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| 2. |
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| 3. |
- Hedenstierna, Louise, et al.
(författare)
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Neither low social support nor low decision latitude at work is associated with disease remission among patients with rheumatoid arthritis : results from the Swedish EIRA study
- 2022
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Ingår i: Arthritis Research & Therapy. - : BioMed Central. - 1478-6362. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate the association between psychosocial vulnerability, defined as either low social support or low decision latitude at work, and disease remission at 3, 12, and 60 months in patients with rheumatoid arthritis (RA).METHODS: This cohort study included all patients enrolled in both the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA) 1996-2015 and the Swedish Rheumatology Quality Register (SRQ, n = 2820). Information on social support and decision latitude at work at RA diagnosis were identified from the EIRA questionnaire. Indexes for levels of social support and decision latitude at work, respectively, were calculated based on the questionnaire. Low social support and low decision latitude at work, respectively, were identified by a score in the lowest quartile and compared with the three other quartiles (not low). Disease-activity parameters were retrieved from SRQ at 3, 12, and 60 months. The associations between social support or decision latitude at work, respectively, and Disease Activity Score 28 joint count with C-reactive protein (DAS28-CRP) remission were analysed using logistic regression models adjusted for age, sex, smoking habits, alcohol habits, symptom duration, and educational level.RESULTS: Having low social support (n = 591) was not associated with DAS28-CRP remission at 3 (OR 0.93, 95% CI 0.74-1.16), 12 (OR 0.96, 95%CI 0.75-1.23), or 60 (OR 0.89, 95%CI 0.72-1.10) months compared to not low social support (n = 2209). No association was observed for low (n = 212) versus not low (n = 635) decision latitude at work and DAS28-CRP remission at 3 (OR 0.84, 95%CI 0.54-1.31), 12 (OR 0.81, 95%CI 0.56-1.16), or 60 (OR 1.37, 95%CI 0.94-2.01) months.CONCLUSION: In a country with general access to healthcare, psychosocial vulnerability does not influence the likelihood of achieving remission in early RA.
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| 4. |
- Lloyd-Spets, Anita, et al.
(författare)
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MISiCFET chemical gas sensors for high temperature and corrosive environment applications
- 2002
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Ingår i: Materials Science Forum. - 0255-5476 .- 1662-9752. ; 389-3, s. 1415-1418
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Tidskriftsartikel (refereegranskat)abstract
- A chemical gas sensor based on a silicon carbide field effect transistor with a catalytic gate metal has been under development for a number of years. The buried gate design allows the sensor to operate at high temperatures, routinely up to 600degreesC and for at least three days at 700degreesC. The chemical inertness of silicon carbide makes it a suitable sensor technology for applications in corrosive environments such as exhaust gases and flue gases from boilers. The selectivity of the sensor devices is established through the choice of type and structure of the gate metal as well as the operation temperature. In this way NH3 sensors with low cross sensitivity to NOx have been demonstrated as potential sensors for control of selective catalytic reduction (SCR) of NOx by urea injection into diesel exhausts. The hardness of the silicon carbide makes it for example more resistant to water splash at cold start of a petrol engine than existing technologies, and a sensor which can control the air to fuel ratio, before the exhaust gases are heated, has been demonstrated. Silicon carbide sensors are also tested in flue gases from boilers. Efficient regulation of the combustion in a boiler will decrease fuel consumption and reduce emissions.
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| 5. |
- Lloyd-Spets, Anita, et al.
(författare)
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SiC based field effect gas sensors for industrial applications
- 2001
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Ingår i: Physica status solidi. A, Applied research. - 0031-8965 .- 1521-396X. ; 185:1, s. 15-25
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Tidskriftsartikel (refereegranskat)abstract
- The development and field-testing of high-temperature sensors based on silicon carbide devices have shown promising results in several application areas. Silicon carbide based field-effect sensors can be operated over a large temperature range, 100-600 degreesC, and since silicon carbide is a chemically very inert material these sensors can be used in environments like exhaust gases and flue gases from boilers. The sensors respond to reducing gases like hydrogen, hydrocarbons and carbon monoxide. The use of different temperatures, different catalytic metals and different structures of the gate metal gives selectivity to different gases and arrays of sensors can be used to identify and monitor several components in gas mixtures. MOSFET sensors based on SIC combine the advantage of simple circuitry with a thicker insulator, which increases the long term stability of the devices. In this paper we describe silicon carbide MOSFET sensors and their performance and give: examples of industrial applications such as monitoring of car exhausts and flue gases. Chemometric methods have been used for the evaluation of the data.
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| 10. |
- Andersson, Lars Gustaf, et al.
(författare)
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Alberto Moravias De likgiltiga
- 1992
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Ingår i: Moderna klassiker. 16 föreläsningar om texter från vår tid. - 9188396002 ; 1, s. 117-128
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Bokkapitel (populärvet., debatt m.m.)abstract
- Analysis of the novel "Gli indifferenti" by Italian novelist Alberto Moravia
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| 11. |
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| 12. |
- Andersson, Lars Gustaf, et al.
(författare)
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Förälskelsemomentet
- 1999
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Ingår i: Den största lyckan. En bok till Vilhelm Ekelund. - 9186489968 ; , s. 33-37
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Bokkapitel (populärvet., debatt m.m.)abstract
- Short comparative study of Vilhelm Ekelund and Emanuel Swedenborg
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| 13. |
- Björkenstam, Charlotte, et al.
(författare)
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Suicide or undetermined intent? : A register-based study of signs of misclassification
- 2014
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Ingår i: Population Health Metrics. - : Springer Science and Business Media LLC. - 1478-7954. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several studies have concluded that some deaths classified as undetermined intent are in fact suicides, and it is common in suicide research in Europe to include these deaths. Our aim was to investigate if information on background variables would be helpful in assessing if deaths classified as undetermined intent should be included in the analyses of suicides. Methods: We performed a register study of 31,883 deaths classified as suicides and 9,196 deaths classified as undetermined intent in Sweden from 1987 to 2011. We compared suicide deaths with deaths classified as undetermined intent with regard to different background variables such as sex, age, country of birth, marital status, prior inpatient care for self-inflicted harm, alcohol and drug abuse, psychiatric inpatient care, and use of psychotropics. We also performed a multivariate analysis with logistic regression. Results: Our results showed differences in most studied background factors. Higher education was more common in suicides; hospitalization for self-inflicted harm was more common among female suicides as was prior psychiatric inpatient care. Deaths in foreign-born men were classified as undetermined intent in a higher degree and hospitalization for substance abuse was more common in undetermined intents of both sexes. Roughly 50% of both suicide and deaths classified as undetermined intent had a filled prescription of psychotropics during their last six months. Our multivariate analysis showed male deaths to more likely be classified as suicide than female: OR: 1.13 (1.07-1.18). The probability of a death being classified as suicide was also increased for individuals aged 15-24, being born in Sweden, individuals who were married, and for deaths after 1987-1992. Conclusion: By analyzing Sweden's unique high-validity population-based register data, we found several differences in background variables between deaths classified as suicide and deaths classified as undetermined intent. However, we were not able to clearly distinguish these two death manners. For future research we suggest, separate analyses of the two different manners of death.
