| 1. |
- Bergemalm, Daniel, 1977-, et al.
(författare)
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Systemic Inflammation in Preclinical Ulcerative Colitis
- 2021
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Ingår i: Gastroenterology. - : AGA Institute. - 0016-5085 .- 1528-0012. ; 161:5, s. 1526-1539.e9
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Preclinical ulcerative colitis is poorly defined. We aimed to characterize the preclinical systemic inflammation in ulcerative colitis, using a comprehensive set of proteins.Methods: We obtained plasma samples biobanked from individuals who developed ulcerative colitis later in life (n = 72) and matched healthy controls (n = 140) within a population-based screening cohort. We measured 92 proteins related to inflammation using a proximity extension assay. The biologic relevance of these findings was validated in an inception cohort of patients with ulcerative colitis (n = 101) and healthy controls (n = 50). To examine the influence of genetic and environmental factors on these markers, a cohort of healthy twin siblings of patients with ulcerative colitis (n = 41) and matched healthy controls (n = 37) were explored.Results: Six proteins (MMP10, CXCL9, CCL11, SLAMF1, CXCL11 and MCP-1) were up-regulated (P < .05) in preclinical ulcerative colitis compared with controls based on both univariate and multivariable models. Ingenuity Pathway Analyses identified several potential key regulators, including interleukin-1β, tumor necrosis factor, interferon-gamma, oncostatin M, nuclear factor-κB, interleukin-6, and interleukin-4. For validation, we built a multivariable model to predict disease in the inception cohort. The model discriminated treatment-naïve patients with ulcerative colitis from controls with leave-one-out cross-validation (area under the curve = 0.92). Consistently, MMP10, CXCL9, CXCL11, and MCP-1, but not CCL11 and SLAMF1, were significantly up-regulated among the healthy twin siblings, even though their relative abundances seemed higher in incident ulcerative colitis.Conclusions: A set of inflammatory proteins are up-regulated several years before a diagnosis of ulcerative colitis. These proteins were highly predictive of an ulcerative colitis diagnosis, and some seemed to be up-regulated already at exposure to genetic and environmental risk factors.
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| 2. |
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| 3. |
- Carlsen, Hanne Krage, et al.
(författare)
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Exposure to traffic and lung function in adults: A general population cohort study
- 2015
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 5:6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate the association between living near dense traffic and lung function in a cohort of adults from a single urban region. Design: Cross-sectional results from a cohort study. Setting: The adult-onset asthma and exhaled nitric oxide (ADONIX) cohort, sampled during 2001-2008 in Gothenburg, Sweden. Exposure was expressed as the distance from participants' residential address to the nearest road with dense traffic (>10 000 vehicles per day) or very dense traffic (>30 000 vehicles per day). The exposure categories were: low (>500 m; reference), medium (75-500 m) or high (<75 m). Participants: The source population was a population-based cohort of adults (n=6153). The study population included 5441 participants of European descent with good quality spirometry and information about all outcomes and covariates. Outcome measures: Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were measured at a clinical examination. The association with exposure was examined using linear regression adjusting for age, gender, body mass index, smoking status and education in all participants and stratified by sex, smoking status and respiratory health status. Results: We identified a significant dose-response trend between exposure category and FEV1 (p=0.03) and borderline significant trend for FVC (p=0.06) after adjusting for covariates. High exposure was associated with lower FEV1 (-1.0%, 95% CI -2.5% to 0.5%) and lower FVC (-0.9%, 95% CI -2.2% to 0.4%). The effect appeared to be stronger in women. In highly exposed individuals with current asthma or chronic obstructive pulmonary disease, FVC was lower (-4.5%, 95% CI -8.8% to -0.1%). Conclusions: High traffic exposure at the residential address was associated with lower than predicted FEV1 and FVC lung function compared with living further away in a large general population cohort. There were particular effects on women and individuals with obstructive disease.
