| 1. |
- Ruilope, LM, et al.
(författare)
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Design and Baseline Characteristics of the Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease Trial
- 2019
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Ingår i: American journal of nephrology. - : S. Karger AG. - 1421-9670 .- 0250-8095. ; 50:5, s. 345-356
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. <b><i>Patients and</i></b> <b><i>Methods:</i></b> The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate ≥25 mL/min/1.73 m<sup>2</sup> and albuminuria (urinary albumin-to-creatinine ratio ≥30 to ≤5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level α = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. <b><i>Conclusions:</i></b> FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049.
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| 2. |
- Watanabe, A, et al.
(författare)
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Gunnar Fant 60 years
- 1979
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Ingår i: TMH-QPSR. ; 20:2, s. 1-45
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Tidskriftsartikel (refereegranskat)
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| 3. |
- Barrios, C. A., et al.
(författare)
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GaAs/AlGaAs buried-heterostructure vertical-cavity surface-emitting laser with semi-insulating GalnP : Fe regrowth
- 2000
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Ingår i: Electronics Letters. - 0013-5194 .- 1350-911X. ; 36:18, s. 1542-1544
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Tidskriftsartikel (refereegranskat)abstract
- The authors report the first results of a GaAs/AlGaAs buried-heterostructure vertical-cavity surface-emitting laser (VCSEL) with semi-insulating Ga0.51In0.49P:Fe (SI-GaInP:Fe) as the burying layer. Regrowth of SI-GaInP:Fe around 15 mu m diameter and 8 mu m tall VCSEL mesas was carried out by hydride vapour phase epitaxy (HVPE). Under room temperature continuous wave (CW) operation. the device exhibited a threshold current of 3.5mA, a differential quantum efficency of 33% and a light output power of 4.2mW. CW operation at temperatures up to 97 degrees C is also demonstrated.
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| 4. |
- Sjöström, Jenny K., 1978-, et al.
(författare)
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Complex evolution of Holocene hydroclimate, fire and vegetation revealed by molecular, minerogenic and biogenic proxies, Marais Geluk wetland, eastern Free State, South Africa
- 2023
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Ingår i: Quaternary Science Reviews. - 0277-3791 .- 1873-457X. ; 314
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Tidskriftsartikel (refereegranskat)abstract
- The Holocene climate history of Southern Africa remains inconclusive despite the increasing number of proxy records from the region. This might be related to the diversity of proxy records, how the proxies are interpreted, or that proxies may respond to more than one forcing (e.g. hydroclimate, fire, temperature.). Here, a 175-cm peat sequence from Free State, South Africa (28°17′53″S, 29°25′10.9″E), was analyzed using a comprehensive set of novel and conventional proxies, including isotopic (δ13C), elemental (CS-XRF), mineral (pXRD), molecular (FTIR-ATR and pyrolysis-GC-MS), grain size (Malvern 3000) and GSSC phytolith composition. The chronology was constructed through AMS radiocarbon dating (n = 7). The early Holocene (10,380–7000 cal yr BP) was characterized by an initial wet phase, followed by relative dryness, at least seasonally, evidenced by slow accumulation rates, low organic content and dominance of terrestrial vegetation in the organic matter matrix. From 7000 cal yr BP, decreasing temperatures, as evidenced in regional climate reconstructions, were associated at Marias Geluk with higher biogenic silica and organic matter content and an increase of moisture-adapted grasses, indicating increasingly mesic conditions. This trend was amplified after 6000 cal yr BP, co-occurring with a southward displacement of the ITCZ. Complex proxy dynamics were observed between 4300 and 2180 cal yr BP, with bulk organic proxies indicating a drier environment (lower carbon content, slow accumulation rates, enriched δ13C values) but the phytolith record pointing towards relatively mesic conditions. The period was also associated with increased fire frequency, that also reached the local wetland. We suggest that the period was associated with seasonally mesic conditions together with increased fire incidence, which affected some of the organic proxies. Increased fire activity was also recorded in the region, while the hydroclimatic indications differed. The last 2000 years, during which human activity is known to have increased in the region, was characterized by lower fire incidence and variable, but relatively moist, conditions. The hydroclimatic inferences for the last 2000 years are in line with previous studies from the region, but additional studies are needed to decipher if the decline in fire incidence was associated to climate forcings, human activities, or a combination of both. The multiproxy approach applied here - in particular the inclusion of FTIR-ATR and pyrolysis GC-MS - revealed a complex interplay between vegetation dynamics, hydrology and paleofire variability. This study confirms that relatively small Holocene temperature variations (compared to northern higher latitudes) were associated with major hydrological variability at Marais Geluk, and reinforces concerns from earlier studies that the hydroclimate of the region is vulnerable to climate change. The result s also show that the southward displacement of the ITCZ, and associated tropical air masses, likely had significant effects on regional hydrology and fire incidence.
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| 5. |
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| 6. |
- Barrios, C. A., et al.
(författare)
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Epitaxially regrown GaAs/AlGaAs laser mesas with semi-insulating GaInP : Fe and GaAs : Fe
- 2001
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Ingår i: Journal of Electronic Materials. - 0361-5235 .- 1543-186X. ; 30:8, s. 987-991
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Tidskriftsartikel (refereegranskat)abstract
- Selective regrowth of semi-insulating iron-doped Ga0.51In0.49P (SI-GaInP:Fe) and SI-GaAs:Fe around GaAs/AlGaAs mesas by hydride vapor phase epitaxy (HVPE) has been achieved. A HCl based in-situ cleaning procedure has been used to remove aluminum oxide from the etched walls of the mesas. Regrowth conducted without proper cleaning results in an irregular interface with voids. Regrowth morphology aspects are also presented. Our cleaning and regrowth methods have been used for fabricating GaAs/AlGaAs buried heterostructure in-plane lasers and vertical-cavity surface-emitting lasers.
