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Sökning: WFRF:(Hällgren A.)

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1.
  • Andreasson, A., et al. (författare)
  • Fosfomycin versus Ciprofloxacin as transrectal prostatebiopsy antibiotic prophylaxis an open randomized controlled multicenter drug trial
  • 2023
  • Ingår i: European Urology. - : Elsevier. - 0302-2838 .- 1873-7560. ; 83:Suppl. 1, s. S180-S180
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction & Objectives: Antibiotic prophylaxis are administered as a routine to decrease the risk for septic complications following transrectal prostate biopsy. Fosfomycin administered 1 h or more prior to biopsy has equal or better infectious complication rates as compared to Ciprofloxacin in both prospective and retrospective studies from countries with high rates of antibiotic resistance. The aim of this study was to investigate if Fosfomycin administered immediately prior to prostate biopsy was as effective as Ciprofloxacin in Sweden, a country with low rates of antibiotic resistance.Materials & Methods: A randomized, controlled, open, multicenter, non-inferiority-study including men of all ages undergoing transrectal prostate biopsy was performed in the urology departments of three Swedish hospitals. The total number of patients were planned for 3448, divided into low and high infection risk groups. The low-risk group was randomized to either one dose of Fosfomycin 3g or Ciprofloxacin 750mg before biopsy. The high-risk group was randomized to either two doses of Fosfomycin 3g prior to biopsy and one more 24 h after biopsy or Ciprofloxacin 500mg once prior to biopsy and then twice daily for three days. The drugs were administered orally. All patients had a rectal swab for culture before and after biopsy. The endpoint was hospitalisation due to urinary tract infection within 14 days from biopsy, follow-up was performed with a phone interview.Results: The safety board prematurely interrupted the study after 42 included patients due to an unusual high number of hospitalisations. Four out of 20 patients (20%), three in the low-risk group and one in the high-risk group, had been hospitalised due to urosepsis in the Fosfomycin group. One further patient described fever symptoms but did not seek health care. No patient in the Ciprofloxacin group (n=21) described symptoms of infection from the urinary tract. One patient was lost to follow-up. A one-sided binomial test showed a p-value of <0.001. Two of the four hospitalised patients had a positive blood culture for Pseudomonas Aeruginosa and one had a positive rectal swab culture for Pseudomonas species both before and after biopsy.Conclusions: The study does not support the use of Fosfomycin administered immediately prior to prostate biopsy. The results may have been affected by the unexpected high number of Pseudomonas infections, a bacteria where Fosfomycin often lack effect. If Fosfomycin is to be used it should be with caution if Pseudomonas has been seen in earlier cultures
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2.
  • Birgegård, Gunnar, 1944-, et al. (författare)
  • Serum ferritin during infection : A longitudinal study
  • 1978
  • Ingår i: Scandinavian journal of haematology. - 0036-553X. ; 21:4, s. 333-340
  • Tidskriftsartikel (refereegranskat)abstract
    • Serum ferritin, transferrin, iron and haptoglobin have been investigated in a longitudinal study in 18 patients hospitalized for various acute infections. Within a couple of days after the onset of an infection, a rise in serum ferritin was seen, the magnitude of which was not dependent on the type of infection (bacterial or viral). The serum ferritin level remained elevated for several weeks in some patients, and 7 out of the 18 patients still had abnormally high values 5 weeks after the onset of illness. The mean curves for serum ferritin and the acute phase reactant haptoglobin were parallel. Possible mechanisms causing the elevation in serum ferritin are discussed.
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3.
  • Lindqvist, Maria, et al. (författare)
  • Long-term persistence of a multi-resistant methicillin-susceptible Staphylococcus aureus (MR-MSSA) clone at a university hospital in southeast Sweden, without further transmission within the region
  • 2015
  • Ingår i: European Journal of Clinical Microbiology and Infectious Diseases. - : Springer Verlag (Germany). - 0934-9723 .- 1435-4373. ; 34:7, s. 1415-1422
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective of this study was to characterise isolates of methicillin-susceptible Staphylococcus aureus (MSSA) with resistance to clindamycin and/or tobramycin in southeast Sweden, including the previously described ECT-R clone (t002) found in Östergotland County, focusing on clonal relatedness, virulence determinants and existence of staphylococcal cassette chromosome (SCC) mec remnants. MSSA isolates with resistance to clindamycin and/or tobramycin were collected from the three county councils in southeast Sweden and investigated with spa typing, polymerase chain reaction (PCR) targeting the SCCmec right extremity junction (MREJ) and DNA microarray technology. The 98 isolates were divided into 40 spa types, and by microarray clustered in 17 multi-locus sequence typing (MLST) clonal complexes (MLST-CCs). All isolates with combined resistance to clindamycin and tobramycin (n = 12) from Östergotland County and two additional isolates (clindamycin-R) were designated as spa type t002, MREJ type ii and were clustered in CC5, together with a representative isolate of the ECT-R clone, indicating the clones persistence. These isolates also carried several genes encoding exotoxins, Q9XB68-dcs and qacC. Of the isolates in CC15, 83 % (25/30) were tobramycin-resistant and were designated spa type t084. Of these, 68 % (17/25) were isolated from new-borns in all three counties. The persistence of the ECT-R clone in Östergotland County, although not found in any other county in the region, carrying certain virulence factors that possibly enhance its survival in the hospital environment, highlights the fact that basic hygiene guidelines must be maintained even when MRSA prevalence is low.
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4.
  • Advancing Research on Projects and Temporary Organizations
  • 2014
  • Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
    • Project management as a field is sometimes characterised by prescriptive analysis often founded on little deep research. This book is different - drawing on some of the most interesting contributors to the field, it should be read by anyone interested in seeing projects as a social accomplishment in which people, rather than systems, have the most pertinent role.
