| 1. |
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| 2. |
- Bentham, James, et al.
(författare)
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A century of trends in adult human height
- 2016
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Ingår i: eLIFE. - 2050-084X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.522.7) and 16.5 cm (13.319.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
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| 3. |
- Bentham, James, et al.
(författare)
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A century of trends in adult human height
- 2016
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Ingår i: eLIFE. - : eLife Sciences Publications Ltd. - 2050-084X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3– 19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8– 144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
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| 4. |
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| 5. |
- Carlsson, Lars V, et al.
(författare)
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Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: I. Preliminary investigations--52 patients followed for 3 years.
- 2006
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Ingår i: Acta orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 77:4, s. 549-58
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We developed a total hip system using osseointegration guidelines, a metaphyseal-loading proximal femoral replacement in the retained neck and a dual-geometry titanium shell in the acetabulum. PATIENTS AND METHODS: A randomized controlled clinical trial was undertaken in 52 patients (53 hips), using the cemented Spectron stem and cementless Harris-Galante II cup as control implants (24 patients in experimental group, 29 control patients). Clinical measures of Harris Hip Score (HHS), pain score and radiostereometric analysis (RSA) at regular intervals for up to three years were used to monitor progress. RESULTS: No statistically significant differences were found in HHS and pain score; the stability of the cementless experimental implant was also comparable to that of the cemented controls by RSA. 3 revisions were required for migration in the experimental group and 1 was required for component dislocation in the control group. INTERPRETATION: Our findings indicate the practicality of osseointegration of titanium implants, but suggest that current performance is inadequate for clinical introduction. However, the stable fixation achieved in the retained neck in the majority of patients is indicative of osseointegration. This finding will encourage technical and design improvements for enhancement of clinical osseointegration and should also encourage further study. Periprosthetic osteolysis might be avoided by the establishment and maintenance of direct implant-bone connection: "osseointegration".
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| 6. |
- Fridén, Michael, et al.
(författare)
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Effects of a low-carbohydrate high polyunsaturated fat diet or a healthy Nordic diet versus usual care on liver fat content and cardiometabolic risk factors in people with type 2 diabetes and prediabetes: a randomized controlled trial (NAFLDiet)
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: Previous trials have shown that plant-derived polyunsaturated fatty acids (PUFA) in place of saturated fat reduces liver fat, a prerequisite for non-alcoholic fatty liver disease (NAFLD). The effect on liver fat from a novel “anti-lipogenic diet” replacing carbohydrates with PUFA or a healthy Nordic diet (HND) higher in whole-grains but lower in saturated fat has not yet been examined. Objectives: To investigate the effects on changes in liver fat (primary outcome) and other cardiometabolic risk factors after 12 months of follow-up in individuals with prediabetes or T2D from three different diet comparisons: a low carbohydrate high PUFA (LCPUFA) diet versus a HND, a LCPUFA diet versus usual care (UC) and a HND versus UC. Methods: A three-arm parallel ad libitum randomized trial was conducted. Adult men and women (n=148) were randomized to one of the three diet groups. Participants in all groups received key food items on a monthly/bimonthly basis. Liver fat and cardiometabolic risk factors were assessed at baseline and after 12 months. Dietary adherence was assessed using weighed food diaries and objective biomarkers. General linear models were employed to estimate the intention-to-treat (ITT) effect. Results: Dietary adherence was high for all diet groups. Liver fat was reduced to a similar extent in the LCPUFA and the HND group compared to UC (-1.46% (95% CI: -2.42, -0.51)) and -1.76 % (95% CI: -2.96, -0.57), respectively. No difference in liver fat between LCPUFA and HND was observed. Body weight and HbA1c decreased more in the HND compared to the other diet groups whereas no differences were observed between LCPUFA and UC. Similar reductions in LDL-cholesterol were observed for the HND and the LCPUFA group compared to UC, but only the HND reduced triglycerides and C-reactive protein (CRP) compared with UC. No differences were observed for any other secondary outcomes.Conclusions: A LCPUFA diet and a HND both reduced liver fat as compared with UC. Given the sustained weight loss after the HND compared to the other groups, together with improvements in other cardiometabolic markers, the HND in particular seems to be useful for the treatment of T2D and NAFLD.
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| 7. |
- Gabrielsson, Britt, 1957, et al.
(författare)
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Depot-specific expression of fibroblast growth factors in human adipose tissue.
- 2002
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Ingår i: Obesity research. - : Wiley. - 1071-7323 .- 1550-8528. ; 10:7, s. 608-16
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Tidskriftsartikel (refereegranskat)abstract
- We have investigated the expression of several fibroblast growth factors (FGFs) and FGF-receptors (FGFRs) in human adipose tissue and adipose-tissue cell fractions obtained from both subcutaneous (sc) and omental (om) depots.
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| 8. |
- Gabrielsson, Britt, 1957, et al.
(författare)
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High expression of complement components in omental adipose tissue in obese men.
- 2003
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Ingår i: Obesity research. - : Wiley. - 1071-7323 .- 1550-8528. ; 11:6, s. 699-708
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Accumulation of visceral fat is recognized as a predictor of obesity-related metabolic disturbances. Factors that are predominantly expressed in this depot could mediate the link between visceral obesity and associated diseases. RESEARCH METHODS AND PROCEDURES: Paired subcutaneous and omental adipose tissue biopsies were obtained from 10 obese men. Gene expression was analyzed by DNA microarrays in triplicate and by real-time polymerase chain reaction. Serum C3 and C4 were analyzed by radial immunodiffusion assays in 91 subjects representing a cross section of the general population. Body composition was measured by computerized tomography. RESULTS: Complement components C2, C3, C4, C7, and Factor B had higher expression in omental compared with subcutaneous adipose tissue ( approximately 2-, 4-, 17-, 10-, and 7-fold, respectively). In addition, adipsin, which belongs to the alternative pathway, and the classical pathway components C1QB, C1R, and C1S were expressed in both depots. Analysis of tissue distribution showed high expression of C2, C3, and C4 in omental adipose tissue, and only liver had higher expression of these genes. Serum C3 levels correlated with both visceral and subcutaneous adipose tissue in both men (r = 0.65 and p < 0.001 and r = 0.52 and p < 0.001, respectively) and women (r = 0.34 and p = 0.023 and r = 0.49 and p < 0.001, respectively), whereas C4 levels correlated with only visceral fat in men (r = 0.36, p = 0.015) and with both depots in women (visceral: r = 0.58, p < 0.001; and subcutaneous: r = 0.51, p < 0.001). DISCUSSION: Recent studies show that the metabolic syndrome is associated with chronically elevated levels of several immune markers, some of which may have metabolic effects. The high expression of complement genes in intra-abdominal adipose tissue might suggest that the complement system is involved in the development of visceral adiposity and/or contributes to the metabolic complications associated with increased visceral fat mass.
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| 9. |
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| 10. |
- Agarkova, Irina, et al.
(författare)
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The molecular composition of the sarcomeric M-band correlates with muscle fiber type
- 2004
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Ingår i: European Journal of Cell Biology. - 0171-9335. ; 83:5, s. 193-204
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Tidskriftsartikel (refereegranskat)abstract
- The M-band is the transverse structure that cross-links the thick filaments in the center and provides a perfect alignment of the A-band in the activated sarcomere. The molecular composition of the M-bands in adult mouse skeletal muscle is fiber-type dependent. All M-bands in fast fibers contain M-protein while M-bands in slow fibers contain a significant proportion of the EH-myomesin isoform, previously detected only in embryonic heart muscle. This fiber-type specificity develops during the first postnatal weeks. However, the ratio between the amounts of myosin and of myomesin, taken as sum of both isoforms, remains nearly constant in all studied muscles. Ultrastructural analysis demonstrates that some of the soleus fibers show a diffuse appearance of the M-band, resembling the situation in the embryonic heart. A model is proposed to explain the functional consequence of differential M-band composition for the physiological and morphological properties of sarcomeres in different muscle types.
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| 11. |
- Ahlberg, Erik, et al.
(författare)
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"Vi klimatforskare stödjer Greta och skolungdomarna"
- 2019
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Ingår i: Dagens nyheter (DN debatt). - 1101-2447.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- DN DEBATT 15/3. Sedan industrialiseringens början har vi använt omkring fyra femtedelar av den mängd fossilt kol som får förbrännas för att vi ska klara Parisavtalet. Vi har bara en femtedel kvar och det är bråttom att kraftigt reducera utsläppen. Det har Greta Thunberg och de strejkande ungdomarna förstått. Därför stödjer vi deras krav, skriver 270 klimatforskare.
