| 1. |
- Albano, Amanda, et al.
(författare)
-
Echocardio-variability - Low and high frequency beat-to-beat variability in echocardiographic signals
- 2013
-
Ingår i: Computing in Cardiology 2013. - 9781479908844 ; , s. 767-770
-
Konferensbidrag (refereegranskat)abstract
- Measurement signals originating from the cardiovascular system are known to comprise oscillating components and beat-to-beat variability, e.g., heart-rate variability and blood pressure variability. In clinical echocardiographic procedures, typically only a few cardiac cycles are acquired. This pilot study analyses the beat-to-beat variability of echocardiographic variables (echocardio-variability) in minute long acquisitions.
|
|
| 2. |
|
|
| 3. |
- Arne, Mats, 1954-, et al.
(författare)
-
Physical activity and quality of life in subjects with chronic disease : chronic obstructive pulmonary disease compared with rheumatoid arthritis and diabetes mellitus
- 2009
-
Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 27:3, s. 141-147
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Chronic diseases interfere with the life situation of the affected person in different ways. The aim was to compare the burden of disease in three chronic diseases - chronic obstructive pulmonary disease (COPD), rheumatoid arthritis (RA), diabetes mellitus (DM) - and in healthy subjects, with a particular interest in physical activity, quality of life, and psychological health. DESIGN: Cross-sectional, observational study. SETTING AND SUBJECTS: Postal survey questionnaire to a stratified, random population of 68 460 subjects aged 18-84 years in Sweden. The subjects included were 40-84 years old (n = 43 589) and data were analysed for COPD (n = 526), RA (n = 1120), DM (n = 2149) and healthy subjects (n = 6960). RESULT: Some 84% of subjects with COPD, 74% (RA), 72% (DM), and 60% in healthy subjects (p < 0.001, COPD versus RA, DM, and healthy subjects) had a physical activity level considered too low to maintain good health according to guidelines. Quality of life (EuroQol five-dimension questionnaire, EQ-5D) was lower in COPD and RA than in DM. Anxiety/depression was more common in subjects with COPD (53%) than in those with RA (48%) and DM (35%) (p < 0.001, COPD versus RA and DM), whereas mobility problems were more common in RA (55%) than COPD (48%) and DM (36%) (p < 0.001, RA versus COPD and DM). All differences between groups remained significant after adjusting for age, sex, and socioeconomic background factors. CONCLUSION: Subjects with chronic diseases had a low level of physical activity, most evident in subjects with COPD. COPD and RA had a higher negative impact on quality of life than DM. Our results indicate that increased attention regarding physical inactivity in subjects with chronic diseases is needed to minimize the burden of disease.
|
|
| 4. |
|
|
| 5. |
- Axelsson, Christer, et al.
(författare)
-
Outcome after out-of-hospital cardiac arrest witnessed by EMS : changes over time and factors of importance for outcome in Sweden.
- 2012
-
Ingår i: Resuscitation. - : Elsevier Ireland Ltd. - 0300-9572 .- 1873-1570. ; 83:10, s. 1253-1258
-
Tidskriftsartikel (refereegranskat)abstract
- Background Among patients who survive after out-of-hospital cardiac arrest (OHCA), a large proportion are recruited from cases witnessed by the Emergency Medical Service (EMS), since the conditions for success are most optimal in this subset. Aim To evaluate outcome after EMS-witnessed OHCA in a 20-year perspective in Sweden, with the emphasis on changes over time and factors of importance. Methods All patients included in the Swedish Cardiac Arrest Register from 1990 to 2009 were included. Results There were 48,349 patients and 13.5% of them were EMS witnessed. There was a successive increase in EMS-witnessed OHCA from 8.5% in 1992 to 16.9% in 2009 (p for trend < 0.0001). Among EMS-witnessed OHCA, the survival to one month increased from 13.9% in 1992 to 21.8% in 2009 (p for trend < 0.0001). Among EMS-witnessed OHCA, 51% were found in ventricular fibrillation, which was higher than in bystander-witnessed OHCA, despite a lower proportion with a presumed cardiac aetiology in the EMS-witnessed group. Among EMS-witnessed OHCA overall, 16.0% survived to one month, which was significantly higher than among bystander-witnessed OHCA. Independent predictors of a favourable outcome were: (1) initial rhythm ventricular fibrillation; (2) cardiac aetiology; (3) OHCA outside home and (4) decreasing age. Conclusion In Sweden, in a 20-year perspective, there was a successive increase in the proportion of EMS-witnessed OHCA. Among these patients, survival to one month increased over time. EMS-witnessed OHCA had a higher survival than bystander-witnessed OHCA. Independent predictors of an increased chance of survival were initial rhythm, aetiology, place and age.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Casado-Bedmar, Maite, et al.
(författare)
-
Elevated F-EDN correlates with mucosal eosinophil degranulation in patients with IBS : A possible association with microbiota?
- 2022
-
Ingår i: Journal of Leukocyte Biology. - : Alan R. Liss Inc.. - 0741-5400 .- 1938-3673. ; 111:3, s. 655-665
-
Tidskriftsartikel (refereegranskat)abstract
- Eosinophils have been linked to functional dyspepsia; however, less is known about their role in irritable bowel syndrome (IBS). This study tested the hypothesis of alterations in levels of fecal eosinophil-derived neurotoxin (F-EDN) and eosinophil density and degranulation within the colonic mucosa of IBS patients compared with healthy controls (HC). Colonic biopsies were collected from 37 IBS patients and 20 HC and analyzed for eosinophil numbers and local degranulation of eosinophil cationic protein (ECP) by histologic procedures. Fecal samples were collected for F-EDN and microbiota analysis. Differentiated 15HL-60 cells were used in vitro to investigate the direct effect of live bacteria on eosinophil activation measured by a colorimetric assay with o-phenylenediamine (OPD) substrate. We observed a higher number of eosinophils and increased extracellular ECP in the mucosa of IBS patients compared with HC. Moreover, F-EDN levels in IBS samples were elevated compared with HC and positively correlated to extracellular ECP. Metagenomic analysis showed significant correlations between bacterial composition and eosinophil measurements in both HC and IBS patients. In vitro experiments revealed an increased degranulation of 15HL-60 after stimulation with Salmonella typhimurium, Salmonella enterica, and Yersinia enterocolitica. To conclude, we could demonstrate alterations related to eosinophils in IBS, and, for the first time, a positive correlation between F-EDN levels and degranulated eosinophils in the colonic mucosa of IBS patients. Together our results suggest that eosinophils play a role in the pathophysiology of IBS and the mechanisms might be linked to an altered microbiota.
|
|
| 9. |
|
|
| 10. |
|
|
| 11. |
- Engvall, Christer, et al.
(författare)
-
Can myocardial strain differentiate hypertrophic from infiltrative etiology of a thickened septum?
- 2011
-
Ingår i: Echocardiography. - : Wiley. - 0742-2822 .- 1540-8175. ; 28:4, s. 408-415
-
Tidskriftsartikel (refereegranskat)abstract
- Septal systolic strain measurements showed reduced longitudinal function but its localized nature failed to demonstrate radial disturbances in patients with pathologically thickened septum. No difference was found in systolic strain between patients according to the etiology of septal thickness. This limitation might be either technical or is explained by the maintained radial function in all patient groups.
|
|
| 12. |
|
|
| 13. |
- Grönlund, Christer, 1975-, et al.
