| 1. |
- Augustin, L S A, et al.
(författare)
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Glycemic index, glycemic load and glycemic response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC).
- 2015
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Ingår i: Nutrition Metabolism and Cardiovascular Diseases. - : Elsevier BV. - 1590-3729 .- 0939-4753. ; 25:9, s. 795-815
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: The positive and negative health effects of dietary carbohydrates are of interest to both researchers and consumers. Methods: International experts on carbohydrate research held a scientific summit in Stresa, Italy, in June 2013 to discuss controversies surrounding the utility of the glycemic index (GI), glycemic load (GL) and glycemic response (GR). Results: The outcome was a scientific consensus statement which recognized the importance of postprandial glycemia in overall health, and the GI as a valid and reproducible method of classifying carbohydrate foods for this purpose. There was consensus that diets low in GI and GL were relevant to the prevention and management of diabetes and coronary heart disease, and probably obesity. Moderate to weak associations were observed for selected cancers. The group affirmed that diets low in GI and GL should always be considered in the context of diets otherwise understood as healthy, complementing additional ways of characterizing carbohydrate foods, such as fiber and whole grain content. Diets of low GI and GL were considered particularly important in individuals with insulin resistance. Conclusions: Given the high prevalence of diabetes and pre-diabetes worldwide and the consistency of the scientific evidence reviewed, the expert panel confirmed an urgent need to communicate information on GI and GL to the general public and health professionals, through channels such as national dietary guidelines, food composition tables and food labels.
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| 2. |
- Blaak, E E, et al.
(författare)
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Impact of postprandial glycaemia on health and prevention of disease.
- 2012
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Ingår i: Obesity Reviews. - 1467-7881. ; 13:10, s. 923-984
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Tidskriftsartikel (refereegranskat)abstract
- Postprandial glucose, together with related hyperinsulinemia and lipidaemia, has been implicated in the development of chronic metabolic diseases like obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). In this review, available evidence is discussed on postprandial glucose in relation to body weight control, the development of oxidative stress, T2DM, and CVD and in maintaining optimal exercise and cognitive performance. There is mechanistic evidence linking postprandial glycaemia or glycaemic variability to the development of these conditions or in the impairment in cognitive and exercise perfomance. Nevertheless, postprandial glycaemia is interrelated with many other (risk) factors as well as to fasting glucose. In many studies, meal-related glycaemic response is not sufficiently characterized, or the methodology with respect to the description of food or meal composition, or the duration of the measurement of postprandial glycaemia is limited. It is evident that more randomized controlled dietary intervention trials using effective low vs. high glucose response diets are necessary in order to draw more definite conclusions on the role of postprandial glycaemia in relation to health and disease. Also of importance is the evaluation of the potential role of the time course of postprandial glycaemia.
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| 3. |
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| 4. |
- Andrén, T., et al.
(författare)
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The Baltic Sea IODP project
- 2012
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Ingår i: EGU General Assembly Conference Abstracts. ; , s. 7682-7682
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 5. |
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| 6. |
- Jones, T. R., et al.
(författare)
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Delayed maximum northern European summer temperatures during the Last Interglacial as a result of Greenland Ice Sheet melt
- 2017
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Ingår i: Geology. - 0091-7613. ; 45:1, s. 23-26
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Tidskriftsartikel (refereegranskat)abstract
- Here we report a new quantitative mean July temperature reconstruction using non-biting midges (chironomids) from the Danish Last Interglacial (LIG) site Hollerup (spanning 127-116 ka). We find that peak mean July temperatures of 17.5 °C, similar to those of the present day (1961-1990 CE), were reached shortly before the onset of the regional Carpinus pollen zone. Through comparison to terrestrial and marine sequences we demonstrate that peak summer warmth took place some three millennia after the onset of LIG warming in Europe, a marked delay in line with records from the North Atlantic. Crucially, the warmest northern European summer temperatures appear to follow maximum Greenland Ice Sheet mass loss, implying that meltwater substantially reduced Atlantic Meridional Overturning Circulation and depressed European temperatures during the early part of the interglacial.
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| 7. |
- Lundgren, Fredrik, et al.
(författare)
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PTFE bypass to below-knee arteries : distal vein collar or not? A prospective randomised multicentre study
- 2010
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 39:6, s. 747-754
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPatency and limb salvage after synthetic bypass to the arteries below-knee are inferior to that which can be achieved with autologous vein. Use of a vein collar at the distal anastomosis has been suggested to improve patency and limb salvage, a problem that is analysed in this randomised clinical study.MethodsPatients with critical limb ischaemia undergoing polytetrafluoroethylene (PTFE) bypass to below-knee arteries were randomly either assigned a vein collar or not in two groups – bypass to the popliteal artery below-knee (femoro-popliteal below-knee (FemPopBK)) and more distal bypass (femoro-distal bypass (FemDist)). Follow-up was scheduled until amputation, death or at most 5 years, whichever event occurred first.ResultsIn the FemPopBK and in the FemDist groups, 115/202 and 72/150 were randomised to have a vein collar, respectively. Information was available for 345 of 352 randomised patients (98%).At 3 years, primary patency was 26% (95% confidence interval (CI) 18–38) with a vein collar and 43 (33–58) without a vein collar for femoro-popliteal bypass and 20 (11–38), and 17 (9–33) for femoro-distal bypass, respectively. The corresponding figures for limb salvage were 64 (54–75) and 61 (50–74) for femoro-popliteal bypass, and 59 (46–76) and 44 (32–61) for femoro-distal bypass with and without a vein collar, respectively. Log-rank-test for the whole Kaplan–Meier life table curve showed no statistically significant differences with or without vein collar primary patency: p = 0.0853, p = 0.228; secondary patency: p = 0.317, p = 0.280; limb salvage: p = 0.757, p = 0.187 for FemPopBK and FemDist, respectively. The use of a vein collar did not influence patency or limb salvage.ConclusionThis study failed to show any benefit for vein collar with PTFE bypass to a below-knee artery.
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| 8. |
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| 9. |
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| 10. |
- Rydberg, Lennart, 1944, et al.
(författare)
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Extracorporeal ("ex vivo") connection of pig kidneys to humans. II. The anti-pig antibody response.
