| 1. |
- Ruilope, LM, et al.
(författare)
-
Design and Baseline Characteristics of the Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease Trial
- 2019
-
Ingår i: American journal of nephrology. - : S. Karger AG. - 1421-9670 .- 0250-8095. ; 50:5, s. 345-356
-
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.
|
|
| 2. |
|
|
| 3. |
- Watanabe, A, et al.
(författare)
-
Gunnar Fant 60 years
- 1979
-
Ingår i: TMH-QPSR. ; 20:2, s. 1-45
-
Tidskriftsartikel (refereegranskat)
|
|
| 4. |
- Ivancev, Krassi, et al.
(författare)
-
Options for treatment of persistent aneurysm perfusion after endovascular repair
- 1996
-
Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 1432-2323 .- 0364-2313. ; 20:6, s. 673-678
-
Tidskriftsartikel (refereegranskat)abstract
- Persistent aneurysm perfusion represents failure of endovascular repair. The leak may occur around either end of the prosthesis or through a collateral route. Most cases can be treated by endovascular means. Stents can be rotated, the prosthesis can be lengthened at either end, and collateral pathways can be occluded, all without recourse to open repair. This report describes the management of persistent aneurysm perfusion in five patients from a total experience of 32 cases of endovascular aneurysm repair.
|
|
| 5. |
- Klefsgård, Rosemarie, et al.
(författare)
-
A 1-year follow-up quality of life study after hemodynamically successful or unsuccessful surgical revascularization of lower limb ischemia
- 2001
-
Ingår i: Journal of Vascular Surgery. - : Elsevier BV. - 1097-6809 .- 0741-5214. ; 33:1, s. 114-122
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The impact of hemodynamically successful or unsuccessful bypass grafting or angioplasty on patients' quality of life was assessed throughout the first year postsurgery. METHODS: A total of 146 patients, 97 patients who underwent successful revascularization and 49 patients who underwent unsuccessful revascularization, were assessed for quality of life with the Nottingham Health Profile. RESULTS: Hemodynamically successful revascularization resulted in an immediate and lasting impact on the patients' quality of life. Despite hemodynamic failure, patients had improvements in pain, emotional reactions, sleep, and family relationships at the 1-year follow-up assessment. A successful revascularization in patients with claudication demonstrated the most marked quality of life benefits, including all health dimensions that were not normal at baseline. Patients with critical ischemia had improved quality of life for pain, sleep, and physical mobility. High ankle pressure, in the claudicant group, and a high sense of coherence were significantly associated with high quality of life. CONCLUSION: The treatment of lower limb ischemia resulted in an immediate and relatively lasting improvement in patients' quality of life. Patients who underwent hemodynamically successful bypass grafting procedures or angioplasty demonstrated higher quality of life benefits than patients who underwent a failed bypass grafting procedure. Quality of life was further determined by means of the patients' sense of coherence.
|
|
| 6. |
- Klefsgård, Rosemarie, et al.
(författare)
-
Nottingham Health Profile and Short-Form 36 Health Survey questionnaires in patients with chronic lower limb ischemia: Before and after revascularization.
- 2002
-
Ingår i: Journal of Vascular Surgery. - : Elsevier BV. - 1097-6809 .- 0741-5214. ; 36:2, s. 310-317
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The purpose of this study was to compare the usefulness of the Nottingham Health Profile (NHP) and the Short-Form 36 Health Survey (SF-36) as general outcome measures after vascular intervention for lower limb ischemia with respect to patients' quality of life, on the basis of validity, reliability, and responsiveness analyses. Patients and Methods: Eighty patients, 40 with claudication and 40 with critical ischemia, were assessed before and one month after revascularization by using comparable domains of the NHP and the SF-36 questionnaires. RESULTS: The SF-36 scores were less skewed and were distributed more homogeneously than the NHP scores. Discriminate validity results showed that NHP was better than SF-36 in discriminating among levels of ischemia with respect to pain and physical mobility. For both questionnaires, the reliability standards were satisfactory in most respects. The NHP was more responsive than the SF-36 in detecting within-patient changes. All of the NHP domains not zero at baseline were improved significantly one month after hemodynamically successful revascularization for patients with claudication, whereas patients with critical ischemia showed significant abatement of pain and improvements in physical mobility and social isolation. The SF-36 scores indicated a significant decrease in bodily pain and improvements in physical functioning and vitality for patients with claudication, and decrease in bodily pain and improvement in physical functioning for patients with critical ischemia. CONCLUSIONS: The findings indicated that both NHP and SF-36 were reliable. The SF-36 scores were less skewed than the NHP scores, whereas NHP discriminated better among levels of ischemia and was more responsive in detecting quality-of-life changes over time than SF-36 in these particular patients.
|
|
| 7. |
- Klefsgård, Rosemarie, et al.
