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- Grigoroglou, C., et al.
(författare)
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Effectiveness of collaborative care in reducing suicidal ideation: An individual participant data meta-analysis
- 2021
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Ingår i: General Hospital Psychiatry. - : Elsevier BV. - 0163-8343. ; 71, s. 27-35
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Tidskriftsartikel (refereegranskat)abstract
- To assess whether CC is more effective at reducing suicidal ideation in people with depression compared with usual care, and whether study and patient factors moderate treatment effects. Method: We searched Medline, Embase, PubMed, PsycINFO, CINAHL, CENTRAL from inception to March 2020 for Randomised Controlled Trials (RCTs) that compared the effectiveness of CC with usual care in depressed adults, and reported changes in suicidal ideation at 4 to 6 months post-randomisation. Mixed-effects models accounted for clustering of participants within trials and heterogeneity across trials. This study is registered with PROSPERO, CRD42020201747. Results: We extracted data from 28 RCTs (11,165 patients) of 83 eligible studies. We observed a small significant clinical improvement of CC on suicidal ideation, compared with usual care (SMD, 0.11 [95%CI, 0.15 to 0.08]; I-2, 0.47% [95%CI 0.04% to 4.90%]). CC interventions with a recognised psychological treatment were associated with small reductions in suicidal ideation (SMD, 0.15 [95%CI -0.19 to 0.11]). CC was more effective for reducing suicidal ideation among patients aged over 65 years (SMD, 0.18 [95%CI -0.25 to 0.11]). Conclusion: Primary care based CC with an embedded psychological intervention is the most effective CC framework for reducing suicidal ideation and older patients may benefit the most.
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- Harju, Eva-Liz, 1958-
(författare)
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Quantitative and qualitative analysis of touch, cold and warmth in health, neuropathic pain and fibromyalgia
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim of the present thesis is to examine tactile and thermal perceptual (dys)function by quantitative and qualitative tests of patients with neuropathic pain or fibromyalgia, and to compare results with those of healthy persons. A specific aim is to provide individual data for diagnostic purposes, specific to touch, cold, and warmth (profiles). The first question addressed is whether patients with ongoing pain are able to perform reliably in a scaling experiment. A second question addressed is on the nature of the relation between patient’s ongoing pain, and tactile and thermal (dys)function.In Study I-IV patients’ spontaneous ongoing pain is scaled, and in psychophysical experiments perception thresholds determined, perceived intensity scaled, and perceived quality assessed. Inter-individual comparability in perceived intensity is achieved by calibrating individual scales of perceived intensity according to the Master Scaling procedure. In Study I, the applicability of the method of Master Scaling is extensively discussed and it is found to be particularly well suited for perceived intensity of touch, cold, and warmth, because of the common frame of reference represented by perceived intensity at thenar for the modality tested.Study II examines tactile and thermal perception in patients with peripheral or central neuropathic pain, and shows: (a) patients are able to adequately scale perceived intensity; (b) paradoxical heat perception is reported for cold stimulation by five of seven patients with central post-stroke pain (CPSP), but by none of the patients with peripheral lesions; (c) peripheral nerve lesions are modality specific, with tactile and thermal functions independently affected, or, preserved; and (d) ongoing pain and perceived intensity of touch, cold, and warmth are uncorrelated, independent phenomena.Study III examines the effects of age and gender on thermal perception in healthy persons, and shows that elderly and young women’s and men’s thermal perception varies in relation to body area. Thus, it provides useful reference data for future psychophysical tests. Study IV examines tactile and thermal perception in patients with fibromyalgia syndrome (FMS), and their age-matched controls, and shows: (a) paradoxical heat perception for cold stimulation in all FMS patients but in none of the controls, and (b) normal perceptions of touch and warmth in all patients and controls. Study V examines the effect of an ischemic nerve block on the experimentally induced perceptual phenomenon of "synthetic heat" in healthy persons. "Synthetic heat" has been hypothesized to be a model for CPSP patients’ cold-evoked burning pain, however, the results show: (a) A-delta cold specific fibers are not responsible for "synthetic heat" perception, and (b) "synthetic heat" is not described as "painful", only as "hot", results that question the involvement of nociceptors. In summary, the methods applied provide very specific individual profiles of perception of touch, cold, and warmth in health and pain disease. Perception of pradoxical heat for cold stimulation is found in CPSP patients in Study I, and in FMS patients in Study IV, and it is, therefore, suggested as a marker for centrally induced pain mechanisms.