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| 7. |
- Berg, B., et al.
(författare)
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Development of osteoarthritis in patients with degenerative meniscal tears treated with exercise therapy or surgery : a randomized controlled trial
- 2020
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Ingår i: Osteoarthritis and Cartilage. - : Elsevier BV. - 1063-4584. ; 28:7, s. 897-906
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate progression of individual radiographic features 5 years following exercise therapy or arthroscopic partial meniscectomy as treatment for degenerative meniscal tear. Design: Randomized controlled trial including 140 adults, aged 35–60 years, with a magnetic resonance image verified degenerative meniscal tear, and 96% without definite radiographic knee osteoarthritis. Participants were randomized to either 12-weeks of supervised exercise therapy or arthroscopic partial meniscectomy. The primary outcome was between-group difference in progression of tibiofemoral joint space narrowing and marginal osteophytes at 5 years, assessed semi-quantitatively by the OARSI atlas. Secondary outcomes included incidence of radiographic knee osteoarthritis and symptomatic knee osteoarthritis, medial tibiofemoral fixed joint space width (quantitatively assessed), and patient-reported outcome measures. Statistical analyses were performed using a full analysis set. Per protocol and as treated analysis were also performed. Results: The risk ratios (95% CI) for progression of semi-quantitatively assessed joint space narrowing and medial and lateral osteophytes for the surgery group were 0.89 (0.55–1.44), 1.15 (0.79–1.68) and 0.77 (0.42–1.42), respectively, compared to the exercise therapy group. In secondary outcomes (full-set analysis) no statistically significant between-group differences were found. Conclusion: The study was inconclusive with respect to potential differences in progression of individual radiographic features after surgical and non-surgical treatment for degenerative meniscal tear. Further, we found no strong evidence in support of differences in development of incident radiographic knee osteoarthritis or patient-reported outcomes between exercise therapy and arthroscopic partial meniscectomy.
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| 8. |
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| 9. |
- Borg, E, et al.
(författare)
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Language development in hearing-impaired children - Establishment of a reference material for a 'Language test for hearing-impaired children', LATHIC
- 2002
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - 1872-8464. ; 65:1, s. 15-26
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Tidskriftsartikel (refereegranskat)abstract
- Objective: In Sweden, there has previously been no normalised test material for the evaluation of language development in individual hearing-impaired children, and for the assessment of various methods of auditory habilitation. The purpose of the present study was to compose, apply and evaluate a test for language development in hearing-impaired children, and to establish the first set of reference values related to age, sex, type and degree of hearing impairment. Methods: A test consisting of nine subtests was assembled and developed for, and subsequently applied to, hearing-impaired children in the age range 4-6 years. The inclusion criteria were a pure tone average of 80 dBHL or less and oral language (Swedish) as the first language. Two hundred and eleven hearing-impaired children and 87 normal hearing control children were tested. Results: The results show that: (1) children with hearing impairment-also unilateral-have a delayed language development; (2) the delay is greater in children with larger losses and tends to decrease with increasing age; (3) 6-year-olds with hearing loss greater than 60 dB have not reached the level of the control group; (4) no difference between right- or left sided deafness with respect to language development was observed; (5) a reference material, applicable during clinical assessment, was established for the most common types of hearing impairment. Conclusions: The test designed gave graded measures of important aspects of language development in hearing-impaired children. The results merit further application of the test material. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
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| 10. |
- Elfgren, C., et al.
(författare)
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Neuropsychological tests as discriminators between dementia of Alzheimer type and frontotemporal dementia
- 1994
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 1099-1166 .- 0885-6230. ; 9:8, s. 635-642
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine whether cognitive test performance alone could distinguish patients with dementia of Alzheimer type (DAT) from those with frontotemporal dementia (FTD). Scores from three neuropsychological tests were used as discriminating variables in 28 cases with postmortem verified diagnoses. The selected tests measured verbal ability, visuospatial ability and verbal memory. Eighty-nine per cent of the sample was correctly classified by discriminant analysis. Evaluating the ability of the obtained discriminant function to differentiate between groups of DAT and FTD in a new, clinically diagnosed sample of 38 cases yielded an overall success rate of 84%. The results suggest that cognitive tests may be helpful for differential diagnosis in the context of a neuropsychiatric examination.
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| 11. |
- Emery, Carolyn A, et al.
(författare)
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Establishing outcome measures in early knee osteoarthritis
- 2019
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Ingår i: Nature Reviews Rheumatology. - : Springer Science and Business Media LLC. - 1759-4804 .- 1759-4790. ; 15:7, s. 438-448
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Forskningsöversikt (refereegranskat)abstract
- The classification and monitoring of individuals with early knee osteoarthritis (OA) are important considerations for the design and evaluation of therapeutic interventions and require the identification of appropriate outcome measures. Potential outcome domains to assess for early OA include patient-reported outcomes (such as pain, function and quality of life), features of clinical examination (such as joint line tenderness and crepitus), objective measures of physical function, levels of physical activity, features of imaging modalities (such as of magnetic resonance imaging) and biochemical markers in body fluid. Patient characteristics such as adiposity and biomechanics of the knee could also have relevance to the assessment of early OA. Importantly, research is needed to enable the selection of outcome measures that are feasible, reliable and validated in individuals at risk of knee OA or with early knee OA. In this Perspectives article, potential outcome measures for early symptomatic knee OA are discussed, including those measures that could be of use in clinical practice and/or the research setting.
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| 12. |
- Helmens, Karin F., et al.
