| 1. |
- Andersson, Roland, et al.
(författare)
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Interventionell radiologi
- 2004
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Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 78-78
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 2. |
- Isaksson, Björn, et al.
(författare)
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Hepatic encephalopathy verified by psychometric testing and EEG in cirrhotic patients : Effects of mesocaval interposition shunt or sclerotherapy
- 2005
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Ingår i: HPB. - : Elsevier BV. - 1365-182X .- 1477-2574. ; 7:1, s. 65-72
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Tidskriftsartikel (refereegranskat)abstract
- Background. The aim of this randomised prospective study was to evaluate hepatic encephalopathy after mesocaval interposition shunt operation and after repeated endoscopic sclerotherapy. Methods. Forty-five patients with bleeding oesophageal varices due to liver cirrhosis were randomised to the two treatment groups, 24 to the shunt group and 21 to the sclerotherapy group. The patients were evaluated preoperatively regarding blood tests, hepatic encephalopathy as measured by electroencephalogram with spectral analysis and by a battery of psychometric tests. The direction of portal flow in the shunt group was investigated by shunt phlebography and ultrasonography with Doppler. During follow-up the same investigations were performed twice at median 6.7 and 14.7 months after operation. Results. No statistically significant difference was found during follow-up regarding blood tests and electroencephalography with spectral analysis. Although the preoperative psychometric tests showed that the shunt group performed significantly better than the sclerotherapy group, the first follow-up showed that the shunt group performed statistically worse than the sclerotherapy group in seven of the tests: Synonyms (measuring verbal ability), Block Design Test (measuring visuo-spatial ability), Memory for Design Test, Error Score (measuring memory function), Revised Visual Retention Test, correct answers and the same test error answers (measuring visuo-spatial memory, ability and immediate memory), Digit Symbol Test (measuring perceptual ability) and Trial Making Test B (measuring cognitive motor abilities). Conclusions. Patients treated by mesocaval interposition shunt showed a progressive general reduction in psychometric performance compared with patients treated with repeated sclerotherapy, in whom a general intellectual improvement was observed. This finding corresponds to the reverse direction of the preoperative portal flow to a hepatofugal pattern at first follow-up and at 12 months among two-thirds of the patients. © 2005 Taylor & Francis Group Ltd.
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| 3. |
- Klarin, Bengt, et al.
(författare)
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Adhesion of the probiotic bacterium Lactobacillus plantarum 299v onto the gut mucosa in critically ill patients: a randomised open trial.
- 2005
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Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535. ; 9:3, s. 285-293
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Tidskriftsartikel (refereegranskat)abstract
- Introduction To achieve any possible positive effect on the intestinal mucosa cells it is important that probiotics adhere tightly onto the intestinal mucosa. It has been shown in healthy volunteers that Lactobacillus plantarum 299v (Lp 299v) (DSM 9843), a probiotic bacterium, given orally in a fermented oatmeal formula adheres onto the intestinal mucosa, but whether this also occurs in critically ill patients is unknown. Methods After randomisation, nine enterally fed, critically ill patients treated with broad-spectrum antibiotics received an oatmeal formula fermented with Lp 299v throughout their stay in the intensive care unit; eight patients served as controls. Biopsies of the rectal mucosa were made at admission and then twice a week, and the biopsies were analysed blindly. Results Four patients in the control group were colonised with Lp 299v at admission but thereafter all their biopsies were negative (Lp 299v is an ingredient in a common functional food, ProViva(R), in Sweden). Of the treated patients none was colonised at admission but three patients had Lp 299v adhered on the mucosa from the second or third biopsy and in the following samples. Conclusion This study shows that Lp 299v could survive the passage from the stomach to the rectum and was able adhere onto the rectal mucosa also in critically ill, antibiotic-treated patients.
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| 4. |
- Klarin, Bengt, et al.
(författare)
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Lactobacillus plantarum 299v reduces colonisation of Clostridium difficile in critically ill patients treated with antibiotics
- 2008
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 52:8, s. 1096-1102
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Tidskriftsartikel (refereegranskat)abstract
- Background: The incidence of Clostridium difficile-associated disease (CDAD) in hospitalised patients is increasing. Critically ill patients are often treated with antibiotics and are at high risk of developing CDAD. Lactobacillus plantarum 299v (Lp299v) has been found to reduce recurrence of CDAD. We investigated intensive care unit (ICU) patients regarding the impact of Lp299v on C. difficile colonisation and on gut permeability and parameters of inflammation and infection in that context. Methods: Twenty-two ICU patients were given a fermented oatmeal gruel containing Lp299v, and 22 received an equivalent product without the bacteria. Faecal samples for analyses of C. difficile and Lp299v were taken at inclusion and then twice a week during the ICU stay. Other cultures were performed on clinical indication. Infection and inflammation parameters were analysed daily. Gut permeability was assessed using a sugar probe technique. Main Results: Colonisation with C. difficile was detected in 19% (4/21) of controls but in none of the Lp299v-treated patients (p < 0.05). Conclusions: Enteral administration of the probiotic bacterium Lp299v to critically ill patients treated with antibiotics reduced colonisation with C. difficile. Trial registration: Current Controlled Trials ISRCTN85655545
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| 5. |
- Klarin, Bengt, et al.
(författare)
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Susceptibility to antibiotics in isolates of Lactobacillus plantarum RAPD-type Lp299v, harvested from antibiotic treated, critically ill patients after administration of probiotics.