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| 4. |
- Dahgam, Santosh, et al.
(författare)
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Haplotypes of the inducible nitric oxide synthase gene are strongly associated with exhaled nitric oxide levels in adults: a population-based study
- 2014
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Ingår i: Journal of Medical Genetics. - : BMJ. - 0022-2593 .- 1468-6244. ; 51:7, s. 449-454
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Tidskriftsartikel (refereegranskat)abstract
- Background Previous genetic association studies have reported evidence for association of single-nucleotide polymorphisms (SNPs) in the NOS2 gene, encoding inducible nitric oxide synthase (iNOS), to variation in levels of fractional exhaled nitric oxide (FENO) in children and adults. In this study, we evaluated 10 SNPs in the region of chromosome 17 from 26.07Mb to 26.13Mb to further understand the contribution of NOS2 to variation in levels of FENO. Methods In a cohort of 5912 adults 25-75years of age, we investigated the relationship between NOS2 haplotypes and FENO, and effect modification by asthma. Results Seven common (frequency 5%) haplotypes (H1-H7) were inferred from all possible haplotype combinations. One haplotype (H3) was significantly associated with lower levels of FENO: -5.8% (95% CI -9.8 to -1.7; p=0.006) compared with the most common baseline haplotype H1. Two haplotypes (H5 and H6) were significantly associated with higher levels of FENO: +10.7% (95% CI 5.0 to 16.7; p=0.0002) and +14.9% (95% CI 10.6 to 19.3; p=7.8x10(-13)), respectively. The effect of haplotype H3 was mainly seen in subjects with asthma (-21.6% (95% CI -33.5 to -5.9)) and was not significant in subjects without asthma (-4.2% (95% CI -8.4 to 0.2)). The p value for interaction between H3 and asthma status was 0.004. Conclusions Our findings suggest that several common haplotypes in the NOS2 gene contribute to variation in FENO in adults. We also saw some evidence of effect modification by asthma status on haplotype H3.
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| 5. |
- Dahgam, Santosh, et al.
(författare)
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Single nucleotide polymorphisms in the NOS2 and NOS3 genes are associated with exhaled nitric oxide
- 2012
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Ingår i: Journal of Medical Genetics. - : BMJ. - 0022-2593 .- 1468-6244. ; 49:3, s. 200-205
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Tidskriftsartikel (refereegranskat)abstract
- Background Polymorphisms in nitric oxide synthase genes (NOS1, NOS2, and NOS3) have been suggested to have a major impact on fraction of exhaled nitric oxide (FENO), a biomarker of airway inflammation. However, the genetic contribution of NOS polymorphisms to FENO is not fully understood. The aim of this study was to investigate comprehensively the association between single nucleotide polymorphisms (SNPs) in all three NOS genes and FENO in an adult population, and to assess whether such associations are modified by asthma or atopy. Method In 1737 adults from a Swedish general population sample, FENO was measured and genetic variation in the NOS genes was assessed using 49 SNPs. The genetic effect of NOS polymorphisms on FENO, asthma, and atopy was estimated using multiple regression methods. Results In a multi-SNP model based on stepwise regression analysis, two SNPs in NOS2 and one in NOS3 showed independent associations with levels of FENO. For NOS2 SNP rs9901734, subjects had 5.3% (95% CI 1.0% to 9.7%) higher levels of FENO per G allele, and for rs3729508, subjects with CC or CT genotypes had 9.4% (95% CI 3.1% to 15.2%) higher levels compared with TT. For NOS3 SNP rs7830, subjects with GT or TT had 5.6% (95% CI 0.4% to 11.1%) higher levels than GG; the genetic effect of this SNP was stronger in asthmatics (21.9%, 95% CI 4.6% to 42.0%). Conclusion These results suggest that NOS2 is the major NOS gene determining variability in exhaled nitric oxide in the healthy adult population, while NOS3 may play a more important role in asthmatic adults.
