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- Andréasson, Björn, 1956
(author)
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Clinical and experimental studies in polycythemia vera and essential thrombocythemia
- 2000
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Doctoral thesis (other academic/artistic)abstract
- It is widely accepted that the diagnoses of polycythemia vera (PV) and essential throbocythemia (ET) are based upon the Polycythemia Vera Study Group criteria. These criteria are, however, of non-specific character and during the recent years more specific criteria have been proposed. In the present work the diagnostic potential of plasma erythropoietin (EPO), EPO-independent erythroid colony (EEC) growth, the stem cell antigen CD34 and thrombopoietin (TPO) were studied. The influence of different myelosuppressive agents on these variables was investigated.The concentration of CD34 positive (CD34+) cells was found to be significantly elevated in peripheral blood (PB) in PV patients compared to healthy controls. This difference was, however, not present in material from aspirated bone marrow (BM) or BM material obtained by biopsy. CD34+ cells were significantly elevated in PV patients with long disease duration and in patients with advanced disease. Also in PB of untreated ET patients CD34+ cells were significantly higher compared with controls.In vitro growth of EEC from BM progenitor cells was present in all PV patients studied. A majority of both PV and ET patients presented EEC growth when PB was used as a progenitor cell source.In all untreated PV patients the plasma EPO concentration was below the lower reference limit. About 50% of the untreated ET patients also had subnormal plasma EPO.No significant differences in plasma TPO concentrations were present when PV patients and healthy controls were compared. The mean plasma TPO concentration in ET patients significantly exceeded the mean for controls. The ET patients with subnormal plasma EPO had significantly lower plasma TPO compared with ET patients with normal or high plasma EPO. There was no significant difference between the ET patients with subnormal plasma EPO and controls.The mean plasma EPO did not rise above the lower reference limit when hemoglobin concentrations were normalized by phlebotomy treatment in PV patients. PV patients treated with different myelosuppressive agents, i.e. hydroxyurea (HU), radiophophorus (32P) or combinations of different cytostatics, presented significantly higher plasma EPO concentration compared with both untreated and phlebotomy treated PV patients. ET patients treated with HU, 32P, a-interferon or combinations of different cytostatics had significantly higher mean plasma EPO compared with untreated ET patients, also when correction for differences in hemoglobin levels were undertaken.PV patients on phlebotomy treatment only had higher concentrations of CD34+ cells and EEC growth compared with PV patients treated with HU. There was no significant difference in TPO concentration between PV on phlebotomy therapy and patients on myelosuppressive agents. Untreated ET patients had significantly higher CD34+ cell concentration and EEC growth compared with ET patients treated with HU. Untreated ET patients presented significantly lower plasma TPO concentrations compared with ET patients on myelosuppressive agents.Plasma EPO concentration should be used as a diagnostic criterion in the diagnosis of PV. Subnormal plasma EPO in ET is a valuable support for diagnosis and yields important information inasmuch as these patients have need for early initiation of myelosuppressive treatment due to high risk for vascular complications. EEC growth in PV and ET has good diagnostic potential and should be included as a diagnostic criterion. The concentration of CD34+ cells is not specific enough to be a diagnostic criterion in PV or ET but could be used as a proliferation marker in PV. Plasma TPO concentration can not be used as a diagnostic tool in PV or ET. There seems to be a relation between TPO and EPO in ET patients. ET patients with normal or high plasma EPO have high plasma TPO. In these patients TPO could even be the cause of platelet elevation.
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- Bergman, Eva, 1959-, et al.
(author)
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Relative growth estimated from self-administered symphysis fundal measurements
- 2011
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 90:2, s. 179-185
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Journal article (peer-reviewed)abstract
- Objective. To establish absolute-and relative-growth reference curves for the detection of intrauterine growth restriction from weekly self-administered symphysis-fundus (SF) measurements and to assess the influence of fetal sex, maternal obesity and parity. Design. Prospective longitudinal study. Setting. Pregnant women from six primary antenatal care centres. Population. Three hundred women with singleton ultrasound dated pregnancies. Methods. Weekly self-administered SF measurements from gestational week 25 until delivery were obtained. A linear mixed longitudinal model was used to estimate the absolute SF growth using the natural logarithm (lnSF). Relative lnSF growth was calculated as the lnSF measurement in one gestational week subtracted by the lnSF measurement in the previous gestational week. The influence of fetal sex, maternal obesity and parity was assessed in regression models and by a graphical display. Main Outcome Measures. Absolute lnSF and relative lnSF growth curves and influence of fetal sex, maternal obesity and parity on these. Results. SF measurements from 191 women were used to establish an SF-growth reference. The absolute lnSF growth was influenced by maternal obesity, and for fetal sex and parity, borderline significance was recorded; while there was no evidence that the relative lnSF growth could depend on these variables. Conclusions. Weekly self-administered SF measurements can be obtained and used to estimate SF growth. Relative growth of the lnSF height seems to be independent of fetal sex, maternal obesity and parity.