(författare)
-
Quality of life associated with varying degrees of chronic lower limb ischaemia: comparison with a healthy sample
- 1999
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 17:4, s. 319-325
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To assess quality of life in patients with varying degrees of ischaemia in comparison with controls, and to determine whether the degree of lower limb ischaemia and sense of coherence were associated with quality of life. MATERIALS AND METHODS: 168 patients, including 93 claudicants and 75 patients with critical ischaemia and 102 controls were studied. Quality of life was assessed using the Nottingham Health Profile in addition to the Sense of Coherence scale. MAIN RESULTS: Patients with lower limb ischaemia scored significantly reduced quality of life in all aspects compared to controls. Pain, physical mobility and emotional reactions were the significant independent factors when using logistic regression analysis. The grade of disease and low sense of coherence were significantly associated with low quality of life. Increasing lower limb ischaemia significantly conferred worse pain, sleeping disturbances and immobility. CONCLUSION: This study showed that the quality of life was impaired among patients with lower limb ischaemia, in all investigated respects. The degree to which quality of life was affected seems to represent an interplay between the grade of ischaemia and the patient's sense of coherence. This suggests the need for a multidimensional assessment prior to intervention.
|
|
| 8. |
- Klefsgård, Rosemarie, et al.
(författare)
-
The effects of successful intervention on quality of life in patients with varying degrees of lower-limb ischaemia
- 2000
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 19:3, s. 238-245
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: to assess the quality of life after successful intervention among patients with varying degrees of lower-limb ischaemia in comparison with healthy controls and the respondents>> degree of sense of coherence. MATERIALS AND METHODS: one hundred and twelve patients and 102 healthy controls were assessed for quality of life (Nottingham Health Profile) and sense of coherence. MAIN RESULTS: successful angioplasty or surgical intervention led to an improved quality of life at 6 months, in particular with regard to pain, sleep, physical mobility, hobbies and holiday and to a level similar to healthy controls in sleep, social isolation, paid employment and family relationships. It remained at a significantly lower level than that of healthy controls with regard to pain, emotional reactions, physical mobility, energy, housework, hobbies, holidays, sex and social life. Critical ischaemia patients did not reach the same level of quality of life as the claudicants or the healthy controls. CONCLUSION: successful treatment for chronic limb ischaemia improved the quality of life significantly, more so in claudicants than in patients with critical ischaemia. The degree to which the quality of life improved was associated with the patients>> sense of coherence and their ankle pressure.
|
|
| 9. |
|
|
| 10. |
- Risberg, B, et al.
(författare)
-
Inter-institutional reproducibility of flow cytometric DNA-analysis in breast carcinomas
- 1994
-
Ingår i: Analytical Cellular Pathology. - 0921-8912. ; 6:1, s. 23-36
-
Tidskriftsartikel (refereegranskat)abstract
- In order to study interinstitutional reproducibility of flow cytometric DNA-analysis (DNA-FCM), frozen pieces from 30 consecutive breast carcinomas were analysed by 5 laboratories. Different instruments, preparation and DNA staining methods were used. A concordance in DNA-ploidy status was obtained in 26 of the 30 tumours. The discrepancy can mainly be explained by intratumoural DNA-heterogeneity since a complete agreement in ploidy status was obtained when four of the laboratories analysed the same cell suspension, where solid bits showed differing results. The sampling method seems therefore to be a crucial step for the results and needs further studies. As far as the estimation of S-phase fraction was concerned, one laboratory obtained significantly higher values compared to the other four. The correlation between the other four laboratories varied between r = 0.66-0.92.
|
|
| 11. |
|
|
| 12. |
- Wendin, Karin, 1963-, et al.
(författare)
-
Low-fat mayonnaise : Influences of fat content, aroma compounds and thickeners
- 1997
-
Ingår i: Food Hydrocolloids. - 0268-005X .- 1873-7137. ; 11:1, s. 87-99
-
Tidskriftsartikel (refereegranskat)abstract
- The effects of fat content and thickeners, propylene glycol alginate (PGA; 1.40%) and guar gum (1.55%), on sensory and instrumental quality descriptors on reduced fat mayonnaises (15 and 30% fat) with and without added aroma compounds, citral (semi-polar) and pyroligneous acid (polar), were investigated. One mayonnaise, 82% fat, without added thickener or aroma compounds was used as reference. Sensory evaluation (quantitative descriptive analysis; QDA), rheological analysis (yield stress, maximum viscosity, G' and G''), measurements of particle size and headspace CC-MS analyses were carried out. Correlations between the results were developed Perceived and instrumental texture, and perceived smell and flavour, changed differently in magnitude and direction due to fat content and type of thickener.
|
|
| 13. |
|
|
| 14. |
- Berg, B., et al.
