| 1. |
- Ajeganova, Sofia, et al.
(författare)
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Effect of FCGR polymorphism on the occurrence of late-onset neutropenia and flare-free survival in rheumatic patients treated with rituximab
- 2017
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Ingår i: Arthritis Research & Therapy. - : BIOMED CENTRAL LTD. - 1478-6362. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: The causes and mechanisms of late-onset neutropenia (LON) following rituximab treatment in patients with rheumatic diseases are not known. In this study, we aimed to investigate the role of established Fc gamma receptor gene (FCGR) polymorphisms and B-cell-activating factor (BAFF) gene promoter polymorphisms for the development of LON and for the efficacy of rituximab in patients with rheumatic diseases. Methods: A single-center case-control retrospective study was nested in a cohort of 214 consecutive patients with rheumatic diseases treated with rituximab. Eleven patients presented with LON. Fifty non-LON control subjects were matched by diagnosis, age, sex, and treatments. Single-nucleotide polymorphisms of FCGR (FCGR2A 131H/R, FCGR2B 232I/T, FCGR3A 158V/F) and BAFF promoter polymorphism -871C/T were analyzed with polymerase chain reaction-based techniques, and serum immunoglobulin M (IgM) and BAFF levels were analyzed by enzyme-linked immunosorbent assay. Flare-free survival was related to LON occurrence and polymorphisms. Results: The FCGR3A V allele, but not other FCGR polymorphisms, correlated with the occurrence of LON; each V allele conferred a fourfold increased OR for LON (p = 0.017). FCGR3A 158V/V and presentation with LON were associated with a longer flare-free survival (p = 0.023 and p = 0.031, respectively). FCGR3A 158V/V was related to lower IgM levels (p = 0.016). Serum BAFF levels showed no relationship with LON and BAFF -871C/T promoter polymorphism. There was a tendency toward longer flare-free survival in patients with the BAFF -871T/T allotype compared with the C/T or C/C allotypes (p = 0.096). Conclusions: The results of the present study suggest that presentation with LON may be a result of the intrinsic efficacy of rituximab in patients with rheumatic diseases. LON could indicate a longer biological and therapeutic activity of rituximab modulated by a certain genotypic polymorphism: the high-affinity FCGR3A V allele. This genotype and the occurrence of LON are both related to longer flare-free survival, suggestive of common mechanisms for LON and duration of response to rituximab. The role of the BAFF -871C/T promoter polymorphism in LON occurrence is unclear.
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| 2. |
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| 4. |
- Billing, Joachim, et al.
(författare)
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Kävlinge : Ett skånskt järnvägssamhälle
- 1983
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Rapport (refereegranskat)abstract
- Denna skrift är resultatet av de studier som Konsthögskolans arkitekturskola ägnade Kävlinge samhälle 1981-82. Den innehåller den första samlade beskrivningen av Kävlinges historiska utveckling, dess växt och bebyggelse, med tyngdpunkt på expansionen vid slutet av 1800-talet och början av 1900-talet. I detalj behandlas det tegelbyggande som blev den snabba tillväxtens fysiska uttryck. I rader av uppmätningar visas de kännetecknande dragen från den tiden upp, något som också idag präglar stora delar av Kävlinges byggnadsbestånd. Med historia och bebyggelseutveckling som grund diskuteras vidare en rad angelägna planeringsuppgifter i centrala Kävlinge. Förslag till förbättringar och kompletteringar i miljön redovisas. Dessa visar också prov på möjligheterna att åter använda tegel som karaktärsgivande fasadmaterial i anknytning till den lokala byggnadstraditionen.