- 2019
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Ingår i: MicrobiologyOpen. - : John Wiley & Sons. - 2045-8827. ; 8:2
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Tidskriftsartikel (refereegranskat)abstract
- Recultured Lactobacillus plantarum 299v-like strains were tested regarding antibiotic susceptibility, and no decrease was detected. Antibiotics are frequently used to treat patients in intensive care units (ICUs) and are associated with a significant risk of selection of resistant bacterial strains. In particular, it is possible that genetic transfer of antibiotic resistance to the resident gastrointestinal flora, as well as to administered probiotics, may be increased in the ICU setting. The aim of the present investigation was to detect possible changes in antimicrobial susceptibility in reisolates of the probiotic strain Lactobacillus plantarum 299v (Lp299v) given to antibiotic treated, critically ill patients. Lp299v-like strains were identified in cultures of biopsies and fecal samples from 32 patients given the probiotic strain enterally in two previous ICU studies. The patients received a variety of antibiotics. Isolates with the same genomic RAPD profile (RAPD-type) as Lp299v were obtained to enable monitoring of antibiotic susceptibility by E-tests. Forty-two isolates, collected throughout the course of illness, were tested against 22 different antibiotics. No obvious decrease in susceptibility was found for 21 of the tested antibiotics. There was a tendency toward decreased susceptibility to ampicillin. The stable antibiotic susceptibility profiles of the Lp299v-like isolates studied here suggests this probiotic is less likely to acquire resistance when administered to critically ill patients treated with broad-spectrum antibiotics.
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| 6. |
- Klarin, Bengt, et al.
(författare)
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Use of the probiotic Lactobacillus plantarum 299 to reduce pathogenic bacteria in the oropharynx of intubated patients : a randomised controlled open pilot study
- 2008
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Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535 .- 1466-609X. ; 12:6, s. R136-
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Ventilator-associated pneumonia (VAP) is usually caused by aspiration of pathogenic bacteria from the oropharynx. Oral decontamination with antiseptics, such as chlorhexidine (CHX) or antibiotics, has been used as prophylaxis against this complication. We hypothesised that the probiotic bacteria Lactobacillus plantarum 299 (Lp299) would be as efficient as CHX in reducing the pathogenic bacterial load in the oropharynx of tracheally intubated, mechanically ventilated, critically ill patients. METHODS: Fifty critically ill patients on mechanical ventilation were randomised to either oral mechanical cleansing followed by washing with 0.1% CHX solution or to the same cleansing procedure followed by oral application of an emulsion of Lp299. Samples for microbiological analyses were taken from the oropharynx and trachea at inclusion and at defined intervals thereafter. RESULTS: Potentially pathogenic bacteria that were not present at inclusion were identified in oropharyngeal samples from eight of the patients treated with Lp299 and 13 of those treated with CHX (p = 0.13). Analysis of tracheal samples yielded similar results. Lp299 was recovered from the oropharynx of all patients in the Lp299 group. CONCLUSIONS: In this pilot study, we found no difference between the effect of Lp299 and CHX used in oral care procedures, when we examined the effects of those agents on colonisation of potentially pathogenic bacteria in the oropharynx of intubated, mechanically ventilated patients.
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| 7. |
- Abdulla, Aree, et al.
(författare)
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CD40L is not involved in acute experimental pancreatitis
- 2011
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Ingår i: European Journal of Pharmacology. - : Elsevier BV. - 1879-0712 .- 0014-2999. ; 659:1, s. 85-88
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Tidskriftsartikel (refereegranskat)abstract
- Recent data suggest that platelets not only control thrombosis and hemostasis but may also regulate inflammatory processes such as acute pancreatitis. However, the specific role of platelet-derived mediators in the pathophysiology of acute pancreatitis is not known. Herein, we examined the role of CD40 ligand (CD40L, CD154) in different models of acute pancreatitis. Acute pancreatitis was induced by repetitive caerulein administration (50 mu g/kg, i.p.) or infusion of sodium taurocholate (5%-10 mu l) into the pancreatic duct in wild-type C578L/6 and CD40L-deficient mice. Neutrophil infiltration, myeloperoxidase (MPO), macrophage inflammatory protein-2 (MIP-2) levels, acinar cell necrosis, edema and hemorrhage in the pancreas as well as serum amylase activity and lung levels of MPO were quantified 24 h after induction of acute pancreatitis. Caerulein and taurocholate challenge caused a clear-cut pancreatic damage characterized by increased acinar cell necrosis, neutrophil infiltration, focal hemorrhage, edema formation as well as increased levels of serum amylase and MIP-2 in the pancreas and lung MPO and histological damage. Notably, CD40L gene-deficient animals exhibited a similar phenotype as wild-type mice after challenge with caerulein and taurocholate. Similarly, administration of an antibody directed against CD40L had no effect against acute pancreatitis. Our data suggest that CD40L does not play a functional role in experimental acute pancreatitis. Thus, other candidates than CD40L needs to be explored in order to identify platelet-derived mediators in the pathophysiology of acute pancreatitis. (C) 2011 Elsevier B.V. All rights reserved.
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| 8. |
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| 9. |
- Abdulla, Aree, et al.
(författare)
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Platelets regulate P-selectin expression and leukocyte rolling in inflamed venules of the pancreas
- 2012
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Ingår i: European Journal of Pharmacology. - : Elsevier BV. - 1879-0712 .- 0014-2999. ; 682:1-3, s. 153-160
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Tidskriftsartikel (refereegranskat)abstract
- Recent data suggest that platelets regulate inflammatory changes and tissue damage in acute pancreatitis although the role of platelets in leukocyte-endothelium interactions in the pancreatic microcirculation is not known. The aim of this study was to define the impact of platelets on leukocyte rolling and adhesion in acute pancreatitis. Acute pancreatitis was induced in C57BL/6 mice by caerulein challenge. Mice were treated with an a anti-GP1b alpha (CD42b) antibody, which depletes platelets, or a control antibody before caerulein. Leukocyte rolling and adhesion were determined by the use of intravital fluorescence microscopy 18 h after the last dose of caerulein. In separate experiments, leukocyte-endothelium interactions were determined before and after administration of an anti-P-selectin, anti-PSGL-1 and a control antibody in mice with caerulein pancreatitis. Circulating platelet-neutrophil aggregates and pancreatic P-selectin mRNA were quantified 1 and 6 h respectively after caerulein challenge. Caerulein administration increased leukocyte and platelet interactions in the pancreatic microvasculature, increased tissue damage and expression of P-selectin mRNA in the pancreas as well as platelet-neutrophil complexes in the circulation. Notably, platelet depletion markedly reduced caerulein-provoked leukocyte rolling and adhesion in postcapillary venules. Interestingly, depletion of platelets significantly decreased caerulein-induced gene expression of P-selectin in the pancreas. Moreover, immunoneutralization of P-selectin and PSGL-1 abolished leukocyte rolling in the pancreatic venules triggered by caerulein. Our novel findings demonstrate that platelets regulate leukocyte rolling in acute pancreatitis via induction of P-selectin, which was critical in supporting leukocyte rolling in inflamed venules of the pancreas. (C) 2012 Elsevier B.V. All rights reserved.