(författare)
-
Development of osteoarthritis in patients with degenerative meniscal tears treated with exercise therapy or surgery : a randomized controlled trial
- 2020
-
Ingår i: Osteoarthritis and Cartilage. - : Elsevier BV. - 1063-4584. ; 28:7, s. 897-906
-
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.
|
|
| 15. |
- Berglund, B E, et al.
(författare)
-
Sweden
- 1996
-
Annan publikation (övrigt vetenskapligt/konstnärligt)
|
|
| 16. |
|
|
| 17. |
- Borg, E, et al.
(författare)
-
Language development in hearing-impaired children - Establishment of a reference material for a 'Language test for hearing-impaired children', LATHIC
- 2002
-
Ingår i: International Journal of Pediatric Otorhinolaryngology. - 1872-8464. ; 65:1, s. 15-26
-
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.
|
|
| 18. |
|
|
| 19. |
|
|
| 20. |
- Emery, Carolyn A, et al.
(författare)
-
Establishing outcome measures in early knee osteoarthritis
- 2019
-
Ingår i: Nature Reviews Rheumatology. - : Springer Science and Business Media LLC. - 1759-4804 .- 1759-4790. ; 15:7, s. 438-448
-
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.
|
|
| 21. |
- Eriksson, Bengt I., 1946, et al.
(författare)
-
Prevention of deep-vein thrombosis and pulmonary embolism after total hip replacement. Comparison of low-molecular-weight heparin and unfractionated heparin.
- 1991
-
Ingår i: The Journal of bone and joint surgery. American volume. - 0021-9355. ; 73:4, s. 484-93
-
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)
|
|
| 22. |
- Eyles, J.P., et al.
(författare)
-
Clinical Outcomes Of Osteoarthritis Management Programs: A Project Of The Oa Trial Bank And Oarsi Joint Effort Initiative Using Individual Participant Data
- 2023
-
Ingår i: Osteoarthritis and Cartilage. - : Elsevier. - 1063-4584 .- 1522-9653. ; 31, s. S385-S386
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: People living with osteoarthritis (OA) often do not receive best evidence care. Coordinated OA management programs (OAMPs) have been implemented to address this global evidence-practice gap. An OAMP is defined as a package of care with the following: i) a personalized management plan; ii) with reassessment and progression; iii) using a minimum of 2 core treatments (education, exercise, weight control), and; iv) optional adjunctive therapies. Existing OAMP models differ in treatment mode, intensity, duration, the health professionals delivering care, and the healthcare systems and settings they operate within. Randomized trials (RCTs) and cohort studies assess the outcomes of different OAMPs, however, these models are unlikely to ever be compared in RCTs due to the huge expense and complicated logistics required. Prognosis research provides another method of comparing outcomes of different OAMP models. This study aimed to estimate the pain and self-reported function outcomes (at 12-, 26- and 52-weeks) of people with hip and/or knee OA who participated in international OAMPs. It also aimed to describe the characteristics of OAMP participants.Methods: This study was undertaken by members of the OARSI Joint Effort Initiative (JEI), in collaboration with the OA Trial Bank (Erasmus MC, Netherlands). RCTs and clinical cohorts assessing OAMPs were identified through the JEI membership and literature searches. Eligible studies included data from an ongoing OAMP, in any real-world setting, with participants who were diagnosed with hip or knee OA, and longitudinal measures of patient-reported pain and function. The investigators of eligible studies were invited to complete data delivery agreements with the OA Trial Bank, share individual participant data (IPD), contribute to study design and authorship. Investigators ensured they had local ethics review board approval to contribute IPD to the OA Trial bank. Each dataset was converted to a common format to enable merging into one dataset. The IPD were evaluated to convert pain and function variables to standardized scales as appropriate. Pain scores were converted to a 0-100 point scale (100 worst). Function scores were converted to a 0-100 point scale (100 best). A generalized estimating equations (GEE) model analysis was performed to assess the change in pain and function from baseline across weeks 12, 26, and 52. The model specification was based on an unstructured correlation structure and robust standard errors. Pain and function estimates were adjusted by age, sex and body mass index (BMI). Data analyses were carried out using Stata 15 (StataCorp 2015) and SPSS 17.Results: The investigators of 13 international OAMPs were invited to take part. IPD from 9 OAMPs were delivered: the OA Chronic Care Program, Ramsay Health OA Management Program, Joint Health Program, University of Wisconsin Health