(författare)
-
Significant beat-to-beat variability of E/e’ irrespective of respiration
- 2013
-
Ingår i: International cardiovascular forum. - : Barcaray Publishing. - 2409-3424 .- 2410-2636. ; 1:2, s. 88-89
-
Tidskriftsartikel (refereegranskat)abstract
- The E/e’ ratio is commonly used in Doppler echocardiographic examinations to estimate the pulmonary capillary wedge pressure. The rationale of using this ratio is to combine left ventricular (LV) filling (E) and relaxation (e’) velocities to indirectly assess left atrial pressure. However, the accuracy of this index has recently been questioned, particularly in patients with controlled heart failure. Likewise, the potential beat-to-beat variability of such measurements remains undetermined. The cardiovascular system is subject to several oscillations with the potential of influencing LV function and its intra-cavitary pressures, hence measurements of its filling and relaxation velocities. The aim of this pilot study was to assess the beat-to-beat variability of the E/e’ ratio in one minute long examination in healthy subjects, and patients with various severity of amyloid heart disease. The results show that despite critical application of the standard echocardiographic recording recommendations, E/e’ beat-to-beat variability was 36 % (22 to 50%) in healthy subjects and 17 % (11-26%) in patients, and where the most severe amyloid heart disease had the least variability. Thus, clinical use of a single or few cardiac beats might not necessarily reflect an accurate ratio between the two velocities, and hence casts doubt over their diagnostic value.
|
|
| 14. |
- Grönlund, Christer, et al.
(författare)
-
Simultaneous quantification of myocardial and blood flow velocities based on duplex mode ultrasound imaging
- 2013
-
Ingår i: Biomedical engineering online. - : BioMed Central (BMC). - 1475-925X. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Ultrasound imaging of the heart is a commonly used clinical tool to assess cardiac function. The basis for this analysis is the quantification of cardiac blood flow and myocardial velocities. These are typically measured using different imaging modes and on different cardiac cycles. However, due to beat-to-beat variations such as irregular heart rhythm and transient events, simultaneous acquisition is preferred. There exists specialized ultrasound systems for this purpose; however, it would be beneficial if this could be achieved using conventional ultrasound systems due to their wide availability. The conventional Duplex mode ultrasound allows simultaneous acquisition, however at a highly reduced spatial and temporal resolution.METHODS: The aim of this work was to present and evaluate the performance of a novel method to recover myocardial tissue velocity using conventional Duplex ultrasound imaging, and to demonstrate its feasibility for the assessment of simultaneous blood flow and myocardial velocity in-vivo. The essence of the method was the estimation of the axial phase shift of robust echogenic structures between subsequent image frames. The performance of the method was evaluated on synthetic tissue mimicking B-mode image sequences at different frame rates (20--60 Hz) and tissue velocities (peak velocities 5-15cm/s), using cardiac deformation and displacement characteristics. The performance was also compared to a standard 2-D speckle tracking technique.RESULTS: The method had an overall high performance at frame rates above 25 Hz, with less than 15% error of the peak diastolic velocity, and less than 10 ms peak timing error. The method showed superior performance compared to the 2-D tracking technique at frame rates below 50 Hz. The in-vivo quantification of simultaneous blood flow and myocardial tissue velocities verified the echocardiographic patterns and features of healthy subjects and the specific patient group.CONCLUSIONS: A novel myocardial velocity quantification method was presented and high performance at frame rates above 25Hz was shown. In-vivo quantification of simultaneous myocardial and blood flow velocities was feasible using the proposed method and conventional Duplex mode imaging. We propose that the methodology is suitable for retrospective as well as prospective studies on the mechanics and hemodynamics of the heart.
|
|
| 15. |
- Gustafsson, Sandra, et al.
(författare)
-
Can echocardiography differentiate hereditary transthyretin amyloidosis from hypertrophic cardiomyopathy?
- 2013
-
Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 34:Supplement: 1, s. 213-213
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: Hereditary transthyretin amyloidosis (ATTR) andhypertrophic cardiomyopathy (HCM) have many phenotypic similarities when examined by echocardiography. As the two conditions have different treatment strategies it is of importance to accurately diagnose these patients early in the disease. This study aimed to identify the most accurate echocardiographic method in differentiating these two conditions by using traditional and speckle tracking echocardiographyas well as myocardial texture analysis.Methods: We investigated 40 healthy controls, 33 patients with biopsy proven ATTR and 20 with HCM. All patients had septal thickness >12 mm. We measured left ventricular (LV) global strain as intrinsic systolic function and LV E/e' to estimate filling pressures. We also tested septal cyclic integrated backscatter (cIBS) and septal entropy as both being measures for myocardial highly reflection pattern whereas cIBS showing motion of highly reflective echoes and entropy the distribution of highly reflective echoes.Results: LV global strain, cIBS and E/e' were not useful in differentiating ATTR from HCM. However, septal entropy was found to be significantly different and showed an area under the curve from ROC analysis of 0.66 separating ATTR from HCM.Conclusion: After using detailed analysis of different aspects of LV morphology and function we found that myocardial texture behavior from entropy analysis was the only method useful in differentiating patients with ATTR fromHCM.
|
|
| 16. |
|
|
| 17. |
- Gustavsson, Sandra, et al.
(författare)
-
Can echocardiography and ECG discriminate hereditary transthyretin V30M amyloidosis from hypertrophic cardiomyopathy?
- 2015
-
Ingår i: Amyloid. - : Informa UK Limited. - 1350-6129 .- 1744-2818. ; 22:3, s. 163-170
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Hereditary transthyretin (ATTR) amyloidosis with increased left ventricular wall thickness could easily be misdiagnosed by echocardiography as hypertrophic cardiomyopathy (HCM). Our aim was to create a diagnostic tool based on echocardiography and ECG that could optimise identification of ATTR amyloidosis. Methods: Data were analysed from 33 patients with biopsy proven ATTR amyloidosis and 30 patients with diagnosed HCM. Conventional features from ECG were acquired as well as two dimensional and Doppler echocardiography, speckle tracking derived strain and tissue characterisation analysis. Classification trees were used to select the most important variables for differentiation between ATTR amyloidosis and HCM. Results: The best classification was obtained using both ECG and echocardiographic features, where a QRS voltage >30 mm was diagnostic for HCM, whereas in patients with QRS voltage <30 mm, an interventricular septal/posterior wall thickness ratio (IVSt/PWt) >1.6 was consistent with HCM and a ratio <1.6 supported the diagnosis of ATTR amyloidosis. This classification presented both high sensitivity (0.939) and specificity (0.833). Conclusion: Our study proposes an easily interpretable classification method for the differentiation between HCM and increased left ventricular myocardial thickness due to ATTR amyloidosis. Our combined echocardiographic and ECG model could increase the ability to identify ATTR cardiac amyloidosis in clinical practice.
|
|
| 18. |
- Hagberg, Cecilia, et al.