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| 14. |
- Björkman, Alva, et al.
(författare)
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Accuracy and diagnostic performance of doppler echocardiography to estimate mean pulmonary artery pressure in heart failure
- 2021
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Ingår i: Echocardiography. - : John Wiley & Sons. - 0742-2822 .- 1540-8175. ; 38:9, s. 1624-1631
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Tidskriftsartikel (refereegranskat)abstract
- Background: Multiple echocardiographic algorithms have been proposed to estimate mean pulmonary artery pressure (PAPM) and assess pulmonary hypertension (PH) likelihood. We assessed the accuracy of four echocardiographic approaches to estimate PAPM in heart failure (HF) patients undergoing near-simultaneous right heart catheterization (RHC), and compared diagnostic performance to identify PH with recommendation-advised tricuspid regurgitation peak velocity (TRVmax).Methods: We employed four validated echocardiographic algorithms incorporating tricuspid regurgitation peak or mean gradient, pulmonary regurgitation peak gradient, and right ventricular outflow tract acceleration time to estimate PAPM. Echocardiographic estimates of right atrial pressure were incorporated in all algorithms but one. Association and agreement with invasive PAPM were assessed. Diagnostic performance of all algorithms to identify PH was evaluated and compared with the recommended TRVmax cut-off.Results: In 112 HF patients, all echocardiographic algorithms demonstrated reasonable association (r =.41–.65; p < 0.001) and good agreement with invasive PAPM, with relatively lower mean bias and higher precision observed in algorithms that incorporated tricuspid regurgitation peak or mean gradient. All methods demonstrated strong ability to identify PH (AUC =.70–.80; p < 0.001) but did not outperform TRVmax (AUC =.84; p < 0.001). Echocardiographic estimates of right atrial pressure were falsely elevated in 30% of patients.Conclusions: Echocardiographic estimates demonstrate reasonable association with invasive PAPM and strong ability to identify PH in HF. However, none of the algorithms outperformed recommendation-advised TRVmax. The incremental value of echocardiographic estimates of right atrial pressure may need to be re-evaluated.
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| 15. |
- Blennow Nordström, Erik, et al.
(författare)
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Neuropsychological outcome after cardiac arrest : results from a sub-study of the targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest (TTM2) trial
- 2023
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Ingår i: Critical Care. - : BioMed Central (BMC). - 1364-8535 .- 1466-609X. ; 27:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cognitive impairment is common following out-of-hospital cardiac arrest (OHCA), but the nature of the impairment is poorly understood. Our objective was to describe cognitive impairment in OHCA survivors, with the hypothesis that OHCA survivors would perform significantly worse on neuropsychological tests of cognition than controls with acute myocardial infarction (MI). Another aim was to investigate the relationship between cognitive performance and the associated factors of emotional problems, fatigue, insomnia, and cardiovascular risk factors following OHCA.METHODS: This was a prospective case-control sub-study of The Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial. Eight of 61 TTM2-sites in Sweden, Denmark, and the United Kingdom included adults with OHCA of presumed cardiac or unknown cause. A matched non-arrest control group with acute MI was recruited. At approximately 7 months post-event, we administered an extensive neuropsychological test battery and questionnaires on anxiety, depression, fatigue, and insomnia, and collected information on the cardiovascular risk factors hypertension and diabetes.RESULTS: Of 184 eligible OHCA survivors, 108 were included, with 92 MI controls enrolled. Amongst OHCA survivors, 29% performed z-score ≤ - 1 (at least borderline-mild impairment) in ≥ 2 cognitive domains, 14% performed z-score ≤ - 2 (major impairment) in ≥ 1 cognitive domain while 54% performed without impairment in any domain. Impairment was most pronounced in episodic memory, executive functions, and processing speed. OHCA survivors performed significantly worse than MI controls in episodic memory (mean difference, MD = - 0.37, 95% confidence intervals [- 0.61, - 0.12]), verbal (MD = - 0.34 [- 0.62, - 0.07]), and visual/constructive functions (MD = - 0.26 [- 0.47, - 0.04]) on linear regressions adjusted for educational attainment and sex. When additionally adjusting for anxiety, depression, fatigue, insomnia, hypertension, and diabetes, executive functions (MD = - 0.44 [- 0.82, - 0.06]) were also worse following OHCA. Diabetes, symptoms of anxiety, depression, and fatigue were significantly associated with worse cognitive performance.CONCLUSIONS: In our study population, cognitive impairment was generally mild following OHCA. OHCA survivors performed worse than MI controls in 3 of 6 domains. These results support current guidelines that a post-OHCA follow-up service should screen for cognitive impairment, emotional problems, and fatigue.TRIAL REGISTRATION: ClinicalTrials.gov, NCT03543371. Registered 1 June 2018.
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| 16. |
- Blennow Nordström, Erik, et al.
(författare)
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Neuropsychological outcome after cardiac arrest : A prospective case control sub-study of the Targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest trial (TTM2)
- 2020
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: This study is designed to provide detailed knowledge on cognitive impairment after out-of-hospital cardiac arrest (OHCA) and its relation to associated factors, and to validate the neurocognitive screening of the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest trial (TTM2-trial), assessing effectiveness of targeted temperature management after OHCA. Methods: This longitudinal multi-center clinical study is a sub-study of the TTM2-trial, in which a comprehensive neuropsychological examination is performed in addition to the main TTM2-trial neurocognitive screening. Approximately 7 and 24 months after OHCA, survivors at selected study sites are invited to a standardized assessment, including performance-based tests of cognition and questionnaires of emotional problems, fatigue, executive function and insomnia. At 1:1 ratio, a matched control group from a cohort of acute myocardial infarction (MI) patients is recruited to perform the same assessment. We aim to include 100 patients per group. Potential differences between the OHCA patients and the MI controls at 7 and 24 months will be analyzed with a linear regression, using composite z-scores per cognitive domain (verbal, visual/constructive, working memory, episodic memory, processing speed, executive functions) as primary outcome measures. Results from OHCA survivors on the main TTM2-trial neurocognitive screening battery will be compared with neuropsychological test results at 7 months, using sensitivity and specificity analyses. Discussion: In this study we collect detailed information on cognitive impairment after OHCA and compare this to a control group of patients with acute MI. The validation of the TTM2 neurocognitive screening battery could justify its inclusion in routine follow-up. Our results may have a potential to impact on the design of future follow-up strategies and interventions after OHCA. Trial registration: ClinicalTrials.gov, NCT03543371. Registered 1 June 2018
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| 17. |
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| 18. |
- Brink, Mikael, et al.
