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1.
  • Angerås, Oskar, 1976, et al. (författare)
  • Impact of Thrombus Aspiration on Mortality, Stent Thrombosis, and Stroke in Patients with ST-Segment-Elevation Myocardial Infarction: A Report From the Swedish Coronary Angiography and Angioplasty Registry
  • 2018
  • Ingår i: Journal of the American Heart Association. - : John Wiley & Sons. - 2047-9980. ; 7:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background-Thrombus aspiration is still being used in a substantial number of patients despite 2 large randomized clinical trials showing no favorable effect of routine thrombus aspiration during primary percutaneous coronary intervention in patients with STsegment- elevation myocardial infarction. The aim of this observational study was to evaluate the impact of thrombus aspiration on mortality, stent thrombosis, and stroke using all available data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Methods and Results--We identified 42 829 consecutive patients registered in SCAAR between January 2005 and September 2014 who underwent percutaneous coronary intervention for ST-segment-elevation myocardial infarction. Thrombus aspiration was used in 25% of the procedures. We used instrumental variable analysis with administrative healthcare region as the treatmentpreference instrumental variable to evaluate the effect of thrombus aspiration on mortality, stent thrombosis, and stroke. Thrombus aspiration was not associated with mortality at 30 days (risk reduction: -1.2; 95% confidence interval [CI] , -5.4 to 3.0; P=0.57) and 1 year (risk reduction: -2.4; 95% CI, -7.6 to 3.0; P=0.37). Thrombus aspiration was associated with a lower risk of stent thrombosis both at 30 days (risk reduction: -2.7; 95% CI, -4.1 to -1.4; P < 0.001) and 1 year (risk reduction: -3.5; 95% CI, -5.3 to -1.7; P < 0.001). In-hospital stroke and neurologic complications did not differ between groups (risk reduction: 0.1; 95% CI, -0.8 to 1.1; P=0.76). Conclusions--Mortality was not different between the groups. Thrombus aspiration was associated with decreased risk of stent thrombosis. Our study provides important evidence for the external validity of previous randomized studies regarding mortality.
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2.
  • Einarsdottir, Berglind Osk, 1979, et al. (författare)
  • A patient-derived xenograft pre-clinical trial reveals treatment responses and a resistance mechanism to karonudib in metastatic melanoma
  • 2018
  • Ingår i: Cell Death & Disease. - : Springer Science and Business Media LLC. - 2041-4889. ; 9:8
  • Tidskriftsartikel (refereegranskat)abstract
    • Karonudib (TH1579) is a novel compound that exerts anti-tumor activities and has recently entered phase I clinical testing. The aim of this study was to conduct a pre-clinical trial in patient-derived xenografts to identify the possible biomarkers of response or resistance that could guide inclusion of patients suffering from metastatic melanoma in phase II clinical trials. Patient-derived xenografts from 31 melanoma patients with metastatic disease were treated with karonudib or a vehicle for 18 days. Treatment responses were followed by measuring tumor sizes, and the models were categorized in the response groups. Tumors were harvested and processed for RNA sequencing and protein analysis. To investigate the effect of karonudib on T-cell-mediated anti-tumor activities, tumor-infiltrating T cells were injected in mice carrying autologous tumors and the mice treated with karonudib. We show that karonudib has heterogeneous anti-tumor effect on metastatic melanoma. Thus, based on the treatment responses, we could divide the 31 patient-derived xenografts in three treatment groups: progression group (32%), suppression group (42%), and regression group (26%). Furthermore, we show that karonudib has anti-tumor effect, irrespective of major melanoma driver mutations. Also, we identify high expression of ABCB1, which codes for p-gp pumps as a resistance biomarker. Finally, we show that karonudib treatment does not hamper T-cell-mediated anti-tumor responses. These findings can be used to guide future use of karonudib in clinical use with a potential approach as precision medicine.
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3.
  • Kiffin, Roberta, et al. (författare)
  • Anti-Leukemic Properties of Histamine in Monocytic Leukemia: The Role of NOX2
  • 2018
  • Ingår i: Frontiers in Oncology. - : Frontiers Media SA. - 2234-943X. ; 8
  • Tidskriftsartikel (refereegranskat)abstract
    • In patients with acute myeloid leukemia (AML), treatment with histamine dihydrochloride (HDC) and low-dose IL-2 (HDC/ IL-2) in the post-chemotherapy phase has been shown to reduce the incidence of leukemic relapse. The clinical benefit of HDC/ IL-2 is pronounced in monocytic forms of AML, where the leukemic cells express histamine type 2 receptors (H2R) and the NAPDH oxidase-2 (NOX2). HDC ligates to H(2)Rs to inhibit NOX2-derived formation of reactive oxygen species, but details regarding the anti-leukemic actions of HDC remain to be elucidated. Here, we report that human NOX2(+) myelomonocytic/monocytic AML cell lines showed increased expression of maturation markers along with reduced leukemic cell proliferation after exposure to HDC in vitro. These effects of HDC were absent in corresponding leukemic cells genetically depleted of NOX2 (NOX2(-/-)). We also observed that exposure to HDC altered the expression of genes involved in differentiation and cell cycle progression in AML cells and that these effects required the presence of NOX2. HDC promoted the differentiation also of primary monocytic, but not non-monocytic, AML cells in vitro. In a xenograft model, immunodeficient NOG mice were inoculated with wild-type or NOX2(-/-) human monocytic AML cells and treated with HDC in vivo. The administration of HDC reduced the in vivo expansion of NOX2(+/+), but not of NOX2(-/-) human monocytic AML cells. We propose that NOX2 may be a conceivable target in the treatment of monocytic AML.
