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- Andersson, Susanne, 1957-, et al.
(författare)
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Experiences of a Novel Structured Foot Examination Form for Patients With Diabetes From the Perspective of Health Care Professionals : Qualitative Study
- 2023
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Ingår i: JMIR nursing. - : JMIR Publications. - 2562-7600. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Diabetes is a growing threat to public health, and secondary diseases like foot complications are common. Foot ulcers affect the individual's quality of life and are a great cost to society. Regular foot examinations prevent foot ulcers and are a recommended approach both in Sweden and worldwide. Despite existing guidelines, there are differences in the execution of the foot examination, which results in care inequality. A structured foot examination form based on current guidelines was developed in this study as the first step toward digitalized support in the daily routine, and was validated by diabetes health care professionals.OBJECTIVE: The study aimed to validate a structured foot examination form by assessing health care professionals' experiences of working with it "foot side" when examining patients with diabetes.METHODS: Semistructured interviews were held in a focus group and individually with 8 informants from different diabetes professions, who were interviewed regarding their experiences of working with the form in clinical practice. The users' data were analyzed inductively using qualitative content analysis. The study is part of a larger project entitled "Optimised care of persons with diabetes and foot complications," with Västra Götaland Region as the responsible health care authority, where the results will be further developed.RESULTS: Experiences of working with the form were that it simplified the foot examination by giving it an overview and a clear structure. Using the form made differences in work routines between individuals apparent. It was believed that implementing the form routinely would contribute to a more uniform execution. When patients had foot ulcers, the risk categories (established in guidelines) were perceived as contradictory. For example, there was uncertainty about the definition of chronic ulcers and callosities. The expectations were that the future digital format would simplify documentation and elucidate the foot examination, as well as contribute to the accessibility of updated and relevant data for all individuals concerned.CONCLUSIONS: The foot examination form works well as a support tool during preventive foot examination, creates a basis for decision-making, and could contribute to a uniform and safer foot examination with more care equality in agreement with current guidelines.TRIAL REGISTRATION: ClinicalTrials.gov NCT05692778; https://clinicaltrials.gov/ct2/show/NCT05692778.
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| 5. |
- Andersson, Susanne, 1957-, et al.
(författare)
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Experiences of specially trained personnel of group education for patients with type 2 diabetes : A lifeworld approach
- 2019
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Ingår i: Nursing Open. - : Wiley-Blackwell Publishing Inc.. - 2054-1058. ; 6:2, s. 635-641
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Tidskriftsartikel (refereegranskat)abstract
- Aim:To describe how the group education process for people with type 2 diabetes is experienced by diabetes nurses and dietitians who support the patients’ learning, in a primary care setting.Design:The project took place at two primary care settings in the south of Sweden.Methods:Data collected from focus‐group interviews and reflection notes were subjected to phenomenological analysis.Results:The specially trained personnel experienced that group education made it possible for the patients to learn through reflection concerning their own and others’ experiences. Furthermore, group education entailed increased knowledge for the trained personnel. When the patients were challenged to make changes in their lives with the illness, the personnel experienced that both patients and personnel supported each other. The study concludes that the trained personnel person‐centred approach, with help of the didactic model, get tools to support patients learning.
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| 6. |
- Andersson, Susanne, 1957
(författare)
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Med risk för diabetes- studier av symtom, självskattad hälsa och erfarenhet av att leva med prediabetes
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Individuals with impaired glucose tolerance (IGT) have a high risk of developing both type 2 diabetes mellitus (T2DM) and cardiovascular disease. T2DM is a common chronic disease in a global perspective, and it is estimated to continue to grow, which is a serious health problem. It is of significance to increase knowledge about persons with IGT to direct preventive activities more efficiently thus to limit its progression to T2DM. Aim: The overall aim was to describe experiences of living with the increased risk of type 2 diabetes, and to identify self-reported symptoms and bodily sensations associated to prediabetes by the persons themselves. Specific aim were to explore the associations between experiences of sleep, vitality and self-rated health, respectively, and IGT. Methods: The design was explorative and descriptive. Participants were randomly selected from a cross-sectional population-based survey in two municipalities in South-western of Sweden. Data were collected by means of interviews and a questionnaire about life-style and health. Results: Living with prediabetes means living in the borderline between health and type 2 diabetes. Living in the borderline and the balance between opportunities and obstacles were interpreted as a burdensome sense of living with increased risk of developing type 2 diabetes, although this feeling could be changed so you could see either opportunities or obstacles. Persons with IGT are experiencing symptoms, which they relate to their elevated plasma glucose level associated with IGT. The diagnosis in itself gave them something to relate to because they received confirmation and a possible explanation for their symptoms. In men a statistically significant age-adjusted association was found between self-reported lack of sleep and IGT: It did not weaken after further adjustment for BMI, smoking, education, and leisure time physical activity No such associations were found in females. Corresponding age-adjusted statistically significant associations between low vitality and IGT in both men and women were successively lost with multivariate adjustments. Both men and women with low self-rated health had a worse risk factor profile than those with high self-rated health and a statistically significant crude association between self-rated health and IGT. After controlling for major lifestyles factors and biomedical variables the association remained only in men. Conclusions: A special focus must be directed towards persons with prediabetes as they experience both opportunities and obstacles. Although prediabetes is often described as a condition without symptoms, persons with IGT experienced many symptoms, which they related to their IGT. Insufficient sleep and low self-rated health may be a risk factor for IGT in men. A generous sampling of plasma glucose, Hba1c and oral glucose tolerance tests is suggested, even in vague symptoms. There is a link between the measurable (signs) and the perceived in form of symptoms, interpreted as “the guiding feeling”. This should be considered in pedagogical encounters with patients to prevent the onset of type 2 diabetes.
