| 1. |
- Akner, Gunnar, 1953-, et al.
(författare)
-
Adrenocorticotropin and cortisol response to lysine vasopressin in relation to the outcome of the dexamethasone suppression test in major depressive disorder
- 1988
-
Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447. ; 77:4, s. 404-410
-
Tidskriftsartikel (refereegranskat)abstract
- The pathophysiology behind the abnormalities of the hypothalamic pituitary adrenal cortex axis found in patients with major depressive disorder was studied by the use of the vasopressin test. The response of plasma adrenocorticotropin (ACTH) and cortisol to the injection of 10 IU lysine-vasopressin (LVP) was investigated in 18 patients meeting the DSM-III criteria for major depressive episode. The response was correlated to the outcome of the dexamethasone suppression test (DST) with the use of two different cut-off points, 139 nmol/l and 200 nmol/l respectively. The results show that no significant difference was found in ACTH or cortisol response between patients having a normal or abnormal DST. The results do not seem to support the hypothesis that the abnormalities of the hypothalamic pituitary adrenal cortex axis involve a hypersecretion of corticotropin-releasing factor (CRF) and a subsequent desensitization of the corticotrophs to CRF-stimulated ACTH release.
|
|
| 2. |
|
|
| 3. |
- Akner, Gunnar, 1953-
(författare)
-
Analysis of multimorbidity in individual elderly nursing home residents : development of a multimorbidity matrix
- 2009
-
Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 49:3, s. 413-419
-
Tidskriftsartikel (refereegranskat)abstract
- The chronic multimorbidity in individual elderly people is rarely documented in its entirety in present medical records, neither as cross-sectional overview nor as longitudinal time-course of various health problems. This obviously hampers an integrated clinical analysis. This work was aimed at evaluating the chronic multimorbidity in individual elderly patients and developing a method to map, quantify and grade the prevalence of the multimorbidity. An explorative study in 70 nursing home residents (55 women), mean age 85 was performed. Information on health problems was obtained through history, clinical examination and medical records. A 19-item multimorbidity matrix that maps, quantifies and grades the chronic morbidity in individual patients is presented. The 70 residents exhibited 275 different health problems; the top 3 items being neuropsychiatric, cardiovascular and gastrointestinal ones. The residents had a mean of 17 different chronic health problems and were prescribed a mean of 6.6 continuous medications per day. There was a significant correlation between the number of continuous drug prescriptions and both quantitative and graded multimorbidity-scores. The presented multimorbidity matrix provides a useful taxonomic overview over the health situation in individual multimorbid elderly and constitutes the basis for ongoing work to develop and renew the electronic health record into an "interactive health analysis system".
|
|
| 4. |
- Akner, Gunnar
(författare)
-
Arbetsmetod
- 2003
-
Ingår i: Evidensbaserad äldrevård. - Stockholm : Statens beredning för medicinsk utvärdering (SBU). - 9187890836 ; , s. 45-50
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 5. |
- Akner, Gunnar, 1953-
(författare)
-
Back to basics
- 2014
-
Ingår i: Sjukhusläkaren. - 1651-2715. ; :1, s. 35-
-
Tidskriftsartikel (populärvet., debatt m.m.)
|
|
| 6. |
- Akner, Gunnar, 1953-
(författare)
-
Back to basics
- 2014
-
Ingår i: Sjukhusläkaren. - : Sjukhusläkarföreningen. - 1651-2715. ; :1, s. 35-
-
Tidskriftsartikel (populärvet., debatt m.m.)
|
|
| 7. |
- Akner, Gunnar
(författare)
-
Background
- 2003
-
Ingår i: Geriatric care and treatment. - Stockholm : Statens beredning för medicinsk utvärdering (SBU). ; , s. 23-42
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 8. |
- Akner, Gunnar
(författare)
-
Bakgrund
- 2003
-
Ingår i: Evidensbaserad äldrevård. - Stockholm : Statens beredning för medicinsk utvärdering (SBU). - 9187890836 ; , s. 25-44
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 9. |
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
- Akner, Gunnar, 1953-, et al.
(författare)
-
Chromosomal aberrations in a patient with severe psychopathology
- 1992
-
Ingår i: British Journal of Psychiatry. - : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 161, s. 551-555
-
Tidskriftsartikel (refereegranskat)abstract
- The case of a female patient showing aggressive, compulsive, destructive behaviour, ritualistic faecal smearing, and hyperactivity is presented. The behaviour is long standing, therapy-resistant, and its aetiology is unknown, although it is seemingly associated with chromosomal abnormalities secondary to abnormal plasma factors.
|
|
| 13. |
|
|
| 14. |
|
|
| 15. |
- Akner, Gunnar, 1953-, et al.