(författare)
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Anti-citrullinated protein antibody specificities and pulmonary fibrosis in relation to genetic loci in early rheumatoid arthritis
- 2022
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Ingår i: Rheumatology. - : Oxford University Press. - 1462-0324 .- 1462-0332. ; 61:12, s. 4985-4990
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Pulmonary manifestations in RA are common comorbidities, but the underlying mechanisms are largely unknown. The added value of a multiplex of ACPA and genetic risk markers was evaluated for the development of pulmonary fibrosis (PF) in an inception cohort. Methods A total of 1184 patients with early RA were consecutively included and followed prospectively from the index date until death or 31 December 2016. The presence of 21 ACPA fine specificities was analysed using a custom-made microarray chip (Thermo Fisher Scientific, Uppsala, Sweden). Three SNPs, previously found related to PF were evaluated, rs2609255 (FAM13A), rs111521887 (TOLLIP) and rs35705950 (MUC5B). ACPA and genetic data were available for 841 RA patients, of whom 50 developed radiologically defined PF. Results In unadjusted analyses, 11 ACPA specificities were associated with PF development. In multiple variable analyses, six ACPA specificities were associated with increased risk of PF: vimentin (Vim)60-75, fibrinogen (Fib)beta 62-78 (72), Fib alpha 621-635, Bla26, collagen (C)II359-369 and F4-CIT-R (P < 0.01 to P < 0.05). The number of ACPA specificities was also related to PF development (P < 0.05 crude and adjusted models). In multiple variable models respectively adjusted for each of the SNPs, the number of ACPA specificities (P < 0.05 in all models), anti-Vim60-75 (P < 0.05, in all models), anti-Fib beta 62-78 (72) (P < 0.001 to P < 0.05), anti-CII359-369 (P < 0.05 in all models) and anti-F4-CIT-R AQ4 (P < 0.01 to P < 0.05), anti-Fib alpha 621-635 (P < 0.05 in one) and anti-Bla26 (P < 0.05 in two) were significantly associated with PF development. Conclusion The development of PF in an inception cohort of RA patients was associated with both presence of certain ACPA and the number of ACPA specificities and risk genes.
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| 19. |
- Brooke, Hannah Louise, et al.
(författare)
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The Swedish cause of death register
- 2017
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Ingår i: European Journal of Epidemiology. - : Springer. - 0393-2990 .- 1573-7284. ; 32:9, s. 765-773
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Tidskriftsartikel (refereegranskat)abstract
- Sweden has a long tradition of recording cause of death data. The Swedish cause of death register is a high quality virtually complete register of all deaths in Sweden since 1952. Although originally created for official statistics, it is a highly important data source for medical research since it can be linked to many other national registers, which contain data on social and health factors in the Swedish population. For the appropriate use of this register, it is fundamental to understand its origins and composition. In this paper we describe the origins and composition of the Swedish cause of death register, set out the key strengths and weaknesses of the register, and present the main causes of death across age groups and over time in Sweden. This paper provides a guide and reference to individuals and organisations interested in data from the Swedish cause of death register.
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| 20. |
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| 21. |
- Dong, Yang, et al.
(författare)
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HEARTBREAK Controls Post-translational Modification of INDEHISCENT to Regulate Fruit Morphology in Capsella
- 2020
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Ingår i: Current Biology. - : Elsevier BV. - 0960-9822 .- 1879-0445. ; 30:19, s. 3880-3888
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Tidskriftsartikel (refereegranskat)abstract
- Morphological variation is the basis of natural diversity and adaptation. For example, angiosperms (flowering plants) evolved during the Cretaceous period more than 100 mya and quickly colonized terrestrial habitats [1]. A major reason for their astonishing success was the formation of fruits, which exist in a myriad of different shapes and sizes [2]. Evolution of organ shape is fueled by variation in expression patterns of regulatory genes causing changes in anisotropic cell expansion and division patterns [3-5]. However, the molecular mechanisms that alter the polarity of growth to generate novel shapes are largely unknown. The heart-shaped fruits produced by members of the Capsella genus comprise an anatomical novelty, making it particularly well suited for studies on morphological diversification [6-8]. Here, we show that post-translational modification of regulatory proteins provides a critical step in organ-shape formation. Our data reveal that the SUMO protease, HEARTBREAK (HTB), from Capsella rubella controls the activity of the key regulator of fruit development, INDEHISCENT (CrIND in C. rubella), via de-SUMOylation. This post-translational modification initiates a transduction pathway required to ensure precisely localized auxin biosynthesis, thereby facilitating anisotropic cell expansion to ultimately form the heart-shaped Capsella fruit. Therefore, although variation in the expression of key regulatory genes is known to be a primary driver in morphological evolution, our work demonstrates how other processes-such as post-translational modification of one such regulator-affects organ morphology.
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| 22. |
- Franzén, Lars, 1950, et al.
(författare)
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A carbon fibre composite (CFC) Byelorussian peat corer.
- 2009
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Ingår i: Mires and Peat. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- New composite materials offer the possibility to construct equally strong or even stronger field instrumentation than those made by steel or other metals. We have constructed a lightweight carbon fibre composite (CFC) Byelorussian (Russian) peat corer with this new material. On the positive side is a significant weight reduction. The total weight of a 10.5 metre coring set adds up at only 5.2 kg, whereas similar standard stainless and soft steel equipment weighs around 16 kg i.e. a weight reduction of almost 70 per cent. The 500 mm long and 65 mm inner diameter CFC sample shuttle contains little less that twice the amount of peat collected with a standard 45 mm i.d. steel corer. 30 mm rods are used which makes the set more ergonomic and the CFC has better thermic properties for winter use. On the positive side is also an eliminated risk of contamination from the corer material, notably from chromium and nickel. Whereas the CFC sampler works well in softer peats such as Sphagnum and Carex types it is less suitable for less decomposed fibrous and forest peats such as “Polytrichum” and those containing hardwood remnants, especially in more compacted bottom layers. It should work fine with organic lake sediments, but less well with stiffer coarse mineral deposits.
