| 1. |
- Järnerot, Gunnar, et al.
(författare)
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Allopurinol in addition to 5-aminosalicylic acid based drugs for the maintenance treatment of ulcerative colitis
- 2000
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Ingår i: Alimentary Pharmacology and Therapeutics. - : Wiley. - 0269-2813 .- 1365-2036. ; 14:9, s. 1159-1162
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To investigate the value of combined treatment with allopurinol and 5-aminosalicylic (5-ASA) based drugs as maintenance treatment for ulcerative colitis (UC). METHODS: 199 patients with UC in remission but with active disease during the preceding 3 years were included. Allopurinol 100 mg twice daily or placebo was added to the 5-ASA based maintenance treatment. Clinical and endoscopic follow up was performed after 1, 6 and 12 months. RESULTS: Intention-to-treat analysis after 6 and 12 months showed similar results in both groups. A log-rank test showed that 77% in the allopurinol compared to 59% in the placebo group were still in remission after 6 months (P=0.0083) and 62% and 53% after 12 months, respectively (P=0.0936). This was mainly due to a higher than expected number of relapses during the first 3 months in the placebo group. After the first 3 months, the rate of relapse in each group was similar. CONCLUSIONS: It appears possible that allopurinol in combination with 5-ASA is better than 5-ASA alone for a 6-month, but not a 12-month period. This has to be verified in further dose-ranging studies.
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| 2. |
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| 3. |
- Nilsson, Å., et al.
(författare)
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Olsalazine versus sulphasalazine for relapse prevention in ulcerative colitis : A multicenter study
- 1995
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Ingår i: American Journal of Gastroenterology. - 0002-9270 .- 1572-0241. ; 90:3, s. 381-387
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the relapse-preventing effect and the frequency of adverse events of olsalazine and sulphasalazine in sulphasalazine-tolerant patients with ulcerative colitis. METHODS: Patients in remission, with at least two episodes of active disease during the last 5 yr, were randomized to 2 g of sulphasalazine or 1 g of olsalazine daily and were followed for 6-18 months. Relapse rates in the two groups were compared using frequency and life-table analysis. Sixty-nine patients with proctitis, 140 with left-sided colitis, and 113 with subtotal or total colitis were evaluated. RESULTS: In the intention-to-treat analysis, the failure rate (relapses plus withdrawals) was 54.7% in the olsalazine and 47.2% in the sulphasalazine group. In the per-protocol analysis excluding withdrawals, 44.7% relapsed in the olsalazine and 39.3% in the sulphasalazine group. Remission curves did not differ significantly, although at all time intervals the frequency of remission was slightly higher in the sulphasalazine group (p = 0.19 in the intention-to-treat analysis and p = 0.42 in the per-protocol analysis estimated by the log-rank test). Twelve patients (of whom five had diarrhea) in the olsalazine group versus eight patients in the sulphasalazine group discontinued the study because of side effects. CONCLUSION: The relapse-preventing effect of olsalazine and sulphasalazine in sulphasalazine-tolerant patients did not differ. Furthermore, the tolerability of olsalazine, particularly concerning diarrhea, appears to be better than previously reported.
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| 4. |
- Stål, P, et al.
(författare)
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Clinical trial : the safety and short-term efficacy of recombinant cholera toxin B subunit in the treatment of active Crohn's disease.
- 2010
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Ingår i: Alimentary Pharmacology and Therapeutics. - : Wiley. - 0269-2813 .- 1365-2036. ; 31:3, s. 387-395
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The cholera toxin B subunit ameliorates experimentally induced colitis in mice. In humans, cholera toxin B subunit has never been tested in the treatment of Crohn's disease (CD). AIM: To evaluate the safety and efficacy of treatment with recombinant cholera toxin B subunit of patients with CD. METHODS: An open-label, multicentre, nonrandomized trial including 15 patients with mild/moderate CD. Patients received an oral solution of 5 mg recombinant cholera toxin B subunit three times weekly for 2 weeks. Reduction in CD Activity Index (CDAI) with >100 between baseline and days 15, 29, 42 and 70 defined clinical response. Patients with CDAI score < or = 150 were defined as being in remission. RESULTS: A significant decrease in CDAI score was observed. Response rates were 40% in the full analysis set and 42% in the per protocol analysis. Two patients receiving adjuvant treatment after day 29 were excluded, after which 40% were in remission at 4 weeks and 30% at 8 weeks post-treatment. Mild side effects (arthralgia, headache and pruritus) were seen in 33% of patients. CONCLUSIONS: Treatment with recombinant cholera toxin B subunit was safe. Approximately 40% of patients with active CD responded to treatment. Randomized studies are needed to establish the clinical efficacy of recombinant cholera toxin B subunit.