- 1996
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Ingår i: Xenotransplantation. - : Wiley. - 0908-665X .- 1399-3089. ; 3:4, s. 340-53
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Tidskriftsartikel (refereegranskat)abstract
- Pig kidneys were extracorporeally "ex vivo" connected to the circulation of two volunteer male dialysis patients (Breimer et al., this issue). The patients were pretreated by daily plasmapheresis for 3 consecutive days, which reduced the anti-pig lymphocytotoxic titer from 8 to 2 in the first patient and from 8 to 1 in the second patient. The anti-pig hemagglutinating titers were reduced from 32 to 4 in the first patient and from 2 to 1 in the second patient. No drugs, except heparin, were given. The perfusion lasted for 65 min in patient 1 and the experiment was terminated due to increased vascular resistance in the pig kidney. Ultrastructural investigation showed a picture similar to a hyperacute vascular rejection. Immunohistochemical studies showed a weak staining of IgM antibodies, but no IgG in the small arteries and glomeruli. The pig kidney of patient 2 was perfused for 15 min and the experiment terminated due to serious side effects of the patient. Light and electron microscopical investigation showed virtually no structural changes of the kidney tissue and immunostaining for human antibodies was negative. In both patients, serum samples collected 2-5 weeks postperfusion showed a strong anti-pig antibody titer rise (up to 512) which thereafter declined but stabilized on a higher level than before the experiment. The antibody response in the two patients was different. In patient 1, the major anti-pig antibodies directed to carbohydrate antigens were of IgG (IgG1 and IgG2 subclasses) type, while the IgM response was less prominent and virtually no IgA antibodies were produced. Despite the short duration of the perfusion in patient 2, a humoral immune response was seen that was mainly confined to the IgA immunoglobulin class (IgA1 subclass). Blood group glycospingolipid fractions, prepared from the contralateral kidney of the donor pigs, were used for immunostaining with patient serum samples. In both patients, the antibodies produced after the perfusion, mainly recognized the Galα1-3Gal epitope both as part of the "linear B" pentasaccharide but also on more complex carbohydrate structures. Patient 1 was HLA-immunized before the experiment due to a kidney allograft and had a panel reactivity of 85% before the perfusion. No change in the panel reactivity of HLA-antibodies was found after the perfusion experiments. Patient 2 had no HLA antibodies before and remained negative after the perfusion. Patient serum samples collected before and after the perfusion were tested for reactivity against human endothelial cell lines. No antibodies were generated.
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| 11. |
- Sedimbi, S. K., et al.
(författare)
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SUMO4 M55V polymorphism affects susceptibility to type I diabetes in HLA DR3- and DR4-positive Swedish patients
- 2007
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Ingår i: Genes Immun. - : Springer Science and Business Media LLC. - 1466-4879 .- 1476-5470. ; 8:6, s. 518-21
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Tidskriftsartikel (refereegranskat)abstract
- SUMO4 M55V, located in IDDM5, has been a focus for debate because of its association to type I diabetes (TIDM) in Asians but not in Caucasians. The current study aims to test the significance of M55V association to TIDM in a large cohort of Swedish Caucasians, and to test whether M55V is associated in those carrying human leukocyte antigen (HLA) class II molecules. A total of 673 TIDM patients and 535 age- and sex-matched healthy controls were included in the study. PCR-RFLP was performed to identify the genotype and allele variations. Our data suggest that SUMO4 M55V is not associated with susceptibility to TIDM by itself. When we stratified our patients and controls based on heterozygosity for HLA-DR3/DR4 and SUMO4 genotypes, we found that presence of SUMO4 GG increased further the relative risk conferred by HLA-DR3/DR4 to TIDM, whereas SUMO4 AA decreased the risk. From the current study, we conclude that SUMO4 M55V is associated with TIDM in association with high-risk HLA-DR3 and DR4, but not by itself.
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| 12. |
- Shin, J. H., et al.
(författare)
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IA-2 autoantibodies in incident type I diabetes patients are associated with a polyadenylation signal polymorphism in GIMAP5
- 2007
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Ingår i: Genes Immun. - : Springer Science and Business Media LLC. - 1466-4879 .- 1476-5470. ; 8:6, s. 503-12
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Tidskriftsartikel (refereegranskat)abstract
- In a large case-control study of Swedish incident type I diabetes patients and controls, 0-34 years of age, we tested the hypothesis that the GIMAP5 gene, a key genetic factor for lymphopenia in spontaneous BioBreeding rat diabetes, is associated with type I diabetes; with islet autoantibodies in incident type I diabetes patients or with age at clinical onset in incident type I diabetes patients. Initial scans of allelic association were followed by more detailed logistic regression modeling that adjusted for known type I diabetes risk factors and potential confounding variables. The single nucleotide polymorphism (SNP) rs6598, located in a polyadenylation signal of GIMAP5, was associated with the presence of significant levels of IA-2 autoantibodies in the type I diabetes patients. Patients with the minor allele A of rs6598 had an increased prevalence of IA-2 autoantibody levels compared to patients without the minor allele (OR=2.2; Bonferroni-corrected P=0.003), after adjusting for age at clinical onset (P=8.0 x 10(-13)) and the numbers of HLA-DQ A1*0501-B1*0201 haplotypes (P=2.4 x 10(-5)) and DQ A1*0301-B1*0302 haplotypes (P=0.002). GIMAP5 polymorphism was not associated with type I diabetes or with GAD65 or insulin autoantibodies, ICA, or age at clinical onset in patients. These data suggest that the GIMAP5 gene is associated with islet autoimmunity in type I diabetes and add to recent findings implicating the same SNP in another autoimmune disease.
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| 13. |
- Silveira-Maia, M., et al.
(författare)
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Framework for an inclusive-oriented pedagogical assessment
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This book resulted from the Work Package 1 (WP1) of the Inclusive Assessment Map project – so-called I AM project. I AM is an Erasmus+ funded project (Agreement No. 621435-EPP-1-2020-1-AT- EPPKA3-IPI-SOC-IN) that aims to develop – based on the Internacional Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) – an innovative assessment tool that provides teachers with guidance on how to create school environments in order to be inclusive places. The partner countries are: Austria, Germany, Sweden, Norway, Belgium and Portugal. By identifying the common trends on inclusive education policies of the 4 involved countries and by revising evidence-based supports linked with students’ participation, this book presents a good practices analysis of inclusive-oriented assessment and supports implementation within educational contexts.
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| 14. |
- Wolever, Thomas M S, et al.
(författare)
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Measuring the glycemic index of foods: interlaboratory study.
- 2008
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Ingår i: The American journal of clinical nutrition. - 0002-9165 .- 1938-3207. ; 87:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many laboratories offer glycemic index (GI) services. OBJECTIVE: We assessed the performance of the method used to measure GI. DESIGN: The GI of cheese-puffs and fruit-leather (centrally provided) was measured in 28 laboratories (n=311 subjects) by using the FAO/WHO method. The laboratories reported the results of their calculations and sent the raw data for recalculation centrally. RESULTS: Values for the incremental area under the curve (AUC) reported by 54% of the laboratories differed from central calculations. Because of this and other differences in data analysis, 19% of reported food GI values differed by >5 units from those calculated centrally. GI values in individual subjects were unrelated to age, sex, ethnicity, body mass index, or AUC but were negatively related to within-individual variation (P=0.033) expressed as the CV of the AUC for repeated reference food tests (refCV). The between-laboratory GI values (mean+/-SD) for cheese-puffs and fruit-leather were 74.3+/-10.5 and 33.2+/-7.2, respectively. The mean laboratory GI was related to refCV (P=0.003) and the type of restrictions on alcohol consumption before the test (P=0.006, r2=0.509 for model). The within-laboratory SD of GI was related to refCV (P<0.001), the glucose analysis method (P=0.010), whether glucose measures were duplicated (P=0.008), and restrictions on dinner the night before (P=0.013, r2=0.810 for model). CONCLUSIONS: The between-laboratory SD of the GI values is approximately 9. Standardized data analysis and low within-subject variation (refCV<30%) are required for accuracy. The results suggest that common misconceptions exist about which factors do and do not need to be controlled to improve precision. Controlled studies and cost-benefit analyses are needed to optimize GI methodology. The trial was registered at clinicaltrials.gov as NCT00260858.
