| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Bodelsson, Gunilla, et al.
(författare)
-
Effects of propofol on substance P-induced relaxation in isolated human omental arteries and veins
- 2000
-
Ingår i: European Journal of Anaesthesiology. - 1365-2346. ; 17:12, s. 720-728
-
Tidskriftsartikel (refereegranskat)abstract
- To elucidate if an effect of propofol on endothelium-dependent relaxation could contribute to propofol-induced vasodilation, smooth muscle relaxation of isolated human omental artery and vein segments precontracted by endothelin-1 were measured. Substance P induced a concentration-dependent relaxation (mean +/- SEM) in both artery (63 +/-8.4% of precontraction, n = 9) and vein (60+/-11%, n = 7). The relaxation was enhanced by 10(-6) M propofol (artery, 72+/-9.5%, n = 9; vein, 81+/-12%, n = 7) but not affected by 10(-7), 10(-5) and 10(-4) M propofol. In the presence of Nomega-nitro-L-arginine methyl ester (nitric oxide synthase inhibitor), 10(-6) M propofol still enhanced the substance P-induced relaxation in arteries but not veins, whereas 10(-4) M propofol inhibited the relaxation in both arteries (rightward shift of the concentration-response curve) and veins (28+/-7.5%, n = 8). In the presence of potassium chloride (to prevent hyperpolarization), the enhancement of substance P-induced relaxation by 10(-6) M propofol was abolished in both arteries and veins whereas 10(-5) and 10(-4) M propofol reduced the relaxation in arteries (38+/-13% at 10(-5) M, n = 6; 30+/-11% at 10(-4) M, n = 6) but not in veins. These results demonstrate that propofol, at lower, clinically relevant concentrations, promotes endothelium-dependent relaxation mediated via hyperpolarization in human omental arteries and via both nitric oxide and hyperpolarization in human omental veins.
|
|
| 9. |
|
|
| 10. |
- Forsmark, A., et al.
(författare)
-
Health Economic Analysis of Open and Robot-assisted Laparoscopic Surgery for Prostate Cancer Within the Prospective Multicentre LAPPRO Trial
- 2018
-
Ingår i: European Urology. - : Elsevier BV. - 0302-2838 .- 1873-7560. ; 74:6, s. 816-824
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The rapid adoption of robot-assisted laparoscopy in radical prostatectomy has preceded data regarding associated costs. Qualitative evidence regarding cost outcomes is lacking. Objective: This study assessed how costs were affected by robot-assisted laparoscopic prostatectomy (RALP) compared with open surgery. Design, setting, and participants: Cost analysis was based on the dataset of the LAPPRO (Laparoscopic Prostatectomy Robot Open) clinical trial, which is a prospective controlled, nonrandomised trial of patients who underwent prostatectomy at 14 centres in Sweden between September 2008 and November 2011. Currently, data are available from a follow-up period of 24 mo. Intervention: In the LAPPRO trial, RALP was compared with radical retropubic prostatectomy (RRP). Outcome measurements and statistical analysis: Costs per surgical technique were assessed based on resource variable data from the LAPPRO database. The calculation of average costs was based on mean values; Swedish currency was converted to purchasing power parity US dollar (PPP$). All tests were two-tailed and conducted at alpha = 0.05 significance level. Results and limitations: The cost analysis comprised 2638 men. Based on the LAPPRO trial data, RALP was associated with an increased cost/procedure of PPP$ 3837 (95% confidence interval: 2747-4928) compared with RRP. The result was sensitive to variations in caseload. Main drivers of overall cost were robotic system cost, operation time, length of stay, and sick leave. Limitations of the study include the uneven distribution between RALP and RRP regarding procedures in public/for-profit hospitals and surgeon/centre procedural volume. Conclusions: Based on the LAPPRO trial data, this study showed that RALP was associated with an increased cost compared with RRP in Swedish health care. There are many factors influencing the costs, making the absolute result dependent on the specific setting. However, by identifying the main cost drivers and/or most influential parameters, the study provides support for informed decisions and predictions. Patient summary: In this study, we looked at the cost outcome when performing prostatectomies by robot-assisted laparoscopic technique compared with open surgery in Sweden. We found that the robot-assisted procedure was associated with a higher mean cost. (C) 2018 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology.
|
|
| 11. |
|
|
| 12. |
|
|
| 13. |
- Johnson, Mats, 1956, et al.