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| 7. |
- Andersson, Susanne, 1957, et al.
(författare)
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Perceived symptoms in people living with impaired glucose tolerance.
- 2011
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Ingår i: Nursing Research and Practice. - : Hindawi Limited. - 2090-1429 .- 2090-1437. ; 2011:Article ID 937038
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to identify symptoms in people with impaired glucose tolerance (IGT) and describe their experiences of living with the symptoms which they related to their condition. Twenty-one participants, from a cross-sectional population-based study, diagnosed as having IGT, were invited for an interview. The interviews were analyzed in two phases by means of a manifest and latent content analysis. The narratives included seven categories of symptoms (and more than 25 different symptoms) presented by the respondents. This study shows that symptoms such as the patient's own interpretation of different perceptions in the body must be considered, as well as signs and/or objective observations. Symptoms ought to be seen as complementary components in the health encounter and health conversation. The results of this study indicate that health professionals should increase their awareness of the balance between the implicit and the explicit bodily sensations that individuals communicate. Further studies are needed.
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| 9. |
- Andersson, Susanne, 1957, et al.
(författare)
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The association between self-rated health and impaired glucose tolerance in Swedish adults: A cross-sectional study
- 2013
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 31:2, s. 111-118
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate gender differences in the association between self-rated health (SRH) and impaired glucose tolerance (IGT) in subjects unaware of their glucose tolerance. Design. A cross-sectional population-based study. Setting. The two municipalities of Vara and Skövde in south-western Sweden. Subjects. A total of 2502 participants (1301 women and 1201 men), aged 30–75, were randomly selected from the population. Main outcome measures. IGT was regarded as the outcome measure and SRH as the main risk factor. Results. The prevalence of IGT was significantly higher in women (11.9%) than in men (10.1%), (p = 0.029), as was the prevalence of low SRH (women: 35.4%; men: 22.1%, p = 0.006). Both men and women with low SRH had a poorer risk factor profile than those with high SRH, and a statistically significant crude association between SRH and IGT was found in both men (OR = 2.8, 95% CI 1.8–4.4) and women (OR = 1.5, 95% CI 1.0–2.2, p = 0.033). However, after controlling for several lifestyle factors and biomedical variables, the association was attenuated and remained statistically significant solely in men (OR = 2.3, 95% CI 1.2–4.3). Conclusion. The gender-specific associations found between SRH and IGT suggest that SRH may be a better indicator of IGT in men than in women. Future studies should evaluate the utility of SRH in comparison with objective health measures as a potential aid to health practitioners when deciding whether to screen for IGT and T2DM.
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| 10. |
- Berglund, Ingrid, 1954, et al.
(författare)
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Vocational teacher students’ critical reflections in site-based education
- 2020
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Ingår i: International Journal of Training Research. - : Informa UK Limited. - 1448-0220 .- 2204-0544. ; 18:1, s. 22-36
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Tidskriftsartikel (refereegranskat)abstract
- Critical reflection is an essential element in the professional teacher’s practice. This article investigates vocational teacher education (VTE) students´ ability to reflect when engaged in site-based education and considers how arrangements in vocational teacher education enable or constrain this ability. The study was conducted at one Swedish university, where 78 VTE students’ written self-evaluation reports from three practicum courses were analyzed on the basis of the concept of critical reflection and the theory of practice architectures. The findings emphasize the value of a strong relationship between the learning at university and in the teaching workplace, and the progression of critical reflection throughout the education. These findings support the conclusion that practice architectures that improve VTE students’ ability to critical reflection need to include tasks that focuse on both reflection and on bridging the contexts of research-based and experience-based knowledge and practice.