(författare)
-
Lättviktsgrindar av höghållfast stål för säkrare djurhantering och arbetsmiljö
- 2021
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Lightweight gates of high-strength steel for improved worker safety and cattle handling This report presents the work with developing a lightweight gate of high-strength steel for the handling of cattle. The project was conducted as a European Innovation Partnership (EIP) project. The project group consisted of co-workers from the unit of Agriculture and Horticulture and the unit of Process and Environmental Engineering at Research Institutes of Sweden (RISE Jordbruk och trädgård och RISE Kretsloppsteknik), Parsteel AB (former Nilssons Plåtindustri AB), SSAB EMEA AB, Sophie Atkinson at Smart Animal Handling, Swedish University of Agricultural Sciences (SLU) in Skara and the cattle farmer Lars Olsson. The main objectives of the project were to develop a lightweight gate weighing at least 50% less and being three times as strong as a traditional gate for cattle handling. The main motive was to improve the ergonomic conditions and working environment for the animal handlers. Additionally, for the safety of both animals and handlers, the gate must withstand the loads from cattle. Other objectives were to design and construct a gate that does not exceed the price of a high-quality gate and not contribute to increased negative environmental impact. A lightweight gate can be made of various materials such as plastic, fiberglass or steel. Regarding the project group's participants and their competencies, in addition to the numerous requirements placed on a lightweight gate, the choice fell on high-strength steel. High-strength steel is characterized by having high yield strengths, up to 1300 MPa, in comparison with traditional construction steel with yield strength of 355 MPa. For the specific lightweight gate, steel pipes with a yield strength of approximately 750 MPa were chosen. These pipes are mainly used in the automotive and engine industry, where high demands are placed on strength while at the same time a light construction is desired. The gate itself was designed during the project and several details were examined and developed in regard to functionality and safety for both cattle and handlers. The work environment legislation states that gates must be dimensioned and anchored so that the animals cannot break out (AFS 2008:17). The gates must also not pose a risk of injury to the cattle. In order to work safely with cattle, knowledge of cattle behavior is essential and consequently the report contains a chapter describing cattle senses and behavior. Both the lightweight gates and the handling system, built up by the gates, must be adapted to the cattle. In the project, the bud box handling system was tested. The handling system was originally developed to make use of the behavioral characteristics of cattle to encourage forward movement in the desired direction. In the project the handling system's functionality and safety, by using lightweight gates and additional equipment and components, were further designed. The handling system was tested in two groups of heifers at the SLU Götala Beef and Lamb Research Centre. The lightweight gates were also tested in a dairy herd and a beef herd, while hoof trimming, and at a small-scale abattoir. Generally, the light weight of the gates was considered an advantage as the handling of the gates is simplified also resulting in more frequent use of the gates, increasing safety for both animals and humans. During the project, several strength tests were performed by building unique test rigs. In one test rig, the weld of the pipes of the lightweight gate was tested. In another test rig, the strength of lightweight gates, compared with traditional gates on the market, were tested. The outcome of the tests confirmed the original aim of the project, a lightweight gate made of high-strength steel, about 50% lighter and at least three times as strong as traditional gates, had been developed and designed during the project period.
|
|
| 19. |
- Hasselqvist-Ax, Ingela, et al.
(författare)
-
Early cardiopulmonary resuscitation in out-of-hospital cardiac arrest.
- 2015
-
Ingår i: The New England journal of medicine. - 1533-4406 .- 0028-4793. ; 372:24, s. 2307-15
-
Tidskriftsartikel (refereegranskat)abstract
- Three million people in Sweden are trained in cardiopulmonary resuscitation (CPR). Whether this training increases the frequency of bystander CPR or the survival rate among persons who have out-of-hospital cardiac arrests has been questioned.
|
|
| 20. |
- Henein, Mark, et al.
(författare)
-
Left atrial strain rate estimates PCWP
- 2013
-
Ingår i: International cardiovascular forum. - 2409-3424. ; :1, s. 25-30
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Raised left atrial (LA) pressure is a common pathway for many pathologies and is known for its complications. It has a direct effect on LA cavity size and potentially also its function. We hypothesized that raised LA pressure, as shown by pulmonary capillary wedge pressure (PCWP), correlates with severity of global LA deformation abnormalities during atrial systole (LASRa). DESIGN AND PATIENTS: We prospectively studied 46 consecutive patients, mean age 61 ±13 years, 17 males, of various etiologies who underwent right heart catheterization and simultaneous Doppler echocardiography using spectral, tissue Doppler and speckle tracking echocardiography techniques for assessing LA structure and function. RESULTS: PCWP correlated with direct measurements of LA structure and function: LA volume (r= 0.43, p<0.01) and LASRa (r=0.79, p<0.001). PCWP correlated also with other indirect measures of LA pressure such as E/A (r=0.65, p<0.001), E wave deceleration time (r=0.54, p<0.001), E/e’ (r=0.49, p<0.001) and LA systolic filling fraction (r=0.52, p<0.001). However, LASRa together with LA systolic filling fraction, had the highest areas under the curve (0.83 and 0.87, respectively) for identifying patients with PCWP > 15 mmHg. CONCLUSION: PCWP correlates with LA deformation rate during atrial systole and to a higher extent than conventional Doppler measures of raised LA pressures. These findings should have significant clinical implications in correctly identifying breathless patients due to raised LA pressure.
|
|
| 21. |
- Henein, Michael, et al.
(författare)
-
Long mitral valve leaflets determine left ventricular outflow tract obstruction during exercise in hypertrophic cardiomyopathy
- 2016
-
Ingår i: International Journal of Cardiology. - : Elsevier. - 0167-5273 .- 1874-1754. ; 212, s. 47-53
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Development of left ventricular outflow tract obstruction (LVOTO) in patients with hypertrophic cardiomyopathy (HCM) is important for explaining symptoms and designing management. LVOTO is mostly caused by a combination of septal hypertrophy and systolic anterior movement of the mitral valve (SAM). The aim of the present study was to determine predictors of exercise induced LVOTO in a group of HCM patients.METHODS: We performed supine exercise Doppler echocardiography, including measurements of LV morphology and function and anterior mitral leaflet length, in 51 mildly symptomatic HCM (septal thickness≥15mm) and compared them with 50 healthy controls. Measurements were made at 1) rest, 2) Valsalva maneuver, 3) peak exercise and 4) post exercise. LVOTO was diagnosed as a LVOT gradient of >30mmHg at rest, after Valsalva and after exercise or ≥50mmHg at peak exercise.RESULTS: All patients stopped exercise because of exhaustion. 35% of the patients had resting LVOTO and 48% during Valsalva. At peak exercise, only 37% had LVOTO, who increased to 64% post exercise. Patients who developed LVOTO at peak exercise were more prone to continue having it post exercise (p<0.001), to have attenuated systolic blood pressure rise (p=0.011) and to have long anterior mitral valve leaflets (p<0.001). Backward multiple regression analysis showed the anterior mitral leaflet length as the strongest single independent predictor (β=0.36, p=0.010) for increased LVOT velocities, followed by basal septal thickness.CONCLUSION: In patients with HCM, LV outflow tract obstruction seems to be relatively uncommon during exercise but rather occurring minutes after stopping exercise. Exercise LVOTO seems to be determined by long anterior mitral leaflets in addition to the well established septal hypertrophy.
|
|
| 22. |
- Henein, Michael Y, et al.