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| 6. |
- Fransson, Per-Anders, et al.
(författare)
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Oculomotor deficits caused by 0.06% and 0.10% blood alcohol concentrations and relationship to subjective perception of drunkenness.
- 2010
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Ingår i: Clinical Neurophysiology. - : Elsevier BV. - 1872-8952 .- 1388-2457. ; Jul 1, s. 2134-2142
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The visual system is vital during critical activities such as driving. Studying how alcohol compromises the visual system physiologically is therefore important for safety reasons. The objective of the study was to investigate alcohol-related impairments in visual tasks performed under controlled breath alcohol concentrations (BAC) to determine dose-dependent effects. METHODS: Alcohol's effects on smooth pursuit and saccadic eye movements at 0.06% and 0.10% BAC were examined whilst recording alcohol levels by real-time measurements using a high precision breath analyzer. Oculomotor performance was recorded from 25 subjects by electronystagmography comprising measurements of smooth pursuit gain, saccade velocity, saccade accuracy and two novel parameters further describing oculomotor performance. RESULTS: Alcohol deteriorated accuracy of smooth pursuit movements (p<0.001) and saccadic velocities (p<0.01) at 0.06% BAC. At 0.10% BAC, smooth pursuit gains (p<0.01), saccade accuracies and saccade latencies (p<0.01) were also affected. The ratio between saccade velocity and saccade amplitude decreased significantly under alcohol intoxication (p<0.01). Self-perceptions of drunkenness correlated well with changes in smooth pursuit accuracy, but poorly with other oculomotor measures. CONCLUSIONS: Several of the smooth pursuit and saccade functions were altered dose-dependently by alcohol and small changes in BAC substantially changed the effects observed. Additionally, alcohol altered the relationship between saccade velocity and saccade amplitude, diminishing the capacity for saccades to reach high peak velocities. SIGNIFICANCE: The alcohol-induced oculomotor deficits, which were found already at 0.06% BAC by our more sensitive analysis methods, may have safety implications for tasks that rely on visual motor control and visual feedback.
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| 7. |
- Hafström, Anna, et al.
(författare)
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Acute alcohol intoxication impairs segmental body alignment in upright standing.
- 2014
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Ingår i: Journal of Vestibular Research. - 1878-6464. ; 24:4, s. 297-304
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Tidskriftsartikel (refereegranskat)abstract
- Balance control when standing upright is a complex process requiring input from several partly independent mechanisms such as coordination, feedback and feedforward control, and adaptation. Acute alcohol intoxication from ethanol is recognized as a major contributor to accidental falls requiring medical care. This study aimed to investigate if intoxication at 0.06 and 0.10% blood alcohol concentration affected body alignment. Mean angular positions of the head, shoulder, hip, and knee were measured with 3D-motion analysis and compared with the ankle position in 25 healthy adults during standing with or without perturbations, and with eyes open or closed. Alcohol intoxication had significant effects on body alignment during perturbed and unperturbed stance, and on adaptation to perturbations. It induced a significantly more posterior alignment of the knees and shoulders, and a tendency for a more posterior and left deviated head alignment in perturbed stance than when sober. The impact of alcohol intoxication was most apparent on the knee alignment, where availability of visual information deteriorated the adaptation to perturbations. Thus, acute alcohol intoxication resulted in inadequate balance control strategies with increased postural rigidity and impaired adaptation to perturbations. These factors probably contribute to the increased risk of falling when intoxicated with alcohol.
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| 8. |
- Hafström, Anna, et al.
(författare)
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Effectuation of adaptive stability and postural alignment strategies are decreased by alcohol intoxication.