(författare)
-
Anti-inflammatory, antibacterial and immunomodulatory treatment in children with symptoms corresponding to the research condition PANS (Pediatric Acute-onset Neuropsychiatric Syndrome): A systematic review
- 2021
-
Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 16:7
-
Tidskriftsartikel (refereegranskat)abstract
- Objective To assess effects of treatment against a hypothesized neuroinflammation in children with symptoms corresponding to the research condition Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) which is not included in current diagnostic systems. Methods Systematic literature searches were performed (1998 to June 2020) in PubMed, Embase, the Cochrane Library, CINAHL, PsycInfo, and HTA databases. Inclusion criteria: patients (P) were children (< 18 years) with PANS; intervention (I)/comparison (C) was use of, versus no use of, anti-inflammatory, antibacterial or immunomodulating treatments; outcomes (O) were health-related quality of life (HRQL), level of functioning, symptom change, and complications. Results Four randomised controlled trials (RCTs) and three non-RCTs, including 23 to 98 patients, fulfilled the PICO. HRQL was not investigated in any study. Regarding level of functioning, two RCTs investigated antibiotics (penicillin V, azithromycin) and one RCT investigated immunomodulating treatments (intravenous immunoglobulins (IVIG), plasma exchange). Regarding symptoms, two non-RCTs investigated anti-inflammatory treatment (cyclooxygenase (COX) inhibitors, corticosteroids), two RCTs and one non-RCT investigated antibiotics (penicillin V, azithromycin), and two RCTs investigated immunomodulating treatments (IVIG, plasma exchange). Complications, reported in five studies, were consistent with those listed in the summary of products characteristics (SPC). All studies were assessed to have some or major problems regarding directness, the absence of an established diagnosis contributing to clinical diversity in the studied populations. All studies were assessed to have major risk of bias, including selection and detection biases. Due to clinical and methodological diversity, meta-analyses were not performed. Conclusion This systematic review reveals very low certainty of evidence of beneficial effects, and moderate certainty of evidence of adverse effects, of anti-inflammatory, antibacterial or immunomodulating treatments in patients with symptoms corresponding to the research condition PANS. Available evidence neither supports nor excludes potential beneficial effects, but supports that such treatment can result in adverse effects.
|
|
| 14. |
|
|
| 15. |
|
|
| 16. |
|
|
| 17. |
- Pramling, Niklas, 1973, et al.
(författare)
-
Learning, Teaching, and Didaktik
- 2019
-
Ingår i: Play-Responsive Teaching in Early Childhood Education. - Cham : Springer. - 2468-8746. - 9783030159580 ; , s. 17-29
-
Bokkapitel (refereegranskat)abstract
- In this chapter, our perspective on teaching, learning and didaktik are presented. What we refer to as didaktik highlights issues concerning content and context, and we therefore discuss these notions more closely. © 2019, The Author(s).
|
|
| 18. |
- Pramling, Niklas, 1973, et al.
(författare)
-
The Letter Thief: From Playing to Teaching to Learning to Playing
- 2019
-
Ingår i: Play-Responsive Teaching in Early Childhood Education. - Cham : Springer International Publishing. - 2468-8746.
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- In this chapter, we show how a learning content can be introduced in a child-initiated play frame, without interrupting the play. The chapter therefore gives an example of how what is sometimes referred to as academic content can be promoted through such activity. The analysis clarifies how reading and graphical symbols become structuring resources in children’s play. A real-world problem (as is) is introduced and managed within the fictional realm of play (as if). © 2019, The Author(s).
|
|
| 19. |
- Pramling, Niklas, 1973, et al.
(författare)
-
The Lion and the Mouse: How and Why Teachers Succeed in Becoming Participants in Children’s Ongoing Play
- 2019
-
Ingår i: Play-Responsive Teaching in Early Childhood Education. - Cham : Springer. - 2468-8746. - 9783030159580 ; , s. 87-96
-
Bokkapitel (refereegranskat)abstract
- In this chapter, we investigate preschool teachers’ attempts to participate when children are already engaged in playing (alone or with playmates), and we focus on when and why teachers seem to succeed (or not) in their attempts to enter such play. © 2019, The Author(s).
|
|
| 20. |
- Pramling, Niklas, 1973, et al.
