| 1. |
- Bartosik, I, et al.
(författare)
-
Correlation between plasma concentrations of calcitonin gene related peptide and pulmonary pressure in patients with systemic sclerosis.
- 2002
-
Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 61:3, s. 261-263
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine plasma levels of calcitonin gene related peptide (p-CGRP) in patients with systemic sclerosis (SSc) and pulmonary hypertension (PH). MATERIAL AND METHODS: Twenty nine patients with SSc, 10 with diffuse form, 18 with limited form and one with overlapping systemic lupus erythematosus were examined. Twelve patients displayed normal systolic pulmonary artery pressure (PAPsyst) < or =30 mm Hg and 17 increased PAPsyst
|
|
| 2. |
- Chizzolini, C, et al.
(författare)
-
Systemic sclerosis Th2 cells inhibit collagen production by dermal fibroblasts via membrane-associated tumor necrosis factor alpha
- 2003
-
Ingår i: Arthritis and Rheumatism. - : Wiley. - 1529-0131 .- 0004-3591. ; 48:9, s. 2593-2604
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. In systemic sclerosis (SSc; scleroderma), T cells infiltrate organs undergoing fibrotic changes and may participate in dysregulated production of collagen by fibroblasts. The objective of this study was to functionally characterize T cells infiltrating skin lesions in early SSc and investigate their capacity to affect production of type I collagen and interstitial collagenase (matrix metalloproteinase 1 [MMP-1]) by dermal fibroblasts. Methods. Four-color cytometric analysis was used to characterize subset distribution and production of interferon-gamma (IFNgamma) and interleukin-4 (IL-4) in T cell lines generated from the skin of patients with SSc. T cell clones were generated, and their capacity to modulate collagen and MMP-1 production by fibroblasts derived from patients with SSc and from normal individuals was assessed. Neutralizing reagents were used to identify T cell mediators involved in fibroblast modulation. Results. The skin of individuals with early-stage SSc contained T cells preferentially producing high levels of IL-4. Cloned CD4+ Th2-like cells inhibited collagen production by normal fibroblasts. Th2 cell-dependent inhibition was, at least in part, contact-dependent, was essentially mediated by tumor necrosis factor alpha (TNFalpha), and was dominant over the enhancement induced by profibrotic IL-4 and transforming growth factor beta cytokines. The simultaneous induction of MMP-1 production confirmed the specificity of these observations. To be inhibitory, Th2 cells required activation by CD3 ligation. Th2 cells were less potent than were Th1 cells in inhibiting collagen production by normal fibroblasts via cell-to-cell interaction, and SSc fibroblasts were resistant to inhibition. Conclusion. These findings indicate that, despite their production of IL-4, Th2 cells reduce type I collagen synthesis by dermal fibroblasts because of the dominant effect of TNFalpha, and suggest that strategies based on TNFalpha blockade aimed at controlling fibrosis in SSc may be unwise.
|
|
| 3. |
- Denton, Christopher P., et al.
(författare)
-
Recombinant human anti-transforming growth factor beta 1 antibody therapy in systemic sclerosis - A multicenter, randomized, placebo-controlled phase I/II trial of CAT-192
- 2007
-
Ingår i: Arthritis and Rheumatism. - : Wiley. - 1529-0131 .- 0004-3591. ; 56:1, s. 323-333
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. To evaluate CAT-192, a recombinant human antibody that neutralizes transforming growth factor beta 1 (TGF beta 1), in the treatment of early-stage diffuse cutaneous systemic sclerosis (dcSSc). Methods. Patients with SSc duration of < 18 months were randomly assigned to the placebo group or to 1 of 3 CAT-192 treatment groups: 10 mg/kg, 5 mglkg, 0.5 mg/kg. Infusions were given on day 0 and weeks 6, 12, and 18. The primary objective of this study was to evaluate the safety, tolerability, and pharmacokinetics of CAT-192. Secondary outcomes included the modified Rodnan skin thickness score (MRSS), the Scleroderma Health Assessment Questionnaire, assessment of organ-based disease, serum levels of soluble interleukin-2 receptor, collagen propeptides (N propeptide of type I [PINP] and type III collagen), and tissue levels of messenger RNA for procollagens I and III and for TGF beta 1 and TGF beta 2. Results. Forty-five patients were enrolled. There was significant morbidity and mortality, including I death in the group receiving 0.5 mg/kg of CAT-192 and 3 deaths in the group receiving 5 mg/kg of CAT-192. There were more adverse events and more serious adverse events in patients receiving CAT-192 than in those receiving placebo, although these events were not more frequent in the high-dose treatment group. The MRSS improved in all groups during the study, but there was no evidence of a treatment effect for CAT-192. Improvement in the MRSS correlated with the disease duration (r = -0.54, P = 0.0008). Changes in the PINP level from baseline correlated with changes in the MRSS (r = 0.37, P = 0.027). Conclusion. We report the first evaluation of a systemically administered and repeatedly dosed anti-TGF beta 1 drug. In this pilot study, CAT-192, in doses up to 10 mg/kg, showed no evidence of efficacy. The utility of clinical and biochemical outcome measures and the feasibility of multicenter trials of early dcSSc were confirmed.