- 2014
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Ingår i: Human Movement Science. - : Elsevier BV. - 1872-7646 .- 0167-9457. ; 35:Apr 29, s. 30-49
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Tidskriftsartikel (refereegranskat)abstract
- Human stability control is a complex process comprising contributions from several partly independent mechanisms such as coordination, feedback and feed-forward control, and adaptation. Acute alcohol intoxication impairs these functions and is recognized as a major contributor to fall traumas. The study aimed to investigate how alcohol intoxication at .06% and .10% blood alcohol concentration (BAC) affected the movement spans and control of posture alignment. The angular positions of the head, shoulder, hip and knees relative to the ankles were measured with a 3D motion analysis system in 25 healthy adults during standing with eyes open or closed and with or without vibratory balance perturbations. Alcohol intoxication significantly increased the movement spans of the head, shoulders, hip and knees in anteroposterior and lateral directions during quiet stance (p⩽.047 and p⩽.003) and balance perturbations (p<.001, both directions). Alcohol intoxication also decreased the ability to reduce the movement spans through adaptation in both anteroposterior (p⩽.011) and lateral (p⩽.004) directions. When sober and submitted to balance perturbations, the subjects aligned the head, shoulders, hip and knees more forward relative to the ankle joint (p<.001), hence adopting a more resilient posture increasing the safety margin for backward falls. Alcohol intoxication significantly delayed this forward realignment (p⩽.022). Alcohol intoxication did not cause any significant posture realignment in the lateral direction. Thus, initiation of adaptive posture realignments to alcohol or other disruptions might be context dependent and associated with reaching a certain level of stability threats.
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| 9. |
- Hafström, Anna, et al.
(författare)
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Increased visual dependence and otolith dysfunction with alcohol intoxication
- 2007
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Ingår i: NeuroReport. - 1473-558X. ; 18:4, s. 391-394
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Tidskriftsartikel (refereegranskat)abstract
- dAlcohol intoxication affects the vestibular system and balance control in many ways. We have investigated how acute, moderate (blood alcohol concentrations of 0.06 +/- 0.01%), and high (0.10 +0.02%) alcohol intoxication affects the ability to perceive the visual horizontal and vertical and the visual field dependence measured with the rod and frame tests in 24 healthy participants. Alcohol ingestion impaired the ability to use gravitational vestibular cues when determining the visual vertical and horizontal, and caused increased visual field dependence. With conflicting gravitational and visual information, alcohol seems to promote a reweighting in balance control from a vestibular to a more visual dependency. Furthermore, the results indicate that alcohol intoxication at these levels start instigating a decompensation of minute subdinical vestibular asymmetries.
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| 10. |
- Levinsson, Anna, et al.
(författare)
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Interaction effects of long-term air pollution exposure and variants in the GSTP1, GSTT1 and GSTCD genes on risk of acute myocardial infarction and hypertension : a case-control study
- 2014
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:6, s. e99043-
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Experimental and epidemiological studies have reported associations between air pollution exposure, in particular related to vehicle exhaust, and cardiovascular disease. A potential pathophysiological pathway is pollution-induced pulmonary oxidative stress, with secondary systemic inflammation. Genetic polymorphisms in genes implicated in oxidative stress, such as GSTP1, GSTT1 and GSTCD, may contribute to determining individual susceptibility to air pollution as a promoter of coronary vulnerability.AIMS: We aimed to investigate effects of long-term traffic-related air pollution exposure, as well as variants in GSTP1, GSTT1 and GSTCD, on risk of acute myocardial infarction (AMI) and hypertension. In addition, we studied whether air pollution effects were modified by the investigated genetic variants.METHODS: Genotype data at 7 single nucleotide polymorphisms (SNPs) in the GSTP1 gene, and one in each of the GSTT1 and GSTCD genes, as well as air pollution exposure estimates, were available for 119 AMI cases and 1310 randomly selected population controls. Population control individuals with systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg or on daily antihypertensive medication were defined as hypertensive (n = 468). Individual air pollution exposure levels were modeled as annual means of NO₂ (marker of vehicle exhaust pollutants) using central monitoring data and dispersion models, linking to participants' home addresses.RESULTS: Air pollution was significantly associated with risk of AMI: OR 1.78 (95%CI 1.04-3.03) per 10 µg/m³ of long-term NO₂ exposure. Three GSTP1 SNPs were significantly associated with hypertension. The effect of air pollution on risk of AMI varied by genotype strata, although the suggested interaction was not significant. We saw no obvious interaction between genetic variants in the GST genes and air pollution exposure for hypertension.CONCLUSION: Air pollution exposure entails an increased risk of AMI, and this risk differed over genotype strata for variants in the GSTP1, GSTT1 and GSTCD genes, albeit not statistically-significantly.