Knee and Hip Comprehensive Non-Surgical OA Management Clinic, Improved Management of Patients With Hip and Knee OA in Primary Health Care, Joint Academy, Amsterdam OA cohort, Management of OA In Consultations, and Collaborative model of care between Orthopaedics and allied healthcare professionals in knee OA. The characteristics of the OAMPs are summarised in table 1. The OAMPs were conducted in-person except for the Joint Academy that was implemented as an online OAMP. Individual participant data from 9819 participants were analyzed. The cohort studies were missing large amounts of data, as expected in clinical practice. The characteristics of OAMP participants are summarised in Table 2. The majority of OAMP participants reported the knee as their index joint, their mean age ranged between 62- 67 years, 58-74% were female, 25-48% were working and mean BMI indicated they were overweight at baseline. Pain was most commonly assessed using a Numeric Rating Scale or validated questionnaires e.g. the Knee Injury and OA Outcome Scale (KOOS). Function was mostly assessed using validated questionnaires such as the KOOS. The pain and fuction measured in the original datasets are reported in Table 1. The changes in pain and function of the OAMP participants from baseline across weeks 12, 26, and 52 are summarised in Table 3. There were reductions in pain scores and improvements in function scores seen across all programs at the majority of timepoints.Conclusions: We established the first data bank of IPD from different international OAMPs. Analysis of the IPD demonstrated modest improvements in pain and function across the programs at all timepoints. The most rapid improvements were made by week-12, however, these gains were maintained at week-52. In future work this project will use IPD meta-analysis to identify prognostic factors of people with OA who participate in OAMPs.
|
|
| 23. |
- Fink, H., et al.
(författare)
-
Enhanced endothelial cell attachment on RGD-modified bacterial cellulose
- 2008
-
Ingår i: World Biomater. Congr.. - 9781615670802
-
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.
|
|
| 24. |
|
|
| 25. |
|
|
| 26. |
- Hare, Kristoffer B., et al.
(författare)
-
Middle-aged patients with an MRI-verified medial meniscal tear report symptoms commonly associated with knee osteoarthritis : A cross-sectional study of 199 patients
- 2017
-
Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 88:6, s. 664-669
-
Tidskriftsartikel (refereegranskat)abstract
- Background and purpose — No consensus exists on when to perform arthroscopic partial meniscectomy in patients with a degenerative meniscal tear. Since MRI and clinical tests are not accurate in detecting a symptomatic meniscal lesion, the patient’s symptoms often play a large role when deciding when to perform surgery. We determined the prevalence and severity of self-reported knee symptoms in patients eligible for arthroscopic partial meniscectomy due to a degenerative meniscal tear. We investigated whether symptoms commonly considered to be related to meniscus injury were associated with early radiographic signs of knee osteoarthritis. Patients and methods — We included individual baseline items from the Knee injury and Osteoarthritis Outcome Score collected in 2 randomized controlled trials evaluating treatment for an MRI-verified degenerative medial meniscal tears in 199 patients aged 35–65 years. Each item was scored as no, mild, moderate, severe, extreme, and at least “mild” considering the symptoms present. Early radiographic signs of osteoarthritis, defined as a Kellgren and Lawrence grade of at least 1, were seen in 70 patients. Results — At least monthly knee pain, pain during stair walking and when twisting on the knee, and lack of confidence in knee was present in at least 80% of the patients. Median severity was at least moderate for knee pain, pain when twisting on the knee, pain walking on stairs, lack of confidence in knee, and clicking. Mechanical symptoms such as catching were rare. Early radiographic signs of osteoarthritis were associated with an increased risk of self-reported swelling, catching, and stiffness later in the day; the odds ratio was 2.4 (95% CI 1.2–4.9), 2.3 (1.2–4.3), and 2.3 (1.1–5.0), respectively. Interpretation — Middle-aged patients with a degenerative medial meniscus tear reported symptoms commonly associated with knee osteoarthritis. Frequent knee pain, presence of lack of confidence in the knee, and clicking did not distinguish those with a meniscal tear alone from those with early radiographic knee OA. Our findings support the notion that symptoms reported by those with a degenerative meniscal tear represent early signs of knee osteoarthritis.
|
|
| 27. |
- Jahnson, S., et al.