|
|
| 4. |
- Hesselstrand, Roger, et al.
(författare)
-
High-frequency ultrasound of skin involvement in systemic sclerosis reflects oedema, extension and severity in early disease.
- 2008
-
Ingår i: Rheumatology (Oxford, England). - : Oxford University Press (OUP). - 1462-0332 .- 1462-0324. ; 47:1, s. 84-87
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim was to compare skin assessment by palpation and by high-frequency ultrasound in patients with SSc with disease duration <2 yrs. METHODS: Skin thickness and skin echogenicity were measured by 20 MHz ultrasound at five different anatomical sites in 106 individuals within 2 yrs from the first non-Raynaud's symptom and compared with the modified Rodnan skin score (mRss). RESULTS: The patients with short disease duration were characterized by high skin thickness and low skin echogenicity, which correlated inversely, reflecting oedema. Patients with diffuse skin involvement displayed higher skin thickness and lower skin echogenicity than did patients with limited skin involvement. The ultrasound measurements correlated to the local mRss from the corresponding anatomical region and also to the total mRss. However, there was a considerable overlap in both skin thickness and skin echogenicity between different local mRss at all five anatomical sites. Skin involvement of the chest could be detected earlier by ultrasound than by palpation. CONCLUSION: In SSc patients with short disease duration, high-frequency ultrasound can identify the oedematous phase that may precede palpable skin involvement and may thus be useful to identify patients with diffuse skin involvement very early in the disease process. Ultrasound measurements also reflect the severity of the overall skin involvement.
|
|
| 5. |
- Hesselstrand, Roger, et al.
(författare)
-
Mortality and causes of death in a Swedish series of systemic sclerosis patients
- 1998
-
Ingår i: Annals of the Rheumatic Diseases. - 1468-2060. ; 57:11, s. 682-686
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To analyse survival rates and the causes of death in a systemic sclerosis (SSc) population, and to evaluate the occurrence of fatal malignant neoplasms and their possible association with oral cyclophosphamide (CYC) treatment. METHODS: Survival was calculated for 249 SSc patients followed up for up to 13 years. Mean (SD) follow up was 5.8 (4.2) years. The 49 decreased patients were subdivided according to causes of death and its relation to SSc. Fatal malignancies in CYC treated patients were compared with those occurring in non-CYC treated patients. RESULTS: The overall 5 and 10 year survival rates were 86% and 69% respectively. There was a 4.6-fold increased risk of death, as compared with the general population. Prognosis was worse in the diffuse cutaneous involvement (dSSc) and male subgroups than in the limited cutaneous involvement (1SSc) and female subgroups. Of the 49 deaths, 24 were attributable to pulmonary complications such as pulmonary fibrosis, pulmonary hypertension, pneumonia or pulmonary malignancy. Treatment with oral CYC did not increase the risk of dying of cancer. CONCLUSIONS: Mortality is increased both in the SSc population as a whole and in its different subsets (dSSc and 1SSc). Prognosis is worst among male patients with dSSc. However, the 5 year survival rate was better than those reported from earlier studies. Most patients die of cardiopulmonary disease. Five of seven fatal lung cancers were adenocarcinomas, possibly caused by chronic inflammatory disease of the lung. In this study, CYC treatment was not associated with an increased incidence of fatal malignant neoplasms.
|
|
| 6. |
|
|
| 7. |
- Hesselstrand, Roger, et al.