(författare)
-
Right and left heart dysfunction predict mortality in pulmonary hypertension
- 2017
-
Ingår i: Clinical Physiology and Functional Imaging. - : Wiley-Blackwell. - 1475-0961 .- 1475-097X. ; 37:1, s. 45-51
-
Tidskriftsartikel (refereegranskat)abstract
- In pulmonary hypertension (PH), the right heart dysfunction is a strong predictor of adverse clinical outcome, while the role of the left heart is not fully determined. The aim of this study was to identify predictors of mortality in precapillary PH including measures of both right and left heart function. We studied 34 patients (mean age 64 ± 13, range 31-82 years, 24 females) with precapillary PH, all of whom underwent detailed Doppler echocardiographic examination of the right and left heart function using conventional and speckle-tracking echocardiography. Patients were followed up for up to 8 years (mean 4·2 ± 1·9 years). At follow-up, 16 patients survived. Left ventricular (LV) filling time (P = 0·007), pulmonary artery acceleration time (P = 0·009), right atrial pressure (RAP) (P<0·001) and tricuspid regurgitation (TR) severity (P = 0·007) were worse in the deceased group. RV global longitudinal strain (GLS) (P = 0·001), RAP (P≤0·001), LV filling time (P<0·001) and TR severity (P<0·001) were the most accurate predictors, having the largest AUC (>0·65) and carried the highest risk for mortality (P<0·001 for all). The strongest predictors of mortality in precapillary PH indirectly reflect both left and right heart dysfunction including atrial structure and function disturbances. While an interaction pattern is observed, it needs to be confirmed in a larger cohort.
|
|
| 23. |
|
|
| 24. |
- Hossain, Akter, 1967-
(författare)
-
Studies on Redox-proteins and Cytokines in inflammation and Cancer
- 2007
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The redox state in the cell plays a major role in determining vital functions and its major imbalance can lead to severe cell injury or death. Redox active proteins and cytokines involved in this process includes thioredoxin (Trx), protein disulfide isomerase (PDI), and tumor necrosis factor (TNF) superfamilies. Trx is a multipotent protein and key regulator of cellular redox balance operating in synergy with Trx reductase and NADPH (the Trx system). Trx has gene regulatory activity of several transcription factors. It also controls in a fascinating way redox-sensitive “on-off” decisions for apoptotic or hypertrophic pathways. Trx protects against H2O2 and TNFmediated cytotoxicity, a pathway in which TNF receptor-binding generates ROS. TNF is an autocrine growth factor and survival factor in vitro and in vivo for B-type of chronic lymphocytic leukemia (B-CLL) cells. The overall aim of this study was to investigate the importance of redox active proteins and cytokines in inflammation and cancer. We focused on: i) the role of Trx, TrxR, and selenium in carcinogenesis and in resistant cancer cells. ii) the importance of Trx in cancer cells and the redox regulation of TNF and its receptors TNFR1 and TNFR2. iii) the potential role of Trx as a key regulator in cellular redox balance, in the pathogenesis of cardiac dysfunction; its relationship to stress response parameters. iv) whether unmutated CLL (UCLL) responses to PKC and ROS pathways were different from mutated CLL (M-CLL) responses.Our results demonstrate pronounced selective selenium-mediated apoptosis in therapy resistant cells and suggest that redox regulation through the Trx system is an important target for cancer therapy. Trx was strikingly elevated in heart failure cases compared with controls signifying an adaptive stress response that is higher the more severe the disease. TNF autocrine release was redox modulated and the TNF receptors interacted at the cell surface membrane with the redox-active PDI, which excerted a stringent redox-control of the TNFR signaling. The proliferative response as well as increase of autocrine TNF and Trx were higher in U-CLL than in M-CLL.The overall conclusion of the four papers included in this thesis is that redox-active proteins and cytokines plays an important role in control and regulation of cancer and inflammation. Furthermore, redox regulation via thioredoxin by selenium, may offer novel treatment possibilities for resistant tumors disease.
|
|
| 25. |
- Hultman, Martin, et al.
(författare)
-
Driver sleepiness detection with deep neural networks using electrophysiological data
- 2021
-
Ingår i: Physiological Measurement. - : IOP PUBLISHING LTD. - 0967-3334 .- 1361-6579. ; 42:3
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. The objective of this paper is to present a driver sleepiness detection model based on electrophysiological data and a neural network consisting of convolutional neural networks and a long short-term memory architecture. Approach. The model was developed and evaluated on data from 12 different experiments with 269 drivers and 1187 driving sessions during daytime (low sleepiness condition) and night-time (high sleepiness condition), collected during naturalistic driving conditions on real roads in Sweden or in an advanced moving-base driving simulator. Electrooculographic and electroencephalographic time series data, split up in 16 634 2.5 min data segments was used as input to the deep neural network. This probably constitutes the largest labeled driver sleepiness dataset in the world. The model outputs a binary decision as alert (defined as <= 6 on the Karolinska Sleepiness Scale, KSS) or sleepy (KSS >= 8) or a regression output corresponding to KSS epsilon [1-5, 6, 7, 8, 9]. Main results. The subject-independent mean absolute error (MAE) was 0.78. Binary classification accuracy for the regression model was 82.6% as compared to 82.0% for a model that was trained specifically for the binary classification task. Data from the eyes were more informative than data from the brain. A combined input improved performance for some models, but the gain was very limited. Significance. Improved classification results were achieved with the regression model compared to the classification model. This suggests that the implicit order of the KSS ratings, i.e. the progression from alert to sleepy, provides important information for robust modelling of driver sleepiness, and that class labels should not simply be aggregated into an alert and a sleepy class. Furthermore, the model consistently showed better results than a model trained on manually extracted features based on expert knowledge, indicating that the model can detect sleepiness that is not covered by traditional algorithms.
|
|
| 26. |
- Jacobsson, Maritha, 1960-
(författare)
-
Terapeutens rätt : rättslig och terapeutisk logik i domstolsförhandlingar
- 2006
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In this dissertation, I explore a quite unique legal situation, namely administrative court hearings relating to coercive interventions: the Care of Young Persons Act (LVU), Care of Abusers (Special Provisions) Act (LVM), and the Compulsory Psychiatric Care Act (LPT). There are three central participatory roles in the court hearings: The official party is the authority who files the application for coercive intervention – either a chief psychiatrist or a social welfare board (typically represented by a social worker or sometimes a lawyer assisted by a social worker), whereas the citizen party is the person about whom the application is brought. The citizen party is represented by a legal representative. The professionals represent two different logics: therapeutic and judicial.The purpose of this dissertation has been to study the tension between therapeutic and judicial logic in court hearings relating to compulsory care. With theoretical concepts from Scott (1995) and Wetherell & Potter (1998), it is possible to say that the therapeutic and judicial logics are built up by institutional elements that are communicated through interpretative repertoires. Three questions are central:1. How do professional participators handle the different role expectations embedded in therapeutic and judicial logic? In this case, I am particularly interested in role conflicts faced by social workers and psychiatrists.2. How do different institutional elements (regulative, normative/cognitive) play out in the court hearings?3. To what extent can these court hearings be considered a scrutinizing order of discourse, where the arguments of official party are subjected to critical examination?In my analysis I am inspired by both critical discourse analysis and organizational theory, more precisely, new institutionalism. These two perspectives provide useful insights and make it possible to combine the micro- and macro levels in the analysis. Data for the analysis consist of 43 court hearings and 31 interviews, gathered from two different county administrative courts in Sweden. All written documents used and produced by the courts are also part of our data.The dissertation consists of five studies that indicate that the court hearings hardly can be described as a scrutinising order of discourse. In spite of this, the court constantly finds that the legal criteria for coercive intervention are satisfied. Neither the official party nor the legal representative argue according to a judicial logic. Instead, therapeutic logic dominates the order of discourse. When the arguments for compulsory care are therapeutic, they are not explicitly related to the criteria in the law. In my interpretation, the reason why the conflict between therapeutic and judicial logic is not realised can be found in the existence of a logic of normalisation. This ideological logic of normalisation can be found in most of the institutions in the Swedish society and are built on the idea of traditional welfare norms.
|
|
| 27. |
- Karlsson, Helen, et al.