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| 23. |
- Holmberg, Lars, et al.
(författare)
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Measurement of antihaemophilic factor A antigen (VII:CAg) with a solid phase immunoradiometric method based on homologous non-haemophilic antibodies.
- 1979
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Ingår i: Scandinavian Journal of Haematology. - 0036-553X. ; 23:1, s. 17-24
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Tidskriftsartikel (refereegranskat)abstract
- Antihaemophilic-factor-A-antibodies, which had spontaneously arisen in 2 patients, were used to develop an immunoradiometric method for measurement of antihaemophilic factor A antigen (VIII:CAg). 13 patients with severe haemophilia A had VIII: CAg below the limit of detection (0.01 U/ml). Patients with moderate and mild haemophilia A either had VIII:CAg roughly equal to factor VIII clotting activity (VIII:C) or a not detectable VIII:CAg, suggesting 2 different molecular mechanisms in moderate and mild haemophilia A. VIII:CAg could be detected in serum but in lower amounts than in plasma. In 2 patients with von Willebrand's disease VIII:CAg equalled VIII:C. The post-transfusional retarded increase of VIII:C in 1 patient with von Willebrand's disease was accompanied by a slight increase in VIII:CAg. Fetal plasma contained measurable amounts of VIII:CAg.
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| 24. |
- 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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| 25. |
- Holmberg, Lars, et al.
(författare)
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The effects of plasmin and protein Ca on factor VIII:C and VIII:CAg
- 1983
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Ingår i: Thrombosis Research. - : Elsevier BV. - 0049-3848. ; 31:1, s. 41-50
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Tidskriftsartikel (refereegranskat)abstract
- The effects of various concentrations of plasmin and activated protein C on the factor VIII procoagulant activity (VIII:C) and coagulant antigen (VIII:CAg) were studied in factor VIII concentrates and normal plasma. Small amounts (0.1 CTA U/ml) of plasmin rapidly destroyed VIII:C, and affected, but did not destroy VIII:CAg, in factor VIII concentrates. In normal plasma larger amounts of plasmin (1.8 CTA U/ml) was required to inactivate VIII:C in order to exceed the neutralizing capacity of alpha 2-antiplasmin. VIII:CAg was unchanged indicating a limited proteolysis. The difference between VIII:C and VIII:CAg was found also in urokinase-activated plasma. Activated protein C (5 micrograms/ml), in the presence of Ca2+ and phospholipids, inactivated VIII:C without affecting VIII:CAg in a high purity factor VIII concentrate. Higher concentrations of activated protein C (25 micrograms/ml) caused a slight decrease of VIII:CAg, even in the absence of Ca2+ and phospholipids, but did not change VIII:CAg in normal plasma or serum.
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| 26. |
- Janszky, Imre, et al.
(författare)
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Daylight saving time shifts and incidence of acute myocardial infarction - Swedish Register of Information and Knowledge About Swedish Heart Intensive Care Admissions (RIKS-HIA)
- 2012
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Ingår i: Sleep Medicine. - : Elsevier. - 1389-9457 .- 1878-5506. ; 13:3, s. 237-242
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Tidskriftsartikel (refereegranskat)abstract
- Background: Daylight saving time shifts can be looked upon as large-scale natural experiments to study the effects of acute minor sleep deprivation and circadian rhythm disturbances. Limited evidence suggests that these shifts have a short-term influence on the risk of acute myocardial infarction (AMI), but confirmation of this finding and its variation in magnitude between individuals is not clear. less thanbrgreater than less thanbrgreater thanMethods: To identify AMI incidence on specific dates, we used the Register of Information and Knowledge about Swedish Heart Intensive Care Admission, a national register of coronary care unit admissions in Sweden. We compared AMI incidence on the first seven days after the transition with mean incidence during control periods. To assess effect modification, we calculated the incidence ratios in strata defined by patient characteristics. less thanbrgreater than less thanbrgreater thanResults: Overall, we found an elevated incidence ratio of 1.039 (95% confidence interval, 1.003-1.075) for the first week after the spring clock shift forward. The higher risk tended to be more pronounced among individuals taking cardiac medications and having low cholesterol and triglycerides. There was no statistically significant change in AMI incidence following the autumn shift. Patients with hyperlipidemia and those taking statins and calcium-channel blockers tended to have a lower incidence than expected. Smokers did not ever have a higher incidence. less thanbrgreater than less thanbrgreater thanConclusions: Our data suggest that even modest sleep deprivation and disturbances in the sleep-wake cycle might increase the risk of AMI across the population. Confirmation of subgroups at higher risk may suggest preventative strategies to mitigate this risk.
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| 27. |
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| 28. |
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| 29. |
- Jonsson, Malin, et al.
(författare)
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Biomechanical differences in double poling (DP) for world- and national-class female elite cross-country (XC) skiers during a 10-km classical race
- 2016
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Ingår i: Proceedings ICSS in St. Christoph am Arlberg, Austria.