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| 5. |
- Dinka, David, 1974-
(författare)
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Role, Identity and Work : Extending the design and development agenda
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In order to make technology easier to handle for its users, the field of HCI (Human- Computer Interaction) has recently often turned the environment and the context of use. In this thesis the focus is on the relation between the user and the technology. More specifically, this thesis explores how roles and professional identity effects the use and views of the technology used. The exploration includes two different domains, a clinical setting and a media production setting, where the focus is on the clinical setting. These are domains that have strong professional identities in common, in the clinical setting neurosurgeons and physicists, and the media setting journalists. These settings also have a strong technological profile, in the clinical setting the focus has been on a specific neurosurgical tool called Leksell GammaKnife and in the journalistic setting the introduction of new media technology in general has been in focus. The data collection includes interviews, observations and participatory design oriented workshops. The data collected were analyzed with qualitative methods inspired by grounded theory. The work with the Leksell GammaKnife showed that there were two different approaches towards the work, the tool and development, depending on the work identity. Depending on if the user were a neurosurgeon or a physicist, the definition of the work preformed was inline with their identity, even if the task preformed was the same. When it comes to the media production tool, the focus of the study was a participatory design oriented development process. The outcome of the process turned out to be oriented towards the objectives that were inline with the users identity, more than with the task that were to be preformed. At some level, even the task was defined from the user dentity.
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| 6. |
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| 7. |
- Grüning, Björn, et al.
(författare)
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Bioconda: A sustainable and comprehensive software distribution for the life sciences
- 2017
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- We present Bioconda (https://bioconda.github.io), a distribution of bioinformatics software for the lightweight, multi-platform and language-agnostic package manager Conda. Currently, Bioconda offers a collection of over 3000 software packages, which is continuously maintained, updated, and extended by a growing global community of more than 200 contributors. Bioconda improves analysis reproducibility by allowing users to define isolated environments with defined software versions, all of which are easily installed and managed without administrative privileges.
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| 12. |
- Gusak, Viktoria, 1983, et al.
(författare)
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Thickness Dependence of Plasmonic Charge Carrier Generation in Ultrathin a-Si:H Layers for Solar Cells
- 2011
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Ingår i: ACS Nano. - : American Chemical Society (ACS). - 1936-086X .- 1936-0851. ; 5:8, s. 6218-6225
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Tidskriftsartikel (refereegranskat)abstract
- Nanocomposite layers of Ag nanoparticles and a-Si:H film constitute attractive candidates for the realization of ultrathin "two- dimensional" plasmonic solar cells, with an ideal 18% efficiency predicted for an average layer thickness of only 20 nm. By combining optical spectroscopy with photoconductivity measurements, we here characterize different contributions to the light absorption and charge carrier generation in such nanocomposites. We focus in particular on the important role of the absorber layer thickness for these processes, by studying a range of a-Si:H thicknesses from 9 to 67 nm. Through detailed comparison with numerical calculations by the finite element method, observed experimental features are connected to specific resonance modes and charge carrier generation mechanisms. The influence of dipolar and quadrupolar near-field distributions are evaluated with respect to different figures of merit for plasmonic solar cells. We briefly discuss how the present findings may be implemented in practical solar cell configurations. © 2011 American Chemical Society.
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| 14. |
- Hallböök, Helene, et al.
(författare)
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Autologous and allogeneic stem cell transplantation in adult ALL : The Swedish Adult ALL Group experience
- 2005
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Ingår i: Bone Marrow Transplantation. - London : Springer Science and Business Media LLC. - 0268-3369 .- 1476-5365. ; 35:12, s. 1141-1148
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Tidskriftsartikel (refereegranskat)abstract
- Adult patients with acute lymphoblastic leukaemia (ALL) have been treated according to national protocols in Sweden since 1986. Stem cell transplantation (SCT) has been recommended in first remission for patients with risk factors for relapse, and for standard risk patients only after relapse. In this retrospective study, the results of autologous and allogeneic SCT in these populations were evaluated. In total, 187 patients with a median age of 34 years (17-66 years) underwent SCT. The 5-year disease-free survival (DFS), for all patients, was 26% (Confidence intervals (CI) 20-32%). The 5-year DFS was higher for patients transplanted in first remission 32% (CI 24-40%) compared to 14% (CI 5-23%; P<0.0001) in patients transplanted beyond first remission. No significant differences in DFS (P=0.06) were determined between autologous, related donor and unrelated donor SCT in the whole cohort. A lower relapse rate was counterbalanced by higher treatment-related mortality in patients undergoing allogeneic SCT. In Philadelphia-positive ALL, allogeneic SCT was superior to autologous SCT, with a 5-year DFS of 30% (CI 12-47%) vs 0% (P=0.04). Limited chronic graft-versus-host-disease (GVHD) was associated with an improved DFS of 53% (CI 38-69%) compared to no chronic GVHD of 22% (CI 10-36%; P=0.0008), indicating a clinically important graft-versus-leukaemia effect.