(författare)
-
Drug treatment
- 2003. - 1
-
Ingår i: Geriatric care and treatment. - Stockholm : Statens beredning för medicinsk utvärdering (SBU). ; , s. 233-256
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 16. |
|
|
| 17. |
|
|
| 18. |
- Akner, Gunnar, 1953-, et al.
(författare)
-
Evidence for colocalization of glucocorticoid receptor with cytoplasmic microtubules in human gingival fibroblasts, using two different monoclonal anti-GR antibodies, confocal laser scanning microscopy and image analysis
- 1991
-
Ingår i: Journal of Steroid Biochemistry and Molecular Biology. - : Elsevier BV. - 0960-0760 .- 1879-1220. ; 39:4A, s. 419-432
-
Tidskriftsartikel (refereegranskat)abstract
- The cellular distribution of the glucocorticoid receptor (GR) in relation to the microtubule protein tubulin was studied in human gingival fibroblasts, using two different anti-GR antibodies of different Ig-classes, by indirect immunofluorescence immunocytology. Further studies were performed by confocal laser scanning microscopy and digital image analysis. The study focused on fluorochrome separation, optical sectioning, digital subtraction techniques and reconstruction of projections obtained using stacks of recorded transversal sections. The data presented further strengthens the notion of a structural colocalization between GR and cytoplasmic microtubules in human fibroblasts.
|
|
| 19. |
- Akner, Gunnar, 1953-, et al.
(författare)
-
Evidence for reversible, non-microtubule and non-microfilament-dependent nuclear translocation of hsp90 after heat shock in human fibroblasts
- 1992
-
Ingår i: European Journal of Cell Biology. - 0171-9335 .- 1618-1298. ; 58:2, s. 356-364
-
Tidskriftsartikel (refereegranskat)abstract
- A monoclonal antibody (29A) directed against rat liver heat shock protein M(r) 90,000 (hsp90) was produced. By Western immunoblotting of cytosols prepared from several different tissues and species, 29A was shown to specifically recognize only one band with M(r) approximately 90,000. Localization of hsp90 in human gingival fibroblasts was studied using the 29A antibody by indirect mono- and double-staining immunofluorescence and confocal laser scanning microscopy. The distribution was compared to that of the glucocorticoid receptor (GR) and various cytoskeletal structures. Cells were analyzed in interphase and mitosis under basal culture conditions, after heat shock and after microtubule and microfilament depolymerization, sometimes combined with heat shock. A major part of hsp90 immunoreactivity was diffusely distributed throughout the interphase cytoplasm, but a weak nuclear staining with non-stained nucleoli was also present, however, only detectable after methanol and not after formaldehyde/Triton X-100 fixation. Heat shock induced a time-dependent translocation of hsp90 from the cytoplasm to the cell nucleus reaching a plateau after 15 h. This compartment shift was reversible and also occurred in the absence of intact microtubules or intact microfilaments.
|
|
| 20. |
|
|
| 21. |
|
|
| 22. |
- Akner, Gunnar, 1953-
(författare)
-
Frailty and and multimorbidity in Elderly people : a shift in management approach
- 2013
-
Ingår i: Clinical Geriatrics. - : HMP Communications. - 1095-1598. ; :9
-
Tidskriftsartikel (refereegranskat)abstract
- Frailty and multimorbidity may be regarded as a homeostatic failure of a complex system, and these conditions are commonly encountered in elderly people. The concept of “frailty” has been used to describe an individual’s biological age, and the concept of “multimorbidity” is reserved for the simultaneous presence of two or more chronic health problems in one person. As frailty and multimorbidity are being better understood, optimal management of frail, multimorbid elderly patients is being re-evaluated. In this article, the author provides an overview of frailty, chronic disease, and multimorbidity, and describes how their optimal management can serve as a foundation for developing more expedient, organized, and goal-oriented care of elderly people with complex health problems. The author also describes important challenges for future research and development regarding the management of complex health issues in elderly people; these include transitioning from single disease management to multiple disease management, and expanding the conventional organ-based work-up and treatment plan with repeated evaluations of different systems and functional domains using the comprehensive geriatric assessment method. As noted, one particular challenge that must be addressed is the development of medical records that can serve as a much-needed “geroscope,” enabling an overview of the patient’s health situation, disease management, and follow-up care.