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| 11. |
- Modig, Fredrik, et al.
(författare)
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Blood alcohol concentration at 0.06 and 0.10% causes a complex multifaceted deterioration of body movement control.
- 2012
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Ingår i: Alcohol. - : Elsevier BV. - 0741-8329. ; 46, s. 75-88
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Tidskriftsartikel (refereegranskat)abstract
- Alcohol-related falls are recognized as a major contributor to the occurrence of traumatic brain injury. The control of upright standing balance is complex and composes of contributions from several partly independent mechanisms such as appropriate information from multiple sensory systems and correct feedback and feed forward movement control. Analysis of multisegmented body movement offers a rarely used option for detecting the fine motor problems associated with alcohol intoxication. The study aims were to investigate whether (1) alcohol intoxication at 0.06 and 0.10% blood alcohol concentration (BAC) affected the body movements under unperturbed and perturbed standing; and (2) alcohol affected the ability for sensorimotor adaptation. Body movements were recorded in 25 participants (13 women and 12 men, mean age 25.1 years) at five locations (ankle, knee, hip, shoulder, and head) during quiet standing and during balance perturbations from pseudorandom pulses of calf muscle vibration over 200s with eyes closed or open. Tests were performed at 0.00, 0.06, and 0.10% BAC. The study revealed several significant findings: (1) an alcohol dose-specific effect; (2) a direction-specific stability decrease from alcohol intoxication; (3) a movement pattern change related to the level of alcohol intoxication during unperturbed standing and perturbed standing; (4) a sensorimotor adaptation deterioration with increased alcohol intoxication; and (5) that vision provided a weaker contribution to postural control during alcohol intoxication. Hence, alcohol intoxication at 0.06 and 0.10% BAC causes a complex multifaceted deterioration of human postural control.
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| 12. |
- Modig, Fredrik
(författare)
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Effects of acute alcohol intoxication on human sensory orientation and postural control
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Alcohol affects balance and is related to falls and injuries. Even though alcohol effects on balance and eye movement have been studied before we know less about the dose and time dependent effects and how each supportive sense to balance contributes during acute alcohol intoxication. The purpose was to investigate parallel effects of acute alcohol intoxication on balance (postural control), balance efficiency (adaptation) and its supporting senses. We included 25 healthy subjects on three different test occasions during acute alcohol intoxication of 0.06% and 0.1% blood alcohol concentration (BAC) and sober, ensured using a real time breath analyzer. Balance was evaluated with a balance force plate and a 3D-system for individual body segment detection. Spatial orientation and eye movements were measured. Foot sensation was measured when sober and the subjective feeling of intoxication was continuously followed. Instability was considerably higher at 0.1% BAC compared to 0.06% BAC and was more obvious in the medio-lateral (side to side) direction compared to the anterior-posterior (front and back). When standing balance is perturbed by vibration of the calf muscles, body movement increases. Repetition of these perturbations drives balance learning (adaptation) in sober subjects and the result is a reduction of body movement. When intoxicated however, normal adaptation is reduced or abolished. Whilst visual feedback is important for maintaining stability, it didn’t fully compensate for being intoxicated and contradictorily decreased medio-lateral stability. This could partly be explained by the impaired eye movements by intoxication. Additionally, being intoxicated increased visual dependence, i.e., the use of visual senses for positioning ourselves within the environment. Together, it illustrates that being intoxicated causes an over-reliance on visual senses which aren’t always helpful. When visual senses are absent, intoxicated subjects will rely upon foot mechanoreceptive sensation for standing balance, and change their balancing strategy by pivoting more prominently forwards and backwards around the knee level. One’s own perception of drunkenness matches slow eye movements as well as upper body movement. In summary, alcohol intoxication at levels common in society, has a widespread disturbing effect on the components of the human balance system, from each sensory system to the Central Nervous System’s integrative and cognitive processing, and also effects adaptive ability, the summation of which produces a complex attack on postural and oculomotor behaviors.