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| 12. |
- Andersson, J., et al.
(författare)
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Worse survival for TP53 (p53)-mutated breast cancer patients receiving adjuvant CMF
- 2005
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Ingår i: Ann Oncol. - : Elsevier BV. - 0923-7534 .- 1569-8041. ; 16:5, s. 743-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: TP53 has been described as a prognostic factor in many malignancies, including breast cancer. Whether it also might be a predictive factor with reference to chemo- and endocrine therapy is more controversial. PATIENTS AND METHODS: We investigated relapse-free (RFS), breast cancer-corrected (BCCS) and overall survival (OS) related to TP53 status in node-positive breast cancer patients that had received polychemotherapy [cyclophosphamide, methotrexate, 5-fluorouracil (CMF)] and/or endocrine therapy (tamoxifen). Sequence analyses of the whole TP53 coding region was performed in 376 patients operated on for primary breast cancer with axillary lymph node metastases between 1984 and 1989 (median follow-up time 84 months). RESULTS: TP53 mutations were found in 105 patients (28%). We found 90 (82%) of the 110 mutations in the more frequently analysed exons 5-8, while the other 20 (18%) were located in exons 3-4 and 9-10, respectively. Univariate analyses showed TP53 to be a significant prognostic factor with regard to RFS, BCCS and OS in patients who received adjuvant CMF. CONCLUSIONS: TP53 mutations might induce resistance to certain modalities of breast cancer therapy. Sequence-determined TP53 mutation was of negative prognostic value in the total patient population and in the CMF treated patients.
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| 13. |
- Arvidsson, Eva, 1959-, et al.
(författare)
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Vägen framåt
- 2013
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Ingår i: Att välja rättvist. - Lund : Studentlitteratur AB. ; , s. 207-214
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Som vi visat har utvecklingen av metoder och strukturer för öppna prioriteringar i Sverige kommit långt. Många frågor återstår likväl. Under vårt arbete med denna bok har vi identifierat ett antal förbättringsområden och utmaningar som vi avslutningsvis vill lyfta fram. Det rör sig om vilka som ska delta i prioriteringarna, tydliggörande av värdegrunden, behov av bättre kunskap, baserad på både vetenskaplig metod och erfarenhet, och fortsatt utveckling av prioriteringsprocesser på olika nivåer och i olika sammanhang. Även om vi i Sverige skulle nå en god enighet kring principer och kriterier för prioriteringar så kommer vi alltid finna många olika sätt att praktiskt lösa specifika prioriteringsproblem.
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| 14. |
- Benson, Mikael, 1954, et al.
(författare)
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DNA microarray analysis of chromosomal susceptibility regions to identify candidate genes for allergic disease: A pilot study
- 2004
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 1651-2251 .- 0001-6489. ; 124:7, s. 813-819
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Tidskriftsartikel (refereegranskat)abstract
- Objective-To examine whether DNA microarray analysis of chromosomal susceptibility regions for allergy can help to identify candidate genes. Material and Methods-Nasal biopsies were obtained from 23 patients with allergic rhinitis and 12 healthy controls. RNA was extracted from the biopsies and pooled into three patient and three control pools. These were then analysed in duplicate with DNA microarrays containing 12626 genes. Candidate genes were further examined in nasal biopsies (real-time polymerase chain reaction) and blood samples (single nucleotide polymorphisms) from other patients with allergic rhinitis and from controls. Results-A total of 37 differentially expressed genes were identified according to criteria involving both the size and consistency of the gene expression levels. The chromosomal location of these genes was compared with the chromosomal susceptibility regions for allergic disease. Using a statistical method, five genes were identified in these regions, including serine protease inhibitor, Kazal type, 5 (SPINK5) and HLA-DRB2. The relevance of these genes was examined in other patients with allergic rhinitis and in controls; none of the genes were differentially expressed in nasal biopsies. Moreover, no association between allergic rhinitis and SPINK5 polymorphisms was found, at either the genotype or haplotype level. Conclusions-DNA microarray analysis of chromosomal susceptibility regions did not lead to identification of candidate genes that could be validated in a new material. However, because gene polymorphisms may cause differential gene expression, further studies, including validation data, are needed to examine this approach.
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| 15. |
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| 16. |
- Benson, Mikael, 1954, et al.
(författare)
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DNA microarray analysis of transforming growth factor-β and related transcripts in nasal biopsies from patients with allergic rhinitis
- 2002
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Ingår i: Cytokine. ; 18:1, s. 20-25
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Tidskriftsartikel (refereegranskat)abstract
- Decreased activity of anti-inflammatory cytokines like transforming growth factor (TGF)-β may contribute to allergic inflammation. In vivo effects of TGF-β-effects are difficult to infer from local concentrations, since TGF-β-effects depend on a complex system of regulatory proteins and receptors. Instead the effects of TGF-β might be inferred by examining TGF-β-inducible transcripts. In this study DNA microarrays were used to examine local expression of TGF-β, TGF-β-regulatory and -inducible transcripts in nasal biopsies from patients with symptomatic allergic rhinitis and healthy controls. In addition, nasal fluids were analysed with cytological and immunological methods. Nasal fluid eosinophils, albumin, eosinophil granulae proteins and IgE, but not TGF-β, were higher in patients than in controls. DNA microarray analysis of nasal mucosa showed expression of transcripts encoding TGF-β, TGF-β-regulatory proteins and -receptors at variable levels in patients and controls. By comparison, analysis of 28 TGF-β-inducible transcripts indicated that 23 of these had lower measurement values in patients than in controls, while one was higher, and the remaining four were absent in both patients and controls. In summary, TGF-β and a complex system of regulatory genes and receptors are expressed in the nasal mucosa. Low expression of TGF-β-inducible transcripts may indicate decreased TGF-β activity in allergic rhinitis. DNA microarray analysis may be a way to study cytokine effects in vivo.
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| 17. |
- Benson, Mikael, 1954, et al.
(författare)
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DNA microarrays to study gene expression in allergic airways.
- 2002
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Ingår i: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. - : Wiley. - 0954-7894 .- 1365-2222. ; 32:2, s. 301-8
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Tidskriftsartikel (refereegranskat)abstract
- Allergic rhinitis results from interactions between a large number of cells and mediators in different compartments of the body. DNA microarrays allow simultaneous measurement of expression of thousands of genes in the same tissue sample.
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| 18. |
- Benson, Mikael, 1954, et al.
(författare)
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Increased expression of Vascular Endothelial Growth Factor-A in seasonal allergic rhinitis.
- 2002
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Ingår i: Cytokine. - : Elsevier BV. - 1043-4666 .- 1096-0023. ; 20:6, s. 268-73
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Tidskriftsartikel (refereegranskat)abstract
- Increased vascular dilatation and permeability characterize allergic rhinitis. In this study oligonucleotide microarrays (Affymetrix HuGe95A) were used to identify differentially expressed vasoactive genes in nasal biopsies from 23 patients with symptomatic seasonal allergic rhinitis (SAR) and 12 healthy controls. RNA was extracted from the biopsies and pooled in three patient and three control pools. Out of 12,626 analysed transcripts, 39 were higher and 81 lower in the patients. Of these transcripts two have vasoactive effects: Vascular Endothelial Growth Factor-A (VEGF-A) and the Beta-1-Adrenergic Receptor. Both were higher in patients than in controls. The mean +/- SEM expression levels in arbitrary units of VEGF-A were 130 +/- 123 in the patients and 59 +/- 53 in the controls. The fold ratio in expression levels between patients/controls was 2.2. The corresponding values for the beta-1-adrenergic receptor were 129 +/- 123 in the patients and 40 +/- 31 in the controls. The fold ratio between patient/controls was 3.2. The role of VEGF-A was assessed by determining VEGF-A concentrations in nasal fluids from another 30 patients with SAR before and after allergen provocation. VEGF-A increased from 124.3 +/- 30.2 to 163.2 +/- 37.8 pg/ml after challenge, P < 0.05. In summary, oligonucleotide microarray analysis of nasal biopsies and protein analyses of nasal fluids indicate that VEGF-A may be an important mediator in SAR.
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| 19. |
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| 20. |
- Carlsson, Björn, 1958, et al.