(författare)
-
Characterization of apolipoprotein M isoforms in low-density lipoprotein
- 2006
-
Ingår i: Journal of proteome research. - : American Chemical Society (ACS). - 1535-3893 .- 1535-3907. ; 5:10, s. 2685-2690
-
Tidskriftsartikel (refereegranskat)abstract
- Apo M is a recently discovered human lipoprotein thought to be involved in the metabolism of lipids and lipoprotein particles. Here, a proteomic approach was applied to examine the glycosylation pattern of apo M in human LDL. We treated LDL proteins with N-glycosidase or neuraminidase, studied mobility shifts of Apo M by two-dimensional gel electrophoresis, and different isoforms were then identified with mass spectrometry. This way, we demonstrated the presence of five isoforms of apo M in LDL: three that are both N-glycosylated and sialylated, one that is N-glycosylated but not sialylated, and one that is neither N-glycosylated nor sialylated. As judged from the examination of LDL from 20 healthy human subjects, the three N-glycosylated and sialylated forms are most abundant (80−100% of the total apo M in LDL) whereas the unsialylated and unglycosylated variants constitute at most 20%. Comparative analysis showed that the same five isoforms of apo M are also present in HDL. Further studies aiming at elucidating the role of apo M in health and disease will have to take this polymorphism of apo M proteins into account.
|
|
| 28. |
|
|
| 29. |
- Karlsson, Helen, et al.
(författare)
-
Protein profiling of low-density lipoprotein from obese subjects
- 2009
-
Ingår i: Proteomics - Clinical Applications. - : Wiley. - 1862-8354 .- 1862-8346. ; 3:6, s. 663-671
-
Tidskriftsartikel (refereegranskat)abstract
- Although obesity and high levels of low-density lipoprotein (LDL) are well-known risk factors for cardiovascular disease, the precise role(s) of different LDL constituents in obesity has not been explored. In the present study, we compared the LDL proteome of healthy control adults (body mass index 30). LDL was isolated by density-gradient ultracentrifugation and proteins were separated with 2-D PAGE, quantified, and identified by peptide mass fingerprinting using MALDI-TOF MS. A new LDL-associated protein was identified as transthyretin and found to be significantly more abundant in LDL from the obese subjects. In addition, LDL from the obese subjects contained relatively more alpha(1)-antitrypsin, apo J, apo C-II, than LDL from controls, and also more of an acidic isoform (pI/Mr; 5.2/23 100) of apo A-I. On the other hand, the relative amounts of apo A-IV and the major isoform of apo A-I (pI/Mr; 5.3/23 100) were significantly less in LDL from the obese subjects. Apo E was less and non-sialylated apo C-III more abundant in LDL from obese men than control men, while there were no such differences between LDL from obese and control women. These findings illustrate that obesity is not only associated with increased LDL-cholesterol levels but also with alterations in the LDL protein composition. The presence of transthyretin in LDL from obese subjects may reflect over-nutrition and affect the lipid metabolism in obesity.
|
|
| 30. |
|
|
| 31. |
- Lindqvist, Aron, 1964-
(författare)
-
Hand Injury from Powered Wood Splitters
- 2010
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this study on hand injury from powered wood splitters was to describe injury epidemiology and anatomy, to rate injury severity, to evaluate the outcome after injury and to describe factors of possible importance for the occurrence of injury.By searching a computerized patient registry, 131 patients injured by wood splitters from 1995 to 2001 were identified. Information was obtained from hospital records and radiographs, a written questionnaire and a structured telephone interview. Injury severity was rated according to the Hand Injury Severity Scoring System (HISS system) and the Injury Severity Score (ISS). Outcome was evaluated with the Disabilities of the Arm, Shoulder and Hand outcome questionnaire (DASH) and, in 26 of the most severely injured patients, with the Sollerman test.Forty-six percent of the injuries occurred during April or May. Wedge splitters caused 82 % of all injuries and most often injured the index finger, while screw splitters caused 18 % of all injuries and most often injured the metacarpus. Screw splitters caused palmar perforation and thumb avulsion. Sixty-three percent of all patients had an amputation or devascularising injury. The reliability of HISS rating was good. The mean Hand Injury Severity Score (HISS) was 63 which is equivalent to a severe hand injury. The mean ISS was 3.7. Nineteen percent of patients had minor, 31 % had moderate, 23 % had severe and 27 % had major injury according to the HISS system. Children had more severe injuries than adults. There was no significant difference regarding HISS or DASH scores between wedge and screw splitter injuries. The mean DASH score was 15, indicating moderate residual sequelae, but patients without sequelae and patients with grave sequelae were found in all HISS severity grades. There was a weak but significant correlation between the HISS and DASH scores. The mean Sollerman score in the injured hand was 66, indicating significantly impaired hand function. Twenty-nine percent of splitters were home-made. Very few machines had the safety measures required by European Standards. Children were present during splitting in at least 15 % of cases. Not being alone at the machine was one cause of wedge splitter injury. Glove use was one cause of screw splitter injury.Hand injury from powered wood splitters is a significant problem. Many of the injuries are severe, and cause long term sequels and impairment of hand function. Prevention is essential and should focus on unsafe machines and dangerous patterns of use.
|
|
| 32. |
- Lindqvist, Ann-Sophie, 1973, et al.
(författare)
-
A retrospective 30-year follow-up study of former Swedish-elite male athletes in power sports with a past anabolic androgenic steroids use: a focus on mental health.
- 2013
-
Ingår i: British journal of sports medicine. - : BMJ. - 1473-0480 .- 0306-3674. ; 47:15, s. 965-969
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The knowledge concerning the long-term effect of former anabolic androgenic steroids (AAS)-use on mental health is sparse. AIM: This study aims to investigate whether previous AAS-use affects mental health, present sociodemographic data, sport activity and substance abuse in a retrospective 30-year follow-up study of former elite athletes. METHODS: Swedish male-elite power sport athletes (n=683) on the top 10 national ranking lists during any of the years 1960-1979 in wrestling, Olympic lifting, powerlifting and the throwing events in track and field answered a questionnaire. RESULTS: At least 20% of the former athletes admitted previous AAS-use. They had more often sought professional expertise for mental problems and had used illicit drugs compared to those not having used AAS. The AAS-users also differed in former sport activity pattern compared to non AAS-users. CONCLUSIONS: It is clear that a relationship exists between use of AAS and mental-health problems. Further studies need to be done in order to clarify this relationship.
|
|
| 33. |
- Lindqvist, Ann-Sophie, 1973, et al.
(författare)
-
Increased mortality rate and suicide in Swedish former elite male athletes in power sports.