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| 13. |
- Modig, Fredrik, et al.
(författare)
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Study I: Effects of 0.06% and 0.10% blood alcohol concentration on human postural control.
- 2012
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Ingår i: Gait & Posture. - : Elsevier BV. - 1879-2219 .- 0966-6362. ; 35:3, s. 410-418
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Tidskriftsartikel (refereegranskat)abstract
- Alcohol intoxication causes many accidental falls presented at emergency departments, with the injury severity often related to level of blood alcohol concentration (BAC). One way to evaluate the decline in postural control and the fall risk is to assess standing stability when challenged. The study objective was to comprehensively investigate alcohol-related impairments on postural control and adaptive motor learning at specific BAC levels. Effects of alcohol intoxication at 0.06% and 0.10% BAC were examined with posturography when unperturbed or perturbed by calf vibration. Twenty-five participants (mean age 25.1years) were investigated standing with either eyes open or closed. Our results revealed several significant findings: (1) stability declined much faster from alcohol intoxication between 0.06% and 0.10% BAC (60-140%) compared with between 0.0% and 0.06% BAC (30%); (2) sustained exposure to repeated balance perturbations augmented the alcohol-related destabilization; (3) there were stronger effects of alcohol intoxication on stability in lateral direction than in anteroposterior direction; and (4) there was a gradual degradation of postural control particularly in lateral direction when the balance perturbations were repeated at 0.06% and 0.10% BAC, indicating adaptation deficits when intoxicated. To summarize, alcohol has profound deteriorating effects on human postural control, which are dose dependent, time dependent and direction specific. The maximal effects of alcohol intoxication on physiological performance might not be evident initially, but may be revealed first when under sustained sensory-motor challenges.
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| 14. |
- Modig, Fredrik, et al.
(författare)
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Study II: Mechanoreceptive sensation is of increased importance for human postural control under alcohol intoxication.
- 2012
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Ingår i: Gait & Posture. - : Elsevier BV. - 1879-2219 .- 0966-6362. ; 35:3, s. 419-427
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Tidskriftsartikel (refereegranskat)abstract
- Standing postural stability relies on input from visual, vestibular, proprioceptive and mechanoreceptive sensors. When the information from any of these sensors is unavailable or disrupted, the central nervous system maintains postural stability by relying more on the contribution from the reliable sensors, termed sensory re-weighting. Alcohol intoxication is known to affect the integrity of the vestibular and visual systems. The aim was to assess how mechanoreceptive sensory information contributed to postural stability at 0.00% (i.e. sober), 0.06% and 0.10% blood alcohol concentration (BAC) in 25 healthy subjects (mean age 25.1 years). The subjects were assessed with eyes closed and eyes open under quiet standing and while standing was perturbed by repeated, random-length, vibratory stimulation of the calf muscles. Plantar cutaneous mechanoreceptive sensation was assessed for both receptor types: slowly adapting (tactile sensitivity) and rapidly adapting (vibration perception). The correlation between recorded torque variance and the sensation from both mechanoreceptor types was calculated. The recorded stability during alcohol intoxication was significantly influenced by both the tactile sensation and vibration perception of the subjects. Moreover, the study revealed a fluctuating association between the subjects' vibration perception and torque variance during balance perturbations, which was significantly influenced by the level of alcohol intoxication, vision and adaptation. Hence, one's ability to handle balance perturbations under the influence of alcohol is strongly dependent on accurate mechanoreceptive sensation and efficient sensory re-weighting.