(författare)
-
The association between changes in skin echogenicity and the fibroblast production of biglycan and versican in systemic sclerosis
- 2002
-
Ingår i: Clinical and Experimental Rheumatology. - 1593-098X. ; 20:3, s. 301-308
-
Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate a possible association between the longitudinal changes in skin involvement and the fibroblast production of proteoglycans in vitro, among patients with early and untreated systemic sclerosis (SSc). Methods In 11 patients, 6 with diffuse cutaneous systemic sclerosis (dSSc) and 5 with limited cutaneous systemic sclerosis (lSSc), and in 6 controls skin thickness and skin echogenicity, of the forearm was measured by high frequency (20 MHz) ultrasound, A skin biopsy was taken from the area of the ultrasound measurements, and from cultivated fibroblasts the production of the proteoglycans versican, perlecan, biglycan and decorin were measured. To investigate longitudinal changes in skin involvement, the ultrasound examination was repeated after 1-3 years. Results Compared to controls, SSc Patients had increased skin thickness at the first evaluation. Patients with dSSc had lower skin echogenicity than both patients with ISSc and the controls. Patients with greater changes in skin thickness and skin echogenicity produced more versican, whereas the production of biglycan and decorin was higher only, in patients with greater changes in skin echogenicity. There was a negative correlation between fibroblast production of biglycan and disease duration. Conclusion High fibroblast synthesis of the proteoglycans versican and biglycan is associated with changes in skin echogenicity and may predict more progressive skin sclerosis in SSc.
|
|
| 8. |
|
|
| 9. |
- Kurti, Erdelina
(författare)
-
Institutional Tensions and Complexity in the Digital Innovation of Incumbent Business Models
- 2020
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Digitalization has influenced all areas of our lives, including businesses. It has provided numerous opportunities to organisations; at the same time, it has significantly challenged established business models in many sectors that were traditionally proven to be stable and successful, thus a need to innovate was called for. In this research the focus is on the newspaper industry, representing one of the contexts which has been highly affected by digitalization. Digital technologies enable new ways of operating which in turn challenge prevailing business assumptions and cause complexities. This leads to the aim of this research which is to explore institutional complexity in digital business model innovation in a newspaper organization.This research builds on business model theory, conceptualized as an activity system. It adds literature from digital innovation and finally utilizes institutional logics to explore the complexity emerging in the avenue of digital business model innovation. A case study design has been undertaken drawing on several data sources such as: interviews, observations and the study of documents.The outcome of this research illustrates that digitalization has a profound impact on business models of newspaper organizations. Innovation brought by digitalization entailed challenges but also enabled complementarities in value offering, activities, and competences, including new actors entering the market. The complementarities caused complexity based on different institutional logics, each with its own rationality, which needed to be governed. Research outcomes also include institutional mechanisms that were applied to govern the digital business model innovation, such as strategies leading to a hybrid of print and digital mode of operation; and also more concrete purposive actions and activities in the form of e.g. education and learning, theorization and top management commitment.This research contributes to the theoretical frameworks of business model innovation, digital business model innovation and institutional logics, both separately and in combination. Further, the research provides some recommendations to practice for managing the complexity that digitalization of incumbents entails.
|
|
| 10. |
- Lagerlöf, Ingemar, et al.
(författare)
-
No excess long-term mortality in stage I-IIA Hodgkin lymphoma patients treated with ABVD and limited field radiotherapy
- 2020
-
Ingår i: British Journal of Haematology. - : John Wiley & Sons. - 0007-1048 .- 1365-2141. ; 188:5, s. 685-691
-
Tidskriftsartikel (refereegranskat)abstract
- When treating limited stage classical Hodgkin lymphoma (cHL), balancing treatment efficacy and toxicity is important. Toxicities after extended-field radiotherapy are well documented. Investigators have aimed at reducing toxicity without compromising efficacy, mainly by using combined modality treatment (CMT), i.e. chemotherapy and limited-field radiotherapy. In some clinical trials, radiotherapy has been omitted. We evaluated 364 patients with stage I-IIA cHL treated between 1999 and 2005. Patients were treated with two or four cycles of doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) according to presence of risk factors, followed by 30 Gy limited-field (reduced compared to involved-field) radiotherapy. After a median follow-up of 16 years for survival, freedom from progression at five and ten years was 93% and overall survival at 5 and 10 years was 98% and 96%, respectively. Only two relapses, out of 27, occurred after more than 5 years. There was no excess mortality compared to the general population. Of the analysed subgroups, only patients with progression within five years showed significant excess mortality. The absence of excess mortality questions the concept of omitting radiotherapy after short-term chemotherapy, a strategy that has been associated with an elevated risk of relapse but not yet with a proven reduced long-term excess mortality.
|
|
| 11. |
- Merkel, Peter A, et al.