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| 15. |
- Balaz, P., et al.
(författare)
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Is It Worthwhile Treating Occluded Cold Stored Venous Allografts by Thrombolysis?
- 2016
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 52:3, s. 370-376
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Thrombolysis has been reported to be suboptimal in occluded vein grafts and cryopreserved allografts, and there are no data on the efficacy of thrombolysis in occluded cold stored venous allografts. The aim was to evaluate early outcomes, secondary patency and limb salvage rates of thrombolysed cold stored venous allograft bypasses and to compare the outcomes with thrombolysis of autologous bypasses. Methods: This was a single center study of consecutive patients with acute and non-acute limb ischemia between September 1, 2000, and January 1, 2014, with occlusion of cold stored venous allografts, and between January 1, 2012, and January 1, 2014, with occlusion of autologous bypass who received intra-arterial thrombolytic therapy. Results: Sixty-one patients with occlusion of an infrainguinal bypass using a cold stored venous allograft (n = 35) or an autologous bypass (n = 26) underwent percutaneous intra-arterial thrombolytic therapy. The median duration of thrombolysis was 20 h (IQR 18-24) with no difference between the groups (p = .14). The median follow up was 18.5 months (IQR 11.0-52.0). Secondary patency rates of thrombolysed bypass at 6 and 12 months were 44 +/- 9% and 32 +/- 9% in patients with a venous allograft bypass and 46 +/- 10% and 22 +/- 8% with an autologous bypass, with no difference between groups (p = .40). Limb salvage rates at 1, 6, and 12 months after thrombolysis in the venous allograft group were 83 +/- 7%, 72 8% and 63 +/- 9%, and in the autologous group 91 +/- 6%, 76 +/- 9%, and 65 +/- 13%, with no difference between groups (p = .69). Conclusions: Long-term results of thrombolysis of venous allograft bypasses are similar to those of autologous bypasses. Occluded cold stored venous allograft can be successfully re-opened in most cases with a favorable effect on limb salvage.
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| 16. |
- Beck, AW, et al.
(författare)
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Variations in abdominal aortic aneurysm care : a report from the International consortium of vascular registries
- 2016
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Ingår i: Circulation. - 0009-7322 .- 1524-4539.
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Tidskriftsartikel (refereegranskat)abstract
- Background: This project by the ICVR (International Consortium of Vascular Registries), a collaboration of 11 vascular surgical quality registries, was designed to evaluate international variation in the contemporary management of abdominal aortic aneurysm (AAA) with relation to recommended treatment guidelines from the Society for Vascular Surgery and the European Society for Vascular Surgery.Methods: Registry data for open and endovascular AAA repair (EVAR) during 2010 to 2013 were collected from 11 countries. Variations in patient selection and treatment were compared across countries and across centers within countries.Results: Among 51 153 patients, 86% were treated for intact AAA (iAAA) and 14% for ruptured AAA. Women constituted 18% of the entire cohort (range, 12% in Switzerland–21% in the United States; P<0.01). Intact AAAs were repaired at diameters smaller than recommended by guidelines in 31% of men (<5.5 cm; range, 6% in Iceland–41% in Germany; P<0.01) and 12% of women with iAAA (<5 cm; range, 0% in Iceland–16% in the United States; P<0.01). Overall, use of EVAR for iAAA varied from 28% in Hungary to 79% in the United States (P<0.01) and for ruptured AAA from 5% in Denmark to 52% in the United States (P<0.01). In addition to the between-country variations, significant variations were present between centers in each country in terms of EVAR use and rate of small AAA repair. Countries that more frequently treated small AAAs tended to use EVAR more frequently (trend: correlation coefficient, 0.51; P=0.14). Octogenarians made up 23% of all patients, ranging from 12% in Hungary to 29% in Australia (P<0.01). In countries with a fee-for-service reimbursement system (Australia, Germany, Switzerland, and the United States), the proportions of small AAA (33%) and octogenarians undergoing iAAA repair (25%) were higher compared with countries with a population-based reimbursement model (small AAA repair, 16%; octogenarians, 18%; P<0.01). In general, center-level variation within countries in the management of AAA was as important as variation between countries.Conclusions: Despite homogeneous guidelines from professional societies, significant variation exists in the management of AAA, most notably for iAAA diameter at repair, use of EVAR, and the treatment of elderly patients. ICVR provides an opportunity to study treatment variation across countries and to encourage optimal practice by sharing these results.
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| 17. |
- Behrendt, Christian-Alexander, et al.
(författare)
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Editor's Choice - Recommendations for Registry Data Collection for Revascularisations of Acute Limb Ischaemia : A Delphi Consensus from the International Consortium of Vascular Registries
- 2019
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : W B SAUNDERS CO LTD. - 1078-5884 .- 1532-2165. ; 57:6, s. 816-821
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To develop a minimum core data set for evaluation of acute limb ischaemia (ALI) revascularisation treatment and outcomes that would enable collaboration among international registries. Methods: A modified Delphi approach was used to achieve consensus among international multidisciplinary vascular specialists and registry members of the International Consortium of Vascular Registries (ICVR). Variables identified in the literature or suggested by the expert panel, and variables, including definitions, currently used in 15 countries in the ICVR, were assessed to define both a minimum core and an optimum data set to register ALI treatment. Clinical relevance and practicability were both assessed, and consensus was defined as >= 80% agreement among participants. Results: Of 40 invited experts, 37 completed a preliminary survey and 31 completed the two subsequent Delphi rounds via internet exchange and face to face discussions. In total, 117 different items were generated from the various registry data forms, an extensive review of the literature, and additional suggestions from the experts, for potential inclusion in the data set. Ultimately, 35 items were recommended for inclusion in the minimum core data set, including 23 core items important for all registries, and an additional 12 more specific items for registries capable of capturing more detail. These 35 items supplement previous data elements recommended for registering chronic peripheral arterial occlusive disease treatment. Conclusion: A modified Delphi study allowed 37 international vascular registry experts to achieve a consensus recommendation for a minimum core and an optimum data set for registries covering patients who undergo ALI revascularisation. Continued global harmonisation of registry infrastructure and definition of items allows international comparisons and global quality improvement. Furthermore, it can help to define and monitor standards of care and enable international research collaboration.
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| 18. |
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| 19. |
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| 20. |
- Björck, S., et al.
(författare)
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An event stratigraphy for the Last Termination in the North Atlantic region based on the Greenland Ice-core record: a proposal by the INTIMATE group.
- 1998
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Ingår i: Journal of Quaternary Science. - 0267-8179 .- 1099-1417. ; 13:4, s. 283-292
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Tidskriftsartikel (refereegranskat)abstract
- It is suggested that the GRIP Greenland ice-core should constitute the stratotype for the Last Termination. Based on the oxygen isotope signal in that core, a new event stratigraphy spanning the time interval from ca. 22.0 to 11.5 k GRIP yr BP (ca. 19.0-10.0 k C-14 yr BP) is proposed for the North Atlantic region. This covers the period from the Last Glacial Maximum, through Termination 1 of the deep-ocean record, to the Pleistocene-Holocene boundary, and encompasses the Last Glacial Late-glacial of the traditional northwest European stratigraphy. The isotopic record for this period is divided into two stadial episodes, Greenland Stadials 1 (GS-1) and 2 (GS-2), and two interstadial events, Greenland Interstadials 1 (GI-1) and 2 (GI-2). In addition, GI-1 and GS-2 are further subdivided into shorter episodes. The event stratigraphy is equally applicable to ice-core, marine and terrestrial records and is considered to be a more appropriate classificatory scheme than the terrestrially based radiocarbon-dated chronostratigraphy that has been used hitherto.