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Konferensbidrag (refereegranskat)abstract
- Introduction The DP technique of classical XC-skiing involves both the upper and lower body (Holmberg et al.,2005) and has become more important the last years with skiers using exclusively DP during some competitions. Our purpose was to characterize biomechanical differences in DP by world- (WC) and national-class (NC) women skiers. Methods The participants were 40 elite female XC skiers (20 WC and 20 NC) who competed in the 10-km classical race at the Norwegian National Championships, 2016. On a flat measurement section (22 m long) 0.8 km from the start, the skiers employed DP only and were video-filmed (Panasonic GH4, 96 Hz). Three DP cycles were analyzed using the Kinovea software (France, v 8.25) for joint and pole angles at pole plant (PP) and pole off (PO), as well as cycle length (CL) and rate (CR), and poling (PT) and swing times (ST). Results The total racing time for the WC-group was 10.5% faster than for the NC-skiers, with no differences in CL, CR, PT or ST. The WC-group skied faster on the flat section (6.30±0.23 vs 6.04±0.25 m/s) and exhibited a smaller ankle-shoulder angle relative to horizontal at PP (73.0±1.8 vs 75.0±1.5°) and a smaller hip angle at PO (62.7±5.2 vs 69.1±6.4°) with no difference in minimal trunk angle with respect to horizontal (19.2±3.2 vs 21.7±4.8°). 27 of the skiers (15 WC and 12 NC) used active heel raise to create force. There was a difference between the groups for when the heel raise ended, with the NC-group stopping just before PP and the WC-group after. No difference between the groups were found for when the heel raise started . There was a negative correlation between DP velocity and total racing time (r = -0.48, p<0.05) and a positive correlation between total racing time and the ankle-shoulder angle relative to horizontal at PP (r = 0.54, p<0.01), the hip angle at PO (r = 0.51, p<0.01) and minimal trunk angle relative to horizontal during the cycles (r = 0.41, p<0.01). Discussion The WC-group had 4.1% higher DP velocity which correlated with total racing time. Moreover, the finding that faster skiers have a more forward lean of the body at PP and a better timing of the ending of the heel raise, indicates that they can bring more bodyweight on their poles at PP. The WC-group had a smaller hip angle at PO which is in line with the findings of Lindinger et al.(2009). This study shows the importance of a high relative velocity during DP sections of the track and highlights the benefit of a more forward body position at PP to create higher DP velocity in female XC skiers. References Holmberg, H.C., Lindinger, S., Stöggl, T., Eitzlmair, E. & Müller, E. (2005). Biomechanical analysis of double poling in elite cross-country skiers. Med Sci Sports Exerc, 37(5), 807-818 Lindinger, S., Stöggl, T., Müller, E. & Holmberg, H.C. (2009). Control of speed during the double poling technique performed by elite cross-country skiers. Med Sci Sports Exerc, 41(1), 210-220
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| 30. |
- Klein, Inger, et al.
(författare)
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Framstående utbildningsmiljö - Hur blir man det?
- 2008
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Ingår i: Nätverket Ingenjörsutbildningarnas Utvecklingskonferens 2008.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Studierektorsområdet Reglersystem vid LiTH (Tekniska Högskolan vid Linköpings universitet) tilldelades 2007 utmärkelsen Framstående Utbildningsmiljö av Högskoleverket. Utmärkelsen gavs till sammanlagt fem utbildningsmiljöer, varav två är verksamma inom ingenjörsutbildning. I detta bidrag avser vi att redogöra för denna process och de faktorer som främst bidrog till att området Reglersystem fick denna utmärkelse. De faktorer som lyfts fram som centrala för att åstadkomma en god utbildningskvalité är framför allt att ha tydliga mål för utbildningen, en gedigen ämnesmässig grund, en väl fungerande organisation och positiv attityd bland alla medverkande samt former för lärande och examination som är anpassade till utbildningens mål.
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| 31. |
- Kluge, N. E. Jimmy, et al.
(författare)
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An Experimental Study of Temperature Distribution in an Autoclave
- 2016
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Ingår i: Journal of reinforced plastics and composites (Print). - : SAGE Publications. - 0731-6844 .- 1530-7964. ; 35:7, s. 566-578
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Tidskriftsartikel (refereegranskat)abstract
- In this work, the temperature distribution on an industrial mold tool is monitored during autoclave runs with three settings. In one of the settings, the temperature and pressure follow a scheme used in real moldings, while in the other two cases, the temperature is increased as fast as possible with and without an applied pressure. The temperature difference over the tool is relatively large and varies between 29℃ and 76℃ validating a detailed investigation of the temperature at different points. Two results of this are that positions on the up-stream side of the tool are heated faster than positions down-stream and the heating over the tool is symmetric while that within is asymmetric. Roughly estimated heat transfer coefficients reveal that the temperature ramping has no significant effect on the local heat transfer coefficients while the applied pressure more than doubled them. In addition flow field measurements with particle image velocimetry are performed, revealing a very slow flow near the roof of the autoclave and a velocity peak near the floor of it, indicating that the flow profile within the autoclave and variation in heat transfer coefficients should be considered in autoclave simulations.
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| 32. |
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| 33. |
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| 34. |
- Ljung Faxén, Ulrika, et al.
(författare)
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HFpEF and HFrEF Display Different Phenotypes as Assessed by IGF-1 and IGFBP-1
- 2017
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Ingår i: Journal of Cardiac Failure. - : Elsevier BV. - 1071-9164 .- 1532-8414. ; 23:4, s. 293-303
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAnabolic drive is impaired in heart failure with reduced ejection fraction (HFrEF) but insufficiently studied in heart failure with preserved ejection fraction (HFpEF). Insulin-like growth factor 1 (IGF-1) mediates growth hormone effects and IGF binding protein 1 (IGFBP-1) regulates IGF-1 activity. We tested the hypothesis that HFpEF and HFrEF are similar with regard to IGF-1 and IGFBP-1.Methods and ResultsIn patients with HFpEF (n = 79), HFrEF (n = 85), and controls (n = 136), we analyzed serum IGF-1 and IGFBP-1 concentrations, correlations, and associations with outcome. Age-standardized scores of IGF-1 were higher in HFpEF, median arbitrary units (interquartile range); 1.21 (0.57–1.96) vs HFrEF, 0.09 (-1.40–1.62), and controls, 0.22 (-0.47-0.96), P overall <.001. IGFBP-1 was increased in HFpEF, 48 (28–79), and HFrEF, 65 (29–101), vs controls, 27(14–35) µg/L, P overall <.001. These patterns persisted after adjusting for metabolic and HF severity confounders. IGF-1 was associated with outcomes in HFrEF, hazard ratio per natural logarithmic increase in IGF-1 SD score 0.51 (95% confidence interval 0.32–0.82, P = .005), but not significantly in HFpEF. IGFBP-1 was not associated with outcomes in either HFpEF nor HFrEF.ConclusionHFpEF and HFrEF phenotypes were similar with regard to increased IGFBP-1 concentrations but differed regarding IGF-1 levels and prognostic role. HFrEF and HFpEF may display different impairment in anabolic drive.
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| 35. |
- Ljung Faxen, Ulrika, et al.