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5.
  • Birgegård, Gunnar, 1944-, et al. (författare)
  • Serum ferritin during infection : A longitudinal study in renal transplant patients
  • 1979
  • Ingår i: Acta medica Scandinavica. - 0001-6101. ; 205:7, s. 641-645
  • Tidskriftsartikel (refereegranskat)abstract
    • In order to follow the dynamics in the reaction of iron kinetic variables to acute infection, 8 renal transplantation patients were followed with test samples every second or third day for about two months. It was found that they just as previously shown in otherwise healthy subjects, responded to acute infection with a rise in serum ferritin levels, sometimes to very high values. In most cases the ferritin elevation started within two days after the onset of fever. The peak was reached within a week, except when very high values were obtained. The fall in serum ferritin after recovery from infection was much faster than in previously investigated groups of patients: the plasma half disappearance time for ferritin in one case was but 1.5 days. Transferrin did not change in response to infection. The expected fall in serum iron during infection was often absent and sometimes obscured by unexpected, sharp peaks in serum iron, which bore a temporal relationship to episodes of transplant rejection in 7 of 12 cases.
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7.
  • Buchanan, David A., et al. (författare)
  • Surviving a zombie apocalypse : Leadership configurations in extreme contexts
  • 2019
  • Ingår i: Management Learning. - : Sage Publications. - 1350-5076 .- 1461-7307. ; 50:2, s. 152-170
  • Tidskriftsartikel (refereegranskat)abstract
    • What can the classic zombie movie, Day of the Dead, tell us about leadership? In our analysis of this film, we explore leadership behaviours in an extreme context - a zombie apocalypse where survivors face persistent existential threat. Extreme context research presents methodological challenges, particularly with regard to fieldwork. The use of films as proxy case studies is one way in which to overcome these problems, and for researchers working in an interpretivist perspective, 'social science fiction' is increasingly used as a source of inspiration and ideas. The contribution of our analysis concerns highlighting the role of leadership configurations in extreme contexts, an approach not previously addressed in this field, but one that has greater explanatory power than current perspectives. In Day of the Dead, we observe several different configurations - patterns of leadership styles and behaviours - emerging, shifting and overlapping across the phases of the narrative, each with radically different consequences for the group of survivors. These observations suggest a speculative theory of leadership configurations and their implications in extreme contexts, for exploring further, with other methods.
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9.
  • Dreschler, W. A., et al. (författare)
  • Charactering the individual ear by the "Auditory Profile
  • 2008
  • Ingår i: Journal of the Acoustical Society of America. - Melville, NY, USA : A I P Publishing LLC. - 0001-4966 .- 1520-8524. ; 123:5
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper describes a new approach to auditory diagnostics, which is one of the central themes of the EU-project HEARCOM. For this purpose we defined a so-called "Auditory Profile" that can be assessed for each individual listener using a standardized battery of audiological tests that - in addition to the pure-tone audiogram - focus on loudness perception, frequency resolution, temporal acuity, speech perception, binaural functioning, listening effort, subjective hearing abilities, and cognition. For the sake of testing time only summary tests are included from each of these areas, but the broad approach of characterizing auditory communication problems by means of standardized test is expected to have an added value above traditional testing in understanding the reasons for poor speech reception. The Auditory profile may also be relevant in the field of auditory rehabilitation and for design of acoustical environments. The results of an international 5-center study (in 4 countries and in 4 languages) will be presented and the relevance of a broad but well-standardized approach will be discussed.
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10.
  • Dreschler, W. A., et al. (författare)
  • D-2-6: Report about the results of the multicentre evaluation of the Auditory Profile. Public report
  • 2009
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Twenty-eight partners participated in the FP6 EU-funded project HearCom, with the goal to improve hearing in our communication society. One of the main achievements has been the provision of advanced hearing screening tests by telephone and Internet. For hearing diagnostics it was aimed at the harmonization of hearing diagnostic tests within Europe. For this the concept of the Auditory Profile has been developed with several tests for various languages. Hearing problems are also a result of adverse acoustical circumstances for which the effects have been studied, modelled and evaluated for hearing impaired. For hearing rehabilitation a large scale comparison study was performed on signal enhancement techniques (algorithms) for hearing devices. Modern technology may assist on hearing and communication by the use of wireless technology and automatic speech transcription. On this it is shown that improvements for auditory communication can be obtained, but that technology should develop further. An overview is given on the HearCom portal with sections for screening diagnostics, hearing information for the public and professionals, and a new service called HearCompanion that provides step-by-step support for the hearing rehabilitation process.
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15.
  • Farzad, A, et al. (författare)
  • Luminal release of hyaluronan (hyaluronic acid) in intestinal ischemia in the rat.
  • 1993
  • Ingår i: Digestion. - 0012-2823 .- 1421-9867. ; 54:3, s. 168-72
  • Tidskriftsartikel (refereegranskat)abstract
    • Hyaluronan (HA) is a glycosaminoglycan, the water-binding properties of which are suggested to be pivotal for an optimal hydration of tissues. The lamina propria of the intestinal villi is characterized by a high concentration of HA. Increased amounts of HA are observed in the intestinal lumen in patients with Crohn's disease. We have evaluated whether epithelial denudation as such is sufficient to increase the concentration of HA in the lumen of the small intestine. Epithelial damage was accomplished by reversible ischemia-reperfusion injury to the rat ileum and the concentration of HA was determined in luminal perfusate. The perfusate concentration of HA was increased from 26 +/- 8 micrograms/l before ischemia, to 68 +/- 13 and 41 +/- 12 micrograms/l 0-30 and 30-60 min after a 60-min period of subtotal ischemia without venous stasis (p < 0.05). In sham-operated animals, in contrast, the perfusate concentration of HA was virtually unchanged (31 +/- 18, 13 +/- 3 and 10 +/- 1 microgram/l, respectively). Specific staining for HA on sections revealed loss of HA from the villus tips after ischemia. The results show that epithelial denudation results in loss of HA from the villus interstitium to the intestinal lumen.