(författare)
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Obese (ob) gene defects are rare in human obesity
- 1997
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Ingår i: Obesity Research. - 1071-7323 .- 1550-8528. ; 5:1, s. 30-5
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Tidskriftsartikel (refereegranskat)abstract
- Our knowledge of the role of the recently cloned ob-protein (leptin) in the regulation of body fat stores is largely derived from experiments performed in mice. Different mouse models exhibit abnormalities in ob-gene expression, with extreme overexpression in mice which lack bioactive ob-protein, have nonfunctional ob-receptors or hypothalamic lesions, and undetectable expression in mice with suggested defects in regulatory elements. The aim of this study is to examine if defects, corresponding to those in mice, exist in human obesity. Adipose tissue was obtained from 94 adult obese subjects and from six children who had developed obesity after surgery in the hypothalamic region. Total RNA was isolated and ob-gene expression was examined by reverse transcriptase-polymerase chain reaction (RT-PCR) and Northern blot. The coding region of the ob-gene was sequenced in both directions in the 94 obese adults. No mutations were detected in the coding region of the ob-gene and ob-gene expression was detectable in all subjects and none of the subjects had an extreme overexpression. There was no systematic increase in ob-expression in obese children with hypothalamic disease compared to their healthy brothers and sisters. These results show that severe abnormalities involving the ob-gene, analogous to those described in mouse models, are rare in human obesity. We therefore conclude that the cloning and subsequent analysis of the ob-gene has not provided information that can, by itself, explain the genetic component in the development of human obesity.
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| 21. |
- Carlsson, Lars, 1952, et al.
(författare)
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Bone conserving hip replacement.
- 2004
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Ingår i: 3rd Annual SICOT/SIROT Conference 2004.
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Konferensbidrag (refereegranskat)
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| 22. |
- Carlsson, Lars, et al.
(författare)
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Early multidisciplinary assessment was associated with longer periods of sick leave : A randomized controlled trial in a primary health care centre
- 2013
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 31:3, s. 141-146
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo study the effects on sick leave from an early multidisciplinary assessment at a primary health care centre. Design. Randomized controlled trial.SettingPatients who saw GPs at a primary health care centre in mid-Sweden and asked for a sickness certificate for psychiatric or musculoskeletal diagnoses were invited to participate. Patients included were sick-listed for less than four weeks; 33 patients were randomized either to an assessment within a week by a physiotherapist, a psychotherapist, and an occupational therapist or to "standard care". The therapists used methods and tools they normally use in their clinical work.Main outcome measureProportion of patients still sick-listed three months after randomization, total and net days on sick leave, and proportion who were on part-time sick leave.ResultsAt follow-up after three months, in contrast to the pre-trial hypothesis, there was a trend toward a higher proportion of patients still sick-listed in the intervention group (7/18) as compared with the control group (3/15). The intervention group also had significantly longer sick-listing periods (mean 58 days) than the control group (mean 36 days) (p = 0.038). The proportion of patients who were part time sick-listed was significantly higher in the intervention group (10/18) than in the control group (2/15) (p = 0.027).ConclusionsIn this study an early multidisciplinary assessment was associated with longer periods on sick leave and more individuals on part-time sick leave.
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| 23. |
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| 24. |
- Carlsson, Lars, et al.
(författare)
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Enhanced systolic myocardial function in elite endurance athletes during combined arm-and-leg exercise
- 2011
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Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 111:6, s. 905-913
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Tidskriftsartikel (refereegranskat)abstract
- The aim here was to employ color tissue velocity imaging (TVI), to test the hypothesis that highly trained endurance athletes exhibit enhanced systolic function of the left ventricular (LV) myocardium both at rest and during combined arm-and-leg exercise in comparison with untrained subjects. For each of the ten elite male (EG) and ten matched control participants (CG), LV dimensions and systolic function were assessed at rest using echocardiography. Subsequently, these subjects exercised continuously on a combined arm-and-leg cycle ergometer for 3 min each at 50, 60, 70, 80, 90 and 100% of VO2max. Oxygen uptake, heart rate, systolic blood pressure (SBP) and peak contraction systolic velocities of the LV myocardium (PSV) were recorded in the end of each level. At rest, the trained and untrained groups differed with respect to LV dimensions, but not systolic function. At 60–100% VO2max, the EG group demonstrated both higher PSV and SBP. The observation that the EG athletes had higher PSV than CG during exercise at 60–100% VO2max, but not at rest or at 50% of VO2max, suggested an enhanced systolic capacity. This improvement is likely to be due to an enhanced inotropic contractility, which only becomes apparent during exercise.
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| 25. |
- Carlsson, Lena M S, 1957, et al.
(författare)
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Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects.
- 2012
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Ingår i: The New England journal of medicine. - : Massachusetts Medical Society. - 1533-4406 .- 0028-4793. ; 367:8, s. 695-704
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Weight loss protects against type 2 diabetes but is hard to maintain with behavioral modification alone. In an analysis of data from a nonrandomized, prospective, controlled study, we examined the effects of bariatric surgery on the prevention of type 2 diabetes.
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| 26. |
- Carlsson, Lars, 1952, et al.
(författare)
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Minimally invasive surgery vs conventional exposure using the Miller-Galante unicompartmental knee arthroplasty: a randomized radiostereometric study
- 2006
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Ingår i: J Arthroplasty. - 0883-5403. ; 21:2, s. 151-6
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Tidskriftsartikel (refereegranskat)abstract
- Forty-one patients were randomized to a cemented Miller-Galante unicompartmental (Zimmer, Warsaw, Ind) knee arthroplasty inserted with either minimally invasive surgery or with a standard exposure. Clinical data and conventional radiographs were recorded and patients were followed with radiostereometric analysis to measure migration rate of the tibial component. The rehabilitation of patients operated through a small incision was faster, and there was a significant difference in days of hospitalization (P = .03). No statistical significant difference was found between the 2 groups regarding clinical or radiographic data. The Hospital for Special Surgery score was 96 and 92, respectively, for the minimally invasive surgery and conventional group at 2 years. The limb alignment was equal in both groups with a mean femorotibial axis of 182 degrees after surgery. The rate of migration for tibial components was very small, with a maximal total point motion of 0.8 mm for both groups after 2 years follow-up.
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| 27. |
- Carlsson, Lars, 1952, et al.
(författare)
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Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: II. Clinical proof of concept--40 patients followed for 2 years
- 2006
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 77:4, s. 559-566
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We have developed a bone-conserving commercially pure titanium hip replacement system using osseointegration principles: a metaphyseal loading proximal femoral component affixing into the retained neck and metaphysis only, leaving the femoral canal untouched. The acetabular cup closely fits a dual-geometry cavity, avoiding stress protection at the dome. PATIENTS AND METHODS: After extensive laboratory and clinical pilot trial investigations, the surface-engineered implants were submitted to a prospective randomized controlled clinical trial involving 40 patients (40 hips), in which they were compared to the cemented Spectron femoral component and cementless Trilogy cup as control implant. The following clinical measures were used to monitor progress at regular intervals for the first 2 postoperative years: radiostereometric analysis (RSA), Harris Hip Score, pain score, WOMAC, and SF-36. RESULTS: After 2 years of follow-up, no statistically significant differences were seen between the groups concerning rotation or translation along the cardinal axes. The patients receiving the Gothenburg osseointegrated titanium (GOT) system had significantly higher Harris Hip Score at 6 months, suggesting more rapid recovery. WOMAC, SF-36 and pain analysis were similar for the first 2 postoperative years. INTERPRETATION: Our RSA data suggest that osseointegration was achieved for all patients receiving the GOT hip system. This bone-conserving prosthesis may provide a good alternative, especially for young and active patients.
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| 28. |
- Carlsson, Magnus, et al.
