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| 5. |
- Stegmayr, B. G., et al.
(författare)
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Plasma exchange or immunoadsorption in patients with rapidly progressive crescentic glomerulonephritis : A Swedish multi-center study
- 1999
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Ingår i: International Journal of Artificial Organs. - : SAGE Publications. - 0391-3988 .- 1724-6040. ; 22:2, s. 81-87
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Tidskriftsartikel (refereegranskat)abstract
- A therapeutic removal of antibodies may be achieved by immunoadsorption (IA) or by plasma exchange (PE). The aim of this prospective randomised study was to compare the efficacy of these different techniques with regard to treatment of patients with rapidly progressive glomerulonephritis (RPG) having at least 50% crescents. Forty-four patients with a RPG were included for treatment either by IA or PE (with albumin as substitution for removed plasma). All patients were additionally treated with immunosuppression. A median of 6 sessions of PEs were performed in 23 patients compared with 6 IAs in 21 patients. Goodpasture's syndrome (GP) was present in 6 patients (PE 3, IA 3). All of them started and ended in dialysis, two died. Among the remaining 38 patients (26 men, 12 women) 87% had antibodies to ANCA. Creatinine clearance for PE versus IA were at a median at start 17.1 and 19.8 ml/min, and at 6 months 49 and 49 ml/min, respectively. At 6 months 7 of 10 patients did not need dialysis (remaining: IA 0/5 and PE 2/5, n.s.). The extent of improvement did not differ between the groups. Three patients died during the observation period of 6 months (IA 2; PE 1, on HD). Although no difference was found between the IA or the PE group this study shows that the protocol used was associated with an improved renal function in most patients (except for Goodpasture's syndrome) whereas 70% of them could leave the dialysis program.
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- Almroth, Gabriel, 1953-, et al.
(författare)
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Detection and prevention of hepatitis C in dialysis patients and renal transplant recipients : A long-term follow up (1989–January 1997)
- 2002
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 251:2, s. 119-128
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Tidskriftsartikel (refereegranskat)abstract
- Background. Hepatitis C is frequent problem in dialysis wards.Design. A long time (1989–97) follow up of hepatitis C virus (HCV) infection in a Swedish nephrology unit was performed with anti-HCV screening, confirmatory antibody tests, viral RNA detection and molecular characterization. Case histories were reviewed with focus, onset of infection, liver morbidity and mortality.Results. In October 1991, 10% (19 of 184) of the patients in the unit (haemodialysis-, peritoneal dialysis and transplanted patients) were verified or suspected HCV carriers, whilst the number at the end of 1996 was 8% (13 of 157). Most patients were infected before 1991 but only in one case from a known HCV-infected blood donor. No new HCV infections associated with haemodialysis occurred during the study period. A total of 13 of 24 viremic patients had HCV genotype 2b, a pattern suggesting nosocomial transmission. This was further supported by phylogenetic analysis of HCV viral isolates in seven. HCV viremia was also common in patients with an incomplete anti-HCV antibody pattern as 8 of the 12 indeterminant sera were HCV-RNA positive.Conclusions. Awareness, prevention, identification of infected patients and donor testing limited transmission. Indeterminant recombinant immunoblot assays (RIBA)-results should be regarded with caution as a result of the relative immunodeficiency in uremic patients. Our data indicate nosocomial transmission in several patients.
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| 12. |
- Alpizar, F., et al.
(författare)
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A framework for selecting and designing policies to reduce marine plastic pollution in developing countries
- 2020
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Ingår i: Environmental Science and Policy. - : Elsevier BV. - 1462-9011 .- 1873-6416. ; 109:July 2020, s. 25-35
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Tidskriftsartikel (refereegranskat)abstract
- © 2020 The Authors The polluting of marine ecosystems with plastics is both a global and a local problem with potentially severe consequences for wildlife, economic activity, and human health. It is a problem that originates in countries’ inability to adequately manage the growing flow of waste. We use an impact pathway framework to trace the flow of plastics through the socio-ecological system and identify the role of specific policy instruments in achieving behavioral changes to reduce marine plastic waste. We produce a toolbox for finding a policy that is suitable for different countries. We use the impact pathway and toolbox to make country-specific recommendations that reflect the reality in each of the selected countries.
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| 13. |
- Asker, Noomi, 1968, et al.