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| 5. |
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| 6. |
- Ahokas, Essi, et al.
(författare)
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Menstruation has no effect on heart rate variability and subjective sleep quality of physically active women
- 2021
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- INTRODUCTION:Subjective sleep quality may decrease during menstruation, although the duration and composition of sleep remains relatively stable across the menstrual cycle (MC) (1). Recording heart rate variability (HRV) is a tool to monitor the autonomic nervous system and recovery of the body. Meta-analytical data has not revealed significant changes in HRV from the early follicular phase (menses) to the mid-follicular phase (2). However, reduced HRV-values were observed during menses compared to follicular phase in women with pain during menses (dysmenorrhea) (3). Only a few studies have examined effects of the MC on nocturnal HRV. The aim of this study was to investigate how menses and associated pain affects nocturnal HRV and subjective sleep quality.METHODS:Participants included 14 healthy, physically active women, who did not use hormonal contraception. During one MC, participants completed a diary of sleep, MC and related symptoms. HRV was registered every night (Bodyguard 2, Firstbeat Technologies Ltd., Finland). HRV-data (RMSSD and LF/HF-ratio) were analyzed for two nights after a blood sample and over a four-hour period beginning 30 min after bedtime. Only the menses (M) and mid-follicular phases (FP) are used in this study. Blood samples (estradiol, E2, and progesterone, P4) were collected during M (day 2-3 of the MC) and FP (day 7-10) to ensure normal hormonal function associated with the MC (4).RESULTS:E2 was higher (p=0.012) during FP (267±150 pmol/L) compared to M (143±88 pmol/L), but P4 remained stable (p=0.103). Mean heart rate (HRmean) was higher during M (54±8 beats/min) compared to FP (52±7 beats/min, p=0.022). However, HRV-variables did not differ between M and FP (RMSSD: 76.7±34.5 to 77.3±27.0 ms, p=0.872; LF/HF: 1.416±1.380 to 1.273±0.769, p=0.826). Subjectively-assessed sleep quality remained unchanged between M and FP (p=0.349). The change in RMSSD and HRmean between M and FP did not differ (RMSSD: p=0.728; HRmean: p=0.149) between participants with and without menstrual pains.CONCLUSION:Menses has no effect on nocturnal HRV and subjective sleep quality of physically active women, though the higher nocturnal HRmean during M may indicate decreased recovery during menses.REFERENCES:1. Driver, H.S., Werth, E., et al. The Menstrual Cycle Effects on Sleep. Sleep Med Clin 2008, 3:1–11.2. Schmalenberger, K.M., Eisenlohr-Moul, T.M., et al. A Systematic Review and Meta-Analysis of Within-Person Changes in Cardiac Vagal Activity across the Menstrual Cycle: Implications for Female Health and Future Studies. J Clin Med 2019, 8:1946.3. Jayamala, A.K., Preethi, B.L., et al. Comparative Analysis of Heart Rate Variability During Different Phases of Menstrual Cycle in Eumenorrhea & Dysmenorrhea Subjects. Exp Clin Physiol Biochem 2017, 1.4. Elliot-Sale, K.J., Minahan, C.L., et al. Methodological Considerations for Studies in Sport and Exercise Science with Women as Participants: A Working Guide for Standards of Practice for Research on Women. Sports Med 2021, 51:843–861.
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| 7. |
- Angelison, Leif, et al.
(författare)
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Long-term outcome of infliximab treatment in chronic active ulcerative colitis : a Swedish multicentre study of 250 patients
- 2017
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Ingår i: Alimentary Pharmacology and Therapeutics. - : Wiley-Blackwell Publishing Inc.. - 0269-2813 .- 1365-2036. ; 45:4, s. 519-532
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Tidskriftsartikel (refereegranskat)abstract
- Background: Real-life long-term data on infliximab treatment in ulcerative colitis are limited.Aim: To study the long-term efficacy and safety of infliximab in chronic active ulcerative colitis and possible predictors of colectomy and response were also examined.Methods: A retrospective multi-centre study of infliximab treatment in 250 patients with chronic active ulcerative colitis with inclusion criteria: age ≥18 years, ambulatory treated, steroid-dependent or intolerant and/or immunomodulator refractory or intolerant.Results: Steroid-free clinical remission was achieved by 123/250 patients (49.2%) at 12 months and in 126/250 patients at a median follow-up of 2.9 years (50.4%). Primary response at 3 months was achieved by 190/250 (76.0%) patients and associated with a high probability of response 168/190 (88.4%) at 12 months and 143/190 (75.3%) at follow-up. Long-term rate of colectomy in primary responders was 6/190 (3.2%) at 12 months and 27/190 (14.2%) at last follow-up. Failure to achieve response at 3 months was associated with a high risk of subsequent colectomy, 29/60 (48.3%) at 12 months and 41/60 (68.3%) at follow-up. Response at 12 months was associated with a low risk of subsequent colectomy, 14/181 (7.7%) compared with non-response 19/34 (55.9%) (P < 0.0001). Non-response at 3 months was an independent predictor of subsequent colectomy (HR = 9.40, 95% CI = 5.10-17.35, P < 0.001). Concomitant azathioprine therapy did not influence outcome in terms of colectomy.Conclusions: Long-term efficacy of infliximab treatment in chronic active ulcerative colitis is excellent especially in patients who respond to induction treatment. Conversely, non-response at 3 months predicts a poor outcome, with a high risk of subsequent colectomy.