|
|
| 23. |
|
|
| 24. |
- Akner, Gunnar, 1953-
(författare)
-
Geriatric care in Sweden
- 2014
-
Ingår i: Current Diagnosis & Treatment. - USA : McGraw-Hill. - 9780071792080 ; , s. 539-542
-
Bokkapitel (refereegranskat)
|
|
| 25. |
- Akner, Gunnar, 1953-
(författare)
-
Geriatric medicine in Sweden : a study of the organisation, staffing and care production in 2000-2001
- 2004
-
Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 33:4, s. 338-341
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: the organisation of long-term medicine and geriatric medicine has undergone many changes during the last 15 years. The aim of this study is to gain an overall perspective of the present organisation of geriatric medicine in Sweden.DESIGN: questionnaire survey.METHODS: The Swedish Society for Geriatric Medicine and Gerontology, in collaboration with the Federation of County Councils and the Swedish Association of Local Authorities, sent out a survey to people in all county councils in Sweden. The subject of the survey was the speciality of geriatric medicine in the Swedish healthcare system, with regard to healthcare organisation, staffing and care production in 2000/2001.RESULTS: there were 52 separate geriatric units, 41 independent 'clinics' and 11 'sections' within other departments. There were a total of 3,101 geriatric inpatient beds. On average, there was one geriatric bed for every 799 individuals within the local population aged 65 years and over, with a 10-fold variation between counties. Four counties had no geriatric provision. The 'geriatric clinics' were mainly located in university towns and averaged 85 beds per clinic, again with a 10-fold variation. There were 604 established positions for doctors within geriatrics, of which 63% were at geriatric clinics. On average, the clinics had 16 positions each (of which 75% were filled with geriatric specialists) with 7 beds per doctor. The corresponding averages for nurses and paramedics could not be summarised due to organisational differences between the county councils. In general, there were very few nurses with specialist training in geriatric medicine.CONCLUSIONS: the field of geriatric medicine in Sweden is very heterogeneous regarding terminology, designations, structure, staffing and care production. There is no overall structural plan for the role of geriatric medicine in Swedish healthcare, with the desired close connection between content and dimensioning of geriatric specialist training and the practical organisation of the activities. The county councils designate geriatric medicine so differently that it is hardly possible to compare different geriatric facilities today. Considering how many patients at hospitals today are elderly and suffer from multiple illnesses, it is a major quality issue to ensure that these patients have access to geriatric specialists.
|
|
| 26. |
|
|
| 27. |
|
|
| 28. |
|
|
| 29. |
- Akner, Gunnar, 1953-, et al.
(författare)
-
Glucocorticoid receptor inhibits microtubule assembly in vitro.
- 1995
-
Ingår i: Molecular and cellular endocrinology. - : Elsevier BV. - 0303-7207 .- 1872-8057. ; 110:1-2, s. 49-54
-
Tidskriftsartikel (refereegranskat)abstract
- The effect of glucocorticoid hormones, purified glucocorticoid receptor (GR) and purified heat shock protein M(r) 90,000 (hsp90) on microtubule (MT) assembly in vitro was tested by a spectrophotometric MT assembly assay and electron microscopy. GR significantly prolonged the nucleation phase, slowed down the assembly rate and reduced the maximal amplitude of MT assembly compared with control. The effects were partially reversed by the addition of glucocorticoid hormone. GR associated with MTs. These results indicate that GR affects MT assembly in vitro, which may be a functional correlate to the structural association of GR with MTs. This implies that factors affecting GR may affect MT assembly in vivo.
|
|
| 30. |
- Akner, Gunnar, 1953-
(författare)
-
Ibsens princip bör styra vårdsektorn
- 2014
-
Ingår i: Sjukhusläkaren. - Stockholm : Sjukhusläkarföreningen. - 1651-2715. ; :5, s. 26-26
-
Tidskriftsartikel (populärvet., debatt m.m.)
|
|
| 31. |
- Akner, Gunnar, 1953-, et al.
(författare)
-
Immunocytochemical localization of glucocorticoid receptor in human gingival fibroblasts and evidence for a colocalization of glucocorticoid receptor with cytoplasmic microtubules
- 1990
-
Ingår i: European Journal of Cell Biology. - 0171-9335 .- 1618-1298. ; 53:2, s. 390-401
-
Tidskriftsartikel (refereegranskat)abstract
- The cellular distribution of the glucocorticoid receptor (GR) in relation to various intracellular and plasma membrane structures in human fibroblasts was studied using indirect immunofluorescence techniques with monoclonal and polyclonal antibodies. During interphase, GR was located predominantly in the cytoplasm, showing a similar pattern as tubulin. In mitotic cells, GR and tubulin were localized in mitotic spindles and in telophase midbodies. Colchicine and vinblastine induced a similar redistribution of GR and tubulin to the cell periphery. This redistribution was reversible for colchicine but not for vinblastine. Vinblastine also induced paracrystals containing GR and tubulin. These results support the hypothesis that GR interacts in vivo with cytoplasmic microtubules.
|
|
| 32. |
- Akner, Gunnar, 1953-, et al.