(författare)
-
The Magical Fruits: Establishing a Narrative Play Frame for Mutual Problem Solving
- 2019
-
Ingår i: Play-Responsive Teaching in Early Childhood Education. - Cham : Springer. - 2468-8746. - 9783030159580 ; , s. 137-151
-
Bokkapitel (refereegranskat)abstract
- In this chapter, we analyze a prolonged activity from initiation to conclusion, focusing on (i) how the teacher establishes a narrative, imaginary, frame for the activity, (ii) how children participate and contribute to this activity, (iii) what didaktikal challenges are actualized and what support the children are given in the activity, including what contents are constituted, and (iv) what the implications of the activity are for children’s development. © 2019, The Author(s).
|
|
| 21. |
|
|
| 22. |
- Rajani, Rupesh, et al.
(författare)
-
The epidemiology and clinical features of portal vein thrombosis : a multicentre study
- 2010
-
Ingår i: ALIMENTARY PHARMACOLOGY and THERAPEUTICS. - : Blackwell Publishing Ltd. - 0269-2813 .- 1365-2036. ; 32:9, s. 1154-1162
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Reliable epidemiological data for portal vein thrombosis are lacking. AIMS: To investigate the incidence, prevalence and survival rates for patients with portal vein thrombosis. METHODS: Retrospective multicentre study of all patients registered with the diagnosis of portal vein thrombosis between 1995 and 2004. RESULTS: A total of 173 patients (median age 57 years, 93 men) with portal vein thrombosis were identified and followed up for a median of 2.5 years (range 0-9.7). The mean age-standardized incidence and prevalence rates were 0.7 per 100,000 per year and 3.7 per 100,000 inhabitants, respectively. Liver disease was present in 70 patients (40%), malignancy in 27%, thrombophilic factors in 22% and myeloproliferative disorders in 11%. Two or more risk factors were identified in 80 patients (46%). At diagnosis, 65% were put on anticoagulant therapy. Thrombolysis, TIPS, surgical shunting and liver transplantation were performed in 6, 3, 2 and 8 patients, respectively. The overall survival at 1 year and 5 years was 69% and 54%. In the absence of malignancy and cirrhosis, the survival was 92% and 76%, respectively. CONCLUSIONS: The incidence and prevalence rates of portal vein thrombosis were 0.7 per 100,000 inhabitants per year and 3.7 per 100,000 inhabitants, respectively. Concurrent prothrombotic risk factors are common. The prognosis is variable and highly dependent on underlying disease.
|
|
| 23. |
- Sandstrom, K, et al.
(författare)
-
Effects of propofol on desipramine-sensitive [3H]-noradrenaline uptake kinetics in rat femoral artery
- 2000
-
Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172. ; 44:8, s. 1011-1016
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The intravenous anaesthetic propofol inhibits the neuronal uptake of noradrenaline (uptake1) from the vascular sympathetic neuromuscular junction, resulting in an enhancement of the sympathetic neurotransmission. This could be important for maintenance of blood pressure during propofol anaesthesia. The aim of the present study was to determine how propofol influences the kinetics of uptake1. METHODS: Isolated segments of rat femoral arteries were incubated with [3H]-noradrenaline in the presence or absence of propofol and the radioactivity taken up was measured in a scintillation counter. The uptake1 inhibitor, desipramine, was used to delineate the specific neuronal uptake. RESULTS: Desipramine and 10 microM propofol significantly reduced the uptake in segments incubated with 0.1 microM [3H]-noradrenaline. Propofol at 1 microM and 100 microM did not affect the uptake. Non-linear regression analysis of specific uptake yielded Km 0.50 microM, Vmax 1.6 pmol mg(-1) 15 min(-1) and Hill coefficient 1.1. Propofol (1-10 microM) increased the Km value and propofol (10-100 microM) increased the Vmax value concentration-dependently, while the Hill coefficient was not affected. CONCLUSION: Propofol seems to have a biphasic effect on the uptake of noradrenaline in the vascular sympathetic neuromuscular junction. At lower propofol concentrations there is a decrease in the affinity of the noradrenaline transporters. The resulting uptake inhibition is counteracted at higher propofol concentrations by an increase in the efficacy of the uptake.
|
|
| 24. |
|
|
| 25. |
- Sundvall, H., et al.
