11. |
- Axelsson, Birger, et al.
(författare)
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Milrinone improves diastolic function in coronary artery bypass surgery as assessed by acoustic quantification and peak filling rate : a prospective randomized study
- 2010
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Ingår i: Journal of Cardiothoracic and Vascular Anesthesia. - : Elsevier BV. - 1053-0770 .- 1532-8422. ; 24:2, s. 244-249
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the effects of a bolus dose of milrinone, 50 microg/kg, to placebo on diastolic function (active relaxation) in patients undergoing on-pump coronary artery bypass grafting (CABG).DESIGN: Prospective, randomized, double-blind, placebo-controlled study.SETTING: University hospital.PARTICIPANTS: Twenty-four patients with stable angina and left ventricular ejection fraction >30%, scheduled for elective CABG using cardiopulmonary bypass (CPB), were included.INTERVENTION: Patients were randomized to receive either 50 microg/kg of milrinone (n = 12) or placebo (n = 12) after aortic declamping.MEASUREMENTS AND MAIN RESULTS: The diastolic function of the left ventricle (LV) was measured as peak filling rate (dA/dt [maximal diastolic area change over time]) with transesophageal echocardiography (TEE) using acoustic quantification (AQ) before CPB and 10 minutes after termination of CPB. The normalized peak filling rate (dA/dt)/EDA was also calculated. Active relaxation was statistically significantly increased in the milrinone group compared with the placebo group after CPB.CONCLUSION: Patients undergoing CABG surgery and treated with milrinone after aortic declamping had better diastolic function following cardiopulmonary bypass.
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12. |
- Bazargani, Farhan, 1969-, et al.
(författare)
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Effect of Interceptive Extraction of Deciduous Canine on Palatally Displaced Maxillary Canine : A Prospective Randomized Controlled Study
- 2014
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Ingår i: Angle orthodontist. - : The EH Angle Education and Research Foundation Inc. - 0003-3219 .- 1945-7103. ; 84:1, s. 3-10
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the effect of the extraction of deciduous canines on palatally displaced canines (PDCs), to analyze the impact of the age of the patient on this interceptive treatment, and to assess the outcome of one-sided extraction of a maxillary primary canine on the midline of the maxilla. Materials and Methods: This study included 48 PDCs in 24 consecutive patients with bilateral PDCs. The mean age of the patients at diagnosis was 11.6 years (standard deviation 1.2 years). After randomization, one deciduous canine of each patient was assigned to extraction, and the contralateral side served as control. The patients were then followed at 6-month intervals for 18 months with panoramic and intraoral occlusal radiographs. Results: The rates of successful eruption of the PDCs at extraction and control sites were 67% and 42%, respectively, at 18 months. The difference between the sites was statistically significant, and the effect was significantly more pronounced in the younger participants. A significant decrease in arch perimeter occurred at extraction sites compared to control sites during the observation period. No midline shift toward the extraction side was observed in any patient. Conclusions: The extraction of the deciduous canine is an effective measure in PDC cases, but it must be done in younger patients in combination with early diagnosis, at the age of 10-11 years. Maintenance of the perimeter of the upper arch is an important step during the observation period, and a palatal arch as a space-holding device is recommended.
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13. |
- Bazargani, Farhan, 1969-, et al.
(författare)
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Palatally displaced maxillary canines : factors influencing duration and cost of treatment
- 2013
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Ingår i: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 35:3, s. 310-316
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this retrospective study was to assess the relationship between the initial position of palatally displaced canines (PDCs) on panoramic radiographs and the duration of the orthodontic treatment and further to estimate the costs of the treatment. Data from panoramic radiographs and patient records of 66 consecutive patients (mean age 14.9 +/- 1.7 years) with PDC were analysed. The initial position of the canine, the distance between the canine cusp tip and the occlusal plane, and the inclination of the canine were significantly associated with treatment duration both unadjusted and adjusted for background characteristics. The average estimated cost of the treatment of PDC was euro3200 per case. The total annual cost for treatment of PDC in Sweden may therefore be estimated at euro600 0000. In this study, duration of treatment averaged 17 months for canines displaced in impaction zone 1 or 2, 2.6 [95% confidence interval (CI) -1.0 to 6.2] months longer for those in impaction zone 3, and 7.6 (95% CI 4.1-11.1) months longer for canines displaced in impaction zone 4 or 5. This information makes it easier, through study of the panoramic radiograph, to estimate the duration of treatment and to give patients more precise information about the expected length of their treatment.
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14. |
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15. |
- Björkenheim, Anna, 1980-, et al.