(författare)
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A gene to organism approach-assessing the impact of environmental pollution in eelpout (Zoarces viviparus) females and larvae
- 2015
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Ingår i: Environmental Toxicology and Chemistry. - : Wiley. - 0730-7268 .- 1552-8618. ; 34:7, s. 1511-1523
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Tidskriftsartikel (refereegranskat)abstract
- A broad biomarker approach was applied to study the effects of marine pollution along the Swedish west coast using the teleost eelpout (Zoarces viviparus) as the sentinel species. Measurements were performed on different biological levels, from the molecular to the organismal, including measurements of messenger RNA (mRNA), proteins, cellular and tissue changes, and reproductive success. Results revealed that eelpout captured in Stenungsund had significantly higher hepatic ethoxyresorufin O-deethylase activity, high levels of both cytochrome P4501A and diablo homolog mRNA, and high prevalence of dead larvae and nuclear damage in erythrocytes. Eelpout collected in Göteborg harbor displayed extensive macrovesicular steatosis, whereby the majority of hepatocytes were affected throughout the liver, which could indicate an effect on lipid metabolism. Results also indicate that eelpouts collected at polluted sites might have an affected immune system, with lower mRNA expression of genes involved in the innate immune system and a higher number of lymphocytes. Biomarker assessment also was performed on livers dissected from unborn eelpout larvae collected from the ovary of the females. No significant differences were noted, which might indicate that the larvae to some extent are protected from effects of environmental pollutants. In conclusion, usage of the selected set of biological markers, covering responses from gene to organism, has demonstrated site-specific biomarker patterns that provided a broad and comprehensive picture of the impact of environmental stressors.
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| 14. |
- Athey, S. N., et al.
(författare)
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Unraveling Physical and Chemical Effects of Textile Microfibers
- 2022
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Ingår i: Water (Switzerland). - : MDPI AG. - 2073-4441. ; 14:23
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Forskningsöversikt (refereegranskat)abstract
- Microfibers are the most prevalent microplastics in most terrestrial, freshwater, and marine biota as well as in human tissues and have been collected from environmental compartments across most ecosystems and species sampled worldwide. These materials, made of diverse compound types, range from semi-synthetic and treated natural fibers to synthetic microfibers. Microfibers expose organisms across diverse taxa to an array of chemicals, both from the manufacturing process and from environmental adsorption, with effects on organisms at subcellular to population levels. Untangling the physical versus chemical effects of these compounds on organisms is challenging and requires further investigations that tease apart these mechanisms. Understanding how physical and chemical exposures affect organisms is essential to improving strategies to minimize harm.
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| 15. |
- Carney Almroth, Bethanie, 1974, et al.
(författare)
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Waterborne beclomethasone dipropionate affects the physiology of fish while its metabolite beclomethasone is not taken up
- 2015
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697 .- 1879-1026. ; 511, s. 37-46
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Tidskriftsartikel (refereegranskat)abstract
- Asthma is commonly treated with inhalable glucocorticosteroids, including beclomethasone dipropionate (BDP). This is a synthetic prodrug which is metabolized to the more active monopropionate (BMP) and free beclomethasone in humans. To evaluate potential effects of residual drugs on fish, we conducted a 14 day flow-through exposure experiment with BDP and beclomethasone using rainbow trout, and analyzed effects on plasma glucose, hepatic glutathione and catalase activity together with water and body concentrations of the BDP, BMP and beclomethasone. We also analyzed hepatic gene expression in BDP-exposed fish by microarray and quantitative PCR. Beclomethasone (up to 0.65 μg/L) was not taken up in the fish while BDP (0.65 and 0.07 μg/L) resulted in accumulation of both beclomethasone, BMP and BDP in plasma, reaching levels up to those found in humans during therapy. Accordingly, exposure to 0.65 μg/L of BDP significantly increased blood glucose as well as oxidized glutathione levels and catalase activity in the liver. Exposure to beclomethasone or the low concentration of BDP had no effect on these endpoints. Both exposure concentrations of BDP resulted in significantly higher transcript abundance of phosphoenolpyruvate carboxykinase involved in gluconeogenesis, and of genes involved in immune responses. As only the rapidly metabolized prodrug was potent in fish, the environmental risks associated with the use of BDP are probably small. However, the observed physiological effects in fish of BDP at plasma concentrations known to affect human physiology provides valuable input to the development of read-across approaches in the identification of pharmaceuticals of environmental concern.