(författare)
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Physiological demands of competitive sprint and distance performance in elite female cross-country skiing
- 2016
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Ingår i: Journal of Strength and Conditioning Research. - : Lippincott Williams & Wilkins. - 1064-8011 .- 1533-4287. ; 30:8, s. 2138-2144
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Tidskriftsartikel (refereegranskat)abstract
- The purpose was to investigate the relationship between elite females' competitive performance capability in sprint and distance cross-country skiing and the variables of gross efficiency (GE), work rate at the onset of blood-lactate accumulation (OBLA4mmol), maximal oxygen uptake (V[Combining Dot Above]O2max), maximal speed (Vmax), and peak upper-body oxygen uptake (V[Combining Dot Above]O2peak). Ten elite female cross-country skiers (age 24.5 ± 2.8 years) completed treadmill roller-skiing tests to determine GE, OBLA4mmol, and V[Combining Dot Above]O2max using the diagonal-stride technique as well as Vmax and V[Combining Dot Above]O2peak using the double-poling technique. International Ski Federations ranking points for sprint (FISsprint) and distance (FISdist) races were used as competitive performance data. There were correlations between the FISsprint and the V[Combining Dot Above]O2max expressed absolutely (p = 0.0040), Vmax (p = 0.012), and V[Combining Dot Above]O2peak expressed absolutely (p < 0.001) and as a simple ratio-standard (p = 0.049). The FISdist were correlated with OBLA4mmol (p = 0.048), V[Combining Dot Above]O2max expressed absolutely (L·min) (p = 0.015) and as a simple ratio-standard (p = 0.046), and V[Combining Dot Above]O2peak expressed absolutely (p = 0.036) and as a simple ratio-standard (ml·min·kg) (p = 0.040). The results demonstrate that the physiological abilities reflected by V[Combining Dot Above]O2max and V[Combining Dot Above]O2peak are indicators of competitive sprint and distance performance in elite female cross-country skiing. In addition, the ability to generate a high Vmax indicates the performance in sprint races, whereas the skier's OBLA4mmol reflects the performance capability in distance races. Based on the results, when evaluating the performance capacity of elite female cross-country skiers, it is recommended to use physiological variables that reflect competitive performance.
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| 29. |
- Carlsson, Per, 1951-, et al.
(författare)
-
Prioritering av läkemedel för behandling av patienter med sällsynta sjukdomar
- 2014
-
Ingår i: Läkemedel för djur, maskinell dos och sällsynta tillstånd. - Stockholm : Fritzes. - 9789138242070 ; , s. 639-699
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- I vilken utsträckning kan särskilda hänsyn tas vid prioritering av särläkemedel och läkemedel för behandling av sällsynta tillstånd? Bör man i vissa speciella situationer kunna acceptera sämre kostnadseffektivitet och lägre krav på vetenskapligt underlag? Om så, vad är det för villkor/kriterier som då bör vara uppfyllda? Hur stämmer ett sådant undantag med den etiska plattformen för prioriteringar? Finns det andra argument som talar för eller mot en särbehandling av sällsynta tillstånd? Detta är frågor som vi diskuterar i denna rapport som tagits fram på uppdrag av Läkemedels- och apoteksutredningen.I rapporten konstaterar vi att särläkemedel är en relativt heterogen grupp av läkemedel och att det finns andra läkemedel med motsvarande egenskaper som inte ansökt eller kunnat ansöka om status som särläkemedel. Ur prioriteringssynpunkt är det därför mer relevant att fokusera på alla typer av läkemedel, som används för sällsynta tillstånd, när vi diskuterar vilka principer för prioriteringar som bör gälla.Utifrån litteratur och erfarenheter i andra länder, som formulerat kriterier för en särskild hantering av läkemedel vid sällsynta sjukdomar, drar vi den preliminära slutsatsen att samhället bör kunna betala mer per hälsovinst (kostnad per kvalitetsjusterat levnadsår (QALY)) och acceptera lägre krav på vetenskapligt underlag vid prioritering av läkemedel för behandling av sällsynta sjukdomar om samtliga följande villkor är uppfyllda:att behandlingen har en hög kostnad per hälsovinst som en konsekvens av att den omfattar endast få patienter,att det rör sig om ett tillstånd med mycket stor svårighetsgrad,att det behandlingsalternativ som övervägs på goda grunder ska antas ha en väsentlig effekt,att det inte finns någon alternativ behandling med en väsentlig effekt som förväntas förebygga, bota, fördröja försämring eller lindra det aktuella tillståndet.Om dessa kriterier anses uppfyllda kan läkemedlet bedömas i relation till ett förhöjt tröskelvärde för kostnadseffektivitet. Hur högt detta värde kan vara för att anses rimligt tar vi inte ställning till i rapporten, men en viktig ståndpunkt är att det måste finnas en övre gräns för hur hög kostnad per QALY samhället kan acceptera. Detta bör gälla även om ovanstående kriterier är uppfyllda, annars riskerar det uppstå oacceptabla undanträngningseffekter av andra prioriterade åtgärder. Även lägre krav på vetenskapligt underlag skakunna accepteras....
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| 30. |
- Carlsson, Per, et al.
(författare)
-
Prioritering och finansiering av läkemedel för behandling av patienter med sällsynta sjukdomar
- 2012
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Den pågående Läkemedels- och apoteksutredningen har i ett tilläggsdirektiv fått i uppdrag att analysera behovet av särskilda lösningar vid beslut om subventionering för särläkemedel. Ett särläkemedel är ett läkemedel som uppfyller vissa villkor och därmed omfattas av ett särskilda stimulansåtgärder innan godkännande av läkemedelsmyndighet samt möjlighet, men inte rätt, till ensamrätt på marknaden under 10 år. Till villkoren hör bl.a. att läkemedlet är avsett för att diagnostisera, förebygga eller behandla livshotande tillstånd eller tillstånd med kronisk funktionsnedsättning och som högst 5 av 10 000 personer i gemenskapen lider av vid ansökningstillfället.
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| 31. |
- Carlsson, Per, et al.
(författare)
-
Prioritering och finansiering av läkemedel för behandling av patienter med sällsynta sjukdomar : Reviderad version
- 2015
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I vilken utsträckning kan särskilda hänsyn tas vid prioritering av särläkemedel och läkemedel för behandling av sällsynta tillstånd? Bör man i vissa speciella situationer kunna acceptera sämre kostnadseffektivitet och lägre krav på vetenskapligt underlag? Om så, vad är det för villkor/kriterier som då bör vara uppfyllda? Hur stämmer ett sådant undantag med den etiska plattformen för prioriteringar? Finns det andra argument som talar för eller mot en särbehandling av sällsynta tillstånd? Detta är frågor som vi diskuterar i denna rapport som tagits fram på uppdrag av Läkemedels- och apoteksutredningen.I rapporten konstaterar vi att särläkemedel är en relativt heterogen grupp av läkemedel och att det finns andra läkemedel med motsvarande egenskaper som inte ansökt eller kunnat ansöka om status som särläkemedel. Ur prioriteringssynpunkt är det därför mer relevant att fokusera på alla typer av läkemedel, som används för sällsynta tillstånd, när vi diskuterar vilka principer för prioriteringar som bör gälla.Utifrån litteratur och erfarenheter i andra länder, som formulerat kriterier för en särskild hantering av läkemedel vid sällsynta sjukdomar, drar vi den preliminära slutsatsen att samhället bör kunna betala mer per hälsovinst (kostnad per kvalitetsjusterat levnadsår (QALY)) och acceptera lägre krav på vetenskapligt underlag vid prioritering av läkemedel för behandling av sällsynta sjukdomar om samtliga följande villkor är uppfyllda:att behandlingen har en hög kostnad per hälsovinst som en konsekvens av att den omfattar endast få patienter,att det rör sig