(författare)
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Predictors of hospitalization for heart failure and of all-cause mortality after atrioventricular nodal ablation and right ventricular pacing for atrial fibrillation
- 2014
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Ingår i: Europace. - : Oxford University Press. - 1099-5129 .- 1532-2092. ; 16:12, s. 1772-1778
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Atrioventricular junction ablation (AVJA) is a highly effective treatment in patients with therapy refractory atrial fibrillation (AF) but renders the patient pacemaker dependent. We aimed to analyse the long-term incidence of hospitalization for heart failure (HF) and all-cause mortality in patients who underwent AVJA because of AF and to determine predictors for HF and mortality.Methods and results: We retrospectively enrolled 162 consecutive patients, mean age 67 +/- 9 years, 48% women, who underwent AVJA because of symptomatic AF refractory to pharmacological treatment (n = 117) or unsuccessful repeated pulmonary vein isolation (n = 45). Hospitalization for HF occurred in 32 (20%) patients and 35 (22%) patients died, representing a cumulative incidence for hospitalization for HF and mortality over the first 2 years after AVJA of 9.1 and 5.2%, respectively. Hospitalization for HF occurred to the same extent in patients who failed pharmacological treatment as in patients with repeated pulmonary vein isolation (PVI), although the mortality was slightly higher in the former group. QRS prolongation >= 120 ms and left atrial diameter were independent predictors of hospitalization for HF, while hypertension and previous HF were independent predictors of death.Conclusion: The long-term hospitalization rate for HF and all-cause mortality was low, which implies that long-term ventricular pacing was not harmful in this patient population, including patients with unsuccessful repeated PVI.
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16. |
- Carlsson, Per-Inge, 1959-, et al.
(författare)
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Severe to profound hearing impairment : quality of life, psychosocial consequences and audiological rehabilitation
- 2014
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Ingår i: Disability and Rehabilitation. - Oxon, United Kingdom : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 37:20, s. 1849-1856
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To study the quality of life (QoL) and psychosocial consequences in terms of sick leave and audiological rehabilitation given to patients with severe to profound hearing impairment.Method: A retrospective study of data on 2319 patients with severe to profound hearing impairment in The Swedish Quality Register of Otorhinolaryngology, followed by a posted questionnaire including The Hospital Anxiety and Depression Scale (HADS). Results: The results indicate greater levels of anxiety and depression among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo had strong negative effects on QoL. The proportion of sick leave differed between the studied dimensions in the study. The proportion of patients who received extended audiological rehabilitation was 38% in the present study. Conclusions: Treatment focused on anxiety, depression, tinnitus and vertigo must be given early in the rehabilitation process in patients with severe or profound hearing impairment. Because sick leave differs greatly within this group of patients, collaboration with the regional Social Insurance Agency is crucial part of the rehabilitation. The study also shows that presently, only a small proportion of patients in Sweden with severe to profound hearing impairment receive extended audiological rehabilitation. Implications for RehabilitationGreater levels of anxiety and depression have been found among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo have strong negative effects on QoL in this group of patients.Only a small proportion of patients with severe to profound hearing impairment receive extended audiological rehabilitation today, including medical, technical and psychosocial efforts.Extended audiological rehabilitation focused on anxiety, depression, tinnitus and vertigo must be given, together with technical rehabilitation, early in the rehabilitation process in patients with severe or profound hearing impairment.
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17. |
- Fransén, Karin, 1973-, et al.
(författare)
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Polymorphism in the retinoic acid metabolizing enzyme CYP26B1 and the development of Crohn's disease
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:8, s. e72739-
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Tidskriftsartikel (refereegranskat)abstract
- Several studies suggest that Vitamin A may be involved in the pathogenesis of inflammatory bowel disease (IBD), but the mechanism is still unknown. Cytochrome P450 26 B1 (CYP26B1) is involved in the degradation of retinoic acid and the polymorphism rs2241057 has an elevated catabolic function of retinoic acid, why we hypothesized that the rs2241057 polymorphism may affect the risk of Crohn's disease (CD) and Ulcerative Colitis (UC). DNA from 1378 IBD patients, divided into 871 patients with CD and 507 with UC, and 1205 healthy controls collected at Örebro University Hospital and Karolinska University Hospital were analyzed for the CYP26B1 rs2241057 polymorphism with TaqMan® SNP Genotyping Assay followed by allelic discrimination analysis. A higher frequency of patients homozygous for the major (T) allele was associated with CD but not UC compared to the frequency found in healthy controls. A significant association between the major allele and non-stricturing, non-penetrating phenotype was evident for CD. However, the observed associations reached borderline significance only, after correcting for multiple testing. We suggest that homozygous carriers of the major (T) allele, relative to homozygous carriers of the minor (C) allele, of the CYP26B1 polymorphism rs2241057 may have an increased risk for the development of CD, which possibly may be due to elevated levels of retinoic acid. Our data may support the role of Vitamin A in the pathophysiology of CD, but the exact mechanisms remain to be elucidated.