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| 10. |
- Abdulla, Aree, et al.
(författare)
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Role of platelets in experimental acute pancreatitis.
- 2011
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; 98, s. 93-103
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:: Platelets not only control thrombosis and haemostasis but may also regulate inflammatory processes. Acute pancreatitis (AP) is characterized by changes in both coagulation and proinflammatory activities. The role of platelets in AP is not yet known. METHODS:: AP was induced in C57BL/6 mice by repeated caerulein administration (50 µg/kg intraperitoneally). Mice received a platelet-depleting or control antibody before caerulein challenge. Neutrophil infiltration, myeloperoxidase (MPO) and macrophage inflammatory protein (MIP) 2 levels, acinar cell necrosis and haemorrhage in the pancreas, as well as serum amylase activity, were determined 24 h after caerulein injection. In an alternative model of pancreatitis, L-arginine (4 g/kg intraperitoneally) was given twice with an interval of 1 h and tissue samples were taken after 72 h [Correction added after online publication 29 September 2010: in the preceding sentence, 4 mg/kg was corrected to 4 g/kg]. RESULTS:: Caerulein administration increased acinar cell necrosis, neutrophil infiltration, focal haemorrhage and serum amylase levels. Platelet depletion reduced acinar cell necrosis, haemorrhage and serum amylase levels in AP. Depletion of platelets decreased caerulein-induced MPO levels and neutrophil recruitment in the pancreas. Platelet depletion abolished caerulein-induced MIP-2 generation in the pancreas and circulation. The effects of platelet depletion on necrosis, neutrophils and MPO levels were confirmed in L-arginine-induced pancreatitis. CONCLUSION:: Platelets play a crucial role in AP by regulating neutrophil infiltration, most likely mediated by MIP-2 production in the pancreas. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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| 11. |
- Adawi, Diya, et al.
(författare)
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Safety of the probiotic strain Lactobacillus plantarum DSM 9843 (strain 299v) in an endocarditis animal model
- 2002
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Ingår i: Microbial Ecology in Health and Disease. - : Informa UK Limited. - 0891-060X .- 1651-2235. ; 14:1, s. 50-53
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Lactobacilli are often considered to be beneficial or non-pathogenic to man, with small numbers of human infections being reported, including septicemia and infective endocarditis. To verify the safety of Lactobacillus plantarum DSM 9843 (=strain 299v) administration, we used a well-known endocarditis animal model. Design: Experimental study using Sprague-Dawley rats. Setting: University Hospital, Sweden. Interventions: A catheter was passed down the right common carotid artery into the lumen of the left ventricle. The catheter was tied in place and the neck incision was closed. After 48 h, 0.5 ml of a bacterial suspension was injected through the tail vein. In the endocarditis control we inoculated Staphylococcus lugdunesis CCUG 25349T (T = type strain) and L. plantarum 299v was injected in the blood in L. plantarum group. Main outcome measures: Rats were sacrificed 96 h later and samples were taken from the heart, blood and catheter for bacterial culture and Randomly Amplified Polymorphic DNA (RAPD) evaluation. Results: L. plantarum 299v was injected in the blood but no lactobacilli were found in the heart, blood or catheter after 96 h. RAPD evaluation showed that S. lugdunesis CCUG 25349T was isolated from both blood and heart. Conclusion: The results showed that L. plantarum 299v has no role in the tested endocarditis animal model, which indicates the safety of L. plantarum 299v.
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| 12. |
- Ahrén, Irini Lazou, et al.
(författare)
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Decreasing the Adverse Effects in Pelvic Radiation Therapy: A Randomized Controlled Trial Evaluating the Use of Probiotics
- 2023
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Ingår i: Advances in Radiation Oncology. - : Elsevier BV. - 2452-1094. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this randomized controlled trial was to evaluate the potential benefit from 2 probiotic bacteria of the species Lactiplantibacillus plantarum against radiation therapy-induced comorbidities. Methods and Materials: Women (>18 years of age) scheduled for radiation therapy because of gynecologic cancer were randomly allocated to consume placebo or either low-dose probiotics (1 pound 1010 colony-forming unit/capsule twice daily) or high-dose probiotics (5 pound 1010 colony-forming unit/capsule twice daily). The intervention started approximately 1 week before the onset of radiation therapy and continued until 2 weeks after completion. During this period the participants were daily filling in a study diary documenting the incidence and severity of symptoms, intake of concomitant medication, and stool consistency. The primary endpoint was the probiotic effect on the mean number of loose stools during radiation therapy. Results: Of the 97 randomized women, 75 provided data for the analysis of the results. The mean number of loose stools (sum of Bristol stool type 6 and 7) was not significantly reduced in the probiotic groups, but there was a significant reduction in the mean number of days with >1 loose stool with 15.04 +/- 8.92 days in the placebo and 8.65 +/- 5.93 days in the high-dose probiotics group (P = .014). The benefit was even more pronounced in the 2 weeks following the end of radiation therapy (P = .005). Moreover, intake of the probiotics resulted in a reduced severity of the symptoms grinding abdominal pain (P = .041) and defecation urgency (P = .08) and a reduced percentage of days with these symptoms (P = .023 and P = .042, respectively), compared with placebo. There were no differences regarding reported adverse events. Conclusions: Intake of the 2 probiotic bacteria was beneficial and reduced many measures or symptoms of the radiation-induced toxicity in women treated for gynecologic cancer. (c) 2022 The Authors. Published by Elsevier Inc. on behalf of American Society for Radiation Oncology. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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| 13. |
- Andersson, Magnus V., et al.