(författare)
-
Validity, reliability, and feasibility of durometer measurements of scleroderma skin disease in a multicenter treatment trial
- 2008
-
Ingår i: Arthritis and Rheumatism. - : Wiley. - 1529-0131 .- 0004-3591. ; 59:5, s. 699-705
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. To determine the validity, reliability, and feasibility of durometer measurements of skin hardness as an outcome measure in clinical trials of scleroderma. Methods. Skin hardness was measured during a multicenter treatment trial for scleroderma using handheld digital durometers with a continuous scale. Skin thickness was measured by modified Rodnan skin score (MRSS). Other outcome data collected included the Scleroderma Health Assessment Questionnaire. In a reliability exercise in advance of the trial, 9 investigators examined the same 5 scleroderma patients by MRSS and durometry. Results. Forty-three patients with early diffuse cutaneous systemic sclerosis were studied at 11 international centers (mean age 49 years [range 24-76], median disease duration 6.4 months [range 0.3-23], and median baseline MRSS 22 [range 11-38]). The reliability of durometer measurements was excellent, with high interobserver intraclass correlation coefficients (ICCs) (0.82-0.92), and each result was greater than the corresponding skin site ICCs for MRSS (0.54-0.85). Baseline durometer scores correlated well with MRSS (r = 0.69, P < 0.0001), patient self-assessments of skin disease (r = 0.69, P < 0.0001), and Health Assessment Questionnaire (HAQ) disability scores (r = 0.34, P = 0.03). Change in durometer scores correlated with change in MRSS (r = 0.70, P < 0.0001.), change in patient self-assessments of skin disease (r = 0.52, P = 0.003), and change in HAQ disability scores (r = 0.42, P = 0.017). The effect size was greater for durometry than for MRSS or patient self-assessment. Conclusion. Durometer measurements of skin hardness in patients with scleroderma are reliable, simple, accurate, demonstrate good sensitivity to change compared with traditional skin scoring, and reflect patients' self-assessments of their disease. Durometer measurements are valid, objective, and scalable, and should be considered for use as a complementary outcome measure to skin scoring in clinical trials of scleroderma.
|
|
| 12. |
- Persson, Nils-Krister, et al.
(författare)
-
Re: en ny samhällssektor spirar
- 2016
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Resurser och hållbarhet är nära förknippade. Hållbarhet innebär att hushålla med resurser - materiella, miljömässiga och mänskliga. Och hushållning är per definition kärnan i ekonomi. Man börjar alltmer se framväxten av en hel arsenal av verktyg och förhållnings- och angreppssätt för att bygga hållbarhet. Detta förenas av ett synsätt att det som hitintills setts om avfall och värdelöst, och rent utav besvärligt att ta hand om, nu blir en värdefull resurs. Det glömda och gömda kommer åter. Faktum är att många ord och begrepp kring detta börjar på just åter- eller re- . Internationellt talar man om Redesign, Recycling, Remake, Recycle, Recraft, Reuse, Recreate, Reclaim, Reduce, Repair, Refashion.Vad är då allt detta? Ja, vill man dra det långt, är det inte mindre än framväxten av ett nyvunnet sätt att tänka, ja av en ny samhällssektor, en bransch och en industri, sammanbundet av filosofin att återanvändningen, spillminskningen, vidarebruket, efterlivet anses som viktiga faktorer för ett miljömedvetet samhälle. Re: blir paraplytermen för detta. I denna antologi av forskare från skilda discipliner vid Högskolan i Borås lyfts ett antal av dessa begrepp inom Re: fram.
|
|
| 13. |
|
|
| 14. |
|
|
| 15. |
- Sandqvist, Gunnel, et al.
(författare)
-
Evaluation of paraffin bath treatment in patients with systemic sclerosis.