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| 8. |
- Arlander, E, et al.
(författare)
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Exploring anorectal manometry as a method to study the effect of locally administered ropivacaine in patients with ulcerative colitis
- 2013
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Ingår i: ISRN gastroenterology. - : Hindawi Limited. - 2090-4398 .- 2090-4401. ; 2013, s. 656921-
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Tidskriftsartikel (refereegranskat)abstract
- The symptoms of distal ulcerative colitis have been related to changes in rectal sensitivity and capacity due to inflammation, altered gastrointestinal motility, and sensory perception. With the use of anorectal manometry, the function was measured in seven patients with active distal proctitis during local treatment with ropivacaine. Seven healthy subjects were studied in the same way for comparison with normal conditions. The anal resting pressure and squeezing pressure were similar in all groups. Significantly lower rectal distention volumes were required for rectal sensation, critical volume, and to induce rectal contractility in patients with active disease compared to controls. Rectal compliance was significantly reduced in patients with active and quiescent disease. The increased rectal sensitivity and contractility in patients with active colitis appear to be related to active mucosal inflammation and ulceration. The frequency and urgency of defecation and the fecal incontinence may be due to a hypersensitive, hyperactive, and poorly compliant rectum. The findings in our study indicate that the inflammatory damage to the rectal wall with poor compliance is unaffected by local anaesthetics such as ropivacaine. The symptomatic relief and reduction in clinical symptoms following treatment are not reflected in the anorectal manometric findings.
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| 9. |
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| 10. |
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| 11. |
- Einarsdottir, Elisabet, et al.
(författare)
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IL23R in the Swedish, Finnish, Hungarian and Italian populations : association with IBD and psoriasis, and linkage to celiac disease
- 2009
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Ingår i: BMC Medical Genetics. - : Springer Science and Business Media LLC. - 1471-2350. ; 10:8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Association of the interleukin-23 receptor (IL23R) with inflammatory bowel disease (IBD) has been confirmed in several populations. IL23R also associates with psoriasis, suggesting that the gene may be an important candidate for many chronic inflammatory diseases.METHODS: We studied association of single-nucleotide variants in IL23R with IBD in Swedish patients, in both Crohn's disease (CD) and ulcerative colitis (UC) subsets. The same genetic variants were also studied in Finnish patients with psoriasis or celiac disease, and in Hungarian and Italian patients with celiac disease.RESULTS: Association of IL23R with IBD was replicated in our Swedish patients, and linkage and association of the IL23R region with psoriasis was found in the Finnish population. The IL23R region was also linked to celiac disease in Finnish families, but no association of IL23R variants with celiac disease was found in the Finnish, Hungarian or Italian samples.CONCLUSION: Our study is the first to demonstrate association of IL23R with CD and UC in Swedish patients with IBD. It is also the first study to report linkage and association of the IL23R region with psoriasis in the Finnish population. Importantly, this is the first report of linkage of the IL23R region to celiac disease, a chronic inflammatory condition in which IL23R has not been previously implicated.
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| 12. |
- Fritz, Michael, et al.