(författare)
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Kirurgi – omistligt komplement till medicinsk behandling
- 2009
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 106:45, s. 3003-9
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Tidskriftsartikel (refereegranskat)abstract
- Kirurgi på rätt indikation och vid rätt tidpunkt är ett omistligt komplement till medicinsk behandling vid inflammatorisk tarmsjukdom, som förebygger sjukdomskomplikationer, förbättrar patienternas livskvalitet och ibland är livräddande. Kirurgi för ulcerös kolit görs oftast som ett tvåstegsförfarande: först kolektomi plus ileostomi med rektum lämnad intakt och i senare skede, med optimerad patient, tarmrekonstruktion anpassad efter patientens individuella livssituation. Kirurgi vid Crohns sjukdom korrigerar komplikationer (stenoser och fistlar) och sparar tarm genom begränsade resektioner och strikturplastiker. Laparoskopisk kirurgi verkar ha viktiga fördelar vid primära tarmresektioner. Modern medicinsk behandling har förändrat indikationerna men ännu inte minskat behovet av kirurgi. Pågående antiinflammatorisk och immunmodulerande behandling är viktig att beakta i samband med kirurgi. Ett nära samspel mellan gastroenterolog och kolorektalkirurg är nödvändigt för att uppnå bästa möjliga långtidsprognos för de individer som lever med IBD.
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| 14. |
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| 15. |
- Andersson, Roland, et al.
(författare)
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Akut buk
- 2004
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Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 102-102
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 16. |
- Andersson, Roland, et al.
(författare)
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Appendicit
- 2004
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Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 144-144
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 17. |
- Andersson, Roland, et al.
(författare)
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Bråck
- 2004
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Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 156-156
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 18. |
- Andersson, Roland, et al.
(författare)
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Bukhålan - peritonit, abscess och ileus
- 2004
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Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 107-107
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 19. |
- Andersson, Roland, et al.
(författare)
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Gallvägssjukdomar
- 2004
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Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 119-119
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 20. |
- Andersson, Roland, et al.
(författare)
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Implantable drainage after major abdominal surgery in compromised patients
- 1990
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Ingår i: HPB Surgery. - : Hindawi Limited. - 1607-8462 .- 0894-8569. ; 2:4, s. 261-264
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Tidskriftsartikel (refereegranskat)abstract
- The risk of superinfection following routine abdominal drainage after major surgery is debated. Especially in patients with malignant diseases and a compromised host defense, this might be a factor increasing morbidity and mortality. During a 3-year period (1986-1988) 41 patients operated on for malignant abdominal conditions received a peritoneal catheter connected to a subcutaneous portal inserted in order to participate in a trial on postoperative intraperitoneal chemotherapy using 5-Fluorouracil. No abdominal drains were inserted. In 15 patients, the subcutaneous portal was used for evacuation of postoperative fluid accumulation within the abdomen. The mean age was 53 (range 41-70) years. Inserted catheters were used for drainage up to 14 days postoperatively. The daily amount of fluid drained varied from 20 to 2,000 ml with a mean of 610 ml/patient and day. One patient required removal of the catheter due to infection around the subcutaneous chamber. Otherwise, the catheter system was not associated with any other complications or complaints. One patient developed a postoperative left subphrenic abscess drained percutaneously by the guidance of ultrasonography, a complication that could not be attributed to the catheter system but merely to the major operation per se. An implantable device for peritoneal access thus also seem useful for drainage of postoperative fluid collection, as evaluated in this preliminary report.
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| 21. |
- Andersson, Roland, et al.
(författare)
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Inflammation
- 2004
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Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 29-29
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 22. |
- Andersson, Roland, et al.
(författare)
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Kirurgisk intensivvård
- 2004
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Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 415-415
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 23. |
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| 24. |
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| 25. |
- Andersson, Roland, et al.
(författare)
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Komplikationer hos kirurgiska patienter
- 2004
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Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 408-408
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 26. |
- Andersson, Roland, et al.
(författare)
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Pankreas
- 2004
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Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 130-130
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 27. |
- Andersson, Roland, et al.
(författare)
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Perioperativ vård
- 2004
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Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 82-82
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 28. |
- Andersson, Roland, et al.
(författare)
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Tunntarmssjukdomar
- 2004
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Ingår i: Kirurgiska sjukdomar: patofysiologi, behandling, specifik omvårdnad. - 9144024185 ; , s. 139-139
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 29. |
- Arnell, Magnus, et al.
(författare)
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Modellering av avloppsreningsverk för multikriteriebedömning av prestanda och miljöpåverkan
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Genom att använda detaljerade dynamiska modeller och kombinera resultat från årslånga simuleringar av ARV (såväl vatten- som slamlinjer) med livscykelanalys kan olika driftstrategier utvecklas och utvärderas utifrån en bred uppsättning hållbarhetskriterier fö att maximera resursutvinning och energieffektivitet samtidigt som vattenkvalitén bibehålls och driftskostnaderna kontrolleras. Metodiken har tillämpats vid en omfattande fallstudie av Käppalaverket.
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| 30. |
- ARNELL, MAGNUS
(författare)
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Performance Assessment of Wastewater Treatment Plants : Multi-Objective Analysis Using Plant-Wide Models
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- As the knowledge about anthropogenic impacts of climate change has grown, the awareness of the contributions from treatment of wastewater has widened the scope for wastewater treatment plants (WWTPs). Not only shall ever stricter effluent constraints be met, but also energy efficiency be increased, greenhouse gases mitigated and resources recovered. All under a constant pressure on costs. The main objective of this research has been to develop a plant-wide modelling tool to evaluate the performance of operational strategies for multiple objectives at the plant and for off-site environmental impact. The plant-wide model platform Benchmark Simulation Model no. 2 (BSM2) has been modified to improve the evaluation of energy efficiency and include greenhouse gas emissions. Furthermore, the plant-wide process model has been coupled to a life cycle analysis (LCA) model for evaluation of global environmental impact. For energy evaluation, a dynamic aeration system model has been adapted and implemented. The aeration model includes oxygen transfer efficiency, dynamic pressure in the distribution system and non-linear behaviour of blower performance. To allow for modelling of energy recovery via anaerobic co-digestion the digestion model of BSM2 was updated with a flexible co-digestion model allowing for dynamic co-substrate feeds. A feasible procedure for substrate characterisation was proposed. Emissions of the greenhouse gases CO2, CH4 and N2O were considered. The bioprocess model in BSM2 was updated with two-step nitrification, four-step denitrification and nitrifier denitrification to capture N2O production. Fugitive emissions of the three gases were included from digestion, cogeneration and sludge storage. The models were tested in case studies for the three areas of development: aeration, co-digestion and greenhouse gas production. They failed to reject the hypothesis that dynamic process models are required to assess the highly variable operations of wastewater treatment plants. All parts were combined in a case study of the Käppala WWTP in Lidingö, Sweden, for comparison of operational strategies and evaluation of stricter effluent constraints. The averaged model outputs were exported to an LCA model to include off-site production of input goods and impact of discharged residues and wastes. The results reveal trade-offs between water quality, energy efficiency, greenhouse gas emissions and abiotic depletion of elemental and fossil resources. The developed tool is generally applicable for WWTPs and the simulation results from this type of combined models create a good basis for decision support.