(författare)
-
p53 and Rb immunostaining in locally advanced bladder cancer : relation to prognostic variables and predictive value for the local response to radical radiotherapy
- 1995
-
Ingår i: European Urology. - Basel, Switzerland : S. Karger. - 0302-2838 .- 1873-7560. ; 28:2, s. 135-142
-
Tidskriftsartikel (refereegranskat)abstract
- The association between known prognostic variables and altered immunostaining for the nuclear proteins retinoblastoma (Rb) and p53 was studied in a homogeneous series of locally advanced bladder cancer. The predictive value of this immunostaining for the local response to intended radical radiotherapy was investigated. Among 262 patients treated with intended radical radiotherapy between 1967 and 1986, a total of 154 patients were evaluable with respect to local response to treatment. The paraffin-embedded specimen from the tumour prior to irradiation was immunostained with the monoclonal antibodies PMG3-245 for Rb and 1801 for p53 nuclear proteins after heating in a microwave oven for 40 min at 650 W. An altered expression of Rb and p53 was observed in 18 and 42% of the tumours, respectively. p53 overexpression was associated with higher tumour grade. However, the results of the p53 and Rb immunostaining procedures had no predictive value for tumor response to radiation treatment, local control or cancer-specific mortality.
|
|
| 28. |
|
|
| 29. |
- Janczewska, Izabella, et al.
(författare)
-
Clinical application of the multigene analysis test in discriminating between ulcerative colitis and Crohn's disease : a retrospective study
- 2012
-
Ingår i: Scandinavian journal of gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 47:2, s. 162-9
-
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.
|
|
| 30. |
- Jeppsson, B, et al.
(författare)
-
Kirurgi.
- 2010
-
Bok (övrigt vetenskapligt/konstnärligt)
|
|
| 31. |
- Jeppsson, B, et al.
(författare)
-
Kirurgi.
- 2005
-
Bok (övrigt vetenskapligt/konstnärligt)
|
|
| 32. |
- Lebel, L, et al.
(författare)
-
Effect of increased hydrostatic pressure on lymphatic elimination of hyaluronan from sheep lung.
- 1988
-
Ingår i: Journal of applied physiology. - 8750-7587 .- 1522-1601. ; 64:4, s. 1327-32
-
Tidskriftsartikel (refereegranskat)abstract
- The effects of increased hydrostatic pressure on the concentrations of hyaluronan (hyaluronic acid) in lung lymph and serum were investigated in awake sheep with a cannula in the efferent vessel from the caudal mediastinal lymph node. Lung lymph was sampled at base line [left atrial pressure (LAP) 6.5 +/- 1.7 mmHg] and after two increases of LAP to 25.7 +/- 2.2 mmHg (level 1) and 37.0 +/- 5.1 mmHg (level 2). The lung lymph flow increased from 1.9 +/- 0.5 at base line to 9.3 +/- 2.2 and 15.9 +/- 0.7 ml/30 min, and the lymph-to-plasma concentration ratio of total protein decreased from 0.63 +/- 0.02 to 0.32 +/- 0.04 and 0.32 +/- 0.05 at the two elevated levels of LAP, respectively. The hyaluronan concentration in lung lymph was unchanged, and there was a flow-dependent elimination of hyaluronan from the lung that increased from 23 +/- 8 to 87 +/- 19 and 137 +/- 37 micrograms/30 min, respectively. The lung concentration of hyaluronan was 167 +/- 28 micrograms/g fresh lung, and at base line it was calculated that slightly less than 2% of the lung hyaluronan was eliminated by the lymphatic route in 24 h. If extrapolated to 24 h, the elimination rate of hyaluronan seen during elevated LAP would result in lymphatic elimination of 18% of the lung hyaluronan over this time period. Since hyaluronan is responsible for part of the protein exclusion in the extracellular matrix, it is plausible that washout of interstitial hyaluronan contributes to the decrease in albumin exclusion from the interstitium that occurs after an elevation of LAP.
|
|
| 33. |
- Lebel, L, et al.
(författare)
-
Increased lymphatic elimination of interstitial hyaluronan during E. coli sepsis in sheep.