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16.
  • Hällgren, Markus, 1977-, et al. (författare)
  • The Dark Side of Group Behavior : Zombie Apocalypse Lessons
  • 2020
  • Ingår i: Academy of Management Perspectives. - : Academy of Management (ACAD). - 1558-9080 .- 1943-4529. ; 34:4, s. 434-457
  • Tidskriftsartikel (refereegranskat)abstract
    • How will groups of survivors behave in a doomsday scenario? Will there be competition for scarce resources? Will they collaborate in reconstruction? While we cannot research these questions directly, we can find clues in four places. First, there are historical examples of apocalyptic events. Second, social identity theory offers explanations of group behavior. Third, there have been studies undertaken of group dynamics in extreme contexts. We discuss the limitations of these three sources, before turning a fourth-a fictional account-in search of ideas. Adopting a narrative theoretical lens, we consider "the theory on offer" in the television series The Walking Dead, which portrays a zombie apocalypse. We find that group behavior is shaped by the nature of survivor group composition, and by the properties of the doomsday context that they face. We demonstrate the potential for the emergence of a dark, violent side of group behavior. We illustrate a methodological solution to the problem of researching extreme contexts using "speculative fiction." And, by exploiting the zombie movie genre, we address the "failure of imagination" that can increase society's vulnerability to unforeseen events. Our analysis has implications for organization theory as well as for policy and practice in doomsday scenarios.
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17.
  • Hällgren, R, et al. (författare)
  • Accumulation of hyaluronan (hyaluronic acid) in myocardial interstitial tissue parallels development of transplantation edema in heart allografts in rats.
  • 1990
  • Ingår i: Journal of Clinical Investigation. - 0021-9738 .- 1558-8238. ; 85:3, s. 668-73
  • Tidskriftsartikel (refereegranskat)abstract
    • By using biotin-labeled proteoglycan core protein, hyaluronan (hyaluronic acid; HA) was visualized in rat heart grafts at different times (2, 4, and 6 d) after transplantation. In normal, nontransplanted hearts HA was present in the adventitia of arteries and veins and in the myocardial interstitial tissue. An increased accumulation of HA was evident in the edematous interstitial tissue, infiltrated with lymphocytes, on day 4 after allogeneic transplantation, and was even more pronounced by day 6. No apparent increase in HA was seen in syngeneic grafts. Biochemical assay of HA in heart tissue demonstrated that the myocardial content of HA had increased 60% by day 2 after transplantation in allogeneic as well as syngeneic grafts, indicating that surgical trauma may induce some HA accumulation in heart grafts. The extractable amount of HA declined during the following days in the syngeneic grafts, but increased progressively during the development of rejection in the allogeneic grafts, and increased on average three times by day 6. The relative water content also increased progressively during rejection of allogeneic grafts and correlated with the HA accumulation. The interstitial accumulation of HA, a glycosaminoglycan with unique water-binding qualities, is presumably implicated in the development of interstitial edema during rejection of heart grafts.
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18.
  • Johnsson, C, et al. (författare)
  • Hyaluronidase ameliorates rejection-induced edema.
  • 1999
  • Ingår i: Transplant International. - 0934-0874 .- 1432-2277. ; 12:4, s. 235-43
  • Tidskriftsartikel (refereegranskat)abstract
    • Hyaluronan, a glucosaminoglycan with unique water-binding capacity, is accumulated in the interstitial edematous tissue in rejecting organs. We here investigated whether the increased tissue content of water and hyaluronan seen during allograft rejection can be prevented by treatment with the hyaluronan-degrading enzyme hyaluronidase. Heterotopic heart transplantations between PVG and Wistar/Kyoto rats were performed. Recipient rats were treated with hyaluronidase prophylactically or therapeutically, either alone or in combination with cyclosporine. Daily intravenous injections of hyaluronidase induced a significant reduction of the cardiac content of both hyaluronan and water, as evaluated on day six after transplantation. Morphological examination revealed grafts with better preserved morphology and fewer infiltrating mononuclear cells, compared to untreated controls. Hyaluronidase therapy, alone or combined with cyclosporine, resulted in prolonged graft survival times. Hyaluronidase infusion for two hours also reduced already established edema five days after transplantation. This study confirms the hypothesis that hyaluronan accumulation plays a critical role in edema formation, and that hyaluronidase therapy can be used to reduce edema after organ transplantation.
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19.
  • Kilman, Lisa, et al. (författare)
  • Episodic long-term memory by native and non-native stories masked by speech
  • 2015
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • The purpose of the current study was to investigate how well normal-hearing adults recalled Swedish (native) and English (non-native) fictional stories masked by speech in Swedish and English. Each story was 15 min long and divided into three parts of 5 min each. One part was masked by Swedish speech, one by English speech and one was presented unmasked as a baseline. Audibility was rated immediately after listening to each fragment. Episodic long-term memory was assessed using 24 multiple choice questions (4AFC). Every 8 questions corresponded to 5 min of recorded story and included 4 simple and 4 complex questions. Participants also performed complex span test of working memory capacity and proficiency tests in Swedish and English. The main result was that the stories in quiet were significantly better recalled than the stories masked by Swedish. Although the stimuli were correctly identified at the perceptual level, challenging listening
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20.