om ett tillstånd med mycket stor svårighetsgrad,att det behandlingsalternativ som övervägs på goda grunder ska antas ha en väsentlig effekt,att det inte finns någon alternativ behandling med en väsentlig effekt som förväntas förebygga, bota, fördröja försämring eller lindra det aktuella tillståndet.Om dessa kriterier anses uppfyllda kan läkemedlet bedömas i relation till ett förhöjt tröskelvärde för kostnadseffektivitet. Hur högt detta värde kan vara för att anses rimligt tar vi inte ställning till i rapporten, men en viktig ståndpunkt är att det måste finnas en övre gräns för hur hög kostnad per QALY samhället kan acceptera. Detta bör gälla även om ovanstående kriterier är uppfyllda, annars riskerar det uppstå oacceptabla undanträngningseffekter av andra prioriterade åtgärder. Även lägre krav på vetenskapligt underlag ska kunna accepteras.Denna preliminära slutsats prövas sedan mot den svenska etiska plattformen och ur ett samhällsekonomiskt perspektiv. Våra slutsatser från den etiska analysen är att:Människovärdesprincipen tillåter att sällsynta tillstånd som ger upphov till höga behandlingskostnader kan särbehandlas och därmed kan vårt första kriterium accepteras utifrån den etiska plattformen. När ett högre tröskelvärde (kostnad per vunnen hälsovinst) för behandling av sällsynta tillstånd accepteras, så ges dessa patienter större likhet i tillgång till hälsa jämfört med andra patienter (under förutsättning att även andra kriterier är uppfyllda). Detta innebär dock inte automatiskt att alla sällsynta tillstånd som ger upphov till höga behandlingskostnader bör särbehandlas.Enligt behovs-solidaritetsprincipen bör samhället sträva efter att alla medborgare i så stor utsträckning som möjligt ges lika möjligheter till vård; men även att de uppnår en så lika nivå av hälsa som möjligt. Det senare förutsätter att vi i första hand prioriterar dem som ligger längst ifrån en sådan lika nivå, dvs. de med störst behov. För att vi ska kunna påverka möjligheter och utfall när det gäller hälsa krävs det att de åtgärder som används faktiskt kan påverka personer till att närma sig ett mer lika utfall, dvs. att dessa åtgärder har en väsentlig effekt på hälsan.Kostnadseffektivitetsprincipen säger att vid val mellan olika verksamhetsområden eller åtgärder bör en rimlig relation mellan kostnader och effekt eftersträvas. Det framgår att mycket svåra tillstånd ska gå före lindrigare tillstånd, även om åtgärderna gentemot de förra är förknippade med förhållandevis högre kostnader per hälsovinst. När ovanstående kriterier är uppfyllda för behandling av ett sällsynt tillstånd innebär det endast att behandlingen kan bli föremål för en bedömning av om ett höjt tröskelvärde kan accepteras. Det innebär alltså inte automatiskt att behandlingen bör erbjudas eller att ett läkemedel till exempel ska inkluderas i läkemedelsförmånerna. Även med dessa kriterier uppfyllda och att det därmed finns skäl för särbehandling av behandlingen, bör beslutfattaren även i det läget komma fram till vad som är en rimlig relation mellan kostnader och effekt, dvs. vilket som är ett acceptabelt tröskelvärde i den aktuella beslutssituationen.Sammanfattningsvis anser vi att dagens etiska plattform tillsammans med den modifiering av kostnadseffektivitetsprincipen, som finns i senare lagstiftning, ger möjlighet att ta särskilda hänsyn vid prioritering av läkemedel riktade till sällsynta och mycket svåra tillstånd. För att en särbehandling av ett läkemedel ska kunna övervägas bör det ha en väsentlig effekt på det aktuella tillståndet. Det är en skillnad mellan behandlingar som har dålig kostnadseffektivitet på grund av liten effekt respektive om de har det på grund av hög kostnad. Skillnaden motiveras utifrån att effektstorleken hos behandlingen påverkar dess möjlighet att bidra till ett utfall som ligger i linje med resten av befolkningens hälsa och livskvalitet, där en större effektstorlek närmar sig detta på ett bättre sätt. Vår tolkning är att om det finns två åtgärder med samma kostnadseffektivitetskvot och samma svårighetsgrad men där den ena har större effekt på tillståndet än den andra, så är den med störst effekt som ska ges företräde.Vi har även undersökt om det finns några argument utifrån samhällsekonomisk effektivitet som talar för eller emot en särbehandling av sällsynta tillstånd. Detta görs utifrån teoretisk och empirisk litteratur i ämnet och preliminära data från en svensk studie. Enligt vissa studier finns det ett samhälleligt värde i vetskapen om att människor blir omhändertagna oavsett situation och det skapar större trygghet och tillit till samhället utifrån dels ett egenintresse eftersom alla människor i ett samhälle löper en risk att drabbas av svåra tillstånd. Det finns också en altruistisk motivering som består i att människor i allmänhet kan påverkas positivt av att bara veta att de lever i ett barmhärtigt samhälle.Det finns dock inget stöd i renodlade empiriska studier för att människor i allmänhet anser att behandling av sällsynta sjukdomar, allt annat lika, ska särbehandlas. Med andra ord saknas empiriskt stöd för att sällsynthet i sig är ett relevant kriterium vid prioritering. Det var även slutsatsen av vår tidigare etiska argumentation kring detta (se Carlsson et al. 2012). Preliminära data från en pågående svensk studie kommer delvis fram till samma slutsats. När analysen i samma studie fördjupas och kompletteras med attitydfrågor och fokusgruppsintervjuer framträder dock en mer nyanserad bild, nämligen att om det rör sig om sällsynta tillstånd med hög svårighetsgrad, och det är den enda behandlingen, så kan stöd finnas för särbehandling.Efter att ha konstaterat att särskild hänsyn kan övervägas vid prioritering av läkemedel som ska användas vid svåra och sällsynta tillstånd utifrån den etiska plattformen och ur ett välfärdsekonomiskt perspektiv återstår att ta ställning till en rad praktiska överväganden vid utformning av procedurer för prioriteringar, nämligen:Utifrån målet att minska olikheter och garantera vård på lika villkor för sällsynta tillstånd är antagligen en modell med ett nationellt beslutsfattande att föredra. Samma principer för prioritering av läkemedel vid sällsynta och svåra tillstånd bör gälla oavsett hur läkemedlet når patienten, dvs. oavsett om detta sker som läkemedel på recept eller rekvisitionsläkemedel. Om prioriteringen görs av en eller flera instanser är en organisatorisk fråga som vi inte tar ställning till i denna rapport.Ur prioriteringssynpunkt bör det inte göras åtskillnad mellan särläkemedel och andra läkemedel som används för sällsynta tillstånd. När det gäller beslut om särläkemedel i allmänhet ska ingå i förmånssystemet bör de utvärderas och beslutas av Tandvård- och läkemedelsförmånsverket (TLV) på sedvanligt sätt medan vid sådana läkemedel som riktas mot tillstånd som både är mycket sällsynta och mycket svåra kan särskild hänsyn behöva tas och handläggas enligt en modifierad ordning. Detta bör avse såväl kostnaden per hälsovinst som hantering av osäkerhet i det vetenskapliga underlaget och bör gälla oavsett status som särläkemedel eller ej.I vissa situationer när det vetenskapliga underlaget är mycket osäkert uppstår problem vid ställningstagande om generell användning av dyra läkemedel för svår sjukdom på gruppnivå. Det förefaller i det läget rimligt att initialt ge visst avkall på evidensunderlaget för kostnadseffektivitet vid svåra sjukdomar när det av olika skäl inte ter sig möjligt av praktiska skäl att få fram ett sådant. Det kan dock finnas en konflikt i att både acceptera en högre betalningsvilja och dessutom acceptera en större osäkerhet i beslutsunderlaget. I sådana fall är det särskilt angeläget att sörja för en adekvat uppföljning för att så snart som möjligt försöka minska osäkerheten och eventuellt ompröva beslutet.De finns olika principer för hur en patientgrupp med mycket svåra och sällsynta tillstånd kan avgränsas. Gruppen kan dels
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| 32. |
- Carlsson, Per, et al.
