| 1. |
- Holmqvist, Lina, et al.
(författare)
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Drug adherence in treatment resistant and in controlled hypertension - Results from the Swedish Primary Care Cardiovascular Database (SPCCD)
- 2018
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Ingår i: Pharmacoepidemiology and Drug Safety. - : Wiley. - 1053-8569 .- 1099-1557. ; 27:3, s. 315-321
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To assess drug adherence in patients treated with 3 antihypertensive drug classes, with both controlled and uncontrolled blood pressure and describe associated factors for nonadherence. Methods Patients with hypertension, without cardiovascular comorbidity, aged >30years treated with 3 antihypertensive drug classes were followed for 2years. Both patients with treatment resistant hypertension (TRH) and patients with controlled hypertension were included. Clinical data were derived from a primary care database. Pharmacy refill data from the Swedish Prescribed drug registry was used to calculate proportion of days covered (PDC). Patients with a PDC level80% were included. Results We found 5846 patients treated 3 antihypertensive drug classes, 3508 with TRH (blood pressure140/90), and 2338 with controlled blood pressure (<140/90mmHg). TRH patients were older (69.1 vs 65.8years, P<.0001) but had less diabetes (28.5 vs 31.7%, P<.009) compared with patients with controlled blood pressure. The proportion of patients with PDC80% declined with 11% during the first year in both groups. Having diabetes was associated with staying adherent at 1year (RR 0.82; 95% CI, 0.68-0.98) whilst being born outside Europe was associated with nonadherence at one and (RR 2.05; 95% CI, 1.49-2.82). ConclusionsPatients with multiple antihypertensive drug therapy had similar decline in adherence over time regardless of initial blood pressure control. Diabetes was associated with better adherence, which may imply that the structured caregiving of these patients enhances antihypertensive drug treatment.
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| 2. |
- Seifert, Mariam B., et al.
(författare)
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Genetic variants on chromosomes 7p31 and 12p12 are associated with abnormal atrial electrical activation in patients with early-onset lone atrial fibrillation
- 2019
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Ingår i: Annals of Noninvasive Electrocardiology. - : Wiley. - 1082-720X .- 1542-474X. ; 24:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Abnormal P-wave morphology (PWM) has been associated with a history of atrial fibrillation (AF) in earlier studies. Although lone AF is believed to have substantial genetic basis, studies on associations between single nucleotide polymorphisms (SNP) linked to lone AF and PWM have not been reported. We aimed to assess whether SNPs previously associated with lone AF (rs2200733, rs13376333, rs3807989, and rs11047543) are also linked to P-wave abnormalities. Methods: Four SNPs were studied in 176 unrelated individuals with early-onset lone AF (age at onset <50 years), median age 38 years (19–63 years), 149 men. Using sinus rhythm ECG, orthogonal PWM was classified as Type 1—positive in leads X and Y and negative in lead Z, Type 2—positive in leads X and Y and biphasic (−/+) in lead Z, Type 3—positive in lead X and biphasic in lead Y (+/−), and the remaining as atypical. Results: Two SNPs were found to be significantly associated with altered P-wave morphology distribution: rs3807989 near the gene CAV1/CAV2 and rs11047543 near the gene SOX5. Both SNPs were associated with a higher risk of non-Type 1 P-wave morphology (rs3807989: OR = 4.8, 95% CI = 2.3–10.2, p < 0.001; rs11047543: OR = 4.7, 95% CI = 1.1–20.5, p = 0.04). No association was observed for rs2200733 and rs13376333. Conclusion: In this study, the two variants rs3807989 and rs11047543, previously associated with PR interval and lone AF, were associated with altered P-wave morphology distribution in patients with early-onset lone AF. These findings suggest that common genetic variants may modify atrial conduction properties.
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| 3. |
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| 4. |
- Wang, Dong, et al.
(författare)
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A study of artificial eyes for the measurement of precision in eye-trackers
- 2017
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Ingår i: Behavior Research Methods. - : Springer Science and Business Media LLC. - 1554-3528. ; 49:3, s. 947-959
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Tidskriftsartikel (refereegranskat)abstract
- The precision of an eye-tracker is critical to the correct identification of eye movements and their properties. To measure a system’s precision, artificial eyes (AEs) are often used, to exclude eye movements influencing the measurements. A possible issue, however, is that it is virtually impossible to construct AEs with sufficient complexity to fully represent the human eye. To examine the consequences of this limitation, we tested currently used AEs from three manufacturers of eye-trackers and compared them to a more complex model, using 12 commercial eye-trackers. Because precision can be measured in various ways, we compared different metrics in the spatial domain and analyzed the power-spectral densities in the frequency domain. To assess how precision measurements compare in artificial and human eyes, we also measured precision using human recordings on the same eye-trackers. Our results show that the modified eye model presented can cope with all eye-trackers tested and acts as a promising candidate for further development of a set of AEs with varying pupil size and pupil–iris contrast. The spectral analysis of both the AE and human data revealed that human eye data have different frequencies that likely reflect the physiological characteristics of human eye movements. We also report the effects of sample selection methods for precision calculations. This study is part of the EMRA/COGAIN Eye Data Quality Standardization Project.