  • Kilman, Lisa, et al. (författare)
  • Subjective ratings of masker disturbance during the perception of native and non-native speech
  • 2015
  • Ingår i: Frontiers in Psychology. - : Frontiers. - 1664-1078. ; 6
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the present study was to address how 43 normal-hearing (NH) and hearing-impaired (HI) listeners subjectively experienced the disturbance generated by four masker conditions (i.e., stationary noise, fluctuating noise, Swedish two-talker babble and English two-talker babble) while listening to speech in two target languages, i.e., Swedish (native) or English (non-native). The participants were asked to evaluate their noise-disturbance experience on a continuous scale from 0 to 10 immediately after having performed each listening condition. The data demonstrated a three-way interaction effect between target language, masker condition, and group (HI versus NH). The HI listeners experienced the Swedish-babble masker as significantly more disturbing for the native target language (Swedish) than for the non-native language (English). Additionally, this masker was significantly more disturbing than each of the other masker types during the perception of Swedish target speech. The NH listeners, on the other hand, indicated that the Swedish speech-masker was more disturbing than the stationary and the fluctuating noise-maskers for the perception of English target speech. The NH listeners perceived more disturbance from the speech maskers than the noise maskers. The HI listeners did not perceive the speech maskers as generally more disturbing than the noise maskers. However, they had particular difficulty with the perception of native speech masked by native babble, a common condition in daily-life listening conditions. These results suggest that the characteristics of the different maskers applied in the current study seem to affect the perceived disturbance differently in HI and NH listeners. There was no general difference in the perceived disturbance across conditions between the HI listeners and the NH listeners.
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22.
  • Kloster Smerud, Hilde, et al. (författare)
  • Gastrointestinal sensitivity to soy and milk proteins in patients with IgA nephropathy
  • 2010
  • Ingår i: Clinical Nephrology. - 0301-0430. ; 74:5, s. 364-371
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Sensitivity to food antigens has been postulated as a contributing factor to the pathogenesis of IgA nephropathy (IgAN) Methods In this study we used a recently developed mucosal patch technique to evaluate rectal mucosal sensitivity to soy and cow's milk (CM) proteins in IgAN patients (n = 28) compared to healthy subjects (n = 18) The rectal mucosal production of nitric oxide (NO) and release of myeloperoxidase (M PO) and eosinophil cationic protein (ECP) were measured Serum samples were analyzed for IgA and IgG antibodies to a-lactalbumin, P-lactoglobulin, casein and soy Results 14 of 28 (14/28) patients experienced a rectal mucosal reaction, measured by increased NO and/or MPO levels, upon rectal challenge with soy and/or cow's milk proteins The levels of IgG antibodies to a-lactalbumin, beta-lactoglobulin and casein were significantly higher in CM sensitive as compared with non-sensitive IgAN patients, whereas the mean serum levels of IgA antibodies were similar No differences were seen in serum levels of IgA or IgG antibodies to soy Conclusion It is concluded that approximately half of our IgAN patients have a rectal mucosal sensitivity to soy or CM, and that an immune reactivity against antigens may be involved in the pathogenesis of IgAN in this subgroup of patients
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23.
  • Kozlov, Alexander K., et al. (författare)
  • Gating of steering signals through phasic modulation of reticulospinal neurons during locomotion
  • 2014
  • Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 111:9, s. 3591-3596
  • Tidskriftsartikel (refereegranskat)abstract
    • The neural control of movements in vertebrates is based on a set of modules, like the central pattern generator networks (CPGs) in the spinal cord coordinating locomotion. Sensory feedback is not required for the CPGs to generate the appropriate motor pattern and neither a detailed control from higher brain centers. Reticulospinal neurons in the brainstem activate the locomotor network, and the same neurons also convey signals from higher brain regions, such as turning/steering commands from the optic tectum (superior colliculus). A tonic increase in the background excitatory drive of the reticulospinal neurons would be sufficient to produce coordinated locomotor activity. However, in both vertebrates and invertebrates, descending systems are in addition phasically modulated because of feedback from the ongoing CPG activity. We use the lamprey as a model for investigating the role of this phasic modulation of the reticulospinal activity, because the brainstem-spinal cord networks are known down to the cellular level in this phylogenetically oldest extant vertebrate. We describe how the phasic modulation of reticulospinal activity from the spinal CPG ensures reliable steering/turning commands without the need for a very precise timing of on-or offset, by using a biophysically detailed large-scale (19,600 model neurons and 646,800 synapses) computational model of the lamprey brainstem-spinal cord network. To verify that the simulated neural network can control body movements, including turning, the spinal activity is fed to a mechanical model of lamprey swimming. The simulations also predict that, in contrast to reticulospinal neurons, tectal steering/turning command neurons should have minimal frequency adaptive properties, which has been confirmed experimentally.
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24.