(författare)
-
Prioritering och finansiering av läkemedel för behandling av patienter med sällsynta sjukdomar : Reviderad version
- 2012
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I ett tilläggsdirektiv till utredningen om vissa frågor om prissättning, tillgänglighet och marknadsförutsättningar inom läkemedels- och apoteksområdet (Dir. 2011:82) ingår att analysera behovet av särskilda lösningar vid beslut om subventionering för särläkemedel. Ett särläkemedel är ett läkemedel som uppfyller vissa villkor och därmed omfattas av särskilda stimulansåtgärder innan godkännande av läkemedelsmyndighet samt möjlighet, men inte rätt, till ensamrätt på marknaden under 10 år.I rapporten analyseras den etiska plattformen och läkemedelsförmånslagen, som är Tandvårds- och läkemedelsförmånsverkets (TLV) utgångspunkter för subventionsbeslut. En slutsats som dras är att dagens etiska plattform tillsammans med den modifiering av kostnadseffektivitetsprincipen, som finns i lagen om läkemedelsförmåner, ger möjlighet att komma till slutsatsen att samhället är berett att betala mer per hälsovinst för läkemedel riktade till mycket sällsynta och svåra sjukdomar/tillstånd.Människovärdesprincipen ger uttryck för att irrelevant grupptillhörighet eller gruppegenskap inte ska påverka en patientgrupps lika möjligheter och lika utfall när det gäller hälsa. Huruvida en patientgrupp är liten eller stor är en sådan irrelevant gruppegenskap och gruppens storlek eller tillståndets sällsynthet bör därmed inte påverka gruppens möjligheter till behandling eller till att kunna uppnå ett jämlikt hälsoutfall jämfört med andra större grupper eller grupper med mer vanliga sjukdomar. Däremot kan den konsekvens i form av höga kostnader för behandling som sällsynthet kan medföra, vara en grund för särbehandling.Behovs-solidaritetsprincipen ger dels uttryck för att alla medborgare bör ges lika möjligheter att uppnå god hälsa och dels uttryck för att vi bör uppnå ett så lika hälsoutfall som möjligt för medborgarna. Om vi låter utvecklingskostnaden för läkemedel mot sällsynta tillstånd påverka möjligheten att ta del av dessa läkemedel ges inte medborgarna lika möjligheter till att uppnå god hälsa. Utifrån detta drar vi slutsatsen att sällsynta och svåra tillstånd bör ges likartade möjligheter att uppnå god hälsa som vanliga och allvarliga tillstånd.Kostnadseffektivitetsprincipen. När en sämre kostnadseffektivitet främst beror på höga kostnader som framför allt är kopplade till storleken på den grupp som patienten tillhör dvs. storleken på marknaden för läkemedlet och inte på dålig effekt hos åtgärden finns det av rättviseskäl anledning att dels försöka påverka kostnadsaspekten av läkemedlet, dels i vissa fall acceptera en sämre kostnadseffektivitet. Kostnaden kan påverkas genom t.ex. prissättning på läkemedel efter särskilda avtal med det marknadsförande företaget. Det finns ett värde i att veta att man lever i ett barmhärtigt samhälle som tar hand om och försöker hjälpa de människor som befinner sig i livshotande eller andra svåra situationer. Detta värde består dels i att vetskapen skapar större trygghet och tillit till samhället utifrån ett egenintresse eftersom vi alla kan löpa risk att drabbas av svåra tillstånd, dels utifrån en mer altruistisk motivering som består i att vi påverkas positivt av att bara veta att vi lever i ett barmhärtigt samhälle. Detta är en faktor som därför även borde vägas in i kostnadseffektivitetskalkyler. Storleken på detta värde är oklart.Särläkemedel är en relativt heterogen grupp och det finns andra läkemedel med motsvarande egenskaper som inte ansökt om status som särläkemedel. Ur prioriteringssynpunkt är det mer relevant att istället fokusera på läkemedel som används för sällsynta och svåra sjukdomar. Läkemedel vid mycket sällsynta och svåra tillstånd, särskilt när annan behandling saknas, bör därför handläggas i sär- skild ordning oavsett status som särläkemedel eller ej. För att säkerställa jämlik tillgång, transparenta beslut och god vård är en modell med nationellt beslutsfattande för sådana läkemedel att föredra. Tre alternativa principer för beslut och finansiering diskuteras: staten som huvudman, samarbete mellan stat och landsting samt samarbete mellan landstingen.
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| 33. |
- Carlsson, Tomas, et al.
(författare)
-
The effects of strength training versus ski-ergometer training on double-poling capacity of elite junior cross-country skiers
- 2017
-
Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 117:8, s. 1523-1532
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeTo compare the effects of strength training versus ski-ergometer training on double-poling gross efficiency (GE), maximal speed (Vmax), peak oxygen uptake (V˙O2peak" role="presentation" style="box-sizing: border-box; display: inline-table; line-height: normal; letter-spacing: normal; word-spacing: normal; word-wrap: normal; white-space: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; padding: 0px; margin: 0px; position: relative;">V˙O2peakV˙O2peak) for elite male and female junior cross-country skiers.MethodsThirty-three elite junior cross-country skiers completed a 6-week training-intervention period with two additional 40-min training sessions per week. The participants were matched in pairs and within each pair randomly assigned to either a strength-training group (STR) or a ski-ergometer-training group (ERG). Before and after the intervention, the participants completed three treadmill roller-skiing tests to determine GE, Vmax, and V˙O2peak" role="presentation" style="box-sizing: border-box; display: inline-table; line-height: normal; letter-spacing: normal; word-spacing: normal; word-wrap: normal; white-space: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; padding: 0px; margin: 0px; position: relative;">V˙O2peakV˙O2peak. Mixed between-within subjects analysis of variance (ANOVA) was conducted to evaluate differences between and within groups. Paired samples t tests were used as post hoc tests to investigate within-group differences.ResultsBoth groups improved their Vmax and V˙O2peak" role="presentation" style="box-sizing: border-box; display: inline-table; line-height: normal; letter-spacing: normal; word-spacing: normal; word-wrap: normal; white-space: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; padding: 0px; margin: 0px; position: relative;">V˙O2peakV˙O2peak expressed absolutely (all P < 0.01). For the gender-specific sub-groups, it was found that the female skiers in both groups improved both Vmax and V˙O2peak" role="presentation" style="box-sizing: border-box; display: inline-table; line-height: normal; letter-spacing: normal; word-spacing: normal; word-wrap: normal; white-space: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; padding: 0px; margin: 0px; position: relative;">V˙O2peakV˙O2peak expressed absolutely (all P < 0.05), whereas the only within-group differences found for the men were improvements of Vmax in the STR group. No between-group differences were found for any of the investigated variables.ConclusionsPhysiological and performance-related variables of importance for skiers were improved for both training regimes. The results demonstrate that the female skiers’ physiological adaptations to training, in general, were greater than those of the men. The magnitude of the physiological adaptations was similar for both training regimes.
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| 34. |
- Carlsson, Tomas, et al.
(författare)
-
The Modern Double-Poling Technique Is Not More Energy Efficient Than the Old-Fashioned Double-Poling Technique at a Submaximal Work Intensity
- 2022
-
Ingår i: Frontiers in Sports and Active Living. - : Frontiers Media SA. - 2624-9367. ; 4
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was to investigate whether there are energy-efficiency differences between the execution of the old-fashioned double-poling technique (DPOLD) and the modern double-poling technique (DPMOD) at a submaximal work intensity among elite male cross-country skiers. Fifteen elite male cross-country skiers completed two 4-min tests at a constant mechanical work rate (MWR) using the DPMOD and DPOLD. During the last minute of each test, the mean oxygen uptake (VO2) and respiratory exchange ratio (RER) were analyzed, from which the metabolic rate (MR) and gross efficiency (GE) were calculated. In addition, the difference between pretest and posttest blood-lactate concentrations (BLadiff) was determined. For each technique, skiers’ joint angles (i.e., heel, ankle, knee, hip, shoulder, and elbow) were analyzed at the highest and lowest positions during the double-poling cycle. Paired-samples t-tests were used to investigate differences between DPMOD and DPOLD outcomes. There were no significant differences in either VO2mean, MR, GE, or BLadiff (all P > 0.05) between the DPMOD and DPOLD tests. DPMOD execution was associated with a higher RER (P < 0.05). Significant technique-specific differences were found in either the highest and/or the lowest position for all six analyzed joint angles (all P < 0.001). Hence, despite decades of double-poling technique development, which is reflected in the significant biomechanical differences between DPOLD and DPMOD execution, at submaximal work intensity, the modern technique is not more energy efficient than the old-fashioned technique.
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| 35. |
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| 36. |
- Dahlström, Lars, et al.
(författare)
-
Comparison of effects of electromyographic biofeedback and occlusal splint therapy on mandibular dysfunction.
- 1982
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Ingår i: Scandinavian journal of dental research. - 0029-845X. ; 90:2, s. 151-6
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Tidskriftsartikel (refereegranskat)abstract
- In order to evaluate and compare the effects of biofeedback and occlusal splint therapy on mandibular dysfunction, 30 patients were randomly divided into two treatment groups. The patients were women aged 20--40 years without any obvious organic reasons for their symptoms. There were no significant differences between the two groups before the start of treatment in respect of signs and symptoms of mandibular dysfunction. One group used full coverage splints at night for 6 weeks. The other group received biofeedback training up to six times, 30 min per session. One month after completion of the therapy the patients were re-examined. Both groups showed a significant reduction in symptoms, both subjectively and clinically. No significant differences between the groups were found. The two treatments were thus equally effective in the short-term perspective in patients with signs and symptoms of mandibular dysfunction.
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| 37. |
- Delling, Lotta, et al.
(författare)
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Feasibility of bariatric surgery as a strategy for secondary prevention in cardiovascular disease: a report from the Swedish obese subjects trial.