(författare)
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Warm summers and rich biotic communities during N-Hemisphere deglaciation
- 2018
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Ingår i: Global and Planetary Change. - : Elsevier BV. - 0921-8181 .- 1872-6364. ; 167, s. 61-73
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Tidskriftsartikel (refereegranskat)abstract
- Detailed studies on fossil remains of plants or animals in glacial lake sediments are rare. As a result, environmental conditions right at the moment of deglaciation of the large N-Hemisphere ice-sheets remain largely unknown. Here we study three deglacial phases of the Fennoscandian Ice Sheet as a unique, repeated element in a long sediment record preserved at Soldl in northern Finland. We summarize extensive multi-proxy data (diatoms, phytoliths, chironomids, pollen, spores, non-pollen palynomorphs, macrofossils, lithology, loss-on-ignition, C/N) obtained on glacial lake sediments dated to the early Holocene (ca. 10 kyr BP), early MIS 3 (ca. 50 kyr BP) and early MIS 5a (ca. 80 kyr BP). In contrast to the common view of an unproductive ice-marginal environment, our study reconstructs rich ecosystems both in the glacial lake and along the shores with forest on recently deglaciated land. Higher than present-day summer temperatures are reconstructed based on a large variety of aquatic taxa. Rich biota developed due to the insolation-induced postglacial warming and high nutrient levels, the latter resulting from erosion of fresh bedrock and sediment, leaching of surface soils, decay of plant material under shallow water conditions, and sudden decreases in lake volume. Aquatic communities responded quickly to deglaciation and warm summers and reflect boreal conditions, in contrast to the terrestrial ecosystem which responded with some delay probably due to time required for slow soil formation processes. Birch forest is reconstructed upon deglaciation of the large LGM ice-sheet and shrub tundra following the probably faster melting smaller MIS 4 and MIS 5b ice-sheets. Our study shows that glacial lake sediments can provide valuable palaeo-environmental data, that aquatic biota and terrestrial vegetation rapidly accommodated to new environmental conditions during deglaciation, and that glacial lake ecosystems, and the carbon stored in their sediments, should be included in earth system modeling.
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| 13. |
- Lahdesmaki, A, et al.
(författare)
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Ataxia-telangiectasia kartlagd i Sverige
- 2000
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Ingår i: Läkartidningen. - 0023-7205. ; 97:40, s. 4461-4467
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Tidskriftsartikel (refereegranskat)abstract
- Ataxia-telangiectasia (AT) is a rare autosomal recessive disease with a complex phenotype involving cerebellar degeneration, immunodeficiency, cancer risk and radiosensitivity. Our aim has been to identify Swedish AT patients in order to study the possible "Swedish phenotype" of the disease. In the 19 patients identified in Sweden we found a phenotype fairly similar to what has been described internationally, with the exception of some differences including lower cancer incidence in patients and their relatives and somewhat more pronounced immunodeficiency and concomitant susceptibility to infections.
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| 14. |
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| 15. |
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| 16. |
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| 17. |
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| 18. |
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| 19. |
- Wijn, Stan R.W., et al.
(författare)
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Arthroscopic meniscectomy versus non-surgical or sham treatment in patients with MRI confirmed degenerative meniscus lesions : A protocol for an individual participant data meta-analysis
- 2020
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Arthroscopic partial meniscectomy (APM) after degenerative meniscus tears is one of the most frequently performed surgeries in orthopaedics. Although several randomised controlled trials (RCTs) have been published that showed no clear benefit compared with sham treatment or non-surgical treatment, the incidence of APM remains high. The common perception by most orthopaedic surgeons is that there are subgroups of patients that do need APM to improve, and they argue that each study sample of the existing trials is not representative for the day-to-day patients in the clinic. Therefore, the objective of this individual participant data meta-analysis (IPDMA) is to assess whether there are subgroups of patients with degenerative meniscus lesions who benefit from APM in comparison with non-surgical or sham treatment. Methods and analysis: An existing systematic review will be updated to identify all RCTs worldwide that evaluated APM compared with sham treatment or non-surgical treatment in patients with knee symptoms and degenerative meniscus tears. Time and effort will be spent in contacting principal investigators of the original trials and encourage them to collaborate in this project by sharing their trial data. All individual participant data will be validated for missing data, internal data consistency, randomisation integrity and censoring patterns. After validation, all datasets will be combined and analysed using a one-staged and two-staged approach. The RCTs' characteristics will be used for the assessment of clinical homogeneity and generalisability of the findings. The most important outcome will be the difference between APM and control groups in knee pain, function and quality of life 2 years after the intervention. Other outcomes of interest will include the difference in adverse events and mental health. Ethics and dissemination: All trial data will be anonymised before it is shared with the authors. The data will be encrypted and stored on a secure server located in the Netherlands. No major ethical concerns remain. This IPDMA will provide the evidence base to update and tailor diagnostic and treatment protocols as well as (international) guidelines for patients for whom orthopaedic surgeons consider APM. The results will be submitted for publication in a peer-reviewed journal.
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| 20. |
- Wijn, S. R.W., et al.