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| 31. |
- Awla, Darbaz, et al.
(författare)
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Neutrophil-derived matrix metalloproteinase-9 is a potent activator of trypsinogen in acinar cells in acute pancreatitis.
- 2012
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Ingår i: Journal of Leukocyte Biology. - : Oxford University Press (OUP). - 1938-3673 .- 0741-5400. ; 91, s. 711-719
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Tidskriftsartikel (refereegranskat)abstract
- MMPs are generally considered to regulate degradation and remodeling of the ECM. Convincing data also implicate a role for MMPs in inflammatory conditions, such as AP, although the mechanisms are not known. The aim of this study was to define the role of MMPs in regulating activation of trypsinogen and tissue damage in AP, which was induced by infusion of taurocholate into the pancreatic duct in mice. A broad-spectrum MMP inhibitor (BB-94) and MMP-9 gene-deficient mice were used. Neutrophil secretions and rMMP-9 were used to stimulate trypsinogen activation in isolated acinar cells. Taurocholate challenge increased serum amylase, neutrophil infiltration, MIP-2 (CXCL2) formation, trypsinogen activation, and tissue damage in the pancreas. Treatment with the broad-spectrum inhibitor of MMPs, BB-94, markedly reduced activation of trypsinogen, levels of CXCL2, infiltration of neutrophils, and tissue damage in AP. Taurocholate challenge increased serum levels of MMP-9 but not MMP-2. Taurocholate-induced amylase levels, neutrophil accumulation, production of CXCL2, trypsinogen activation, and tissue damage in the pancreas were abolished in MMP-9-deficient mice. Moreover, secretions from activated neutrophils isolated from WT but not from MMP-9-deficient animals stimulated trypsinogen activation in acinar cells. Notably, rMMP-9 greatly enhanced activation of trypsinogen in acinar cells. These findings demonstrate that neutrophil-derived MMP-9 is a potent activator of trypsinogen in acinar cells and regulates pathological inflammation and tissue damage in AP.
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| 32. |
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| 33. |
- Blom, Johannes, et al.
(författare)
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A 9-year follow-up study of participants and nonparticipants in sigmoidoscopy screening : importance of self-selection
- 2008
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Ingår i: Cancer Epidemiology, Biomarkers and Prevention. - 1055-9965 .- 1538-7755. ; 17:5, s. 1163-1168
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Self-selection may compromise cost-effectiveness of screening programs. We hypothesized that nonparticipants have generally higher morbidity and mortality than participants. METHODS: A Swedish population-based random sample of 1,986 subjects ages 59 to 61 years was invited to sigmoidoscopy screening and followed up for 9 years by means of multiple record linkages to health and population registers. Gender-adjusted cancer incidence rate ratio (IRR) and overall and disease group-specific and mortality rate ratio (MRR) with 95% confidence intervals (95% CI) were estimated for nonparticipants relative to participants. Cancer and mortality rates were also estimated relative to the age-matched, gender-matched, and calendar period-matched Swedish population using standardized incidence ratios and standardized mortality ratios. RESULTS: Thirty-nine percent participated. The incidence of colorectal cancer (IRR, 2.2; 95% CI, 0.8-5.9), other gastrointestinal cancer (IRR, 2.7; 95% CI, 0.6-12.8), lung cancer (IRR, 2.2; 95% CI, 0.8-5.9), and smoking-related cancer overall (IRR, 1.4; 95% CI, 0.7-2.5) tended to be increased among nonparticipants relative to participants. Standardized incidence ratios for most of the studied cancers tended to be >1.0 among nonparticipants and <1.0 among participants. Mortality from all causes (MRR, 2.4; 95% CI, 1.7-3.4), neoplastic diseases (MRR, 1.9; 95% CI, 1.1-3.5), gastrointestinal cancer (MRR, 4.7; 95% CI, 1.1-20.7), and circulatory diseases (MRR, 2.3; 95% CI, 1.2-4.2) was significantly higher among nonparticipants than among participants. Standardized mortality ratio for the studied outcomes tended to be increased among nonparticipants and was generally decreased among participants. CONCLUSION: Individuals who might benefit most from screening are overrepresented among nonparticipants. This self-selection may attenuate the cost-effectiveness of screening programs on a population level.
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| 34. |
- Blom, J, et al.
(författare)
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Compliance and findings in a Swedish population screened for colorectal cancer with sigmoidoscopy
- 2002
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Ingår i: European Journal of Surgical Oncology. - : Elsevier BV. - 1532-2157 .- 0748-7983. ; 28, s. 827-
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to evaluate the patterns of compliance and the frequency of adenomas and neoplasms in a Swedish population. Methods: In 1996, 2000 men and women born in 1935 or 1936 were selected at random from the population registers of Uppsala and Malmo/Lund. All subjects were invited by mail to participate. In a randomised study design, subjects were either called up by a nurse to schedule the appointment for sigmoidoscopy or instructed to call themselves. At sigmoidoscopy subjects with a cancer, an adenoma (neoplastic polyp) or more than three hyperplastic polyps were scheduled for a complete colonoscopy. Results: Thirty-nine percent (770/1988) of all the invited subjects had a sigmoidoscopy. The participation differed between the two centres, 47% at the Uppsala centre and 30% at the Malmo/Lund centre (P < 0.01). There was no statistically significant difference between the two different invitation groups. In all, 98 subjects (13%) were planned for colonoscopy. Thirty-one (35%) of the subjects having a colonoscopy were women and 57 (65%) were men. Fifty-five true adenomas were found in 46 subjects. All together, six subjects had proximal adenomas. Five adenocarcinomas were diagnosed, all within the reach of the sigmoidoscope. Conclusions: The compliance was lower and the adenomas were fewer than expected. To increase compliance it is necessary with rigorously controlled invitation routines. (C) 2002 Elsevier Science Ltd. All rights reserved.