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| 15. |
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| 16. |
- Herngren, Bengt, et al.
(författare)
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Outcomes after slipped capital femoral epiphysis: a population-based study with three-year follow-up
- 2018
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Ingår i: Journal of Childrens Orthopaedics. - : SAGE Publications. - 1863-2521 .- 1863-2548. ; 12:5, s. 434-443
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To evaluate outcomes three years after treatment for slipped capital femoral epiphysis (SCFE): development of avascular necrosis (AVN), subsequent surgery, hip function and the contralateral hip. Methods This prospective cohort study included a total national population of 379 children treated for SCFE between 2007 and 2013. A total of 449 hips treated for SCFE and 151 hips treated with a prophylactic fixation were identified. The Barnhoft questionnaire, a valid patient-reported outcome measure (PROM), was used. Results In all, 90 hips had a severe slip, 61 of these were clinically unstable. AVN developed in 25 of the 449 hips. Six of 15 hips treated with capital realignment developed AVN. A peri-implant femur fracture occurred in three slipped hips and in two prophylactically pinned hips. In three of these five hips technical difficulties during surgery was identified. In 43 of 201 hips scheduled for regular follow-up a subsequent SCFE developed in the contralateral hip. Implant extraction after physeal closure was performed in 156 of 449 hips treated for SCFE and in 51 of 151 prophylactically fixed hips. Children with impaired hip function could be identified using the Barnhoft questionnaire. Conclusion Fixation in situ is justified to remain as the primary treatment of choice in SCFE. Overweight is more common in children with SCFE than in the average population. Prophylactic fixation is a safe procedure when performed using a correct technique. The number of patients who developed AVN after capital realignment is of concern. We recommend rigorous follow-up of both hips, including PROM evaluation, until physeal closure.
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| 19. |
- Holmstedt, Göran, et al.
(författare)
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Validation of CFD codes
- 2008
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Use of CFD (computional fluid dynamics) softwarepackages within fire performance based engineeringand risk assessment is increasing substantially.An important part in the process is thequality assurance. For this reason the SwedishRescue Services Agency (SRV) sponsored aunique research project. Within the project differentcodes for smoke spread and evacuationhave been evaluated. This poster will focus onthe evaluation of four CFD software codes.
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| 23. |
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| 26. |
- Hägglund, Carl, 1975, et al.
(författare)
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Maximized Optical Absorption in Ultrathin Films and Its Application to Plasmon-Based Two-Dimensional Photovoltaics
- 2010
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Ingår i: Nano Letters. - : American Chemical Society (ACS). - 1530-6992 .- 1530-6984. ; 10:8, s. 3135-3141
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Tidskriftsartikel (refereegranskat)abstract
- For ultrathin films of a given material, light absorption is proportional to the film thickness. However, if the optical constants of the film are chosen in an optimal way, light absorption can be high even for extremely thin films and optical path length. We derive the optimal conditions and show how the maximized absorptance depends on film thickness. It is then shown that the optimal situation can be emulated by tuning of the geometric parameters in feasible nanocomposites combining plasmonic materials with semiconductors. Useful design criteria and estimates for the spatial absorption-distribution over the composite materials are provided. On the basis of efficient exchange of oscillator strength between the plasmonic and semiconductor constituents, a high quantum yield for semiconductor absorption can be achieved. The results are far-reaching with particularly promising opportunities for plasmonic solar cells.
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| 27. |
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| 28. |
- Hägglund, Carl, 1975, et al.