(författare)
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Arthroscopic partial meniscectomy vs non-surgical or sham treatment in patients with MRI-confirmed degenerative meniscus tears : a systematic review and meta-analysis with individual participant data from 605 randomised patients
- 2023
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Ingår i: Osteoarthritis and Cartilage. - : Elsevier BV. - 1063-4584. ; 31:5, s. 557-566
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Forskningsöversikt (refereegranskat)abstract
- Objective: To identify subgroups of patients with magnetic resonance imaging (MRI)-confirmed degenerative meniscus tears who may benefit from arthroscopic partial meniscectomy (APM) in comparison with non-surgical or sham treatment. Methods: Individual participant data (IPD) from four RCTs were pooled (605 patients, mean age: 55 (SD: 7.5), 52.4% female) as to investigate the effectiveness of APM in patients with MRI-confirmed degenerative meniscus tears compared to non-surgical or sham treatment. Primary outcomes were knee pain, overall knee function, and health-related quality of life, at 24 months follow-up (0–100). The IPD were analysed in a one- and two-stage meta-analyses. Identification of potential subgroups was performed by testing interaction effects of predefined patient characteristics (e.g., age, gender, mechanical symptoms) and APM for each outcome. Additionally, generalized linear mixed-model trees were used for subgroup detection. Results: The APM group showed a small improvement over the non-surgical or sham group on knee pain at 24 months follow-up (2.5 points (95% CI: 0.8–4.2) and 2.2 points (95% CI: 0.9–3.6), one- and two-stage analysis, respectively). Overall knee function and health-related quality of life did not differ between the two groups. Across all outcomes, no relevant subgroup of patients who benefitted from APM was detected. The generalized linear mixed-model trees did also not identify a subgroup. Conclusions: No relevant subgroup of patients was identified that benefitted from APM compared to non-surgical or sham treatment. Since we were not able to identify any subgroup that benefitted from APM, we recommend a restrained policy regarding meniscectomy in patients with degenerative meniscus tears.
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| 21. |
- Brekke, Helge R., et al.
(författare)
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Identification of p53 as a strong predictor of survival for patients with malignant peripheral nerve sheath tumors
- 2009
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Ingår i: Neuro-Oncology. - : Oxford University Press (OUP). - 1523-5866 .- 1522-8517. ; 11:5, s. 514-528
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to identify new prognostic biomarkers with clinical impact in malignant peripheral nerve sheath tumor (MPNST), a highly aggressive malignancy for which no consensus therapy exists besides surgery. We have used tissue microarrays (TMAs) to assess in situ expression of 14 cell-cycle-regulating proteins in 64 well-characterized MPNST patients: 36 sporadic and 28 with neurofibromatosis type 1 (NF1). We developed a new software application for evaluation and logistics of the TMA images and performed a literature survey of cell cycle proteins in MPNST. For NF1-associated patients, there was a clear association between nuclear expression of p53 and poor survival (p = 0.004). Among the other proteins analyzed, we also found significant associations between survival and clinical variables, but none were as strong as that for p53. For the total series of MPNSTs, p53 was shown to be an independent predictor of survival, and patients without remission, with tumor size larger than 8 cm, and with positive p53 expression had a 60 times greater risk of dying within the first 5 years compared with the remaining patients (p = 0.000002). This is the most comprehensive study of in situ protein expression in MPNST so far, and expressed p53 was found to be a strong surrogate marker for outcome. Patients in complete remission with a primary p53-positive MPNST diagnosis may be considered in a high-risk subgroup and candidates for adjuvant treatment. Neuro-Oncology 11, 514-528, 2009 (Posted to Neuro-Oncology [serial online], Doc. D08-00271, January 30, 2009.)
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| 22. |
- Chuter, Timothy A M, et al.
(författare)
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A telescopic stent-graft for aortoiliac implantation
- 1997
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Ingår i: European Journal of Vascular and Endovascular Surgery. - 1532-2165. ; 13:1, s. 79-84
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To test a new delivery system for a telescopic stent-graft. MATERIALS: Variable overlap between the components of this stent-graft combination allows length adjustment. This device differs from other multi-component stent-grafts in that both components are contained within a single delivery system. METHODS: The stent-graft was implanted in the distal thoracic to suprarenal aorta of five pigs (35-50 kg), where the arterial diameter falls by almost 50%. The proximal and distal components of the stent-graft were targeted to bony landmarks in the vertebral column. RESULTS: Inspection of completion angiograms showed both proximal and distal stent-grafts to be within 1 mm of their target locations in all five experiments. Overall combined stent-graft length varied from 13.5 cm to 16.1 cm depending on the location of the bony landmark chosen as the distal target, and on the size of the pig. CONCLUSIONS: This system may be useful for the repair of abdominal aortic aneurysm whenever preoperative sizing is difficult due to aortic tortuosity, or precluded due to the urgency of the procedure.
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| 23. |
- Chuter, Timothy A M, et al.
(författare)
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Aneurysm pressure following endovascular exclusion
- 1997
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Ingår i: European Journal of Vascular and Endovascular Surgery. - 1532-2165. ; 13:1, s. 85-87
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To assess the effect of stent-graft implantation on the pressure within an abdominal aortic aneurysm. METHODS: Aneurysm exclusion was performed using an aorto-uniiliac stent-graft in eight patients. Following stent-graft implantation, pressure measurements were performed through a catheter adjacent to the graft in the aneurysm. This "aneurysm pressure" was compared with radial arterial pressure. RESULTS: The pressure was lower in the aneurysm than in the radial artery, in all cases. Mean aneurysm pressure was 36.5/33.8 mmHg, while mean radial arterial pressure was 118.5/50.5 mmHg (p < 0.05, for both systolic and diastolic pressures). These findings corresponded with a reduction in the palpable abdominal pulse, and an absence of perigraft perfusion on follow-up computerised tomography. CONCLUSION: Stent-graft implantation produces a fall in the pressure within an abdominal aortic aneurysm.
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| 24. |
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| 25. |
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| 26. |
- Eriksson, Bengt I., 1946, et al.
(författare)
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Prevention of deep-vein thrombosis and pulmonary embolism after total hip replacement. Comparison of low-molecular-weight heparin and unfractionated heparin.