- 2004
-
Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 26:16, s. 981-987
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the effects of treatment with paraffin bath in patients with systemic sclerosis (scleroderma). Methods: In 17 patients with scleroderma one hand was treated daily with paraffin bath in combination with hand exercise. The other hand was treated with exercise only and was considered a control. Hand function was estimated before treatment and after 1 month of treatment, concerning hand mobility and grip force, and perceived pain, stiffness and skin elasticity. Results: At the follow-up, finger flexion and extension, thumb abduction, volar flexion in the wrist, and perceived stiffness and skin elasticity had improved significantly in the paraffin-treated hand compared with the baseline values. The improved hand function was independent of skin score and disease duration. Improvements in function were significantly greater in the hand which was treated with paraffin bath and exercise than in the hand treated with exercise only concerning extension deficit, perceived stiffness and skin elasticity. Conclusions: In this pilot study hand exercise in combination with paraffin bath seemed to improve mobility, perceived stiffness and skin elasticity. However, further studies with larger sample size are needed to attain more reliable results of the effect of paraffin bath treatment in patients with scleroderma.
|
|
| 16. |
- Scheja, Agneta, et al.
(författare)
-
BAL fluid derived fibroblasts differ from biopsy derived fibroblasts in systemic sclerosis.
- 2007
-
Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 1399-3003 .- 0903-1936. ; 29:3, s. 446-452
-
Tidskriftsartikel (refereegranskat)abstract
- Growth of fibroblasts from bronchoalveolar lavage fluid (BALF) in patients with systemic sclerosis (SSc) has previously been described. The purpose of the present study was to characterise fibroblasts from BALF and bronchial biopsies from SSc patients with alveolitis and from controls, to analyse fibroblast proliferation, migration, stress fibres and proteoglycan production. BALF and bronchial biopsies were collected from 10 patients with SSc and alveolitis and from 15 controls. Outgrowth of fibroblasts was observed from the BALF of four patients, particularly in those with a markedly increased percentage of eosinophils in BALF, but not in any member of the control group. Increased levels of granulocyte-macrophage colony-stimulating factor, correlating with the percentage of eosinophils in BALF, were found in patients when compared with controls. Fibroblasts from BALF showed an elongated, mobile phenotype and increased proteoglycan production compared to the corresponding biopsy fibroblasts. In conclusion, outgrowth of fibroblasts with an altered phenotype is reported from bronchoalveolar lavage fluid in systemic sclerosis patients with alveolitis and an increased percentage of eosinophils in the bronchoalveolar lavage fluid. These findings indicate a possible role for eosinophil-fibroblast interaction in pulmonary fibrosis in systemic sclerosis.
|
|
| 17. |
|
|
| 18. |
|
|
| 19. |
|
|
| 20. |
- Scheja, Agneta, et al.
(författare)
-
Von Willebrand factor propeptide as a marker of disease activity in systemic sclerosis (scleroderma)
- 2001
-
Ingår i: Arthritis Research & Therapy. - : Springer Science and Business Media LLC. - 1465-9913 .- 1465-9905. ; 3:3, s. 178-182
-
Tidskriftsartikel (refereegranskat)abstract
- In 44 consecutive patients with systemic sclerosis (SSc), plasma concentrations of von Willebrand factor (vWf) were higher than those of the vWf propeptide, but the propeptide showed less variability within patient subgroups. Higher values of the propeptide were observed in patients with early pulmonary involvement. A closer correlation of the propeptide than of vWf to biochemical markers of activity was also evident. Our results suggest that the propeptide, despite a shorter circulating half-time and lower plasma concentrations than vWf, is more useful in the assessment of disease activity in SSc.
|
|
| 21. |
- Seiger Cronfalk, Berit, et al.
(författare)
-
A qualitative study-Patient experience of tactile massage after stroke.