(författare)
-
Prevalence and initiation of statin therapy in the oldest old-a longitudinal population-based study
- 2022
-
Ingår i: European Journal of Clinical Pharmacology. - : Springer Science and Business Media LLC. - 0031-6970 .- 1432-1041. ; 78:9, s. 1459-1467
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose To investigate the prevalence and initiation of statins as well as treatment intensity in the oldest old, with younger olds as a reference. Methods A population-based cohort was used, including record-linked data from the Total Population Register, the Swedish Prescribed Drug Register, and the Swedish Patient Register. In each year over the study period (2009-2015), statin use was described in individuals 85 years or older and 65-84 years of age, and initiation rates were calculated among individuals with no statin treatment during a preceding 3-year period. Results A total of 1,764,836 individuals >= 65 years in 2009, increasing to 2,022,764 in 2015, were included in the analyses. In individuals 85 years or older, the prevalence of statin therapy increased from 11% in 2009 to 16% in 2015, the corresponding initiation rates being 1.3% and 1.7%, respectively. Corresponding prevalence and incidence figures in 65-84-year-olds were 23 to 25% and 3.0 to 3.3%, respectively. Overall, the proportion of individuals initiating statin with high-intensity treatment (atorvastatin >= 40 mg or rosuvastatin >= 20 mg) in the oldest old increased from 1 to 36% during the study period, and a similar increase was seen in the younger age group. Over the study years, the presence of an established indication for statin treatment varied between 70 and 76% in the oldest old and between 30 and 39% in the younger olds. Conclusion Prevalence and initiation of statin therapy are increasing among the oldest old, despite the fact that randomized controlled trials focusing on this age group are lacking and safety signals are difficult to detect.
|
|
| 26. |
- Sundvall, H., et al.
(författare)
-
Use of statins in the elderly according to age and indicationa cross-sectional population-based register study
- 2019
-
Ingår i: European Journal of Clinical Pharmacology. - : Springer Science and Business Media LLC. - 0031-6970 .- 1432-1041. ; 75:7, s. 959-967
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeTo investigate statin use in the elderly by age (80 vs. 65-79years) in relation to established indications.MethodsA population-based cohort, including data from four registers, encompassing inhabitants in Region Vastra Gotaland, Sweden, was used. Statin users were defined as those filling statin prescriptions 75% of the year 2010. Primary care and hospital diagnoses in 2005-2010 regarding ischemic heart disease, stroke, transient ischemic attacks, and diabetes were considered established indications.ResultsA total of 278,205 individuals were analyzed. In individuals aged 80 and 65-79years (n=81,885 and n=196,320, respectively), 17% (95% confidence interval 17%; 18%) and 23% (23%; 23%) respectively, were statin users. Among the statin users, 74% (73%; 74%) of those aged 80 and 60% (59%; 60%) of those aged 65-79years had 1 established indication. Conversely, of those with 1 established indication, 30% (30%; 31%) and 53% (52%; 53%) were on statins in the respective age groups. Logistic regression revealed that age, nursing home residence, and multi-dose drug dispensing were the most prominent negative predictors for statin use; adjusted odds ratios (95% confidence interval): 0.45 (0.44; 0.46), 0.39 (0.36; 0.42), and 0.47 (0.44; 0.49), respectively.ConclusionsIn the oldest old (80years), statin users were fewer and had more often an established indication, suggesting that physicians extrapolate scientific evidence for beneficial effects in younger age groups to the oldest, but require a more solid ground for treatment. As the oldest old, nursing home residents, and those with multi-dose drug-dispensing were statin users to a lesser extent, physicians may often refrain from treatment in those with lower life expectancy, either due to age or to severely reduced health status. In both age groups, our results however also indicate some over- as well as undertreatment.
|
|
| 27. |
|
|
| 28. |
|
|
| 29. |
|
|
| 30. |
- Wallerstedt, S M, et al.
(författare)
-
Characteristics of contractile 5-HT receptors in isolated human omental arteries: presence of 5-HT1 and 5-HT2 receptors
- 1996
-
Ingår i: Pharmacology and Toxicology. - 1600-0773. ; 78:1, s. 50-54
-
Tidskriftsartikel (refereegranskat)abstract
- 5-Hydroxytryptamine (5-HT) has a variety of biological effects, e.g. it induces and modulates vascular smooth muscle activity. The effects are mainly mediated via a hetergenous group of 5-HT receptor subtypes. In order to elucidate the 5-HT receptor mechanisms in the human splanchnic circulation, in vitro studies were carried out on omental arteries obtained from patients undergoing abdominal surgery. Four 5-HT receptor agonists with different selectivity all induced concentration-dependent contraction (potency and order of potency indicated): 5-HT (non-selective; 6.12 +/- 0.14)=sumatriptan (5-HT1; 6.32 +/- 0.07) > alpha-methyl-5-HT (5-HT2; 5.41 +/- 0.05) > 2-methyl-5-HT (5-HT3; < or =4.46+/-0.05). The 5-HT1/5-HT2 receptor antagonist methiothepin antagonised the contraction induced by 5-HT, sumatriptan, alpha-methyl-5-HT and 2-methyl-5-HT. The 5-HT2 receptor antagonist ketanserin antagonised the contraction induced by 5-HT, alpha-methyl-5-HT and 2-methyl-5-HT. The 5-HT3 receptor antagonist tropisetron did not antagonise the contraction elicited by 2-methyl-5-HT. The results suggest that 5-HT-induced conataction in human omental arteries involves both 5-HT1 and 5-HT2, but maybe not 5-HT3-receptors.