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| 5. |
- Agyemang, Alex Adusei, et al.
(författare)
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Cerebellar Exposure to Cell-Free Hemoglobin Following Preterm Intraventricular Hemorrhage: Causal in Cerebellar Damage?
- 2017
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Ingår i: Translational Stroke Research. - : Springer Science and Business Media LLC. - 1868-4483 .- 1868-601X. ; 8:5, s. 461-473
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Tidskriftsartikel (refereegranskat)abstract
- Decreased cerebellar volume is associated with intraventricular hemorrhage (IVH) in very preterm infants and may be a principal component in neurodevelopmental impairment. Cerebellar deposition of blood products from the subarachnoid space has been suggested as a causal mechanism in cerebellar underdevelopment following IVH. Using the preterm rabbit pup IVH model, we evaluated the effects of IVH induced at E29 (3 days prior to term) on cerebellar development at term-equivalent postnatal day 0 (P0), term-equivalent postnatal day 2 (P2), and term-equivalent postnatal day 5 (P5). Furthermore, the presence of cell-free hemoglobin (Hb) in cerebellar tissue was characterized, and cell-free Hb was evaluated as a causal factor in the development of cerebellar damage following preterm IVH. IVH was associated with a decreased proliferative (Ki67-positive) portion of the external granular layer (EGL), delayed Purkinje cell maturation, and activated microglia in the cerebellar white matter. In pups with IVH, immunolabeling of the cerebellum at P0 demonstrated a widespread presence of cell-free Hb, primarily distributed in the white matter and the molecular layer. Intraventricular injection of the Hb scavenger haptoglobin (Hp) resulted in a corresponding distribution of immunolabeled Hp in the cerebellum and a partial reversal of the damaging effects observed following IVH. The results suggest that cell-free Hb is causally involved in cerebellar damage following IVH and that blocking cell-free Hb may have protective effects.
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| 6. |
- Granqvist, Svante, et al.
(författare)
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Resonance tube phonation in water : High-speed imaging, electroglottographic and oral pressure observations of vocal fold vibrations - A pilot study
- 2015
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Ingår i: Logopedics, Phoniatrics, Vocology. - : Taylor & Francis. - 1401-5439 .- 1651-2022. ; 40:3, s. 113-121
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Tidskriftsartikel (refereegranskat)abstract
- Phonation into glass tubes (resonance tubes), keeping the free end of the tube in water, has been a frequently used voice therapy method in Finland and more recently also in other countries. The purpose of this exploratory study was to investigate what effects tube phonation with and without water has on the larynx. Two participants were included in the study. The methods used were high-speed imaging, electroglottographic observations of vocal fold vibrations, and measurements of oral pressure during tube phonation. Results showed that the fluctuation in the back pressure during tube phonation in water altered the vocal fold vibrations. In the high-speed imaging, effects were found in the open quotient and amplitude variation of the glottal opening. The open quotient increased with increasing water depth (from 2 cm to 6 cm). A modulation effect by the water bubbles on the vocal fold vibrations was seen both in the high-speed glottal area tracings and in the electroglottography signal. A second experiment revealed that the increased average oral pressure was largely determined by the water depth. The increased open quotient can possibly be explained by an increased abduction of the vocal folds and/or a reduced transglottal pressure. The back pressure of the bubbles also modulates glottal vibrations with a possible massage effect on the vocal folds. This effect and the well-defined average pressure increase due to the known water depth are different from those of other methods using a semi-occluded vocal tract.
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| 7. |
- Halmin, Märit, et al.