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| 35. |
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| 36. |
- Blom, Johannes, et al.
(författare)
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Toward understanding non participation in sigmoidoscopy screening for colorectal cancer
- 2008
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 122:7, s. 1618-1623
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Tidskriftsartikel (refereegranskat)abstract
- Understanding the reasons for nonparticipation in cancer screening may give clues about how to improve compliance. However, limited cooperation has hampered research on nonparticipant profiles. We took advantage of Sweden's comprehensive demographic and health care registers to investigate characteristics of all participants and nonparticipants in a pilot program for colorectal cancer screening with sigmoidoscopy. A population-based sample of 1986 Swedish residents 59-61 years old was invited. Registers provided information on each individual's gender, country of birth, marital status, education, income, hospital contacts, place of residence, distance to screening center and cancer within the family. Odds ratios (ORs) with 95% confidence intervals (CIs), modeled with multivariable logistic regression, estimated the independent associations between each background factor and the propensity for nonparticipation after control for the effects of other factors. All statistical tests were 2-sided. Being male (OR = 1.27, 95% CI = 1.03-1.57, relative to female), unmarried or divorced (OR = 1.69, 95% CI = 1.23-2.30 and OR = 1.49, 95% CI = 1.14-1.95, respectively, relative to married) and having an income in the lowest tertile (OR = 1.68, 95% CI = 1.27-2.23, relative to highest tertile) was associated with increased nonparticipation. Living in the countryside or in small communities and having a documented family history of colorectal cancer was associated with better participation. Distance to the screening center did not significantly affect participation, nor did recent hospital care consumption or immigrant status. To increase compliance, invitations must appeal to men, unmarried or divorced people and people with low socioeconomic status.
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| 37. |
- Brorson, Håkan, et al.
(författare)
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Lymfsystemet och dess sjukdomar.
- 2005
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Ingår i: Kirurgi. - 9789144043555 ; 2nd ed, s. 469-488
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 38. |
- Brorson, Håkan, et al.
(författare)
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Lymfsystemet och dess sjukdomar
- 2001
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Ingår i: Kirurgi. - 9144016697 ; , s. 393-417
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 39. |
- Brorson, Håkan, et al.
(författare)
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Lymfödem
- 2016. - 4
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Ingår i: Kirurgi. - 9789144099842 ; , s. 645-653
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Bokkapitel (refereegranskat)abstract
- Lymfsystemets anatomi och fysiologi. Orsaker till svullnad. Utredning av ödem. Etiologi. Komplikationer vid lymfödem. Behandling och resultat.
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| 40. |
- Bränning, Camilla, et al.
(författare)
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Blueberry husks and multi-strain probiotics affect colonic fermentation in rats.
- 2009
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Ingår i: British Journal of Nutrition. - 1475-2662. ; 100:1, s. 859-870
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate how blueberry husks and/or mixtures of probiotic strains (Lactobacillus crispatus DSM16743, L. gasseri DSM16737 and L. plantarum DSM15313 (LABmix), or Bifidobacterium infantis DSM15159 and DSM15161 (BIFmix)) affect colonic fermentation, caecal counts of lactobacilli, bifidobacteria and Enterobacteriaceae, body weight gain, and blood concentrations of carboxylic acids (CA) and ammonia in rats. Dietary fibres in blueberry husks were fermented to 61 % in colon, and the elevated faecal excretion of fibre and protein contributed to the high faecal bulking capacity (1.3). The caecal pool of CA was higher in rats fed blueberry husks than the fibre-free control (P < 0.05), and the propionic acid proportion was higher in the distal colon than in the control group (P < 0.05). Probiotics lowered the caecal amount of CA when added to blueberry husks (P < 0.001), while the propionic acid proportion was higher with LABmix (P < 0.01) than blueberry husks only. The propionic acid and butyric acid concentrations in blood were higher in rats fed blueberry husks and probiotics than those fed blueberry husks only (P < 0.01), implying that the absorption of these acids was facilitated by the bacteria. The caecal counts of lactobacilli, bifidobacteria and Enterobacteriaceae were lower in rats fed blueberry husks than the control diet (P < 0.05). The body weight gain was partly influenced by the caecal tissue and contents weights, and BIFmix decreased the ammonia concentration in blood (P < 0.05). We conclude that colonic fermentation is differentially affected by dietary fibre and probiotics, which may be of importance when developing foods with certain health effects.
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| 41. |
- Canaparo, Roberto, et al.
(författare)
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Expression of cytochromes P450 3A and P-glycoprotein in human large intestine in paired tumour and normal samples
- 2007
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Ingår i: Basic & Clinical Pharmacology & Toxicology. - : Wiley. - 1742-7843 .- 1742-7835. ; 100:4, s. 240-248
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Tidskriftsartikel (refereegranskat)abstract
- Our objective was to investigate the expression of different cytochromes P450 3A (CYP3A4, CYP3A5, and CYP3A7) and P-glycoprotein (ABCBI) genes along the human large intestine in paired tumour and normal samples. Real-time reverse transcriptase-polymerase chain reaction was used to measure CYP3A4-, CYP3A5-, CYP3A7- and ABCB1-specific mRNA expression, and Western blot analysis was used to measure membrane protein levels of CYP3A4/7, CYP3A5 and P-glycoprotein. Levels of mRNA and membrane protein fractions in the large intestine were compared with those of normal human liver. The mRNA expressions of CYP3A4, CYP3A5, CYP3A7 and ABCB1 in the large intestine were found to be highly variable, but overall the levels were significantly lower than those measured in liver (P < 0.0001, P < 0.00 1, P < 0.0001 and P < 0.01, respectively). At the membrane protein level, CYP3A4/7 was detected in all large intestine samples examined and the levels were substantially higher than those of the liver (P < 0.01). Although expression of CYP3A5 was detected in all large intestine samples, in most the levels were too low to allow quantification. P-glycoprotein was readily detected at levels slightly higher than those of liver (P < 0.05). Comparison between paired samples of normal and tumour in large intestine showed no significant differences in either the mRNA or membrane protein levels of these genes. In conclusion, this work suggests a potential role of the large intestine in the absorption and metabolism of xenobiotics and nutrients and no difference in the CYP3A and P-glycoprotein membrane protein fractions and mRNA expression between normal and tumour tissues.