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| 11. |
- Berglund, Mia, et al.
(författare)
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Att drabbas av långvarig sjukdom
- 2017. - 1
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Ingår i: Vägen till patientens värld och personcentrerad vård. - Stockholm : Liber. - 9789147112715 ; , s. 93-116
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Bokkapitel (refereegranskat)
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| 12. |
- Fransson, Susanne, 1975, et al.
(författare)
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p37δ is a new isoform of PI3K p110δ that increases cell proliferation and is overexpressed in tumors
- 2012
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Ingår i: Oncogene. - : Nature Publishing Group. - 0950-9232 .- 1476-5594. ; 31:27, s. 3277-3286
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Tidskriftsartikel (refereegranskat)abstract
- The phosphatidylinositol 3-kinases (PI3Ks) regulate cell growth, proliferation and survival, and are frequently affected in human cancer. PI3K is composed of a catalytic subunit, p110, and a regulatory subunit, p85. The PI3K catalytic subunit p110δ is encoded by PIK3CD and contains p85- and RAS-binding domains, and a kinase domain. Here we present an alternatively spliced PIK3CD transcript encoding a previously unknown protein, p37δ, and demonstrate that this protein is expressed in human ovarian and colorectal tumors. p37δ retains the p85-binding domain and a fraction of the RAS-binding domain, lacks the catalytic domain, and has a unique carboxyl-terminal region. In contrast to p110δ, which stabilizes p85, p37δ promoted p85 sequestering. Despite the truncated RAS-binding domain, p37δ bound to RAS and we found a strong positive correlation between the protein levels of p37δ and RAS. Overexpressing p37δ, but not p110δ, increased the proliferation and invasive properties of HEK-293 cells and mouse embryonic fibroblasts. Cells overexpressing p37δ showed a quicker phosphorylation response of AKT and ERK1/2 following serum stimulation. Ubiquitous expression of human p37δ in the fruit fly increased body size, DNA content and phosphorylated ERK1/2 levels. Thus, p37δ appears to be a new tumor-specific isoform of p110δ with growth-promoting properties.
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| 13. |
- Hipkiss, Anna Maria, et al.
(författare)
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(Practicing and) testing pupils’ subject specific literacy in history and chemistry
- 2023
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Ingår i: WRAB 2023: Writing Research Across Borders VI, From early literacy learning to writing in professional life, 18–22 February 2023, NTNU, Trondheim, Norway.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This study is part of a collaborative project between a comprehensive school and a university in Sweden – a project funded through a government initiative to support such collaboration for the benefit of both parties. In the project, the potential of genre pedagogy for strengthening subject literacy in school subjects is explored, with special attention paid to social and natural sciences and Swedish. The school, located in an underprivileged, suburban area, has a pupil population with diverse language backgrounds. For most of the pupils, Swedish is a second language. Since pupils from this background are overrepresented among those who do not succeed in school, further efforts are needed to improve the situation, not least for reasons of equity and fairness. This proposal investigates writing assignments and tests in year 6 chemistry and history, two subjects that require different types of subject specific writing, in this instance exemplified by historical recount in history and procedural recount in chemistry. Data has been collected in a year 6 (pupils 12-13 years of age) in a Swedish primary school. Data consists of texts collected from a history unit focusing Sweden in the 1600’s and a chemistry unit focusing household chemicals. Test questions and pupil answers in history and laboratory instructions and pupil laboratory reports in chemistry along with test questions and pupil answers have been analysed. The analyses are based in genre theory (Martin & Rose, 2008) and tasks and responses have been analysed for genre, including stages and phases and prevalence of subject specific lexicogrammar. The results of text analyses are also understood in light of previous studies of lesson activities in the work units in order to be able to make connections between what has been taught as regards writing and what pupils later produce individually in writing. In history the pupils were expected to answer test questions asking them to retell and/or present reasons for or consequences of significant events from Sweden’s Great Power Era. In chemistry they were expected to produce laboratory reports, often as co-constructions with individual focus on hypothesizing. In the test they were for example expected to be able to describe and distinguish between mixtures and solutions. The analysis of the history texts (both tasks and responses) reveals that although some pupils manage to produce texts where they use and unpack subject typical concepts, in line with the pattern introduced during the lessons, many would require more practise to be able to retell and/or explain historical events in writing. The analysis of chemistry texts has shown that the pupils are well-versed in the structure of the laboratory report as it is continually modelled by the teacher up until the aspect of hypotheses, which pupils often formulate on their own. These hypotheses vary in focus and breadth as in pupils guessing wildly what might happen or making hypotheses based on teacher introductions. As the hypotheses are individually constructed, there is also less subject specific knowledge on display. Being able to express contents through the expected genre, has been in focus for this study. In both subjects, joint reading and writing are used as tools for developing the pupil’s disciplinary literacy. The many second language pupils in this study seem to need stronger scaffolding in order to understand and be able to express historical knowledge in writing. In contrast, pupils in chemistry received strong scaffolding when preparing laboratory reports and were to the main part successful in this task. However, as the history unit does not include writing of longer subject specific texts, the next step could be to read and collect notes for joint constructing a longer, coherent text in which the teacher models and the pupils practise historical reasoning in writing. In chemistry, the next step is likely to model the construction of hypotheses and the discussions of the results of laboratory work
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| 14. |
- Kjellsdotter, Anna, et al.