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| 21. |
- Björck, S., et al.
(författare)
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Synchronized terrestrial-atmospheric deglacial records around the North Atlantic.
- 1996
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 274:5290, s. 1155-1160
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Tidskriftsartikel (refereegranskat)abstract
- On the basis of synchronization of three carbon-14 (C-14)-dated lacustrine sequences from Sweden With tree ring and ice core records, the absolute age of the Younger Dryas-Preboreal climatic shift was determined to be 11,450 to 11,390 +/- 80 years before the present. A 150-year-long cooling in the early Preboreal, associated with rising Delta(14)C values, is evident in all records and indicates an ocean ventilation change. This cooling is similar to earlier deglacial coolings, and box-model calculations suggest that they all may have been the result of increased freshwater forcing that inhibited the strength of the North Atlantic heat conveyor, although the Younger Dryas may have begun as an anomalous meltwater event.
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| 22. |
- Björck, S., et al.
(författare)
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The Preboreal oscillation around the Nordic Seas : Terrestrial and lacustrine responses
- 1997
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Ingår i: Journal of Quaternary Science. - 0267-8179. ; 12:6, s. 455-465
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Tidskriftsartikel (refereegranskat)abstract
- The occurrence of an early Preboreal climatic cooling/oscillation (PBO) in lacustrine and glacial records from northwest Europe, Iceland and Greenland is reviewed and documented. The often subtle response of the proxy records to this oscillation, in combination with its short duration, make it difficult to detect. Owing to its chronostratigraphic position between the 10000-9900 and 9600-9500 14C plateaux (c. 11 300-11 150 calendar yr BP) it is also difficult to 14C date with precision. We find that the vegetation response to the PBO varies between sites and regions. In contrast to the pioneer vegetation in Iceland and southern Sweden, the expanding birch-pine forest in Germany-Denmark was more susceptible to deteriorating growing conditions. The combined lacustrine, tree-ring and glacial records imply that the PBO was characterised by cool and humid conditions throughout northwestern and central Europe. This is documented by vegetation changes, decreased aquatic production, increased soil erosion, increased 2H and 13C content in tree-rings, readvances or stillstands of the ice sheet in Norway and Finland, and ingression of brackish water into the Baltic. Icelandic proxy records from lake sediments and glacial moraines imply cooler conditions than during the previous Preboreal period, but not as extreme as during the Younger Dryas. Greenland records suggest that the early Preboreal was characterised by ice readvances, as an effect of cool climate and increased precipitation (in relation to the Younger Dryas). It was not until the end of the PBO that climate was warm enough to melt the land-based ice sheet. This Preboreal oscillation, found on both sides of the Nordic Seas, is interpreted as an effect of increased freshwater forcing on the thermohaline circulation in the Nordic Seas, which is implied by a simultaneous and distinct rise in the atmospheric 14C/12C ratio. A slow-down of the thermohaline circulation may temporarily have pushed the Polar Front further south.
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| 23. |
- Björck, S, et al.
(författare)
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Uttalande från klimatgruppen inom akademiens klass för geovetenskaper angående Climate Change 2007: The Physical Science Basis
- 2007
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Annan publikation (populärvet., debatt m.m.)abstract
- Björck S., Backman J., Bengtsson S., Destouni G., Rodhe H., Uttalande från klimatgruppen inom akademiens klass för geovetenskaper angående Climate Change 2007: The Physical Science Basis (Statement on Climate Change 2007: The Physical Science Basis; in Swedish), Climate Group of the Class of Geosciences at the Royal Swedish Academy of Sciences, 5 June, 2007.
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| 24. |
- Conte, Michael S., et al.
(författare)
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Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia
- 2019
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Saunders Elsevier. - 1078-5884 .- 1532-2165. ; 58:1, s. S1-S109
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Tidskriftsartikel (refereegranskat)abstract
- Chronic limb-threatening ischemia (CLTI) is associated with mortality, amputation, and impaired quality of life. These Global Vascular Guidelines (GVG) are focused on definition, evaluation, and management of CLTI with the goals of improving evidence-based care and highlighting critical research needs. The term CLTI is preferred over critical limb ischemia, as the latter implies threshold values of impaired perfusion rather than a continuum. CLTI is a clinical syndrome defined by the presence of peripheral artery disease (PAD) in combination with rest pain, gangrene, or a lower limb ulceration >2 weeks duration. Venous, traumatic, embolic, and nonatherosclerotic etiologies are excluded. All patients with suspected CLTI should be referred urgently to a vascular specialist. Accurately staging the severity of limb threat is fundamental, and the Society for Vascular Surgery Threatened Limb Classification system, based on grading of Wounds, Ischemia, and foot Infection (WIfI) is endorsed. Objective hemodynamic testing, including toe pressures as the preferred measure, is required to assess CLTI. Evidence-based revascularization (EBR) hinges on three independent axes: Patient risk, Limb severity, and ANatomic complexity (PLAN). Average-risk and high-risk patients are defined by estimated procedural and 2-year all-cause mortality. The GVG proposes a new Global Anatomic Staging System (GLASS), which involves defining a preferred target artery path (TAP) and then estimating limb-based patency (LBP), resulting in three stages of complexity for intervention. The optimal revascularization strategy is also influenced by the availability of autogenous vein for open bypass surgery. Recommendations for EBR are based on best available data, pending level 1 evidence from ongoing trials. Vein bypass may be preferred for average-risk patients with advanced limb threat and high complexity disease, while those with less complex anatomy, intermediate severity limb threat, or high patient risk may be favored for endovascular intervention. All patients with CLTI should be afforded best medical therapy including the use of antithrombotic, lipid-lowering, antihypertensive, and glycemic control agents, as well as counseling on smoking cessation, diet, exercise, and preventive foot care. Following EBR, long-term limb surveillance is advised. The effectiveness of nonrevascularization therapies (eg, spinal stimulation, pneumatic compression, prostanoids, and hyperbaric oxygen) has not been established. Regenerative medicine approaches (eg, cell, gene therapies) for CLTI should be restricted to rigorously conducted randomizsed clinical trials. The GVG promotes standardization of study designs and end points for clinical trials in CLTI. The importance of multidisciplinary teams and centers of excellence for amputation prevention is stressed as a key health system initiative.
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| 25. |
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| 26. |
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| 27. |
- Gallego-Sala, Angela V., et al.