(författare)
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Prostaglandin-dependent modulation of dopaminergic neurotransmission elicits inflammation-induced aversion in mice
- 2016
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Ingår i: Journal of Clinical Investigation. - : AMER SOC CLINICAL INVESTIGATION INC. - 0021-9738 .- 1558-8238. ; 126:2, s. 695-705
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Tidskriftsartikel (refereegranskat)abstract
- Systemic inflammation causes malaise and general feelings of discomfort. This fundamental aspect of the sickness response reduces the quality of life for people suffering from chronic inflammatory diseases and is a nuisance during mild infections like common colds or the flu. To investigate how inflammation is perceived as unpleasant and causes negative affect, we used a behavioral test in which mice avoid an environment that they have learned to associate with inflammation-induced discomfort. Using a combination of cell-type-specific gene deletions, pharmacology, and chemogenetics, we found that systemic inflammation triggered aversion through MyD88-dependent activation of the brain endothelium followed by COX1-mediated cerebral prostaglandin E-2 (PGE(2)) synthesis. Further, we showed that inflammation-induced PGE(2) targeted EP1 receptors on striatal dopamine D1 receptor-expressing neurons and that this signaling sequence induced aversion through GABA-mediated inhibition of dopaminergic cells. Finally, we demonstrated that inflammation-induced aversion was not an indirect consequence of fever or anorexia but that it constituted an independent inflammatory symptom triggered by a unique molecular mechanism. Collectively, these findings demonstrate that PGE(2)-mediated modulation of the dopaminergic motivational circuitry is a key mechanism underlying the negative affect induced by inflammation.
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| 13. |
- Holmberg, Lars, et al.
(författare)
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Prenatal diagnosis of hemophilia B by an immunoradiometric assay of factor IX
- 1980
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Ingår i: Blood. - 0006-4971. ; 56:3, s. 397-401
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Tidskriftsartikel (refereegranskat)abstract
- An immunoradiometric assay of factor IX was developed based on homologous antibodies that arose in a hemophilic patient. With this assay, 11 of 12 patients with severe hemophilia B had factor IX antigen levels below 1 U/dl and 6 patients with mild hemophilia B had various levels. Factor IX antigen in 8 fetuses (16th-20th gestational week) aborted for therapeutic reasons ranged from 1.8 to 10.0 U/dl. Six amniotic fluids contained 0.28-1.2 U/dl factor IX antigen. Using the immunoradiometric assay, we could diagnose hemophilia B prenatally in one fetus at risk. No factor IX antigen (< 0.2 U/dl) was detectable in the fetoscopic sample. After termination of the pregnancy, analysis of blood from the abortus confirmed the diagnosis of severe hemophilia B. We conclude that very sensitive immunologic assays, such as the one described here, will prove useful in prenatal diagnosis of severe hemophilia B, since determination of factor IX activity in fetoscopic samples is unrealiable because of possible contamination with thromboplastic material.
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| 14. |
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| 15. |
- Klingspor, Måns, 1989-
(författare)
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Low-rank optimization in system identification
- 2019
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In this thesis, the use of low-rank approximations in connection with problems in system identification is explored. Firstly, the motivation of using low-rank approximations in system identification is presented and the framework for low-rank optimization is derived. Secondly, three papers are presented where different problems in system identification are considered within the described low-rank framework. In paper A, a novel method involving the nuclear norm forestimating a Wiener model is introduced. As shown in the paper, this method performs better than existing methods in terms of finding an accurate model. In paper B and C, a group lasso framework is used to perform input selection in the model estimation which also is connected to the low rank framework. The model structures where these novel methods of input selection is used on are ARX models and state space models, respectively. As shown in the respective papers, these strategies of performing input selection perform better than existing methods in both terms of estimation and input selection.
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| 16. |
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| 17. |
- Löfberg, Robert, et al.
(författare)
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Oral budesonide versus prednisolone in patients with extensive and left sided ulcerative colitis
- 1996
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Ingår i: Gastroenterology. - : Elsevier BV. - 1528-0012 .- 0016-5085. ; 110:6, s. 1713-1718
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Systemic glucocorticosteroids (GCSs) have proven efficacy in active ulcerative colitis but cause undesired systemic side effects. Therefore, new GCSs with high topical activity and a high rate of metabolism may be of clinical value in this condition. The aim of this study was to explore the efficacy and safety of the topically acting GCS budesonide in an oral controlled-release formulation in extensive or left-sided, mild to moderately active ulcerative colitis. METHODS: A 9-week, randomized, double-blind, controlled trial was performed, and treatments with 10 mg budesonide or 40 mg prednisolone daily, both gradually tapered, were compared. Endoscopic improvement and effect on endogenous plasma cortisol were assessed. RESULTS: Thirty-four patients were administered budesonide, and 38 patients were administered prednisolone. Mean endoscopic scores improved significantly in both groups but without difference between the groups. Five patients in the budesonide group and 7 patients in the prednisolone group deteriorated and were withdrawn from the study. Morning plasma cortisol levels were suppressed in the prednisolone group (entry, 449 nmol/L; 2 weeks, 116 nmol/L; 4 weeks, 195 nmol/L) but were unchanged in the budesonide group. CONCLUSIONS: The GCS budesonide administered in an oral controlled-release formulation seems to give an overall treatment result in active ulcerative colitis approaching that of prednisolone but without suppression of plasma cortisol levels. This concept merits further evaluation.
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