(författare)
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Nanoparticle plasmonics for 2D-photovoltaics: Mechanisms, Optimization, and Limits
- 2009
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Ingår i: Optics Express. - 1094-4087 .- 1094-4087. ; 17:14, s. 11944-11957
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Tidskriftsartikel (refereegranskat)abstract
- Plasmonic nanostructures placed within or near photovoltaic (PV) layers are of high current interest for improving thin film solar cells. We demonstrate, by electrodynamics calculations, the feasibility of a new class of essentially two dimensional (2D) solar cells based on the very large optical cross sections of plasmonic nanoparticles. Conditions for inducing absorption in extremely thin PV layers via plasmon near-fields, are optimized in 2D-arrays of (i) core-shell particles, and (ii) plasmonic particles on planar layers. At the plasmon resonance, a pronounced optimum is found for the extinction coefficient of the PV material. We also characterize the influence of the dielectric environment, PV layer thickness and nanoparticle shape, size and spatial distribution. The response of the system is close to that of a 2D effective medium layer, and subject to a 50% absorption limit when the dielectric environment around the 2D layer is symmetric. In this case, a plasmon induced absorption of about 40% is demonstrated in PV layers as thin as 10 nm, using silver nanoparticle arrays of only 1 nm effective thickness. In an asymmetric environment, the useful absorption may be increased significantly for the same layer thicknesses. These new types of essentially 2D solar cells are concluded to have a large potential for reducing solar electricity costs.
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| 29. |
- Hägglund, Patricia, et al.
(författare)
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Oral neuromuscular training in patients with dysphagia after stroke : a prospective, randomized, open-label study with blinded evaluators
- 2020
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Ingår i: BMC Neurology. - : Springer Nature. - 1471-2377. ; 20
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Tidskriftsartikel (refereegranskat)abstract
- Background: Oral and pharyngeal swallowing dysfunction are common complications in acute stroke patients. This primary aim of this study was to determine whether oral neuromuscular training improves swallowing function in participants with swallowing dysfunction after stroke. A secondary aim was to assess how well results of the timed water-swallow test (TWST) correspond with swallowing dysfunction diagnosed by videofluoroscopy (VFS).Methods: This was an intention-to-treat two-centre prospective randomized open-label study with blinded-evaluators (PROBE) design. At 4 weeks after stroke onset, participants with swallowing dysfunction were randomized to 5 weeks of continued orofacial sensory-vibration stimulation with an electric toothbrush or additional oral neuromuscular training with an oral device (Muppy®). Participants were examined with TWST, a lip-force test, and VFS before (baseline), after 5 weeks’ treatment (the end-of-treatment), and 12 months after treatment (follow-up). The baseline VFS results were compared with the TWST results. The primary endpoint was changes in swallowing rate assessed using TWST, from baseline to the end of training and from baseline to follow-up based on intention-to-treat analyses. The secondary endpoint was the corresponding changes in lip-force between baseline, the end of treatment, and follow-up.Results: The participants were randomly assigned as controls (n = 20) or for intervention with oral neuromuscular training (n = 20). After treatment, both groups had improved significantly (intervention, P < 0.001; controls, P = 0.001) in TWST but there was no significant between-group difference in swallowing rate. At the 12-month follow-up, the intervention group had improved further whereas the controls had deteriorated, and there were significant between-group differences in swallowing rate (P = 0.032) and lip force (P = 0.001). A TWST < 10 mL/sec at baseline corresponded to VFS-verified swallowing dysfunction in all assessed participants.Conclusion: The 5-week oral neuromuscular training improved swallowing function in participants with post-stroke dysphagia compared with the controls 12 months after intervention, but there was no between-group difference in improvement immediately after treatment. TWST results corresponded with VFS results, making TWST a feasible method for identifying persons with swallowing dysfunction after stroke. Larger randomized controlled trials are required to confirm our preliminary positive long-term results.Trial registration: Retrospectively registered at ClinicalTrials.gov: NCT04164420. Registered on 15 November 2019.
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| 30. |
- Kozlowski, Piotr, 1969-, et al.