(författare)
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Latitudinal limits to the predicted increase of the peatland carbon sink with warming
- 2018
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Ingår i: Nature Climate Change. - : Springer Science and Business Media LLC. - 1758-678X .- 1758-6798. ; 8:10, s. 907-
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Tidskriftsartikel (refereegranskat)abstract
- The carbon sink potential of peatlands depends on the balance of carbon uptake by plants and microbial decomposition. The rates of both these processes will increase with warming but it remains unclear which will dominate the global peatland response. Here we examine the global relationship between peatland carbon accumulation rates during the last millennium and planetary-scale climate space. A positive relationship is found between carbon accumulation and cumulative photosynthetically active radiation during the growing season for mid- to high-latitude peatlands in both hemispheres. However, this relationship reverses at lower latitudes, suggesting that carbon accumulation is lower under the warmest climate regimes. Projections under Representative Concentration Pathway (RCP)2.6 and RCP8.5 scenarios indicate that the present-day global sink will increase slightly until around AD 2100 but decline thereafter. Peatlands will remain a carbon sink in the future, but their response to warming switches from a negative to a positive climate feedback (decreased carbon sink with warming) at the end of the twenty-first century.
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| 28. |
- Huber, Thomas S., et al.
(författare)
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Chronic mesenteric ischemia : Clinical practice guidelines from the Society for Vascular Surgery
- 2021
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Ingår i: Journal of Vascular Surgery. - : Elsevier. - 0741-5214 .- 1097-6809. ; 73:1, s. 87S-115S
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic mesenteric ischemia (CMI) results from the inability to achieve adequate postprandial intestinal blood flow, usually from atherosclerotic occlusive disease at the origins of the mesenteric vessels. Patients typically present with postprandial pain, food fear, and weight loss, although they can present with acute mesenteric ischemia and bowel infarction. The diagnosis requires a combination of the appropriate clinical symptoms and significant mesenteric artery occlusive disease, although it is often delayed given the spectrum of gastrointestinal disorders associated with abdominal pain and weight loss. The treatment goals include relieving the presenting symptoms, preventing progression to acute mesenteric ischemia, and improving overall quality of life. These practice guidelines were developed to provide the best possible evidence for the diagnosis and treatment of patients with CMI from atherosclerosis. Methods: The Society for Vascular Surgery established a committee composed of vascular surgeons and individuals experienced with evidence-based reviews. The committee focused on six specific areas, including the diagnostic evaluation, indications for treatment, choice of treatment, perioperative evaluation, endovascular/open revascularization, and surveillance/remediation. A formal systematic review was performed by the evidence team to identify the optimal technique for revascularization. Specific practice recommendations were developed using the Grading of Recommendations Assessment, Development, and Evaluation system based on review of literature, the strength of the data, and consensus. Results: Patients with symptoms consistent with CMI should undergo an expedited workup, including a computed tomography arteriogram, to exclude other potential causes. The diagnosis is supported by significant arterial occlusive disease in the mesenteric vessels, particularly the superior mesenteric artery. Treatment requires revascularization with the primary target being the superior mesenteric artery. Endovascular revascularization with a balloon-expandable covered intraluminal stent is there commended initial treatment with open repair reserved for select younger patients and those who are not endovascular candidates. Long-term follow-up and surveillance are recommended after revascularization and for asymptomatic patients with severe mesenteric occlusive disease. Patient with recurrent symptoms after revascularization owing to recurrent stenoses should be treated with an endovascular-first approach, similar to the de novo lesion. Conclusions: These practice guidelines were developed based on the best available evidence. They should help to optimize the care of patients with CMI. Multiple areas for future research were identified. (J Vasc Surg 2021;73:87S-115S.)
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| 29. |
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| 30. |
- Johansson, M L, et al.
(författare)
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Survival of Lactobacillus plantarum DSM 9843 (299v), and effect on the short-chain fatty acid content of faeces after ingestion of a rose-hip drink with fermented oats
- 1998
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Ingår i: International Journal of Food Microbiology. - 0168-1605. ; 42:1-2, s. 29-38
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Tidskriftsartikel (refereegranskat)abstract
- In a controlled and randomised double-blind study, 26 healthy adult volunteers consumed, for 21 d, 400 ml of a rose-hip drink containing oats (0.7 g/100ml) fermented with Lactobacillus plantarum DSM 9843 (RHL; containing 5 x 10(7) cfu ml(-1)), and 22 volunteers in a second group the same amount of a pure rose-hip drink (RH). Significant increases in the total faecal concentration of carboxylic acids (P < 0.05 after 1 week and P < 0.01 after 3 weeks of intake), acetic acid (P < 0.01 after 3 weeks of intake) and propionic acid (P < 0.01 after 3 weeks of intake and P < 0.05 eight days after intake ceased) were recorded in the RHL group, indicating increased fermentation in the colon. In both groups a significant increase was obtained in the concentration of faecal lactic acid (P < 0.001 after 1 and 3 weeks of intake). No changes were seen in the concentration of faecal butyrate. The numbers of faecal bifidobacteria and lactobacilli increased significantly in both groups after 3 weeks of intake. Sulphite-reducing clostridia rapidly decreased in the group receiving the product with Lb. plantarum DSM 9843 after 1 week of intake, and then also in the pure rose-hip group after 3 weeks of intake. No changes were seen in the numbers of total anaerobes, gram-negative anaerobes or total aerobes during administration. Lb. plantarum DSM 9843 was recovered in faeces from all volunteers in the RHL group. Median amounts were 7.0 (5.0-8.8) log10 cfu g(-1) after one week of intake, and 6.7 (5.0-8.9) log10 cfu g(-1) after 3 weeks, respectively. The strain was still recovered from faeces of five volunteers 8 d after administration ceased (> 4.8 log10 cfu g(-1)). During the period of intake the volunteers in the RHL group experienced a significant increase in stool volume, a significant decrease in flatulence and slightly softer stools. Volunteers in the RH group experienced a slight but significant decrease in stool volume.
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| 31. |
- Livesey, Geoffrey, et al.
(författare)
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Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes : A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies
- 2019
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Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 11:6
-
Forskningsöversikt (refereegranskat)abstract
- Published meta-analyses indicate significant but inconsistent incident type-2 diabetes(T2D)-dietary glycemic index (GI) and glycemic load (GL) risk ratios or risk relations (RR). It is nowover a decade ago that a published meta-analysis used a predefined standard to identify validstudies. Considering valid studies only, and using random effects dose-response meta-analysis(DRM) while withdrawing spurious results (p < 0.05), we ascertained whether these relationswould support nutrition guidance, specifically for an RR > 1.20 with a lower 95% confidence limit>1.10 across typical intakes (approximately 10th to 90th percentiles of population intakes). Thecombined T2D-GI RR was 1.27 (1.15-1.40) (p < 0.001, n = 10 studies) per 10 units GI, while that forthe T2D-GL RR was 1.26 (1.15-1.37) (p < 0.001, n = 15) per 80 g/d GL in a 2000 kcal (8400 kJ) diet.The corresponding global DRM using restricted cubic splines were 1.87 (1.56-2.25) (p < 0.001, n =10) and 1.89 (1.66-2.16) (p < 0.001, n = 15) from 47.6 to 76.1 units GI and 73 to 257 g/d GL in a 2000kcal diet, respectively. In conclusion, among adults initially in good health, diets higher in GI or GLwere robustly associated with incident T2D. Together with mechanistic and other data, thissupports that consideration should be given to these dietary risk factors in nutrition advice.Concerning the public health relevance at the global level, our evidence indicates that GI and GLare substantial food markers predicting the development of T2D worldwide, for persons ofEuropean ancestry and of East Asian ancestry.