  • Kristjánsson, Gudjon, et al. (författare)
  • Clinical and subclinical intestinal inflammation assessed by the mucosal patch technique : Studies of mucosal neutrophil and eosinophil activation in inflammatory bowel syndrome
  • 2004
  • Ingår i: Gut. - : BMJ. - 0017-5749 .- 1468-3288. ; 53:12, s. 1806-1812
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND AND AIMS: There is a clear need for a rapid, simple, safe, and sensitive method of determining the type and intensity of inflammation in the gut mucosa in clinical practice. In this study, we have evaluated the potential of a new method, the mucosal patch technique, in patients with and without apparent gut inflammation, as assessed by conventional diagnostic procedures. Subjects and METHODS: The technique tested is based on the idea that inflammatory mediators released from the rectal mucosa can be absorbed by and then extracted from cellulose patches brought into contact with the mucosa by use of an instrument with an inflatable balloon. Measurements were performed in healthy controls (n = 16) and in patients with active (n = 19) and inactive ulcerative colitis (UC, n = 8), collagen colitis (CC, n = 12), coeliac disease (n = 13), and irritable bowel syndrome (IBS, n = 13). RESULTS: Inflammatory mediators from neutrophils (myeloperoxidase (MPO)) and eosinophils (eosinophil cationic protein (ECP)) were increased on average 300- and 10-fold, respectively, in patients with active UC compared with healthy controls and were correlated with the endoscopic score. Patients with inactive UC, CC, coeliac disease, and IBS exhibited no endoscopic signs of inflammation. These patient groups had significantly lower levels of MPO and ECP than the active UC group but showed on average a four- to sevenfold increase in MPO compared with healthy controls. CONCLUSION: The mucosal patch technique was well tolerated by patients and easily applied by the investigator. Pronounced neutrophil and eosinophil involvement in UC was demonstrated. With the high sensitivity of the technique, low degree mucosal neutrophil activation could also be quantified in patients with CC and UC in clinical remission. The finding of increased neutrophil involvement in patients with IBS contributes to the pathophysiological ideas of this disease.
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25.
  • Lundin, Rolf A., et al. (författare)
  • An introduction by the editors
  • 2014
  • Ingår i: Advancing research on projects and temporary organizations. - Copenhagen : CBS Press. - 9788763002486 ; , s. 7-18
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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26.
  • Lundin, Rolf A., et al. (författare)
  • Current foci of Nordic approaches to project research
  • 2013
  • Ingår i: International Journal of Managing Projects in Business/Emerald. - : Emerald Group Publishing Limited. - 1753-8378 .- 1753-8386. ; 6:1
  • Tidskriftsartikel (refereegranskat)
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28.
  • Nilsson, B, et al. (författare)
  • Reconstitution of the alternative pathway of complement by plasma infusions given to a patient with an SLE-like syndrome associated with a hereditary C3 dysfunction.
  • 1994
  • Ingår i: Annals of the Rheumatic Diseases. - 0003-4967 .- 1468-2060. ; 53:10, s. 691-694
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To reconstitute a dysfunctional form of complement factor C3 in a patient with a systemic lupus erythematosus (SLE)-like syndrome.METHODS: The propositus was treated with plasma infusions during five sessions over a period of eight months.RESULTS: The alternative pathway was reconstituted to normal levels for approximately two to three days after each infusion. C3 fragments were incorporated into previously detected deposits of IgG and IgM at the dermal-epidermal junction and the immune complex levels gradually decreased during the whole treatment period.CONCLUSION: The reconstitution appears to result in the solubilisation of tissue immune complexes and a subsequent transportation to the fixed macrophage system.
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29.
  • Nylander, O, et al. (författare)
  • Duodenal mucosal alkaline secretion, permeability, and blood flow.
  • 1993
  • Ingår i: American Journal of Physiology. - 0002-9513 .- 2163-5773. ; 265:6 Pt 1, s. G1029-38
  • Tidskriftsartikel (refereegranskat)abstract
    • The relationship between duodenal mucosal alkaline secretion, permeability, and blood flow was examined in anesthetized rats. Duodenum was perfused with saline, and rate of luminal alkalinization (LA), mucosal permeability (clearance of 51Cr-EDTA from blood to lumen), effluent volume, mean arterial blood pressure (MABP), and blood flow (laser-Doppler flowmetry) were determined. Infusion of vasoactive intestinal polypeptide (VIP, 13.5 micrograms.kg-1 x h-1 i.v.) increased LA and fluid secretion but decreased MABP and mucosal permeability. The concentration of base in the secreted fluid was 45 mM. Systemic infusion of VIP (2.5 micrograms.kg-1 x h-1) increased LA and fluid secretion; the HCO3- concentration in secreted fluid was 86 mM. The lower VIP dose affected neither blood flow nor mucosal permeability. Both intravenous (10 mg/kg + 3 mg.kg-1 x h-1) and intraluminal (3 x 10(-3) M) N omega-nitro-L-arginine (L-NNA) increased LA and effluent volume; the HCO3- concentration in the secreted fluid was 38 and 44 mM, respectively. Intravenous, but not intraluminal, L-NNA increased mucosal permeability and decreased blood flow. Reduction of arterial blood pressure by blood withdrawal or by injection of prazosin (50 micrograms/kg i.v.) or hexamethonium (20 mg/kg i.v.) decreased LA and mucosal permeability. Prazosin decreased blood flow, whereas hexamethonium slightly increased blood flow. We conclude that NO may be an inhibitory regulator of LA and that both L-NNA and VIP increase LA via stimulation of active HCO3- transport. VIP probably increases HCO3- and fluid secretion by two separate ion transport mechanisms. No causal relationship exists between LA and blood flow, between LA and mucosal permeability, or between mucosal permeability and blood flow. A positive linear correlation exists between MABP and mucosal permeability, suggesting that marked changes of MABP may influence permeation of small water-soluble solutes across duodenal mucosa.
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30.
  • Nylander, O, et al. (författare)
  • Exposure of the duodenum to high concentrations of hydrochloric acid. Effects on mucosal permeability, alkaline secretion, and blood flow.