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| 42. |
- Carling, Malin S, et al.
(författare)
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Preoperative plasma fibrinogen concentration, factor XIII activity, perioperative bleeding, and transfusions in elective orthopaedic surgery: A prospective observational study
- 2016
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Ingår i: Thrombosis Research. - : Elsevier BV. - 0049-3848. ; 139, s. 142-147
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Tidskriftsartikel (refereegranskat)abstract
- Background: Major orthopaedic surgery involves a calculated risk of bleeding. In other groups of surgical patients, low preoperative plasma fibrinogen concentration and factor XIII (FXIII) activity have been associated with an elevated risk of bleeding. In the present study we investigated the association between preoperative fibrinogen plasma concentration and FXIII activity on bleeding and transfusion requirements in patients undergoing a spinal fusion procedure or hip or knee arthroplasty. Methods: Two hundred and forty-five adult patients undergoing spine fusion surgery (n = 52), total unilateral primary hip arthroplasty (n=114), or total knee arthroplasty (n=79) were included in a prospective observational study. Blood samples were collected <24 h before surgery and analysed for fibrinogen concentration and FXIII activity. Intraoperative and postoperative bleeding volume and transfusion requirements were recorded. Results: Spinal fusion surgery patients with a low preoperative fibrinogen concentration (<= 2.5 g/L) had a greater total perioperative median bleeding volume than patients with fibrinogen > 2.5 g/L (2430 (400-6560) mL vs. 1390 (400-7420) mL, p = 0.029). No significant association between low fibrinogen levels and perioperative bleeding volume was observed for arthroplasty patients. There was no association between low fibrinogen levels and transfusion requirements in any of the groups. Low FXIII activity was not significantly associated with bleeding volume and transfusion requirements in any group. Conclusion: Measurement of preoperative fibrinogen plasma concentration can identify spinal fusion patients with an increased risk of excessive perioperative bleeding. Measurement of FXIII activity cannot identify orthopaedic patients with elevated risk of bleeding.
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| 43. |
- Carling, Malin S, et al.
(författare)
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Transfusions and blood loss in total hip and knee arthroplasty: a prospective observational study
- 2015
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Ingår i: Journal of Orthopaedic Surgery and Research. - : Springer Science and Business Media LLC. - 1749-799X. ; 10:48
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is a high prevalence of blood product transfusions in orthopedic surgery. The reported prevalence of red blood cell transfusions in unselected patients undergoing hip or knee replacement varies between 21% and 70%. We determined current blood loss and transfusion prevalence in total hip and knee arthroplasty when tranexamic acid was used as a routine prophylaxis, and further investigated potential predictors for excessive blood loss and transfusion requirement. Methods/materials: In total, 193 consecutive patients undergoing unilateral hip (n = 114) or knee arthroplasty (n = 79) were included in a prospective observational study. Estimated perioperative blood loss was calculated and transfusions of allogeneic blood products registered and related to patient characteristics and perioperative variables. Results: Overall transfusion rate was 16% (18% in hip patients and 11% in knee patients, p = 0.19). Median estimated blood loss was significantly higher in hip patients (984 vs 789 mL, p < 0.001). Preoperative hemoglobin concentration was the only independent predictor of red blood cell transfusion in hip patients while low hemoglobin concentration, body mass index, and operation time were independent predictors for red blood cell transfusion in knee patients. Conclusions: The prevalence of red blood cell transfusion was lower than previously reported in unselected total hip or knee arthroplasty patients. Routine use of tranexamic acid may have contributed. Low preoperative hemoglobin levels, low body mass index, and long operation increase the risk for red blood cell transfusion.
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| 44. |
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| 45. |
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| 46. |
- Dold, Stefan, et al.
(författare)
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P-selectin glycoprotein ligand-1-mediated leukocyte recruitment regulates hepatocellular damage in acute obstructive cholestasis in mice.
- 2010
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Ingår i: Inflammation Research. - : Springer Science and Business Media LLC. - 1420-908X .- 1023-3830. ; 59, s. 291-298
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Leukocytes mediate hepatocellular injury in obstructive cholestasis. The aim of the present study was to define the role of P-selectin glycoprotein ligand-1 (PSGL-1) in cholestasis-induced leukocyte recruitment and liver damage. METHODS: C57BL/6 mice were pre-treated with an anti-PSGL-1 antibody or a control antibody prior to bile duct ligation (BDL) for 12 h. Hepatic recruitment of leukocytes and sinusoidal perfusion were determined by means of intravital fluorescence microscopy. Liver damage was monitored by measuring serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Hepatic levels of CXC chemokines were determined by ELISA. RESULTS: BDL caused significant hepatocellular damage indicated by increased serum activities of ALT and AST as well as decreased sinusoidal perfusion and clear-cut hepatic infiltration of leukocytes. Administration of the anti-PSGL-1 antibody reduced BDL-induced levels of ALT by 78% and AST by 77%. Inhibition of PSGL-1 decreased BDL-provoked leukocyte rolling and adhesion in post-sinusoidal venules by more than 81%. Moreover, we found that immunoneutralisation of PSGL-1 restored sinusoidal perfusion and decreased hepatic formation of CXC chemokines in cholestatic mice. CONCLUSIONS: Our novel data show that PSGL-1 plays an important role in cholestatic liver damage by regulating leukocyte rolling in post-sinusoidal venules. Consequently, interference with PSGL-1 attenuates cholestasis-provoked leukocyte adhesion and extravasation in the liver. Thus, inhibition of PSGL-1 may help to protect against hepatocellular damage in cholestatic diseases.