- 1989
-
Ingår i: American Journal of Physiology. - 0002-9513 .- 2163-5773. ; 256:6 Pt 2, s. H1524-31
-
Tidskriftsartikel (refereegranskat)abstract
- The effect of septicemia on the elimination of hyaluronan (HA) from the lung interstitium was investigated in awake sheep with chronic lung lymph and thoracic duct fistulas. The result was compared with that after elevation of left atrial pressure (LAP). Lymph was sampled before and after a 20-min infusion of Escherichia coli (10(9) bacteria/kg body wt.), after elevation of LAP, or both. Infusion of E. coli caused an increased flux of HA in lung lymph and thoracic duct lymph. After an elevation of LAP, the HA flux in lung lymph was increased to a comparable extent. In animals subjected to an increase in LAP and subsequently to infusion of E. coli, no additive effect on HA flux was seen. The weight-average molecular weight of HA in lung lymph was increased both after sepsis and after elevation of LAP. The findings show that sepsis and elevated transvascular hydrostatic pressure result in increased mobilization of HA from the interstitium. This might partly explain the increased HA concentrations in plasma in clinical sepsis and may also lead to a change in the characteristics of the interstitial matrix in this condition.
|
|
| 34. |
|
|
| 35. |
- Malina, Martin, et al.
(författare)
-
Renal arteries covered by aortic stents: clinical experience from endovascular grafting of aortic aneurysms
- 1997
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - 1532-2165. ; 14:2, s. 109-113
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: During the endovascular repair of abdominal aortic aneurysms (AAAs), effective anchoring of the stent-graft is difficult in the presence of a short infrarenal aneurysm neck. The aim of this study was to investigate renal artery patency and renal function after deployment of graft anchoring stents across the renal arteries. DESIGN: Retrospective open study. PATIENTS: Twenty-five renal arteries, in 18 patients treated by endovascular exclusion of an AAA, were intentionally covered with the Gianturco Z-stent to ensure stent graft attachment. METHODS: Renal artery patency was assessed by repeated spiral computed tomography (CT) scans and angiography. Creatinine levels, blood pressure and antihypertensive medication were recorded. Follow-up was a median 6 months (2-9). RESULTS: All 25 stent-covered renal arteries remained patent. CT showed a small infarct in one kidney. Creatinine was 108 mumol/l (89-133) before intervention and 98 mumol/l (87-127) at follow-up. Blood pressure was 150/80 mmHg on both occasions. Antihypertensive therapy was intensified in one patient whose creatinine level remained stable and whose separate renin sampling was normal. CONCLUSIONS: Covering the renal arteries with the Gianturco Z-stent does not seem to affect renal function within 6 months. Further follow-up is needed before suprarenal stent deployment can be advocated.
|
|
| 36. |
- Mangell, Peter, et al.
(författare)
-
Are self-expanding stents superior to balloon-expanded in dilating aortas? An experimental study in pigs
- 1996
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - 1532-2165. ; 12:3, s. 287-294
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the stent/vessel interaction and distensibility following the natural increase in vascular diameter using self-expanding and balloon-expanded stents. DESIGN: Open experimental study. SETTING: Animal laboratory, university hospital. MATERIALS AND METHODS: Eight Palmaz (P) and eight Gianturco (G) stents were transluminally placed in the infrarenal aortas of 16 pigs. Pulsatile diameter changes above, at and below the stents were non-invasively monitored with an ultrasound phase-locked echo-tracking system before and immediately after stenting and at 4 and 18 weeks. Blood pressure was registered intra-arterially and stiffness (beta) was calculated. Intravascular ultrasound (IVUS) was performed at 18 weeks. RESULTS: Median weight increased from 20 kg (19-26) to 93 kg (62-130). Diameter of the aorta increased 60%. In group P no pulsatile diameter change could be measured at the stent (beta = infinity). In group G stenting increased stiffness from beta 20.7 (9.2) to 43.2 (8.0) (p < 0.05). After 18 weeks stiffness returned to beta 20.1 (12.4). Expanded, median diameter of the P stents was 7.4 (0.8) mm, not increasing after 18 weeks. Initial diameter of the G stents was 7.8 (1.0) mm, increasing 56% to 12.2 (2.3) mm (p < 0.05). IVUS revealed the G stents to be well attached to the vascular wall, but five P stents were detached within half of the circumference. CONCLUSION: Self-expanding stents follow the pulsatile diameter change of the vessel wall, not adversely affecting distensibility after 18 weeks. They show good attachment despite 56% dilation. In contrast, the balloon-expanded stents do not show pulsatile movement and may detach during vessel diameter increase. This may be of importance when choosing stents for endovascular treatment of abdominal aortic aneurysms.
|
|
| 37. |
- Minthon, Lennart, et al.