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| 15. |
- Modig, L., et al.
(författare)
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Short-Term Exposure to Ozone and Levels of Exhaled Nitric Oxide
- 2014
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Ingår i: Epidemiology. - : Ovid Technologies (Wolters Kluwer Health). - 1044-3983. ; 25:1, s. 79-87
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Tidskriftsartikel (refereegranskat)abstract
- Background: Adverse effects of air pollution include respiratory inflammation. A few epidemiologic studies have shown elevations in the fraction of exhaled nitric oxide, a marker of airway inflammation, after exposure to traffic-related pollutants. Methods: We examined whether short-term exposures to ozone (O-3), oxides of nitrogen (NOx), or particulate matter <10 m (PM10) were associated with proximal and distal airway inflammation. The study included 5841 randomly selected Swedish adults from 25 to 75 years of age. Fraction of exhaled nitrogen was measured at two flow rates: 50 ml/s representing the proximal airways and 270 ml/s representing the distal airways. Air pollution data were obtained from an urban monitoring site. We applied linear regression to estimate short-term associations of O-3, NOx, and PM10 with fractions of exhaled NO at 50 and 270 ml/s. Results: An interquartile range increase in 120-hour average O-3 levels was associated with a 5.1% (95% confidence interval = 1.7% to 8.5%) higher level of fraction of exhaled NO at 270 ml/s and 3.6% (-0.4% to 3.4%) higher level of the fraction of exhaled NO at 50 ml/s. For NOx, a small effect was seen for the 24-hour average on the fraction of exhaled NO at 270 ml/s, while for PM10 no clear effects were seen. There was a tendency for a weaker effect of ozone and a stronger effect of NOx in subjects with asthma. Conclusions: Exposure to O-3 was associated with a marker of distal airway inflammation, while the association was less obvious for inflammation of the proximal airways.
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| 16. |
- Modig, Lars, et al.
(författare)
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Short-Term Exposure to Ozone and Levels of Exhaled Nitric Oxide
- 2014
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Ingår i: Epidemiology. - : Lippincott Williams & Wilkins. - 1044-3983 .- 1531-5487. ; 25:1, s. 79-87
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Tidskriftsartikel (refereegranskat)abstract
- Background: Adverse effects of air pollution include respiratory inflammation. A few epidemiologic studies have shown elevations in the fraction of exhaled nitric oxide, a marker of airway inflammation, after exposure to traffic-related pollutants. Methods: We examined whether short-term exposures to ozone (O-3), oxides of nitrogen (NOx), or particulate matter <10 m (PM10) were associated with proximal and distal airway inflammation. The study included 5841 randomly selected Swedish adults from 25 to 75 years of age. Fraction of exhaled nitrogen was measured at two flow rates: 50 ml/s representing the proximal airways and 270 ml/s representing the distal airways. Air pollution data were obtained from an urban monitoring site. We applied linear regression to estimate short-term associations of O-3, NOx, and PM10 with fractions of exhaled NO at 50 and 270 ml/s. Results: An interquartile range increase in 120-hour average O-3 levels was associated with a 5.1% (95% confidence interval = 1.7% to 8.5%) higher level of fraction of exhaled NO at 270 ml/s and 3.6% (-0.4% to 3.4%) higher level of the fraction of exhaled NO at 50 ml/s. For NOx, a small effect was seen for the 24-hour average on the fraction of exhaled NO at 270 ml/s, while for PM10 no clear effects were seen. There was a tendency for a weaker effect of ozone and a stronger effect of NOx in subjects with asthma. Conclusions: Exposure to O-3 was associated with a marker of distal airway inflammation, while the association was less obvious for inflammation of the proximal airways.