(författare)
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High curability via intensive reinduction chemotherapy and stem cell transplantation in young adults with relapsed acute lymphoblastic leukemia in Sweden 2003-2007
- 2012
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Ingår i: Haematologica. - : Ferrata Storti Foundation. - 0390-6078 .- 1592-8721. ; 97:9, s. 1414-1421
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Tidskriftsartikel (refereegranskat)abstract
- Background less thanbrgreater than less thanbrgreater thanA minority of patients with adult acute lymphoblastic leukemia who relapse are rescued. The aim of this population-based study was to assess the results of reinduction treatment and allogeneic stem cell transplantation in patients in second complete remission. less thanbrgreater than less thanbrgreater thanDesign and Methods less thanbrgreater than less thanbrgreater thanBetween 2003-2007, 76 adults (andlt;66 years) with relapsed acute lymphoblastic leukemia (Burkitts leukemia excluded) were prospectively reported to The Swedish Adult Acute Leukemia Registry and later evaluated. less thanbrgreater than less thanbrgreater thanResults less thanbrgreater than less thanbrgreater thanReinduction with: (i) mitoxantrone, etoposide, and cytarabine (MEA); (ii) fludarabine, cytarabine, pegylated-asparaginase plus granulocyte colony-stimulating factor (FLAG-Asp); and (iii) cytarabine, betamethasone, cyclophosphamide, daunorubicin, and vincristine (ABCDV) resulted in complete remission in 6/9 (67%), 10/16 (63%) and 9/21 (43%) of the patients, respectively. Allogeneic stem cell transplantation was performed during second complete remission in 29 patients. Multivariate analysis regarding overall survival after relapse revealed that age over 35 years at diagnosis and relapse within 18 months were negative prognostic factors. Overall survival rates at 3 and 5 years were 22% (95% CI: 13-32) and 15% (95% CI: 7-24). Of 19 patients less than 35 years at diagnosis who underwent allogeneic stem cell transplantation in second remission, ten (53%) are still alive at a median of 5.5 years (range, 4.2-8.3) after relapse, whereas all patients over 35 years old at diagnosis have died. less thanbrgreater than less thanbrgreater thanConclusions less thanbrgreater than less thanbrgreater thanAllogeneic stem cell transplantation remains the treatment of choice for young adults with relapsed acute lymphoblastic leukemia. Both (i) mitoxantrone, etoposide, and cytarabine and (ii) fludarabine, cytarabine, pegylated-asparaginase plus granulocyte colony-stimulating factor seem effective as reinduction treatments and should be further evaluated. New salvage strategies are needed, especially for patients over 35 years old at diagnosis.
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| 31. |
- Kozlowski, Piotr, 1969-, et al.
(författare)
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High relapse rate of T cell acute lymphoblastic leukemia in adults treated with Hyper-CVAD chemotherapy in Sweden
- 2014
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Ingår i: European Journal of Haematology. - : Wiley. - 1600-0609 .- 0902-4441. ; 92:5, s. 377-381
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Tidskriftsartikel (refereegranskat)abstract
- Background Hyper-CVAD is widely used to treat acute lymphoblastic leukemia (ALL) and aggressive lymphomas. This multicenter, population-based study assessed the efficacy of Hyper-CVAD as first-line therapy in patients with T-cell ALL (T-ALL). Patients and methods Between October 2002 and September 2006, 24 patients were diagnosed with T-ALL in Sweden; 19 were eligible for treatment with the protocol. Results The median age was 32yr (range 18-72yr). Complete remission (CR) was obtained in 17 of 19 (89%) patients, and the treatment was relatively well tolerated. Allogeneic stem cell transplantation (SCT) was recommended in high-risk disease and was performed in four patients upfront. Two- and 5-yr leukemia-free survivals (LFS) in 17 patients with CR achievement were identical, at 29% (95% confidence interval [CI]: 8-51). Two- and 5-yr overall survival (OS) in whole cohort was 63% (95% CI: 42-85) and 47% (95% CI: 26-69), respectively. The 5-yr LFS for 15 patients who did not receive allogeneic SCT upfront were 20% (95% CI: 0-40), although 14 of 15 completed the protocol (eight cycles). Relapse occurred in 2 of 4 upfront-transplanted patients and in 12 of 15 patients treated with chemotherapy alone, six of whom received allogeneic SCT in CR2. Age >= 35yr influenced OS negatively in univariate analysis (HR 5.1, 95% CI: 1.55-16.7). Conclusions Hyper-CVAD treatment resulted in a high CR rate and appeared safe, but it showed poor efficacy at preventing relapse. Therefore, this treatment is no longer recommended for adults with T-ALL in Sweden.