(författare)
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To take charge of one's life : group-based education for patients with type 2 diabetes in primary care - a lifeworld approach
- 2020
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The number of people suffering from diabetes worldwide, including Sweden, has increased. To strengthen the patient's empowerment and thus improve their ability to take care of their own health, patient education in self-care management plays a central role in diabetes care.Purpose: The specific aim in this study was to describe patients' experiences of group-based education using the Taking charge of one's life with type 2 diabetes model.Methods: A qualitative approach with a phenomenological lifeworld perspective was used. The study was based on group and individual interviews and reflection books.Results: The group-based education model made it possible for the patients to learn through reflection concerning their own and others' experiences. The learning that occurred with support from the group reflections and the reflection books contributed to the understanding of the complexity of the illness. This increased the motivation and desire to be responsible for the treatment and implementation of habits. The group contributed to a sense of belonging and community that inspired a continued and active learning.Conclusion: The results showed that from the patients' perspective, this didactic model was both suitable and appreciated, supporting and facilitating learning.
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| 15. |
- Kjellsdotter, Anna, et al.
(författare)
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Together for the future – development of a digital website to support chronic obstructive pulmonary disease self-management : A qualitative study
- 2021
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Ingår i: Journal of Multidisciplinary Healthcare. - : Dove Medical Press Ltd. - 1178-2390. ; 14, s. 757-766
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Tidskriftsartikel (refereegranskat)abstract
- Background: Symptom burden, impaired functional performance and decreased quality of life are not only consequences of the underlying physiological disorder chronic obstructive pulmonary disease (COPD) but also dependent on a patient’s ability to learn to live with and manage their illness. A digital website may be important for empowering patients with COPD to learn about and self-manage their illness. The aim of this study was to describe a developing process of a digital COPD-web as a part of a self-management education program for persons living with COPD. Methods: A qualitative approach with a phenomenological perspective was used. The study was based on group and individual interviews with a multidisciplinary COPD-team and patients who developed the COPD-web. Results: The developing process appears as a person-centred and holistic self-care approach both in content and development. Developing a digital COPD-web requires ongoing multi-disciplinary collaboration and spawns a sense of pride that reinforces shared responsibility. The phenomenon consists of four constituents: learning by participating in development, the patient perspective as guiding approach, responsibility and motivation as driving forces and digital technology as a knowledge arena. Conclusion: The results indicate that constructive collaboration between a multidisciplinary COPD-team and patients as co-creators in an ongoing creative and reflective process is a key concept to develop a digital COPD-web with a holistic approach. Digital resources in the future might create time and space for reflective conversations in a COPD-web with virtual chatrooms.
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| 16. |
- Kjellsdotter, Anna, et al.