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| 17. |
- Modig, Sara, et al.
(författare)
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Assessment of medication discrepancies with point prevalence measurement : how accurate are the medication lists for Swedish patients?
- 2022
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Ingår i: Drugs and Therapy Perspectives. - : Springer Science and Business Media LLC. - 1172-0360 .- 1179-1977. ; 38:4, s. 185-193
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Tidskriftsartikel (refereegranskat)abstract
- Background: Medication discrepancies are common, potentially harmful and may result from poor medication information across medical records. Our aim was to describe current medication discrepancy rates, types and severity in hospital, primary and specialized outpatient care in Sweden, as well as comparing these with previous measurements. Methods: Participants visiting health care in Skåne in November 2020 were randomly selected to include 100 adult patients each in public and private primary health care centers, hospitals and outpatient care. Within 2 weeks after a health care visit or hospital admission, a pharmacist medication reconciliation was performed to identify any discrepancies. Two general practitioners assessed their potential to cause harm. Descriptive and comparative statistics were used. Results: In total, 405 patients (mean age 61.6 years, median 6.5 medications) were included in the analysis. The majority (72%) of the included patients had ≥1 medication list discrepancy. Total number of discrepancies was 1038 (average 2.6 per patient), with a significantly higher discrepancy rate (4.5) noted in specialized outpatient care (p < 0.001). Overall, unintentional addition (44%) or omission (39%) of drug were most frequent. Out of all discrepancies, 20.7% were rated to have moderate (18.2%) or high (2.5%) potential risk of harm. Cardiovascular, nervous system and antidiabetic medications were more often involved in potentially harmful discrepancies. When compared with previous measurements, the proportion of accurate medication lists significantly improved in primary care compared to 2018 (34% vs 20%, p = 0.0011), as well as a decrease in overall discrepancy rate (p = 0.0029). Conclusion: Medication discrepancies were in general abundant despite a recent health care visit, both in hospital care and primary care, with the highest number in specialized outpatient care. A considerable share was classified as potentially harmful thus implying a major threat to medication safety.
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| 18. |
- Patel, Mitesh, et al.
(författare)
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Alcohol intoxication at 0.06 and 0.10% blood alcohol concentration changes segmental body movement coordination.
- 2010
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Ingår i: Experimental Brain Research. - : Springer Science and Business Media LLC. - 0014-4819 .- 1432-1106. ; 202, s. 431-443
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Tidskriftsartikel (refereegranskat)abstract
- Alcohol intoxication is the cause of many falls requiring emergency care. The control of upright standing balance is complex and comprises contributions from several partly independent mechanisms like coordination, feedback and feedforward control and adaptation. Analysis of the segmental body movement coordination offers one option to detect the severity of balance problems. The study aims were (1) to investigate whether alcohol intoxication at 0.06 and 0.10% blood alcohol concentration (BAC) affected the segmental movement pattern under unperturbed and perturbed standing; (2) whether alcohol affected the ability for movement pattern adaptation; (3) whether one's own subjective feeling of drunkenness correlated to the movement pattern used. Twenty-five participants (13 women and 12 men, mean age 25.1 years) performed tests involving alcohol intoxication. Body movements were recorded at five locations (ankle, knee, hip, shoulder and head) during quiet standing and pseudorandom pulses of calf muscle vibration for 200 s with eyes closed or open. There was no significant effect of alcohol on the general movement pattern in unperturbed stance or on adaptation. However, when balance was repeatedly perturbed, knee movements became significantly less correlated to other body movements over time at 0.10% BAC and when visual information was unavailable, suggesting that the normal movement pattern could not be maintained for a longer period of time while under 0.10% BAC intoxication. Subjective feelings of drunkenness correlated often with a changed upper body movement pattern but less so with changed knee movements. Thus, an inability to relate drunkenness with changed knee movements may be a contributing factor to falls in addition to the direct effect of alcohol intoxication.
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