(författare)
-
Oral tetrahydroaminoacridine treatment of Alzheimer's disease evaluated clinically and by regional cerebral blood flow and EEG
- 1993
-
Ingår i: Dementia (Switzerland). - 1013-7424. ; 4:1, s. 32-42
-
Tidskriftsartikel (refereegranskat)abstract
- Neurochemical evidence indicates that cognitive impairment in dementia of Alzheimer type (DAT) is related to degeneration of cholinergic neurons in the brain. A pharmacological approach is treatment with a cholinesterase inhibitor such as tetrahydroaminoacridine (THA). THA treatment of 17 patients with DAT was studied with a double-blind crossover design with three types of treatment, THA + lecithin, THA + placebo and placebo + placebo. Each treatment period was 6 weeks with wash out periods of 2 weeks. The treatment was evaluated with clinical ratings, psychometric testing, EEG and regional cerebral blood flow (rCBF) measurements. No significant clinical differences between treatment periods were found in the total sample, but marked individual differences were observed. The patients were subdivided into three outcome groups based on four clinical measures: 6 patients improved (responders), 5 patients were mainly unchanged, and 6 patients showed further deterioration during the trial period of 26 weeks. Pretreatment rCBF in responders differed significantly from that of the deteriorated patients. EEG showed more high frequency activity among responders. Hepatotoxic side effects were observed in several cases. Three subjects showed marked increases of liver enzymes, with normalization following dose reduction. The majority of patients who improved or remained unchanged during the study chose to continue THA treatment in an open trial.
|
|
| 38. |
- Pedersen, M, et al.
(författare)
-
Four Distinct 5-Year Trajectories of Knee Function Emerge in Patients Who Followed the Delaware-Oslo ACL Cohort Treatment Algorithm
- 2022
-
Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 50:11, s. 2944-2952
-
Tidskriftsartikel (refereegranskat)abstract
- Impairments and dysfunction vary considerably after anterior cruciate ligament (ACL) injury, and distinct subgroups may exist. Purpose: (1) To identify subgroups of patients with ACL injury who share common trajectories of patient-reported knee function from initial presentation to 5 years after a treatment algorithm where they chose either ACL reconstruction (ACLR) plus rehabilitation or rehabilitation alone. (2) To assess associations with trajectory affiliation. Study Design: Cohort study; Level of evidence, 3. Methods: We included 276 patients with a acute first-time complete unilateral ACL injury. All patients underwent a 5-week neuromuscular and strength training program before a shared decision-making process about treatment. Within their latest attended follow-up, 62% of patients had undergone early ACLR (<6 months after the 5-week program), 11% delayed ACLR (>6 months after the 5-week program), and 27% progressive rehabilitation alone. Patients completed the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) at inclusion, after the 5-week program, and at 6 months, 1 year, 2 years, and 5 years after ACLR or completion of the 5-week program (patients treated with rehabilitation alone). We used group-based trajectory modeling to identify trajectories of IKDC-SKF and multinomial logistic regression to assess associations with trajectory affiliation. Results: Four distinct trajectories of IKDC-SKF were identified: Low (n = 22; 8.0% of the cohort), Moderate (n = 142; 51.4%), High (n = 105; 38.0%), and High Before Declining (n = 7; 2.5%). The High trajectory had higher scores at inclusion than the Moderate trajectory, but both improved considerably within 1 year and had thereafter stable high scores. The High Before Declining trajectory also started relatively high and improved considerably within 1 year but experienced a large deterioration between 2 and 5 years. The Low trajectory started low and had minimal improvement. New knee injuries were important characteristics of the High Before Declining trajectory, concomitant meniscal injuries were significantly associated with following the Low (vs Moderate) trajectory, and early/preoperative quadriceps strength and hop symmetry (measured at inclusion) were significantly associated with following the High (vs Moderate) trajectory. Conclusion: We identified 4 distinct 5-year trajectories of patient-reported knee function, indicating 4 subgroups of patients with ACL injury. Importantly, 88% of the patients who followed our treatment algorithm followed the Moderate and High trajectories characterized by good improvement and high scores. Due to eligibility criteria and procedures in our cohort, we can only generalize our model to athletes without major concomitant injuries who follow a similar treatment algorithm. Concomitant meniscal injuries and new knee injuries were important factors in the unfavorable Low and High Before Declining trajectories. These associations were exploratory but support the trajectories’ validity. Our findings can contribute to patient education about prognosis and underpin the importance of continued secondary injury prevention.
|
|
| 39. |
- Pedersen, M, et al.
