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- Dellgren, Göran, 1961, et al.
(författare)
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Three decades of heart transplantation in Scandinavia: long-term follow-up
- 2013
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Ingår i: European Journal of Heart Failure. - : Wiley. - 1879-0844 .- 1388-9842. ; 15:3, s. 308-315
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Tidskriftsartikel (refereegranskat)abstract
- Aim Heart transplantation (HTx) has become a standard treatment for patients with end-stage heart disease. The aim of this study was to report the long-term outcome after HTx in Scandinavia. Methods and results During the period, 1983-2009,2333 HTxs were performed in 2293 patients (mean age 45 +/- 16 years, range 0-70,78% mate). The main indications for HTx were non-ischaemic cardiomyopathy (50%), ischaemic cardiomyopathy (34%), valvular cardiomyopathy (3%), congenital heart disease (7%), retransplantation (2%), and miscellaneous (4%). The registry consists of pre-operative data from recipients and donors, data from pre-operative procedures, and long-term follow-up data. Mean follow-up was 7.8 +/- 6.6 years (median 6.9, interquartile range 2.5-12.3, interval 0-27) and no patients were lost to follow-up. Long-term survival for HTx patients was 85, 76, 61, 43, and 30% at 1, 5, 10, 15, and 20 years of follow-up, respectively. Ten-year survival in patients bridged with mechanical circulatory support, in children, after retransplantation, and after concomitant other organ transplantation was 56, 74, 38, and 43%, respectively. Older patients (age >55 years) had a significantly worse survival (P < 0.001). Patients transplanted more recently had a significantly better survival (P < 0.001). In a multivariate Cox regression analysis, independent predictors of long-term survival were recipient age (P < 0.001), donor age (P < 0.001), diagnosis (P = 0.001), and era of transplantation (P < 0.001). Conclusions HTx in Scandinavia proves to have a significantly better survival among patients transplanted in the last decade. HTxs from mechanical circulatory support, in children, after retransplantation, and with concomitant other organ transplantation were performed with acceptable results.
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- Hagerman, Inger, et al.
(författare)
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Effects on heart rate variability by artificially generated indoor nano-sized particles in a chamber study
- 2014
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Ingår i: Atmospheric Environment. - : Elsevier BV. - 1352-2310. ; 88, s. 165-171
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Tidskriftsartikel (refereegranskat)abstract
- Background: Airborne particles are associated with increased morbidity and mortality due to respiratory and cardiovascular diseases in polluted areas. There is a growing interest in nano-sized particles with diameter < 100 nm and their potential health effects. Heart rate variability (HRV) is a noninvasive method for cardiovascular risk prediction in high prevalent groups. Aim of study: The aim was to evaluate the impact of nano-sized indoor air particles on HRV for healthy and adult females. Methods: All exposures were performed as controlled chamber experiments with particle exposure from burning candles, terpene + ozone reactions or filtered air in a double-blind cross over design. Twenty-two healthy females were investigated during 10 min periods at different exposures and the reactivity in high frequency (HF) spectral band of HRV were computed. Results: Heart rate was unchanged from baseline values in all groups during all experimental settings. HF power of HRV tended to increase during exposure to particles from burning candle while particles from terpene + ozone reactions tended to decrease HF power. Conclusions: Exposure to nano-sized particles of burning candles or terpene + ozone reactions results in different patterns of heart rate variability, with signs of altered autonomic cardiovascular control. Practical implications: This study indicates that the HRV method may be used for information on physiological responses of exposure to different nano-sized particles and contribute to the understanding of mechanisms behind health effects of particle exposures. (C) 2014 The Authors. Published by Elsevier Ltd.
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- Hedlund, Pe rOlov, et al.
(författare)
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Significance of pretreatment cardiovascular morbidity as a risk factor during treatment with parenteral oestrogen or combined androgen deprivation of 915 patients with metastasized prostate cancer: Evaluation of cardiovascular events in a randomized trial
- 2011
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Ingår i: Scandinavian Journal of Urology and Nephrology. - London : Informa Healthcare. - 0036-5599 .- 1651-2065. ; 45:5, s. 346-353
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Tidskriftsartikel (refereegranskat)abstract
- Objective. This study aimed to evaluate prognostic risk factors for cardiovascular events during treatment of metastatic prostate cancer patients with high-dose parenteral polyoestradiol phosphate (PEP, Estradurin (R)) or combined androgen deprivation (CAD) with special emphasis on pretreatment cardiovascular disease. Material and methods. Nine-hundred and fifteen patients with T0-4, Nx, M1, G1-3, hormone- naive prostate cancer were randomized to treatment with PEP 240 mg i.m. twice a month for 2 months and thereafter monthly, or to flutamide (Eulexin (R)) 250 mg per os three times daily in combination with either triptorelin (Decapeptyl (R)) 3.75 mg i.m. per month or on an optional basis with bilateral orchidectomy. Pretreatment cardiovascular morbidity was recorded and cardiovascular events during treatment were assessed by an experienced cardiologist. A multivariate analysis was done using logistic regression. Results. There was a significant increase in cardiovascular events during treatment with PEP in patients with previous ischaemic heart disease (p = 0.008), ischaemic cerebral disease (p = 0.002), intermittent claudication (p = 0.031) and especially when the whole group of patients with pretreatment cardiovascular diseases was analysed together (p andlt; 0.001). In this group 33% of the patients had a cardiovascular event during PEP treatment. In the multivariate analysis PEP stood out as the most important risk factor for cardiac complications (p = 0.029). Even in the CAD group there was a significant increase in cardiovascular events in the group with all previous cardiovascular diseases taken together (p = 0.036). Conclusions. Patients with previous cardiovascular disease are at considerable risk of cardiovascular events during treatment with high-dose PEP and even during CAD therapy. Patients without pretreatment cardiovascular morbidity have a moderate cardiovascular risk during PEP treatment and could be considered for this treatment if the advantages of this therapy, e. g. avoidance of osteopenia and hot flushes and the low price, are given priority.
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- Isaxon, Christina, et al.
(författare)
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A Novel System for Source Characterization and Controlled Human Exposure to Nanoparticle Aggregates Generated During Gas–Metal Arc Welding
- 2013
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Ingår i: Aerosol Science and Technology. - : Informa UK Limited. - 1521-7388 .- 0278-6826. ; 47:1, s. 52-59
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in Undetermined The aim of this study was to achieve a method to perform detailed characterization and human exposure studies of nanosized and nanostructured aerosol particles. The source chosen was mild steel, active gas, arc welding fume. The setup consisted of a generation chamber, where welding can be performed, connected to an airtight stainless steel 22 m(3) exposure chamber. Instrumentation, consisting of a tapered element oscillating microbalance, a scanning mobility particle sizer, and a sampler for electron microscopy and particle-induced X-ray emission analysis was connected to the stainless steel chamber. The feasibility of the system for human exposure studies was evaluated by exposing 31 human volunteers, in groups of three, to a test aerosol containing 1 mg/m(3) welding fumes and to conditioned, filtered air. The results show that an aerosol that accurately represents dilute welding fume exposures that occur in workplaces can be produced in a controlled manner, and that the experimental setup can be used for 6 h, double-blind, exposures of human subjects. Particle mass concentration levels could be varied from <5 mu g/m(3) to more than 1000 mu g/m(3). Fumes from metal active gas welding showed a unimodal size distribution with a mean mobility diameter of 160 nm, transmission electron microscopy showed aggregates with a clearly nanosized structure.
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