- 2014
-
Ingår i: Scandinavian journal of medicine & science in sports. - : Wiley. - 1600-0838 .- 0905-7188. ; 24:6, s. 1000-1005
-
Tidskriftsartikel (refereegranskat)abstract
- Physical training has been shown to reduce mortality in normal subjects, and athletes have a healthier lifestyle after their active career as compared with normal subjects. Since the 1950s, the use of anabolic androgenic steroids (AAS) has been frequent, especially in power sports. The aim of the present study was to investigate mortality, including causes of death, in former Swedish male elite athletes, active 1960-1979, in wrestling, powerlifting, Olympic lifting, and the throwing events in track and field when the suspicion of former AAS use was high. Results indicate that, during the age period of 20-50 years, there was an excess mortality of around 45%. However, when analyzing the total study period, the mortality was not increased. Mortality from suicide was increased 2-4 times among the former athletes during the period of 30-50 years of age compared with the general population of men. Mortality rate from malignancy was lower among the athletes. As the use of AAS was marked between 1960 and 1979 and was not doping-listed until 1975, it seems probable that the effect of AAS use might play a part in the observed increased mortality and suicide rate. The otherwise healthy lifestyle among the athletes might explain the low malignancy rates.
|
|
| 34. |
|
|
| 35. |
|
|
| 36. |
- Lindqvist Bagge, A, et al.
(författare)
-
Withdrawal from anabolic androgenic steroids does not affect personality characteristics
- 2016
-
Ingår i: Journal of Alcoholism and Drug Dependence. - : OMICS Publishing Group. - 2329-6488. ; 4:4
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to investigate the relationship between anabolic androgenic steroids (AAS) and personality characteristics with the following research questions: 1) Do personality characteristics differ between AAS-abusers and an AAS-naïve comparison group? 2) Do personality characteristics differ between active AASabusers and former AAS-abusers? 3) Does time of withdrawal from AAS affect personality characteristics? Design: Retrospective observational study. Methods: Sixty men (active n=20, former n=40) seeking medical consultation for their AAS abuse were included in the study. Personality characteristics were assessed by the Karolinska Scales of Personality (KSP) inventory. Comparisons were made with an age- and gender-matched group of AAS-naïve body-builders (n=30). Results: AAS-abusers differed significantly in their personality characteristics from the AAS-naïve control group. No major differences were found between active and former AAS-abusers. No correlations were found between personality characteristics and time of withdrawal or duration of AAS abuse. Conclusions: Individuals with AAS abuse differ in their personality characteristics from those who have never used AAS. Withdrawal from AAS does not, however, alter personality characteristic in AAS-abusers, although the causality of this relationship is unclear, indirectly stating that AAS do not seem to alter personality characteristics in a major fashion. On the other hand, it could be argued that AAS gives a more permanent change on personality that is not affected by time of withdrawal from AAS. Thus, the present results do not explain the causality of the relationship between AAS abuse and personality characteristics and further studies are needed in order to clarify this relationship.
|
|
| 37. |
- Lindqvist, Camilla, et al.
(författare)
-
Both CD4(+) FoxP3(+) and CD4(+) FoxP3(-) T cells from patients with B-cell malignancy express cytolytic markers and kill autologous leukaemic B cells in vitro.
- 2011
-
Ingår i: Immunology. - : Wiley. - 0019-2805 .- 1365-2567. ; 133:3, s. 296-306
-
Tidskriftsartikel (refereegranskat)abstract
- P>Cytotoxic CD4+ T cells have been found in patients with chronic lymphocytic leukaemia (CLL) and seem to be involved in the regulation of malignant B cells. The CD4+ T regulatory cells (Tregs) can regulate various immune cells, including B cells, by inducing their apoptosis. Hence, different subgroups of CD4+ T cells may be involved in the regulation of malignant B cells. In this study, the cytotoxic phenotype and function of various CD4+ T-cell subgroups were investigated in patients with B-cell malignancies. Peripheral blood was collected from patients with CLL, various B-cell lymphomas, healthy adult donors, children with precursor B-cell acute lymphoblastic leukaemia (pre-B ALL) and from healthy children. CD4+ T cells (CD3+ CD4+ FoxP3-), Tregs (CD3+ CD4+ CD127low FoxP3+) and CD127high FoxP3+ T cells (CD3+ CD4+ CD127high FoxP3+) were analysed for their expression of the cytolytic markers CD107a and Fas ligand. Patients with CLL had increased CD107a expression on all tested T-cell subgroups compared with healthy donors. Similar results were found in patients with B-cell lymphomas whereas the CD107a expression in children with pre-B ALL was no different from that in healthy controls. Fas ligand expression was similar between patient cells and cells of healthy donors. CD4+ T cells and Tregs from patients with CLL and healthy donors were subsequently purified and cultured in vitro with autologous B cells. Both subgroups lysed B cells and killing was confirmed by granzyme ELISAs. In conclusion, cytotoxic populations of CD4+ T cells, including Tregs, are present in patients with B-cell malignancy and may be an important factor in immune-related disease control.
|
|
| 38. |
|
|
| 39. |
|
|
| 40. |
- Lindqvist, Olav, et al.
(författare)
-
Time and Bodily Changes in Advanced Prostate Cancer : Talk About Time As Death Approaches
- 2008
-
Ingår i: Journal of Pain and Symptom Management. - : Elsevier BV. - 0885-3924 .- 1873-6513. ; 36:6, s. 648-656
-
Tidskriftsartikel (refereegranskat)abstract
- The disease trajectory of living with incurable cancer is characterized by, increasing bodily deterioration and problems. In this paper, we have focused on the change in temporal awareness as manifested in the narrations of two men with hormone refractory prostate cancer and, skeletal metastases as they approach death. The two men participated in in-depth research interviews during the last part of their lives, sharing a similar disease trajectory with increaseing bodily change and decreasing physical function. Both died a lingering cancer,related death. The first and last research interviews were analyzed using a discourse analytic method. Findings show that the temporal awareness in the interviews changes as the illness progresses and death approaches. In the last interviews, the present is flooded with bodily problems; the past and the future are hardly present except for the future beyond the mens own deaths. Pain.,fatigue, nausea, and other symptoms figure largely in this change, and there is no time for much more than attending to bodily needs in a present that is dominated by problems. Here, the importance of alleviating bodily problems once again becames paramount, and two questions are raised: Is the often reported withdrawal from life, when death is imminent, a physical necessity rather than a psychological one, and is it possible to free time from, the time-consuming problems of the present by means of a more concentrated attempt, to alleviate these problems?
|
|
| 41. |
- Lindqvist, Per, et al.
(författare)
-
Pulsed tissue Doppler and strain imaging discloses early signs of infiltrative cardiac disease: a study on patients with familial amyloidotic polyneuropathy.
- 2006
-
Ingår i: Eur J Echocardiogr. ; 7:1, s. 22-30
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Familial amyloidotic polyneuropathy (FAP) is a hereditary systemic amyloidosis with cardiac involvement. As early identification of the cardiac involvement is of major clinical interest we performed this study to test the hypothesis that tissue Doppler imaging (TDI) and strain imaging (SI) might disclose cardiac involvement in patients with early stages of FAP. METHODS: Twenty-two patients with FAP and 36 healthy controls were studied. Standard M-mode and Doppler echocardiography were performed. TDI and SI were used to assess the regional longitudinal left ventricular (LV) lateral and septal and right ventricular (RV) wall functions. All time intervals were corrected for heart rate by dividing with R-R interval and presented as percentage. RESULTS: We found that patients in comparison with controls had increased LV and RV wall thickness and by using TDI a prolonged isovolumic relaxation time (IVRt) at the septal segment (15.0+/-7.0 vs 10.7+/-4.1%, p<0.05) and prolonged isovolumic contraction time (IVCt) at LV lateral (12.8+/-4.3 vs 10.1+/-3.3%, p<0.05), septal (12.5+/-3.5 vs 8.9+/-1.9%, p<0.001) and RV free wall segments (12.0+/-3.6 vs 8.3+/-2.1%, p<0.001). Strain was reduced at LV lateral basal segment (-4.6+/-14.0 vs -20.2+9.1, p<0.001), RV free wall mid segment (-16.2+/-12.8 vs -29.4+/-15.2) as well as both septal segments (-4.1+/-11.7 vs -16.2+/-9.0%, p<0.001, -8.8+/-11.5 vs -19.4+/-8.4%, p<0.001 for septal basal and mid-segment). Even in the absence of septal hypertrophy the septal strain was reduced and the regional IVCt was prolonged. CONCLUSIONS: This is the first clinical study using TDI and strain in patients with FAP showing functional abnormalities before any morphological echocardiographic abnormalities were present. Both the left and right heart functions are involved and the disease should therefore be regarded as biventricular.
|
|
| 42. |
- Lindqvist, Per, et al.