(författare)
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Together for the Future – Development of a Digital Website to Support Chronic Obstructive Pulmonary Disease Self-Management: A Qualitative Study
- 2021
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Ingår i: Journal of Multidisciplinary Healthcare. - : Informa UK Limited. - 1178-2390. ; 14, s. 757-766
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Tidskriftsartikel (refereegranskat)abstract
- Background: Symptom burden, impaired functional performance and decreased quality of life are not only consequences of the underlying physiological disorder chronic obstructive pulmonary disease (COPD) but also dependent on a patient's ability to learn to live with and manage their illness. A digital website may be important for empowering patients with COPD to learn about and self-manage their illness. The aim of this study was to describe a developing process of a digital COPD-web as a part of a self-management education program for persons living with COPD.Methods: A qualitative approach with a phenomenological perspective was used. The study was based on group and individual interviews with a multidisciplinary COPD-team and patients who developed the COPD-web.Results: The developing process appears as a person-centred and holistic self-care approach both in content and development. Developing a digital COPD-web requires ongoing multidisciplinary collaboration and spawns a sense of pride that reinforces shared responsibility. The phenomenon consists of four constituents: learning by participating in development, the patient perspective as guiding approach, responsibility and motivation as driving forces and digital technology as a knowledge arena.Conclusion: The results indicate that constructive collaboration between a multidisciplinary COPD-team and patients as co-creators in an ongoing creative and reflective process is a key concept to develop a digital COPD-web with a holistic approach. Digital resources in the future might create time and space for reflective conversations in a COPD-web with virtual chatrooms.
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| 17. |
- Lindquist, Susanne, et al.
(författare)
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Effects of bile salt-stimulated lipase on blood cells and associations with disease activity in human inflammatory joint disorders
- 2023
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:8
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Tidskriftsartikel (refereegranskat)abstract
- The bile salt-stimulated lipase (BSSL) was originally recognized as a lipolytic enzyme expressed by the exocrine pancreas and in some species, notably humans, the lactating mammary gland, being secreted into the duodenum and with the mother’s milk, respectively. However, BSSL is also present in the blood and has been assigned additional functions, even beyond the gastrointestinal tract. Conventional BSSL knockout mice are protected from developing disease in animal models of arthritis, and antibodies directed towards BSSL prevent or mitigate disease in similar models. The aim of this study was to investigate the role of BSSL as a newly discovered player in inflammation and specifically in inflammatory joint disorders. As part of mechanism of action, we here show that BSSL is secreted by neutrophils, interacts with monocytes and stimulates their migration in vitro. An anti-BSSL antibody that blocks the human BSSL-monocyte interaction was shown to simultaneously prevent the signaling pathway by which BSSL induce cell migration. Moreover, in this cohort study we show that BSSL levels are significantly higher in blood samples from patients with rheumatoid arthritis and psoriatic arthritis compared to healthy controls. The BSSL levels in patients’ blood also correlated with disease activity scores and established inflammatory markers. Hence, although the mode of action is not yet fully clarified, we conclude that BSSL could be considered a proinflammatory component in the innate immune system and thus a possible novel target for treatment of chronic inflammation.
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| 18. |
- Myrelid, Pär, 1970-, et al.
(författare)
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Azathioprine as a postoperative prophylaxis reduces symptoms in aggressive Crohn's disease
- 2006
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 41:10, s. 1190-1195
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Recurrence of Crohn's disease (CD) after surgery is common. Azathioprine/6-mercaptopurine (Aza/6-MP) is effective in controlling medically induced remission but, so far, has only been sparsely investigated after surgically induced remission. This study comprises a subset of CD patients considered to have an aggressive disease course and chosen for treatment with Aza postoperatively. Material and methods. In 1989-2000, a total of 100 patients with CD were given Aza/6-MP as a postoperative prophylaxis. Fourteen Aza/6-MP-intolerant patients were compared with 28 Aza-tolerant patients, matched for gender, age, and duration of disease. Patients were prospectively registered for symptoms using a modified Crohn's disease activity index (CDAI) and perceived health was assessed on a visual analogue scale (VAS). The primary outcome variable was the modified CDAI postoperatively integrated over time, other variables were time to first relapse (modified CDAI ≥ 150), time to first repeated surgery, number of courses of steroids, and repeated surgery per year of follow-up. Patients were followed for a median of 84.7months (23.2-140). Results. The modified CDAI integrated over time was 93 for Aza-treated patients compared with 184 for controls (p = 0.01) and time to first relapse was 53 and 24 months, respectively (p < 0.05). Aza-treated patients needed fewer courses of corticosteroids (p = 0.05) compared with controls. Perceived health did not differ between the groups, nor did need of repeated surgery. Time to first repeat operation was 53 and 37 months, respectively. Conclusions. In CD patients considered to have an aggressive disease course, Aza reduced symptoms after surgery and prolonged the time to symptomatic relapse. The findings support a role for Aza as a postoperative maintenance treatment in CD. © 2006 Taylor & Francis.
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