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| 32. |
- Livesey, Geoffrey, et al.
(författare)
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Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes : Assessment of Causal Relations
- 2019
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Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 11:6
-
Forskningsöversikt (refereegranskat)abstract
- While dietary factors are important modifiable risk factors for type 2 diabetes (T2D), the causal role of carbohydrate quality in nutrition remains controversial. Dietary glycemic index (GI) and glycemic load (GL) have been examined in relation to the risk of T2D in multiple prospective cohort studies. Previous meta-analyses indicate significant relations but consideration of causality has been minimal. Here, the results of our recent meta-analyses of prospective cohort studies of 4 to 26-y follow-up are interpreted in the context of the nine Bradford-Hill criteria for causality, that is: (1) Strength of Association, (2) Consistency, (3) Specificity, (4) Temporality, (5) Biological Gradient, (6) Plausibility, (7) Experimental evidence, (8) Analogy, and (9) Coherence. These criteria necessitated referral to a body of literature wider than prospective cohort studies alone, especially in criteria 6 to 9. In this analysis, all nine of the Hill's criteria were met for GI and GL indicating that we can be confident of a role for GI and GL as causal factors contributing to incident T2D. In addition, neither dietary fiber nor cereal fiber nor wholegrain were found to be reliable or effective surrogate measures of GI or GL. Finally, our cost-benefit analysis suggests food and nutrition advice favors lower GI or GL and would produce significant potential cost savings in national healthcare budgets. The high confidence in causal associations for incident T2D is sufficient to consider inclusion of GI and GL in food and nutrient-based recommendations.
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| 33. |
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| 34. |
- Muscheler, R, et al.
(författare)
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The cosmic ray clock during the Younger Dryas cold period clues about climate forcing and the timing of climate change : clues about climate forcing and the timing of climate change
- 2009
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Konferensbidrag (refereegranskat)abstract
- The last cold spell of the last deglaciation, the Younger Dryas period, serves as the prime example for rapid climate change induced by ocean circulation changes. However, the detailed processes behind this cold event are far from being satisfactorily understood. Although, the oceanic involvement in this climate deterioration is not disputed, there are various speculations about mechanisms that could have triggered and terminated it. Here we present 10Be data from the GRIP ice core around the transition from the Bölling/Alleröd warm period into the Younger Dryas cold period. The data provide a high-resolution cosmic ray signal that can be used to synchronize different radionuclide records and the connected climate reconstructions. This approach can lead to robust results about synchronous and non-synchronous climate changes at different locations, insights into the possible processes behind the changes and also the prospect of an improved 14C calibration beyond the Holocene period.
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| 35. |
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| 36. |
- Nordmyr, J., et al.
(författare)
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Vacuum assisted wound closure in patients with lower extremity arterial disease : The experience from two tertiary referral-centres
- 2009
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Ingår i: International Journal of Angiology. - 0392-9590 .- 1827-1839. ; 28:1, s. 26-31
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The purpose of this investigation was to analyze predictors for wound healing, amputation and mortality after vacuum assisted closure (VAC) therapy of wounds in the lower limb in patients with arterial disease. METHODS: One hundred and twenty one wounds were treated and followed for 12 months at two vascular centres in Uppsala and Malmö, Sweden. VAC therapy was applied in the wound at a topical negative pressure of 125 mmHg. RESULTS: Median age of the patients was 74 years and critical lower limb ischemia was present in 87% of the patients at admission. Intestinal flora was cultivated in 74% of the wounds. VAC associated bleeding occurred in four patients. Complete wound healing was achieved in 66%. Deep groin infections were associated with synthetic graft infection (P<0.001), treatment outside hospital (P<0.001), faster healing (P<0.01) and lower amputation rate (P<0.005). Diabetes mellitus (OR 2.7; [95% CI 1.2-6.2]) and foot wound (OR 3.0; [95% CI 1.2-7.4]) were independent predictors for amputation. The absence of complete wound healing was the strongest factor for both amputation (P<0.001) and death (P<0.001). CONCLUSIONS: VAC therapy of complex wounds in the lower limbs in patients with vascular disease was associated with high healing rates. Non-healed wounds after VAC therapy were predictors for amputation and death.
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| 37. |
- Sjöström, Jenny K., 1978-, et al.
(författare)
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Late Holocene peat paleodust deposition in south-western Sweden : exploring geochemical properties, local mineral sources and regional aeolian activity
- 2022
-
Ingår i: Chemical Geology. - : Elsevier. - 0009-2541 .- 1872-6836. ; 602
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Tidskriftsartikel (refereegranskat)abstract
- Atmospheric mineral dust not only interacts with the climate system by scattering incoming solar radiation and affecting atmospheric photochemistry, but also contributes critical nutrients to marine and terrestrial ecosystems. In a high-resolution analysis of paleodust deposition, peat development and soil dust sources, we assess the interplay between dust deposition and bog development of the Davidsmosse bog in south-western Sweden. Analyses of the 5400-year record (458 cm) included radiocarbon dating, bulk density, ash content, chemical and mineralogical composition and carbon stable isotopes, subsequently explored using principal component analysis. Fourteen dust events (DEs) were recorded (cal BP) in the peat sequence: 3580–3490; 3280; 3140; 3010–2840; 2740; 2610; 2480; 2340; 2240–2130; 1690; 1240; 960, 890–760, and 620–360. The majority of the DEs were coupled to increases in peat accumulation rates and increased nutrient content (N, P and K) suggesting that the DEs contributed with nutrients to the bog ecosystem, promoting increased accumulation. We also analyzed the chemical and mineral composition of potential mineral source deposits (separated into 6 grain-size fractions) from sites within a 4 km radius as well as aeolian dunes closer to the coast (25 km). The composition deposited on the present-day bog surface indicates that the bulk of the contemporary minerals have a local origin (<1.5 km), but the DEs may be of a more distant origin. The results also indicate that quartz and plagioclase feldspar content consistently increase with increasing grain-size, both in the source samples as well as in the peat sequence, and that the Si/Al ratio can be used to infer grain size changes in the peat. Two longer phases saw numerous DEs, between 2800 and 2130 cal BP and a stepwise increase from 960 towards 360 cal BP. The episodic character of the events, together with the inferred coarse grain size, suggest that the particles were deposited by (winter) storms. Future studies should include grain size analysis as well as a more in-depth comparison with regional paleo dust and storm records to increase knowledge on both transport processes (creep, saltation, suspension) and the climate processes driving late Holocene dust and storm events in Scandinavia.
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| 38. |
- Stegmayr, B., et al.