- 2010
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Ingår i: Journal of obesity (Online). - : Hindawi Limited. - 2090-0716 .- 2090-0708. ; 2010
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Forskningsöversikt (refereegranskat)abstract
- Aims. Evaluation of bariatric surgery as secondary prevention in obese patients with ischemic heart disease (IHD). Methods. Analysis of data from 4047 subjects in the Swedish Obese Subjects (SOSs) study. Thirty-five patients with IHD are treated with bariatric surgery (n = 21) or conventional treatment (n = 14). Mean follow-up is 10.8 years. Results. Bariatric surgery resulted in sustained weight loss during the study period. After 2 years, the surgery group displayed significant reductions in cardiovascular risk factors, relief from cardiorespiratory symptoms, increments in physical activity, and improved quality of life. After 10 years, recovery from hypertension, diabetes, physical inactivity, and depression was still more common in the surgery group. There were no signs of increased cardiovascular morbidity or mortality in the surgery group. Conclusion. Bariatric surgery appears to be a safe and feasible treatment to achieve long-term weight loss and improvement in cardiovascular risk factors, symptoms, and quality of life in obese subjects with IHD.
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| 38. |
- Ekbäck, Gustav, et al.
(författare)
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Preoperative platelet-rich plasmapheresis and hemodilution with an autotransfusion device in total hip replacement surgery
- 2000
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Ingår i: Journal of clinical apheresis. - 0733-2459 .- 1098-1101. ; 15:4, s. 256-261
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Tidskriftsartikel (refereegranskat)abstract
- The effectiveness of both preoperative autologous donation (PAD) and intraoperative autotransfusion (IAT) with an autotransfusion device has recently been questioned. Preoperative apheresis, with separation of concentrated platelet rich-plasma (c-PRP) and erythrocyte concentrate (ERC), represents an aggressive use of the autotransfusion device. Can such a procedure replace PAD in total hip replacement surgery (THR)? Eighty patients undergoing THR were investigated in a prospective and randomized study. Forty patients underwent PAD, and 2 units of ERC + plasma were retrieved within 4 weeks preoperatively. Another 40 patients underwent an immediately preoperative apheresis with a concomitant hemodilution with 4% albumin, retrieving c-PRP (30% of the platelet pool) and 2 units of ERC. Both groups used IAT up to 2 hours postoperatively, with 3% dextran-60 as a plasma substitute according to our standard of care. There were no differences in blood loss, B-hemoglobin or allogeneic transfusions between the groups: 85% of the patients did not receive allogeneic blood. Both apheresis and reinfusion of c-PRP had minor impact on the coagulation parameters. Platelet count increased slightly but significantly (P < 0.05) from 154 to 179 × 109/L after the c-PRP at wound closure. Preoperative apheresis with an autotransfusion device, separating platelet-rich plasma and erythrocyte concentrate, is a useful alternative for patients who are unable to utilize the PAD technique for either religious or practical reasons.
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| 39. |
- Gabrielsson, Britt, 1957, et al.
(författare)
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Molecular characterization of a local sulfonylurea system in human adipose tissue.
- 2004
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Ingår i: Molecular and cellular biochemistry. - 0300-8177 .- 1573-4919. ; 258:1-2, s. 65-71
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Tidskriftsartikel (refereegranskat)abstract
- ATP-sensitive potassium (KATP) channels are present in many cell types and link cellular metabolism to the membrane potential. These channels are heterooctamers composed of two subunits. The sulfonylurea receptor (SUR) subunits are targets for drugs that are inhibitors or openers of the KATP channels, while the inwardly rectifying K+ (Kir) subunits form the ion channel. Two different SUR genes (SUR1 and SUR2) and two different Kir6.x genes (Kir6.1 and Kir6.2) have been identified. In addition, isoforms of SUR2, SUR2A and SUR2B, have been described. We have previously performed expression profiling on pooled human adipose tissue and found high expression of SUR2. Others have reported expression of SUR1 in human adipocytes. The aim of this study was to characterize the expression of the sulfonylurea receptor complex components in human adipose tissue. RT-PCR analysis, verified by restriction enzyme digestions and DNA sequencing, showed that SUR2B, Kir6.1 and alpha-endosulfine, but not SUR1, SUR2A or Kir6.2, are expressed in human adipose tissue. Real-time RT-PCR showed that SUR2B was expressed at higher levels in subcutaneous compared with omental adipose tissue in paired biopsies obtained from seven obese men (p < 0.05). Analysis of tissue distribution showed that SUR2B expression in adipose tissue was lower than that in muscle, similar to that in heart and liver, while the expression in pancreas was lower. The effect of caloric restriction was tested in obese men (n = 10) treated with very low calorie diet for 16 weeks, followed by a gradual reintroduction of ordinary food for 2 weeks. Biopsies were taken at week 0, 8 and 18. There was no consistent effect of weight reduction on SUR2B or Kir6.1 expression. We conclude that the necessary components for a local sulfonylurea system are expressed in human adipose tissue and that the sulfonylurea receptor complex in this tissue is composed of SUR2B and Kir6.1. The expression of SUR2B was higher in subcutaneous compared with omental adipose tissue and was not affected by weight loss.
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| 40. |
- Gummesson, Anders, 1973, et al.
(författare)
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Intestinal Permeability Is Associated With Visceral Adiposity in Healthy Women.
- 2011
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Ingår i: Obesity (Silver Spring, Md.). - : Wiley. - 1930-7381.
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Tidskriftsartikel (refereegranskat)abstract
- Increased visceral fat, as opposed to subcutaneous/gluteal, most strongly relates to key metabolic dysfunctions including insulin resistance, hepatic steatosis, and inflammation. Mesenteric fat hypertrophy in patients with Crohn's disease and in experimental rodent models of gut inflammation suggest that impaired gut barrier function with increased leakage of gut-derived antigens may drive visceral lipid deposition. The aim of this study was to determine whether increased intestinal permeability is associated with visceral adiposity in healthy humans. Normal to overweight female subjects were recruited from a population-based cohort. Intestinal permeability was assessed using the ratio of urinary excretion of orally ingested sucralose to mannitol (S/M). In study 1 (n = 67), we found a positive correlation between waist circumference and S/M excretion within a time frame of urine collection consistent with permeability of the lower gastrointestinal tract (6-9 hours post-ingestion; P = 0.022). These results were followed up in study 2 (n = 55) in which we used computed tomography and dual energy X-ray absorptiometry to measure visceral and subcutaneous fat areas of the abdomen, liver fat content, and total body fat of the same women. The S/M ratio from the 6-12 h urine sample correlated with visceral fat area (P = 0.0003) and liver fat content (P = 0.004), but not with subcutaneous or total body fat. This novel finding of an association between intestinal permeability and visceral adiposity and liver fat content in healthy humans suggests that impaired gut barrier function should be further explored as a possible mediator of excess visceral fat accumulation and metabolic dysfunction.
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| 41. |
- Gummesson, Anders, 1973, et al.
(författare)
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Relations of Adipose Tissue Cell Death-Inducing DFFA-like Effector A Gene Expression to Basal Metabolic Rate, Energy Restriction and Obesity: Population-based and Dietary Intervention Studies.
- 2007
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 92:12, s. 4759-65
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Tidskriftsartikel (refereegranskat)abstract
- Context: Cell death-inducing DFFA-like effector A (CIDEA) could be a potential target for the treatment of obesity via the modulation of metabolic rate, based on the findings that CIDEA inhibits the brown adipose tissue uncoupling process in rodents. Objective: To investigate the putative link between CIDEA and basal metabolic rate in humans, and to further elucidate the role of CIDEA in human obesity. Design: We have explored CIDEA gene expression in adipose tissue in two different human studies: A cross-sectional and population-based study assessing body composition and metabolic rate (Mölndal Metabolic study, n=92), and a longitudinal intervention-study of obese subjects treated with a very low calorie diet (VLCD study, n=24). Results: The CIDEA gene was predominantly expressed in adipocytes as compared to other human tissues. CIDEA gene expression in adipose tissue was inversely associated with basal metabolic rate independently of body composition, age and gender (p=0.014). VLCD induced an increase in adipose tissue CIDEA expression (p<0.0001) with a subsequent decrease in response to refeeding (p<0.0001). Reduced CIDEA gene expression was associated with a high body fat content (p<0.0001) and with high insulin levels (p<0.01). No dysregulation of CIDEA expression was observed in individuals with the metabolic syndrome when compared with BMI-matched controls. In a separate sample of VLCD-treated subjects (n=10), uncoupling protein 1 expression was reduced during diet (p=0.0026) and inversely associated with CIDEA expression (p=0.0014). Conclusion: The findings are consistent with the concept that CIDEA plays a role in adipose tissue energy expenditure.