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| 32. |
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Människan i skogen, skogen i människan : Miun Research Exhibition
- 2021
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Konstnärligt arbeteabstract
- Med utställningen Människan i skogen, skogen i människan vill projektet belysa ett antal aktuella och viktiga frågor för vår region och samtid, samlade under ett tema: skog och hållbar utveckling. I utställningen får besökaren möta kunskap och perspektiv från fem forskare och forskargrupper vid Mittuniversitetet. Forskarna är verksamma inom biologi, ekoteknik, historia, litteraturvetenskap respektive turismvetenskap. Forskningens olika perspektiv länkas i utställningen samman genom sina förhållningssätt till tid, såsom avgörande för förståelse, kunskap och handling. De olika forskningsinriktningarna visar också fram spänningar mellan olika synsätt på skog och kan tillsammans ge flera svar och berättelser om skogens värden. En arbetsgrupp vid Universitetsbiblioteket står för gestaltning och produktion av utställningen.
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| 33. |
- Nahi, Hareth, et al.
(författare)
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An investigation into whether deletions in 9p reflect prognosis in adult precursor B-cell acute lymphoblastic leukemia : a multi-center study of 381 patients
- 2008
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Ingår i: Haematologica. - Pavia : Ferrata Storti Foundation (Haematologica). - 1592-8721 .- 0390-6078. ; 93:11, s. 8-1734
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Tidskriftsartikel (refereegranskat)abstract
- In acute lymphoblastic leukemia, besides age and white cell count at diagnosis, the cytogenetic abnormalities t(9;22)/BCR-ABL and t(4;11)/MLL-AF4 are important prognostic markers and are often included in the treatment stratification of patients with adult acute lymphoblastic leukemia. Deletions in 9p are seen in about 9% of cases of adult acute lymphoblastic leukemia, but their prognostic impact has been controversial. Cytogenetic data from 381 patients diagnosed with B-precursor acute lymphoblastic leukemia were reviewed. Chromosomal analysis was successful in 240 cases. Of these cases, 18 (8%) had abnormalities in 9p and they were compared with patients with normal karyotypes and patients with t(9;22)/BCR-ABL. Patients with abnormalities of chromosome 9 showed significantly shorter overall survival compared with patients with normal karyotypes. In fact, overall survival was similar to that in the poor prognosis t(9;22)/BCR-ABL-positive group. Our data suggest that chromosomal abnormalities involving 9p may have a significant negative impact on survival in adult B-precursor acute lymphoblastic leukemia.
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| 34. |
- Petersson, Mikael, et al.
(författare)
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Control Structure Assessment in an Industrial Control System
- 2002
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Ingår i: Proceedings : control systems 2002, june 3-5 2002, Stockholm, Sweden : The world pulp and paper week 2002 (SPCI-meddelande ; 76). - 0280-6800. ; 76
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Konferensbidrag (refereegranskat)abstract
- This paper describes the implementation of a structure assessmentmethod in an industrial control system. The method uses available signals to evaluate if a given signal can be used for additional feed forward control action to improve the performance of a control loop.
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| 35. |
- Scandurra, Isabella, 1973-, et al.
(författare)
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User needs for development of context dependent devices in mobile home care
- 2003
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Ingår i: Human-Computer Interaction with Mobile Devices and Services. - Berlin, Heidelberg : Springer-Verlag. - 9783540408215 - 9783540452331 ; , s. 446-450
-
Bokkapitel (refereegranskat)abstract
- Mobile work situations within home care of the elderly require immediate and ubiquitous access to patient-oriented data. We intend to develop a mobile information system that provides correct information in a proper way to the right person in the appropriate occasion of care. This requires a thorough user needs analysis that so far often has been neglected during systems development in health care. We conducted the user needs analysis in interdisciplinary working groups in order to achieve a holistic view of the entire work process. This allows for the development of not only patient-oriented but care process oriented systems. In this paper, we describe how the user needs analysis was conducted, the impact of this work on the user group and some of the requirements found to be specific for mobile IT-support for home care of the elderly.