(författare)
-
Low Rates of Radiographic Knee Osteoarthritis 5 Years After ACL Reconstruction or Rehabilitation Alone: The Delaware-Oslo ACL Cohort Study
- 2021
-
Ingår i: Orthopaedic journal of sports medicine. - : SAGE Publications. - 2325-9671. ; 9:8, s. 23259671211027530-
-
Tidskriftsartikel (refereegranskat)abstract
- Patients and clinicians often struggle to choose the optimal management strategy for posttraumatic knee osteoarthritis (OA) after an anterior cruciate ligament (ACL) injury. An evaluation of radiographic outcomes after a decision-making and treatment algorithm applicable in clinical practice can help to inform future recommendations and treatment choices. Purpose: To describe and compare 5-year radiographic outcomes and knee pain in individuals who had gone through our decision-making and treatment algorithm and chosen (1) early (<6 months) ACL reconstruction (ACLR) with pre- and postoperative rehabilitation, (2) delayed (>6 months) ACLR with pre- and postoperative rehabilitation, or (3) progressive rehabilitation alone. Study Design: Cohort study; Level of evidence, 2. Methods: We included 276 patients with unilateral ACL injury from a prospective cohort study. Patients chose management using a shared decision-making process and treatment algorithm, and 5-year postoperative radiographs of the index and contralateral knees were assessed using the Kellgren and Lawrence (K&L) classification and minimum joint space width measurements. We defined radiographic tibiofemoral OA as K&L grade ≥2 and knee pain as a Knee injury and Osteoarthritis Outcome Score for Pain ≤72. To further explore early radiographic changes, we included alternative cutoffs for radiographic knee OA using K&L grade ≥2/osteophyte (definite osteophyte without joint space narrowing) and K&L grade ≥1. Results: At 5 years, 64% had undergone early ACLR; 11%, delayed ACLR; and 25%, progressive rehabilitation alone. Radiographic examination was attended by 187 patients (68%). Six percent of the cohort had radiographic tibiofemoral OA (K&L grade ≥2) in the index knee; 4%, in the contralateral knee. Using the alternative cutoffs at K&L grade ≥2/osteophyte and K&L grade ≥1, the corresponding numbers were 20% and 33% in the index knee and 18% and 29% in the contralateral knee. Six percent had a painful index knee. There were no statistically significant differences in any radiographic outcomes or knee pain among the 3 management groups. Conclusion: There were no statistically significant differences in any 5-year radiographic outcomes or knee pain among the 3 management groups. Very few of the patients who participated in our decision-making and treatment algorithm had knee OA or knee pain at 5 years.
|
|
| 40. |
|
|
| 41. |
|
|
| 42. |
|
|
| 43. |
|
|
| 44. |
|
|
| 45. |
|
|
| 46. |
- Risberg, Mikael, et al.
(författare)
-
Influence from fuel type on the performance of an air-blown cyclone gasifier
- 2014
-
Ingår i: Fuel. - : Elsevier BV. - 0016-2361 .- 1873-7153. ; 116, s. 751-759
-
Tidskriftsartikel (refereegranskat)abstract
- Entrained flow gasification of biomass using the cyclone principle has been proposed in combination with a gas engine as a method for combined heat and power production in small to medium scale (<20 MW). This type of gasifier also has the potential to operate using ash rich fuels since the reactor temperature is lower than the ash melting temperature and the ash can be separated after being collected at the bottom of the cyclone. The purpose of this work was to assess the fuel flexibility of cyclone gasification by performing tests with five different types of fuels; torrefied spruce, peat, rice husk, bark and wood. All of the fuels were dried to below 15% moisture content and milled to a powder with a maximum particle size of around 1 mm. The experiments were carried out in a 500 kWth pilot gasifier with a 3-step gas cleaning process consisting of a multi-cyclone for removal of coarse particles, a bio-scrubber for tar removal and a wet electrostatic precipitator for removal of fine particles and droplets from the oil scrubber (aerosols). The lower heating value (LHV) of the clean producer gas was 4.09, 4.54, 4.84 and 4.57 MJ/Nm3 for peat, rice husk, bark and wood, respectively, at a fuel load of 400 kW and an equivalence ratio of 0.27. Torrefied fuel was gasified at an equivalence ratio of 0.2 which resulted in a LHV of 5.75 MJ/Nm3 which can be compared to 5.50 MJ/Nm3 for wood powder that was gasified at the same equivalence ratio. A particle sampling system was designed in order to collect ultrafine particles upstream and downstream the gasifier cleaning device. The results revealed that the gas cleaning successfully removed >99.9% of the particulate matter smaller than 1 μm.
|
|
| 47. |
|
|
| 48. |
|
|
| 49. |
|
|
| 50. |
|
|