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| 42. |
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| 43. |
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| 44. |
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| 45. |
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| 46. |
- Hjort, Rebecka, et al.
(författare)
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Low birthweight is associated with an increased risk of LADA and type 2 diabetes: results from a Swedish case-control study
- 2015
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 58:11, s. 2525-2532
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Tidskriftsartikel (refereegranskat)abstract
- Aims/hypothesis Our aim was to investigate the association between birthweight and latent autoimmune diabetes in adults (LADA), a common diabetes form with features of both type 1 and type 2 diabetes. Methods We used data from the Epidemiological Study of Risk Factors for LADA and Type 2 Diabetes (ESTRID), a Swedish population-based study. Eligible for the analysis were 134 incident LADA cases (glutamic acid decarboxylase antibody [GADA] positive), 350 incident type 2 diabetes cases (GADA negative) and 603 randomly selected controls. We present ORs and 95% CIs for LADA and type 2 diabetes in relation to birthweight, adjusted for sex, age, BMI and family history of diabetes. Results Low birthweight increased the risk of LADA as well as the risk of type 2 diabetes; OR per kg reduction was estimated as 1.52 (95% CI 1.12, 2.08) and 1.58 (1.23, 2.04), respectively. The OR for participants weighing < 3 kg compared with >= 4 kg at birth was estimated as 2.38 (1.23, 4.60) for LADA and 2.37 (1.37, 4.10) for type 2 diabetes. A combination of low birthweight (< 3 kg) and current overweight (BMI >= 25) further augmented the risk: LADA, OR 3.26 (1.69, 6.29); and type 2 diabetes, OR 39.93 (19.27, 82.71). Family history of diabetes had little impact on these estimates. Conclusions/interpretation Our results suggest that low birthweight may be a risk factor for LADA of the same strength as for type 2 diabetes. These findings support LADA, despite its autoimmune component, having an aetiology that includes factors related to type 2 diabetes.
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| 47. |
- Hjort, Rebecka, et al.
(författare)
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Physical Activity, Genetic Susceptibility, and the Risk of Latent Autoimmune Diabetes in Adults and Type 2 Diabetes
- 2020
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 105:11
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Physical activity (PA) has been linked to a reduced risk of type 2 diabetes by reducing weight and improving insulin sensitivity. We investigated whether PA is associated with a lower incidence of latent autoimmune diabetes in adults (LADA) and whether the association is modified by genotypes of human leukocyte antigen (HLA), transcription factor 7-like 2 (TCF7L2)-rs7903146, or the fat mass and obesity-associated gene, FTO-rs9939609. METHODS: We combined data from a Swedish case-control study and a Norwegian prospective study including 621 incident cases of LADA and 3596 cases of type 2 diabetes. We estimated adjusted pooled relative risks (RRs) and 95% CI of diabetes in relation to high (≥ 30 minutes of moderate activity 3 times/week) self-reported leisure time PA, compared to sedentariness. RESULTS: High PA was associated with a reduced risk of LADA (RR 0.61; CI, 0.43-0.86), which was attenuated after adjustment for body mass index (BMI) (RR 0.90; CI, 0.63-1.29). The reduced risk applied only to noncarriers of HLA-DQB1 and -DRB1 (RR 0.49; CI, 0.33-0.72), TCF7L2 (RR 0.62; CI, 0.45-0.87), and FTO (RR 0.51; CI, 0.32-0.79) risk genotypes. Adjustment for BMI attenuated but did not eliminate these associations. For type 2 diabetes, there was an inverse association with PA (RR 0.49; CI, 0.42-0.56), irrespective of genotype. MAIN CONCLUSIONS: Our findings indicate that high PA is associated with a reduced risk of LADA in individuals without genetic susceptibility.
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| 48. |
- Hyldahl, H., et al.
(författare)
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All-polyethylene vs. metal-backed tibial component in total knee arthroplasty-a randomized RSA study comparing early fixation of horizontally and completely cemented tibial components: part 1. Horizontally cemented components: AP better fixated than MB
- 2005
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Ingår i: Acta Orthop. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 76:6, s. 769-77
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Controversy still exists as to whether to mount the tibial bearing on a metal baseplate or not. Furthermore, the tibial component can be either horizontally or completely cemented. We evaluated metal backing versus all-polyethylene using horizontal cementing technique. PATIENTS AND METHODS: We randomized 40 patients with knee arthrosis (40 knees) to 2 groups: cemented total knee arthroplasty (AGC, Biomet) using either all-polyethylene (AP) or metal-backed (MB) tibial components (n = 20 for each group). All tibial implants had a total thickness of 8 mm. We used proximal cement-ing, including only the horizontal part of the tibia with avoidance of the stem-bone interface. RESULTS: The positioning of the implants, as judged by the HKA angle, showed an average neutral alignment in both groups. Preoperatively and after 2 years, there was no statistically significant difference between the HSS scores in both groups (p = 0.6 and 0.4). After 2 years, the metal-backed components had rotated more around the longitudinal axis, median 0.5 degrees vs. 0.2 degrees (internal or external rotation, p = 0.002), and showed increased maximum total point motion, median 1.0 vs. 0.4 mm (maximum migration or MTPM, p = 0.003). INTERPRETATION: Our study indicates that better fixation can be obtained with the all-polyethylene design if proximally cemented thin components are used.
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| 49. |
- Hyldahl, H., et al.
(författare)
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All-polyethylene vs. metal-backed tibial component in total knee arthroplasty-a randomized RSA study comparing early fixation of horizontally and completely cemented tibial components: part 2. Completely cemented components: MB not superior to AP components
- 2005
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Ingår i: Acta Orthop. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 76:6, s. 778-84
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Uncertainty exists as to whether metal backing (MB) of the tibial component is better than an all-polyethylene component (AP). This is valid for both horizontally and completely cemented components. We evaluated completely cemented MB vs. AP (Part 2). PATIENTS AND METHODS: In a randomized study, 39 patients (40 knees) with knee arthrosis were operated with cemented low-conforming total knee arthroplasty (AGC, Biomet) with a tibial component of uniform thickness (8 mm), cemented both beneath the tibial tray and around the stem. 20 patients had an all-polyethylene (AP) tibial component and 20 patients had an identical but metal-backed (MB) tibial component. We used clinical examination and radiostereometric analysis (RSA) to evaluate the hypothesis that MB improves component fixation. Fixation was evaluated using RSA up to 2 years after surgery. Clinical assessment was performed preoperatively and after 2 years using the Hospital for Special Surgeons (HSS) score. RESULTS: We found no differences in micromotion, and no differences in clinical scores could be detected between the groups at any time point. INTERPRETATION: Our findings indicate that there was equal initial fixation of the AP and MB stemmed monobloc components when they were cemented beneath the tibial plateau and around the stem.
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| 50. |
- Högman, Marieann, et al.
(författare)
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Differences in nitric oxide airway diffusion after maximum oxygen uptake test in asthmatic and nonasthmatic elite junior cross-country skiers
- 2021
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Ingår i: ERJ Open Research. - : European Respiratory Society (ERS). - 2312-0541. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Asthma is common in cross-country skiers and is often treated with ß2-agonists and inhaled corticosteroids (ICS). Exhaled nitric oxide is often used to guide ICS treatment in asthma. This study investigated the change in the pulmonary NO dynamics before and after a maximum oxygen uptake (V̇O2-max) test.An extended NO analysis was performed among Swedish elite junior cross-country skiers (n=25), with and without declared asthma, before and after a V̇O2-max test using roller skis. Asthma was declared by six boys and two girls among whom five occasionally used ICS.There were no differences in the baseline NO parameters between those with and without declared asthma. The diffusion capacity over airway wall (DawNO) was 21 (17,25) mL·s−1 (median, quartiles), which is much increased for this age group. After the V̇O2-max test, there were statistically significant differences from the baseline fraction of exhaled nitric oxide (FENO50), NO-flux from airways, DawNO and alveolar NO values; but not in the NO content in airway wall (CawNO) for all subjects together as one group. However, in the asthma group, differences were only seen in the FENO50 and in CawNO.Interestingly, a majority of the subjects had an increase in the DawNO. An increase in DawNO has been found with allergic asthma together with elevated CawNO. The skiers did not have elevated CawNO, which indicates an absence of inflammation in the airway wall. Modelling of lung NO production clearly shows that the asthma among our skiers is distinct from the allergic asthma in non-athletes.
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