- 1991
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Ingår i: The Journal of bone and joint surgery. American volume. - 0021-9355. ; 73:4, s. 484-93
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Tidskriftsartikel (refereegranskat)abstract
- In a prospective, randomized, double-blind study, the efficacy and safety of a low-molecular-weight heparin were compared with those of unfractionated sodium heparin (standard heparin) in 136 patients who had elective total hip replacement. The patients received subcutaneous injection of either 5000 international units of low-molecular-weight heparin once daily or 5000 international units of standard heparin three times a day. Treatment with low-molecular-weight heparin began twelve hours before the operation, and treatment with standard heparin began two hours preoperatively; both regimens were continued for ten days. Twelve days postoperatively, bilateral ascending phlebography was performed in 122 patients, sixty-three in the treatment group that received low-molecular-weight heparin and fifty-nine in the treatment group that received standard heparin. Pulmonary scintigraphy was performed in 127 patients. Deep-vein thrombosis was diagnosed in forty-four patients: nineteen (30 per cent) of the sixty-three who received low-molecular-weight heparin and twenty-five (42 per cent) of the fifty-nine who received standard heparin. All but four patients, two from each treatment group, were asymptomatic. The difference in the total rate of thrombosis in the two groups was not significant (p = 0.189). However, thrombosis occurred in the thigh in only six (10 per cent) of the patients who received low-molecular-weight heparin but in eighteen (31 per cent) of those who received standard heparin, a significant difference (p = 0.011). Pulmonary embolism was detected in twenty-seven patients: eight (12.3 per cent) of those who received low-molecular-weight heparin and nineteen (30.6 per cent) of those who received standard heparin. Only three patients had clinical signs of embolism. Pulmonary embolism was significantly more frequent in the group that received standard heparin (p = 0.016). Total loss of blood and the total amount of blood that was transfused were significantly reduced in the patients who received low-molecular-weight heparin compared with those who received standard heparin. Prophylaxis was not discontinued because of hemorrhage in any patient. The efficacy of low-molecular-weight heparin was superior to that of standard heparin in the prevention of femoral thrombosis and pulmonary embolism, although the over-all incidence of deep-vein thrombosis was not statistically different.(ABSTRACT TRUNCATED AT 400 WORDS)
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| 27. |
- Fink, H., et al.
(författare)
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Enhanced endothelial cell attachment on RGD-modified bacterial cellulose
- 2008
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Ingår i: World Biomater. Congr.. - 9781615670802
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Konferensbidrag (refereegranskat)abstract
- Studies show so far that BC is a promising material for use in the cardiovascular research area. The possibility to easy modify the surface of the BC makes it a good candidate for pre-seeding in vitro with or recruiting of endothelial cell in vivo.
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| 28. |
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| 29. |
- Impellizzeri, Franco M., et al.
(författare)
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Patient-reported outcome measures for hip-related pain : A review of the available evidence and a consensus statement from the International Hip-related Pain Research Network, Zurich 2018
- 2020
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Ingår i: British journal of sports medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 54:14, s. 848-857
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Forskningsöversikt (refereegranskat)abstract
- Hip-related pain is a well-recognised complaint among active young and middle-aged active adults. People experiencing hip-related disorders commonly report pain and reduced functional capacity, including difficulties in executing activities of daily living. Patient-reported outcome measures (PROMs) are essential to accurately examine and compare the effects of different treatments on disability in those with hip pain. In November 2018, 38 researchers and clinicians working in the field of hip-related pain met in Zurich, Switzerland for the first International Hip-related Pain Research Network meeting. Prior to the meeting, evidence summaries were developed relating to four prioritised themes. This paper discusses the available evidence and consensus process from which recommendations were made regarding the appropriate use of PROMs to assess disability in young and middle-aged active adults with hip-related pain. Our process to gain consensus had five steps: (1) systematic review of systematic reviews; (2) preliminary discussion within the working group; (3) update of the more recent high-quality systematic review and examination of the psychometric properties of PROMs according to established guidelines; (4) formulation of the recommendations considering the limitations of the PROMs derived from the examination of their quality; and (5) voting and consensus. Out of 102 articles retrieved, 6 systematic reviews were selected and assessed for quality according to AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews). Two showed moderate quality. We then updated the most recent review. The updated literature search resulted in 10 additional studies that were included in the qualitative synthesis. The recommendations based on evidence summary and PROMs limitations were presented at the consensus meeting. The group makes the following recommendations: (1) the Hip and Groin Outcome Score (HAGOS) and the International Hip Outcome Tool (iHOT) instruments (long and reduced versions) are the most appropriate PROMs to use in young and middle-aged active adults with hip-related pain; (2) more research is needed into the utility of the HAGOS and the iHOT instruments in a non-surgical treatment context; and (3) generic quality of life measures such as the EuroQoL-5 Dimension Questionnaire and the Short Form Health Survey-36 may add value for researchers and clinicians in this field. We conclude that as none of the instruments shows acceptable quality across various psychometric properties, more methods studies are needed to further evaluate the validity of these PROMS-the HAGOS and iHOT-as well as the other (currently not recommended) PROMS.
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| 30. |
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| 31. |
- Ivancev, Krassi, et al.
(författare)
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Abdominal aortic aneurysms: experience with the Ivancev-Malmo endovascular system for aortomonoiliac stent-grafts
- 1997
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Ingår i: Journal of Endovascular Surgery. - 1074-6218. ; 4:3, s. 242-251
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To describe a component-based aortomonoiliac stent-graft system and the first clinical results achieved with this device in endovascular abdominal aortic aneurysm (AAA) repair. METHODS: From November 1993 to October 1996, 45 patients aged 60 to 86 years underwent endoluminal exclusion of true AAAs (median diameter 60 mm) involving the common iliac arteries (median diameter 16 mm right and 15 mm left) using unilimb stent-grafts deployed with the Iancev-Malmo system. RESULTS: Six immediate conversions occurred in the beginning of the series due to endografts that were too short. Complications, including 2 inadvertent renal artery occlusions, 7 kinked grafts, 6 iliac artery dissections, and 3 perioccluder leaks, were prominent features in the first 15 patients. Five patients died in the postoperative period, four of whom were nonsurgical candidates. There were five significant stent-graft migrations: one 3 weeks after surgery due to mechanical injury of the proximal stent and four after 1 year owing to continuous dilation of a wide proximal neck, stent-graft placement in a conical, thrombus-lined proximal neck, and two instances of proximal extension separation from the main graft. Translumbar aneurysm perfusion required embolization in 3 patients. CONCLUSIONS: Despite early complications associated with a learning curve, exclusion of large AAAs using unilimb stent-grafts is feasible. Strict inclusion criteria are necessary in order to improve mortality among nonsurgical candidates and minimize the risk for late migration.