(författare)
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Length of Storage of Red Blood Cells and Patient Survival After Blood Transfusion : A Binational Cohort Study
- 2017
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Ingår i: Annals of Internal Medicine. - 0003-4819 .- 1539-3704. ; 166:4, s. 248-256
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Tidskriftsartikel (refereegranskat)abstract
- Background: Possible negative effects, including increased mortality, among persons who receive stored red blood cells (RBCs) have recently garnered considerable attention. Despite many studies, including 4 randomized trials, no consensus exists.Objective: To study the association between the length of RBC storage and mortality in a large population-based cohort of patients who received transfusions, allowing detection of small yet clinically significant effects.Design: Binational cohort study.Setting: All transfusion recipients in Sweden and Denmark. Patients: 854 862 adult patients who received transfusions from 2003 to 2012.Measurements: Patients were followed from first blood transfusion. Relative and absolute risks for death in 30 days or 1 year in relation to length of RBC storage were assessed by using 3 independent analytic approaches. All analyses were conducted by using Cox proportional hazards regression.Results: Regardless of the analytic approach, no association was found between the length of RBC storage and mortality. The difference in 30-day cumulative mortality between patients receiving blood stored for 30 to 42 days and those receiving blood stored for 10 to 19 days was -0.2% (95% CI, -0.5% to 0.1%). Even among patients who received more than 6 units of RBCs stored for 30 days or longer, the hazard ratio of death was 1.00 (CI, 0.96 to 1.05) compared with those who received no such units.Limitation: Observational study; risk of confounding by indication.Conclusion: Consistent with previous randomized trials, this study found no association between the length of storage of transfused RBCs and patient mortality. Results were homogeneous, with differences in absolute mortality consistently less than 1% among the most extreme exposure categories. These findings suggest that the current practice of storing RBCs for up to 42 days does not need to be changed.
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| 8. |
- Holmqvist, F., et al.
(författare)
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Pacemaker programming in patients with first-degree AV-block : Programming pattern and possible consequences
- 2018
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Ingår i: Health Science Reports. - : Wiley. - 2398-8835. ; 1:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: The optimal way of pacing in patients with an indication for pacing and concomitant first-degree atrioventricular (AV)–block is not known, and consequently, firm guidelines on this topic are lacking. This study explored the current pacemaker programming pattern in patients with first-degree AV-block who have a dual chamber pacemaker without cardiac resynchronization. Methods: The study was a retrospective chart review conducted at Duke University Hospital. Patients receiving a pacemaker due to sinus node dysfunction with coexistent first-degree AV-block were studied. Baseline demographics and characteristics, as well as pacemaker programming parameters and follow-up data, were collected through chart review. Preimplantation and postimplantation electrocardiograms were analyzed. Results: A total of 74 patients were included (mean age, 75 ± 11 y; 53% men). The mean ± SD preimplant PR interval and QRS duration was 243 ± 46 and 110 ± 30 milliseconds, respectively. A history of atrial fibrillation was present in 49% of the patients, and 77% had a normal left ventricular ejection fraction. The majority of patients (65%) had their pacemakers programmed to atrial pacing (AAI/DDD +/−R), whereas 32% and 2.7% of the pacemakers were programmed to AV-sequential pacing (DDD) and ventricular pacing (VVI), respectively. There were no significant differences in baseline characteristics or electrocardiogram measures between patients programmed to the 3 pacing modes. Patients with pacemakers programmed to AAI had a lower ventricular pacing percentage at follow-up (8 vs 55, and 46% [DDD and VVI, respectively]; P <.001). Conclusions: There was no evident association between baseline characteristics and programmed pacing mode in patients with first-degree AV-block. The choice of pacing mode affects long-term pacing burden, which in turn has been shown to influence outcome.
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| 9. |
- Holmqvist-Jämsén, S., et al.
(författare)
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Investigating the role of salivary cortisol on vocal symptoms
- 2017
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Ingår i: Journal of Speech, Language, and Hearing Research. - 1092-4388. ; 60:10, s. 2781-2791
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: We investigated whether participants who reported more often occurring vocal symptoms showed higher salivary cortisol levels and if such possible associations were different for men and women. Method: The participants (N = 170; men n = 49, women n = 121) consisted of a population-based sample of Finnish twins born between 1961 and 1989. The participants submitted saliva samples for hormone analysis and completed a web questionnaire including questions regarding the occurrence of 6 vocal symptoms during the past 12 months. The data were analyzed using the generalized estimated equations method. Results: A composite variable of the vocal symptoms showed a significant positive association with salivary cortisol levels (p <.001). Three of the 6 vocal symptoms were significantly associated with the level of cortisol when analyzed separately (p values less than.05). The results showed no gender difference regarding the effect of salivary cortisol on vocal symptoms. Conclusions: There was a positive association between the occurrence of vocal symptoms and salivary cortisol levels. Participants with higher cortisol levels reported more often occurring vocal symptoms. This could have a connection to the influence of stress on vocal symptoms because stress is a known risk factor of vocal symptoms and salivary cortisol can be seen as a biomarker for stress. © 2017 American Speech-Language-Hearing Association.
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