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- Hinkula, J, et al.
(författare)
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Genetic immunization with multiple HIV-1 genes provides protection against HIV-1/MuLV pseudovirus challenge in vivo
- 2004
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Ingår i: Cells, tissues, organs. - : S. Karger AG. - 1422-6405 .- 1422-6421. ; 177:3, s. 169-184
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Tidskriftsartikel (refereegranskat)abstract
- Superinfection by HIV-1 of a cell line containing the complete murine leukemia virus (MuLV) genome was shown to give rise to pseudotyped HIV-1/MuLV. Such superinfection was successful with certain strains of HIV-1 subtypes A–D. Primary spleen cells and cells of the peritoneal cavity of immunocompetent mice of the C57Bl/6 strain were infectable with the pseudotype HIV-1/MuLV and secreted HIV-1 in vitro and in vivo. In contrast, the murine cell lines, NIH 3T3, myeloma cell line Sp2/0, and two murine hybridoma cell lines were relatively resistant to infection and produced no or little HIV. After primary murine spleen cells had been infected with pseudotyped HIV-1 and transferred to C57Bl/6 mice, replication-competent HIV-1 was obtained from the peritoneal cavity for at least 10–14 days. High amounts (>10<sup>5</sup> vRNA copies/ml) of HIV-1 vRNA could be measured in the peritoneal fluid. Presence of HIV-1 proviral DNA was detectable in cells from the peritoneal cavity for up to 24 days after infected cell transfer. Active reverse transcriptase representing both HIV-1 and C-type murine retroviruses was detected in the peritoneal washes. The HIV-infected spleen cells injected into the peritoneal cavity elicited HIV-1-specific cellular immune responses to p24gag, gp160Env, Nef, Tat and Rev. Mice immunized with HIV-1 DNA, but not with HIV-1 protein, cleared their HIV-1-infected cells within 10–14 days after challenge with HIV-1/MuLV-infected syngeneic spleen cells. This novel model system of primarily cellular reactivity to HIV-1-infected cells in vivo may become useful for assaying experimental HIV-1 immunization schedules.
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- Rollman, Ola, et al.
(författare)
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Platelet derived growth factor (PDGF) responsive epidermis formed from human keratinocytes transduced with the PDGF beta receptor gene.
- 2003
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Ingår i: J Invest Dermatol. ; 120, s. 742-
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Tidskriftsartikel (refereegranskat)abstract
- Platelet-derived growth factor is a major proliferative and migratory stimulus for connective tissue cells during the initiation of skin repair processes. In response to injury, locally produced platelet-derived growth factor is secreted by a diversity of cutaneous cell types whereas target activity is confined to cells of mesenchymal origin, e.g. dermal fibroblasts and smooth muscle cells. Although epidermal cells contribute to cutaneous platelet-derived growth factor activity by their ample capacity to secrete platelet-derived growth factor ligand, normal epidermal keratinocytes are not known to express any member of the platelet-derived growth factor receptor family. In order to study if epidermis may be genetically transformed to a platelet-derived growth factor sensitive compartment we aimed to introduce the gene encoding human platelet-derived growth factor receptor beta (PDGF beta R) into epidermal keratinocytes using a retrovirus-derived vector. Successful gene transfer to primary cells was confirmed by immunofluorescence staining, southern blotting, and ligand-induced receptor autophosphorylation. By culturing a mixture of PDGF beta R-transduced and unmodified keratinocytes at the air-liquid interface on devitalized dermis, we were able to establish a multilayered epithelium showing histologic similarities to that evolved from native keratinocytes or keratinocytes transduced with the reporter gene encoding enhanced green fluorescent protein. Receptor-modified epidermal tissue cultured for 6 days and examined by immunofluorescence microscopy was shown to contain PDGF beta R-expressing keratinocytes distributed in all layers of living epidermis. By continued tissue culture in serum-containing medium, the epidermis became increasingly cornified although receptor-positive cells were still observed within the viable basal compartment. Stimulation of PDGF beta R-transduced epidermis with recombinant platelet-derived growth factor BB had a mitogenic effect as reflected by an increased frequency of Ki-67 positive keratinocytes. The study demonstrates that transgene expression of human PDGF beta R can be achieved in epidermal keratinocytes by retroviral transduction, and that ligand activation of such gene-modified skin equivalent enhances cell proliferation. In perspective, viral PDGF beta R gene transfer to keratinocytes may be a useful approach in studies of receptor tyrosine kinase mediated skin repair and epithelialization.
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