|
|
| 31. |
- Wallerstedt, S M, et al.
(författare)
-
Effect of propofol on isolated human omental arteries and veins
- 1997
-
Ingår i: British Journal of Anaesthesia. - 1471-6771. ; 78:3, s. 296-300
-
Tidskriftsartikel (refereegranskat)abstract
- To elucidate the effect and mode of action of propofol on human vascular smooth muscle tension, we have investigated the effect of propofol alone and the effect of propofol on contractions induced by U46619, KCl and caffeine on isolated human omental vessels. Propofol 10(-3) mol litre-1 induced contractions in both arteries and veins attenuated the contraction elicited by U46619, KCl and caffeine in a concentration-dependent manner. The threshold concentrations for the effect of propofol in the artery were: 10(-5) mol litre-1 (U46619, caffeine) and 10(-4) mol litre-1 (KCl); and in the vein, 10(-5) mol litre-1 (U46619) and 10(-4) mol litre-1 (KCl, caffeine). We conclude that propofol at lower concentrations appeared to primarily attenuate contraction involving release of cellularly sequestered calcium. At higher concentrations (> 10(-4.5) mol litre-1), propofol appeared to affect contraction involving extracellular or intracellular calcium fluxes similarly.
|
|
| 32. |
- Wallerstedt, S M, et al.
(författare)
-
Effects of propofol on isolated human pial arteries
- 1999
-
Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172. ; 43:10, s. 1065-1068
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The intravenous anaesthetic propofol has been reported to increase cerebral vascular resistance in vivo. The underlying mechanisms are not fully understood, but may include effects on metabolism and direct effects on the vascular smooth muscle. The present study was designed to evaluate the direct effects of propofol on human pial arteries. METHODS: We investigated the direct effect of propofol (10(-6)-10(-4) M) on isolated human pial arteries at basal tension as well as the influence on contractions induced by 5-hydroxytryptamine, prostaglandin F2alpha, noradrenaline and potassium chloride. RESULTS: Propofol did not change the basal tension. Propofol at 10(-6) and 10(-5) M did not affect the concentration-response curves of any of the contractile agents tested. Propofol at the supraclinical concentration 10(-4) M reduced the contractions induced by all contractile agents. CONCLUSION: Propofol reduces the tone of human pial arteries in vitro at supraclinical concentrations, but has no effect on the tone at clinically relevant concentrations.
|
|
| 33. |
- Wallerstedt, S M, et al.
(författare)
-
Relaxant effects of propofol on human omental arteries and veins
- 1998
-
Ingår i: British Journal of Anaesthesia. - 1471-6771. ; 80:5, s. 655-659
-
Tidskriftsartikel (refereegranskat)abstract
- We have investigated the relaxant effects of propofol on smooth muscle tension in human omental arteries and veins to determine if endothelium-related mechanisms are involved. Isolated vessel segments were precontracted with endothelin-1 and propofol was added cumulatively (10(-7)-10(-4) mol litre-1). In both artery and vein segments, propofol induced relaxation, which was not dependent on an intact endothelium. Relaxation was reduced when the extracellular K+ concentration was increased and in the presence of tetraethylammonium chloride (TEA). In intact segments, N-nitro-L-arginine methyl ester (L-NAME), indomethacin, glibenclamide, 4-aminopyridine, clotrimazole and atropine did not affect the concentration-response curve of propofol. This indicates that propofol relaxes human omental arteries and veins in an endothelium independent manner, and that hyperpolarization caused by activation of the K+ channel, BKCa, may be involved.
|
|
| 34. |
|
|