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5.
  • Andréasson, Per Gunnar, et al. (författare)
  • Seve terranes of the Kebnekaise Mts., Swedish Caledonides, and their amalgamation, accretion and affinity
  • 2018
  • Ingår i: GFF. - : Informa UK Limited. - 1103-5897 .- 2000-0863. ; 140:3, s. 264-291
  • Tidskriftsartikel (refereegranskat)abstract
    • A major allochthon of the Scandinavian Caledonides, the Seve belt has traditionally been considered to be derived from the rifted margin and continent-ocean transition (COT) of Baltica. However, geochronological results obtained from its inferred northern equivalent, the Kalak Nappe Complex (KNC), have been taken to indicate an exotic affinity of this complex and of also Seve terranes, an interpretation adopted in recent palaeogeographic models. In the Kebnekaise Mts., the COT is represented by the Kebnekaise terrane composed of amphibolitized dykes of gabbro and dolerite of depleted magma source and rare felsic and ultramafic rocks. Coronitic dolerite and gabbro with abundant rutile suggest high pressures before or during amalgamation with the underlying Mårma terrane, composed of quartzofeldspathic gneisses intruded by mafic and granitic rocks, the latter including a previously dated c. 845 Ma-old granite. The granite mingled with mildly alkaline dolerites chemically similar to transitional basalts of continental rifts. Following emplacement at shallow (andalusite stability) crustal levels, the igneous complex and host rocks underwent extensive deformation, metamorphism within the sillimanite-kyanite stability field and local migmatization. The Kebnekaise and Mårma terranes amalgamated in early Ordovician as indicated by the U-Pb age of 487±7 Ma obtained from titanite fabrics of deformed granite in thrust vicinity, and by 40Ar-39Ar results. The pressure increase in both terranes suggests that amalgamation occurred during initial subduction and imbrication. Correlation of the Mårma terrane with the KNC is discussed. Results obtained in this study give no reason to ascribe an exotic affinity to the Seve terranes of the Kebnekaise Mts.
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6.
  • Aspelin, Jonas (författare)
  • Omsorg och pedagogik
  • 2018
  • Ingår i: Pedagogik som vetenskap. - Malmö : Gleerups Utbildning AB. ; , s. 157-168
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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7.
  • Athlin, Simon, 1971-, et al. (författare)
  • Management of community-acquired pneumonia in immunocompetent adults : updated Swedish guidelines 2017
  • 2018
  • Ingår i: Infectious Diseases. - : Informa UK Limited. - 2374-4235 .- 2374-4243. ; 50:4, s. 247-272
  • Forskningsöversikt (refereegranskat)abstract
    • Based on expert group work, Swedish recommendations for the management of community-acquired pneumonia in adults are here updated. The management of sepsis-induced hypotension is addressed in detail, including monitoring and parenteral therapy. The importance of respiratory support in cases of acute respiratory failure is emphasized. Treatment with high-flow oxygen and non-invasive ventilation is recommended. The use of statins or steroids in general therapy is not found to be fully supported by evidence. In the management of pleural infection, new data show favourable effects of tissue plasminogen activator and deoxyribonuclease installation. Detailed recommendations for the vaccination of risk groups are afforded.
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8.
  • Dahlman, Disa, et al. (författare)
  • Both localized and systemic bacterial infections are predicted by injection drug use : A prospective follow-up study in Swedish criminal justice clients
  • 2018
  • Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Both skin and soft tissue infections (SSTI) and systemic bacterial infections are common in people who inject drugs (PWID), but data on incidence and risk factors are lacking. We compared registered diagnoses for such infections in Swedish criminal justice clients with regard to injecting drug use. Methods Baseline interview data from the Swedish Prison and Probation Service on drug use in PWID and non-PWID with problematic alcohol use were linked to follow-up data from national Swedish registers on hospital diagnoses and/or death. Associations between drug use and later diagnosis of SSTI and systemic bacterial infection (septicemia or bacterial infection of the heart, bone/joints or central nervous system) were analyzed by Cox regression. Results Incidence rates of SSTI was 28.3 per 1,000 person-years for PWID (n = 2,444) and 10.0 for non-PWID with problematic alcohol use (n = 735). Incidence rates of systemic bacterial infection was 9.1 per 1,000 person-years for PWID and 2.7 per 1,000 person-years for non-PWID. Injection drug use was associated with a significantly increased risk of bacterial infections, for main drugs heroin (SSTI: Hazard ratio [HR] 2.45; systemic infection: HR 2.75), amphetamine (SSTI: HR 1.60; systemic infection: HR 2.19), and polysubstance use (SSTI: HR 1.92; systemic infection: HR 2.01). In relation to injection use of amphetamine and polysubstance use, PWID mainly using heroin had higher risk of SSTI. Conclusions Injection drug use predicted both SSTI and systemic bacterial infection, with a particularly high risk of SSTI in PWID mainly using heroin. The results imply the need for increased attention to bacterial infections among PWID, in terms of clinical management, prevention and research.
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