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| 47. |
- Dold, Stefan, et al.
(författare)
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Simvastatin protects against cholestasis-induced liver injury.
- 2009
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Ingår i: British Journal of Pharmacology. - : Wiley. - 1476-5381 .- 0007-1188. ; 156, s. 466-474
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bile duct obstruction is associated with hepatic accumulation of leukocytes and liver injury. The aim of this study was to evaluate the effect of simvastatin on cholestasis-induced liver inflammation and tissue damage. Experimental approach: C57BL/6 mice were treated with simvastatin (0.02 and 0.2 mg.kg(-1)) and vehicle before and after undergoing bile duct ligation (BDL) for 12 h. Leukocyte recruitment and microvascular perfusion in the liver were analysed using intravital fluorescence microscopy. CXC chemokines in the liver were determined by enzyme-linked immunosorbent assay. Liver damage was monitored by measuring serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Hepatic levels of myeloperoxidase (MPO) were also determined. Key results: Administration of 0.2 mg.kg(-1) simvastatin decreased ALT and AST by 87% and 83%, respectively, in BDL mice. This dose of simvastatin reduced hepatic formation of CXC chemokines by 37-82% and restored sinusoidal perfusion in cholestatic animals. Moreover, BDL-induced leukocyte adhesion in sinusoids and postsinusoidal venules, as well as MPO levels in the liver, was significantly reduced by simvastatin. Notably, administration of 0.2 mg.kg(-1) simvastatin 2 h after BDL induction also decreased cholestatic liver injury and inflammation. Conclusions and implications: These findings show that simvastatin protects against BDL-induced liver injury. The hepatoprotective effect of simvastatin is mediated, at least in part, by reduced formation of CXC chemokines and leukocyte recruitment. Thus, our novel data suggest that the use of statins may be an effective strategy to protect against the hepatic injury associated with obstructive jaundice.
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| 48. |
- Dykstra, Natalie S, et al.
(författare)
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Pulse Probiotic Administration Induces Repeated Small Intestinal Muc3 Expression in Rats.
- 2011
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Ingår i: Pediatric Research. - 1530-0447. ; 69, s. 206-211
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Tidskriftsartikel (refereegranskat)abstract
- Upon ingestion, probiotics may act to protect the host through a number of protective mechanisms including modulation of genes involved in intestinal innate mucosal defense such as epithelial cell derived mucin glycoproteins and inhibitor of apoptosis proteins. To determine the specificity of effect and sustainability of response in vivo, Lactobacillus plantarum 299v (Lp299v), Lactobacillus rhamnosus R0011 (LrR0011) and Bifidobacterium bifidum R0071 (BbR0071) were added repeatedly or intermittently to the drinking water of Sprague-Dawley rats. Following sacrifice via CO2 suffocation, Muc2, Muc3, NAIP, HIAP1/cIAP2 and HIAP2/cIAP1 mRNA and protein levels were analyzed via RT-PCR and immunohistochemistry. Live Lp299v, BbR0071 and LrR0011 increased Muc3 protein and mRNA expression in jejunum and ileum. Heat-killed and a non-adherent derivative of Lp299v failed to induce Muc3 expression. Lp299v did induce expression of HIAP2/cIAP1 and NAIP expression. Muc3 mucin expression was elevated for 5 days following oral administration of Lp299v but this effect was not sustained despite ongoing daily ingestion of a probiotic. Intermittent pulse ingestion of probiotics however, was found to repeatedly increase Muc3 expression. We conclude that selected probiotics can induce protective genes of mucosal intestinal epithelial cells, an effect that is reproducible with pulse probiotic administration. ABBREVIATIONS:
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| 49. |
- Edvardsson, Johanna, et al.
(författare)
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Mer tid för patienten hos läkare i England - En jämförande tidsstudie av svenska och engelska läkares arbetsdag.
- 2014
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Ingår i: Läkartidningen. - 0023-7205. ; 111
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Tidskriftsartikel (refereegranskat)abstract
- Little is known concerning the amount of time doctors spend doing different work tasks. A comparative study between four surgical departments in Sweden and England was performed. The time study shows that doctors in Sweden spent around 37% of working hours on administration and 40% on patient work. The numbers in England were 15% and 66% respectively. From the survey, only performed in Sweden, it appeared that doctors have insufficient time for all their assignments and as a consequence often deprioritize their continuous professional education. Problems within the administrative field have been identified and may be the starting point for task reduction.
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| 50. |
- Falk, Anders, et al.
(författare)
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Ileal pelvic pouch microbiota from two former ulcerative colitis patients, analysed by DNA-based methods, were unstable over time and showed the presence of Clostridium perfringens
- 2007
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 42:8, s. 973-985
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Ileal pouch anal anastomosis ( IPAA) is the preferred method for restorative surgery in patients with ulcerative colitis who have to undergo proctocolectomy. The most common complication is pouchitis and several studies have pointed to the microbiota of the pouch as being a risk factor. The aim of this study was to follow the development of the bacterial microbiota in pouches during the first year. Material and methods. Terminal restriction fragment length polymorphism ( T-RFLP) combined with cloning and sequencing was used to identify the most predominant bacteria on the different sampling occasions. A total of 274 clones were grouped by T-RFLP and clones from each group were selected for sequencing and identified by comparison with known sequences. Results. Differences in T-RFLP profiles and clone libraries were found between the patients, and also in changes apparent in each patient at different time-points. The main bacterial groups in the pouches resembled those of the normal colonic microbiota, with a predominance of the clostridia clusters XIVa and IV, Bacteroides and Enterobacteriaceae. Exceptions were clones with sequences resembling those of the Clostridium perfringens group, in both patients and on all sampling occasions, and the dominance of clones resembling Turicibacter in one of the patients at the time of pouch construction. Conclusions. The pouch microbiota showed similarities to the normal colon microbiota except for the presence of clones with sequences resembling those of the C. perfringens group and Turicibacter. The bacterial composition differed between the two patients and the microbiota changed with time, suggesting that the composition is not stable during the first year.
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