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| 32. |
- Janczewska, Izabella, et al.
(författare)
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Clinical application of the multigene analysis test in discriminating between ulcerative colitis and Crohn's disease : a retrospective study
- 2012
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Ingår i: Scandinavian journal of gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 47:2, s. 162-9
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Methods. The newly described - multigene analysis test (DiBiCol) identifying 7 inflammatory bowel disease (IBD)-specific genes in colonic mucosal biopsy differentiating between ulcerative colitis (UC) and Crohn's disease (CD) with active inflammation - is a new addition to existing methods with a higher stated sensitivity and specificity. Method biopsy material from 78 patients with a complicated course diagnosed as most probably UC in 38, CD in 18 and inflammatory bowel disease unclassified (IBDU) in 22 were investigated by DiBiCol. Results. DiBiCol showed a pattern consistent with CD in 13 patients with UC and led to change of diagnosis in 3 patients and a strong suggestion of CD in 8 patients. A total of 2 patients remained as UC. DiBiCol showed a pattern of UC in 4 patients of 18 with CD leading to a changing of diagnosis to UC in 3 patients, but the fourth remained as CD. In 22 patients with IBDU DiBiCol showed a pattern consistent with UC in 7 cases and with CD in 13 cases. A new evaluation 1 year after the DiBiCol allowed the assessment of clinical diagnosis in 10 patients confirmed in 9 of 10 patients by DiBiCol. In patients with acute flare of colitis the clinical diagnosis corresponded in 10 of 12 UC and in 5 of 6 CD cases. Summary. Adopting the DiBiCol test led to a change of the primary diagnosis in a significant number of patients with the initial diagnosis of UC and CD and suggested a clinically probable diagnosis in most of the patients with IBDU and in those with an acute flare of colitis.
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| 33. |
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| 34. |
- Kemp, Joanne L., et al.
(författare)
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Physiotherapist-led treatment for young to middle-aged active adults with hip-related pain : Consensus recommendations from the International Hip-related Pain Research Network, Zurich 2018
- 2020
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Ingår i: British journal of sports medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 54:9, s. 504-511
-
Tidskriftsartikel (refereegranskat)abstract
- The 1st International Hip-related Pain Research Network meeting discussed four prioritised themes concerning hip-related pain in young to middle-aged adults: (1) diagnosis and classification of hip-related pain; (2) patient-reported outcome measures for hip-related pain; (3) measurement of physical capacity for hip-related pain; (4) physiotherapist-led treatment for hip-related pain. Thirty-eight expert researchers and clinicians working in the field of hip-related pain attended the meeting. This manuscript relates to the theme of physiotherapist-led treatments for hip-related pain. A systematic review on the efficacy of physiotherapist-led interventions for hip-related pain (published separately) was conducted and found that strong evidence for physiotherapist-led treatments was lacking. Prior to the meeting, draft consensus recommendations for consideration in the meeting were also developed based on the systematic review. The draft consensus recommendations were presented to all of the meeting participants via email, at least 1 week prior to the meeting. At the meeting, these recommendations were discussed, revised and voted on. Six recommendations for clinical practice and five recommendations for research were included and all gained consensus. Recommendations for clinical practice were that (i) Exercise-based treatments are recommended for people with hip-related pain. (ii) Exercise-based treatment should be at least 3 months duration. (iii) Physiotherapist-led rehabilitation after hip surgery should be undertaken. (iv) Patient-reported outcome measures, measures of physical impairment and measures of psychosocial factors should be used to monitor response to treatment. (v) Physical activity (that may include sport) is recommended for people with hip-related pain. (vi) Clinicians should discuss patient expectations, use shared-decision making and provide education. Recommendations for research were (i) Reporting of exercise programmes: Exercise descriptors such as load magnitude, number of repetitions and sets, duration of whole programme, duration of contractile element of exercise, duration of one repetition, time under tension, rest between repetitions, range of motion through which the exercise is performed, and rest between exercise sessions should be reported. (ii) Research should investigate the optimal frequency, intensity, time, type, volume and progression of exercise therapy. (iii) Research should examine the effect of patient education in people with hip-related pain. (iv) Research should investigate the effect of other treatments used in people with hip-related pain (for example: manual therapy, medications, injections). (v) Research should examine the impact of comorbidities and social determinants on treatment effectiveness in people with hip-related pain. Clinicians and researchers working with young to middle-aged active adults with hip-related pain may use these consensus recommendations to guide, develop, test and implement individualised, evidence-based physiotherapist-led rehabilitation programmes.
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| 35. |
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| 36. |
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| 37. |
- Malina, Martin, et al.