(författare)
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Septic shock induced by group A streptococcal infection : clinical and therapeutic aspects
- 1992
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Ingår i: Scand J Infect Dis. ; 24:5, s. 589-97
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Tidskriftsartikel (refereegranskat)abstract
- During 1988 and 1989 > 500 cases of serious group A streptococcal infections were reported in Sweden, many with a fatal outcome. We report here on 11 consecutive patients with septic preshock/shock and multiorgan failure, including acute renal failure. 10 had verified group A streptococci (GAS) serotype T1M1 infections while 1 patient was culture negative but with clinical signs of severe infection and serological evidence of GAS infection. Presenting symptoms were high fever, relative bradycardia, edema and renal failure. In all patients the condition deteriorated despite conventional treatment including volume substitution and antibiotics. Systolic blood pressure was transiently < 80 mmHg in 10 patients and 9 of them needed infusion of inotropic agents to avoid fatal circulatory shock. In 9 patients respiratory aid was instituted and 7 were dialysed. Plasma exchange was performed in 7, while the remaining 4 received transfusions with blood and plasma without plasma exchange. 10 patients improved and were discharged within 8 weeks. One woman died within 2 days after admission to the hospital. Renal function recovered in all survivors, with a follow-up serum creatinine < 80 mumol/l. The complicated clinical picture in these patients with many simultaneous therapeutic events confounds the interpretation of the effect of single actions. The favourable outcome in these severely ill patients suggests that potent inotropic agents, immunoglobulin therapy and plasma exchange might be beneficial in severe streptococcal disease when conventional treatment fails.
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| 39. |
- Wohlfart, B., et al.
(författare)
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Problems of AMS dating the Swedish varved clays of the last glacial-interglacial transition and the potential and difficulties of calibrating Late Weichselian "absolute" chronologies.
- 1993
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Ingår i: Boreas. - : Wiley. - 0300-9483 .- 1502-3885. ; 22:2, s. 113-128
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Tidskriftsartikel (refereegranskat)abstract
- The increasing focus on the chronology of environmental and climatic changes of the last glacial-interglacial transition has led to several independent attempts to try to calibrate the 14C time-scale beyond the Holocene. The Late Weichselian Gotiglacial varved clays of the Swedish Time Scale could potentially be used for this purpose. The reliability of the Swedish Time Scale is discussed as well as different ways of using the Swedish varved clays for calibrating the 14C chronology. The strategy and initial results from an ongoing calibration project are presented. They show clearly that, if the right strategy is adopted, varved clay may be dated by accelerator mass spectrometry (AMS) 14C measurement of terrestrial macrofossils. A Late Weichselian 'event stratigraphy', including the Vedde Ash fall-out, is established for south Scandinavia using three dating categories: clay varve measurements, terrestrial macrofossil measurement, and lake sediment (including aquatic mosses) measurements. It suggests that a 14C chronology based on terrestrial organic remains is not consistent with the traditional Late Weichselian chronostratigraphy based on lake-sediment samples, and that 'clay varve years' exceed 'terrestrial 14C years' by c. 900 years at the end of, and by 1100–1200 years at the beginning of the Younger Dryas Chronozone. Further back in time, the time-scales appear to converge. These results are compared with other recently published calibration studies.
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| 40. |
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| 41. |
- Wolever, T M S, et al.
(författare)
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Determination of the glycaemic index of foods: interlaboratory study.
- 2003
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Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 1476-5640 .- 0954-3007. ; 57:3, s. 475-482
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Practical use of the glycaemic index (GI), as recommended by the FAO/WHO, requires an evaluation of the recommended method. Our purpose was to determine the magnitude and sources of variation of the GI values obtained by experienced investigators in different international centres. Design: GI values of four centrally provided foods (instant potato, rice, spaghetti and barley) and locally obtained white bread were determined in 8-12 subjects in each of seven centres using the method recommended by FAO/WHO. Data analysis was performed centrally. Setting: University departments of nutrition. Healthy subjects (28 male, 40 female) were studied. Results: The GI values of the five foods did not vary significantly in different centres nor was there a significant centre´food interaction. Within-subject variation from two centres using venous blood was twice that from five centres using capillary blood. The s.d. of centre mean GI values was reduced from 10.6 (range 6.8-12.8) to 9.0 (range 4.8-12.6) by excluding venous blood data. GI values were not significantly related to differences in method of glucose measurement or subject characteristics (age, sex, BMI, ethnicity or absolute glycaemic response). GI values for locally obtained bread were no more variable than those for centrally provided foods. Conclusions: The GI values of foods are more precisely determined using capillary than venous blood sampling, with mean between-laboratory s.d. of approximately 9.0. Finding ways to reduce within-subject variation of glycaemic responses may be the most effective strategy to improve the precision of measurement of GI values.
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| 42. |
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| 43. |
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| 44. |
- Acosta, S., et al.
(författare)
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Negative-pressure wound therapy for prevention and treatment of surgical-site infections after vascular surgery
- 2017
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Ingår i: British Journal of Surgery. - : WILEY-BLACKWELL. - 0007-1323 .- 1365-2168. ; 104:2, s. E75-E84
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Forskningsöversikt (refereegranskat)abstract
- BackgroundIndications for negative-pressure wound therapy (NPWT) in vascular surgical patients are expanding. The aim of this review was to outline the evidence for NPWT on open and closed wounds. MethodsA PubMed, EMBASE and Cochrane Library search from 2007 to June 2016 was performed combining the medical subject headings terms wound infection', abdominal aortic aneurysm (AAA)', fasciotomy', vascular surgery' and NPWT' or VAC'. ResultsNPWT of open infected groin wounds was associated with shorter duration of wound healing by 47 days, and was more cost-effective than alginate dressings in one RCT. In one RCT and six observational studies, NPWT-related major bleeding and graft preservation rates were 0-10 and 83-100 per cent respectively. One retrospective comparative study showed greater wound size reduction per day, fewer dressing changes, quicker wound closure and shorter hospital stay with NPWT compared with gauze dressings for lower leg fasciotomy. NPWT and mesh-mediated fascial traction after AAA repair and open abdomen was associated with high primary fascial closure rates (96-100 per cent) and low risk of graft infection (0-7 per cent). One retrospective comparative study showed a significant reduction in surgical-site infection, from 30 per cent with standard wound care to 6 per cent with closed incisional NPWT. ConclusionNPWT has a central role in open and infected wounds after vascular surgery; the results of prophylactic care of closed incisions are promising.
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| 45. |
- Andréasson, Karin, et al.
(författare)
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Body mass index in adolescence, risk of type 2 diabetes and associated complications: A nationwide cohort study of men
- 2022
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Ingår i: EClinicalMedicine. - : Elsevier BV. - 2589-5370. ; 46
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Tidskriftsartikel (refereegranskat)abstract
- Background Obesity is a predominant factor in development of type 2 diabetes but to which extent adolescent obesity influences adult diabetes is unclear. We investigated the association between body mass index (BMI) in young men and subsequent type 2 diabetes and how, in diagnosed diabetes, adolescent BMI relates to glycemic control and diabetes complications. Methods Baseline data from the Swedish Conscript Register for men drafted 1968-2005 was combined with data from the National Diabetes and Patient registries. Diabetes risk was estimated through Cox regression and Kaplan-Meier survival estimates. Relationships between BMI, glycemic control and diabetes complications were assessed through multiple linear and logistic regression. Findings Among 1,647,826 men, 63,957 (3.88%) developed type 2 diabetes over a median follow-up of 29.0 years (IQR[21.0-37.0]). The risk of diabetes within 40 years after conscription was nearly 40% in individuals with adolescent BMI >= 35 kg/m(2). Compared to BMI 18.5-<20 kg/m(2) (reference), diabetes risk increased in a linear fashion from HR 1.18(95%CI 1.15-1.21) for BMI 20-<22.5 kg/m(2) to HR 15.93(95%CI 14.88-17.05) for BMI >= 35 kg/m(2), and a difference in age at onset of 11.4 years was seen. Among men who developed diabetes, higher adolescent BMI was associated with higher HbA1c levels and albuminuria rates. Interpretation Rising adolescent BMI was associated with increased risk of type 2 diabetes diagnosed at a younger age, with poorer metabolic control, and a greater prevalence of albuminuria, all suggestive of worse prognosis. Copyright (C) 2022 The Authors. Published by Elsevier Ltd.