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18. |
- Gupta, Anil, et al.
(författare)
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Patient controlled regional analgesia after carpal tunnel release: a double-blind study using distal perineural catheters
- 2011
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Ingår i: JOURNAL OF HAND SURGERY-EUROPEAN VOLUME. - : Elsevier Science B. V., Amsterdam. - 1753-1934 .- 2043-6289. ; 36E:3, s. 219-225
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Tidskriftsartikel (refereegranskat)abstract
- This study was done to assess the efficacy of a perineural catheter for pain relief following carpal tunnel release (CTR). Sixty-six patients undergoing open CTR under local anaesthesia (LA) were randomly divided into three groups: Groups A and B had a perineural catheter and Group C served as non-blinded control group. Postoperative pain relief was by self-administration of either ropivacaine (Group A) or saline (Group B) via an elastometric pump and by oral paracetamol in Group C. Patients in Group A had a significantly greater difference in summed pain intensity than Group B. Fewer patients in Group A requested supplementary analgesics than in Group C. Patient satisfaction was higher in Group A than in Group B on day 1. However better analgesia was not associated with better functional recovery.
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19. |
- Gustavsson, Anders, et al.
(författare)
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Clinical trial : colectomy after rescue therapy in ulcerative colitis-3-year follow-up of the Swedish-Danish controlled infliximab study
- 2010
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Ingår i: Alimentary Pharmacology and Therapeutics. - : Wiley. - 0269-2813 .- 1365-2036. ; 32:8, s. 984-989
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Tidskriftsartikel (refereegranskat)abstract
- Background The long-term efficacy of infliximab as rescue therapy in steroid-refractory ulcerative colitis is not well described. Aim To examine the long-term efficacy of infliximab as a rescue therapy through a 3-year follow-up of a previous placebo-controlled trial of infliximab in acute steroid-refractory ulcerative colitis. Method In the original study, 45 patients were randomized to a single infusion of infliximab 5 mg/kg or placebo, and at 3 months, 7/24 patients given infliximab were operated vs. 14/21 patients given placebo. Three years or later, patients were asked to participate in a clinical follow-up. Results Another seven patients underwent colectomy during follow-up: five in the infliximab group and two in the placebo group. After 3 years, a total of 12/24 (50%) patients given infliximab and 16/21 (76%) given placebo (P = 0.012) had a colectomy. None of eight patients in endoscopic remission at 3 months later had a colectomy compared with 7/14 (50%) patients who were not in remission (P = 0.02). There was no mortality. Conclusion The benefit of rescue therapy with infliximab in steroid-refractory acute ulcerative colitis remained after 3 years. The main advantage of infliximab treatment occurred during the first 3 months, whereas subsequent colectomy rates were similar in the two groups. Mucosal healing at 3 months influenced later risk of colectomy.
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20. |
- Gustavsson, Anders, 1964-, et al.
(författare)
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Endoscopic dilation is an efficacious and safe treatment of intestinal strictures in Crohn's disease
- 2012
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Ingår i: Alimentary Pharmacology and Therapeutics. - Hoboken, USA : Wiley-Blackwell. - 0269-2813 .- 1365-2036. ; 36:2, s. 151-158
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bowel strictures are a major cause of morbidity, hospitalisation and surgery in Crohn's disease.Aim: We report short- and long-term efficacy and safety of endoscopic balloon dilation of strictures due to Crohn's disease.Methods: Retrospective study of patients who underwent endoscopic balloon dilation between 1987 and 2009.Results: We performed 776 dilations, of which 621 (80%) were on anastomotic strictures, in 178 patients (94 women) with Crohn's disease. At first dilation, median (IQR) age of patients was 45 (37-56) years and disease duration 16 (8-22) years. Technical success rate was 689/776 (89%). A subset of 75 patients from the primary catchment area, with >5-year follow-up, underwent a total of 246 dilations. At 1-year follow-up, 60/75 (80%) patients had undergone no further intervention or one additional dilation only. At 3 and 5 years, corresponding figures were 43/75 (57%) and 39/75 (52%). Cumulative proportions of patients undergoing surgery at 1, 3 and 5 years were 13%, 28% and 36%. Complication rate per procedure for all 178 patients was 41/776 (5.3%), bowel perforation (n = 11, 1.4%), major bleeding requiring blood transfusion (n = 8, 1.0%), minor bleeding (n = 10, 1.3%) and abdominal pain or fever (n = 12, 1.5%). Ten patients underwent surgery due to complications (perforation n = 8, bleeding n = 2). There was no procedure-related mortality.Conclusion: Endoscopic balloon dilation is an efficacious and safe alternative to surgical resection of intestinal strictures in Crohn's disease. At 5-year follow-up, 52% of patients required no further or one additional dilation only, whereas 36% had undergone surgical resection. Complication frequency was low.
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