(författare)
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Changing aneurysmal morphology after endovascular grafting: relation to leakage or persistent perfusion
- 1997
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Ingår i: Journal of Endovascular Surgery. - 1074-6218. ; 4:1, s. 23-30
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To relate changing abdominal aortic aneurysm (AAA) morphology after endovascular grafting to the presence of leakage, collateral perfusion, and other factors. METHODS: Thirty-five patients who underwent successful AAA endovascular grafting were evaluated. Self-expanding Z-stents and Dacron grafts were applied in bifurcated and aortomonoiliac systems. Postoperative diameter changes were calculated from repeated spiral computed tomographic scans, angiograms, and ultrasonic phase-locked echo-tracking scans during a median 6-month follow-up (interquartile range [IQR] 3 to 12). RESULTS: At 12 months, the diameters of completely excluded aneurysms had decreased 6 mm (IQR 2 to 11; p = 0.006). The proximal graft-anchoring stents had dilated 2 mm (IQR 0.5 to 3.3; p = 0.01). The aortic diameters immediately below the renal arteries but above the stents had not changed. Endoleakage and collateral perfusion (n = 13) were each associated with preserved aneurysm size and a 12 times higher risk of aneurysm dilation. After the leakage or the collateral perfusion had been treated, the aneurysm size decreased. Aneurysms with extensive intraluminal thrombi presented a reduced risk of leakage or perfusion. CONCLUSIONS: The diameters of endovascularly excluded AAAs decrease, except in cases of leakage or perfusion. Careful follow-up of patients with aortic endografts is necessary.
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| 38. |
- Massuanganhe, Elídio A., et al.
(författare)
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Morphodynamics of deltaic wetlands and implications for coastal ecosystems – A case study of Save River Delta, Mozambique
- 2018
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Ingår i: Geomorphology. - : Elsevier BV. - 0169-555X .- 1872-695X. ; 322, s. 107-116
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Tidskriftsartikel (refereegranskat)abstract
- Deltaic wetlands experience changes over time, with substantial impacts on the coastal ecosystems. These changes, whether they are natural or human-induced, are caused by multiple factors through complex links and interdependences, and constitute challenges for coastal management aiming to set up practical adaptation measures. In this study, we investigate a case study of Save River Delta to interpret the typical morphodynamic pattern on the deltaic plain over an interdecadal timescale and the implications of geomorphological changes for the coastal ecosystems, with emphasis on mangroves. Our results reveal the pattern of the geomorphological changes on the deltaic wetland in river and back-barrier sectors. In both sectors, erosion and accretion are mutually adjusting processes, and they result in geomorphological settings characterized by a distinctive interaction with the ecosystem; on the one hand, mangrove trees colonize new favorable settings; on the other hand, the existing mangrove trees undergo degradation related to the morphodynamic processes. Notwithstanding current episodic events that affect the deltaic wetlands (e.g. cyclones and floods), the changes observed in the study area are part of interdecadal timescale morphodynamics. These changes were consistent for the 50-year time period analyzed. If, on the one hand, some of the episodic and high magnitude weather events such as floods undermine the status of the deltaic ecosystem, on the other hand these events contribute to develop the same ecosystem over a longer timescale. Within interdecadal timescales, biogeomorphological changes in deltaic wetlands are a critical reference frame for understanding future scenarios of environmental changes caused by climate change.
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| 39. |
- Massuanganhe, Elidio A., 1982-, et al.
(författare)
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Palaeogeography and dynamics of the deltaic wetland of Save River, Mozambique
- 2018
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Ingår i: Palaeogeography, Palaeoclimatology, Palaeoecology. - : Elsevier BV. - 0031-0182 .- 1872-616X. ; 489, s. 64-73
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Tidskriftsartikel (refereegranskat)abstract
- Many mangrove wetland systems in deltaic environments are negatively affected by massive sedimentation fromriver inflows. In this paper we use the example of the Save River delta to assess the palaeogeographic distributionof mangrove wetlands and to analyze their dynamics. To track past occurrences of mangrove wetlands in thestudy area we have integrated sedimentological data with siliceous microfossil analysis combined with AMSradiocarbon and OSL dating. The results show a fine-grained deposit with an approximate thickness of 2 m,present at different sampling sites. In the upper deltaic plain, the deposit is interbedded between sand layers,while in the lower deltaic plain the deposit occupies the uppermost stratigraphic position. In most of thesampling sites the deposit shows a succession with brackish-marine diatoms at the bottom of the sequence whilethe upper part shows only scattered occurrences. Based on sedimentological and microfossil characteristics wehave interpreted the layer to represent a mangrove wetland deposit. The development of the deposit in the studyarea is suggested to have been initiated around 3100 cal. yr BP, induced by sea-level rise. Thereafter, the developmentfollowed the combined effect of a sea-level fall and delta progradation processes. In some areas,particularly in the proximal part of the delta, the mangrove deposit has developed progressively on top of thedelta-front. From around 1300 years ago (OSL) onwards, massive alluvial sedimentation impacted the mangroveecosystem. However, the retreat of mangrove wetland coincided with a regional fall of sea level. At the edges ofthe alluvial deposit, the current mangrove ecosystem has reclaimed the habitat in some sectors where gullyerosion has exposed the once extinct mangrove habitat.
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| 40. |
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| 41. |
- Mosler, Andrea Britt, et al.