(författare)
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HFpEF and HFrEF exhibit different phenotypes as assessed by leptin and adiponectin
- 2017
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 228, s. 709-716
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Tidskriftsartikel (refereegranskat)abstract
- Background: Heart failure with reduced ejection fraction (HFrEF) exhibits a reverse metabolic profile. Whether this profile exists in HF with preserved ejection fraction (HFpEF) is unknown. We tested the hypothesis that HFpEF and HFrEF are similar regarding concentrations of and prognostic impact of leptin and adiponectin.Methods: In patients with HFpEF(n = 79), HFrEF(n = 84), and controls(n = 71), we analyzed serum leptin and adiponectin concentrations, their correlations, and associations with outcome.Results: Leptin levels in HFpEF and HFrEF were increased (p < 0.05) compared to controls; with the highest levels in HFpEF, median (IQR), 23.1 (10.2-51.0), vs. HFrEF 15.0 (6.2-33.2), and vs. controls 10.8 (5.4-18.9) ng/mL. There was no difference between HFpEF and HFrEF p=0.125 (adjusted for gender, BMI and age). Leptin was inversely associated with NT-proBNP (r = -0.364 p = 0.001) and associated with better outcome in HFrEF (HR per ln increase of leptin 0.76, 95% CI 0.58-0.99, p = 0.044) but not in HFpEF.Crude levels of adiponectin were similar in HFpEF: 11.8 (7.9-20.1), HFrEF: 13.7 (7.0-21.1), and controls: 10.5 (7.4-15.1) mu g/L. In men, adjusted similarly as leptin, there was no difference between HFpEF and HFrEF, p = 0.310 but, compared to controls, higher levels in HFpEF (p - 0.044) and HFrEF (p - 0.001). Adiponectin correlated positively with NT-proBNP; r = 0.396 p < 0.001 and higher levels were associated with adverse outcome only in HFrEF (HR per ln increase 2.88 (95% CI 1.02-8.14, p = 0.045).Conclusion: HFpEF and HFrEF share elevated levels of leptin and adiponectin. However, the concept of reverse metabolic profile could not be confirmed in HFpEF, suggesting that HFpEF might have a conventional metabolic profile, rather than a distinct HF syndrome.
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| 36. |
- Ljung Faxen, Ulrika, et al.
(författare)
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N-terminal pro-B-type natriuretic peptide in chronic heart failure: The impact of sex across the ejection fraction spectrum
- 2019
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Ingår i: International Journal of Cardiology. - : ELSEVIER IRELAND LTD. - 0167-5273 .- 1874-1754. ; 21, s. 225-225
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim was to assess sex-specific differences in N-terminal B-type natriuretic peptide (NT-proBNP) regarding concentrations, predictors of high concentrations, and prognostic role, in a large and unselected population with chronic heart failure (HF) with preserved (HFpEF), mid-range (HFmrEF), and reduced ejection fraction (HFrEF). Methods and results: In 9847 outpatients with HFpEF, HFmrEF, and HFrEF (49 vs. 35 vs. 25% females, respectively) from the Swedish HF Registry, median NT-proBNP concentrations were 1598 ng/L in females vs. 1310 ng/L in males in HFpEF, 1764 vs. 1464 ng/L in HFmrEF, and 2543 vs. 2226 ng/L in HFrEF (p amp;lt; 0.05 for all). The differences persisted after multiple adjustment. The largest sex-difference in NT-proBNP levels was observed in HFpEF with sinus rhythm, where median concentrations were 1.4 folds higher in females (923 vs. 647 ng/L). Independent predictors of NT-proBNP levels (defined as above the different medians according to sex and HF phenotype) were overall consistent across sexes and EF. NT-proBNP levels were similarly associated with risk of all-cause death/HF hospitalization in both sexes regardless of EF. Conclusion: Concentrations of NT-proBNPwere higher in females across the EF spectrum, with larger relative differences in HFpEF with sinus rhythm. However, similar predictors of high levels were observed in both sexes. There were no sex-differences in the prognostic role of NT-proBNP. These findings support the use of NT-proBNP for prognostic purposes in chronic HF, regardless of sex. (c) 2019 Elsevier B.V. All rights reserved.
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| 37. |
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| 38. |
- Ljung, Lotta, et al.
(författare)
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Response to biological treatment and subsequent risk of coronary events in rheumatoid arthritis
- 2016
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 0003-4967 .- 1468-2060. ; 75:12, s. 2087-2094
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Whether the increased risk of comorbidities, such as cardiovascular disease, in rheumatoid arthritis (RA) can be reverted by particular antirheumatic therapies, or response to these, is unclear but of critical clinical importance. We wanted to investigate whether response to tumour necrosis factor inhibitors (TNFi) translates into a reduced risk for acute coronary syndrome (ACS). Methods A cohort of patients with RA initiating a first TNFi 2001-2012 was identified in the Swedish Biologics Register. The association between European League Against Rheumatism (EULAR) response after 3-8 months of treatment (assessed using the first, the best and the measurement closest to 5 months, respectively), and the risk of incident ACS during the subsequent year was analysed in Cox regression models. Adjustments included cardiovascular risk factors, joint surgery, RA duration, education and work disability. Results During 6592 person-years among TNFi initiators (n=6864, mean age 55 years, 77% women), 47 ACS occurred. The adjusted HRs (95% CI), which were similar to the crude HRs, of the 1-year risk of ACS among EULAR good responders compared with non-responders were 0.5 (0.2 to 1.4), 0.4 (0.2 to 0.9) and 0.5 (0.2 to 1.2), for the first, the best and the evaluation closest to 5 months, respectively. EULAR moderate responders had equal risk to that of EULAR non-responders, who, compared with the general population referents (n=34 229), had a more than twice the risk of ACS. For good responders, there was no statistically significant difference in risk versus the general population. Conclusions Optimised RA disease control has the potential to revert otherwise increased risks for ACS in RA.
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| 39. |
- Ljung, Oskar, et al.
(författare)
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Integration of Simulation and Manufacturing Engineering Software - Allowing Work Place Optimization Based on Time and Ergonomic Parameters
- 2020
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Ingår i: DHM2020. - Amsterdam : IOS Press. - 9781643681047 - 9781643681054 ; , s. 342-347
-
Konferensbidrag (refereegranskat)abstract
- There is a constant strive in industry to be competitive on the market, to manufacture with quality and productivity. At the same time, it is important to offer workers a sustainable work life. Research has shown a clear relationship between poor ergonomics and productivity losses and quality deficiencies, e.g. due to assembly errors, which also causes large costs for companies. In spite of the abovementioned relationship, productivity, ergonomics and quality are commonly treated separately in factory, line and workstation planning. To improve the factory, line and workstation planning, make it more efficient, ergonomic and to improve quality this paper proposes a concept that enables line balancing that considers two parameters in parallel, assembly time and ergonomic load as well as add possibility for mathematical optimization. The concept has been developed in a participative and iterative process. Two software tools and a simulation platform, the digital human modelling tool IPS IMMA, the balancing tool AVIX and the optimization platform EPP, have been used to demonstrate the concept. An integrated solution is formed. The integrated demonstration tool shows promising results. The demonstrator provides the possibility to manually optimize ergonomics and time in parallel, a relatively unique functionality.