  • 1994
  • Ingår i: Scandinavian Journal of Gastroenterology. - 0036-5521 .- 1502-7708. ; 29:5, s. 437-44
  • Tidskriftsartikel (refereegranskat)abstract
    • Proximal duodenum was perfused with HCl for 5 min and the effects on blood-to-lumen clearance of 51Cr-EDTA (ED-Cl), morphology, luminal alkalinization, and blood flow determined in anesthetized rats. The rate of alkalinization was determined by back titration and blood flow assessed by laser Doppler flowmetry or by ultrasonic transit time flowmetry. Perfusion of duodenum with 30, 50 or 100 mM HCl for 5 min increased ED-Cl in a concentration-dependent manner and induced a small increase in alkalinization but had no effect on blood flow. At 55 min after cessation of perfusion with 100 mM HCl ED-Cl was 2.2-fold higher than control whereas the ED-Cl values in animals perfused with 30 or 50 mM HCl were not different from pre-acid control values. 100 mM HCl also induced an increase in 14C-mannitol and 14C-polyethylene glycol 4000 clearance, suggesting that HCl does indeed increase mucosal permeability. The 100 mM HCl-induced rise in mucosal permeability most probably reflects disturbance of mucosal integrity because three of five animals exhibited villous tip damage. The increases in ED-Cl in response to 100 mM HCl were the same in control rats as in rats with the renal pedicles ligated, indicating that the acid susceptibility is not affected by acute functional nephrectomy.
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32.
  • Semb, G, et al. (författare)
  • An Analytical Study of a Composite Dove Tail Joint
  • 2003
  • Ingår i: Journal of Composite Materials. - 0021-9983. ; 37:2, s. 99-109
  • Tidskriftsartikel (refereegranskat)abstract
    • In this paper a simple analytical model for determining the elastic fields in a so called dovetail joint is developed. The model is restricted to joints having a small wedge angle. With some simplifying assumptions regarding for example the mechanical behaviour of the wedge material, the elastic fields can be expressed in terms of convergent polynomial series. Two situations in which closed form solutions exists are identified: (a) when the lateral contraction of the laminates can be ignored, the laminate displacement is obtained in closed form in terms of Bessel functions, whereas (b): when the wedge can be considered to be rigid, it is obtained in terms of exponential functions. Finally, some numerical examples regarding contact pressure, stress distribution and stiffness are presented.
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33.
  • Thörn, M, et al. (författare)
  • Intestinal mucosal secretion of basic fibroblast growth factor in patients with ulcerative colitis.
  • 2000
  • Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 35:4, s. 408-412
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Basic fibroblast growth factor (bFGF) promotes angiogenesis and several other biologic processes, including proliferation of mesenchymal cells and tumor progression. We investigated whether bFGF could be detected in the intraluminal secretion of the small intestine, sigmoid colon, and rectum in healthy individuals and in patients with ulcerative colitis.METHODS: We used endoscopic perfusion techniques to obtain samples from well-defined intestinal segments. The perfusion fluid concentrations of bFGF, biochemical markers of inflammation, myeloperoxidase (MPO), interleukin-6 (IL-6), and permeability (albumin) were determined with immunochemical methods.RESULTS: In the perfusion fluids the albumin concentration, which reflects passive diffusion, was less than 1% of the plasma concentration, whereas the intestinal concentration of bFGF was similar to that in plasma. Among healthy subjects the concentration of bFGF was eightfold higher in the jejunum and twofold higher in the rectum than in the sigmoid colon. The perfusion fluid from colorectal segments in patients with ulcerative colitis had a significantly higher mean concentration of bFGF than that from healthy individuals; an almost 10-fold difference was found in rectal segments. There were strong correlations between the concentration of bFGF and the concentrations of MPO and IL-6.CONCLUSIONS: The high concentrations of bFGF in the intestinal perfusion fluid reflect either a local synthesis or an active secretion of bFGF within the mucosa. The bFGF concentration differs in intestinal anatomic location and increases significantly in patients with ulcerative colitis in close relationship with biochemical markers of inflammation and permeability.
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34.
  • Tufveson, G, et al. (författare)
  • Hyaluronic acid accumulation; the mechanism behind graft rejection edema.
  • 1992
  • Ingår i: Transplant International. - 0934-0874 .- 1432-2277. ; 5 Suppl 1, s. S688-9
  • Tidskriftsartikel (refereegranskat)abstract
    • Hyaluronic acid (HA) is an important stabilizing consistuent of the loose connective tissue and regulates water homeostasis. Thus, excessive accumulation of HA in interstitial tissue immobilizes water and may thereby contribute to interstitial tissue edema. By the use of biotin labelled core protein and an avidin-enzyme system, we visualized HA in grafted rat kidney, rat heart, rat small bowel and also in human kidneys. By an extraction procedure the tissue amounts of HA were measured in the experimental grafts. Simple techniques for measuring water content were also employed. The extracellular amounts of HA increased between 100% and 350% in rejecting tissues as compared to syngeneic controls. The relative water content also increased and correlated well with the HA accumulation. The clinical value of these experimental observations was confirmed in human transplantation where rejecting kidney allografts demonstrated a highly significant increase in HA staining in the interstitium as compared to non-rejecting biopsy specimens. We therefore concluded that transplantation edema--a key features of graft rejection--is regulated by the accumulation of HA not only under experimental conditions but also in the clinical setting.
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35.