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| 16. |
- Carstensen, Jacob, et al.
(författare)
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Factors regulating the coastal nutrient filter in the Baltic Sea
- 2020
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Ingår i: Ambio. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 49:6, s. 1194-1210
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Tidskriftsartikel (refereegranskat)abstract
- The coastal zone of the Baltic Sea is diverse with strong regional differences in the physico-chemical setting. This diversity is also reflected in the importance of different biogeochemical processes altering nutrient and organic matter fluxes on the passage from land to sea. This review investigates the most important processes for removal of nutrients and organic matter, and the factors that regulate the efficiency of the coastal filter. Nitrogen removal through denitrification is high in lagoons receiving large inputs of nitrate and organic matter. Phosphorus burial is high in archipelagos with substantial sedimentation, but the stability of different burial forms varies across the Baltic Sea. Organic matter processes are tightly linked to the nitrogen and phosphorus cycles. Moreover, these processes are strongly modulated depending on composition of vegetation and fauna. Managing coastal ecosystems to improve the effectiveness of the coastal filter can reduce eutrophication in the open Baltic Sea.
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| 17. |
- Lachmann, Florina, et al.
(författare)
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Marine plastic litter on Small Island Developing States (SIDS): Impacts and measures.
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This report was commissioned by the Swedish Agency for Marine and Water management and written by analysts at the Swedish Institute for the Marine Environment (affiliated with the University of Gothenburg, Lund University, and Chalmers University of Technology). This report documents how marine plastic litter reaches even the most remote parts of the oceans with small island states, and how SIDS are especially vulnerable to its impact. The origin and composition of marine plastic litter and its impacts are described. Measures are discussed, both from state agencies and private corporations. Measures from existing RAPs on marine litter are reviewed and examples of private initiatives are mentioned. Also, the corresponding legal framework is given and side effects of marine litter measures on the Sustainable Development Goals of the UN are debated. THE VULNERABILITY OF SIDS SIDS are a set of island nations in the Caribbean Sea, the Pacific Ocean, the Atlantic, Indian Ocean, and the South China Sea. SIDS are exposed to disproportionate concentrations of plastic litter due to their location near the ocean gyres where marine litter accumulates and to often sub-performing waste management systems. ORIGINS AND COMPOSITION OF MARINE PLASTIC LITTER Because plastic make up most marine debris, the focus here is on plastic litter. Marine plastic litter washed ashore on SIDS originates from both distant countries overseas and the SIDS themselves. Buoyant plastic litter is globally distributed by ocean currents and is washed ashore on beach lines around the globe where it negatively impacts ecological and human systems. Plastics end up in the marine environment through leaks from the global value chains that run from the oil industry through various other industries to local retailers and consumers. A smaller but significant stream of plastic litter follows from the difficulties of many SIDS to establish and maintain efficient waste management systems. IMPACT OF PLASTIC LITTER ON ECOLOGICAL, SOCIAL, AND ECONOMIC VALUES Marine litter impacts the environment and organisms therein in various ways, including entanglement, ingestion, transfer of chemicals, or by otherwise altering habitats. The extent of the social and economic impact that plastic on countries is not currently well known. However, the dependence of SIDS on their natural resources through tourism and fisheries, make them economically vulnerable to plastic litter. MITIGATION AND REMEDIATION STRATEGIES For plastic that reaches SIDS, both remediation and mitigation, especially through waste management and recycling, become necessary. LEGAL AND POLITICAL FRAMEWORKS The legal framework for preventing and managing marine litter is present on all levels of governance. A declaration particularly relevant to marine litter on SIDS is the SAMOA Pathway, a declaration from the 3rd International Conference on Small Island Developing States in 2014 calling for measures to manage waste, including marine plastic litter. Multilateral agreements require party states to take actions, but these requirements are often generally formulated, and their achievements depend on the choices and participation of all parties. POLICY MEASURES PROPOSED BY REGIONAL ACTION PLANS There are 18 Regional Seas programmes under the United Nations Environmental Program for the protection of the marine environment. Some Regional Seas programmes have written strategies to guide their actions, the RAPs, i.e. a political agenda for marine litter management agreed on by member governments of the region. The contents of different RAPs show strong similarities. The analyses conducted here show that most measures suggested by RAPs are aimed at downstream processes, while fewer address the problem upstream. Additional measures are needed to solve such a global problem. VOLUNTARY AND COMMERCIAL INITIATIVES Marine litter requires an array of actions from local to global level, and is thus a matter of governance. Most measures suggested in RAPs and other work against marine litter involve government managers as well as businesses, NGOs, and voluntary initiatives. RECOMMENDATION: FUTURE COOPERATION Competence and enthusiasm for the issue on SIDS and elsewhere is growing, but more is needed. Solutions require international cooperation. Four recommendations for cooperation are highlighted here: 1. Prevent litter from entering the ocean and thus reaching SIDS: Support cooperation in regional and international agreements 2. Plastic material reaching SIDS should not be released into the environment: Technical cooperation and support for local waste management 3. If waste reaches the environment, collect it where appropriate: Support beach clean-up campaigns and other remediation measures 4. When waste has been collected, ensure that is has a value: Develop recycling markets and opportunities
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| 18. |
- Metry, G., et al.