(författare)
-
Ventricular dysfunction in type 1 myotonic dystrophy : Electrical, mechanical, or both?
- 2010
-
Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 143:3, s. 378-384
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Myotonic dystrophy type 1 (DM1) is a systemic disease which affects the heart and may be a cause of sudden death. Conduction disturbances are the major cardiac abnormalities seen in this condition. We sought to assess electrical and mechanical cardiac functions to identify abnormalities that might explain sudden cardiac death in DM1. METHODS: Thirty six patients with DM1 and 16 controls were studied using echocardiography including myocardial Doppler. ECG recordings were also obtained. RESULTS: Left ventricular (LV) dimensions were maintained but systolic function was reduced (p<0.001), including stroke volume (p<0.05). LV segmental myocardial isovolumic contraction time was prolonged (p<0.001) and correlated with PR interval (p<0.001). Isovolumic relaxation time was prolonged (p<0.05) and filling time was reduced (p<0.001). LV cavity was significantly asynchronous demonstrated by prolonged total isovolumic time (t-IVT) (p<0.001), high Tei index (p<0.001) and low ejection index (p<0.001). Right ventricular (RV) strain was reduced (p<0.001) as were its systolic and diastolic velocities (p<0.05 for both). 22/36 patients had prolonged LV t-IVT>12.3 s/min (upper 95% normal CI), 13 of whom had PR>/=200 ms, 11 had QRS duration >120 ms (5 had combined abnormality) and the remaining 5 had neither. Over the 3 years follow up 10 patients had events, 6 of them cardiac. t-IVT was prolonged in 5/6 patients, PR interval in 4 and QRS duration in one. CONCLUSIONS: In DM1 patients, LV conventional measurements are modestly impaired but cardiac time relations suggest marked asynchronous cavity function. Although our findings were primarily explained on the basis of long PR interval or broad QRS duration a minority presented an evidence for myocardial cause of asynchrony rather than electrical. Early identification of such abnormalities may guide towards a need for additional electrical resynchronization therapy which may improve survival in a way similar to what has been shown in heart failure trials.
|
|
| 43. |
- Ling Lundström, Maria, et al.
(författare)
-
Faecal biomarkers for diagnosis and prediction of disease course in treatment-naïve patients with IBD.
- 2024
-
Ingår i: Alimentary Pharmacology and Therapeutics. - 0269-2813 .- 1365-2036.
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Faecal biomarkers can be used to assess inflammatory bowel disease (IBD).AIM: To explore the performance of some promising biomarkers in diagnosing and predicting disease course in IBD.METHODS: We included 65 patients with treatment-naïve, new-onset Crohn's disease (CD), 90 with ulcerative colitis (UC), 67 symptomatic controls (SC) and 41 healthy controls (HC) in this prospective observational study. We analysed faecal samples for calprotectin (FC), myeloperoxidase (MPO), human neutrophil lipocalin (HNL), eosinophil cationic protein ECP and eosinophil-derived neurotoxin (EDN) and compared markers among groups. We assessed the diagnostic capability of biomarkers with receiver operating characteristic curves. Clinical disease course was determined for each patient with IBD and analysed the association with biomarkers by logistic regression.RESULTS: All markers were elevated at inclusion in patients with IBD compared with HC (p < 0.001) and SC (p < 0.001). FC (AUC 0.85, 95% CI: 0.79-0.89) and MPO (AUC 0.85, 95% CI: 0.80-0.89) showed the highest diagnostic accuracy in distinguishing IBD from SC. The diagnostic ability of biomarkers differed between IBD subtypes with the highest performance for FC and MPO in CD. The diagnostic accuracy was further improved by combining FC and MPO (p = 0.02). Levels of FC, MPO and HNL at inclusion were predictive of an aggressive disease course with MPO showing the strongest association (p = 0.006).CONCLUSIONS: This study provides new insight into the diagnostic and prognostic capability of neutrophil and eosinophil biomarkers in IBD and suggests that MPO, alone or in combination with FC, may add to the diagnostic power of faecal biomarkers.
|
|
| 44. |
- Ling Lundström, Maria, et al.
(författare)
-
Fecal Biomarkers of Neutrophil and Eosinophil Origin Reflect the Response to Biological Therapy and Corticosteroids in Patients With Inflammatory Bowel Disease
- 2023
-
Ingår i: Clinical and Translational Gastroenterology. - : Nature Publishing Group. - 2155-384X. ; 14:8
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Fecal calprotectin (FC) is anoninvasive tool for examining response to biologics in inflammatory boweldisease (IBD), but its performance in relation to other novel fecal markers of various cellular origins is unknown.Methods: We performed a prospective multicenter cohort study and included patients with active IBD who provided a fecal sample at initiation of biological therapy. Levels of FC, myeloperoxidase (MPO), human neutrophil lipocalin (HNL), and eosinophil-derived neurotoxin (EDN) were analyzed and related to clinical remission status at 3 months. Changes in levels of markers at 3 months were calculated, and the impact of concomitant use of corticosteroids at baseline was estimated.Results: In patients achieving clinical remission (n = 27), a decrease in levels of FC (P = 0.005), MPO (P < 0.001), HNL (P < 0.001), and EDN (P < 0.001) was observed, whereas no significant decrease was seen in patients not achieving remission (n = 39). There was a significant difference in the change in the level of MPO (P = 0.01) and HNL (P = 0.02) between patients achieving clinical remission and those who did not, but changes in FC and EDN could not differentiate between these groups. Patients with concomitant systemic corticosteroids at inclusion had lower levels of HNL (P = 0.01) and EDN (P < 0.001) at baseline, compared with patients without corticosteroids.Discussion: Fecal MPO, HNL, and EDN are all promising biomarkers for assessing the treatment outcome of biologics in patients with IBD. Fecal levels of EDN and HNL are significantly affected by corticosteroids indicating a greater sensitivity to the effects of corticosteroids compared with levels of FC and MPO.
|
|
| 45. |
|
|
| 46. |
- Mörner, Stellan, 1958-, et al.
(författare)
-
Profound cardiac conduction delay predicts mortality in myotonic dystrophy type 1.