  • van Esch, Thamar E. M., et al. (författare)
  • Evaluation of the preliminary auditory profile test battery in an international multi-centre study
  • 2013
  • Ingår i: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 52:5, s. 305-321
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: This paper describes the composition and international multi-centre evaluation of a battery of tests termed the preliminary auditory profile. It includes measures of loudness perception, listening effort, speech perception, spectral and temporal resolution, spatial hearing, self-reported disability and handicap, and cognition. Clinical applicability and comparability across different centres are investigated. Design: Headphone tests were conducted in five centres divided over four countries. Effects of test-retest, ear, and centre were investigated. Results for normally-hearing (NH) and hearing-impaired (HI) listeners are presented. Study sample: Thirty NH listeners aged 19-39 years, and 72 HI listeners aged 22-91 years with a broad range of hearing losses were included. Results: Test-retest reliability was generally good and there were very few right/left ear effects. Results of all tests were comparable across centres for NH listeners after baseline correction to account for necessary differences between test materials. For HI listeners, results were comparable across centres for the language-independent tests. Conclusions: The auditory profile forms a clinical test battery that is applicable in four different languages. Even after baseline correction, differences between test materials have to be taken into account when interpreting results of language-dependent tests in HI listeners.
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36.
  • van Esch, T.E.M., et al. (författare)
  • Relations between psychophysical measures of spatial hearing and self-reported spatial- hearing abilities
  • 2015
  • Ingår i: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 54:3, s. 182-189
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The aim of the present study was to investigate how well the virtual psychophysical measures of spatial hearing from the preliminary auditory profile predict self-reported spatial-hearing abilities. Design: Virtual spatial-hearings tests (conducted unaided, via headphones) and a questionnaire were administered in five centres in Germany, the Netherlands, Sweden, and the UK. Correlations and stepwise linear regression models were calculated among a group of hearing-impaired listeners. Study sample: Thirty normal-hearing listeners aged 19–39 years, and 72 hearing-impaired listeners aged 22–91 years with a broad range of hearing losses, including asymmetrical and mixed hearing losses. Results: Several significant correlations (between 0.24 and 0.54) were found between results of virtual psychophysical spatial-hearing tests and self-reported localization abilities. Stepwise linear regression analyses showed that the minimum audible angle (MAA) test was a significant predictor for self-reported localization abilities (5% extra explained variance), and the spatial speech reception threshold (SRT) benefit test for self-reported listening to speech in spatial situations (6% extra explained variance). Conclusions: The MAA test and spatial SRT benefit test are indicative measures of everyday binaural functioning. The binaural SRT benefit test was not found to predict self-reported spatial-hearing abilities. Read More: http://informahealthcare.com/doi/abs/10.3109/14992027.2014.953216
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37.
  • Waldenström, A, et al. (författare)
  • Accumulation of hyaluronan and tissue edema in experimental myocardial infarction.
  • 1991
  • Ingår i: Journal of Clinical Investigation. - 0021-9738 .- 1558-8238. ; 88:5, s. 1622-8
  • Tidskriftsartikel (refereegranskat)abstract
    • Experimental myocardial infarction was induced in rats. The myocardial accumulation of hyaluronan (HA) and water during the development of infarction was measured. The extractable HA content of the infarcted area increased progressively from day 1 and on day 3 reached a threefold increase compared with the HA amounts in myocardium of sham operated controls. The relative water content of infarcted areas also increased progressively reaching a maximum value by day 3 and was strongly correlated with the HA accumulation. Affinity histochemistry visualized a thin rim of HA in the endoperimysium in healthy myocardium. By day 2 an interstitial edema with inflammatory cells was apparent. The widened endoperimysium stained extensively for HA. By its water-binding ability, interstitial accumulation of HA will contribute to the interstitial edema in infarcted myocardial tissue. An interstitial edema is likely to influence the electromechanical characteristics of the myocardium and facilitate reentry phenomena due to a loss of contact between muscle cells. The edema also induces an increased extracellular pressure and an altered myocardial wall compliance that might impair myocardial microcirculation. The findings are relevant to an understanding of the beneficial effect of hyaluronidase treatment in limiting cellular damage during myocardial ischemia.
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38.
  • Waldenström, A, et al. (författare)
  • Coxsackie B3 myocarditis induces a decrease in energy charge and accumulation of hyaluronan in the mouse heart.
  • 1993
  • Ingår i: European Journal of Clinical Investigation. - 0014-2972 .- 1365-2362. ; 23:5, s. 277-82
  • Tidskriftsartikel (refereegranskat)abstract
    • Interstitial oedema in chronic inflammation and ischaemia is related to an accumulation of hyaluronan (hyaluronic acid; HA) in the interstitium. As interstitial oedema will affect the oxygen transport in the interstitium we have evaluated whether accumulation of HA is related to signs of myocardial energy depletion in virus induced myocarditis. Myocarditis was induced in Balb/c mice by inoculation of Coxsackie B3 virus. The extractable HA content of the myocardium increased progressively from a baseline value of 153 +/- 26 micrograms g-1 dry weight to a maximum of 286 +/- 78 micrograms g-1 dry weight at day 7, whereafter there was a slight decline. Affinity histochemistry visualized HA in the endo-perimysium in healthy myocardium. At day 5 after Coxsackie B3 inoculation there was a general widening of the endomysium, which exhibited a positive staining for HA. In conjunction with focal inflammatory infiltrates the staining for HA was even more pronounced. The energy rich adenylates were reversibly affected by the Coxsackie B3 infection. There was a slight, but significant decline in EC from 0.74 +/- 0.05 in the control group to a minimum value of 0.64 +/- 0.10 at day 5, whereafter a restitution was observed at days 7 and 10. The total adenine nucleotide pool was similarly decreased from 27.8 +/- 2.9 mumol g-1 dry weight in controls to 24.6 +/- 2.1 micrograms g-1 dry weight at day 5, and normalized at days 7 and 10. The data suggest that virus induced myocarditis is associated with a local accumulation of HA in the myocardium.(ABSTRACT TRUNCATED AT 250 WORDS)
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39.
  • Wallander, J, et al. (författare)
  • Intestinal distribution of hyaluronan in small bowel allografting in the rat.