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| 36. |
- Sjöqvist, Bengt-Arne, 1952, et al.
(författare)
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Sponsored senior computers never happened – a 20-year perspective on ICT deployment of healthcare at home!
- 2024
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Ingår i: Health and Technology. - : SPRINGER HEIDELBERG. - 2190-7188 .- 2190-7196. ; In Press
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The article studies the utilization of ICT within healthcare at home in Sweden overlooking a perspective of 20 + years. Starting point are articles by the authors from 2002 and 2003. These outlined an already feasible ICT supported healthcare at home as a tool to address healthcare’s identified challenges—a growing elderly population and general demand for more healthcare in combination with issues on financing and lack of human resources. Despite early signals the care transition has been unexpectedly slow. Why? Methods: With the articles as take-off the journey for ICT based healthcare at home up to today is discussed. In the articles five areas considered as critical for a successful transition were pinpointed and are now used to support the authors considerations, reasoning, and conclusions. Results: Results indicate that technology has never been a limiting factor. Nor has selected medical issues or expected benefits normally been a limitation. Instead limitations and hindrances are found in other areas and activities. Conclusions: Technology is not the main challenge when it comes to implementation, instead a focus on business models, deployment, and scaling issues is now advocated. Initiatives also must make more use of gained knowledge and experience. Not doing so delays utilization and deployment. The impact on healthcare effects and expected savings may be over-optimistic. A thorough analysis of all associated costs, consequences, investments, and benefits is recommended. Non-digital alternatives must continue to be offered to these who cannot go digital. In communication improved medical outcome and patient satisfaction must be emphasised.
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| 37. |
- Tesfa, Daniel, et al.
(författare)
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Late-onset neutropenia following rituximab therapy in rheumatic diseases : association with B lymphocyte depletion and infections
- 2011
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Ingår i: Arthritis and Rheumatism. - : Wiley. - 0004-3591 .- 1529-0131. ; 63:8, s. 2209-2214
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:Late-onset neutropenia following rituximab therapy is a well-recognized side effect in lymphoma patients, but only a few cases of late-onset neutropenia have been reported in patients with autoimmune disorders. The purpose of this study was to define the incidence, clinical features, and some of the underlying mechanisms of late-onset neutropenia in relation to rituximab use in several rheumatic diseases.METHODS:We conducted a retrospective analysis of a cohort of 209 consecutive patients with rheumatic diseases who had been treated with rituximab at a university hospital between June 2003 and March 2009.RESULTS:Eleven patients with late-onset neutropenia were identified. The highest incidence was observed in granulomatosis with polyangiitis (Wegener's) and systemic lupus erythematosus patients (23% and 20%, respectively), whereas the incidence in rheumatoid arthritis patients was 3%. The median time to onset of neutropenia was 102 days (range 40-362 days) and coincided with the entire period of B lymphocyte depletion; this depletion was more pronounced in patients with late-onset neutropenia (P = 0.002) than in a control group of 20 matched patients without late-onset neutropenia. Serum IgM levels decreased during the same time and to a significantly greater amount in patients with late-onset neutropenia than in controls (P = 0.027). No patient with late-onset neutropenia displayed specific antineutrophil antibodies. Seven patients were hospitalized because of infections (6 with sepsis and 1 with febrile neutropenia) that required intravenous antibiotics. Six were treated with granulocyte colony-stimulating factor.CONCLUSION:In patients treated with rituximab for rheumatic diseases, late-onset neutropenia is a clinically significant adverse event associated with marked B lymphocyte depletion and severe infections. The incidence of late-onset neutropenia appears to vary with autoimmune disease type.
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| 39. |
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