- 2020
-
Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 7:5, s. 1446-1452
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim was to evaluate emotional experiences of gentle skin massage, combined with regular rehabilitation in patients shortly after being diagnosed with stroke.Design: A randomized study with two groups: standard individualized rehabilitation and tactile massage for 20 min three times per week (max nine times) or individual standardized rehabilitations.Methods: This study applied a qualitative approach using semi-structured questions to evaluate experiences of receiving tactile massage among patients with first-time-ever stroke. The interviews lasted between 6-25 min and analysed using manifest content analysis. Data was collected between 2015-2017. This study applies to the COREQ checklist.Results: Eight patients >18 years of age participated. The participants experienced emotional worries especially during the night hours affecting their sleep negatively. Receiving tactile massage was reported to relax and to ease worries and anxiety momentarily, during the session and for a longer period. The results also show that physical touch generates feelings of closeness. The findings will be presented in two categories: Human touch and The future.
|
|
| 22. |
|
|
| 23. |
- Svensson, Bengt-Göran, et al.
(författare)
-
Exposure to dioxins and dibenzofurans through the consumption of fish
- 1991
-
Ingår i: New England Journal of Medicine. - 0028-4793. ; 324, s. 8-12
-
Tidskriftsartikel (refereegranskat)abstract
- Background.In some regions, including the Baltic Sea, fatty fish such as salmon and herring contain high levels of polychlorinated dibenzodioxins and dibenzofurans. We investigated human exposure to these potentially toxic substances in relation to the consumption of fish from the Baltic Sea.Methods.Plasma levels of 10 different dibenzofurans and 7 dioxins were analyzed in three groups of Swedish men: one group with a high intake of fish (fish eaten almost daily; n = 11), one with a moderate intake of fish (about once per week; n = 9), and one with no consumption of fish (usually because of allergy; n = 9).Results.Plasma levels of several of the compounds we measured were higher in the men with a high intake of fish than in those who consumed moderate amounts, and the levels were higher in those who ate moderate amounts of fish than in those who ate none. The median amounts of the most toxic dioxin (2,3,7,8-tetrachlorodibenzo-p-dioxin) were 8.0 pg per gram of plasma lipid (range, 2.0 to 13) in the high-intake group, 2.6 pg per gram (range, 1.2 to 4.2) in the moderate-intake group, and 1.8 pg per gram (range, 1.0 to 2.5) in the nonconsumers (P = 0.001 and 0.02, respectively). There were consistent and statistically significant associations between the reported amount of fish eaten and the plasma levels of several of the dibenzofurans and dioxins.Conclusions.Contaminated fish such as those from the Baltic Sea are an important source of exposure to polychlorinated dibenzofurans and dibenzodioxins in persons who eat fish regularly. However, the clinical consequences of such exposure remain uncertain.
|
|
| 24. |
|
|
| 25. |
|
|
| 26. |
- Wildt, Marie, et al.
(författare)
-
Simple counting of nailfold capillary density in suspected systemic sclerosis - 9 years' experience.
- 2007
-
Ingår i: Scandinavian Journal of Rheumatology. - : Informa UK Limited. - 1502-7732 .- 0300-9742. ; 36:6, s. 452-457
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: Capillary damage is a characteristic feature of systemic sclerosis (SSc). This work aimed to explore the potential clinical value of simple microscopic counting of capillary density. Methods: In 325 patients admitted because of a clinical suspicion of SSc and in 80 healthy controls, nailfold capillary microscopy (NCM) was performed using a stereo-zoom microscope in 20x magnification and with a transparent ruler in one of the eyepieces. Capillaries were counted within 3 mm in the centre of the nailfold in eight fingers. Results: Capillary density (loops/mm) was decreased in patients with diffuse cutaneous SSc [median 4.7 (range 2.2-7.3)], limited cutaneous SSc [4.9 (2.0-7.3)], earlySSc [4.7 (2.8-7.3)], and preSSc [5.9 (4.3-8.2)] compared to healthy controls [7.2 (5.8-9.0)]. Patients with morphea and with primary Raynaud's phenomenon had normal numbers of capillaries [7.0 (6.2-7.2) and 7.0 (5.3-8.7), respectively]. In only 21/325 (6%) patients was it not possible to count the capillaries because of insufficient transparency of the skin. There was no discrepancy in capillary density based on counts of two or eight fingers. When 43 patients were reassessed after 1 to 4 years, there was no difference between the two assessments. Conclusion: Determination of capillary density by direct microscopy counts, a simple, inexpensive and rapid method, helps to identify patients with SSc, early in the disease course and in patients with very limited skin involvement.
|
|
| 27. |
|
|
| 28. |
- Woolf, K, et al.