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| 46. |
- Andrén, Thomas, et al.
(författare)
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Correlation of Swedish glacial varves with the Greenland (GRIP) oxygen isotope record
- 1999
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Ingår i: Journal of Quaternary Science. - 0267-8179 .- 1099-1417. ; 14:4, s. 361-371
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Tidskriftsartikel (refereegranskat)abstract
- A mean varve thickness curve has been constructed for a part of the Swedish varve chronology from the northwestern Baltic proper. The mean varve thickness curve has been correlated with the delta(18)O record from the GRIP ice-core using the Younger Dryas-Preboreal climate shift. This climate shift was defined by pollen analyses. The Scandinavian ice-sheet responded to a warming at the end of the Younger Dryas, ca. 10 995 to 10 700 clay-varve yr BP. Warming is recorded as a sequence of increasing mean varve thickness and ice-rafted debris suggesting intense calving of the ice front. The Younger Dryas-Preboreal climatic shift is dated to ca. 10 650 clay-varve yr BP, about 40 yr after the final drainage of the Baltic Ice Lake. Both the pollen spectra and a drastic increase in varve thickness reflect this climatic shift. A climate deterioration, correlated with the Preboreal oscillation, is dated to ca. 10 440 to 10 320 clay-varve yr BP and coincides with the brackish water phase of the Yoldia Sea stage. The ages of the climatic oscillations at the Younger Dryas-Preboreal transition show an 875 yr discrepancy compared with the GRIP record, suggesting a large error in the Swedish varve chronology in the part younger than ca. 10 300 clay-varve yr BP.
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| 47. |
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| 48. |
- Balaz, P, et al.
(författare)
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The role of hybrid procedures in the management of peripheral vascular disease
- 2012
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Ingår i: Scandinavian Journal of Surgery. - 1457-4969 .- 1799-7267. ; 101:4, s. 232-237
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Forskningsöversikt (refereegranskat)abstract
- This paper provides a summary of up-to-date information and experience with the combined treatment of patients suffering from peripheral arterial disease (PAD) with endovascular and open surgery, performed simultaneously and in a single operating room. Hybrid intervention is reported to have good results in well-indicated groups of patients with acute and chronic limb ischemia, even with older, high-risk patients. The indications for the use of this technique remain unclear with inconsistent opinions among vascular surgeons. The indications for treat-ment were divided into three main groups: 1) Patients with chronic limb ischemia, 2) acute limb ischemia, and 3) occlusion of a previous vascular reconstruction. The operating techniques for the most commonly used combinations are described. In conclusion, hybrid operating techniques are often useful when treating complex problems and multilevel disease in patients with chronic or acute lower limb ischemia. Modern vascular surgeons need to master both open and endovascular techniques, and to combine them in a creative fashion to the benefit of our patients.
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| 49. |
- Behrendt, C. A., et al.
(författare)
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International Variations in Amputation Practice: A VASCUNET Report
- 2018
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 56:3, s. 391-399
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study international differences in incidence and practice patterns as well as time trends in lower limb amputations related to peripheral arterial disease and/or diabetes mellitus. Methods: Data on lower limb amputations during 2010-2014 were collected from population based administrative data from countries in Europe and Australasia participating in the VASCUNET collaboration. Amputation rates, time trends, in hospital or 30 day mortality and reimbursement systems were analysed. Results: Data from 12 countries covering 259 million inhabitants in 2014 were included. Individuals aged >= 65 years ranged from 12.9% (Slovakia) to 20.7% (Germany) and diabetes prevalence among amputees from 25.7% (Finland) to 74.3% (Slovakia). The mean incidence of major amputation varied between 7.2/100,000 (New Zealand) and 41.4/100,000 (Hungary), with an overall declining time trend with the exception of Slovakia, while minor amputations increased over time. The older age group (>= 65 years) was up to 4.9 times more likely to be amputated compared with those younger than 65 years. Reported mortality rates were lowest in Finland (6.3%) and highest in Hungary (20.3%). Countries with a fee for service reimbursement system had a lower incidence of major amputation compared with countries with a population based reimbursement system (14.3/100,000 versus 18.4/100,000, respectively, p < .001). Conclusions: This international audit showed large geographical differences in major amputation rates, by a factor of almost six, and an overall declining time trend during the 4 year observation of this study. Diabetes prevalence, age distribution, and mortality rates were also found to vary between countries. Despite limitations attributable to registry data, these findings are important, and warrant further research on how to improve limb salvage in different demographic settings. (C) 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.
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| 50. |
- Benson, Tyler W, et al.
(författare)
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Glycoprotein VI is Critical for the Detection and Progression of Abdominal Aortic Aneurysms.
- 2023
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Ingår i: bioRxiv : the preprint server for biology.
-
Tidskriftsartikel (refereegranskat)abstract
- UNLABELLED: A common feature in patients with abdominal aortic aneurysms (AAA) is the formation of a nonocclusive intraluminal thrombus (ILT) in regions of aortic dilation. Platelets are known to maintain hemostasis and propagate thrombosis through several redundant activation mechanisms, yet the role of platelet activation in the pathogenesis of AAA associated ILT is still poorly understood. Thus, we sought to investigate how platelet activation impacts the pathogenesis of AAA. Using RNA-sequencing, we identify that the platelet-associated transcripts are significantly enriched in the ILT compared to the adjacent aneurysm wall and healthy control aortas. We found that the platelet specific receptor glycoprotein VI (GPVI) is among the top enriched genes in AAA ILT and is increased on the platelet surface of AAA patients. Examination of a specific indicator of platelet activity, soluble GPVI (sGPVI), in two independent AAA patient cohorts is highly predictive of a AAA diagnosis and associates more strongly with aneurysm growth rate when compared to D-dimer in humans. Finally, intervention with the anti-GPVI antibody (J) in mice with established aneurysms blunted the progression of AAA in two independent mouse models. In conclusion, we show that levels of sGPVI in humans can predict a diagnosis of AAA and AAA growth rate, which may be critical in the identification of high-risk patients. We also identify GPVI as a novel platelet-specific AAA therapeutic target, with minimal risk of adverse bleeding complications, where none currently exist.KEY POINTS: Soluble glycoprotein VI, which is a platelet-derived blood biomarker, predicts a diagnosis of AAA, with high sensitivity and specificity in distinguishing patients with fast from slow-growing AAA.Blockade of glycoprotein VI in mice with established aneurysms reduces AAA progression and mortality, indicating therapeutic potential.
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