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| 40. |
- Ljung, R, et al.
(författare)
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Detection of factor IX inhibitors by immunoradiometric assay
- 1983
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Ingår i: Acta Haematologica. - 0001-5792. ; 70:5, s. 11-307
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Tidskriftsartikel (refereegranskat)abstract
- An immunoradiometric assay (IRMA) for the determination of factor IX inhibitors in haemophilia B was developed. The assay was based on competitive binding between radiolabelled anti-IX and inhibitors in the test material of immobilized IX:C. 5 haemophiliacs with known inhibitors were investigated with the new method and with a conventional neutralization test. An inhibitor titre as low as 5 X 10(-4) U/ml could be measured by IRMA, showing it to be about 500 times as sensitive as the conventional neutralization assay used, and in 2 cases the inhibitors could only be detected by IRMA. The new method is thus useful for the investigation of patients with low inhibitor titres, or when inhibitors with divergent properties are suspected.
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| 41. |
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| 42. |
- Ljung, R, et al.
(författare)
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Fanconi's anaemia associated with haemophilia A
- 1979
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Ingår i: Clinical Genetics. - : Wiley. - 0009-9163 .- 1399-0004. ; 16:5, s. 8-364
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Tidskriftsartikel (refereegranskat)abstract
- Fanconi's anaemia and haemophilia A are born inherited diseases creating haemostatic defects. The association of these two rare diseases in one patient is described. The patient's haemophilia was studied with a newly developed immunological technique determining the plasma antigen associated with Factor VIII activity, and was found to be a genetic variant of moderately severe haemophilia A. It was not possible to demonstrate a common bone marrow defect or a common immunological or genetical background of the two diseases. The double haemostatic defect created, i.e. Factor VIII deficiency and thrombocytopenia, resulted in only a slight increase in bleeding tendency. A favourable result was obtained with corticosteroid and androgenic treatment.
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| 43. |
- Ljung, R, et al.
(författare)
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Genetic variants of haemophilia B detected by immunoradiometric assay : implications for prenatal diagnosis
- 1982
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Ingår i: Pediatric Research. - : Springer Science and Business Media LLC. - 0031-3998 .- 1530-0447. ; 16:3, s. 8-256
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Tidskriftsartikel (refereegranskat)abstract
- Fifty patients with haemophilia B, belonging to 29 kindreds, were investigated with a highly sensitive immunoradiometric assay based on a homologous antibody to factor IX. The assay measures factor IX antigen (f.IX:Ag) in plasma down to 0.025 U/dl. Seventeen of 18 investigated patients with severe haemophilia B had very little or no f.IX:Ag. Also four of nine patients with moderately severe disease had very low antigen levels, approximately equal to their factor IX clotting activity (f.IX:C), whereas the other 5 had antigen in excess of activity. Of the 23 investigated patients with mild haemophilia B, 20 had f.IX:Ag approximately equal to f.IX:C, whereas 3 had normal amounts of antigen. One family with mild disease was found to have a possible variant of haemophilia B Leyden, earlier described in a few families with moderately severe disease. No haemophilia BM variants, characterized by prolonged prothrombin time with bovine brain thromboplastin, were found. We have shown earlier that the immunoradiometric assay of f.IX was useful in the prenatal evaluation of one fetus at risk for haemophilia B. The present study shows that the assay can be applied for prenatal diagnostic purposes in the vast majority of carriers of severe haemophilia B and in about half of the carriers of moderately severe disease.
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| 44. |
- Ljung, R, et al.
(författare)
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Haemophilia A and B--two years experience of genetic counselling and prenatal diagnosis
- 1982
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Ingår i: Clinical Genetics. - : Wiley. - 0009-9163 .- 1399-0004. ; 22:2, s. 70-75
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Tidskriftsartikel (refereegranskat)abstract
- Haemophilia A. Thirty-one pregnant women, obligate or probable carriers of haemophilia A, requested prenatal diagnosis if sex determination showed the foetus to be a male. In 11 of the 31 cases the foetuses were females; in two, the genetic variant of the disease rendered prenatal diagnosis impossible; and in two, the mother aborted spontaneously. From the remaining 16 male foetuses, blood samples were obtained in utero in the 17th to 20th week of gestation. Examination of the samples showed that 11 of the foetuses were unaffected and five affected. Haemophilia B. Three carriers of haemophilia B had male foetuses. Examination of foetal blood obtained in utero showed that these three foetuses were affected. Confirmation. All women with an affected foetus requested termination of pregnancy. In one of the cases of abortion, no blood was obtained for confirmative examination. In the remaining cases, the prenatal prediction was confirmed in the abortus or in the child after birth; three women are still pregnant.
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| 45. |
- Ljung, Rolf, et al.
(författare)
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Immunoradiometric assay of inhibitors of antihaemophilic factor A
- 1982
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Ingår i: Acta Paediatrica Scandinavica. - 0001-656X. ; 71:6, s. 1019-1023
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Tidskriftsartikel (refereegranskat)abstract
- An immunoradiometric assay (IRMA) for determination of antibodies against f. VIII:C in haemophilia A was developed. The assay was based on competitive binding of radiolabelled anti-VIII:C and antibodies in the test material to immobilized VIII:C. Fifteen haemophiliacs with known inhibitors were investigated with the new method and with a conventional neutralization test. In 3 cases the inhibitors were detected only with the IRMA and in the other 12 there was good agreement between the inhibitor levels found with the two methods. It was also possible to demonstrate the antibodies in three non-haemophilic patients with acquired inhibitors. The IRMA, which can detect the antibodies down to a concentration of 0.02 inhibitor units per ml, is more sensitive than conventional neutralization tests and is thus of practical importance in the investigation of patients with low inhibitor titres.
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| 46. |
- Ljung, R, et al.
(författare)
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Inheritable molecular variants of moderate and mild hemophilia A
- 1981
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Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 209:1-2, s. 11-16
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Tidskriftsartikel (refereegranskat)abstract
- Factor VIII clotting activity (VIII:C) and factor VIII clotting antigen (VIII:CAg) were investigated in 54 patients with hemophilia A of moderate or mild severity. The patients belonged to 28 kindreds. The study showed a genetically determined molecular variation within hemophilia A of both moderate and mild forms. Each form can be classified into 3 types according to the content of demonstrable VIII:CAg. Type I has no demonstrable VIII:CAg, type IIa has VIII:CAg in an amount smaller than, or approximately equal to, that of VIII:C and type IIb has a larger amount of VIII:CAg than VIII:C. Affected members of one and the same kindred always have the same type of the disease.