(författare)
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Swedish experience of the Dialock
- 2007
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 41:3, s. 249-253
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To study the patency and complications associated with the Dialock, an access device for haemodialysis. Material and methods. The records of seven Swedish patients who were treated with the Dialock access device between 2000 and 2004 were studied retrospectively. Results. A total of 10 Dialock devices were used in seven patients. The mean period of patency was 16.3±13.8 months. Major complications observed were bleeding in the dose pocket in three patients and infection in four. Three patients experienced no complications. The 1-year patency was similar to that of a newly created arteriovenous fistula used in our unit. Conclusions. In spite of the associated complications, the Dialock is an acceptable access device for haemodialysis patients with vascular access problems. Although the Dialock is no longer available on the market, similar access devices may be of importance in the future. © 2007 Taylor & Francis.
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| 20. |
- Schäffer, Andreas, et al.
(författare)
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Conflicts of Interest in the Assessment of Chemicals, Waste, and Pollution
- 2023
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Ingår i: Environmental Science and Technology. - 0013-936X .- 1520-5851. ; 57:48, s. 19066-19077
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Tidskriftsartikel (refereegranskat)abstract
- Pollution by chemicals and waste impacts human and ecosystem health on regional, national, and global scales, resulting, together with climate change and biodiversity loss, in a triple planetary crisis. Consequently, in 2022, countries agreed to establish an intergovernmental science-policy panel (SPP) on chemicals, waste, and pollution prevention, complementary to the existing intergovernmental science-policy bodies on climate change and biodiversity. To ensure the SPP’s success, it is imperative to protect it from conflicts of interest (COI). Here, we (i) define and review the implications of COI, and its relevance for the management of chemicals, waste, and pollution; (ii) summarize established tactics to manufacture doubt in favor of vested interests, i.e., to counter scientific evidence and/or to promote misleading narratives favorable to financial interests; and (iii) illustrate these with selected examples. This analysis leads to a review of arguments for and against chemical industry representation in the SPP’s work. We further (iv) rebut an assertion voiced by some that the chemical industry should be directly involved in the panel’s work because it possesses data on chemicals essential for the panel’s activities. Finally, (v) we present steps that should be taken to prevent the detrimental impacts of COI in the work of the SPP. In particular, we propose to include an independent auditor’s role in the SPP to ensure that participation and processes follow clear COI rules. Among others, the auditor should evaluate the content of the assessments produced to ensure unbiased representation of information that underpins the SPP’s activities.
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| 22. |
- Wahlstrom, I., et al.
(författare)
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Projected climate change impact on a coastal sea-As significant as all current pressures combined
- 2022
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Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 28:17, s. 5310-5319
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Tidskriftsartikel (refereegranskat)abstract
- Climate change influences the ocean's physical and biogeochemical conditions, causing additional pressures on marine environments and ecosystems, now and in the future. Such changes occur in environments that already today suffer under pressures from, for example, eutrophication, pollution, shipping, and more. We demonstrate how to implement climate change into regional marine spatial planning by introducing data of future temperature, salinity, and sea ice cover from regional ocean climate model projections to an existing cumulative impact model. This makes it possible to assess climate change impact in relation to pre-existing cumulative impact from current human activities. Results indicate that end-of-century projected climate change alone is a threat of the same magnitude as the combination of all current pressures to the marine environment. These findings give marine planners and policymakers forewarning on how future climate change may impact marine ecosystems, across space, emission scenarios, and in relation to other pressures.
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