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- Bergman, Eva, et al.
(author)
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Self-administered measurement of symphysis-fundus heights
- 2007
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 86:6, s. 671-677
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Journal article (peer-reviewed)abstract
- Background. Antenatal identification of infants small for gestational age (SGA) improves their perinatal outcome. Repeated measurements of the symphysis-fundus (SF) heights performed by midwives is the most widespread screening method for detection of SGA. However the insufficiency of this method necessitates improved practices. Earlier start and more frequent SF measurements, which could be acomplished by self-administered measurements, might improve the ability to detect deviant growth. The present study was set up to evaluate wether pregnant wome can reliable perform SF measurements by themself. Method. Forty healthy women with singelton and ultrasound-dated pregancies from 2 antenatal clinics in Uppsala, Sweden, were asked to perform 4 consecutive SF measureemnts once a week, from 20 to 25 weeks of gestation until delivery. The self-administered SF measurements were recorded and systematically compared with midwives' SF measurements. Results. Thirty-three pregnant women performed self-administered SF measurements over a 14-week period (range 1-21). The SF curves constructed from self-admiinistered SF measurements had the same shape as previously constructed population-based reference curves. The variance for self-admiinistered SF measurements was higher than that of the midwives. Conclusions. Pregnant women are capable of measuring SF heights by themselves, but with a higher individual variance than midwives. Repeated measurements at each occasion can compensate for the higher variance. The main advantage of self-administered SF measurements is the opportunity to follow fetal growth earlier and more frequently.
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- Mattsson, Lars
(author)
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Modelling dust processing and the evolution of grain sizes in the ISM using the method of moments
- 2016
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In: Planetary and Space Science. - : Elsevier. - 0032-0633 .- 1873-5088.
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Journal article (peer-reviewed)abstract
- Interstellar dust grains do not have a single well-defined origin. Stars are demonstrably dust producers, but also efficient destroyers of cosmic dust. Dust destruction in the ISM is believed to be the result of SN shocks hitting the ambient ISM gas (and dust) and lead to an increased rate of ion sputtering, which reduces the dust mass. Grains located in cold molecular clouds can on the other hand grow by condensation, thus providing a replenishment mechanism or even a dominant channel of dust formation. In dense environments grains may coagulate and form large composite grains and aggregates and if grains collide with large enough energies they may be shattered, forming a range of smaller debris grains. The present paper presents a statistical modelling approach using the method of moments, which is computationally very inexpensive and may therefore be an attractive option when combining dust processing with, e.g., detailed simulations of interstellar gas dynamics. A solar-neighbourhood-like toy model of interstellar dust evolution is presented as an example.
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- Persson, Elna, et al.
(author)
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Att skapa förståelse för fenomenet ilska : en empirisk studie av sjuksköterskestudenters upplevelser av ilska
- 2010
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Reports (other academic/artistic)abstract
- Anledningar till att ilska väcks till liv är individuella och kan exempelvis bero på orättvis behandling eller maktlöshet. Ilska känns på liknande sätt inombords hos alla individer vilket innebär att en student som känner ilska över att kamraten fuskat på en tenta, kan uppleva liknande känslor av ilska inombords som patienten som tvingas vänta på sina mediciner. När ilska väl kommit in i kroppen måste den ”komma ut”. Ilskans väg ut ur kroppen skiljer sig åt från person till person där en del yttrar sin ilska fysiskt medan andra yttrar den verbalt eller via tårar. När ilska försvunnit ut ur kroppen skapas möjlighet för reflektion. En del upplever ilska som en drivkraft för förändring medan andra känner skam och ånger över sitt beteende. Ilska är något vi alla har upplevt och fortsättningsvis kommer att uppleva. Att skapa en förståelse för fenomenet ilska kan skapa förutsättningar för vårdpersonalen att förstå ilska hos patienter. Genom att förstå orsakerna till varför ilska uppstår kan en bra relation mellan vårdpersonal och patient skapas vilket är av stor betydelse för att en god omvårdnad ska kunna utövas.
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