) and Mg (Q~1.3), probably partly depending on differences in size and lipophilicity of metal-carrier complexes and specific carrier mechanisms.
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