(författare)
-
Management of osteoporosis
- 2004
-
Ingår i: Practical Rheumatology. - 0323029396 - 9780323029391 ; , s. 561-561
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 29. |
- Wuttge, Dirk, et al.
(författare)
-
Serum IL-15 in patients with early systemic sclerosis: a potential novel marker of lung disease
- 2007
-
Ingår i: Arthritis Research and Therapy. - : Springer Science and Business Media LLC. - 1478-6362 .- 1478-6354. ; 9:5
-
Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: The pathogenesis of systemic sclerosis (SSc) is characterized by autoimmunity, vasculopathy and fibrosis. IL-15 is a pleiotropic cytokine that has impact on immune, vascular and connective tissue cells. We therefore investigated IL-15 in the circulation of patients with early SSc and explored possible associations of serum IL-15 with vasculopathy and fibrosis. Serum levels of IL-15 were analysed in 63 consecutive patients with SSc of disease duration less than 4 years and without disease-modifying treatment. Thirty-three age-matched healthy control individuals were enrolled. Serum IL-15 levels were increased in the sera of SSc patients compared with that of healthy control individuals (P < 0.01). Serum IL-15 levels correlated with impaired lung function, assessed both by the vital capacity (P < 0.05) and by the carbon monoxide diffusion capacity (P < 0.05). The association between IL-15 and the vital capacity remained after multiple linear regression analysis. Patients with intermediate serum IL-15 levels had a higher prevalence of increased systolic pulmonary pressure compared with patients with either low or high serum IL-15 levels (P < 0.05). Moreover, increased serum IL-15 levels were associated with a reduced nailfold capillary density in multivariable logistic regression analysis (P < 0.01). Serum IL-15 levels also correlated inversely with the systolic blood pressure (P < 0.01). We conclude that IL-15 is associated with fibrotic as well as vascular lung disease and vasculopathy in early SSc. IL-15 may contribute to the pathogenesis of SSc. IL-15 could also be a candidate biomarker for pulmonary involvement and a target for therapy in SSc.
|
|
| 30. |
- Åkesson, Anita, et al.
(författare)
-
Assessment of skin, joint, tendon and muscle involvement
- 2003
-
Ingår i: Clinical and Experimental Rheumatology. - 1593-098X. ; 21:3, s. 5-8
-
Tidskriftsartikel (refereegranskat)abstract
- This report makes recommendations for standardized techniques of data gathering and collection regarding: 1) skin involvement 2) joint and tendon involvement, and 3) involvement of the skeletal muscles. The recommendations in this report derive from a critical review of the available literature and group discussion. Committee recommendations are considered appropriate for descriptive clinical investigation, translational studies and as standards for clinical practice. Skin involvement should be assessed using the modified Rodnan skin score. Joint involvement, when symmetric synovitis is present, could be best assessed by the DAS-28 as is utilized in rheumatoid arthritis. Clinical assessment should include a routinized evaluation for the presence and number of palpable tendon friction rubs. Muscle involvement should be screened for by performance of the serum creatine phosphokinase assay and assessment of proximal weakness. More specific testing including EMG, magnetic resonance imaging and muscle biopsy should be employed in those patients with clinically significant myopathy only.
|
|
| 31. |
|
|
| 32. |
- Åkesson, Mats, et al.
(författare)
-
On-line Detection of Acetate Formation in Escherichia coli Cultures using Dissolved Oxygen Responses to Feed Transients
- 1999
-
Ingår i: Biotechnology and Bioengineering. - 1097-0290. ; 64:5, s. 590-598
-
Tidskriftsartikel (refereegranskat)abstract
- Recombinant protein production in Escherichia coli can be significantly reduced by acetate accumulation. It is demonstrated that acetate production can be detected on-line with a standard dissolved oxygen sensor by superimposing short pulses to the substrate feed rate. Assuming that acetate formation is linked to a respiratory limitation, a model for dissolved oxygen responses to transients in substrate feed rate is derived. The model predicts a clear change in the character of the transient response when acetate formation starts. The predicted effect was verified in fed-batch cultivations of E. coli TOPP1 and E. coli BL21(DE3), both before and after induction of recombinant protein production. It was also observed that the critical specific glucose uptake rate, at which acetate formation starts, was significantly decreased after induction. On-line detection of acetate formation with a standard sensor opens up new possibilities for feedback control of substrate feeding.
|
|