  • 1993
  • Ingår i: Transplant International. - 0934-0874 .- 1432-2277. ; 6:3, s. 133-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Hyaluronan (hyaluronic acid; HA) was demonstrated and quantified in small bowel tissue at different times after small bowel transplantation. Semiallogeneic or semisyngeneic rat models were used to elicit either unidirectional graft rejection or graft-versus-host disease (GVHD). In normal rat small bowel, HA was present in the villous lamina propria and around medium-sized vessels in the interstitium of the crypt area. During graft rejection a cellular infiltrate and edema appeared in the lamina propria in the crypt area where an accumulation of HA was also demonstrated. There was progressive accumulation of HA in the small bowel during rejection, and on day 6 there was a threefold increase compared to the values in syngeneic grafts. The increase in tissue HA was paralleled by an increase in the total water content of the rejecting graft. In specimens from animals suffering from GVHD, no significant changes in water or HA content and distribution were observed until day 12. The data suggest that accumulation of HA might contribute to the pathophysiology of the transplantation edema and that HA might be of potential diagnostic value in differentiating between graft rejection and GVHD.
  •  
40.
  • Westman, J., et al. (författare)
  • Increased cardiovascular mortality in people with schizophrenia : a 24-year national register study
  • 2017
  • Ingår i: Epidemiology and Psychiatric Sciences. - 2045-7960. ; , s. 1-9
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: People who have schizophrenia die earlier from somatic diseases than do people in the general population, but information about cardiovascular deaths in people who have schizophrenia is limited. We analysed mortality in all age groups of people with schizophrenia by specific cardiovascular diseases (CVDs), focusing on five CVD diagnoses: coronary heart disease, acute myocardial infarction, cerebrovascular disease, heart failure and cardiac arrhythmias. We also compared hospital admissions for CVDs in people who had schizophrenia with hospital admissions for CVDs in the general population. Methods: This national register study of 10 631 817 people in Sweden included 46 911 people who were admitted to the hospital for schizophrenia between 1 January 1987 and 31 December 2010. Information from national registers was used to identify people who had schizophrenia and obtain data about mortality, causes of death, medical diagnoses and hospitalisations. Results: CVDs were the leading cause of death in people who had schizophrenia (5245 deaths), and CVDs caused more excess deaths than suicide. The mean age of CVD death was 10 years lower for people who had schizophrenia (70.5 years) than the general population (80.7 years). The mortality rate ratio (MRR) for CVDs in all people who had schizophrenia was 2.80 (95% confidence interval (CI) 2.73–2.88). In people aged 15–59 years who had schizophrenia, the MRR for CVDs was 6.16 (95% CI 5.79–6.54). In all people who had schizophrenia, the MRR for coronary heart disease was 2.83 (95% CI 2.73–2.94); acute myocardial infarction, 2.62 (95% CI 2.49–2.75); cerebrovascular disease, 2.4 (95% CI 2.25–2.55); heart failure, 3.25 (95% CI 2.94–3.6); and cardiac arrhythmias, 2.06 (95% CI 1.75–2.43). Hospital admissions for coronary heart disease were less frequent in people who had schizophrenia than in the general population (admission rate ratio, 0.88 (95% CI 0.83–0.94). In all age groups, survival after hospital admission for CVD was lower in people who had schizophrenia than in the general population. Conclusions: People who had schizophrenia died 10 years earlier from CVDs than did people in the general population. For all five CVD diagnoses, mortality risk was higher for those with schizophrenia than those in the general population. Survival after hospitalisation for CVDs in people who had schizophrenia was comparable with that of people in the general population who were several decades older.
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41.
  •  
42.
  • Woksepp, Hanna, et al. (författare)
  • High target attainment for beta-lactam antibiotics in intensive care unit patients when actual minimum inhibitory concentrations are applied
  • 2017
  • Ingår i: European Journal of Clinical Microbiology and Infectious Diseases. - Heidelberg : Springer. - 0934-9723 .- 1435-4373. ; 36:3, s. 553-563
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients in the intensive care unit (ICU) are at risk for suboptimal levels of beta-lactam antibiotics, possibly leading to poor efficacy. Our aim was to investigate whether the actual minimum inhibitory concentration (MIC) compared to the more commonly used arbitrary epidemiological cut-off values (ECOFFs) would affect target attainment in ICU patients on empirical treatment with broad-spectrum beta-lactam antibiotics and to identify risk factors for not reaching target. In a prospective, multicenter study, ICU patients ae18 years old and treated with piperacillin/tazobactam, meropenem, or cefotaxime were included. Clinical and laboratory data were recorded. Serum trough antibiotic levels from three consecutive days were analyzed by liquid chromatography-mass spectrometry (LC-MS). The target was defined as the free trough concentration above the MIC (100% fT(> MIC)). MICECOFF was used as the target and, when available, the actual MIC (MICACTUAL) was applied. The median age of the patients was 70 years old, 52% (58/111) were males, and the median estimated glomerular filtration rate (eGFR) was 48.0 mL/min/1.73 m(2). The rate of patients reaching 100% fT > MICACTUAL was higher (89%, 31/35) compared to the same patients using MICECOFF (60%, p = 0.002). In total, 55% (61/111) reached 100% fT > MICECOFF. Increased renal clearance was independently associated to not reaching 100% fT > MICECOFF. On repeated sampling, > 77% of patients had stable serum drug levels around the MICECOFF. Serum concentrations of beta-lactam antibiotics vary extensively between ICU patients. The rate of patients not reaching target was markedly lower for the actual MIC than when the arbitrary MIC based on the ECOFF was used, which is important to consider in future studies.
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