- 2010
-
Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 268:1, s. 59-65
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Myotonic dystrophy type 1 (DM1) is known to affect mainly the musculoskeletal system. Early mortality is related to respiratory disease and possibly additional cardiovascular complications. Aims. To identify possible cardiovascular disturbances that could predict survival of DM1 patients. Methods. We studied 30 DM1 patients (mean age 41 +/- 13.5 years, range 16-71, 15 women) who were cardiovascularly stable and compared them with 29 controls (mean age 55 +/- 7.8 years, range 42-66, 14 women) using electrocardiography (ECG) and conventional transthoracic echocardiography. The subgroup that survived a follow-up period of 17 years was re-examined using the same protocol. Results. Of the 30 patients, 10 died of a documented respiratory cause and three of acute myocardial incidents. Compared with controls, left ventricular cavity size, corrected to body surface area, was slightly enlarged at end systole (P < 0.05) and hence fractional shortening was reduced (P < 0.01). Nine patients had first-degree heart block and 15 had a QRS duration >90 ms. Of all ECG and echocardiographic measurements, the sum of QRS duration + PR interval was the best predictor of mortality as shown by the area under the receiver operating characteristic curve of 85%, sensitivity of 70% and specificity of 84%. Conclusions. These findings suggest that silent cardiac dysfunction in DM1 patients may cause significant disturbances that over time result in serious complications. Regular follow-up of such patients with detailed electrical and mechanical cardiac assessment may suggest a need for early intervention that may avoid early mortality in some.
|
|
| 47. |
- Nerhed, Christer, et al.
(författare)
-
Introduction of an Integrated IT Environment for the Healthcare Process
- 2006
-
Ingår i: IFMBE Proceedings WC2003.
-
Konferensbidrag (refereegranskat)abstract
- Introduction of an Integrated IT Environment for the Healthcare ProcessC. Nerhed1, B. Ehrs2, J. Lindqvist1, L. Lyttkens2 and B-E Erlandson11 Medical Informatics and Engineering, University Hospital, S-751 85 Uppsala, Sweden,2 University Hospital, S-751 85 Uppsala, SwedenIntroductionA new IT architecture was introduced in 1998 in the County Council of Uppsala, which is the main healthcare provider with two hospitals, primary care and it supports the health care to the communities. The University Hospital has a yearly turnover of 4,8 billion Euro and 1.300 hospital beds. The vision is to implement a common IT infrastructure with integrated systems for the whole County, including the patient at home, supporting the healthcare processes to all healthcare providers.MethodsIntroduction of IT solutions is managed by healthcare professionals in cooperation with IT professionals. The user requirements and the need for changes of routines are in focus. The introduction is focused on operational issues, and the development is firmly supported by the management. Technically, we want to use standard systems on the market. New applications will be developed in close collaboration between users and vendors. Systemintegrations are performed using standards e.g. XML messages are used for communication with laboratories and pharmacies. Electronic Patient Records is based on the CEN pre-standard HISA.ResultsFunctionality for Patient Administration, i.e. planning/booking, order/request, billing/reimbursement and reports/statistics has already been implemented. Today we have over 9000 users. Functionality for Patient Documentation is now being introduced, including support for basal documentation and for medication. All healthcare professionals, all units and clinics within the County will use the system.DiscussionEfforts have been made in developing the functionality to reach a high usability level. One major issue is to integrate many systems, delivered by different vendors, built with different architectures. Open systems and collaborations between vendors and customers are needed. Integrated systems have to be easy to use and easy to manage. As systems are getting more and more interconnected coordination of activities when updating the systems for function, data integrity and uptime, are increasingly needed. Work has been initiated for integrating applications from two Swedish vendors. A national initiative from CareLink has been made, where vendors and healthcare providers are working closely to develop a “Reference Architecture” with the main purpose to enhance interoperability, and it is supported heavily by Uppsala University Hospital. We must be able to purchase “moduls” of functionality on a competitive market.ConclusionWe are moving forward towards our vision, where information about the patient always will be accessible for care providers and the patient, where and when needed. On the road ahead a lot of challenges must be overcome. Special attention will be given to integration of our applications including technical and operational aspects.
|
|
| 48. |
- Nyman, Emma, et al.
(författare)
-
Area measurement of carotid plaque comparing B-MODE, Doppler color and contrast-enhanced ultrasound imaging
- 2016
-
Ingår i: Atherosclerosis. - : Elsevier. - 0021-9150 .- 1879-1484. ; 252, s. E191-E191
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: Carotid plaque characteristic analysis are suggested to improve risk stratification. Plaque area and echolucent plaques have shown to correlate with increased risk for cardiovascular diseases. A limitation with B-mode imaging is the uncertainty that the whole plaque area is identified, primarily on echolucent plaques. Contrast-enhanced ultrasound (CEUS) is used to improve carotid imaging including better plaque area measurement. Aim: Evaluate if CEUS could improve accurate plaque area measurement compared with B-mode and Doppler color flow imaging. Methods: The study included 28 participants (50% females, mean age 58 years) with identified asymptomatic carotid plaques. We performed B-mode, Doppler color and CEUS ultrasound imaging whereas the plaque area was manually outdrawn by a single operator. Plaques were also subjectively classified as 1 echogenic, 2 echolucent, or 3 mixed plaques. Results: We did not find a significant difference in plaque area measurements between different ultrasound image modalities having all plaque types included. In the group of echolucent plaques (n= 11) we found a significant different between B-mode and CEUS (p=0.049) and also between B-mode and Doppler color imaging (p=0.039) (Illustrated in Fig 1). Conclusions: Echolucent plaque can be underestimated with B-mode imaging. Use of contrast-enhanced ultrasound should be considered in carotid plaque imaging on echolucent plaques when plaque outline is difficult to identify.
|
|
| 49. |
|
|
| 50. |
- Nyman, Emma, et al.
(författare)
-
Risk marker variability in subclinical carotid plaques based on ultrasound is influenced by cardiac phase, echogenicity and size
- 2018
-
Ingår i: Ultrasound in Medicine and Biology. - : Elsevier. - 0301-5629 .- 1879-291X. ; 44:8, s. 1742-1750
-
Tidskriftsartikel (refereegranskat)abstract
- Identification of risk markers based on quantitative ultrasound texture analysis of carotid plaques has the ability to define vulnerable components that correlate with increased cardiovascular risk. However, data describing factors with the potential to influence the measurement variability of risk markers are limited. The aim of this study was to evaluate the influence of electrocardiogram-guided image selection, plaque echogenicity and area on carotid plaque risk markers and their variability in asymptomatic carotid plaques. Plaque risk markers were measured in 57 plaques during three consecutive heartbeats at two cardiac cycle time instants corresponding to the electrocardiogram R-wave (end diastole) and end of T-wave (end systole), resulting in six measurements for each plaque. Risk marker variability was quantified by computing the coefficient of variation (CV) across the three heartbeats. The CV was significantly higher for small plaques (area <15 mm2, 10%) than for large plaques (area >15 mm2, 6%) (p <0.001) in measurements of area, and the CV for measurements of gray-scale median were higher for echolucent plaques (<40, 15%) than for echogenic plaques (>40, 9%) (p <0.001). No significant differences were found between systole and diastole for the mean of any risk marker or the corresponding CV value. However, in a sub-analysis, the echolucent plaques were found to have a higher CV during systole compared with diastole. The variability also caused plaque type reclassification in 16% to 25% of the plaques depending on cutoff value. The results of this study indicate that echolucent and small plaques each contribute to increased risk marker variability. Based on these results, we recommend that measurements in diastole arc preferred to reduce variation, although we found that it may not be possible to characterize small plaques accurately using contemporary applied risk markers.
|
|