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| 47. |
- Ljung, R., et al.
(författare)
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Platelet-associated IgG in childhood idiopathic thrombocytopenic purpura : measurements on intact and solubilized platelets and after gammaglobulin treatment
- 1986
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Ingår i: Scandinavian Journal of Haematology. - : Wiley. - 0036-553X. ; 36:4, s. 402-407
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Tidskriftsartikel (refereegranskat)abstract
- An immunoradiometric assay was developed for determining platelet-associated IgG (PAIgG) both on intact and solubilized platelets. In 20 healthy subjects PAIgG was 0.28 ± 0.20 ng/106 platelets and 2.2 ± 1.1 ng/106 platelets on intact and on solubilized platelets, respectively. 13 children with acute ITP all had increased concentrations of PAIgG, but no correlation was found between the severity of thrombocytopenia and PAIgG concentrations, either on intact or on solubilized platelets. Neither was there any correlation of the increase in PAIgG between intact and solubilized preparations. 3 out of 4 children who received high-dose i.v. gammaglobulin showed a concomitant normalization of the platelet count and of the PAIgG concentration both on intact and lyzed platelets. The remaining child did not respond to gammaglobulin and continued to have abnormal PAIgG.
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| 48. |
- Ljung, R., et al.
(författare)
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Purification of F.VIII:C by antigen-antibody chromatography
- 1978
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Ingår i: Thrombosis Research. - : Elsevier BV. - 0049-3848. ; 12:4, s. 667-675
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Tidskriftsartikel (refereegranskat)abstract
- Purification of F.VIII:C devoid of F.VIII:Ag was achieved by antigen-antibody chromatography. The antibody used neutralized VIIIR:Ag but not VIII:C in liquid phase but extracted both VIII:Ag and VIII:C from plasma when bound to Sepharose. VIII:C was eluted with calcium-containing buffer. When plasma was used as starting material VIII:C was obtained free from VIIIR:Ag but contaminated with some other proteins. When a well-defined pure F.VIII preparation was used as starting material the VIII:C active fractions contained no immunoradiometrically detectable VIIIR:Ag, no VIIIR:RCF and no detectable protein. When stabilized with albumin VIII:C could be frozen and thawed with retained activity and could be activated with thrombin.
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| 49. |
- Ljung, Tryggve, et al.
(författare)
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Granulocyte, monocyte/macrophage apheresis for inflammatory bowel disease : the first 100 patients treated in Scandinavia
- 2007
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Ingår i: Scandinavian Journal of Gastroenterology. - Oslo : Taylor & Francis. - 0036-5521 .- 1502-7708. ; 42:2, s. 221-227
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Selective leukocyte apheresis is a new type of non-pharmacological treatment for patients with active ulcerative colitis and Crohn's disease. Preliminary data have indicated that this type of therapy is safe and efficacious, and large sham-controlled studies are currently in progress. In Scandinavia, a substantial number of patients with chronic inflammatory bowel disease have already received leukocyte apheresis on a compassionate use basis and the aim of this study was to report the clinical outcome and adverse events in the first patients treated. MATERIAL AND METHODS: Clinical details of the first consecutive 100 patients with inflammatory bowel disease treated with granulocyte, monocyte/macrophage (Adacolumn) apheresis in Scandinavia were prospectively registered. Median length of follow-up was 17 months, (range 5-30). RESULTS: The study population comprised 52 patients with ulcerative colitis, 44 patients with Crohn's disease and 4 patients with indeterminate colitis. In 97 patients the indication for Adacolumn treatment was steroid-refractory or steroid-dependent disease. Clinical remission was attained in 48% of the patients with ulcerative colitis, and an additional 27% had a clinical response to the apheresis treatment. The corresponding figures for patients with Crohn's disease were 41% and 23%, respectively. Complete steroid withdrawal was achieved in 27 out of the 50 patients taking corticosteroids at baseline. Adverse events were reported in 15 patients and headache was most frequently reported (n=7). CONCLUSIONS: Granulocyte, monocyte/macrophage apheresis treatment seems to be a valuable adjuvant therapy in selected patients with refractory inflammatory bowel disease. The risk for toxicity or severe adverse events appears to be low.
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| 50. |
- Lund, Lars H., et al.
(författare)
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Acyl ghrelin improves cardiac function in heart failure and increases fractional shortening in cardiomyocytes without calcium mobilization
- 2023
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Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645.
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Tidskriftsartikel (refereegranskat)abstract
- Background and AimsGhrelin is an endogenous appetite-stimulating peptide hormone with potential cardiovascular benefits. Effects of acylated (activated) ghrelin were assessed in patients with heart failure and reduced ejection fraction (HFrEF) and in ex vivo mouse cardiomyocytes.Methods and resultsIn a randomized placebo-controlled double-blind trial, 31 patients with chronic HFrEF were randomized to synthetic human acyl ghrelin (0.1 µg/kg/min) or placebo intravenously over 120 min. The primary outcome was change in cardiac output (CO). Isolated mouse cardiomyocytes were treated with acyl ghrelin and fractional shortening and calcium transients were assessed. Acyl ghrelin but not placebo increased cardiac output (acyl ghrelin: 4.08 ± 1.15 to 5.23 ± 1.98 L/min; placebo: 4.26 ± 1.23 to 4.11 ± 1.99 L/min, P < 0.001). Acyl ghrelin caused a significant increase in stroke volume and nominal increases in left ventricular ejection fraction and segmental longitudinal strain and tricuspid annular plane systolic excursion. There were no effects on blood pressure, arrhythmias, or ischaemia. Heart rate decreased nominally (acyl ghrelin: 71 ± 11 to 67 ± 11 b.p.m.; placebo 69 ± 8 to 68 ± 10 b.p.m.). In cardiomyocytes, acyl ghrelin increased fractional shortening, did not affect cellular Ca2+ transients, and reduced troponin I phosphorylation. The increase in fractional shortening and reduction in troponin I phosphorylation was blocked by the acyl ghrelin antagonist D-Lys 3.ConclusionIn patients with HFrEF, acyl ghrelin increased cardiac output without causing hypotension, tachycardia, arrhythmia, or ischaemia. In isolated cardiomyocytes, acyl ghrelin increased contractility independently of preload and afterload and without Ca2+ mobilization, which may explain the lack of clinical side effects. Ghrelin treatment should be explored in additional randomized trials.
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