(författare)
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Standardised measurement of physical capacity in young and middle-aged active adults with hip-related pain : Recommendations from the first International Hip-related Pain Research Network (IHiPRN) meeting, Zurich, 2018
- 2020
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Ingår i: British journal of sports medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 54:12, s. 702-710
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Tidskriftsartikel (refereegranskat)abstract
- Hip-related pain can significantly impact quality of life, function, work capacity, physical activity and family life. Standardised measurement methods of physical capacity of relevance to young and middle-aged active adults with hip-related pain are currently not established. The aim of this consensus paper was to provide recommendations for clinical practice and research on standardised measurement methods of physical capacity in young and middle-aged active adults with hip-related pain. Four areas of importance were identified: (1) clinical measures (range of motion, muscle strength, functional impairments), (2) laboratory-based measures (biomechanics and muscle function (muscle activity, size and adiposity)), (3) physical activity, and (4) return to sport/performance. The literature was reviewed, and a summary circulated to the working group to inform discussion at the consensus meeting. The working group developed clinical and research recommendations from the literature review, which were further discussed and modified within the working group at the consensus meeting. These recommendations were then presented to all 38 International Hip-related Pain Research Network (IHiPRN) participants for further discussion, refinement and consensus voting. Therefore, the recommendations voted on were based on a combination of current evidence and expert opinion. The consensus meeting voted on 13 recommendations, six of which were clinically orientated, and seven more research specific. We recommended that clinicians working with young and middle-aged active adults with hip-related pain assess strength using objective methods of measurement, and clinically assess performance of functional tasks, including walking and running. Physical activity should be quantified using both self-reported and objective measures, and patient expectations of recovery should be quantified prior to treatment. It was recommended that return to physical activity (including sport and occupation) be quantified, and sport-specific activities should be assessed prior to return to sport. The IHiPRN participants were uncertain regarding recommendations for range of motion assessment. Research recommendations were that the measurement properties of range of motion, strength and functional performance tests be investigated, reported and improved in both clinical and research settings. Reporting of movement-related parameters (biomechanics and muscle function) should be standardised and the relationship among movement-related parameters, symptoms, function, quality of life, and intra-articular and imaging findings should be investigated. Quantification of return to physical activity (including sport and occupational demands) is required in future research, and the return to sport continuum should be used. Future research is required to determine the best criteria for rehabilitation progression and return to physical activity following hip-related pain management.
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| 42. |
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| 43. |
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| 44. |
- Ray, C. A., et al.
(författare)
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Diastereoselective Lewis acid-catalysed 4+2 cycloadditions of 3-alkyl-, 3-aryl- and 3-carboxyl-2H-azirines : a route to aziridine containing azabicyclo 4.1.0 heptanes and azatricyclo 2.2.1.0 nonanes
- 2002
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Ingår i: Tetrahedron. - 0040-4020 .- 1464-5416. ; 58:30, s. 5983-5987
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Tidskriftsartikel (refereegranskat)abstract
- 3-Substituted-2H-azirines have been employed as 2pi components in Lewis acid-catalysed hetero Diels-Alder reactions with a variety of diene systems. A series of Lewis acids were screened for catalytic behaviour in the reaction between Danishefsky's diene and 3-phenyl-2H-azirine to give the cycloaddition adduct, and in most cases elevated temperature were required to effect cycloaddition. A noteworthy exception was a BF3.Et2O-catalysed cycloaddition which proceeded in less than I h between -70degreesC and -60degreesC. The cycloadditions were found to proceed with endo selectivity providing a single diastereoisomeric product. Benzyl 2H-azirine-3-carboxylates were found to be activated by Lewis acids and participate in endo selective cycloadditions at -20degreesC.
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| 45. |
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| 46. |
- Reiman, Michael P., et al.
(författare)
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Consensus recommendations on the classification, definition and diagnostic criteria of hip-related pain in young and middle-aged active adults from the International Hip-related Pain Research Network, Zurich 2018
- 2020
-
Ingår i: British journal of sports medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 54:11, s. 631-641
-
Forskningsöversikt (refereegranskat)abstract
- There is no agreement on how to classify, define or diagnose hip-related pain-a common cause of hip and groin pain in young and middle-aged active adults. This complicates the work of clinicians and researchers. The International Hip-related Pain Research Network consensus group met in November 2018 in Zurich aiming to make recommendations on how to classify, define and diagnose hip disease in young and middle-aged active adults with hip-related pain as the main symptom. Prior to the meeting we performed a scoping review of electronic databases in June 2018 to determine the definition, epidemiology and diagnosis of hip conditions in young and middle-aged active adults presenting with hip-related pain. We developed and presented evidence-based statements for these to a panel of 37 experts for discussion and consensus agreement. Both non-musculoskeletal and serious hip pathological conditions (eg, tumours, infections, stress fractures, slipped capital femoral epiphysis), as well as competing musculoskeletal conditions (eg, lumbar spine) should be excluded when diagnosing hip-related pain in young and middle-aged active adults. The most common hip conditions in young and middle-aged active adults presenting with hip-related pain are: (1) femoroacetabular impingement (FAI) syndrome, (2) acetabular dysplasia and/or hip instability and (3) other conditions without a distinct osseous morphology (labral, chondral and/or ligamentum teres conditions), and that these terms are used in research and clinical practice. Clinical examination and diagnostic imaging have limited diagnostic utility; a comprehensive approach is therefore essential. A negative flexion-adduction-internal rotation test helps rule out hip-related pain although its clinical utility is limited. Anteroposterior pelvis and lateral femoral head-neck radiographs are the initial diagnostic imaging of choice-advanced imaging should be performed only when requiring additional detail of bony or soft-tissue morphology (eg, for definitive diagnosis, research setting or when planning surgery). We recommend clear, detailed and consistent methodology of bony morphology outcome measures (definition, measurement and statistical reporting) in research. Future research on conditions with hip-related pain as the main symptom should include high-quality prospective studies on aetiology and prognosis. The most common hip conditions in active adults presenting with hip-related pain are: (1) FAI syndrome, (2) acetabular dysplasia and/or hip instability and (3) other conditions without distinct osseous morphology including labral, chondral and/or ligamentum teres conditions. The last category should not be confused with the incidental imaging findings of labral, chondral and/or ligamentum teres pathology in asymptomatic people. Future research should refine our current recommendations by determining the clinical utility of clinical examination and diagnostic imaging in prospective studies.
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| 47. |
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| 48. |
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| 49. |
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