(författare)
-
Individual assessment of intake of energy, nutrients and water in 54 elderly multidiseased nursing-home residents
- 2003
-
Ingår i: The Journal of Nutrition, Health & Aging. - 1279-7707 .- 1760-4788. ; 7:1, s. 1-12
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Examination of the individual intake of energy, nutrients and water in clinically stable multidiseased nursing-home residents. METHODS: Comprehensive clinical assessment of 54 elderly nursing-home residents (80 +/- 10 years, mean +/- SD). The intake of food and beverages was measured by the weighed food intake method during five consecutive week days followed by computerized transformation to energy, 21 different nutrients, dietary fiber, alcohol and water. The resting energy expenditure was determined by indirect calorimetry. RESULTS: There was at least 2-3-fold, variation in intake of energy, nutrients and water, present also when expressed per kg body weight. For some micronutrients the relative intake variation was more than 8-fold. The results are compared with the present swedish recommended dietary allowances as well as with seven other studies of dietary intake in elderly using the weighed food intake method. The residents had on average 14.1 (range 6-31) different current clinical problems and were treated with a mean of 9.5 different drugs. The nursing staff spent 40 % of the total daytime working hours (7 am to 7 pm) on nutrition related issues. CONCLUSIONS: The nursing-home residents exhibited a large interindividual heterogeneity regarding intake of energy, nutrients and water. More emphasis should be given to individualized nutrition assessment in clinical geriatric care as a more solid base for nutrition treatment programmes integrated with the regular medical management and evaluation.
|
|
| 33. |
- Akner, Gunnar, 1953-, et al.
(författare)
-
Inrätta ett geriatriskt centrum som utvecklar vården
- 2012
-
Ingår i: Dagens medicin. - Stockholm : Dagens Medicin Sverige AB. - 1104-7488. ; :8, s. 18-19
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Ett geriatriskt centrum skulle fungera som en utvecklingsmotor för att sprida kunskaper och erfarenheter till hela vård-/omsorgssystemet, skriver tre debattörer
|
|
| 34. |
|
|
| 35. |
|
|
| 36. |
|
|
| 37. |
- Akner, Gunnar, 1953-, et al.
(författare)
-
Intramuscular ceruletide does not affect food intake in obese and non-obese human subjects
- 1985
-
Ingår i: Appetite. - : Elsevier BV. - 0195-6663 .- 1095-8304. ; 6:1, s. 21-24
-
Tidskriftsartikel (refereegranskat)abstract
- Intramuscular ceruletide or placebo was given in a randomized double-blind crossover design to 12 non-obese and 12 obese individuals, 30 min before a palatable lunch meal. No significant effects were found on the amount of food intake or the hunger ratings in any group. Although rapid CCK or ceruletide infusions have been found in some studies to reduce food intake in man and animals, slow infusions have increased food intake. Under the present study conditions, the moderate rate of release of ceruletide from intramuscular depots did not affect the food intake.
|
|
| 38. |
|
|
| 39. |
|
|
| 40. |
|
|
| 41. |
|
|
| 42. |
|
|
| 43. |
- Akner, Gunnar, 1953-
(författare)
-
Klinisk nutrition har svag ställning i vårdsystemet
- 2015
-
Ingår i: Äldre i centrum. - Stockholm : Stiftelsen Stockholms läns Äldrecentrum. - 1653-3585. ; :1, s. 15-17
-
Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- »Många studier genom åren har visat att inte ens en så enkel och lätt bestämd variabel som kroppsvikt registreras och analyseras tydligt över tid.«Man försöker trycka in kvalitet i klinisk nutrition i ett vårdsystem som inte är förberett på saken. Detta i en situation med a) brist på infrastruktur i vården, b) brist på utbildning/träning i klinisk nutrition hos personalen och c) avsaknad av en medicinsk specialitet för klinisk nutrition. Det skriver professor Gunnar Akner i en debatterande översiktsartikel.
|
|
| 44. |
|
|
| 45. |
|
|
| 46. |
|
|
| 47. |
|
|
| 48. |
- Akner, Gunnar, 1953-
(författare)
-
Kroniska sjukdomar kräver komplexa lösningar
- 2014
-
Ingår i: Sjukhusläkaren. - Stockholm : Sjukhusläkarföreningen. - 1651-2715. ; :3, s. 33-
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 49. |
|
|
| 50. |
|
|
